Abstract

Since the initial reports of COVID-19 in December 2019, the world has been gripped by the disastrous acute respiratory disease caused by the SARS-CoV-2 virus. There are an ever-increasing number of reports of neurological symptoms in patients, from severe (encephalitis), to mild (hyposmia), suggesting the potential for neurotropism of SARS-CoV-2. This Perspective investigates the hypothesis that the reliance on self-reporting of hyposmia has resulted in an underestimation of neurological symptoms in COVID-19 patients. While the acute effect of the virus on the nervous system function is vastly overshadowed by the respiratory effects, we propose that it will be important to monitor convalescent individuals for potential long-term implications that may include neurodegenerative sequelae such as viral-associated parkinsonism. As it is possible to identify premorbid harbingers of Parkinson’s disease, we propose long-term screening of SARS-CoV-2 cases post-recovery for these expressions of neurodegenerative disease. An accurate understanding of the incidence of neurological complications in COVID-19 requires long-term monitoring for sequelae after remission and a strategized health policy to ensure healthcare systems all over the world are prepared for a third wave of the virus in the form of parkinsonism.

中文翻译：

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帕金森症是COVID-19大流行的第三波？

摘要

自2019年12月发布COVID-19的首次报告以来，SARS-CoV-2病毒引起的灾难性急性呼吸道疾病困扰着世界。从严重（脑炎）到轻度（血尿）患者的神经系统症状的报告数量不断增加，这表明SARS-CoV-2有向神经性的可能性。该观点调查了以下假设：依赖自我报告的低渗血症导致低估了COVID-19患者的神经系统症状。尽管该病毒对神经系统功能的急性影响在很大程度上被呼吸作用所掩盖，但我们建议，对恢复期的个体进行潜在的长期影响（包括神经退行性后遗症，如病毒相关性帕金森综合症）的监测，将非常重要。由于有可能鉴定出帕金森氏病的病前兆，我们建议对这些神经退行性疾病的表达进行恢复后的长期筛查SARS-CoV-2病例。要准确了解COVID-19中神经系统并发症的发生率，就需要长期监测缓解后的后遗症，并制定战略性的健康政策，以确保全世界的医疗保健系统都已为帕金森氏症形式的第三波病毒做好准备。