COVID-19感染的神经肌肉表现和并发症

Akhmadeeva L.R., Izhbuldina E.V., Khairullin A.T.
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摘要

本文考虑了冠状病毒感染的各种神经肌肉表现,并重点介绍了神经系统损伤的方法。这些包括SARS-CoV-2的“细胞因子风暴”、止血功能受损、神经嗜性和神经毒力。病毒在体内的持续存在会影响合并症的病程,因此需要对患者采取系统的治疗方法。本文讨论了现代研究论文和临床病例的数据,包括最新的国际文献和我们自己的临床实践:它是最常见的情况-格林-巴-巴综合征-急性炎症性脱髓鞘性多神经病变。我们提出罕见和常见的神经肌肉疾病,他们的临床发病,可能的发病机制,变体的表现。根据现有文献资料,对新型冠状病毒感染SARS-CoV-2相关格林-巴罗综合征患者的评估和管理与与大流行无关的经典病例没有重大差异。我们的病人是我们自己的病例,他住院了,作为住院病人来观察。在管理算法中采用血浆置换治疗。这个案例的结果是积极的。我们的结论是,新型冠状病毒感染SARS-CoV-2的神经肌肉表现可能是新的,可能与该疾病有关,但也可能被描述为病前疾病的恶化。例如,在新型冠状病毒SARS-CoV-2感染引起的大流行期间,遗传性神经肌肉疾病可能会有不同的变异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
NEUROMUSCULAR MANIFESTATIONS AND COMPLICATIONS OF COVID-19 INFECTION
In this paper, various neuromuscular manifestations of coronavirus infection are considered and methods of damage to the nervous system are highlighted. These include the "cytokine storm", impaired hemostasis, neurotropicity and neurovirulence of SARS-CoV-2. The persistence of the virus in the body affects the course of comorbid diseases, which requires a systematic approach to patient treatment. In this paper we discuss the data from modern research papers and clinical cases both from updated international literature and from our own clinical practice: it is the most frequently met condition - Guillain-Barré syndrome – acute inflammatory demyelinating polyneuropathy. We present both rare and common neuro-muscular conditions, their clinical onset, possible pathogenesis, variants of manifestation. According to the data from current publications, the evaluation and management of patients suffering from Guillain-Barré syndrome associated with new coronaviral infection SARS-CoV-2 is does not have major differences with the classical ones, that are not associated with the pandemic. Our patient that we present as our own case, was hospitalized, and observed as an in-patient. She was treated using plasma exchange in the algorithm of management. The outcome of this case was positive. We conclude that neuromuscular manifestation of new coronaviral infection SARS-CoV-2 could be new and possibly associated with this disease, but also could be described as worsening of the premorbid disorders. For instance, inherited neuromuscular diseases could have different variants during the period of pandemic caused by novel coronavirus SARS-CoV-2 infection.
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