住院COVID-19幸存者的COVID后微血管功能障碍与急性疾病严重程度和持续的认知投诉有关
Noa van der Knaap1, Simona Klinkhammer2, Alida A Postma3
1Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, the Netherlands; Department of Intensive Care, Maastricht University Medical Center, the Netherlands; Mental Health & Neuroscience Research Institute (MHeNs), Maastricht University, the Netherlands.
来自重症监护室的COVID-19幸存者表现出比普通病房患者更广泛的脑微血管功能障碍. 白质中的这种功能障碍与持续的认知投诉有关,即使没有客观认知缺陷.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 冠状病毒疾病2019 (COVID-19) 可以影响大脑血管系统,可能导致感染后持续的血管和认知问题.
- 导致COVID后认知功能障碍的特定病理途径尚不清楚.
研究的目的:
- 为了研究COVID-19幸存者的大脑微血管特性.
- 为了将这些特性与急性系统性血液标记物以及COVID后的认知功能和投诉相关联.
主要方法:
- 一项观察性队列研究比较了108名住院COVID-19幸存者 (53名普通病房,55名ICU).
- 多b值扩散MRI评估了大脑微血管特性 (fmv,fmv·Dmv) 在皮质灰质 (cGM),正常出现的白质 (NAWM) 和白质超强度 (WMH) 中,大约在感染后9个月.
主要成果:
- 与普通病房的幸存者相比,ICU幸存者在cGM,NAWM和WMH中表现出显著较低的微血管输液体积分 (fmv) 和血流 (fmv·Dmv).
- 在NAWM中较低的fmv与主观认知投诉的增加相关,独立于客观认知表现.
- 在ICU幸存者中,住院期间血中乳酸盐水平较高与NAWM中fmv和fmv·Dmv的降低有关.
结论:
- COVID-19重症监护室幸存者出现了更广泛的感染后大脑微血管功能障碍.
- 在NAWM中微血管功能障碍可能是急性感染期间大脑组织缺氧的结果.
- 这种功能障碍与持续的主观认知投诉有关,即使没有客观认知障碍.
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