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Review
. 2023 Feb;94(2):84-92.
doi: 10.1007/s00115-022-01417-9. Epub 2022 Dec 15.

[Neurointensive care medicine and COVID-19]

[Article in German]
Konstantinos Dimitriadis  1   2 , Moritz Schmidbauer  3 , Julian Bösel  4
Affiliations
Review

[Neurointensive care medicine and COVID-19]

[Article in German]
Konstantinos Dimitriadis et al. Nervenarzt. 2023 Feb.

Abstract
in English, German

This review article summarizes important findings on the interfaces between the coronavirus disease 2019 (COVID-19) pandemic and neurology with an emphasis of the implications for neurointensive care medicine. More specifically, the prevalence, pathomechanisms and impact of neurological manifestations are reported. The most common neurological manifestations of critically ill COVID-19 patients are cerebrovascular complications, encephalopathies and intensive care unit-acquired weakness (ICUAW). A relevant direct pathophysiological effect by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself has not yet been established with certainty. In fact, indirect systemic inflammatory processes triggered by the viral infection and side effects of intensive care treatment are much more likely to cause the reported sequelae. The impact of the pandemic on patients with neurological disorders and neurointensive care medicine is far-reaching but not yet sufficiently studied.

Die vorliegende Übersichtsarbeit fasst wichtige Erkenntnisse der Schnittstellen Corona-virus-disease-2019(COVID-19)-Pandemie und Neurologie mit Fokus auf Neurointensivmedizin zusammen. Insbesondere werden auf Prävalenz, Pathomechanismen und Auswirkungen neurologischer Manifestationen eingegangen. Die häufigsten Manifestationen schwer kranker Intensivpatienten sind zerebrovaskuläre Komplikationen, Enzephalopathien und die „intensive care unit-acquired weakness“ (ICUAW). Ein direkter, neurodestruktiver Effekt durch das Virus an sich konnte bisher nicht sicher nachgewiesen werden. Vielmehr kommen ursächlich durch die virale Infektion ausgelöste systemische inflammatorische Prozesse sowie Nebenwirkungen der intensivmedizinischen Therapie infrage. Die Auswirkungen der Pandemie auf Patienten mit neurologischen Erkrankungen und die Neurointensivmedizin sind weitreichend, aber noch nicht ausreichend untersucht.

Keywords: Intensive care unit-acquired weakness; Neurological manifestations; Pathomechanisms; Prevalence; SARS-CoV‑2.

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