COVID-19感染后的脱髓鞘疾病

N. Bozhenko, M. Shorobura, A.V. Paenok, L. Lapovets, T. Nehrych
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引用次数: 2

摘要

SARS-COV-2是一种嗜神经病毒,未来可能引发大规模的神经系统并发症爆发。SARS-COV-2病毒具有神经侵袭性和嗜神经性,使其能够进入中枢神经系统(CNS)并感染神经元,在神经组织中积累并促进延迟性神经退行性过程的发展。在迄今为止SARS-CoV-2的神经系统并发症中,我们可以区分出一组中枢神经系统脱髓鞘病变。本文报道了2例重症COVID-19患者,MRI上伴有神经系统疾病和多灶性白质病变,可能对应于脱髓鞘性中枢神经系统疾病。这两个病例都可能是与COVID-19相关的急性感染性脱髓鞘过程的表现,因为临床表现合适,神经影像学显示白质多灶性病变。证实这一诊断的其他临床症状是,两例患者先前均确诊为急性病毒性COVID-19感染,且均无多发性硬化症等脱髓鞘疾病史。监测这类患者有助于更好地了解和确定疾病早期阶段的因素,并预测其进展。在未来,它还将允许制定有效的治疗策略,并能够降低在SARS-CoV-2感染期间脱髓鞘过程或其进展的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DEMYELINATING DISEASE AFTER COVID-19 INFECTION
SARS-COV-2 is a neurotropic virus that can trigger a large-scale outbreak of neurological complications in the future. SARS-COV-2 virus has neuroinvasive and neurotropic properties allow it to enter the central nervous system (CNS) and infect neurons, accumulate in nervous tissue and promote the development of delayed neurodegenerative processes. Among the neurological complications of SARS-CoV-2 to date, we can distinguish a group of demyelinating lesions of the CNS. The paper describes two cases of severe COVID-19, which were accompanied by neurological disorders and multifocal white matter lesions on MRI, which may correspond to demyelinating CNS disease. Both cases may be a manifestation of an acute infectious demyelinating process associated with COVID-19, as the clinical picture was appropriate, and neuroimaging showed multifocal lesions of the white matter. Other clinical signs confi rming this diagnosis were previously confi rmed acute viral COVID-19 infection and the absence of a history of demyelinating diseases such as multiple sclerosis in both patients. Monitoring such patients can help to understand better and identify factors in the early stages of the disease and to predict its progression. In the future, it will also allow the development of eff ective treatment strategies and the ability to reduce the risk of demyelinating process or its progression during SARS-CoV-2 infection.
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