clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2024-102-9-10-707-713clinmed-946Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПатогенез поражений нервной системы и клинические синдромы новой коронавирусной инфекции COVID-19Pathogenesis of nervous system lesions and clinical syndromes of the new coronavirus infection COVID-19https://orcid.org/0000-0001-8391-1691ПаценкоМ. Б.PatsenkoM. B.

Паценко Михаил Борисович — д-р мед. наук, доцент, главный терапевт Минобороны России, начальник кафедры терапии неотложных состояний филиала

Москва

AuthorID 1122515

Mikhail B. Patsenko — Doctor of Medical Sciences, Associate Professor, Chief Therapist of the Ministry of Defense of the Russian Federation, Head of the Department of Emergency Medicine 

Moscow

https://orcid.org/0000-0002-2727-4090ГлоткоВ. Л.GlotkoV. L.

Глотко Владимир Леонидович — д-р мед. наук, доцент кафедры терапии неотложных состояний филиала

Москва

AuthorID: 638113

Vladimir L. Glotko — Doctor of Medical Sciences, Associate Professor of the Department of Emergency Medicine 

Moscow

ШироковЕ. А.ShirokovE. A.

Широков Евгений Алексеевич — д-р мед. наук, профессор кафедры кардиологии

Москва

AuthorID: 481848

Evgeniy A. Shirokov — Doctor of Medical Sciences, Professor of the Department of Cardiology

Moscow

https://orcid.org/0000-0002-2330-8302ГайворонскийИ. Н.GaivoronskiiI. N.

Гайворонский Иван Николаевич — канд. мед. наук, доцент кафедры терапии неотложных состояний

Москва

Ivan N. Gaivoronskii — Candidate of Medical Sciences, Associate Professor of the Department of Emergency Medicine 

Moscow

ФГБВОУ ВО «Филиал Военно-медицинской академии им. С.М. Кирова» в г. Москве, Минобороны РоссииРоссияMilitary Medical Academy named after S.M. Kirov (Branch, Moscow) of the Ministry of Defense of the RussiaRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of the RussiaRussian Federation2024050220251029-10707–713Copyright © Паценко М.Б., Глотко В.Л., Широков Е.А., Гайворонский И.Н., 20252025Паценко М.Б., Глотко В.Л., Широков Е.А., Гайворонский И.Н.Patsenko M.B., Glotko V.L., Shirokov E.A., Gaivoronskii I.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/946

На основании анализа литературных данных освещены вопросы неврологических осложнений после новой коронавирусной инфекции COVID-19. Существует мало доказательств прямого механизма нейроинвазивности и нейротоксичности вируса SARS-CoV-2. Обсуждаются различные механизмы проникновения коронавирусов в головной мозг — антероградный и ретроградный, нейрональное распространение, транскрипционный и гематогенный пути. Ретроградный/антероградный транспорт и транссинаптический перенос вируса подтверждены исследованиями in vitro. Проникновение вируса в центральную нервную систему возможно также путем распространения по периферическим нервам, например, по блуждающему, который иннервирует легкие и кишечник. Есть несколько возможных механизмов распространения SARS-CoV-2 через гематоэнцефалический барьер: циркуляция вирусных частиц в кровотоке, вирусный трансцитоз через эндотелиальные клетки сосудов и капилляров, инфицирование вирусами лейкоцитов и перенос ими вирусов сквозь гематоэнцефалический барьер. Гипоксия, вызванная цитокиновым штормом, и респираторный дистресс приводят к нарушению метаболизма мозга и развитию неврологических осложнений.

Цель работы

Цель работы. Анализ данных литературы по изучению ранних и отдаленных проявлений неврологических нарушений и болезней при новой коронавирусной инфекции, постковидном синдроме (long COVID-19), а также после вакцинации.

Результаты

Результаты. Среди большого количества нарушений нервной системы выделяют пять основных видов с длительно существующими неврологическими осложнениями, связанных с СOVID-19: 1) энцефалопатии с делирием/психозом; 2) воспалительные синдромы центральной нервной системы; 3) ишемические инсульты; 4) периферические невропатии, в частности, синдром Гиена–Барре и плечевые плексопатии; 5) другие расстройства центральной нервной системы.

Based on the analysis of literature data, the issues of neurological complications after the new coronavirus infection COVID-19 are highlighted. There is little evidence for a direct mechanism for the neuroinvasiveness and neurotoxicity of the SARS-CoV-2 virus. Various mechanisms of coronavirus penetration into the brain are discussed - anterograde and retrograde, neuronal spread, transcriptional and hematogenous pathways. Retrograde/anterograde transport and transsynaptic transfer of the virus have been confi rmed by in vitro studies. Penetration of the virus into the central nervous system is also possible by spreading through peripheral nerves, for example, along the vagus nerve, which innervates the lungs and intestines. There are several possible mechanisms for the spread of SARS-CoV-2 across the blood-brain barrier: circulation of viral particles in the bloodstream, viral transcytosis through endothelial cells of blood vessels and capillaries, infection of leukocytes by viruses and transfer of viruses through the blood-brain barrier. Hypoxia caused by cytokine storm and respiratory distress lead to disruption of brain metabolism and the development of neurological complications.

Aim

Aim. Analysis of literature data on the study of early and long-term manifestations of neurological disorders and diseases during a new coronavirus infection, postCovid syndrome (long COVID-19), as well as after vaccination.

Results

Results. Among the large number of nervous system disorders, there are five main types with long-term neurological complications associated with COVID-19: 1) encephalopathy with delirium/psychosis; 2) inflammatory syndromes of the central nervous system; 3) ischemic strokes; 4) peripheral neuropathies, in particular Guillain–Barre syndrome and brachial plexopathies; 5) other disorders of the central nervous system.

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