{"id":17355,"date":"2021-04-29T12:00:14","date_gmt":"2021-04-29T10:00:14","guid":{"rendered":"https:\/\/idibell.cat\/?p=17355"},"modified":"2021-04-29T12:00:14","modified_gmt":"2021-04-29T10:00:14","slug":"el-60-dels-pacients-hospitalitzats-per-covid-19-desenvolupen-simptomatologia-neurologica","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2021\/04\/el-60-dels-pacients-hospitalitzats-per-covid-19-desenvolupen-simptomatologia-neurologica\/","title":{"rendered":"El 60% dels pacients hospitalitzats per Covid-19 desenvolupen simptomatologia neurol\u00f2gica"},"content":{"rendered":"<p>\u201cHem pogut observar que el SARS-CoV-2 t\u00e9 diverses vies per produir afectaci\u00f3 neurol\u00f2gica: per invasi\u00f3 directa de virus en el sistema nervi\u00f3s central, a trav\u00e9s de la resposta immune, o sobretot per afectaci\u00f3 indirecta. La invasi\u00f3 directa sembla anecd\u00f2tica i molt poc probable\u201d, assenyala el Dr. Cardona, que va moderar la taula <em>Afectaci\u00f3 neurol\u00f2gica en pacients amb Covid-19<\/em>.<\/p>\n<p>\u201cEn els pocs casos en qu\u00e8 s&#8217;ha detectat pres\u00e8ncia de virus en c\u00e8l\u00b7lules del sistema nervi\u00f3s central \u2013afegeix\u2013, aquest sembla haver pogut envair el sistema per tres vies diferents: l\u2019olfact\u00f2ria, mitjan\u00e7ant el l\u00edquid cefalorraquidi o pel torrent sanguini. A m\u00e9s, l&#8217;autoimmunitat tamb\u00e9 podria explicar alguns dels pocs casos trobats de dismielinitzaci\u00f3 (s\u00edndrome de Guillain-Barr\u00e9). En tot cas, la gran majoria d\u2019afectacions neurol\u00f2giques en pacients Covid-19 han estat indirectes, ja siguin com a resposta inflamat\u00f2ria, coagulopatia i\/o danys sobre l&#8217;endoteli vascular o mioc\u00e0rdic, o b\u00e9 per complicacions secund\u00e0ries\u201d.<\/p>\n<p>Un dels \u00faltims estudis que s\u2019han realitzat fins ara indiquen que el 60% dels pacients hospitalitzats per Covid-19 van tenir s\u00edmptomes neurol\u00f2gics, encara que en el 85% dels casos van ser s\u00edmptomes lleus i inespec\u00edfics. Entre ells es troben dolor muscular, encefalitis, encefalopaties, mielitis, crisis epil\u00e8ptiques, neuropaties o, de forma m\u00e9s prevalent, an\u00f2smia (p\u00e8rdua d&#8217;olfacte) i cefalees. Altres complicacions m\u00e9s severes s\u00f3n els accidents cerebrovasculars, com ara els ictus isqu\u00e8mics o hemorr\u00e0gics, o les trombosis venoses cerebrals.<\/p>\n<p>Pel que fa a l\u2019an\u00f2smia, a m\u00e9s de tenir un bon pron\u00f2stic, s\u2019ha identificat com un dels s\u00edmptomes m\u00e9s habituals en persones joves, en dones i en persones amb algun tipus d&#8217;afecci\u00f3 neurol\u00f2gica pr\u00e8via.<\/p>\n<p>Respecte a la cefalea, s&#8217;ha descrit un tipus de mal de cap molt espec\u00edfic i associat al virus. \u00c9s una cefalea semblant a la migranya, de caracter\u00edstiques opressives, que empitjora amb l&#8217;activitat i els moviments de cap, que desperta a la nit a un 33% dels pacients i que, en ocasions, ve acompanyada d&#8217;hipersensibilitat. Es creu que els episodis de cefalees poden ser deguts a la resposta inflamat\u00f2ria. Entre un 10 i un 20% dels amb aquesta simptomatologia desenvolupen una cefalea cr\u00f2nica.<\/p>\n<p>Encara que menys freq\u00fcents, els accidents cerebrovasculars s\u00f3n molt m\u00e9s greus. S\u2019apunta a un increment del risc de patir ictus isqu\u00e8mic del 1-2% i de fins el 4% de trombosis cerebral. Alguns grups internacionals situen la mortalitat per ictus en persones amb Covid-19 en 59%. A l\u2019Hospital de Bellvitge, els casos d&#8217;ictus en pacients amb Covid-19 van suposar entre el 15 i el 20% dels casos totals.<\/p>\n<p>De forma general, un recent estudi realitzat a Espanya assenyala que el 51% de pacients que ha sobreviscut a la Covid-19 han desenvolupat seq\u00fceles que poden prolongar-se fins a 12 mesos. Entre elles, els s\u00edmptomes neurol\u00f2gics arriben a un 12% dels pacients post-Covid i entre ells destaquen sobretot la cefalea i els problemes cognitius (l\u2019anomenada \u201cboira mental\u201d). Tamb\u00e9 s\u00f3n molt habituals altres s\u00edmptomes no exclusivament neurol\u00f2gics com poden ser la fatiga o el dolor muscular (m\u00e9s del 50% dels pacients que han passat la Covid-19). A m\u00e9s, el mal de cap, la fatiga i el dolor muscular figuren entre les seq\u00fceles m\u00e9s persistents.<\/p>\n<p>D\u2019altra banda, el Dr. Cardona ha explicat que \u201cla incid\u00e8ncia de trombosi venosa cerebral en relaci\u00f3 amb la vacuna \u00e9s molt anecd\u00f2tica. No ha calgut modificar els fluxos de treball en Neurologia ni en els circuits assistencials a Urg\u00e8ncies, tot i que s\u00ed que hem observat un lleu increment de consultes per cefalea tant en atenci\u00f3 prim\u00e0ria com als hospitals&#8221;.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em>L\u2019Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l&#8217;Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l&#8217;Institut Catal\u00e0 de la Salut, l&#8217;Institut Catal\u00e0 d&#8217;Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/em><\/p>\n<p><em>L\u2019IDIBELL \u00e9s membre del Campus d&#8217;Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L&#8217;any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>El 60% dels pacients hospitalitzats per Covid-19 desenvolupen simptomatologia neurol\u00f2gica i un 12% dels pacients post-Covid tenen seq\u00fceles neurol\u00f2giques<\/p>\n","protected":false},"author":8,"featured_media":17362,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[416,340,457],"tags":[],"class_list":["post-17355","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-malalties-neurologiques-i-neurogenetica","category-neurociencies","category-p-de-neurociencies"],"publishpress_future_action":{"enabled":false,"date":"2024-12-25 08:39:58","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/17355","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=17355"}],"version-history":[{"count":0,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/17355\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/17362"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=17355"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=17355"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=17355"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}