COVID-19 患者出院或自我隔离后康复过程中的大脑结构和功能：一项纵向观察研究方案。
Brain structure and function in people recovering from COVID-19 after hospital discharge or self-isolation: a longitudinal observational study protocol.
机构信息
Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont.
出版信息
CMAJ Open. 2021 Nov 30;9(4):E1114-E1119. doi: 10.9778/cmajo.20210023. Print 2021 Oct-Dec.
BACKGROUND
The detailed extent of neuroinvasion or deleterious brain changes resulting from COVID-19 and their time courses remain to be determined in relation to "long-haul" COVID-19 symptoms. Our objective is to determine whether there are alterations in functional brain imaging measures among people with COVID-19 after hospital discharge or self-isolation.
METHODS
This paper describes a protocol for NeuroCOVID-19, a longitudinal observational study of adults aged 20-75 years at Sunnybrook Health Sciences Centre in Toronto, Ontario, that began in April 2020. We aim to recruit 240 adults, 60 per group: people who contracted COVID-19 and were admitted to hospital (group 1), people who contracted COVID-19 and self-isolated (group 2), people who experienced influenza-like symptoms at acute presentation but tested negative for COVID-19 and self-isolated (group 3, control) and healthy people (group 4, control). Participants are excluded based on premorbid neurologic or severe psychiatric illness, unstable cardiovascular disease, and magnetic resonance imaging (MRI) contraindications. Initial and 3-month follow-up assessments include multiparametric brain MRI and electroencephalography. Sensation and cognition are assessed alongside neuropsychiatric assessments and symptom self-reports. We will test the data from the initial and follow-up assessments for group differences based on 3 outcome measures: MRI cerebral blood flow, MRI resting state fractional amplitude of low-frequency fluctuation and electroencephalography spectral power.
INTERPRETATION
If neurophysiologic alterations are detected in the COVID-19 groups in our NeuroCOVID-19 study, this information could inform future research regarding interventions for long-haul COVID-19. The study results will be disseminated to scientists, clinicians and COVID-19 survivors, as well as the public and private sectors to provide context on how brain measures relate to lingering symptoms.
背景
与“长新冠”症状相关，新冠病毒引起的神经入侵或有害脑变化的详细程度及其时程仍有待确定。我们的目的是确定在出院或自我隔离后，新冠病毒感染者的功能性脑影像学测量是否发生改变。
方法
本文描述了一项针对新冠病毒神经学（NeuroCOVID-19）的研究方案，该研究是在安大略省多伦多市桑尼布鲁克健康科学中心对 20-75 岁成年人进行的一项纵向观察性研究，始于 2020 年 4 月。我们计划招募 240 名成年人，每组 60 人：感染新冠病毒并住院的人（第 1 组）、感染新冠病毒并自我隔离的人（第 2 组）、急性发作时有类似流感症状但新冠病毒检测阴性并自我隔离的人（第 3 组，对照组）和健康人（第 4 组，对照组）。根据既往神经或严重精神疾病、不稳定心血管疾病和磁共振成像（MRI）禁忌证排除参与者。初始和 3 个月随访评估包括多参数脑 MRI 和脑电图。感觉和认知与神经精神评估和症状自我报告一起评估。我们将根据 3 项结果测量指标（MRI 脑血流、MRI 静息状态低频振幅和脑电图频谱功率）测试初始和随访评估中组间差异的数据。
解释
如果在我们的 NeuroCOVID-19 研究中新冠病毒感染组中检测到神经生理改变，这些信息可以为未来关于“长新冠”干预措施的研究提供信息。研究结果将传播给科学家、临床医生和新冠病毒幸存者，以及私营和公共部门，以说明脑测量与挥之不去的症状之间的关系。
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