据报道,严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)感染后,相当一部分患者出现了长期持续的症状。这个条件,定义为“急性冠状病毒病(COVID)后,\“\”长科维德,“或”长途COVID,“在门诊患者和急性感染期间无症状的个体中也有描述。该病症与功能性神经障碍(FND)之间可能存在重叠。我们报道了一个23岁的男人,在无症状的COVID-19之后,这是一种以疲劳为特征的复杂症状,间歇性呼吸急促,夜间心动过速,和胸痛。他还抱怨注意力和记忆困难,波动的肢体感觉障碍,和他左臂的虚弱。神经系统检查后,做出了FND的诊断。值得注意的是,患者也在COVID后中心接受了评估,并被诊断为长型COVID-19综合征.在我们的FND中心进行了4个月的精神分析心理治疗和针对性物理治疗后,感觉障碍和运动症状已经解决,主观认知投诉明显改善。然而,由于轻度症状持续限制体力活动,患者尚未完全康复.COVID后的长期症状和FND可能具有潜在的生物学机制,如压力和炎症。我们的病例表明,功能性症状可能与长期COVID症状并存,并可能通过有针对性的干预措施得到改善。在SARS-CoV-2感染后出现新的波动症状的患者中,应考虑FND的诊断,积极的临床症状应该仔细调查。
Long lasting symptoms have been reported in a considerable proportion of patients after a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. This condition, defined as either \"post-acute coronavirus disease (COVID),\" \"long COVID,\" or \"long-haul COVID,\" has also been described in outpatients and in individuals who are asymptomatic during the acute infection. A possible overlap exists between this condition and the functional neurological disorders (FNDs). We report a 23-year-old man who developed, after asymptomatic COVID-19, a complex symptomatology characterized by fatigue, episodic shortness of breath, nocturnal tachycardia, and chest pain. He also complained of attention and memory difficulties, fluctuating limb dysesthesia, and weakness of his left arm. After neurological examination, a diagnosis of FND was made. Notably, the patient was also evaluated at a post-COVID center and received a diagnosis of long COVID-19 syndrome. After 4 months of psychoanalytic psychotherapy and targeted physical therapy in our center for FNDs, dysesthesia and motor symptoms had resolved, and the subjective cognitive complaints had improved significantly. However, the patient had not fully recovered as mild symptoms persisted limiting physical activities. Long-term post COVID symptoms and FNDs may share underlying biological mechanisms, such as stress and inflammation. Our
case suggests that functional symptoms may coexist with the long COVID symptoms and may improve with targeted interventions. In patients presenting with new fluctuating symptoms after SARS-CoV-2 infection, the diagnosis of FNDs should be considered, and the positive clinical signs should be carefully investigated.