SARS-CoV-2 感染与神经退行性疾病之间的联系:回顾与最新进展

Amaan Javed, Anika Batra, Mehak Singh, Parnica Sarkar
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摘要

2002 年出现的严重急性呼吸系统综合征冠状病毒(SARS-CoV),以及 2012 年引起致命疾病的中东呼吸系统综合征冠状病毒(MERS-CoV),使冠状病毒成为公共卫生问题。由SARS-CoV-2感染引起的2019年冠状病毒病(COVID-19)不仅影响呼吸系统,而且还被观察到引发神经系统表现,其中无嗅和老年无嗅最为常见,其次是头痛、癫痫发作、神经病和脑病。除了 SARS-CoV 和 MERS-CoV 被证实具有神经侵袭性之外,SARS-CoV-2 除了引发急性神经症状之外,还被发现会加重帕金森病和阿尔茨海默病等原有的长期神经退行性疾病。由于重要数据有限,COVID-19 与相对罕见的神经退行性疾病(如肌萎缩性脊髓侧索硬化症和亨廷顿氏病)之间的关联尚未得到证实。研究表明,COVID-19 似乎并不会加重这些疾病,与 COVID-19 相关的疾病和死亡的严重程度在患者中并没有明显高于普通人群。然而,据报道,这些疾病晚期患者的并发症会增加。因此,当务之急是对 SARS-CoV-2 对神经退行性疾病的影响进行长期、全面的调查,最终目的是制定适当的干预措施。当务之急是对不同年龄、病程和种族的人群进行更大规模的研究。
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Linkage between SARS-CoV-2 infection and neurodegenerative disorders: Review and current update
The emergence of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002, followed by the Middle East respiratory syndrome coronavirus (MERS-CoV) that causes fatal illness in 2012, has made coronaviruses a public health concern. Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection does not only affect the respiratory system but has also been observed to elicit neurological manifestations, with anosmia and ageusia being the most common, followed by headache, seizures, neuropathies, and encephalopathy. In addition to SARS-CoV and MERS-CoV which have been proven to be neuroinvasive, SARS-CoV-2 has been found to worsen preexisting long-term neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease, apart from triggering the acute neurological symptoms. The association between COVID-19 and relatively rare neurodegenerative disorders such as amyotrophic lateral sclerosis and Huntington’s disease has yet to be corroborated due to limited significant data. Studies have shown that COVID-19 does not seem to exacerbate these disorders, and the severity of COVID-19-related disease and fatalities is not significantly higher in the affected patients than in the general population. However, increased complications have been reported among the patients in advanced stages of these diseases. Hence, it is imperative to conduct long-term, comprehensive investigations on the effects of SARS-CoV-2 on neurodegenerative disorders, with the ultimate aim of developing appropriate interventions. Studies involving larger cohorts of people of varying ages, disease duration, and ethnicity are urgently warranted.
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