The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings

作者：Ross W. Paterson, Rachel Brown, Laura Benjamin, Ross Nortley, Sarah Wiethoff, Tehmina Bharucha, Dipa Jayaseelan, Guru Kumar, Rhian Raftopoulos, L. Zambreanu, Vinojini Vivekanandam, Anthony Khoo, Ruth Geraldes, Krishna Chinthapalli, E Boyd, Hatice Tuzlalı, Gary Price, Gerry Christofi, Jasper M. Morrow, Patricia McNamara, Benjamin C. Mcloughlin, Soon Tjin Lim, Puja R. Mehta, Viva Levee, Stephen Keddie, Wisdom Yong, S. Anand Trip, Alexander Foulkes, Gary Hotton, Thomas D. Miller, Alex Everitt, Christopher Carswell, Nicholas Davies, Michael Yoong, David Attwell, Jemeen Sreedharan, Eli Silber, Jonathan M. Schott, Arvind Chandratheva, Richard Perry, Robert Simister, Anna M. Checkley, Nicky Longley, Simon F. Farmer, Francesco Carletti, Catherine Houlihan, Maria Thom, Michael P. Lunn, Jennifer Spillane, Robin Howard, Angela Vincent, David J. Werring, Chandrashekar Hoskote, Hans Rolf Jäger, Hadi Manji, Michael S. Zandi · 发表于：Brain · 年份：2020 · DOI：10.1093/brain/awaa240 · 被引用次数：1171 · 研究领域：Long-Term Effects of COVID-19、COVID-19 Clinical Research Studies、Infectious Encephalopathies and Encephalitis

Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness. Responding to this, a weekly virtual coronavirus disease 19 (COVID-19) neurology multi-disciplinary meeting was established at the National Hospital, Queen Square, in early March 2020 in order to discuss and begin to understand neurological presentations in patients with suspected COVID-19-related neurological disorders. Detailed clinical and paraclinical data were collected from cases where the diagnosis of COVID-19 was confirmed through RNA PCR, or where the diagnosis was probable/possible according to World Health Organization criteria. Of 43 patients, 29 were SARS-CoV-2 PCR positive and definite, eight probable and six possible. Five major categories emerged: (i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalities, and with 9/10 making a full or partial recovery with supportive care only; (ii) inflammatory CNS syndromes (n = 12) including encephalitis (n = 2, para- or post-infectious), acute disseminated encephalomyelitis (n = 9), with haemorrhage in five, necrosis in one, and myelitis in two, and isolated myelitis (n = 1). Of these, 10 were treated with corticosteroids, and three of these patients also received intravenous immunoglobulin; one made a full recovery, 10 of 12 made a partial recovery, and one patient died; (iii) ischaemic strokes (n = 8) associated w...