新型冠状病毒肺炎儿童合并急性脑炎的临床特点及研究进展

doi:10.7499/j.issn.1008-8830.2208033

摘要
图/表
参考文献(46)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (614 KB) [HTML]
输出: BibTeX | EndNote (RIS) 背景资料

摘要 2019年底以来，新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）在世界范围内大流行，该病出现神经系统症状的报道不断增加。其中，脑炎被认为是COVID-19严重的神经系统并发症，但国内报道缺乏。合并急性脑炎患儿症状重，如未能早期识别、及时治疗，病死率高，预后差。目前全球疫情仍在流行期间，有必要对COVID-19儿童神经系统重症表现予以关注。因此该综述通过文献检索及详细病案分析，探讨COVID-19合并急性脑炎的临床特点，旨在为临床医生应对可能出现的COVID-19合并急性脑炎病例提供参考。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	许普
	王来栓
	周文浩

关键词 ：新型冠状病毒肺炎, 脑炎, 儿童

Abstract：Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic since the end of 2019. There is an increasing number of reports on nervous system symptoms, among which encephalitis is considered a serious neurological complication of COVID-19, but there are few reports of this complication in China. Acute encephalitis has severe symptoms. If it is not identified early and treated in time, the mortality is high and the prognosis is poor. During the current global epidemic, it is necessary to pay attention to the severe nervous system symptoms of COVID-19. Therefore, this article summarizes the clinical features of COVID-19 complicated by acute encephalitis through literature review and a detailed analysis of medical records, so as to provide a reference for clinicians to deal with the cases of COVID-19 complicated by acute encephalitis.

Key words： Coronavirus disease 2019 Acute encephalitis Child

收稿日期: 2022-08-07

通讯作者: 王来栓，男，主任医师。Email：laishuanwang@fudan.edu.cn。 E-mail: laishuanwang@fudan.edu.cn

作者简介: 许普，男，硕士研究生；

引用本文:

许普,王来栓,周文浩. 新型冠状病毒肺炎儿童合并急性脑炎的临床特点及研究进展[J]. 中国当代儿科杂志, 2022, 24(12): 1301-1306.

XU Pu,WANG Lai-Shuan,ZHOU Wen-Hao. Clinical features of children with coronavirus disease 2019 complicated by acute encephalitis and related research advances[J]. CJCP, 2022, 24(12): 1301-1306.

链接本文:

http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2208033 或 http://www.zgddek.com/CN/Y2022/V24/I12/1301

