Vasculitis-related stroke in young as a presenting feature of novel coronavirus disease (COVID19) - Case report
Vasculitis-related stroke in young as a presenting feature of novel coronavirus disease (COVID19) - Case report
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DOI：
10.1016/j.jocn.2020.07.034
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发表时间：
2020-09-01
影响因子：
2
通讯作者：
Soares de Sousa, Emanuel de Jesus
中科院分区：
文献类型：
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作者：
de Sousa, Gustavo Celeira;de Sousa, Thiago Celeira;Soares de Sousa, Emanuel de Jesus
COVID-19是由新型冠状病毒（SARS-CoV-2）感染引起的疾病，由于其易传播性和多种临床表现，是当前世界主要的公共卫生问题。世界范围内报道的主要症状是干咳、呼吸困难和发热，以及嗅觉丧失和味觉丧失。COVID-19诊断是通过RT-PCR进行的，但许多其他补充检查可用于指导临床实践，例如胸部计算机断层扫描（CT），显示毛玻璃样阴影;炎症标志物增加，如C反应蛋白和红细胞沉降率;血象可能显示低白蛋白血症，血小板减少症。严重者可演变为血栓栓塞和动脉粥样硬化栓塞事件，导致中风、心肌梗死、肺血栓栓塞。男，28岁，因在预约前夕出现剧烈头痛、构音障碍、唇音偏离而前往神经科预约。既往健康，无合并症或风险因素。进行脑MRI和血清学分析。SARS-CoV-2通过破坏血脑屏障影响脑内环境的稳定性，使其更易发生缺血性或炎症性损害，并侵袭中枢神经系统。神经系统症状和综合征是COVID-19大流行的主要后果，必须通过适当的临床管理加以预防。(C)2020爱思唯尔有限公司保留所有权利。
COVID-19 is the disease caused by Novel Coronavirus (SARS-CoV-2) infection and world current main public health problem, due to its easy transmissibility and multiple clinical presentations. The main symptoms reported worldwide are dry cough, dyspnea, and fever, as well as anosmia and ageusia. COVID-19 diagnosis is made with RT-PCR, but many other complementary exams may be used to guide clinical practice, such as Chest Computerized Tomography (CT), showing ground glass opacities; increase in inflammatory markers, as C-Reactive Protein and Erythrocyte Sedimentation Rate; hemogram might show hypoalbuminemia, thrombocytopenia. Severe cases may evolve to thromboembolic and atheroembolic events, leading to stroke, myocardial infarction, pulmonary thromboembolism. Male, 28 years old, went for neurological appointment after presenting episode of intense headache, dysarthria, deviation of lip rhyme on appointment's eve. Previously healthy, no comorbidities or risk factors. Underwent brain MRI and serum serological analysis. SARS-CoV-2 capacity of affecting brain homeostasis by breaking blood-brain barrier, makes it easier to develop ischemic or inflammatory damage, and invading central nervous system. Neurological symptoms and syndromes are the main consequences of COVID-19 pandemic and must be prevented through adequate clinical management. (C) 2020 Elsevier Ltd. All rights reserved.