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与严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)和 2019 冠状病毒病(COVID-19)相关的神经症状、表现和并发症。

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19).

机构信息

Department of Neurosurgery, University Hospital, Ludwig-Maximilians-University of Munich, Marchionistr. 15, 81377, Munich, Germany.

Department of Neuropathology, Leipzig University Hospital, Leipzig, Germany.

出版信息

J Neurol. 2021 Sep;268(9):3059-3071. doi: 10.1007/s00415-021-10406-y. Epub 2021 Jan 23.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain-Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.

摘要

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是一种新型冠状病毒,引发了 2019 年冠状病毒病(COVID-19)疫情,于 2019 年 12 月在中国武汉首次被发现。显然,COVID-19 大流行已成为一个具有挑战性的世界性问题。尽管大多数 COVID-19 患者主要表现为呼吸道症状,但越来越多的与 COVID-19 相关的神经系统症状和表现被观察到。在本叙述性综述中,我们详细阐述了目前文献中报道的 COVID-19 的推测神经嗜性机制和各种神经系统症状、表现和并发症。为此,我们对所有当前已发表的文献(研究、病例报告、病例系列、综述、社论和其他文章)进行了回顾,并总结了 COVID-19 的神经后遗症。味觉和嗅觉功能障碍、肌痛、头痛、意识状态改变、意识混乱、谵妄和头晕等重要和常见的神经系统症状分别在不同部分进行了介绍。此外,还系统地讨论了诸如中风、脑(窦)静脉血栓形成、癫痫发作、脑膜脑炎、吉兰-巴雷综合征、米勒费舍尔综合征、急性脊髓炎和后部可逆性脑病综合征(PRES)等备受关注的神经系统表现和并发症。需要进一步研究神经症状和表现对疾病进程的影响,以进一步阐明和评估 COVID-19 患者的神经并发症与临床结局之间的关联。为了限制长期后果,医疗保健专业人员必须能够早期发现可能的神经系统症状,并熟悉 COVID-19 日益常见的神经系统表现和并发症。

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