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Yıl:2020; Cilt: 57; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2020;57(2):154-159
Nörolog Gözüyle Koronavirüs Hastalığı 2019 (COVID-19): Pandemi ile Mücadele Sırasında Dikkat Edilmesi Gereken Nörolojik Bulgu ve Semptomlar
ANÖ Acarlı, B Samancı, E Ekizoğlu, A Çakar, NG Şirin, T Gündüz , Y Parman , B BaykanN
İstanbul Üniversitesi, İstanbul
Bazı solunum yolu virüslerinin nörolojik tutulum yapabildiği uzun yıllardır bilinmektedir. Ne yazık ki, Aralık 2019’da ortaya çıkan ve akut ağır solunum yetersizliği sendromuna yol açan yeni tip koronavirüs 2 (SARSCoV-2), diğer adıyla koronavirüs hastalığı 19 (COVID-19) ile artık nörolojik envazyon potansiyeli olan virüsler grubuna yeni bir üyenin katıldığı görülmektedir. Önüne geçilemeyen bir hızla tüm dünyada yayılmaya devam eden ve şimdiden milyonlarca insanı enfekte eden SARSCoV-2 ile ilişkili nörolojik semptom ve bulgulara gün geçtikçe yenileri eklenmektedir. Başağrısı, “dizziness”, bilinç bulanıklığı, ataksi, epilepsi, iskemik inme, nöropatik ağrı ve miyopatinin özellikle enfeksiyonun ağır seyrettiği olgularda daha sık olarak görüldüğü bildirilmektedir. Ayrıca ikincil nörolojik semptom gelişmesinin kötü sonlanım ile ilişkili olduğu da ifade edilmektedir. Öte yandan, çok sayıda SARS-CoV-2 taşıyıcısında ise tek semptomun koku duyusunda azalma olduğu ve bu semptomun hastalık belirteci olarak kabul edilebileceği ileri sürülmüştür. Kısacası hafif semptomu olan ya da hastalığın ağır seyrettiği geniş spektrumda, SARS-CoV-2’nin direkt ve dolaylı mekanizmalar aracılığıyla bu nörolojik semptomlara yol açabileceği düşünülmektedir. Bununla birlikte, bir ensefalit hastasının beyin omurilik sıvısında virüsün gen sekanslaması ile gösterilebilmesinin ardından, virüsün nöro-envazyon yapabildiğine ve merkezi sinir sistemini enfekte edebildiğine yüksek olasılık olarak bakılmaya başlanmıştır. Sonuçta, salgının yükselme dönemini yaşamakta olduğumuz dönemde, pandemi süresince en fazla karşılaşacağımız hastalığın olası nörolojik bulguları ile ilgili bilgi sahibi olmak değerlidir. Bu amaçla, literatürde SARS-CoV-2 ile ilişkilendirilmiş nörolojik tablolara ek olarak, yeni koronavirüsün yüksek oranda homoloji gösterdiği SARSCoV veya Ortadoğu solunum sendromu (MERS)-CoV gibi insanda enfeksiyona yol açan diğer koronavirüslere ilişkin literatürün de gözden geçirilmesi ve salgının uzun dönem komplikasyonlarıyla ilgili fikir sahibi olunması amaçlanmıştır
Coronavirus Disease 2019 (COVID-19) From the Point of View of Neurologists: Observation of Neurological Findings and Symptoms During the Combat Against a Pandemic
Some respiratory viruses have long been known to cause neurological involvement. A novel coronavirus, leading to severe acute respiratory syndrome, also called coronavirus disease 19 (COVID-19), seems to be a new member of neuroinvasive viruses. While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) keeps on spreading around the world rapidly, reports about the neurological manifestations associated with SARS-CoV-2, increases day by day. It is reported that a variety of symptoms and syndromes such as headache, dizziness, confusion, ataxia, epilepsy, ischemic stroke, neuropathic pain and myopathy are common especially in more severe COVID-19 patients. It is also suggested that the development of neurological complications is strongly associated with a poor outcome. On the other hand, hyposmia can be the unique symptom in COVID-19 carriers and this can serve as a marker for identifying the otherwise asymptomatically infected patients. It is thought that SARSCoV-2 may cause neurological symptoms through direct or indirect mechanisms. Nevertheless, neuroinvasion capability of SARS-CoV2 is confirmed by the presence of the virus, in the cerebrospinal fluid of a COVID-19 patient with encephalitis, and this is proven by gene sequencing. In conclusion, during the COVID-19 pandemic, it is crucial to be aware of the possible neurological complications of the disease. Therefore, in this review, we aimed to report neurological manifestations associated with SARS-CoV-2 and possible underlying pathophysiological mechanisms. Due to the high homology of SARS-CoV-2 with other human coronaviruses such as SARS-CoV or Middle East Respiratory Syndrome (MERS)-CoV, reviewing the neurological involvement also associated with these coronaviruses will also provide an idea about the long-term complications of COVID-19.

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