2020年3月11日，SARS-COV-2被宣布为大流行，一种主要影响呼吸系统的病毒。在几个月之内，还报道了神经系统障碍，例如缺乏气味和味道，头晕和头痛。随着病毒继续从武汉传播到邻国和大陆，这些神经和精神病病例的患病率和严重程度越来越大。
关于Covid-19的神经和精神病症状的全国性监测研究明显缺乏，在武汉和法国只有少数案例研究和两项小人群研究。
这re are many vital questions to answer regarding the neurological and psychiatric effects of COVID. How common are neurological and psychiatric complications in COVID-19 patients? What proportion affects the central versus the peripheral nervous system, and are novel syndromes emerging? And who is at risk?
这Coro神经研究小组是一项合作努力，旨在跟踪Covid-19的可疑神经系统并发症。一个paperpublished late last year aimed to answer some of these questions in a UK cohort.
不同临床神经科学专业之间的合作
To evaluate the cases of neurological and psychiatric symptoms of COVID-19 an online network of rapid-response case reports was developed, with collaborations from various clinical neurosciences specialties headed by theCoroNerve Studies group.
Patients were stratified into a younger (under 60) group and an older (over 60) group, and symptoms were clustered into broader clinical syndromes associated with COVID-19 and classified into case definitions, including ‘Cerebrovascular event (abnormalities of the blood flow in the brain)’, ‘Altered Mental Status’, ‘Peripheral Neurology’, and ‘Encephalitis’.
Members of these professional organizations identified patients exhibiting these syndromes and a swift 5-minute clinical dataset was completed. It contained four critical components: diagnosis of COVID-19, demography, geography, and nature of the clinical syndrome.
What did these collaborative clinical datasets reveal?
153独特的情况下满足临床病例definitions in the UK were identified. Ages ranged between 23-94 years, with the median age being 71 years. Overall, 49% of cases were notified through BASP, 35% through ABN/CoroNerve.com, and 16% through the RCPsych portal. From 153 cases those without complete clinical datasets were excluded, leaving 125 cases.
在具有完整数据（125）的整个队列中，有62％（77）的脑血管事件和31％（39）名患者的精神状况改变，共同占神经系统和精神病学障碍的93％。在这些子集中，脑病和脑炎伴随着41％的精神状态患者，中风是最常见的脑血管事件（74％）。
96％的数据集具有年龄人口统计。与脑血管事件（18％[13]）相比，年轻患者的神经精神疗法数量不成比例（49％[18]），老年患者的脑血管并发症占主导地位（82％[61]）。
Covid-Clinical神经科学研究的未来
这是年轻队列中新的急性精神病并发症与Covid-19的新急性精神病并发症之间的联系的早期指标。衰老大脑的健康状况以及与此相关的危险因素的健康状况可以解释出脑血管并发症的较旧队列的数量不平等，这些问题因重症疾病而加剧。
这项研究是成年人与Covid-19的急性神经系统和精神病并发症的第一个快照。MRC资助COVID-CNS由本尼迪克特·迈克尔（Benedict Michael）博士领导的研究是数据收集的下一个阶段，是英国10多个网站的合作努力。这项研究将进一步深入研究两个关键问题：Covid-19造成伤害？哪些具体机制会造成这种损害？
This in-depth clinical, laboratory, and imaging study will compare COVID-19 patients with neurological/psychiatric complications, a control cohort with COVID-19 with no neurological/psychiatric complications, and another with respiratory problems without COVID-19.
这些患者将评估脑损伤，炎症和脑部扫描变化的标志，以及在不同时间点的症状，体征和脑功能的评估。这将是了解要使用哪种现有药物的关键，例如抗病毒药，或需要开发新药物以治疗这些神经系统作用。
协作是有意义的回应的关键
数据共享和开放协作是促进与COVID-19的发展有关的临床研究的关键。一旦进行了更深入的研究，就可以更容易地确定高危人群，机械测试将进一步研究疾病对中枢神经系统的影响。
不仅在神经和精神综合症中的未来大流行的准备和合作将是快速部署诊断，遏制和消除策略的推动力。
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