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新型冠状病毒肺炎及其对神经系统功能的影响。

COVID-19 and its effects on neurological functions.

机构信息

Division of Applied Biomedical Sciences and Biotechnology, School of Health Sciences, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

出版信息

Trop Biomed. 2021 Sep 1;38(3):435-445. doi: 10.47665/tb.38.3.086.

Abstract

Ever since the first reported case series on SARS-CoV-2-induced neurological manifestation in Wuhan, China in April 2020, various studies reporting similar as well as diverse symptoms of COVID-19 infection relating to the nervous system were published. Since then, scientists started to uncover the mechanism as well as pathophysiological impacts it has on the current understanding of the disease. SARS-CoV-2 binds to the ACE2 receptor which is present in certain parts of the body which are responsible for regulating blood pressure and inflammation in a healthy system. Presence of the receptor in the nasal and oral cavity, brain, and blood allows entry of the virus into the body and cause neurological complications. The peripheral and central nervous system could also be invaded directly in the neurogenic or hematogenous pathways, or indirectly through overstimulation of the immune system by cytokines which may lead to autoimmune diseases. Other neurological implications such as hypoxia, anosmia, dysgeusia, meningitis, encephalitis, and seizures are important symptoms presented clinically in COVID-19 patients with or without the common symptoms of the disease. Further, patients with higher severity of the SARS-CoV-2 infection are also at risk of retaining some neurological complications in the long-run. Treatment of such severe hyperinflammatory conditions will also be discussed, as well as the risks they may pose to the progression of the disease. For this review, articles pertaining information on the neurological manifestation of SARS-CoV-2 infection were gathered from PubMed and Google Scholar using the search keywords "SARS-CoV-2", "COVID-19", and "neurological dysfunction". The findings of the search were filtered, and relevant information were included.

摘要

自 2020 年 4 月中国武汉首次报告 SARS-CoV-2 引起的神经表现病例系列以来,各种报告 COVID-19 感染与神经系统相关的类似和不同症状的研究相继发表。从那时起,科学家开始揭示其机制以及对疾病现有认知的病理生理影响。SARS-CoV-2 结合 ACE2 受体,该受体存在于身体的某些部位,负责调节健康系统中的血压和炎症。受体在鼻腔和口腔、大脑和血液中的存在允许病毒进入体内并引起神经并发症。外周和中枢神经系统也可以通过病毒直接经神经或血源性途径入侵,或通过细胞因子过度刺激免疫系统导致自身免疫性疾病而间接入侵。其他神经影响,如缺氧、嗅觉丧失、味觉障碍、脑膜炎、脑炎和癫痫发作,是 COVID-19 患者出现的重要临床症状,无论是否存在该疾病的常见症状。此外,SARS-CoV-2 感染严重程度较高的患者也有长期保留一些神经并发症的风险。还将讨论治疗这种严重的超炎症状态的方法,以及它们可能对疾病进展带来的风险。为此综述,从 PubMed 和 Google Scholar 中使用搜索关键词“ SARS-CoV-2”、“COVID-19”和“神经功能障碍”收集了有关 SARS-CoV-2 感染的神经表现的文章。对搜索结果进行了筛选,并纳入了相关信息。

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