Hellwig Sabine, Domschke Katharina
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstr. 5, 79104, Freiburg, Deutschland.
Nervenarzt. 2022 Aug;93(8):788-796. doi: 10.1007/s00115-022-01306-1. Epub 2022 May 23.
The World Health Organization (WHO) defines post-coronavirus disease 2019 (COVID-19) as a condition which occurs in individuals with a history of probable or confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection 3 months after the onset of COVID-19 symptoms, lasts for at least 2 months and cannot be explained by an alternative diagnosis. Core symptoms of post-COVID syndrome are fatigue, dyspnea and cognitive dysfunction, which have an impact on everyday functional level. Neuropsychiatric late sequelae are common in COVID-19 patients, with incidence rates over 30%. Beside the abovementioned core symptoms, sleep disorders, depression and anxiety show increased incidences. According to current opinion, associated neuropsychiatric symptoms are subsumed under the term post-COVID syndrome but are also interpreted as comorbidities, which can promote the manifestation of a post-COVID syndrome. The key symptom fatigue shows symptom overlapping and comorbidity with psychiatric disorders. Imaging studies indicate an organic correlate of fatigue in post-COVID patients. Furthermore, psychosocial aspects and psychiatric comorbidities, such as depression and anxiety disorders as modulating and therefore potentially treatable factors were identified. Treatment of fatigue consists of pharmacological management with stimulants and antidepressants as well as nonpharmacological strategies, most notably cognitive behavioral therapy and exercise-focused interventions. The evidence for this comes from meta-analyses of tumor-associated or post-viral fatigue.
世界卫生组织(WHO)将新型冠状病毒肺炎(COVID-19)后状况定义为:在新型冠状病毒2型(SARS-CoV-2)感染可能或确诊为严重急性呼吸综合征的患者中,在COVID-19症状出现3个月后发生的一种状况,持续至少2个月且不能用其他诊断解释。COVID-19后综合征的核心症状是疲劳、呼吸困难和认知功能障碍,这些症状会影响日常功能水平。神经精神后遗症在COVID-19患者中很常见,发病率超过30%。除上述核心症状外,睡眠障碍、抑郁和焦虑的发病率也有所增加。根据目前的观点,相关的神经精神症状被归入COVID-19后综合征这一术语,但也被解释为合并症,这可能会促进COVID-19后综合征的表现。关键症状疲劳表现出与精神障碍的症状重叠和合并。影像学研究表明COVID-19后患者疲劳存在器质性关联。此外,心理社会因素和精神合并症,如抑郁和焦虑症作为调节因素,因此可能是可治疗的因素也已被确定。疲劳的治疗包括使用兴奋剂和抗抑郁药进行药物治疗以及非药物策略,最显著的是认知行为疗法和以运动为重点的干预措施。这方面的证据来自对肿瘤相关或病毒后疲劳的荟萃分析。