Blood Biomarkers for Detection of Brain Injury in COVID-19 Patients.
Blood Biomarkers for Detection of Brain Injury in COVID-19 Patients.
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DOI：
10.1089/neu.2020.7332
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发表时间：
2021-01-01
影响因子：
4.2
通讯作者：
Hayes RL
中科院分区：
文献类型：
--
作者：
DeKosky ST;Kochanek PM;Valadka AB;Clark RSB;Chou SH;Au AK;Horvat C;Jha RM;Mannix R;Wisniewski SR;Wintermark M;Rowell SE;Welch RD;Lewis L;House S;Tanzi RE;Smith DR;Vittor AY;Denslow ND;Davis MD;Glushakova OY;Hayes RL
严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）病毒攻击2019冠状病毒病（COVID-19）患者的多个器官，包括大脑。世界各地都有关于COVID-19患者神经功能障碍的描述。中枢神经系统（CNS）症状可出现在病程的早期。据报道，多达55%的住院COVID-19患者在感染SARS-CoV-2三个月后出现神经障碍。SARS-COV-2病毒的易变性及其直接影响中枢神经系统的潜力凸显了开发诊断、管理和治疗COVID-19患者脑损伤技术的紧迫性。SARS-CoV-2感染中枢神经系统的病理生物学和这种感染的相关神经系统后遗症仍然知之甚少。在这篇综述中，我们概述了使用血液生物标志物（BBs）诊断COVID-19患者脑损伤的基本原理，将其应用于临床实践所需的研究，以及可能导致的患者管理和结果的改善。脑损伤的BBs可能为检测COVID-19患者的脑损伤提供潜在的工具。据报道，在COVID-19患者的脑脊液（CSF）和血液中有BBs升高。已在脑脊液中分析BB蛋白，以检测感染性疾病（包括人类免疫缺陷病毒和结核性脑膜炎）患者的中枢神经系统是否受累。美国食品和药物管理局批准使用BBs诊断轻度和中度创伤性脑损伤，并已确定中风、心脏骤停、缺氧和癫痫后的脑损伤。结合其他诊断工具，BBs可以增强对脑损伤病毒机制的理解，预测神经功能障碍的严重程度，指导患者分诊和分配适当的医疗途径，并评估COVID-19患者治疗干预措施的疗效。
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus attacks multiple organs of coronavirus disease 2019 (COVID-19) patients, including the brain. There are worldwide descriptions of neurological deficits in COVID-19 patients. Central nervous system (CNS) symptoms can be present early in the course of the disease. As many as 55% of hospitalized COVID-19 patients have been reported to have neurological disturbances three months after infection by SARS-CoV-2. The mutability of the SARS-COV-2 virus and its potential to directly affect the CNS highlight the urgency of developing technology to diagnose, manage, and treat brain injury in COVID-19 patients. The pathobiology of CNS infection by SARS-CoV-2 and the associated neurological sequelae of this infection remain poorly understood. In this review, we outline the rationale for the use of blood biomarkers (BBs) for diagnosis of brain injury in COVID-19 patients, the research needed to incorporate their use into clinical practice, and the improvements in patient management and outcomes that can result. BBs of brain injury could potentially provide tools for detection of brain injury in COVID-19 patients. Elevations of BBs have been reported in cerebrospinal fluid (CSF) and blood of COVID-19 patients. BB proteins have been analyzed in CSF to detect CNS involvement in patients with infectious diseases, including human immunodeficiency virus and tuberculous meningitis. BBs are approved by the U.S. Food and Drug Administration for diagnosis of mild versus moderate traumatic brain injury and have identified brain injury after stroke, cardiac arrest, hypoxia, and epilepsy. BBs, integrated with other diagnostic tools, could enhance understanding of viral mechanisms of brain injury, predict severity of neurological deficits, guide triage of patients and assignment to appropriate medical pathways, and assess efficacy of therapeutic interventions in COVID-19 patients.
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影响因子：
3.2
作者：
Anderson AM;Easley KA;Kasher N;Franklin D;Heaton RK;Zetterberg H;Blennow K;Gisslen M;Letendre SL
通讯作者：
Letendre SL
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DOI：
10.1126/science.abd4585
发表时间：
2020-10-23
期刊：
Science (New York, N.Y.)
影响因子：
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作者：
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通讯作者：
Casanova JL
影响因子：
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通讯作者：
Pietri, Sylvia
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