Universitat Internacional de Catalunya, Barcelona, España.
Raigmore Hospital, Inverness, Reino Unido.
Rev Neurol. 2021 Jun 1;72(11):384-396. doi: 10.33588/rn.7211.2021230.
INTRODUCTION: Many patients with mild or severe COVID-19 do not make a full recovery and have a wide range of chronic symptoms for weeks or months after infection, often of a neurological, cognitive or psychiatric nature. The epidemiological evidence, diagnostic criteria and pathogenesis of post-COVID-19 syndrome are reviewed. DEVELOPMENT: Post-COVID-19 syndrome is defined by persistent clinical signs and symptoms that appear while or after suffering COVID-19, persist for more than 12 weeks and cannot be explained by an alternative diagnosis. The symptoms can fluctuate or cause relapses. It is a heterogeneous condition that includes post-viral chronic fatigue syndrome, sequelae in multiple organs and the effects of severe hospitalisation/post-intensive care syndrome. It has been reported in patients with mild or severe COVID-19 and irrespective of the severity of the symptoms in the acute phase. Between 10% and 65% of survivors who had mild/moderate COVID-19 present symptoms of post-COVID-19 syndrome for 12 weeks or more. At six months, subjects report an average of 14 persistent symptoms. The most common symptoms are fatigue, dyspnoea, anxiety, depression, and impaired attention, concentration, memory and sleep. The underlying biological mechanisms are unknown, although an abnormal or excessive autoimmune and inflammatory response may play an important role. CONCLUSIONS: Clinical manifestations are diverse, fluctuating and variable, although fatigue and neurocognitive complaints predominate. There is no defined consensus on post-COVID-19 syndrome and its diagnostic criteria have not been subjected to adequate psychometric evaluation.
简介:许多 COVID-19 轻症或重症患者在感染后数周至数月仍未完全康复,存在广泛的慢性症状,通常具有神经、认知或精神方面的性质。本文回顾了 COVID-19 后综合征的流行病学证据、诊断标准和发病机制。
发展:COVID-19 后综合征的定义为在感染 COVID-19 时或之后出现并持续存在超过 12 周的持续临床体征和症状,且无法用其他诊断解释。症状可能波动或导致复发。它是一种异质性疾病,包括病毒后慢性疲劳综合征、多个器官的后遗症以及严重住院/重症监护后综合征的影响。它在 COVID-19 轻症或重症患者中均有报道,且与急性期症状的严重程度无关。10%至 65%的轻症/中度 COVID-19 幸存者会出现 12 周或更长时间的 COVID-19 后综合征症状。在 6 个月时,患者报告平均有 14 种持续存在的症状。最常见的症状是疲劳、呼吸困难、焦虑、抑郁和注意力、集中力、记忆力和睡眠受损。其潜在的生物学机制尚不清楚,尽管异常或过度的自身免疫和炎症反应可能起重要作用。
结论:临床表现多种多样、波动且多变,尽管疲劳和神经认知主诉更为常见。目前尚未就 COVID-19 后综合征达成明确共识,其诊断标准也未经过充分的心理测量评估。
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