Neurologische Komplikationen bei COVID-19-Infektion

Seit ersten Berichten einer neuen Atemwegsinfektion aus der Hauptstadt Wuhan der zentralchinesischen Provinz Hubei Ende 2019 breitet sich das Coronavirus SARS-CoV-2 weltweit aus. Mittlerweile ist bekannt, dass eine COVID-19-Infektion häufig begleitet wird von neurologischen Symptomen und Komplikationen. Dieser Artikel beleuchtet die klinische Relevanz der COVID-19-Pandemie für die Neurologie im Allgemeinen und insbesondere im Hinblick auf an Parkinson vorerkrankte Patienten.

Kernaussagen

• Das SARS-CoV-2-Virus tritt via ACE2-Rezeptor in seine Wirtszellen ein. Neben einer direkten viralen Infektion des Gehirns ist außerdem eine hämatogene sowie eine retrograde Infektion über das enterische Nervensystem aufsteigend über den N. vagus denkbar.

• Neurologische Symptome und Komplikationen einer COVID-19-Infektion können in jedem Stadium der Erkrankung auftreten.

• Vier von 5 stationär behandelten COVID-19-Patienten entwickeln neurologische Beschwerden.

• Enzephalopathien sind eine häufige neurologische Manifestation und mit erhöhter Letalität und schlechterem funktionalen Outcome assoziiert.

• Eine COVID-19 Erkrankung hat ein erhöhtes Risiko für ischämische Schlaganfälle, insbesondere innerhalb der ersten Wochen nach Infektion.

• Neurologische Vorerkrankungen erhöhen das Risiko eines schweren COVID-19-Verlaufs.

• Das Post-COVID-19-Syndrom zeichnet sich aus durch anhaltende Fatigue und kognitive Beeinträchtigungen.

• Ob eine COVID-19-Infektion Neurodegeneration fördert, ist zum gegenwärtigen Zeitpunkt unklar.

Publication History

Article published online:
24 February 2022

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