病毒载荷在COVID-19引起的脑炎中的作用
Lerzan Dogan1, Dilaver Kaya2, Neval Yurtturan Uyar3
1Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydınlar University, Istanbul 34752, Turkey.
Journal of clinical medicine
|March 14, 2026
概括
较高的SARS-CoV-2病毒载荷和升高的D-二次体水平与重症COVID-19患者脑炎风险增加有关. 这些标记可能有助于识别需要更密切的神经监测的患者.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 急性脑炎是一种与SARS-CoV-2 (导致COVID-19的病毒) 相关的严重神经并发症.
- 中枢神经系统参与COVID-19的确切机制尚不清楚.
- 识别脑炎的危险因素对于管理重症患者至关重要.
研究的目的:
- 调查SARS-CoV-2病毒载量,D-二次体水平和重症患者脑炎的发展之间的关联.
- 为了确定中枢神经系统参与COVID-19的预测因素.
主要方法:
- 对450名已成年ICU患者进行了回顾性队列研究,确认了SARS-CoV-2感染.
- 患者被分为脑炎阳性 (E+) 和脑炎阴性 (E-) 组.
- 分析包括患者特征,病毒载量 (Ct值),D-二次数水平以及使用ROC分析和Cox回归的临床结果.
主要成果:
- 脑炎阳性患者年龄较大,SARS-CoV-2 Ct值显著降低 (病毒载量较高) 和D-二次体水平升高.
- 脑炎患者经历了更长时间的机械呼吸和ICU停留.
- 在ICU入院时,较低的Ct值和较高的D-二聚合物水平是脑炎的独立风险因素.
结论:
- 较高的SARS-CoV-2病毒载荷 (较低的Ct值),年龄较大和D-二次体水平升高与COVID-19相关脑炎的风险增加有关.
- 这些标记可以帮助识别神经复杂症的高风险患者.
- 需要进一步的研究来了解潜在的病理生理学.
相关概念视频
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:25Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
01:27Cytomegalovirus Disease
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
01:26Bacterial Meningitis II: Pathophysiology
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...