Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Clin Neuropsychol. 2020 Oct-Nov;34(7-8):1498-1514. doi: 10.1080/13854046.2020.1811894. Epub 2020 Aug 26.
SARS-CoV-2 infection and its oft-associated illness COVID-19 may lead to neuropsychological deficits, either through direct mechanisms (i.e., neurovirulance) or indirect mechanisms, most notably complications caused by the virus (e.g., stroke) or medical procedures (e.g., intubation). The history of past human coronavirus outbreaks resulting in similar health emergencies suggests there will be a substantial prevalence of post-traumatic stress disorder (PTSD) among COVID-19 survivors. To prepare neuropsychologists for the difficult task of differentiating PTSD-related from neuropathology-related deficits in the oncoming wave of COVID-19 survivors, we integrate research across a spectrum of related areas. Several areas of literature were reviewed: psychiatric, neurologic, and neuropathological outcomes of SARS and MERS patients; neurological outcomes in COVID-19 survivors; PTSD associated with procedures common to COVID-19 patients; and differentiating neuropsychological deficits due to PTSD from those due to acquired brain injuries in other patient groups. Heightened risk of PTSD occurred in MERS and SARS survivors. While data concerning COVID-19 is lacking, PTSD is known to occur in patient groups who undergo similar hospital courses, including ICU survivors, patients who are intubated and mechanically ventilated, and those that experience delirium. Research with patients who develop PTSD in the context of mild traumatic brain injury further suggests that PTSD may account for some or all of a patient's subjective cognitive complaints and neuropsychological test performance. Recommendations are provided for assessing PTSD in the context of COVID-19.
SARS-CoV-2 感染及其常伴随的疾病 COVID-19 可能导致神经心理缺陷，这既可以通过直接机制（即神经毒力），也可以通过间接机制，尤其是由病毒（例如中风）或医疗程序（例如插管）引起的并发症。过去人类冠状病毒爆发导致类似健康紧急情况的历史表明，COVID-19 幸存者中会有相当大比例的创伤后应激障碍（PTSD）。为了让神经心理学家为即将到来的 COVID-19 幸存者浪潮中的 PTSD 相关和神经病理学相关缺陷区分这一艰巨任务做好准备，我们整合了一系列相关领域的研究。回顾了以下几个领域的文献：SARS 和 MERS 患者的精神、神经和神经病理学结果；COVID-19 幸存者的神经学结果；与 COVID-19 患者常见程序相关的 PTSD；以及在其他患者群体中区分由于 PTSD 引起的神经心理缺陷与由于获得性脑损伤引起的神经心理缺陷。MERS 和 SARS 幸存者发生 PTSD 的风险增加。虽然 COVID-19 的相关数据缺乏，但已知在经历类似住院过程的患者群体中会发生 PTSD，包括 ICU 幸存者、插管和机械通气的患者以及出现谵妄的患者。在轻度创伤性脑损伤背景下发生 PTSD 的患者的研究进一步表明，PTSD 可能导致患者主观认知主诉和神经心理学测试表现的部分或全部。为 COVID-19 背景下的 PTSD 评估提供了建议。
