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Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review.

新型冠状病毒肺炎和其他冠状病毒感染的神经系统表现: 系统综述。

  • 影响因子:1.70
  • DOI:10.1016/j.clineuro.2020.105921
  • 作者列表:"Montalvan V","Lee J","Bueso T","De Toledo J","Rivas K
  • 发表时间:2020-07-01

BACKGROUND:Increasing research reports neurological manifestations of COVID-19 patients. SARS-CoV-2 shares homology with other human coronaviruses that have also had nervous system involvement. OBJECTIVE:To review the neurological aspects of SARS-cov2 and other coronavirus, including transmission pathways, mechanisms of invasion into the nervous system, and mechanisms of neurological disease. METHODS:We conducted a systematic review of articles in PubMed, SCOPUS and EMBASE data bases. Reviewed evidence is presented in sections of this manuscript which includes pathogenesis, neuro-invasion, encephalitis, Guillain-Barré, ADEM, multiple sclerosis, polyneuropathy, and cerebrovascular disease. RESULTS:A total 67 studies were included in the final analysis of experimental studies, case reports, series of cases, cohort studies, and systematic reviews related to neurological manifestations of SARS- CoV-2 and other human coronavirus infections. The SARS-CoV-2 receptor is expressed in the nervous system. Common reported symptoms included hyposmia, headaches, weakness, altered consciousness. Encephalitis, demyelination, neuropathy, and stroke have been associated with COVID-19. Infection through the cribriform plate and olfactory bulb and dissemination through trans-synaptic transfer are some of the mechanisms proposed. Invasion of the medullary cardiorespiratory center by SARS-CoV-2 may contribute to the refractory respiratory failure observed in critically-ill COVID-19 patients. CONCLUSION:An increasing number of reports of COVID-19 patients with neurological disorders add to emergent experimental models with neuro-invasion as a reasonable concern that SARS-CoV-2 is a new neuropathogen. How it may cause acute and chronic neurologic disorders needs to be clarified in future research.


背景: 越来越多的研究报道新型冠状病毒肺炎患者的神经系统表现。SARS-CoV-2 与其他人类冠状病毒也有神经系统受累。 目的: 综述SARS-cov2 和其他冠状病毒在神经系统方面的研究进展,包括传播途径、侵入神经系统的机制和神经系统疾病的发病机制。 方法: 我们对PubMed、SCOPUS和EMBASE数据库中的文章进行了系统综述。综述证据在本手稿的章节中提出,包括发病机制、神经侵袭、脑炎、格林-巴利、ADEM、多发性硬化、多发性神经病和脑血管疾病。 结果: 共有 67 项研究纳入最终分析的实验研究、病例报告、系列病例、队列研究、传染性非典型肺炎CoV-2 和其他人类冠状病毒感染的神经系统表现相关的系统综述。SARS-CoV-2 受体在神经体系中表达。常见的报告症状包括嗅觉减退、头痛、虚弱、意识改变。脑炎、脱髓鞘、神经病变和中风与新型冠状病毒肺炎有关。通过筛状板和嗅球的感染和通过跨突触传递的播散是提出的一些机制。SARS-CoV-2 侵犯延髓心肺中枢可能导致危重新型冠状病毒肺炎患者出现难治性呼吸衰竭。 结论: 越来越多的新型冠状病毒肺炎神经系统疾病患者的报道增加了以神经侵袭为合理考虑SARS-CoV-2 是一种新的神经病原体的急诊实验模型。它如何可能导致急性和慢性神经系统疾病需要在未来的研究中阐明。



作者列表:["Lim J","Jeon S","Shin HY","Kim MJ","Seong YM","Lee WJ","Choe KW","Kang YM","Lee B","Park SJ"]

METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

作者列表:["Zhang W","Du RH","Li B","Zheng XS","Yang XL","Hu B","Wang YY","Xiao GF","Yan B","Shi ZL","Zhou P"]

METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.