Post Covid Auto Immune Mediated Encephalopathy by Caspr2 Auto Antibody: The Report of Neurological Division o f “Carlo Poma Civil” Hospital of Mantua

Mirko Avesani, Alfonso Ciccone
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Abstract

A recent cross sectional study ( Liu, 2021 ) suggests that SARS CoV 2 infection has a potential long term impact on the cognition of patients: we have to face with post covid syndrome and with long covid syndrome, the first characterized by symptoms in regression after an year by infection, the last with persisting symptoms after an year by infection. As the COVID 19 pandemic is still raging in many countries and is expected to last for a long period, the long term cognitive sequelae may bec ome a major publi c health issue long after the pandemic has ended. Longitudinal studies to follow up patients who have recovered from COVID 19 are necessary for better understanding the long term cognitive consequences of COVID 19, particularly among those who have recovered from severe disease. But these are not the unique problems of the so called NEUROCOVID. Neuromuscular manifestations of new coronavirus disease 2019 (COVID‐19) infection are frequent, and include dizziness, headache, myopathy, severe (also axonal) Gui llain Barrè Syndrome and olfactory and gustatory disturbances. Patients with acute central nervous system disorders, such as delirium, impaired consciousness, stroke and convulsive seizures, have a high mortality rate ( Shimohata, 2022 An other severe condition is rappresented by autoimmune encefalopathies COVID related. The encephalitis/encephalopathy that causes consciousness disturbance and seizures can be classified into three conditions, including direct infection with the SARS‐CoV‐2 v irus, encephalopa thy caused by central nervous system damage secondary to systemic hypercytokinemia (cytokine storm) and autoimmune‐mediated encephalitis that occurs after infection.
Caspr2自身抗体引起的Covid后自身免疫介导脑病:曼图亚 "卡罗-波马平民 "医院神经科的报告
最近的一项横断面研究(Liu,2021 年)表明,SARS CoV 2 感染对患者的认知能力有潜在的长期影响:我们必须面对后 COVID 综合征和长期 COVID 综合征,前者的特点是感染一年后症状消退,后者是感染一年后症状持续存在。由于 COVID 19 大流行仍在许多国家肆虐,而且预计会持续很长时间,因此在大流行结束后很长时间内,长期认知后遗症可能会成为一个重大的公共卫生问题。为了更好地了解 COVID 19 的长期认知后遗症,尤其是那些从严重疾病中康复的患者,有必要对已从 COVID 19 中康复的患者进行纵向随访研究。但这些并不是所谓的 NEUROCOVID 独有的问题。2019 年新型冠状病毒病(COVID-19)感染的神经肌肉表现很常见,包括头晕、头痛、肌病、严重的(也是轴突性的)桂林巴雷综合征以及嗅觉和味觉障碍。患有急性中枢神经系统疾病(如谵妄、意识障碍、中风和抽搐发作)的患者死亡率很高(Shimohata,2022 年)。导致意识障碍和癫痫发作的脑炎/脑病可分为三种情况,包括直接感染 SARS-CoV-2 病毒、继发于全身高细胞因子血症(细胞因子风暴)的中枢神经系统损伤导致的脑炎以及感染后发生的自身免疫介导的脑炎。
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