Manifestasi neurologis pada COVID-19

Abstract

Coronavirus (CoV) is a large family of viruses that cause illness ranging from mild to severe symptoms known as Coronavirus Disease 2019 (COVID-19) which is a new type of disease that has never been previously identified in humans. Clinical manifestations appear within 2 to 14 days after exposure. Common signs and symptoms of COVID-19 infection vary from asymptomatic, mild symptoms, severe, to lead to fatal conditions and death. Common symptoms include acute respiratory distress such as fever, fatigue, myalgia, arthralgia, sore throat, cough, sputum production, shortness of breath and gastrointestinal symptoms such as diarrhea, nausea, vomiting, leading to multiple systemic infections and multi-organ failure. Neurological manifestations were found in patients infected with COVID-19 with varied symptoms and there were differences in the grouping of neurological manifestations reported from one literature to another. The neurological manifestations that appear in COVID-19 patients are divided into central nervous system (CNS) and peripheral nervous system (PNS) manifestations, and some are grouped into neurological manifestations with specific symptoms and non-specific symptoms. The neurological manifestations of the CNS include dizziness, headache, impaired consciousness, acute cerebrovascular disease, ataxia, and seizures. Meanwhile, the manifestations of PNS are impaired taste, olfactory disturbances, visual disturbances, pain in nerve distribution, and symptoms of skeletal muscle injury. Writing this literature aims to understand more deeply about neurological manifestations of COVID-19 and its mechanisms that can help determine targeted therapy and reduce the severity and reduce mortality of this disease.

ABSTRAK

Coronavirus (CoV) adalah virus yang menyebabkan penyakit mulai dari gejala ringan sampai berat yang dikenal dengan Coronavirus Disease 2019 (COVID-19). Manifestasi klinis muncul dalam 2 hingga 14 hari setelah paparan. Tanda dan gejala umum infeksi COVID-19 bervariasi mulai dari asimtomatik, gejala ringan, berat, hingga mengakibatkan kondisi yang fatal dan kematian. Gejala umum berupa gejala gangguan pernapasan akut seperti demam, fatigue, mialgia, artralgia, nyeri tenggorokan, batuk, produksi sputum, sesak napas dan gejala gastrointestinal seperti diare, nausea, vomitus hingga menyebabkan infeksi sistemik multipel dan kegagalan multiorgan. Manifestasi neurologis dijumpai pada pasien yang terinfeksi COVID-19 dengan gejala yang bervariasi dan terdapat perbedaan pengelompokan manifestasi neurologis yang dilaporkan antara literatur yang satu dengan yang lainnya. Manifestasi neurologis yang muncul pada pasien COVID-19 terbagi menjadi manifestasi central nervous system (CNS) dan peripheral nervous system (PNS), dan ada pula yang mengelompokkan ke dalam manifestasi neurologis dengan gejala yang spesifik dan gejala nonspesifik. Manifestasi neurologis CNS di antaranya adalah dizziness, nyeri kepala, gangguan kesadaran, acute cerebrovascular disease, ataksia, dan kejang. Sementara untuk manifestasi PNS adalah gangguan pengecapan, gangguan penciuman, gangguan penglihatan, nyeri pada distribusi saraf, dan gejala skeletal muskular injury. Penulisan tinjauan pustaka ini bertujuan untuk mengkaji lebih dalam mengenai manifestasi neurologis pada COVID-19 beserta mekanismenya yang mendasari sehingga dapat membantu menentukan target terapi dan mengurangi derajat keparahan (severitas) serta menurunkan mortalitas penyakit ini.