On 11th March 2020 SARS-CoV-2 was declared a pandemic, a virus predominantly affecting the respiratory system. Within months there were also reports of neurological disturbances such as lack of smell and taste, dizziness and headaches. As the virus continued to spread from Wuhan through to neighboring countries and continents there was an increasing prevalence and severity of these neurological and psychiatric cases.
There has been a distinct lack of country-wide surveillance studies on neurological and psychiatric symptoms in COVID-19, with only a handful of case studies and two small population studies in Wuhan and France.
关于Covid的神经和精神病作用，有许多重要的问题要回答。COVID-19患者的神经系统和精神病并发症有多常见？什么比例影响了中心与周围神经系统，并且出现了新型综合征？谁有危险？
The科罗Nerve Studies group is a collaborative effort seeking to track suspected neurological complications of COVID-19. A纸去年年底出版的目的是在英国队列中回答其中一些问题。
Collaboration between different clinical neuroscience specialties
为了评估COVID-19的神经和精神病症状病例，开发了一个快速响应病例报告的在线网络，并从各种临床神经科学专业的合作中进行了合作。科罗神经研究小组。
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’.
这些专业组织的成员确定了表现出这些综合症的患者，并且完成了5分钟的临床数据集。它包含四个关键组成部分：COVID-19的诊断，人口统计学，地理和临床综合征的性质。
这些协作临床数据集揭示了什么？
153个符合英国临床案例定义的独特案例已确定。年龄在23-94岁之间，中位年龄为71岁。总体而言，通过BASP通知了49％的病例，35％通过ABN/科罗NERVE.com，通过RCPSych Portal，为16％。从153例没有完整临床数据集的病例中，排除了125例。
Of the whole cohort with complete data (125), 62% (77) presented with a cerebrovascular event and 31% (39) of patients presented with altered mental status, collectively accounting for 93% of neurological and psychiatric disturbances. Within these subsets, encephalopathy and encephalitis accompanied 41% of the patients with altered mental status, and stroke was the most common cerebrovascular event (74%).
96% of the datasets had age demographics. There was a disproportionate number of neuropsychiatric presentations in younger patients (49% [18]) compared to the cerebrovascular events (18% [13]) and a predominance of cerebrovascular complications in the older patients (82% [61]).
The future of the COVID-Clinical Neuroscience Study
This is an early indicator of the link between new acute psychiatric complications in a younger cohort and COVID-19. The unequal number of the older cohort experiencing cerebrovascular complications could be explained by the state of health of the aging brain and the risk factors associated with this, these issues being exacerbated by critical illness.
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-CNSstudy led by Dr Benedict Michael is the next stage of data collection and is a collaborative effort from over 10 sites around the UK. This study will delve further into two key questions: for whom does COVID-19 cause injury? What specific mechanisms cause this damage?
这项深入的临床，实验室和成像研究将比较199例神经/精神病并发症的患者，这是一个与CoVID-19的对照组，没有神经/精神病并发症，另一个患有COVID-19的呼吸道问题。
Markers of brain injury, inflammation, and brain scan changes will be assessed in these patients, as well as evaluation of symptoms, signs, and brain function at different timepoints. This will be key to understanding which existing medications to use, such as antiviral drugs, or if new medications need to be developed to treat these neurological effects.
Collaborations are key for a meaningful response
Data sharing and open collaborations are key to facilitate clinical research which has been pertinent for COVID-19 developments. Once this more in-depth study has been conducted, at-risk groups can be more readily identified and mechanistic tests will delve further into the impact of the disease on the central nervous system.
Readiness and collaborations for future pandemics, not just in neurological and psychiatric syndromes, will be the driving force for the fast deployment of strategies to diagnose, contain and eradicate.
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