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ORIJINAL ARAŞTIRMA

COVID-19 Pandemisinde Artmış Akut Polinöropati Vakaları; Nörologları Neler Bekliyor?
Increased Cases of Acute Polyneuropathy in COVID-19 Pandemic; What Awaits Neurologists?
Received Date : 25 Apr 2022
Accepted Date : 02 Jun 2022
Available Online : 13 Jun 2022
Doi: 10.31609/jpmrs.2022-90845 - Makale Dili: EN
J PMR Sci. 2022;25(3):346-54
ÖZET
Amaç: Şiddetli akut solunum yolu sendromu koronavirüs hastalığı- 2019 [coronavirus disease-2019 (COVID-19)], öncelikle solunum sistemini etkiler, ancak merkezî ve periferik nörolojik bulgular giderek daha fazla tanınmakta ve literatürde sunulmaktadır. Amacımız, COVID-19 polinöropati ilişkisine ışık tutmaktır. Gereç ve Yöntemler: Çalışma, COVID-19 enfeksiyonundan sonra gelişen akut polinöropatili hastalardan oluşuyordu. Tüm hastalarda tanı polimeraz zincir reaksiyonu pozitifliği ile kesinleşti. On altı hastada elektrofizyolojik, laboratuvar bulguları ve nörolojik muayene ile akut polinöropati tanısı kondu. Tüm hastalara polinöropatinin olası nedenlerini dışlamak için etiyolojik araştırmalar yapıldı. Bulgular: Hastaların yaş ortalaması 64,3’tü (29-83 yıl); vakaların çoğu kadındı (13 kadın, 3 erkek). COVID-19 semptomlarının başlangıcı ile akut polinöropatinin ilk semptomları arasındaki süre 11 ile 63 gün (ortalama: 21,5 gün) arasında değişmekte idi. Elektronöromiyografide 8 hastada akut motor-duyusal aksonal nöropati, 6 hastada akut motor aksonal nöropati ve 2 hastada akut inflamatuar demiyelinizan polinöropati bulguları saptandı Beş hasta lomber ponksiyonu kabul etti; beyin omurilik sıvısı analizinde 2 hastada normal protein seviyesi diğerlerinde albüminositolojik disosiasyon saptandı. Sonuç: Bu makale; akut polinöropati ile COVID-19 arasındaki olası nedensel ilişkinin farkındalığı, nörolojik komplikasyonlar açısından COVID-19 hastalarının daha uzun süreli takibinin gerektiğini göstermektedir.
ABSTRACT
Objective: Severe acute respiratory syndrome coronavirus disease-2019 (COVID-19) primarily affects the respiratory system but central and peripheral neurological manifestations have been increasingly recognized and reported. Our aim is to shed light on the relationship between COVID-19 and polyneuropathy. Material and Methods: The study consisted of patients with acute polyneuropathy that developed after the COVID-19 infection. All patients were confirmed serologically with polymerase chain reaction positivity. In 16 patients, acute polyneuropathy was diagnosed with an electrophysiological, laboratory findings and neurological examination. All patients underwent etiological studies to exclude possible causes of polyneuropathy. Results: The average age of the patients was 64.3 (29-83) years; most cases were female (13 vs 3). The interval between the onset of symptoms of COVID-19 and the first symptoms of acute polyneuropathy ranged from 11 to 63 (mean: 21.5) days. On electroneuromyography, there was acute motor-sensory axonal neuropathy in 8 patients, 6 patients had acute motor axonal neuropathy and 2 patients had acute inflammatory demyelinating polyneuropathy findings. Five patients accepted lumbar puncture; on analysis of the cerebrospinal fluid (CSF), 2 patient had normal protein level and the others showed an albuminocytological dissociation, increased protein in the CSF without increase in cell count, characteristic of the Gullain-Barré syndrome (GBS). Conclusion: This article; awareness of the possible causal association between acute polyneuropathy and COVID-19, recommends long-term follow-up of COVID-19 patients for neurologic complications.
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