In December 2019, an outbreak of illness caused by a novel coronavirus (2019-nCoV, subsequently renamed SARS-CoV-2) was reported in Wuhan, China. Coronavirus disease 2019 (COVID-19) quickly spread worldwide to become a pandemic. Typical manifestations of COVID-19 include fever, dry cough, fatigue, and respiratory distress. In addition, both the central and peripheral nervous system can be affected by SARS-CoV-2 infection. These neurological changes may be caused by viral neurotropism, by a hyperinflammatory and hypercoagulative state, or even by mechanical ventilation-associated impairment. Hypoxia, endothelial cell damage, and the different impacts of different ventilatory strategies may all lead to increased stress and strain, potentially exacerbating the inflammatory response and leading to a complex interaction between the lungs and the brain. To date, no studies have taken into consideration the possible secondary effect of mechanical ventilation on brain recovery and outcomes. The aim of our review is to provide an updated overview of the potential pathogenic mechanisms of neurological manifestations in COVID-19, discuss the physiological issues related to brain-lung interactions, and propose strategies for optimization of respiratory support in critically ill patients with SARS-CoV-2 pneumonia.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, neurological manifestations, neurotropism, 【초록키워드】 Coronavirus disease 2019, pandemic, Stress, mechanical ventilation, fatigue, SARS-COV-2 infection, 2019-nCoV, lung, Brain, Novel coronavirus, Spread, outcomes, outbreak, Impact, Fever, nervous system, SARS-CoV-2 pneumonia, change, pathogenic mechanism, interactions, Inflammatory response, distress, Respiratory Support, neurological, manifestation, physiological, Critically ill patient, dry cough, impairment, complex interaction, ventilatory strategy, endothelial cell damage, Hyperinflammatory, neurological manifestation, Wuhan, China, affected, caused, include, reported, addition, exacerbating, Typical, 【제목키워드】 manifestation, setting, Potential, Mechanical,