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新冠病毒病急性期的认知缺陷:一项综述与荟萃分析

Cognitive Deficits in the Acute Phase of COVID-19: A Review and Meta-Analysis.

作者信息

Jacot de Alcântara Isabele, Nuber-Champier Anthony, Voruz Philippe, Cionca Alexandre, Assal Frederic, Péron Julie A

机构信息

Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, 1205 Geneva, Switzerland.

Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.

出版信息

J Clin Med. 2023 Jan 18;12(3):762. doi: 10.3390/jcm12030762.

Abstract

This meta-analysis was conducted to quantify the risk of patients exhibiting cognitive deficits in the acute phase of COVID-19 at the time of the first variants (i.e., before the vaccine) and quantify the potential vulnerability of older patients and those who experienced more severe respiratory symptoms. To this end, we searched the LitCovid and EMBASE platforms for articles, including preprints, and included all studies ( = 48) that featured a measurement of cognition, which encompassed 2233 cases of COVID-19. Of these, 28 studies reported scores on global cognitive efficiency scales administered in the acute phase of COVID-19 (up to 3 months after infection). We were able to perform a meta-analysis of proportions on 24 articles (N = 943), and a logistic regression on 18 articles (N = 518). The meta-analysis for proportion indicated that 52.31% of patients with COVID-19 exhibited cognitive deficits in the acute phase. This high percentage, however, has to be interpreted taking in consideration the fact that the majority of patients were hospitalized, and some presented neurological complications, such as encephalopathy. A bootstrap procedure with random resampling revealed that an age of 59 was the threshold at which one would be more prone to present cognitive deficits. However, the severity of respiratory symptoms did not influence the scores on a global cognitive efficiency scale. Overall, our results indicated that neuropsychological deficits were a major consequence of the acute phase of the first forms of COVID-19.

摘要

本荟萃分析旨在量化在首次出现病毒变种时(即疫苗接种前)新冠病毒疾病(COVID-19)急性期患者出现认知缺陷的风险,并量化老年患者及出现更严重呼吸道症状患者的潜在易感性。为此,我们在LitCovid和EMBASE平台上搜索文章,包括预印本,并纳入了所有涉及认知测量的研究(n = 48),其中包括2233例COVID-19病例。其中,28项研究报告了在COVID-19急性期(感染后3个月内)进行的整体认知效率量表得分。我们能够对24篇文章(N = 943)进行比例荟萃分析,并对18篇文章(N = 518)进行逻辑回归分析。比例荟萃分析表明,52.31%的COVID-19患者在急性期出现认知缺陷。然而,考虑到大多数患者住院治疗,且部分患者出现脑病等神经系统并发症这一事实,对这一高比例结果需谨慎解读。随机重采样的自助法显示,59岁是更易出现认知缺陷的年龄阈值。然而,呼吸道症状的严重程度并未影响整体认知效率量表得分。总体而言,我们的结果表明,神经心理学缺陷是早期COVID-19急性期的主要后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/393f/9917639/646aa60f388c/jcm-12-00762-g001.jpg

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