Neuroimmune disorders in COVID-19.
Neuroimmune disorders in COVID-19.
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DOI：
10.1007/s00415-022-11050-w
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发表时间：
2022-06
影响因子：
6
通讯作者：
Vogrig A
中科院分区：
文献类型：
--
作者：
Ariño H;Heartshorne R;Michael BD;Nicholson TR;Vincent A;Pollak TA;Vogrig A
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是2019年冠状病毒病(新冠肺炎)的病原体，目前正在全球迅速传播，迄今已报告147,443,848例。据报道，大约30-80%的病例(取决于新冠肺炎的严重程度)有神经系统症状，包括嗅觉障碍、中风和脑病。此外，一些患者已经认识到自身免疫性神经疾病，包括中枢(边缘和脑干脑炎、急性播散性脑脊髓炎[ADEM]和脊髓炎)和外周疾病(格林-巴利综合征和米勒-费舍尔综合征)。我们系统地描述了新冠肺炎博客(https://blogs.bmj.com/jnnp/2020/05/01/the-neurology-and-neuropsychiatry-of-covid-19/)关于神经内科和神经精神病学的133篇系列报道的数据，提供了关于SARS-CoV-2神经免疫介导的并发症患者的诊断和治疗的全面概述。在大多数情况下，神经障碍的潜伏期是高度可变的，涉及的免疫学或其他机制尚不清楚。尽管只有10个人识别出特定的神经元或神经节苷脂抗体，但许多人对免疫治疗有明显的反应。尽管经历免疫介导的神经疾病的患者比例很小，但总人数可能被低估了。免疫调节治疗的早期识别和改善，即使在那些没有识别出自身抗体的患者中也是如此，使得延迟或漏诊有可能导致长期残疾，包括新出现的急性新冠肺炎后遗症(PACS)。最后，还讨论了在既往神经免疫紊乱患者中使用免疫疗法的潜在问题。网上版载有补充材料，可在10.1007/s00415-022-11050-w查阅。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aetiologic agent of the coronavirus disease 2019 (COVID-19), is now rapidly disseminating throughout the world with 147,443,848 cases reported so far. Around 30–80% of cases (depending on COVID-19 severity) are reported to have neurological manifestations including anosmia, stroke, and encephalopathy. In addition, some patients have recognised autoimmune neurological disorders, including both central (limbic and brainstem encephalitis, acute disseminated encephalomyelitis [ADEM], and myelitis) and peripheral diseases (Guillain–Barré and Miller Fisher syndrome). We systematically describe data from 133 reported series on the Neurology and Neuropsychiatry of COVID-19 blog (https://blogs.bmj.com/jnnp/2020/05/01/the-neurology-and-neuropsychiatry-of-covid-19/) providing a comprehensive overview concerning the diagnosis, and treatment of patients with neurological immune-mediated complications of SARS-CoV-2. In most cases the latency to neurological disorder was highly variable and the immunological or other mechanisms involved were unclear. Despite specific neuronal or ganglioside antibodies only being identified in 10, many had apparent responses to immunotherapies. Although the proportion of patients experiencing immune-mediated neurological disorders is small, the total number is likely to be underestimated. The early recognition and improvement seen with use of immunomodulatory treatment, even in those without identified autoantibodies, makes delayed or missed diagnoses risk the potential for long-term disability, including the emerging challenge of post-acute COVID-19 sequelae (PACS). Finally, potential issues regarding the use of immunotherapies in patients with pre-existent neuro-immunological disorders are also discussed. The online version contains supplementary material available at 10.1007/s00415-022-11050-w.
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DOI：
10.1007/s10072-020-04787-7
发表时间：
2020-12
期刊：
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
影响因子：
--
作者：
Gigli GL;Vogrig A;Nilo A;Fabris M;Biasotto A;Curcio F;Miotti V;Tascini C;Valente M
通讯作者：
Valente M
影响因子：
11.2
作者：
Fragiel, Marcos;Miro, Oscar;Gonzalez del Castillo, Juan
通讯作者：
Gonzalez del Castillo, Juan
影响因子：
1.5
作者：
Ghiasvand, Fereshteh;Ghadimi, Maryam;SeyedAlinaghi, SeyedAhmad
通讯作者：
SeyedAlinaghi, SeyedAhmad
影响因子：
14.5
作者：
Fokke, Christiaan;van den Berg, Bianca;Jacobs, Bart Casper
通讯作者：
Jacobs, Bart Casper
影响因子：
4.4
作者：
Garnero, Martina;Del Sette, Massimo;Benedetti, Luana
通讯作者：
Benedetti, Luana