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未检测到 COVID-19 与肌痛性脑脊髓炎/慢性疲劳综合征之间存在因果关系:一项两样本 Mendelian Randomization 研究。

No Causal Effects Detected in COVID-19 and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Two Sample Mendelian Randomization Study.

机构信息

School of Public Health, Xiamen University, Xiamen 361000, China.

Department of Clinical Laboratory, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361000, China.

出版信息

Int J Environ Res Public Health. 2023 Jan 30;20(3):2437. doi: 10.3390/ijerph20032437.

Abstract

New clinical observational studies suggest that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a sequela of COVID-19 infection, but whether there is an exact causal relationship between COVID-19 and ME/CFS remains to be verified. To investigate whether infection with COVID-19 actually causes ME/CFS, this paper obtained pooled data from the Genome Wide Association Study (GWAS) and analyzed the relationship between COVID susceptibility, hospitalization and severity of COVID and ME/CFS, respectively, using two-sample Mendelian randomization (TSMR). TSMR analysis was performed by inverse variance weighting (IVW), weighted median method, MR-Egger regression and weighted mode and simple mode methods, respectively, and then the causal relationship between COVID-19 and ME/CFS was further evaluated by odds ratio (OR). Eventually, we found that COVID-19 severity, hospitalization and susceptibility were all not significantly correlated with ME/CFS (OR:1.000,1.000,1.000; 95% CI:0.999-1.000, 0.999-1.001, 0.998-1.002; = 0.333, 0.862, 0.998, respectively). We found the results to be reliable after sensitivity analysis. These results suggested that SARS-CoV-2 infection may not significantly contribute to the elevated risk of developing CFS, and therefore ME/CFS may not be a sequela of COVID-19, but may simply present with symptoms similar to those of CFS after COVID-19 infection, and thus should be judged and differentiated by physicians when diagnosing and treating the disease in clinical practice.

摘要

新的临床观察性研究表明,肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)是 COVID-19 感染的后遗症,但 COVID-19 和 ME/CFS 之间是否存在确切的因果关系仍有待验证。为了研究 COVID-19 感染是否确实会导致 ME/CFS,本文从全基因组关联研究(GWAS)中获取了汇总数据,并分别使用两样本孟德尔随机化(TSMR)分析了 COVID 易感性、住院和 COVID 严重程度与 ME/CFS 之间的关系。TSMR 分析分别采用逆方差加权(IVW)、加权中位数法、MR-Egger 回归和加权模式和简单模式方法,然后通过比值比(OR)进一步评估 COVID-19 与 ME/CFS 之间的因果关系。最终,我们发现 COVID-19 的严重程度、住院和易感性与 ME/CFS 均无显著相关性(OR:1.000、1.000、1.000;95%CI:0.999-1.000、0.999-1.001、0.998-1.002;=0.333、0.862、0.998,分别)。经过敏感性分析,我们发现结果是可靠的。这些结果表明,SARS-CoV-2 感染可能不会显著增加 CFS 的发病风险,因此 ME/CFS 可能不是 COVID-19 的后遗症,而可能只是在 COVID-19 感染后出现类似于 CFS 的症状,因此在临床实践中诊断和治疗疾病时,医生应进行判断和区分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d5/9915276/0373f1faab55/ijerph-20-02437-g001.jpg

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