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新型冠状病毒肺炎的神经学影响:一项全面的叙述性综述

The Neurological Implications of COVID-19: A Comprehensive Narrative Review.

作者信息

Cheyne Ithamar, Gopinath Venmanassery Sreejan, Muppa Neeharika, Armas Angel Emanuel, Gil Agurto Maria Sophia, Akula Sai Abhigna, Nagpal Shubhangi, Yousaf Muhammad Sheraz, Haider Ali

机构信息

Critical Care, Medical University of Warsaw, Warsaw, POL.

Internal Medicine, University Hospital Coventry and Warwickshire, Coventry, GBR.

出版信息

Cureus. 2024 May 15;16(5):e60376. doi: 10.7759/cureus.60376. eCollection 2024 May.

DOI:10.7759/cureus.60376
PMID:38887342
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11181960/
Abstract

The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 revealed a huge number of problems as well as discoveries in medicine, notably, regarding the effects of the virus on the central nervous system (CNS) and peripheral nervous system (PNS). This paper is a narrative review that takes a deep dive into the complex interactions between COVID-19 and the NS. Therefore, this paper explains the broad range of neurological manifestations and neurodegenerative diseases caused by the virus. It carefully considers the routes through which SARS-CoV-2 reaches the NS, including the olfactory system and of course, the hematogenous route, which are also covered when discussing the virus's direct and indirect mechanisms of neuropathogenesis. Besides neurological pathologies such as stroke, encephalitis, Guillain-Barré syndrome, Parkinson's disease, and multiple sclerosis, the focus area is also given to the challenges of making diagnosis, treatment, and management of these conditions during the pandemic. The review also examines the strategic and interventional approaches utilized to prevent these disorders, as well as the ACE2 receptors implicated in the mediation of neurological effects caused by COVID-19. This detailed overview, which combines research outputs with case data, is directed at tackling this pandemic challenge, with a view toward better patient care and outcomes in the future.

摘要

由冠状病毒SARS-CoV-2引起的COVID-19大流行揭示了医学领域的大量问题以及发现,特别是关于该病毒对中枢神经系统(CNS)和外周神经系统(PNS)的影响。本文是一篇叙述性综述,深入探讨了COVID-19与神经系统之间的复杂相互作用。因此,本文解释了由该病毒引起的广泛神经表现和神经退行性疾病。它仔细考虑了SARS-CoV-2到达神经系统的途径,包括嗅觉系统,当然还有血行途径,在讨论病毒神经发病机制的直接和间接机制时也会涉及这些途径。除了中风、脑炎、吉兰-巴雷综合征、帕金森病和多发性硬化症等神经病理学疾病外,重点还放在了大流行期间对这些病症进行诊断、治疗和管理所面临的挑战上。该综述还研究了用于预防这些疾病的战略和干预方法,以及与COVID-19引起的神经效应介导有关的ACE2受体。这一结合了研究成果和病例数据的详细概述旨在应对这一大流行挑战,以期在未来实现更好的患者护理和治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/7fc1dedf0172/cureus-0016-00000060376-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/46c5b491b3ab/cureus-0016-00000060376-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/56d700307771/cureus-0016-00000060376-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/7fc1dedf0172/cureus-0016-00000060376-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/46c5b491b3ab/cureus-0016-00000060376-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/56d700307771/cureus-0016-00000060376-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ae/11181960/7fc1dedf0172/cureus-0016-00000060376-i03.jpg

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本文引用的文献

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The Role of Furin in the Pathogenesis of COVID-19-Associated Neurological Disorders.弗林蛋白酶在新冠病毒相关神经疾病发病机制中的作用。
Life (Basel). 2024 Feb 19;14(2):279. doi: 10.3390/life14020279.
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Blood-brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment.长新冠相关认知障碍患者的血脑屏障破坏和持续的全身炎症。
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Transcriptional regulation of SARS-CoV-2 receptor ACE2 by SP1.
SP1对新型冠状病毒受体ACE2的转录调控
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ACE2-Fc and DPP4-Fc decoy receptors against SARS-CoV-2 and MERS-CoV variants: a quick therapeutic option for current and future coronaviruses outbreaks.针对新型冠状病毒和中东呼吸综合征冠状病毒变异株的ACE2-Fc和DPP4-Fc诱饵受体:应对当前及未来冠状病毒爆发的快速治疗选择。
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Methotrexate Inhibits the Binding of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Receptor Binding Domain to the Host-Cell Angiotensin-Converting Enzyme-2 (ACE-2) Receptor.甲氨蝶呤抑制严重急性呼吸综合征冠状病毒2(SARS-CoV-2)受体结合域与宿主细胞血管紧张素转换酶2(ACE-2)受体的结合。
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Musculoskeletal and Neuropathic Pain in COVID-19.新型冠状病毒肺炎中的肌肉骨骼和神经性疼痛
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