Pellitteri Gaia, Surcinelli Andrea, De Martino Maria, Fabris Martina, Janes Francesco, Bax Francesco, Marini Alessandro, Milanic Romina, Piani Antonella, Isola Miriam, Gigli Gian Luigi, Valente Mariarosaria
Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy.
Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy.
Front Neurol. 2022 Aug 17;13:929480. doi: 10.3389/fneur.2022.929480. eCollection 2022.
By the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function.
We investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19.
We enrolled 47 subjects diagnosed with COVID-19 pneumonia at University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models.
Prevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder.
Our results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
到2019年底，严重急性呼吸综合征冠状病毒2在全球迅速传播，影响心理健康和睡眠习惯。在疫情期间，人们观察到失眠、睡眠质量受损和昼夜节律改变，尤其是在医护人员以及急性和急性后新冠病毒病患者中。睡眠中断可能会引发与免疫系统功能受损相关的促炎状态。
我们调查了急性后新冠病毒病患者睡眠改变、心理障碍与血液炎症生物标志物之间的关系。
我们纳入了2020年3月至5月间在意大利乌迪内大学医院被诊断为新冠病毒肺炎的47名受试者。选定的患者在出院后2个月（T1）和10个月（T2）接受评估。每次评估时，我们收集临床访谈、神经学检查以及用于评估睡眠和生活质量、焦虑、抑郁和创伤后应激障碍的自填问卷。每次随访时还测量内皮激活、神经炎症和炎症细胞因子的血液生物标志物。使用组间比较和线性回归模型分析收集到的变量。
新冠病毒感染后失眠的患病率从10.6%升至27.3%。在两次研究访视中，41.5%的患者存在睡眠质量差的情况。在T1随访时，睡眠不佳者的神经丝轻链、血管细胞黏附分子1和白细胞介素10水平较高；睡眠质量与心理障碍之间未发现显著关联。在T2随访时，睡眠质量较低与血管细胞黏附分子1和白细胞介素8水平较高有关，但也与焦虑、抑郁和创伤后应激障碍的得分较高有关。
我们的结果表明，在先前住院的中重度新冠病毒病患者中，睡眠质量差与心理障碍和神经炎症均有关联，尽管发生时间不同。
