Клинико-патогенетические особенности поражения нервной системы при COVID-19

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Симптомы поражения нервной системы наблюдаются у 6—36% пациентов с COVID-19. По патогенетическим механизмам выделяют непосредственное (вирусное), вторичное (соматогенное) и пост(пара)инфекционное (аутоиммунное) поражение нервной системы. Наиболее частый вариант — вторичное поражение нервной системы, представленное энцефалопатией гипоксического, инфекционно-токсического или дисметаболического генеза. В его основе лежит отек головного мозга, а основные симптомы представлены общемозговой симптоматикой (головная боль, несистемное головокружение, спутанность сознания). Коронавирусные менингоэнцефалиты представлены единичными наблюдениями. Постинфекционные неврологические осложнения COVID-19 чаще проявляются различными формами синдрома Гийена—Барре. Острые нарушения мозгового кровообращения (ОНМК) наблюдаются в 2,5—5% случаев COVID-19. Их развитие связано с синдромом гиперкоагуляции и эндотелиальной дисфункцией. Чаще ОНМК развивается у пожилых пациентов с сосудистыми факторами риска и тяжелым течением COVID-19. Однако инсульты могут наблюдаться и у лиц младше 50 лет с относительно легкими формами болезни. Необходимы дальнейшие исследования поражений нервной системы при COVID-19.

Ключевые слова:

коронавирус

Авторы:

Кутлубаев М.А.

ГБУЗ «Республиканская клиническая больница им. Г.Г. Куватова»; ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России

Даты поступления:

05.06.2020

Даты принятия в печать:

08.06.2020

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