在COVID-19后患者的认知症状的表征
Michael Ruzicka1, Simone Sachenbacher2, Fides Heimkes2
1Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Munich, Germany. michael.ruzicka@med.uni-muenchen.de.
概括
后COVID-19认知症状是常见的. 神经认知测试显示,在一些患者中出现轻微损伤,而脑部成像很少出现异常. 严重的认知症状与抑郁,疲劳和生活质量下降相关.
科学领域:
- 神经学 神经学
- 精神病学是一个精神病学.
- 传染性疾病 传染性疾病
背景情况:
- 认知症状 (CS) 在COVID-19后 (PC) 状态中很普遍.
- 对PC患者的CS的客观评估对于理解和管理至关重要.
- 现有的研究往往依赖于自我报告的症状,需要客观的诊断方法.
研究的目的:
- 客观地评估PC患者的认知症状,使用神经认知测试 (NCT) 和脑成像 (BI).
- 调查CS严重程度与患者报告结果 (PROs) 之间的关联,包括心理健康和生活质量.
- 确定有助于PC中CS发展的潜在风险因素.
主要方法:
- 315名PC患者的队列在感染后大约6个月被评估.
- 收集了临床数据和PRO,其中一个子集接受了NCT (n=78) 和BI (n=55).
- 标准化的评估包括认知测试,脑成像和验证的问卷 (PHQ-9,FSS,WHOQOL-BREF).
主要成果:
- 73.3%的PC患者报告了CS.
- 虽然NCT主要在工作记忆,注意力和注意力集中方面发现了轻微的障碍,但很少有人超过了病理值.
- 神经认知表现在严重的和不严重的CS组之间没有显著差异. 只有14.5%的BI发现异常,可能与PC无关.
- 严重的CS与更高的抑郁症得分 (PHQ-9),疲劳 (FSS),生活质量下降 (WHOQOL-BREF) 和精神病诊断的更大患病率密切相关.
结论:
- 神经认知测试可以确认一些PC患者的轻度认知缺陷,但结果可能并不总是与症状严重程度相关.
- 大脑成像很少异常,不太可能与PC相关的认知症状直接相关.
- 在PC中认知症状的严重程度与显著的心理痛苦有关,包括抑郁,疲劳和生活质量下降,强调需要进行全面的神经心理评估.
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