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

Yıl 2020, Cilt: 22 Sayı: Special Issue, 1 - 4, 30.11.2020
https://doi.org/10.18678/dtfd.784367

Öz

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.

Kaynakça

  • Siniscalchi A, Gallelli L. Could COVID-19 represent a negative prognostic factor in patients with stroke? Infect Control Hosp Epidemiol. 2020;41(9):1115-6.
  • Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18-22.
  • Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90.
  • Wan S, Yi Q, Fan S, Lv J, Zhang X, Guo L, et al. Characteristics of lymphocyte subsets and cytokines in peripheral blood of 123 hospitalized patients with 2019 novel coronavirus pneumonia (NCP). MedRxiv. 2020. doi: 10.1101/2020.02.10.20021832
  • Yang Y, Shen C, Li J, Yuan J, Yang M, Wang F, et al. Exuberant elevation of IP-10, MCP-3 and IL-1ra during SARS-CoV-2 infection is associated with disease severity and fatal outcome. MedRxiv. 2020. doi: 10.1101/2020.03.02.20029975
  • Zahir JP, Felix AR, Miyara M. A nicotinic hypothesis for COVID-19 with preventive and therapeutic implications. C R Biol. 2020;343(1):33-9.
  • Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620-32.
  • George MR. Hemophagocytic lymphohistiocytosis: review of etiologies and management. J Blood Med. 2014;5:69-86.
  • McGonagle D, Sharif K, O’Regan A, Bridgewood C. The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev. 2020;19(6):102537.
  • Moore JB, June CH. Cytokine release syndrome in severe COVID-19. Science. 2020;368(6490):473-4.
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-8.
  • Brownlee W, Bourdette D, Broadley S, Killestein J, Ciccarelli O. Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic. Neurology. 2020;94(22):949-52.
  • msif.org [Internet]. Multiple Sclerosis International Federation. Global COVID-19 advice for people with MS. [Cited: 2020 March 26]. Available from: http://www.msif.org/wp-content/uploads/2020/03/MSIF-Global-advice-on-COVID-19-for-people-with-MS.docx-1.pdf
  • Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4.
  • Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395(10223):473-5.
  • Nath A. Neurologic complications of coronavirus infections. Neurology. 2020;94(19):809-10.
  • Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277(8):2251-61.
  • Galougahi MK, Ghorbani J, Bakhshayeshkaram M, Naeini AS, Haseli S. Olfactory bulb magnetic resonance imaging in SARS-CoV-2-induced anosmia: the first report. Acad Radiol. 2020;27(6):892-3.
  • Karimi-Galougahi M, Yousefi-Koma A, Bakhshayeshkaram M, Raad N, Haseli S. 18FDG PET/CT scan reveals hypoactive orbitofrontal cortex in anosmia of COVID-19. Acad Radiol. 2020;27(7):1042-3.
  • De Maria A, Varese P, Dentone C, Barisione E, Bassetti M. High prevalence of olfactory and taste disorder during SARS-CoV-2 infection in outpatients. J Med Virol. 2020;[Epub ahead of print]. doi: 10.1002/jmv.25995.
  • Bolay H, Gul A, Baykan B. COVID-19 is a real headache. Headache. 2020;[Epub ahead of print]. doi: 10.1111/head.13856.
  • Borges do Nascimento IJ, Cacic N, Abdulazeem HM, von Groote TC, Jayarajah U, Weerasekara I, et al. Novel coronavirus infection (COVID-19) in humans: a scoping review and meta-analysis. J Clin Med. 2020;9(4):941.
  • Guidon AC, Amato AA. COVID-19 and neuromuscular disorders. Neurology. 2020;94(22):959-69.
  • Solé G, Salort-Campana E, Pereon Y, Stojkovic T, Wahbi K, Cintas P, et al. Guidance for the care of neuromuscular patients during the COVID-19 pandemic outbreak from the French Rare Health Care for Neuromuscular Diseases Network. Rev Neurol (Paris). 2020;176(6):507-15.
  • Zhou Y, Li W, Wang D, Mao L, Jin H, Li Y, et al. Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management. Stroke Vasc Neurol. 2020;5(2):177-9.
  • Qureshi AI, Abd-Allah F, Alsenani F, Aytac E, Borhani-Haghighi A, Ciccone A, et al. Management of acute ischemic stroke in patients with COVID-19 infection: report of an international panel. Int J Stroke. 2020;15(5):540-54.
  • who.int [Internet]. World Health Organization. "Immunity passports" in the context of COVID-19, scientific brief. [Cited: 2020 April 24]. Available from: https://apps.who.int/iris/rest/bitstreams/1275788/retrieve
  • aan.com [Internet]. American Academy of Neurology. AAN issues guideline on vaccines and multiple sclerosis [Cited: 2020 March 26]. Available from: https://www.aan.com/PressRoom/Home/PressRelease/2745.
  • Farez MF, Correale J, Armstrong MJ, Rae-Grant A, Gloss D, Donley D, et al. Practice guideline update summary: vaccine-preventable infections and immunization in multiple sclerosis. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2019;93(13):584-94.
  • Bar-Zeev N, Inglesby T. COVID-19 vaccines: early success and remaining challenges. Lancet. 2020;396(10255):868-9.

