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感染 SARS-CoV-2 后的神经精神疾病。

Neuropsychiatric disorders following SARS-CoV-2 infection.

机构信息

Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.

Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford OX3 7JX, UK.

出版信息

Brain. 2023 Jun 1;146(6):2241-2247. doi: 10.1093/brain/awad008.

Abstract

Several large-scale electronic health records studies have reported increased diagnostic rates for neuropsychiatric disorders following Coronavirus disease 2019 [COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection)], but many questions remain. To highlight the issues, we selectively review this literature, focusing on mood disorder, anxiety disorder, psychotic disorder, and cognitive impairment ('brain fog'). Eight key questions are addressed, comprising: (i) the nature and magnitude of the risks; (ii) their association with severity of infection; (iii) their duration; (iv) whether the risks differ between adults and children, or between men and women; (v) whether prior vaccination protects against them; (vi) the risk profile associated with different SARS-CoV-2 strains; (vii) what the underlying mechanisms might be; and (viii) whether the sequelae can be predicted. We consider the major unknowns, the limitations of electronic health records for research in this area, and the use of additional approaches to help characterize and understand the neuropsychiatric burden of COVID-19.

摘要

几项大规模的电子健康记录研究报告称,在 2019 年冠状病毒病(COVID-19 或严重急性呼吸系统综合症冠状病毒 2[SARS-CoV-2 感染])之后,神经精神障碍的诊断率有所增加,但仍存在许多问题。为了突出这些问题,我们选择性地回顾了这一文献,重点关注情绪障碍、焦虑障碍、精神病障碍和认知障碍(“脑雾”)。提出了八个关键问题,包括:(i)风险的性质和程度;(ii)它们与感染严重程度的关系;(iii)它们的持续时间;(iv)风险在成年人和儿童、男性和女性之间是否存在差异;(v)先前接种疫苗是否能预防这些疾病;(vi)不同 SARS-CoV-2 株相关的风险特征;(vii)潜在的机制可能是什么;以及(viii)后遗症是否可以预测。我们考虑了主要的未知数、电子健康记录在这一领域研究的局限性,以及使用额外的方法来帮助描述和理解 COVID-19 的神经精神负担。

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