COVID-19 in a medical worker and issues of examination of the relationship between disease and occupation

Abstract

One of the most important complications of the novel coronavirus infection is damage to the nervous system. From the point of view of pathogenesis, neurological disorders in COVID-19 can be caused by a "cytokine storm", hypoxemia, homeostasis disorders (encephalopathy of critical conditions), neurotropy and neurovirulence of SARS-CoV-2 (isolated cranial nerve damage, focal and diffuse central nervous system lesions), as well as mixed effects of these factors. COVID-19 also affects the course of chronic neurological diseases. The range of neurological disorders in COVID-19 is wide: from cranial mononeuropathy, clinically manifested by anosmia and ageusia/dysgeusia, to acute Guillain-Barré inflammatory polyneuropathy and severe lesions of the brain and spinal cord in the form of acute hemorrhagic necrotizing encephalopathy and myelopathy. The new coronavirus infection can be regarded as an occupational disease in medical workers if the infection occurred while they were performing their professional duties. In the presented clinical case, one of the possible serious complications of the coronavirus infection is described, i.e. lesion of the central nervous system (encephalopathy) in a medical worker. The article presents the principles and results of a medical examination conducted in order to establish a causal relationship of the disease and professional activity. The need for a multidisciplinary approach to the diagnosis and treatment of COVID-19 and its complications with the mandatory participation of a neurologist is emphasized.