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

Yıl 2020, Cilt: 22 Sayı: Special Issue, 1 - 4, 30.11.2020
https://doi.org/10.18678/dtfd.784367

Öz

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.

Kaynakça

  • Siniscalchi A, Gallelli L. Could COVID-19 represent a negative prognostic factor in patients with stroke? Infect Control Hosp Epidemiol. 2020;41(9):1115-6.
  • Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18-22.
  • Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90.
  • Wan S, Yi Q, Fan S, Lv J, Zhang X, Guo L, et al. Characteristics of lymphocyte subsets and cytokines in peripheral blood of 123 hospitalized patients with 2019 novel coronavirus pneumonia (NCP). MedRxiv. 2020. doi: 10.1101/2020.02.10.20021832
  • Yang Y, Shen C, Li J, Yuan J, Yang M, Wang F, et al. Exuberant elevation of IP-10, MCP-3 and IL-1ra during SARS-CoV-2 infection is associated with disease severity and fatal outcome. MedRxiv. 2020. doi: 10.1101/2020.03.02.20029975
  • Zahir JP, Felix AR, Miyara M. A nicotinic hypothesis for COVID-19 with preventive and therapeutic implications. C R Biol. 2020;343(1):33-9.
  • Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620-32.
  • George MR. Hemophagocytic lymphohistiocytosis: review of etiologies and management. J Blood Med. 2014;5:69-86.
  • McGonagle D, Sharif K, O’Regan A, Bridgewood C. The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev. 2020;19(6):102537.
  • Moore JB, June CH. Cytokine release syndrome in severe COVID-19. Science. 2020;368(6490):473-4.
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-8.
  • Brownlee W, Bourdette D, Broadley S, Killestein J, Ciccarelli O. Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic. Neurology. 2020;94(22):949-52.
  • msif.org [Internet]. Multiple Sclerosis International Federation. Global COVID-19 advice for people with MS. [Cited: 2020 March 26]. Available from: http://www.msif.org/wp-content/uploads/2020/03/MSIF-Global-advice-on-COVID-19-for-people-with-MS.docx-1.pdf
  • Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4.
  • Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395(10223):473-5.
  • Nath A. Neurologic complications of coronavirus infections. Neurology. 2020;94(19):809-10.
  • Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277(8):2251-61.
  • Galougahi MK, Ghorbani J, Bakhshayeshkaram M, Naeini AS, Haseli S. Olfactory bulb magnetic resonance imaging in SARS-CoV-2-induced anosmia: the first report. Acad Radiol. 2020;27(6):892-3.
  • Karimi-Galougahi M, Yousefi-Koma A, Bakhshayeshkaram M, Raad N, Haseli S. 18FDG PET/CT scan reveals hypoactive orbitofrontal cortex in anosmia of COVID-19. Acad Radiol. 2020;27(7):1042-3.
  • De Maria A, Varese P, Dentone C, Barisione E, Bassetti M. High prevalence of olfactory and taste disorder during SARS-CoV-2 infection in outpatients. J Med Virol. 2020;[Epub ahead of print]. doi: 10.1002/jmv.25995.
  • Bolay H, Gul A, Baykan B. COVID-19 is a real headache. Headache. 2020;[Epub ahead of print]. doi: 10.1111/head.13856.
  • Borges do Nascimento IJ, Cacic N, Abdulazeem HM, von Groote TC, Jayarajah U, Weerasekara I, et al. Novel coronavirus infection (COVID-19) in humans: a scoping review and meta-analysis. J Clin Med. 2020;9(4):941.
  • Guidon AC, Amato AA. COVID-19 and neuromuscular disorders. Neurology. 2020;94(22):959-69.
  • Solé G, Salort-Campana E, Pereon Y, Stojkovic T, Wahbi K, Cintas P, et al. Guidance for the care of neuromuscular patients during the COVID-19 pandemic outbreak from the French Rare Health Care for Neuromuscular Diseases Network. Rev Neurol (Paris). 2020;176(6):507-15.
  • Zhou Y, Li W, Wang D, Mao L, Jin H, Li Y, et al. Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management. Stroke Vasc Neurol. 2020;5(2):177-9.
  • Qureshi AI, Abd-Allah F, Alsenani F, Aytac E, Borhani-Haghighi A, Ciccone A, et al. Management of acute ischemic stroke in patients with COVID-19 infection: report of an international panel. Int J Stroke. 2020;15(5):540-54.
  • who.int [Internet]. World Health Organization. "Immunity passports" in the context of COVID-19, scientific brief. [Cited: 2020 April 24]. Available from: https://apps.who.int/iris/rest/bitstreams/1275788/retrieve
  • aan.com [Internet]. American Academy of Neurology. AAN issues guideline on vaccines and multiple sclerosis [Cited: 2020 March 26]. Available from: https://www.aan.com/PressRoom/Home/PressRelease/2745.
  • Farez MF, Correale J, Armstrong MJ, Rae-Grant A, Gloss D, Donley D, et al. Practice guideline update summary: vaccine-preventable infections and immunization in multiple sclerosis. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2019;93(13):584-94.
  • Bar-Zeev N, Inglesby T. COVID-19 vaccines: early success and remaining challenges. Lancet. 2020;396(10255):868-9.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Davetli Derleme
Yazarlar

