Chollet François, Planton Mélanie, Sailler Laurent, De Almeida Sébastien, Alvarez Muriel, Pariente Jérémie
Département de neurologie, CHU de Toulouse, hôpital Pierre-Paul-Riquet, place Baylac, 31059 Toulouse cedex, France.
Service de médecine interne, CHU de Toulouse, hôpital Purpan, place Baylac, 31059 Toulouse cedex, France.
Bull Acad Natl Med. 2023 Jun 21. doi: 10.1016/j.banm.2023.06.009.
Now recognized by health authorities, long COVID is identified as a frequent condition complicating the evolution of SARS-CoV-2 infection. Its polymorphic and sometimes disconcerting clinical expression raises questions about its mechanism. Patterns of clinical expression suggest extensive involvement of the nervous system through an almost ubiquitous cognitive complaint. This article reviews the neurological symptoms and forms of these patients, and the neuropsychological explorations aimed at objectifying a cognitive deficit. The studies published until now confronted with the clinical mode of expression, did not make it possible to define a deficit neuropsychological profile at the level of the groups, and evoked more a functional impairment than a lesion. However, each series mentions a small number of patients in whom a cognitive deficit is objectified. The uncertainties about the causes of the prolonged forms of COVID, the heterogeneity of the published studies, and the virtual absence of temporal evolution data should make one cautious about the interpretation of these data but should in no way delay or prevent taking into account care of these patients.
如今,长期新冠已得到卫生当局的认可,它被视为一种使新冠病毒感染病程复杂化的常见病症。其多样且有时令人困惑的临床表现引发了对其发病机制的疑问。临床症状模式表明,神经系统广泛受累,几乎普遍存在认知方面的主诉。本文回顾了这些患者的神经症状和表现形式,以及旨在明确认知缺陷的神经心理学检查。迄今为止发表的研究面对临床症状表现,无法在群体层面界定出一种明确的神经心理学缺陷特征,更多提及的是功能损害而非病变。然而,每个系列都提到了少数确诊存在认知缺陷的患者。由于新冠长期症状的成因尚不确定、已发表研究的异质性以及几乎没有时间演变数据,人们在解读这些数据时应谨慎,但这绝不应延误或阻碍对这些患者的护理。