Patogénesis de las manifestaciones neuropsiquiátricas en COVID-19.
Pathogenesis of neuropsychiatric manifestations in COVID-19

Wilmer Peña, Ronald Cadenas, Andrés Vega

Resumen


En la actual pandemia por SARS-CoV-2, cada vez son más comunes y frecuentes las manifestaciones neurológicas y psiquiátricas. Los coronavirus tienen la capacidad de infectar neuronas y células gliales, es decir, presentan neurotropismo. Objetivo: Explorar la evidencia científica mundial y concreta sobre el neurotropismo y los mecanismos de patogénesis de las manifestaciones neurológicas y psiquiátricas descritos recientemente en la COVID-19. Metodología: enfoque cualitativo, de tipo exploratorio y diseño no experimental, documental y de corte transversal. Las referencias para esta revisión se obtienen mediante búsquedas en PubMed de artículos científicos publicados entre 2004 y 2020. Discusión: La COVID-19 tiene formas de presentación variables impredecibles. El desenlace y la severidad son mayores en pacientes con comorbilidades no tratadas y no controladas. Conclusiones: Los síntomas neuropsiquiátricos en la COVID-19 pueden iniciar antes que los síntomas respiratorios, y, presentarse en ausencia de clínica respiratoria y estudios imagenológicos de tórax sin lesiones aparentes. Recomendaciones: Emplear el RT-PCR como método diagnóstico, valoración periódica por neurología y estudios de neuroimagen seriados en usuarios con COVID-19 grave. Valoración mental y psicológica continúa en el personal de salud, casos confirmados, casos en remisión o de reincidencia.

In the current SARS-CoV-2 pandemic, neurological and psychiatric manifestations are becoming more common and frequent. Coronaviruses have the ability to infect neurons and glial cells, that is, they present neurotropism. Objective: Explore scientific evidence on the pathogenesis mechanisms of neurological and psychiatric manifestations in COVID-19. Methodology: qualitative approach, exploratory and non-experimental, documentary and cross-sectional design. References for this review are obtained by searching PubMed for scientific articles published between 2004 and 2020. Discussion: COVID-19 has unpredictable variable forms of presentation. The outcome and severity is greater in patients with untreated and uncontrolled comorbidities. Conclusions: Neuropsychiatric symptoms in COVID-19 can begin earlier than respiratory symptoms, and present in the absence of respiratory symptoms and chest imaging studies without apparent lesions. Recommendations: Use RT-PCR as diagnostic method, periodic evaluation by neurology and serial neuroimaging studies in users with severe COVID-19. Continuous mental and psychological evaluation in the health personnel, confirmed cases, cases in remission or recidivism.


Palabras clave


Neurología; Neuropsiquiatría; Neurotropismo; COVID-19; Pandemia. Neurology; Neuropsychiatry; Neurotropism; COVID-19; Pandemic.

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Referencias


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