Badenoch James B, Rengasamy Emma R, Watson Cameron, Jansen Katrin, Chakraborty Stuti, Sundaram Ritika D, Hafeez Danish, Burchill Ella, Saini Aman, Thomas Lucretia, Cross Benjamin, Hunt Camille K, Conti Isabella, Ralovska Sylvia, Hussain Zain, Butler Matthew, Pollak Thomas A, Koychev Ivan, Michael Benedict D, Holling Heinz, Nicholson Timothy R, Rogers Jonathan P, Rooney Alasdair G
Barts Health NHS Trust, London, UK.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Brain Commun. 2021 Dec 17;4(1):fcab297. doi: 10.1093/braincomms/fcab297. eCollection 2022.
The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with . Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies (= 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14-182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4-34.4%)], followed by fatigue [24.4% (17.5-32.9%)], objective cognitive impairment [20.2% (10.3-35.7%)], anxiety [19.1% (13.3-26.8%)] and post-traumatic stress [15.7% (9.9-24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high ( = 79.6-98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection.
新冠病毒病（COVID-19）后持续性神经精神症状的性质和程度尚未明确。为了给大流行恢复阶段的心理健康服务规划提供信息，我们系统地确定了COVID-19幸存者中神经精神症状的患病率。对于这项预先注册的系统评价和荟萃分析（PROSPERO注册号CRD42021239750），我们检索了截至2021年2月20日的MEDLINE、EMBASE、CINAHL和PsycINFO数据库，以及我们自己整理的数据库。我们纳入了同行评审的研究，这些研究报告了COVID-19感染后急性后期或更晚时间点的神经精神症状，以及如有可用的对照组的情况。对于每项研究，至少两名作者提取了汇总数据。对于每种症状，我们使用广义线性混合模型计算合并患病率。异质性用 测量。对COVID-19住院情况、严重程度和随访持续时间进行了亚组分析。从2844个独特标题中，我们纳入了51项研究（=18917名患者）。COVID-19后的平均随访时间为77天（范围14 - 182天）。研究质量最常见为中等。最常见的神经精神症状是睡眠障碍[合并患病率=27.4%（95%置信区间21.4 - 34.4%）]，其次是疲劳[24.4%（17.5 - 32.9%）]、客观认知障碍[20.2%（10.3 - 35.7%）]、焦虑[19.1%（13.3 - 26.8%）]和创伤后应激[15.7%（9.9 - 24.1%）]。只有两项研究报告了对照组的症状，两者均报告COVID-19幸存者的症状频率高于对照组。研究间异质性较高（ =79.6 - 98.6%）。几乎没有证据表明基于住院状态、严重程度或随访持续时间的症状患病率存在差异。COVID-19康复后神经精神症状常见且持续存在。关于长期后果的文献仍在不断完善，但表明感染后前6个月失眠、疲劳、认知障碍和焦虑症的患病率特别高。
