DERLEMELER
Fiziksel Tıp ve Rehabilitasyon Pratiğinde Sık Karşılaşılabilecek, COVID-19 ile İlişkili Kas-İskelet Sistemi Etkilenimleri ve Nörolojik Etkilenimler-Kısa Derleme
COVID-19 Related Musculoskeletal System Effects and Neurological Effects That May Be Encountered Frequently in Physical Medicine and Rehabilitation Practice-Brief Review
Received Date : 03 Dec 2020
Accepted Date : 04 Jan 2021
Available Online : 17 Mar 2021
Elzem BOLKANa, Okan GÜNAYDINb, Emine Gözde AYDEMİR GÜLÖKSÜZc
aUfuk Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE bDışkapı Yıldırım Beyazıt Üniversitesi Yenimahalle Eğitim ve Araştırma Hastanesi, Acil Servisi Fiziksel Tıp ve Rehabilitasyon ABD, Ankara, TÜRKİYE cAnkara Üniversitesi Tıp Fakültesi, İç Hastalıkları ABD, Romatoloji BD, Ankara, TÜRKİYE
Doi: 10.31609/jpmrs.2020-80365 - Makale Dili: TR
J PMR Sci. 2021;24(2):164-8
ÖZET
Mart 2020’de pandemi olarak ilan edilen yeni tip koronavirüs
hastalığı-2019 [coronavirus disease-2019 (COVID-19)], esas olarak solunum
sistemi belirti ve bulguları ile seyretmektedir. Şiddetli akut solunum
sendromu-koronavirüs-2 virüsünün giriş reseptörü olan
anjiyotensin dönüştürücü enzim 2 reseptörlerinin, vücutta yaygın doku
dağılımı mevcuttur. Bu nedenle hastalıkta solunum sistemi belirti ve
bulgularının yanı sıra diğer sistemlerle ilgili semptom ve bulgular da izlenebilmektedir.
Literatürde, COVID-19 ile birlikte görüldüğü en sık
bildirilen kas-iskelet sistemi etkilenimleri artralji, miyalji, yorgunluk
ve kas zayıflığı; nörolojik etkilenim tabloları serebrovasküler olay, baş
ağrısı, sersemlik hissi, bilinç bozuklukları, epilepsi, ataksi, akut dissemine
ensefalomiyelit, viral ensefalit, koku ve/veya tat duyusunda
azalma veya kayıp ve diğer kraniyal sinir tutulumları ile seyreden klinik
tablolar ve Guillain-Barré sendromunu içermektedir. Hastalığın başlangıcında
nonspesifik veya hafif solunum sistemi şikâyeti olan
COVID-19 hastaları, fiziksel tıp ve rehabilitasyon pratiğinde sık karşılaşılan
artralji ve miyalji başta olmak üzere kas-iskelet sistemi ve sinir
sistemi semptom ve bulgularıyla başvurabileceğinden, bu semptom ile
bulguların COVID-19’da izlenen solunum sistemi semptom ve bulgularından
önce de ortaya çıkabildiği gösterildiğinden, ayrıcı tanıda
COVID-19’un akılda tutulması önemlidir. Bu bakış açısı oldukça bulaşıcı
olduğu görülen bu hastalıkta, hastaların tanı ve izolasyonunun
daha erken yapılmasına katkı sağlaması açısından önemlidir.
Anahtar Kelimeler: COVID-19; miyalji; artralji; nörolojik semptomlar
ABSTRACT
The novel coronavirus disease-2019 (COVID-19), declared
as a pandemic in March 2020, mainly progresses with respiratory
system signs and symptoms. Angiotensin converting enzyme-2
receptors, which are the entrance receptors of the severe acute respiratory
syndrome-coronavirus-2, have a common tissue distribution in
the body. Therefore, in addition to respiratory system signs and symptoms,
symptoms and signs related to other systems can be observed in
the disease. In the literature, the most frequently reported musculoskeletal
effects associated with COVID-19 are arthralgia, myalgia,
fatigue and muscle weakness; neurological effects associated with
COVID-19 are cerebrovascular events, headache, dizziness, consciousness
disorders, epilepsy, ataxia, acute disseminated encephalomyelitis,
viral encephalitis, decreased or loss of sense of smell
and/or taste, and other cranial nerve involvement, and Guillain-Barré
syndrome. Since COVID-19 patients with nonspecific or mild respiratory
system complaints at the beginning of the disease may present
with symptoms and signs of the musculoskeletal and nervous system,
especially arthralgia and myalgia, which are common in physical
medicine and rehabilitation practice and these symptoms and signs
may precede the respiratory system symptoms and signs observed in
COVID-19, it is important to keep COVID-19 in mind in differential
diagnosis. This point of view is thought to contribute to the diagnosis
and isolation of patients earlier in this disease, which seems to be
highly contagious.
Keywords: COVID-19; myalgia; arthralgia; neurological symptoms
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