背景:不时,医师在病毒性脑炎患儿的急性治疗方面面临着具有挑战性的诊断和治疗问题.
目的:本文的目的是提供有关SARS-CoV-2与流感脑炎之间异同的最新叙述性综述。
方法:使用关键术语“SARS-CoV-2”或“流感”和“脑炎”对功能“临床查询”进行了PubMed搜索。搜索策略包括荟萃分析,临床试验,随机对照试验,回顾和观察性研究。搜索仅限于英语文献和儿科人群。本文比较了SARS-CoV-2和流感相关脑炎之间的相似性和对比。
结果:脑炎是流感和SARS-CoV-2的罕见表现。两种方法都与发烧和呼吸道症状有关。然而,SARS-CoV-2患者可能仅有轻微症状或无症状,作为沉默携带者,使得疾病传播难以控制。流感患者通常有更严重的症状,并且经常卧床几天限制其传播。流感与季节性和年度爆发有关,而SARS-CoV-2已成为地方病。脑炎的并发症在两种病毒感染中都很少见,但是,当存在时,可能会带来严重的发病率和死亡率。已经描述了许多COVID-19感染的长期后遗症(长COVID-19),但没有描述为流感感染。与脑炎相关的死亡率在流感中似乎高于SARS-CoV-2。通过免疫预防可用于流感和SARS-CoV-2。还可以使用奥司他韦治疗流感,尼马特雷韦/利托那韦治疗SARS-CoV-2。类固醇适用于更严重的SARS-CoV-2,但它们在流感疾病中的作用并不明显。
结论:脑炎是流感和SARS-CoV-2感染的一种罕见并发症。同时具有显著的发病率和死亡率。用于预防的有效疫苗和用于治疗的抗病毒剂可用于两种病毒。
BACKGROUND: From time to time, physicians face challenging diagnostic and therapeutic issues concerning the acute management of children with viral encephalitis.
OBJECTIVE: The aim of this article is to provide an updated narrative review on the similarities and differences between SARS-CoV-2 and influenza encephalitis.
METHODS: A PubMed search was performed with the function \"Clinical Queries\" using the key terms \"SARS-CoV-2\" OR \"Influenza\" AND \"Encephalitis\". The search strategy included metaanalyses, clinical trials, randomized controlled trials, reviews and observational studies. The search was restricted to the English literature and pediatric population. This article compares similarities and contrasts between SARS-CoV-2 and influenza-associated encephalitis.
RESULTS: Encephalitis is an uncommon manifestation of both influenza and SARS-CoV-2. Both viruses are associated with fever and respiratory symptoms. However, SARS-CoV-2 patients may only have mild symptoms or be asymptomatic as silent carriers, rendering the disease spread difficult to control. Influenza patients usually have more severe symptomatology and are often bed bound for several days limiting its spread. Influenza is associated with seasonal and annual outbreaks, whereas SARS-CoV-2 has become endemic. Complications of encephalitis are rare in both viral infections but, when present, may carry serious morbidity and mortality. Many long-term sequelae of COVID- 19 infections (long COVID-19) have been described but not with influenza infections. Mortality associated with encephalitis appears higher with influenza than with SARS-CoV-2. Prophylaxis by immunization is available for both influenza and SARS-CoV-2. Specific efficacious antivirals are also available with oseltamivir for influenza and nirmatrelvir/ritonavir for SARS-CoV-2. Steroids are indicated with more severe SARS-CoV-2 but their role is not distinct in influenza disease.
CONCLUSIONS: Encephalitis is a rare complication of influenza and SARS-CoV-2 infections. Both carry significant morbidity and mortality. Efficacious vaccines for prophylaxis and antivirals for treatment are available for both viruses.