Schilling Claudia, Meyer-Lindenberg Andreas, Schweiger Janina Isabel
Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland.
Nervenarzt. 2022 Aug;93(8):779-787. doi: 10.1007/s00115-022-01297-z. Epub 2022 May 16.
During the last 2 years of the coronavirus disease 2019 (COVID-19) pandemic, knowledge about the long-term effects of the disease, the so-called long COVID, has rapidly grown; however, many questions remain unanswered, especially regarding the causes of persistent symptoms and their prognosis. Cognitive disorders and sleep disturbances are among the most frequent complaints. Both are associated with severe suffering and significant impairment in everyday functioning.
What is known about the occurrence of cognitive disorders and sleep disturbances in long COVID? What are the influencing factors and what is known about the course over time and possible underlying mechanisms? What treatment options are available?
In a narrative review, the most important findings on cognitive disorders and sleep disturbances in long COVID are presented. An overview of cohort studies with data on the prevalence and influencing factors of both symptom complexes is given. Current knowledge and hypotheses on pathophysiological mechanisms are presented and an outlook on treatment approaches is given.
About one in five of those affected report cognitive impairment more than 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and about one third report sleep disturbances. The latter comprise symptoms of insomnia as well as hypersomnia. Cognitive impairment and sleep disturbances occur in patients with all levels of initial disease severity. There are indications of an improvement of cognitive deficits over time but further longitudinal studies are needed.
In addition to the prognosis, the underlying disease mechanisms are still insufficiently understood. Furthermore, there is a great need for research on the efficacy and specific effective factors of therapeutic interventions.
在2019冠状病毒病（COVID-19）大流行的最后两年里，关于该疾病长期影响（即所谓的“长新冠”）的知识迅速增加；然而，许多问题仍未得到解答，尤其是关于持续症状的原因及其预后。认知障碍和睡眠障碍是最常见的症状。这两者都与严重的痛苦和日常功能的显著受损有关。
关于“长新冠”中认知障碍和睡眠障碍的发生情况已知哪些信息？影响因素有哪些，随着时间推移其病程以及可能的潜在机制已知哪些？有哪些可用的治疗选择？
在一篇叙述性综述中，呈现了关于“长新冠”中认知障碍和睡眠障碍的最重要研究结果。给出了关于这两种症状复合体患病率和影响因素数据的队列研究概述。介绍了关于病理生理机制的当前知识和假说，并对治疗方法进行了展望。
约五分之一的感染者在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染3个月后报告有认知障碍，约三分之一报告有睡眠障碍。后者包括失眠和嗜睡症状。认知障碍和睡眠障碍在所有初始疾病严重程度的患者中均有发生。有迹象表明认知缺陷会随着时间改善，但仍需要进一步的纵向研究。
除了预后之外，潜在的疾病机制仍未得到充分理解。此外，对于治疗干预的疗效和具体有效因素有很大的研究需求。
