Komplikasi Sistem Saraf Pusat pada COVID-19 - Tasia Esterita; Budi Riyanto Wreksoatmodjo (PT Kalbe Farma Tbk., 2021)
Coronavirus disease-19 disebabkan oleh virus SARS-CoV-2 yang menyebabkan pandemi sejak Maret 2020. COVID-19 tidak hanya menyebabkan komplikasi pernapasan dan kardiovaskular, tetapi dapat menyebabkan komplikasi sistem saraf pusat yang juga berkontribusi terhadap mortalitas dan morbiditas. Beberapa komplikasi sistem saraf pusat pada COVID-19 adalah stroke iskemik, stroke hemoragik, meningoensefalitis, acute transverse myelitis, dan ensefalopati. Stroke iskemik pada COVID-19 disebabkan oleh beberapa mekanisme, di antaranya koagulopati, disfungsi endotel, kardioemboli, invasi virus ke sistem saraf pusat, dan terapi imunoglobulin. Stroke hemoragik dapat disebabkan oleh kerusakan endotel akibat inflamasi menyebabkan disregulasi tekanan darah yang meningkatkan risiko stroke hemoragik. Meningoensefalitis pada COVID-19 disebabkan invasi virus langsung melalui cribriform plate atau karena kerusakan endotel yang menjadi pintu masuk SARS-CoV-2 ke otak. Mielitis transversa pada COVID-19 disebabkan hiperinflamasi sistemik, molecular mimicry, dan epitope spreading. Kegagalan organ multipel pada pasien COVID-19 akibat badai sitokin dapat menyebabkan ensefalopati. Coronavirus disease-19 is caused by the SARS-CoV-2 virus that has been causing a pandemic since March 2020. Besides respiratory and cardiovascular complications, COVID-19 can cause complications to central nervous system that also contribute to mortality and morbidity. Some central nervous system complications in COVID-19 are ischemic stroke, hemorrhagic stroke, meningoencephalitis, acute transverse myelitis, and encephalopathy. Ischemic stroke in COVID-19 is caused by several mechanisms, including coagulopathy, endothelial dysfunction, cardioembolism, viral invasion of the central nervous system and immunoglobulin therapy. Hemorrhagic stroke can be associated with blood pressure dysregulation caused by inflammational endothelial damage. Meningoencephalitis in COVID-19 can be caused by direct viral invasion through the cribriform plate or due to endothelial damage that facilitate SARS-CoV-2 entrance to the brain. Transverse myelitis in COVID-19 is caused by systemic hyperinflammation, molecular mimicry and epitope spreading. Multiple organ failure in COVID-19 patients due to a cytokine storm can lead to encephalopathy.