长期COVID中的病理生理机制:混合方法系统审查
Nawar Diar Bakerly1,2, Nikki Smith3, Julie L Darbyshire4
1Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK.
概括
长期COVID涉及多个器官系统和症状,这些症状是由各种机制驱动的,例如免疫失调和气体交换受损. 一种"可治疗特征"的方法可以为这个复杂的全球健康问题个性化干预措施.
科学领域:
- 医学研究 医学研究
- 公共卫生 公共卫生
- 免疫学 免疫学 免疫学
背景情况:
- 长期COVID (LC) 是一个重大的全球健康挑战,影响全球超过7000万个人.
- 不同的LC症状越来越多地与不同的病理生理机制有关.
- 了解这些机制对于有效的临床管理和确定治疗点至关重要.
研究的目的:
- 系统地审查和综合有关长期COVID症状背后的病理生理机制的证据.
- 探索已识别的机制与长期COVID的临床表现之间的关系.
- 为长期COVID的有针对性的治疗策略的开发提供信息.
主要方法:
- 进行了两阶段混合方法系统审查.
- 第一阶段涉及对现有系统性审查的元综述;第二阶段审查了初级研究.
- 在主要数据库 (Medline,Embase,Emcare,CINAHL) 中确定了研究,并对其质量进行了评估.
主要成果:
- 免疫系统调节失调,大脑低 perfusion 和肺气体转移受损的强有力的证据显示为LC机制.
- 内皮损伤,高凝血,巨细胞激活,以及对血管受体的自身免疫力都有中度到微弱的证据.
- 在初级研究中,报告质量通常为中等到差.
结论:
- 长期COVID是一个复杂的,多器官状况,由多种病理生理机制驱动的多种表现.
- 建议采用"可治疗特征"的方法来分层患者并指导有针对性的干预措施.
- 未来的研究应该专注于基于这些基于机制的特征的干预反应.
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