在SARS-CoV2感染的神经学后急性后果中持续自主和免疫学异常
David S Goldstein1, Yair Mina1, Brian Walitt1
1From the Autonomic Medicine Section (D.S.G., P.S., J.G., R.I., S.M.), and Infections of the Nervous System Section (Y.M., A.W., B.S.) Clinical Neurosciences Program (CNP), Division of Intramural Research (DIR), National Institute of Neurological Disorders and Stroke (NINDS), NIH, Bethesda, MD; Sackler Faculty of Medicine (Y.M.), Tel Aviv University, Israel; Office of the Clinical Director (B.W., A.N.), and Viral Immunology Section (Y.E.-A., S.J.), DIR, NINDS; and Echocardiography Laboratory (M.-L.N., S.S.), DIR, National Heart, Lung, and Blood Institute, Bethesda, MD.
大多数神经后急性SARS-CoV2 (Neuro-PASC) 患者在首次COVID-19感染一年后表现出持续的自主和免疫异常. 这些长期的神经症状会影响中枢神经系统的功能和自主调节.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
背景情况:
- 称为Neuro-PASC的SARS-CoV-2感染后急性后果通常包括神经症状,如疲劳和认知功能障碍.
- 这些神经PASC异常持续超过一年,需要进一步调查.
研究的目的:
- 评估Neuro-PASC.患者神经和生理异常的长期持续性.
- 评估Neuro-PASC患者的初始发现是否至少在一年后仍然存在.
主要方法:
- 涉及Neuro-PASC患者进行综合住院检测的观察性研究.
- 随访评估包括症状评级,MRI,脑脊液 (CSF) 分析,生理记录 (Valsalva,头向上倾斜),血液体积测量,皮肤活检和血液采样以检测神经内分泌和免疫标志物.
主要成果:
- 71%的最初异常测试结果在7名神经PASC患者的随访中持续存在.
- 持续的异常包括脑液/血清的寡克隆波段,中央儿科胺缺乏,巴罗反射心血管功能障碍,倾斜引起的低血压和MRI上的白质高强度.
结论:
- 在神经PASC患者中,自主和免疫异常常常在感染后一年内持续存在.
- 这些发现突出了一些神经PASC表现的慢性性质,特别是影响自主功能.
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