COVID-19 Neiroradioloģiskā Atrade Pieaugušajiem - Literatūras Apskats.
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
2019. gada decembrī Vuhāņā, Ķīnā, tika konstatēti daudz neizskaidrojamu pneimonijas gadījumu, kas strauji izplatījās arī citās Ķīnas pilsētās un pēc tam Eiropā, Ziemeļamerikā un Āzijā. Tika apstiprināts, ka šo uzliesmojumu izraisīja jauns koronavīruss. Tika secināts, ka šim jaunajam koronavīrusam ir līdzīgi simptomi smagam akūtam respiratoram sindromam, kas tika atklāts 2003. gadā. Abiem vīrusiem ir kopīgs receptoru avots - angiotenzīnu konvertējošais enzīms 2. Tāpēc šis vīruss tika nosaukts par SARS-CoV-2, un 2020. gada februārī Pasaules Veselības organizācija šo slimību nosauca par koronavīrusu slimību 2019. Līdz 2020. gada 5. martam pasaulē bija 95333 apstiprināti COVID-19 gadījumi un 3282 nāves gadījumi.
Pēdējo divu gadu laikā ir aktualizējies jautājums par COVID-19 infekcijas izraisītajiem simptomiem, to sekām un prognozi. Šobrīd ir labi zināms, ka COVID-19 infekcija iesaista ne tikai elpošanas orgānu sistēmu, bet skar visu ķermeni, tai skaitā centrālo nervu sistēmu. Pēc pēdējiem datiem neiroloģiska simptomātika hospitalizētiem COVID-19 pacientiem ir sastopama aptuveni 80% gadījumu. Biežāk sastopamās pazīmes vai sindromi ir akūta encefalopātija, koma un galvas smadzeņu insults. Pacientiem ar neiroloģiskiem simptomiem ir augstāks risks intrahospitālai mirstībai. Laicīga un precīza diagnoze ir pamats veiksmīgai, pacientu ārstēšanai, hospitalizācijas laika un mirstības samazināšanai.
Šī darba mērķis ir, izmantojot literatūras avotus, pētīt tipiskos akūta COVID-19 neiroloģiskos simptomus, to radioloģiskās izpausmes saistībā ar slimības klīniskiem simptomiem un norisi.
Darba uzdevumi ir apkopot un analizēt pasaulē publicētos datus par Neurocovid - 19 patoģenēzi, sastopamības biežumu, klīnisko norisi un neiroradioloģisko atradi. Raksturot biežāk sastopamos COVID-19 neiroradioloģiskos sindromus pieaugušajiem: (a) galvas smadzeņu asinsvadu trombembolijas, (b) intrakraniālas hemorāģijas, (c) leikoencefalopātijas, (d) globālu hipoksisku bojājumu, (e) meningītu un encefalītu, (f) citotoksisku corpus callosum bojājumu, (g) kraniālo nervu bojājumu.
Darbā tiek pētītas šādas hipotēzes: 1. Biežāk sastopamās radioloģiski nosakāmās cerebrālās komplikācijas COVID-19 pacientiem ir cerebrālas angiopātijas, kam ir raksturīgas atšķirīgas radioloģiskās pazīmes; 2. COVID-19 postinfekciozie neiroloģiskie bojājumi var ietekmēt pacientu dzīves kvalitāti ilgtermiņā.
Šis ir retrospektīvs aprakstošs pētījums, sistemātisks pasaules zinātnisko publikāciju apskats. Rakstu meklēšana tika veikta pēc atslēgas vārdiem – Covid 19, CNS involvment, Neurocovid, Neuroimaging, MRI, CT, Neuroimmunology, Cerebrovascular disease, Critical illness. Tika izmantotas tādas datubāzes, kā – PubMed, ClinicalKey, UpToDate, DynaMed. Žurnāli – Proceedings of the National Academy of Sciences of the United States of America (PNAS), American Journal of Neuroradiology (AJNR), American Journal of Roentgenology , The Lancet u.c.
