Hollist Mary, Hollist Abraham, Au Katherine, Betts Colton, Kirmani Maha, Kirmani Maaida, Armour Benjamin, Udeh Mercy C, Kirmani Batool F
Atrium Health, Concord, NC, USA.
Optimal Health Medical Center, Miami, FL, USA.
Neurosci Insights. 2024 Sep 24;19:26331055241265668. doi: 10.1177/26331055241265668. eCollection 2024.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in December 2019, sparking a global health crisis. While initially recognized as a respiratory illness, it has become evident that Coronavirus disease 2019 (COVID-19) also affects the central nervous system. This comprehensive review focuses on the neurological manifestations of COVID-19 and its impact on patients with preexisting neurological disorders, particularly those with multiple sclerosis (MS) receiving disease-modifying therapies. Advancements in management, including vaccinations, antiviral therapy, and targeted prophylaxis, have led to a decline in the incidence and severity of COVID-19. Nevertheless, significant complications persist, particularly in patients with advanced MS, who are highly vulnerable to infectious agents like SARS-CoV-2. This review explores the evolving understanding of MS and its association with SARS-CoV-2, encompassing neuroinvasiveness, pathogenesis, disease severity, and outcomes. Research findings reveal substantial neurological implications for some MS patients with COVID-19, with a potential risk of disease relapse and severity. A notable proportion of MS patients experiencing COVID-19 may manifest new symptoms, experience exacerbation of existing symptoms, or encounter both simultaneously, underscoring the diverse neurological effects of the virus. While vaccination and therapeutics have mitigated the overall impact, specific subgroups, especially those on anti-CD20 therapy and with existing disability, remain at higher risk, necessitating ongoing vigilance and tailored care.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2），一种新型冠状病毒，于2019年12月出现，引发了全球健康危机。虽然最初被认为是一种呼吸道疾病，但很明显，2019冠状病毒病（COVID-19）也会影响中枢神经系统。这篇综述聚焦于COVID-19的神经学表现及其对患有既往神经系统疾病的患者的影响，尤其是那些正在接受疾病修正治疗的多发性硬化症（MS）患者。管理方面的进展，包括疫苗接种、抗病毒治疗和靶向预防，已导致COVID-19的发病率和严重程度下降。然而，严重并发症仍然存在，特别是在晚期MS患者中，他们极易感染SARS-CoV-2等病原体。本综述探讨了对MS及其与SARS-CoV-2关联的不断演变的认识，包括神经侵袭性、发病机制、疾病严重程度和结局。研究结果揭示了COVID-19对一些MS患者具有重大的神经学影响，存在疾病复发和病情加重的潜在风险。相当一部分感染COVID-19的MS患者可能会出现新症状、现有症状加重或两者同时出现，这突出了该病毒多样的神经学影响。虽然疫苗接种和治疗减轻了总体影响，但特定亚组，尤其是那些接受抗CD20治疗且已有残疾的患者，仍然面临更高风险，需要持续警惕和个性化护理。
