SARS-CoV-2 Enfeksiyonunda Nörolojik Bulguların Tanısal ve Prognostik Önemi

Year 2020, Volume: 22 Issue: Special Issue, 1 - 4, 30.11.2020

Dilcan Kotan Taşkın Duman

https://doi.org/10.18678/dtfd.784367

Abstract

Koronavirüsü, nöroinvazyon adını verdiğimiz yayılımla sinir sistemini tutmakta, ‘sitokin fırtınası’ hastalığın gidişatını etkileyen önemli bir faktör olmaktadır. Sitokin fırtınası sonucunda beyin ve diğer organlarda ciddi hasarlar ortaya çıkmaktadır. Tüm dünyada milyonlarca kişiyi enfekte eden koronavirüsün solunum yollarının yanı sıra hem merkezi hem de periferik sinirleri ve kas sistemini etkilediğini gösteren kanıtlar gün geçtikçe birikmektedir. Artan kanıtlar, hastaların %36-54’ünde yani neredeyse her 2 veya 3 hastanın birinde nörolojik tutulumu ortaya koymuştur. Şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) hastalarında koku ve tat bozuklukları, yorgunluk ve kas ağrısı, baş ağrısı, bulantı, kusma, bilinç bozukluğu, el ve ayaklarda uyuşma gibi nörolojik belirtilerle sıkça karşılaşıyoruz. Daha az olarak ise baş dönmesi, beyin zarı iltihapları, sinir dokusunda miyelin kaybı, kas iltihabı, ağır kas yıkımı gibi nörolojik handikaplara rastlıyoruz. SARS-CoV-2 hastalığına eşlik eden sinir sistemi hastalıklarının bir kısmı tam ya da kısmi sekel ile iyileşmektedir. Nörolojik bulgu gösteren hastalarda kalıcı fonksiyon kaybının gözlenmesi, bu olguların değerlendirilmesinde ayrıntılı nörolojik değerlendirmenin önemine dikkati çekmektedir.

Keywords

SARS-CoV-2, nörolojik tutulum, fonksiyon kaybı

The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection

Abstract

The coronavirus invades the nervous system with the spread we call neuroinvasion, and "cytokine storm" becomes an important factor affecting the course of the disease. Serious damage occurs in the brain and other organs as a result of cytokine storm. Evidence is accumulating that the coronavirus, which infects millions of people all over the world, affects both the central and peripheral nervous system and muscles as well as the respiratory tract. Increasing evidence has revealed neurological involvement in 36-54% of the patients, which corresponds to almost one in every 2 or 3 patients. In severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients, we frequently encounter neurological symptoms such as smell and taste disturbances, fatigue and muscle pain, headache, nausea, vomiting, impaired consciousness, numbness in hands and feet. To a lesser extent, we encounter neurological handicaps such as dizziness, inflammation of the meninges, loss of myelin in nerve tissue, muscle inflammation, and severe rhabdomyolysis. Some of the nervous system diseases accompanying SARS-CoV-2 disease recover with complete or partial sequelae. Observation of permanent dysfunction in patients with neurological findings draws attention to the importance of a detailed neurological evaluation in the examination of these cases.

Keywords

SARS-CoV-2, neurological involvement, dysfunction

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