Challenges and management of neurological and psychiatric manifestations in SARS-CoV-2 (COVID-19) patients
Challenges and management of neurological and psychiatric manifestations in SARS-CoV-2 (COVID-19) patients
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DOI：
10.1007/s10072-020-04544-w
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发表时间：
2020-08-06
影响因子：
3.3
通讯作者：
Striano, Pasquale
中科院分区：
文献类型：
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作者：
Orsini, Alessandro;Corsi, Martina;Striano, Pasquale
COVID-19是由人类冠状病毒（HCoV） SARS-CoV-2引起的大流行，于2019年底起源于中国武汉，并于2020年在全球传播。由于这一时期的临床决策困难，我们的研究组回顾了当前关于COVID-19神经和精神方面的文献。尽管人们对这种新发现的病毒的了解在不断发展，但不同的证据表明，COVID-19与头痛、头晕、味觉和嗅觉障碍等神经系统症状以及最终由SARS-CoV-2引发的病理过程引发的涉及神经系统的并发症之间存在关联。年轻患者似乎不太容易患上严重的COVID-19。然而，在儿科患者中也有神经系统症状的报道，在某些情况下，感染会出现神经系统后遗症。此外，患有特定神经系统疾病或接受特定药物（如免疫抑制疗法）治疗的儿童在本次大流行期间必须仔细监测。神经科医生应了解COVID-19治疗的主要药物-药物相互作用和神经系统副作用。值得注意的是，据报道，SARS-CoV-2患者的心理健康受到了不良影响，这可能与社交压力或病毒最终的嗜神经效应有关，而在其他感染中，这种效应已被证明会促进精神症状的发作。此外，精神科人群可能更容易受到感染，并有更高的不良后果风险。
COVID-19 is a pandemic caused by human coronavirus (HCoV) SARS-CoV-2, which originated in Wuhan, China, at the end of 2019 and spread globally during 2020. Due to the difficulty of clinical decision-making during this period, our study group reviewed current literature focusing on the neurological and psychiatric aspects of COVID-19. Despite the knowledge on this newly discovered virus which is constantly evolving, different pieces of evidence reported an association between COVID-19 and neurological symptoms like headache, dizziness, taste and smell disorders and complications involving the nervous system eventually triggered by the pathologic processes elicited by SARS-CoV-2. It seems that younger patients are less prone to develop severe forms of COVID-19. However, neurological signs have been reported in paediatric patients as well, and in some cases, the infection presented neurological sequelae. Furthermore, children with particular neurological diseases or treated with specific drugs (e.g. immune-suppressant therapies) must be carefully monitored during this pandemic. Neurologists should be aware of the main drug-drug interactions and the neurological side effects of COVID-19 treatments. Notably, adverse mental health impact has been reported in patients with SARS-CoV-2, which could be related either to the social strain or to the eventual neurotropic effects of the virus, which in other infections have been proven to promote the onset of psychiatric symptoms. Further, psychiatric population may be more vulnerable to the infection and at higher risk for adverse outcomes.