lvrachЛечащий ВрачLechaschi Vrach1560-51752687-118110.26295/OS.2021.63.96.011lvrach-16Research ArticleСтатьиНеврологические аспекты COVID-19. Тактика ведения пациентов неврологом с учетом эпидемиологической ситуацииNeurological aspects of COVID-19. Management of patients with neurological diseases considering epidemiological situationДемьяновскаяЕ. Г.DemianovskaiaE. G.

Москва

Moscow

gamovaeg@mail.ruКрыжановскийС. М.KryzhanovskiyS. M.

Москва

Moscow

noemail@neicon.ruВасильевА. С.VasilievA. S.

Москва

Moscow

noemail@neicon.ruШмыревВ. И.ShmirevV. I.

Москва

Moscow

noemail@neicon.ruГБУЗ ИКБ № 1 ДЗМРоссияClinical hospital No. 1 of infectious diseases, Moscow Healthcare Agency; Central state medical Academy of Department of President AffairsRussian FederationФГБУ ДПО ЦГМА УДП РФРоссияCentral state medical Academy of Department of President AffairsRussian Federation202123062021025460Copyright © Демьяновская Е.Г., Крыжановский С.М., Васильев А.С., Шмырев В.И., 20212021Демьяновская Е.Г., Крыжановский С.М., Васильев А.С., Шмырев В.И.Demianovskaia E.G., Kryzhanovskiy S.M., Vasiliev A.S., Shmirev V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/16

Практически сразу после объявления Всемирной организацией здравоохранения пандемии новой коронавирусной инфекции (COVID-19) стали появляться работы, в которых неврологические осложнения наблюдались более чем у 30% заболевших. Неврологические проявления не являются лидирующими в клинической картине заболеваний, вызванных коронавирусами. Тем не менее имеются данные о возможных поражениях нервной системы и их роли в развитии дыхательных, сенсорных, двигательных, вегетативных и других расстройств центральной и периферической нервной системы. Особенности строения вириона SARS-CoV-2 обусловливают возможное сродство к ряду рецепторов, экспрессируемых на мембране нервных клеток; получены доказательства наличия вирусных белков или генетического материала в нервной ткани. Также течение уже имеющихся неврологических заболеваний может обостриться, в связи с чем в публикации приводятся основные рекомендации по тактике ведения отдельных групп пациентов с заболеваниями нервной системы, разработанные ведущими зарубежными и отечественными профессиональными сообществами. На основании анализа данных более ранних эпидемий коронaвирусной инфекции, вероятнее всего, в отсроченном периоде неврологи столкнутся с когнитивными и психоэмоциональными расстройствами и другими патологиями. Поэтому важными аспектами являются выбор правильной тактики ведения больных и отслеживание развития ранних и отдаленных последствий неврологических проявлений и осложнений COVID-19.

Almost immediately after a pandemic of a new coronavirus infection (COVID-19) was declared by World Health Organization, we began to see papers which described neurological complications more than in 30% of patients. Neurological manifestations are not leading in the clinic of diseases caused by coronaviruses. However, evolvement of the nervous system is possible shown, and respiratory, sensory, motor, autonomic and other disorders of the central and peripheral nervous system. Structure of virion SARS-CoV-2 determine possible affinity for a number of receptors expressed on the neuronal membrane; viral proteins or genetic material were found in the nervous tissue. Also, COVID-19 can worsen the course of already existed neurological diseases, so, this article provides basic recommendations for management of certain groups of patients with nervous diseases, developed by leading foreign and Russian professional communities. Considering earlier epidemics of other coronavirus infections, neurologists are most likely to encounter cognitive and psychoemotional disorders and other pathologies in the follow-up period. Therefore, it is important to choose appropriate management and monitor the development of early and long-term consequences of neurological manifestations and complications of COVID-19. 

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The authors declare that there are no conflicts of interest present.