长期COVID中的小纤维神经病变:一项用多模式评估和随访的队列研究
Natalia Drobinska1, Mayssam Nehme2, Fréderic Assal1
1Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
European neurology
|June 3, 2025
概括
小纤维神经病变 (SFN) 经常发生在2019年冠状病毒病 (COVID-19) 后,导致持续的神经病痛和dysautonomia. 非侵入性测试有助于诊断SFN,补充长期COVID患者的皮肤活检.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 疼痛医学 医学 疼痛医学
背景情况:
- 后急性SARS-CoV-2感染 (PASC) 或长期COVID的后续症状可以表现为持续的神经病痛和dysautonomic症状.
- 小纤维神经病变 (SFN) 越来越被认为是SARS-CoV-2感染后这些衰弱症状的潜在原因.
研究的目的:
- 为了估计长期COVID患者经历神经病痛的SFN的发生率.
- 评估多式联运SFN评估工具的诊断实用性.
主要方法:
- 评估了18名患有长期COVID-19和神经病痛 (DN4分数≥4) 持续≥90天的患者队列,并进行了正常神经传导研究.
- 多模式评估包括皮肤活检,定量感官测试 (QST),激光唤起潜力 (LEP) 和电化学皮肤导电性 (ESC).
主要成果:
- 在分析的17名患者中,82%的皮肤活检结果异常,70%的患者有自主性投诉.
- 定量感官测试 (QST) 显示了SFN诊断的高灵敏度 (79%) 和特异性 (67%).
- 皮肤电化学导电性 (ESC) 的可靠性很差 (敏感度为7%,特异性为50%).
结论:
- SFN是SARS-CoV-2感染的可能并发症,导致持续的感官和自主功能障碍.
- 非侵入性诊断方法,特别是QST和LEP,是皮肤活检的宝贵补充,用于诊断长期COVID患者的SFN.
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