Neurological disorders in Covid-19: clinical involvement and pathophysiological mechanisms

J. García-Moncó
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Abstract

The recent COVID-19 pandemic caused by the SARS-CoV-2 virus has conditioned a severe pulmonary disease with multi-system involvement. Recently, a variety of neurological disorders has been associated with this infection, including lack of smell (anosmia), lack of taste (ageusia), headache, myalgias, confusional states (encephalopathies), dizziness, seizures, strokes, and cranial and peripheral nerve palsies. A direct damage by the virus as well as secondary inflammatory and immune mechanisms triggered by the viral infection may be responsible for the nervous system abnormalities. The virus can gain access to the nervous system from the bloodstream and/or through the peripheral nerves in a retrograde transport. There is no specific therapy for these problems, thus treatment is symptomatic and supportive. Oftentimes a prothrombotic state is created during the infection; hence, anticoagulation should be considered in those patients.
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新冠肺炎神经系统疾病的临床参与及病理生理机制
最近由严重急性呼吸系统综合征冠状病毒2型病毒引起的新冠肺炎大流行使一种多系统受累的严重肺部疾病成为条件。最近,多种神经系统疾病与这种感染有关,包括嗅觉缺失(嗅觉缺失)、味觉缺失(味觉丧失)、头痛、肌痛、精神错乱(脑病)、头晕、癫痫发作、中风以及颅骨和周围神经麻痹。病毒的直接损伤以及病毒感染引发的继发性炎症和免疫机制可能是神经系统异常的原因。病毒可以通过血液和/或外周神经逆行进入神经系统。目前还没有针对这些问题的具体治疗方法,因此治疗是有症状的和支持性的。通常在感染过程中会产生血栓前状态;因此,这些患者应考虑抗凝治疗。
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