Neuropsychology Unit, ASST Spedali Civili of Brescia, Via Nikolajewka 13, 25123, Brescia, Italy.
Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
J Neurol. 2021 Dec;268(12):4422-4428. doi: 10.1007/s00415-021-10579-6. Epub 2021 May 1.
Central and peripheral nervous system involvement during acute COVID-19 is well known. Although many patients report some subjective symptoms months after the infection, the exact incidence of neurological and cognitive sequelae of COVID-19 remains to be determined. The aim of this study is to investigate if objective neurological or cognitive impairment is detectable four months after SARS-CoV-2 infection, in a group of patients who had mild-moderate COVID-19. A cohort of 120 health care workers previously affected by COVID-19 was examined 4 months after the diagnosis by means of neurological and extensive cognitive evaluation and compared to a group of 30 health care workers who did not have COVID-19 and were similar for age and co morbidities. At 4 month follow-up, 118/120 COVID-19 cases had normal neurological examination, two patients had neurological deficits. COVID-19 patients did not show general cognitive impairment at MMSE. In COVID-19 cases the number of impaired neuropsychological tests was not significantly different from non COVID-19 cases (mean 1.69 and 1 respectively, Mann-Whitney p = n.s.), as well as all the mean tests' scores. Anxiety, stress and depression scores resulted to be significantly higher in COVID-19 than in non COVID-19 cases. The results do not support the presence of neurological deficits or cognitive impairment in this selected population of mild-moderate COVID-19 patients four months after the diagnosis. Severe emotional disorders in patients who had COVID-19 in the past are confirmed.
急性 COVID-19 可累及中枢和外周神经系统。尽管许多患者在感染后数月会报告一些主观症状,但 COVID-19 的神经系统和认知后遗症的确切发生率仍有待确定。本研究旨在调查一组患有轻度至中度 COVID-19 的患者在 SARS-CoV-2 感染后 4 个月是否可检测到客观的神经或认知损伤。通过神经学和广泛的认知评估,对 120 名先前患有 COVID-19 的医护人员进行检查,并与 30 名未感染 COVID-19 且年龄和合并症相似的医护人员进行比较。在 4 个月的随访中,120 例 COVID-19 患者中有 118 例神经系统检查正常,2 例有神经功能缺损。COVID-19 患者在 MMSE 上未表现出总体认知障碍。在 COVID-19 患者中,受损神经心理学测试的数量与非 COVID-19 患者无显著差异(平均值分别为 1.69 和 1,Mann-Whitney p=无显著差异),所有测试的平均分数也是如此。COVID-19 患者的焦虑、压力和抑郁评分明显高于非 COVID-19 患者。结果不支持在诊断后 4 个月内对轻度至中度 COVID-19 患者的这一选定人群存在神经功能缺损或认知障碍。证实了过去患有 COVID-19 的患者存在严重的情绪障碍。