Dilcan Kotan 0000-0002-8624-6321

Taşkın Duman 0000-0002-6552-4193

Yayımlanma Tarihi 30 Kasım 2020
Gönderilme Tarihi 23 Ağustos 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 22 Sayı: Special Issue

Kaynak Göster

APA Kotan, D., & Duman, T. (2020). The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection. Duzce Medical Journal, 22(Special Issue), 1-4. https://doi.org/10.18678/dtfd.784367
AMA Kotan D, Duman T. The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection. Duzce Med J. Kasım 2020;22(Special Issue):1-4. doi:10.18678/dtfd.784367
Chicago Kotan, Dilcan, ve Taşkın Duman. “The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection”. Duzce Medical Journal 22, sy. Special Issue (Kasım 2020): 1-4. https://doi.org/10.18678/dtfd.784367.
EndNote Kotan D, Duman T (01 Kasım 2020) The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection. Duzce Medical Journal 22 Special Issue 1–4.
IEEE D. Kotan ve T. Duman, “The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection”, Duzce Med J, c. 22, sy. Special Issue, ss. 1–4, 2020, doi: 10.18678/dtfd.784367.
ISNAD Kotan, Dilcan - Duman, Taşkın. “The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection”. Duzce Medical Journal 22/Special Issue (Kasım 2020), 1-4. https://doi.org/10.18678/dtfd.784367.
JAMA Kotan D, Duman T. The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection. Duzce Med J. 2020;22:1–4.
MLA Kotan, Dilcan ve Taşkın Duman. “The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection”. Duzce Medical Journal, c. 22, sy. Special Issue, 2020, ss. 1-4, doi:10.18678/dtfd.784367.
Vancouver Kotan D, Duman T. The Diagnostic and Prognostic Importance of Neurological Findings on SARS-CoV-2 Infection. Duzce Med J. 2020;22(Special Issue):1-4.
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