2019年新型冠状病毒病大流行背景下神经、风湿病和传染病的眼部表现:一个病例系列

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摘要

新型冠状病毒病2019 (COVID-19)具有广泛的临床表现。虽然症状如发烧、咳嗽、呼吸困难、肌痛、腹泻、嗅觉丧失和衰老等占主导地位,但也有涉及多系统的较不常见的表现。一些报道的眼部表现包括与角膜结膜炎相关的症状,如化脓、眼痛、畏光、干眼和流泪[1]。除嗅觉和味觉功能障碍外,神经系统症状也被普遍描述,包括头痛、共济失调、头晕、意识水平改变和中风[2]。这些神经眼科的发现是否反映了这些系统的直接参与或对SARS-CoV-2感染的更广泛的反应仍不确定。许多其他神经系统疾病、风湿病和传染病也表现出与COVID-19相似的临床表现,使诊断情况进一步复杂化。在本病例系列中,我们检查了几例出现异常神经-眼科表现的患者,讨论了这些表现与SARS-CoV-2感染的相似之处,并回顾了当前文献中描述确诊COVID-19患者类似表现的可能机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ophthalmic Manifestations of Neurologic, Rheumatologic, and Infectious Diseases in the Context of the novel Coronavirus Disease 2019 Pandemic: A Case Series
The novel Coronavirus Disease 2019 (COVID-19) is known to present with a broad range of clinical manifestations. While symptoms such as fever, cough, dyspnea, myalgias, diarrhea, anosmia, and ageusia predominate, less common manifestations involving multiple systems have also been described. Some reported ocular manifestations include symptoms associated with keratoconjunctivitis, such as chemosis, ocular pain, photophobia, dry eye and tearing [1]. Neurological symptoms in addition to smell and taste dysfunction have been commonly described as well, and include headache, ataxia, dizziness, altered level of consciousness, and stroke [2]. Whether these neuro-ophthalmologic findings reflect direct involvement of these systems or a more generalized response to SARS-CoV-2 infection remains uncertain. Many other neurologic, rheumatologic, and infectious diseases also present with similar clinical findings as those described in COVID-19, further complicating the diagnostic picture. In this case series, we examine several patients presenting with unusual neuro-ophthalmological manifestations and discuss similarities of these findings with those seen in SARS-CoV-2 infection, and review current literature describing possible mechanisms underlying similar findings in patients with confirmed COVID-19.
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