Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series
Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series
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DOI：
10.1097/ccm.0000000000004570
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发表时间：
2020-11-01
影响因子：
8.8
通讯作者：
Cervantes-Arslanian, Anna M.
中科院分区：
文献类型：
--
作者：
Anand, Pria;Zakaria, Asma;Cervantes-Arslanian, Anna M.
目的：描述2019年冠状病毒病患者队列中肌阵挛的风险因素和结局。设计：多中心病例系列。地点：马萨诸塞州、格鲁吉亚和弗吉尼亚州的三家三级医院。患者：2019年冠状病毒病背景下的8例临床肌阵挛患者。干预措施、测量方法和主要结果：肌阵挛患者的结局是可变的，1例患者在研究期间死亡，5例患者成功拔管，认知功能完好，无局灶性神经功能缺损。在5例病例中，肌阵挛在发作后2天内完全消退，而在3例病例中，肌阵挛持续10天或更长时间。7例患者发生了显著的代谢紊乱、低氧血症或暴露于可能导致肌阵挛发生的镇静药物。1例患者出现脑病，并在无明确全身性激发因素的情况下发生长时间肌阵挛。结论：我们的研究结果表明，肌阵挛可以观察到严重急性呼吸综合征冠状病毒2感染的患者，即使在缺氧的情况下。这种相关性需要在更大的队列中进一步评估，以确定肌阵挛的存在是否有助于评估疾病的严重程度、神经系统受累或复发。
Objectives: To describe the risk factors for and outcomes after myoclonus in a cohort of patients with coronavirus disease 2019. Design: Multicenter case series. Setting: Three tertiary care hospitals in Massachusetts, Georgia, and Virginia. Patients: Eight patients with clinical myoclonus in the setting of coronavirus disease 2019. Interventions & Measurements and Main Results: Outcomes in patients with myoclonus were variable, with one patient who died during the study period and five who were successfully extubated cognitively intact and without focal neurologic deficits. In five cases, the myoclonus completely resolved within 2 days of onset, while in three cases, it persisted for 10 days or longer. Seven patients experienced significant metabolic derangements, hypoxemia, or exposure to sedating medications that may have contributed to the development of myoclonus. One patient presented with encephalopathy and developed prolonged myoclonus in the absence of clear systemic provoking factors. Conclusions: Our findings suggest that myoclonus may be observed in severe acute respiratory syndrome coronavirus 2 infected patients, even in the absence of hypoxia. This association warrants further evaluation in larger cohorts to determine whether the presence of myoclonus may aid in the assessment of disease severity, neurologic involvement, or prognostication.