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中枢神经系统瘤患者的COVID-19大流行经验:患者报告结果的差异和实践建议
Amanda L King1, Kayla N Roche1, Elizabeth Vera1
1Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Neuro-oncology practice
|February 7, 2025
概括
中枢神经系统瘤患者在COVID-19期间报告了抑郁症的增加. 这凸显了对情绪障碍的远程监测的需要,以支持这种脆弱人群的治疗成功和生存.
科学领域:
- 神经瘤学神经瘤学
- 心理上的结果.
- 流行病学 流行病学
背景情况:
- COVID-19大流行影响了医疗保健的获取,可能会影响中枢神经系统 (CNS) 瘤患者的患者报告结果 (PROs).
- 了解这些变化对于在公共卫生危机期间调整护理策略至关重要.
研究的目的:
- 为了比较COVID-19大流行期间与大流行前期间中枢神经系统瘤患者的患者报告结果 (PROs).
- 在大流行期间,在中枢神经系统瘤患者中识别与抑郁和焦虑相关的风险因素.
主要方法:
- 神经瘤学分院自然史研究的149名参与者在COVID-19的第一年 (2020年3月至2021年2月) 完成了PRO评估 (PROMIS,EQ-5D-3L,MDASI-BT/脊柱,NeuroQoL).
- 与COVID前的评估进行了比较,使用配对的t测试和比例测试,使用Hedges g和Cohen的h计算效应大小.
- 后勤回归模型确定了抑郁和焦虑的预测因素.
主要成果:
- 在COVID-19期间,与大流行前水平相比,中度至重度抑郁症状显著增加 (13%与8%,p=0.021).
- 还报告了症状负担和认知功能障碍的适度增加.
- 在COVID-19期间,同时的痛苦和低瘤级预测了抑郁和焦虑;心理药物使用预测了抑郁,积极治疗预测了焦虑.
结论:
- 中枢神经系统瘤患者在COVID-19大流行期间经历了高度抑郁,可能会影响治疗结果和生存.
- 需要创新的远程工具和干预措施来识别和管理这种人群中的情绪障碍.
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