非住院COVID-19患者中与性别相关的患者报告的脑雾症状。

Sex-related patient-reported brain fog symptoms in non-hospitalised COVID-19 patients.

作者信息

Chatys-Bogacka Żaneta, Mazurkiewicz Iwona, Słowik Joanna, Nowak Klaudia, Sydor Wojciech, Wizner Barbara, Słowik Agnieszka, Wnuk Marcin, Drabik Leszek

机构信息

Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.

Department of Neurology, University Hospital in Krakow, Poland.

出版信息

Neurol Neurochir Pol. 2023;57(1):111-120. doi: 10.5603/PJNNS.a2023.0010. Epub 2023 Feb 17.

DOI:10.5603/PJNNS.a2023.0010

PMID:36799525

Abstract

INTRODUCTION

Previous studies on the prognostic role of sex in post-COVID-associated brain fog have yielded divergent results. Moreover, limited evidence exists regarding the evolution of brain fog symptoms over time, especially in ambulatory patients and separately for women and men. Therefore, the aim of the current study was to assess brain fog symptoms in nonhospitalised patients with COVID-19, according to their sex.

MATERIAL AND METHODS

We created a neuropsychological questionnaire including eight questions on the presence of brain fog symptoms in the following four time periods: before COVID-19, and 0-4, 4-12, and > 12 weeks post-infection. The validity and reliability of the questionnaire were assessed. In this cross-sectional study, questionnaires were filled out anonymously and retrospectively once only by patients or through a survey link posted online. Included were patients ≥ 18 years, with > 3 months since the SARS-CoV-2 infection onset confirmed by RT-PCR from a nasopharyngeal swab.

RESULTS

The study included 303 patients (79.53% women, 47.52% medical personnel). Median time between COVID-19 onset and questionnaire completion was 208 (IQR 161-248) days. Women, compared to men, reported a higher prevalence of problems with writing, reading, and counting (< 4 weeks, OR 3.05, 95% CI: 1.38-6.72; 4-12 weeks, OR 2.51, 95% CI: 1.02-6.14; > 12 weeks, OR 3.74, 95% CI: 1.12-12.56) and thoughts communication (< 4 weeks, OR 2.53, 95% CI: 1.41-4.54; 4-12 weeks, OR 3.74, 95% CI: 1.93-7.24; > 12 weeks, OR 2.00, 95% CI: 1.01-3.99). The difference between the two sexes in answering questions in an understandable/unambiguous manner was statistically significant between four and 12 weeks after infection (OR 2.63, 95% CI: 1.36-5.10), while a sex difference in recalling new information was found below 12 weeks (OR 2.54, 95% CI: 1.44-4.48 and OR 2.43, 95% CI: 1.37-4.31 for < 4 and 4-12 weeks, respectively). No sex differences in reporting problems with multitasking, remembering information from the past, determining the current date, or field orientation were noted.

CONCLUSIONS

Non-hospitalised women and men retrospectively report a different course of COVID-19-associated brain fog.

摘要

引言

先前关于性别在新冠后脑雾预后作用的研究结果不一。此外，关于脑雾症状随时间的演变，尤其是在非住院患者中以及分别针对女性和男性的情况，证据有限。因此，本研究的目的是根据性别评估非住院新冠患者的脑雾症状。

材料与方法

我们编制了一份神经心理学问卷，包含八个关于以下四个时间段脑雾症状存在情况的问题：新冠之前、感染后0 - 4周、4 - 12周以及> 12周。对问卷的有效性和可靠性进行了评估。在这项横断面研究中，问卷由患者匿名且仅回顾性填写一次，或者通过在线发布的调查链接填写。纳入的患者年龄≥18岁，自鼻咽拭子RT-PCR确诊SARS-CoV-2感染起已超过3个月。

结果

该研究纳入了303名患者（79.53%为女性，47.52%为医务人员）。新冠发病至问卷完成的中位时间为208（四分位间距161 - 248）天。与男性相比，女性报告在书写、阅读和计数方面存在问题的患病率更高（< 4周，比值比3.05，95%置信区间：1.38 - 6.72；4 - 12周，比值比2.51，95%置信区间：1.02 - 6.14；> 12周，比值比3.74，95%置信区间：1.12 - 12.56）以及思维交流方面（< 4周，比值比2.53，95%置信区间：1.41 - 4.54；4 - 12周，比值比3.74，95%置信区间：1.93 - 7.24；> 12周，比值比2.00，95%置信区间：1.01 - 3.99）。在感染后4至12周之间，两性在以可理解/明确的方式回答问题上的差异具有统计学意义（比值比2.63，95%置信区间：1.36 - 5.10），而在12周以下发现两性在回忆新信息方面存在差异（< 4周和4 - 12周的比值比分别为2.54，95%置信区间：1.44 - 4.48和2.43，95%置信区间：1.37 - 4.31）。在报告多任务处理问题、回忆过去信息、确定当前日期或方向定位方面未发现性别差异。