ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
FİZİKSEL TIP VE REHABİLİTASYON
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Fiziksel Tıp ve Rehabilitasyon Pratiğinde Sık Karşılaşılabilecek, COVID-19 ile İlişkili Kas-İskelet Sistemi Etkilenimleri ve Nörolojik Etkilenimler-Kısa Derleme
COVID-19 Related Musculoskeletal System Effects and Neurological Effects That May Be Encountered Frequently in Physical Medicine and Rehabilitation Practice-Brief Review
Received Date : 03 Dec 2020
Accepted Date : 04 Jan 2021
Available Online : 17 Mar 2021
Doi: 10.31609/jpmrs.2020-80365 - Makale Dili: TR
J PMR Sci. 2021;24(2):164-8
ÖZET
Mart 2020’de pandemi olarak ilan edilen yeni tip koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], esas olarak solunum sistemi belirti ve bulguları ile seyretmektedir. Şiddetli akut solunum sendromu-koronavirüs-2 virüsünün giriş reseptörü olan anjiyotensin dönüştürücü enzim 2 reseptörlerinin, vücutta yaygın doku dağılımı mevcuttur. Bu nedenle hastalıkta solunum sistemi belirti ve bulgularının yanı sıra diğer sistemlerle ilgili semptom ve bulgular da izlenebilmektedir. Literatürde, COVID-19 ile birlikte görüldüğü en sık bildirilen kas-iskelet sistemi etkilenimleri artralji, miyalji, yorgunluk ve kas zayıflığı; nörolojik etkilenim tabloları serebrovasküler olay, baş ağrısı, sersemlik hissi, bilinç bozuklukları, epilepsi, ataksi, akut dissemine ensefalomiyelit, viral ensefalit, koku ve/veya tat duyusunda azalma veya kayıp ve diğer kraniyal sinir tutulumları ile seyreden klinik tablolar ve Guillain-Barré sendromunu içermektedir. Hastalığın başlangıcında nonspesifik veya hafif solunum sistemi şikâyeti olan COVID-19 hastaları, fiziksel tıp ve rehabilitasyon pratiğinde sık karşılaşılan artralji ve miyalji başta olmak üzere kas-iskelet sistemi ve sinir sistemi semptom ve bulgularıyla başvurabileceğinden, bu semptom ile bulguların COVID-19’da izlenen solunum sistemi semptom ve bulgularından önce de ortaya çıkabildiği gösterildiğinden, ayrıcı tanıda COVID-19’un akılda tutulması önemlidir. Bu bakış açısı oldukça bulaşıcı olduğu görülen bu hastalıkta, hastaların tanı ve izolasyonunun daha erken yapılmasına katkı sağlaması açısından önemlidir.
ABSTRACT
The novel coronavirus disease-2019 (COVID-19), declared as a pandemic in March 2020, mainly progresses with respiratory system signs and symptoms. Angiotensin converting enzyme-2 receptors, which are the entrance receptors of the severe acute respiratory syndrome-coronavirus-2, have a common tissue distribution in the body. Therefore, in addition to respiratory system signs and symptoms, symptoms and signs related to other systems can be observed in the disease. In the literature, the most frequently reported musculoskeletal effects associated with COVID-19 are arthralgia, myalgia, fatigue and muscle weakness; neurological effects associated with COVID-19 are cerebrovascular events, headache, dizziness, consciousness disorders, epilepsy, ataxia, acute disseminated encephalomyelitis, viral encephalitis, decreased or loss of sense of smell and/or taste, and other cranial nerve involvement, and Guillain-Barré syndrome. Since COVID-19 patients with nonspecific or mild respiratory system complaints at the beginning of the disease may present with symptoms and signs of the musculoskeletal and nervous system, especially arthralgia and myalgia, which are common in physical medicine and rehabilitation practice and these symptoms and signs may precede the respiratory system symptoms and signs observed in COVID-19, it is important to keep COVID-19 in mind in differential diagnosis. This point of view is thought to contribute to the diagnosis and isolation of patients earlier in this disease, which seems to be highly contagious.
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