Du Yanyao, Zhao Wei, Du Lei, Liu Jun
Department of Radiology, Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China.
Clinical Research Center for Medical Imaging in Hunan Province, Changsha 410011, Hunan, China.
Psychoradiology. 2021 Dec 22;1(4):199-211. doi: 10.1093/psyrad/kkab019. eCollection 2021 Dec.
The epidemic of coronavirus disease 2019 (COVID-19) has broken the normal spread mode of respiratory viruses, namely, mainly spread in winter, resulting in over 230 million confirmed cases of COVID-19. Many studies have shown that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can affect the nervous system by varying degrees. In this review, we look at the acute neuropsychiatric impacts of COVID-19 patients, including acute ischemic stroke, encephalitis, acute necrotizing encephalopathy, dysosmia, and epilepsy, as well as the long-term neuropsychiatric sequelae of COVID-19 survivors: mental disorder and neurodegenerative diseases. In particular, this review discusses long-term changes in brain structure and function associated with COVID-19 infection. We believe that the traditional imaging sequences are important in the acute phase, while the nontraditional imaging sequences are more meaningful for the detection of long-term neuropsychiatric sequelae. These long-term follow-up changes in structure and function may also help us understand the causes of neuropsychiatric symptoms in COVID-19 survivors. Finally, we review previous studies and discuss some potential mechanisms of SARS-CoV-2 infection in the nervous system. Continuous focus on neuropsychiatric sequelae and a comprehensive understanding of the long-term impacts of the virus to the nervous system is significant for formulating effective sequelae prevention and management strategies, and may provide important clues for nervous system damage in future public health crises.
2019年冠状病毒病（COVID-19）疫情打破了呼吸道病毒的正常传播模式，即主要在冬季传播，导致超过2.3亿例COVID-19确诊病例。许多研究表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可不同程度地影响神经系统。在本综述中，我们探讨了COVID-19患者的急性神经精神影响，包括急性缺血性中风、脑炎、急性坏死性脑病、嗅觉障碍和癫痫，以及COVID-19幸存者的长期神经精神后遗症：精神障碍和神经退行性疾病。特别是，本综述讨论了与COVID-19感染相关的脑结构和功能的长期变化。我们认为，传统成像序列在急性期很重要，而非传统成像序列对检测长期神经精神后遗症更有意义。这些结构和功能的长期随访变化也可能有助于我们理解COVID-19幸存者神经精神症状的原因。最后，我们回顾了以往的研究，并讨论了SARS-CoV-2感染神经系统的一些潜在机制。持续关注神经精神后遗症并全面了解病毒对神经系统的长期影响，对于制定有效的后遗症预防和管理策略具有重要意义，并且可能为未来公共卫生危机中的神经系统损伤提供重要线索。