	1 World Health Organization. Data at WHO[EB/OL]. [2022-07-25]. https://www.who.int/data.
	Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2[J]. Int J Infect Dis, 2020, 94: 55-58. PMID: 32251791. PMCID: PMC7195378. DOI: 10.1016/j.ijid.2020.03.062.
	Helms J, Kremer S, Merdji H, et al. Neurologic features in severe SARS-CoV-2 infection[J]. N Engl J Med, 2020, 382(23): 2268-2270. PMID: 32294339. PMCID: PMC7179967. DOI: 10.1056/NEJMc2008597.
	Paterson RW, Brown RL, Benjamin L, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings[J]. Brain, 2020, 143(10): 3104-3120. PMID: 32637987. PMCID: PMC7454352. DOI: 10.1093/brain/awaa240.
	Lindan CE, Mankad K, Ram D, et al. Neuroimaging manifestations in children with SARS-CoV-2 infection: a multinational, multicentre collaborative study[J]. Lancet Child Adolesc Health, 2021, 5(3): 167-177. PMID: 33338439. PMCID: PMC7744016. DOI: 10.1016/S2352-4642(20)30362-X.
	Lin JE, Asfour A, Sewell TB, et al. Neurological issues in children with COVID-19[J]. Neurosci Lett, 2021, 743: 135567. PMID: 33352286. PMCID: PMC7831718. DOI: 10.1016/j.neulet.2020.135567.
	Cagnazzo F, Arquizan C, Derraz I, et al. Neurological manifestations of patients infected with the SARS-CoV-2: a systematic review of the literature[J]. J Neurol, 2021, 268(8): 2656-2665. PMID: 33125542. PMCID: PMC7597753. DOI: 10.1007/s00415-020-10285-9.
	Mierzewska-Schmidt M, Baranowski A, Szymanska K, et al. The case of fatal acute hemorrhagic necrotizing encephalitis in a two-month-old boy with Covid-19[J]. Int J Infect Dis, 2022, 116: 151-153. PMID: 34929359. PMCID: PMC8683211. DOI: 10.1016/j.ijid.2021.12.334.
	Kim MG, Stein AA, Overby P, et al. Fatal cerebral edema in a child with COVID-19[J]. Pediatr Neurol, 2021, 114: 77-78. PMID: 33246133. PMCID: PMC7581370. DOI: 10.1016/j.pediatrneurol.2020.10.005.
	10 COVID-19 Grand Rounds: 儿童新冠肺炎并发急性脑炎之临床处置与案例讨论[EB/OL] . (2022-05-21)[2022-06-12]. https://www.youtube.com/watch?v=nzrvg9xCObs&list=PLHo9MfJHPagko6AsJx_HAimvjMwk4MaOQ&index=5&t=1676s.
	11 COVID-19 Grand Rounds: 儿童新冠病毒感染警讯症状与急诊处置[EB/OL] . (2022-05-28)[2022-06-12]. https://www.youtube.com/watch?v=9tTNRhKdUTo&list=PLHo9MfJHPagko6AsJx_HAimvjMwk4MaOQ&index=5&t=2109s.
	12 COVID-19 Grand Rounds: 儿童新冠病毒感染并发重症之临床处置与案例研讨会[EB/OL] . (2022-06-05)[2022-06-12]. https://www.youtube.com/watch?v=kY32Iq26DoE&list=PLHo9MfJHPagko6AsJx_HAimvjMwk4MaOQ&index=4&t=6417s.
	13 COVID-19 Grand Rounds:儿童新冠病毒感染并发重症之临床处置与案例研讨会[EB/OL] . (2022-06-11)[2022-06-12]. https://www.youtube.com/watch?v=67S6WlU3WTo&list=PLHo9MfJHPagko6AsJx_HAimvjMwk4MaOQ&index=3&t=4198s.
	Schober ME, Pavia AT, Bohnsack JF. Neurologic manifestations of COVID-19 in children: emerging pathophysiologic insights[J]. Pediatr Crit Care Med, 2021, 22(7): 655-661. PMID: 33965992. PMCID: PMC8240497. DOI: 10.1097/PCC.0000000000002774.
	Nordvig AS, Fong KT, Willey JZ, et al. Potential neurologic manifestations of COVID-19[J]. Neurol Clin Pract, 2021, 11(2): e135-e146. PMID: 33842082. PMCID: PMC8032406. DOI: 10.1212/CPJ.0000000000000897.
	Meinhardt J, Radke J, Dittmayer C, et al. Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19[J]. Nat Neurosci, 2021, 24(2): 168-175. PMID: 33257876. DOI: 10.1038/s41593-020-00758-5.
