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轻度新型冠状病毒肺炎康复后频繁出现神经认知缺陷。

Frequent neurocognitive deficits after recovery from mild COVID-19.

作者信息

Woo Marcel S, Malsy Jakob, Pöttgen Jana, Seddiq Zai Susan, Ufer Friederike, Hadjilaou Alexandros, Schmiedel Stefan, Addo Marylyn M, Gerloff Christian, Heesen Christoph, Schulze Zur Wiesch Julian, Friese Manuel A

机构信息

Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.

Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

出版信息

Brain Commun. 2020 Nov 23;2(2):fcaa205. doi: 10.1093/braincomms/fcaa205. eCollection 2020.

DOI:10.1093/braincomms/fcaa205
PMID:33376990
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7717144/
Abstract

Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20-105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia or acute inflammation. Additionally, Modified Telephone Interview for Cognitive Status scores did not correlate with depressed mood or fatigue. In two severely affected patients, we excluded structural or other inflammatory causes by magnetic resonance imaging, serum and cerebrospinal fluid analyses. Together, our results demonstrate that sustained sub-clinical cognitive impairments might be a common complication after recovery from COVID-19 in young adults, regardless of clinical course that were unmasked by our diagnostic approach.

摘要

由严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)相关的神经精神并发症越来越受到关注。虽然大多数研究集中在急性感染期间受严重影响的个体,但尚不清楚轻度COVID-19是否会导致年轻患者出现神经认知缺陷。在此,我们建立了一种筛查方法来检测COVID-19康复后的认知缺陷。在这项横断面研究中,我们招募了18名大多为年轻的患者,他们在从轻度至中度疾病康复后20 - 105天(中位数为85天)到我们的门诊进行COVID-19康复护理。值得注意的是,14名(78%)患者报告存在持续的轻度认知缺陷,并且在用于轻度认知障碍的改良认知状态电话访谈筛查测试中的表现比10名年龄匹配的健康对照更差。虽然短期记忆、注意力和专注力受COVID-19影响尤为明显,但筛查结果与住院、治疗、病毒血症或急性炎症无关。此外,改良认知状态电话访谈得分与情绪低落或疲劳无关。在两名受严重影响的患者中,我们通过磁共振成像、血清和脑脊液分析排除了结构性或其他炎症性病因。总之,我们的结果表明,持续的亚临床认知障碍可能是年轻成年人COVID-19康复后的常见并发症,无论临床病程如何,我们的诊断方法都能发现这些问题。

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