Vinogradov Oleg I, Ogarkova Tatyana K, Shamtieva Kamila V, Alexandrov Pavel V, Mushba Astanda V, Kanshina Daria S, Yakovleva Daria V, Surma Maria A, Nikolaev Ilia S, Gorst Nadezhda Kh
Federal State Budgetary Institution "National Medical and Surgical Center Named after N.I. Pirogov", Ministry of Healthcare of the Russian Federation, 105203 Moscow, Russia.
J Clin Med. 2021 Oct 20;10(21):4821. doi: 10.3390/jcm10214821.
The majority of patients with severe COVID-19 suffer from delirium as the main sign of encephalopathy associated with this viral infection. The aim of this study was to identify early markers of the development of this condition.
The prospective cohort-based study included patients with community-acquired pneumonia and confirmed pulmonary tissue infiltration based on CT data, with a lesion consisting of at least 25% of one lung. The main group included patients who have developed acute encephalopathy (10 patients, 3 (30%) women; average age, 47.9 ± 7.3 years). The control group included patients who at discharge did not have acute encephalopathy (20 patients, 11 (55%) women; average age, 51.0 ± 10.5 years). The study collected clinical examination data, comprehensive laboratory data, neurophysiological data, pulse oximetry and CT data to identify the predictors of acute encephalopathy (study ClinicalTrials.gov identifier NCT04405544).
Data analysis showed a significant relationship between encephalopathy with the degree of lung tissue damage, arterial hypertension, and type 2 diabetes mellitus, as well as with D-dimer, LDH, and lymphopenia.
The development of encephalopathy is secondary to the severity of the patient's condition since a more severe course of the coronavirus infection leads to hypoxic brain damage.
大多数重症新型冠状病毒肺炎患者患有谵妄，这是与这种病毒感染相关的脑病的主要症状。本研究的目的是确定这种情况发展的早期标志物。
这项基于前瞻性队列的研究纳入了社区获得性肺炎患者，并根据CT数据证实有肺组织浸润，病变累及至少一个肺的25%。主要组包括发生急性脑病的患者（10例，3例（30%）为女性；平均年龄47.9±7.3岁）。对照组包括出院时没有急性脑病的患者（20例，11例（55%）为女性；平均年龄51.0±10.5岁）。该研究收集了临床检查数据、综合实验室数据、神经生理学数据、脉搏血氧饱和度和CT数据，以确定急性脑病的预测因素（研究在ClinicalTrials.gov的标识符为NCT04405544）。
数据分析显示，脑病与肺组织损伤程度、动脉高血压、2型糖尿病以及D-二聚体、乳酸脱氢酶和淋巴细胞减少之间存在显著关联。
脑病的发生继发于患者病情的严重程度，因为冠状病毒感染的更严重病程会导致缺氧性脑损伤。