	Deigendesch N, Sironi L, Kutza M, et al. Correlates of critical illness-related encephalopathy predominate postmortem COVID-19 neuropathology[J]. Acta Neuropathol, 2020, 140(4): 583-586. PMID: 32851506. PMCID: PMC7449525. DOI: 10.1007/s00401-020-02213-y.
	Lewis A, Frontera J, Placantonakis DG, et al. Cerebrospinal fluid in COVID-19: a systematic review of the literature[J]. J Neurol Sci, 2021, 421: 117316. PMID: 33561753. PMCID: PMC7833669. DOI: 10.1016/j.jns.2021.117316.
	Cosentino G, Todisco M, Hota N, et al. Neuropathological findings from COVID-19 patients with neurological symptoms argue against a direct brain invasion of SARS-CoV-2: a critical systematic review[J]. Eur J Neurol, 2021, 28(11): 3856-3865. PMID: 34339563. PMCID: PMC8444743. DOI: 10.1111/ene.15045.
	Matschke J, Lütgehetmann M, Hagel C, et al. Neuropathology of patients with COVID-19 in Germany: a post-mortem case series[J]. Lancet Neurol, 2020, 19(11): 919-929. PMID: 33031735. PMCID: PMC7535629. DOI: 10.1016/S1474-4422(20)30308-2.
	Jonigk D, Werlein C, Acker T, et al. Organ manifestations of COVID-19: what have we learned so far (not only) from autopsies?[J]. Virchows Arch, 2022, 481(2): 139-159. PMID: 35364700. PMCID: PMC8975445. DOI: 10.1007/s00428-022-03319-2.
	Stafstrom CE, Jantzie LL. COVID-19: neurological considerations in neonates and children[J]. Children (Basel), 2020, 7(9): 133. PMID: 32927628. PMCID: PMC7552690. DOI: 10.3390/children7090133.
	Franke C, Ferse C, Kreye J, et al. High frequency of cerebrospinal fluid autoantibodies in COVID-19 patients with neurological symptoms[J]. Brain Behav Immun, 2021, 93: 415-419. PMID: 33359380. PMCID: PMC7834471. DOI: 10.1016/j.bbi.2020.12.022.
	Smadja DM, Mentzer SJ, Fontenay M, et al. COVID-19 is a systemic vascular hemopathy: insight for mechanistic and clinical aspects[J]. Angiogenesis, 2021, 24(4): 755-788. PMID: 34184164. PMCID: PMC8238037. DOI: 10.1007/s10456-021-09805-6.
	Thakur KT, Miller EH, Glendinning MD, et al. COVID-19 neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital[J]. Brain, 2021, 144(9): 2696-2708. PMID: 33856027. PMCID: PMC8083258. DOI: 10.1093/brain/awab148.
	Solomon IH, Normandin E, Bhattacharyya S, et al. Neuropathological features of Covid-19[J]. N Engl J Med, 2020, 383(10): 989-992. PMID: 32530583. PMCID: PMC7304421. DOI: 10.1056/NEJMc2019373.
	LaRovere KL, Riggs BJ, Poussaint TY, et al. Neurologic involvement in children and adolescents hospitalized in the United States for COVID-19 or multisystem inflammatory syndrome[J]. JAMA Neurol, 2021, 78(5): 536-547. PMID: 33666649. PMCID: PMC7936352. DOI: 10.1001/jamaneurol.2021.0504.
	Sandoval F, Julio K, Méndez G, et al. Neurologic features associated with SARS-CoV-2 infection in children: a case series report[J]. J Child Neurol, 2021, 36(10): 853-866. PMID: 33646895. DOI: 10.1177/0883073821989164.
	Ray STJ, Abdel-Mannan O, Sa M, et al. Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study[J]. Lancet Child Adolesc Health, 2021, 5(9): 631-641. PMID: 34273304. PMCID: PMC8279959. DOI: 10.1016/S2352-4642(21)00193-0.
	Olivotto S, Basso E, Lavatelli R, et al. Acute encephalitis in pediatric multisystem inflammatory syndrome associated with COVID-19[J]. Eur J Paediatr Neurol, 2021, 34: 84-90. PMID: 34425479. PMCID: PMC8339542. DOI: 10.1016/j.ejpn.2021.07.010.
	Urso L, Distefano MG, Cambula G, et al. The case of encephalitis in a COVID-19 pediatric patient[J]. Neurol Sci, 2022, 43(1): 105-112. PMID: 34668122. PMCID: PMC8525855. DOI: 10.1007/s10072-021-05670-9.
