■描述与人类冠状病毒感染有关的主要神经系统表现。
对具有与COVID-19和其他冠状病毒相关的神经系统表现的病例的临床研究进行了系统评价。搜索是在PubMed电子数据库中进行的,Scopus,Embase,和LILACS具有以下关键词:\“冠状病毒\”或\“Sars-CoV-2\”或\“COVID-19\”和\“神经系统表现\”或\“神经系统症状\”或\“脑膜炎\”或\“脑炎\”或\“脑病,“遵循系统评价和荟萃分析(PRISMA)指南。
■纳入了7项研究。CoV感染后的神经系统改变可能从17.3%到36.4%不等,在儿科年龄范围内,脑炎可能与呼吸系统疾病一样频繁,影响11%和12%的患者,分别。该调查包括409例诊断为CoV感染并出现神经系统症状的患者,中位年龄范围从3岁到62岁不等。主要的神经系统改变是头痛(69;16.8%),头晕(57,13.9%),意识改变(46;11.2%),呕吐(26;6.3%),癫痫危机(7;1.7%),神经痛(5;1.2%),共济失调(3;0.7%)。估计的主要诊断是25例(6.1%)患者的急性病毒性脑膜炎/脑炎,缺氧性脑病23例(5.6%),急性脑血管病6例(1.4%),1例(0.2%)可能患有急性播散性脑脊髓炎的患者,1例(0.2%)急性坏死性出血性脑病,2例(1.4%)CoV患者与格林-巴利综合征相关。
■冠状病毒具有重要的嗜神经潜能,它们会引起从轻度到重度的神经系统改变。发现的主要神经系统表现是头痛,头晕和意识改变。
OBJECTIVE: To describe the main neurological manifestations related to coronavirus infection in humans.
METHODS: A systematic
review was conducted regarding clinical studies on cases that had neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic databases PubMed, Scopus, Embase, and LILACS with the following keywords: \"coronavirus\" or \"Sars-CoV-2\" or \"COVID-19\" and \"neurologic manifestations\" or \"neurological symptoms\" or \"meningitis\" or \"encephalitis\" or \"encephalopathy,\" following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS: Seven studies were included. Neurological alterations after CoV infection may vary from 17.3% to 36.4% and, in the pediatric age range, encephalitis may be as frequent as respiratory disorders, affecting 11 % and 12 % of patients, respectively. The Investigation included 409 patients diagnosed with CoV infection who presented neurological symptoms, with median age range varying from 3 to 62 years. The main neurological alterations were headache (69; 16.8 %), dizziness (57, 13.9 %), altered consciousness (46; 11.2 %), vomiting (26; 6.3 %), epileptic crises (7; 1.7 %), neuralgia (5; 1.2 %), and ataxia (3; 0.7 %). The main presumed diagnoses were acute viral meningitis/encephalitis in 25 (6.1 %) patients, hypoxic encephalopathy in 23 (5.6 %) patients, acute cerebrovascular disease in 6 (1.4 %) patients, 1 (0.2 %) patient with possible acute disseminated encephalomyelitis, 1 (0.2 %) patient with acute necrotizing hemorrhagic encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome.
CONCLUSIONS: Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. The main neurological manifestations found were headache, dizziness and altered consciousness.