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2021, Número 4

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Rev Fac Med UNAM 2021; 64 (4)


Infección del sistema nervioso por el coronavirus SARS-CoV-2

Escobar PL, Martínez SSS, del Río QMA, Vaca DL

Idioma: Español
Referencias bibliográficas: 84
Paginas: 7-24
Archivo PDF: 1686.20 Kb.


RESUMEN

El síndrome respiratorio agudo severo es ocasionado por los coronavirus SARS-CoV. Los coronavirus SARS-CoV y SARSCoV- 2 se unen al receptor de angiotensina 2 (ECA2), que se localiza en el tejido epitelial y el endotelio vascular del cuerpo humano. Los efectos devastadores de la COVID-19 incluyen los vasos sanguíneos, el cerebro, el tracto gastrointestinal, los riñones, el corazón y el hígado. La tromboembolia, la coagulación intravascular diseminada, el daño cardiaco y la falla multiorgánica son complicaciones que aparecen de forma directa o indirecta con la COVID-19. Como otros coronavirus, el SARS-CoV-2 produce manifestaciones neurológicas. El epitelio olfatorio es la vía principal de acceso del virus al cuerpo, razón por la cual la pérdida del olfato y gusto es frecuente en la COVID leve. Sin embargo, la infección por el SARS-CoV-2 no cursa con rinorrea o congestión nasal, a diferencia de los coronavirus endémicos. Los síntomas nerviosos de la COVID-19 son variados e incluyen dolor de cabeza, mareos, enfermedad cerebrovascular aguda, epilepsia, trastornos psiquiátricos, encefalitis, neuropatía, embolia y manifestaciones asociadas al sistema nervioso periférico como hiposmia/anosmia, hipoageusia/ageusia, dolor muscular, desmielinización y síndrome de Guillian-Barre, entre otros. A la fecha, no se han encontrado respuestas definitivas que expliquen el amplio espectro de los efectos del SARS-CoV-2 en el sistema nervioso. En esta revisión se abordan los mecanismos fisiopatológicos principales que se han propuesto hasta le fecha, con la finalidad de entender mejor las posibles causas de las manifestaciones neurológicas a corto y largo plazo de los pacientes con COVID-19.


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