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在怀疑COVID-19后患有后病毒综合征的患者中,SARS-CoV-2-特定免疫反应

Zachary S Orban¹, Lavanya Visvabharathy¹, Gina S Perez Giraldo¹

¹From the Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Neurology(R) neuroimmunology & neuroinflammation

|August 23, 2023

概括

许多患有后病毒综合征 (PVS) 的美国人表现出之前接触过SARS-CoV-2的迹象,即使没有COVID-19诊断. 这表明,在疫情初期暴露的数百万人可能有未被诊断的神经PASC,需要类似的护理和研究纳入.

科学领域:

免疫学免疫学免疫学
神经学神经学
传染性疾病传染性疾病

背景情况:

由于测试的局限性,在疫情初期暴露于SARS-CoV-2的数百万人缺乏COVID-19诊断.
许多人患有后病毒综合征 (PVS),神经症状类似于SARS-CoV-2感染 (Neuro-PASC) 的后急性后果.
西北医学院的Neuro COVID-19诊所评估了患有PVS的患者,而不需要证明有SARS-CoV-2感染.

研究的目的:

调查临床和免疫学发现,表明PVS患者的SARS-CoV-2暴露.
为了比较疑似暴露的PVS患者和确定的Neuro-PASC患者之间的免疫反应,症状和认知功能.

主要方法:

测量了SARS-CoV-2 特定的幽默和细胞介导免疫反应对抗核囊和尖端蛋白.
研究了29名PVS患者,32名确诊的神经PASC患者和18名健康对照.
追溯分析了神经系统症状,并发症,生活质量和认知测试数据.

主要成果:

41%的PVS患者 (12/29) 具有可检测的免疫反应,表明先前的SARS-CoV-2暴露 (PVS+).
PVS+患者表现出与Neuro-PASC患者相似的神经症状,但从症状发作 (10.7个月对5.4个月) 后评估.
PVS+和Neuro-PASC患者报告了类似的生活质量损害; PVS+患者表现出类似或更好的客观认知功能.

结论:

免疫检测显示,PVS组中约40%的患者先前暴露于SARS-CoV-2,突出显示需要多目标免疫学评估.
缺乏COVID-19诊断可能推迟了PVS患者的临床护理,这表明数以百万计的PVS症状可能在早期暴露于大流行.
与Neuro-PASC相似的PVS患者应获得与COVID-19确诊患者相似的护理和研究包容.

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