In December 2019, many unexplained cases of pneumonia were detected in Wuhan, China, and it spread rapidly to other Chinese cities and then to Europe, North America and Asia. This outbreak was confirmed to be caused by a novel coronavirus. This novel coranavirus was found to have symptoms similar to severe acute respiratory syndrome, which was discovered in 2003. The two viruses share a common receptor, angiotensin-converting enzyme 2. This virus was therefore named SARS-CoV-2, and in February 2020 the World Health Organisation named the disease Coronavirus Disease 2019 (COVID-19). By 5 March 2020, there were 95333 confirmed cases of COVID-19 and 3282 deaths worldwide. Over the past two years, the symptoms, consequences and prognosis of COVID-19 infection have become an emerging issue. It is now well known that COVID-19 infection involves not only the respiratory system but also the whole body, including the central nervous system. According to recent data, neurological symptomatology in hospitalised COVID-19 patients occurs in about 80% of cases. The most common signs or syndromes are acute encephalopathy, coma and cerebral stroke. Patients with neurological symptoms have a higher risk of intrahospital mortality. Fast and accurate diagnosis is the basis for successful treatment of patients, reducing hospitalisation time and mortality. The aim of this study is to use literature sources to study the typical neurological symptoms of acute COVID-19, radiological manifestations in relation to clinical symptoms and the course of the disease. The objectives of this study are to summarise and analyse data published worldwide on the pathogenesis, incidence, clinical course and neuroradiological findings of Neurocovid-19. To describe the most common neuroradiological syndromes of COVID-19 in patients: (a) brain vessel thromboembolism, (b) intracerebral haemorrhage, (c) leukoencephalopathy, (d) global hypoxic lesions, (e) meningitis and encephalitis, (f) cytotoxic corpus callosum lesions, (g) cranial nerve lesions. The following hypotheses are investigated: 1. Cerebral angiopathies are the most common radiologically detectable cerebral complications in COVID-19 patients and are characterised by distinctive radiological features; 2. Post-infectious neurological damage in COVID-19 patients may affect their long-term quality of life. This is a retrospective descriptive study, a systematic review of scientific publications worldwide. The search for articles was performed using the keywords - Covid 19; CNS involvment, Neurocovid; Neuroimaging, MRI, CT., Neuroimmunology, Cerebrovascular disease, Critical illness. PubMed, ClinicalKey, UpToDate, DynaMed databases were used. Journals - Proceedings of the National Academy of Sciences of the United States of America (PNAS), American Journal of Neuroradiology (AJNR), American Journal of Roentgenology , The Lancet, etc.
In December 2019, many unexplained cases of pneumonia were detected in Wuhan, China, and it spread rapidly to other Chinese cities and then to Europe, North America and Asia. This outbreak was confirmed to be caused by a novel coronavirus. This novel coranavirus was found to have symptoms similar to severe acute respiratory syndrome, which was discovered in 2003. The two viruses share a common receptor, angiotensin-converting enzyme 2. This virus was therefore named SARS-CoV-2, and in February 2020 the World Health Organisation named the disease Coronavirus Disease 2019 (COVID-19). By 5 March 2020, there were 95333 confirmed cases of COVID-19 and 3282 deaths worldwide. Over the past two years, the symptoms, consequences and prognosis of COVID-19 infection have become an emerging issue. It is now well known that COVID-19 infection involves not only the respiratory system but also the whole body, including the central nervous system. According to recent data, neurological symptomatology in hospitalised COVID-19 patients occurs in about 80% of cases. The most common signs or syndromes are acute encephalopathy, coma and cerebral stroke. Patients with neurological symptoms have a higher risk of intrahospital mortality. Fast and accurate diagnosis is the basis for successful treatment of patients, reducing hospitalisation time and mortality. The aim of this study is to use literature sources to study the typical neurological symptoms of acute COVID-19, radiological manifestations in relation to clinical symptoms and the course of the disease. The objectives of this study are to summarise and analyse data published worldwide on the pathogenesis, incidence, clinical course and neuroradiological findings of Neurocovid-19. To describe the most common neuroradiological syndromes of COVID-19 in patients: (a) brain vessel thromboembolism, (b) intracerebral haemorrhage, (c) leukoencephalopathy, (d) global hypoxic lesions, (e) meningitis and encephalitis, (f) cytotoxic corpus callosum lesions, (g) cranial nerve lesions. The following hypotheses are investigated: 1. Cerebral angiopathies are the most common radiologically detectable cerebral complications in COVID-19 patients and are characterised by distinctive radiological features; 2. Post-infectious neurological damage in COVID-19 patients may affect their long-term quality of life. This is a retrospective descriptive study, a systematic review of scientific publications worldwide. The search for articles was performed using the keywords - Covid 19; CNS involvment, Neurocovid; Neuroimaging, MRI, CT., Neuroimmunology, Cerebrovascular disease, Critical illness. PubMed, ClinicalKey, UpToDate, DynaMed databases were used. Journals - Proceedings of the National Academy of Sciences of the United States of America (PNAS), American Journal of Neuroradiology (AJNR), American Journal of Roentgenology , The Lancet, etc.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Covid 19, CNS iesaiste, Neiroradioloģija, MR, DT, Neiroimmunoloģija, Cerebrovaskulāra saslimšana, Kritiska slimība, Covid 19, CNS involvment, Neurocovid, Neuroimaging, MRI, CT, Neuroimmunology, Cerebrovascular disease, Critical illness