Неврологические проявления и осложнения у пациентов с COVID-19

Становится очевидным, что неврологические осложнения COVID-19 значительно распространены, однако в некоторых случаях установление причинно-следственной связи затруднительно. Например, инсульт может происходить по причинам, не связанным с коронавирусной инфекцией, в то время как синдром Гийена–Барре и менингоэнцефалит, вероятно, представляют собой параинфекционное явление. Прояснить некоторые из этих вопросов смогут только долгосрочные эпидемиологические исследования на больших группах пациентов. Это поможет лучше понять механизмы развития осложнений и разработать схемы их лечения и последующей реабилитации. В статье представлены механизмы проникновения коронавируса в нервную систему и систематизированы неврологические проявления и осложнения COVID-19, которые были описаны за первые 3 месяца пандемии. Особое внимание уделено рассмотрению осложнений COVID-19 со стороны центральной и периферической нервной системы, приведены наиболее интересные клинические примеры. Подводя итог анализа литературы, можно сказать, что клиническая картина неврологических заболеваний и синдромов, вызванных коронавирусной инфекцией, соответствует привычным представлениям. Также рассмотрено предположение о том, что SARS-CoV-2 может длительное время сохраняться в центральной нервной системе в виде неактивных фрагментов, а значит, сможет рецидивировать у предрасположенных лиц при возникновении подходящих условий. Это предположение вызывает тревогу относительно отдаленных неврологических осложнений у инфицированных и вылеченных пациентов.

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