	Mydam J, Midivelly S, Vallivedu Chennakesavulu P, et al. Focal seizures in a child following COVID-19 infection: a case report[J]. Cureus, 2022, 14(2): e22083. PMID: 35165644. PMCID: PMC8831452. DOI: 10.7759/cureus.22083.
	Bhavsar SM, Agarwal S, Lewis R, et al. COVID-19 infection associated with encephalitis in an adolescent[J]. Neurol Clin Pract, 2021, 11(2): e189-e192. PMID: 33842090. PMCID: PMC8032413. DOI: 10.1212/CPJ.0000000000000911.
	Lazarte-Rantes C, Guevara-Casta?ón J, Romero L, et al. Acute necrotizing encephalopathy associated with SARS-CoV-2 exposure in a pediatric patient[J]. Cureus, 2021, 13(5): e15018. PMID: 34017667. PMCID: PMC8128972. DOI: 10.7759/cureus.15018.
	Sharma S, Ruparelia J, Bhaskar S, et al. Acute fulminant cerebellitis in children with COVID-19 infection: a rare but treatable complication[J]. Pediatr Neurol, 2021, 119: 45-47. PMID: 33894640. PMCID: PMC7997024. DOI: 10.1016/j.pediatrneurol.2021.03.004.
	36 台湾疾病控制机构举行的严重特殊传染病肺炎记者会[EB/OL]. (2022-09-08)[2022-09-19]. https://www.youtube.com/watch?v=uREKOvhqlDY.
	Koupaei M, Shadab Mehr N, Mohamadi MH, et al. Clinical symptoms, diagnosis, treatment, and outcome of COVID-19-associated encephalitis: a systematic review of case reports and case series[J]. J Clin Lab Anal, 2022, 36(5): e24426. PMID: 35435264. PMCID: PMC9102669. DOI: 10.1002/jcla.24426.
	McLendon LA, Rao CK, Da Hora CC, et al. Post-COVID-19 acute disseminated encephalomyelitis in a 17-month-old[J]. Pediatrics, 2021, 147(6): e2020049678. PMID: 33762311. DOI: 10.1542/peds.2020-049678.
	Wong AM, Lin JJ, Toh CH, et al. Childhood encephalitis: relationship between diffusion abnormalities and clinical outcome[J]. Neuroradiology, 2015, 57(1): 55-62. PMID: 25292353. DOI: 10.1007/s00234-014-1449-5.
	Wong AM, Yeh CH, Lin JJ, et al. Arterial spin-labeling perfusion imaging of childhood encephalitis: correlation with seizure and clinical outcome[J]. Neuroradiology, 2018, 60(9): 961-970. PMID: 30046856. DOI: 10.1007/s00234-018-2062-9.
	Huo L, Xu KL, Wang H. Clinical features of SARS-CoV-2-associated encephalitis and meningitis amid COVID-19 pandemic[J]. World J Clin Cases, 2021, 9(5): 1058. PMID: 33644169. PMCID: PMC7896657. DOI: 10.12998/wjcc.v9.i5.1058.
	Bekta? G, Ak?ay N, Boyda? K, et al. Reversible splenial lesion syndrome associated with SARS-CoV-2 infection in two children[J]. Brain Dev, 2021, 43(2): 230-233. PMID: 33082059. PMCID: PMC7553133. DOI: 10.1016/j.braindev.2020.10.002.
	Siow I, Lee KS, Zhang JJ, et al. Encephalitis as a neurological complication of COVID-19: a systematic review and meta-analysis of incidence, outcomes, and predictors[J]. European journal of neurology, 2021, 28(10): 3491-3502. PMID: 33982853. PMCID: PMC8239820. DOI: 10.1111/ene.14913.
	44 儿童COVID-19感染并发急性脑炎病程变化迅速, 吁请医师提高警觉并参考指引及时诊治(疾病管制署致医界通函第481号)[EB/OL]. (2022-05-27)[2022-06-12]. https://www.pediatr.org.tw/DB/News/file/4297-1.pdf?v=1663619830.
	Wang Y, Zhang D, Du G, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial[J]. Lancet, 2020, 395(10236): 1569-1578. PMID: 32423584. PMCID: PMC7190303. DOI: 10.1016/S0140-6736(20)31022-9.
	46 国家药品监督管理局. 国家药监局应急附条件批准辉瑞公司新冠病毒治疗药物奈玛特韦片/利托那韦片组合包装进口注册[EB/OL]. (2022-02-12)[2022-06-12]. https://www.nmpa.gov.cn/zhuanti/yqyjzxd/yqyjxd/20220212085753142.html.