Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Departments of Public Health, Translational Medicine and Physiology, Semmelweis University, Budapest, Hungary.
Ageing Res Rev. 2023 Jul;88:101962. doi: 10.1016/j.arr.2023.101962. Epub 2023 May 22.
Cerebral small vessel disease (CSVD) is the leading cause of vascular cognitive impairment and is associated with COVID-19. However, contributing factors that often accompany CSVD pathology in COVID-19 patients may influence the incidence of cerebrovascular complications. Thus, a mechanism linking COVID-19 and CSVD has yet to be uncovered and differentiated from age-related comorbidities (i.e., hypertension), and medical interventions during acute infection. We aimed to evaluate CSVD in acute and recovered COVID-19 patients and to differentiate COVID-19-related cerebrovascular pathology from the above-mentioned contributing factors by assessing the localization of microbleeds and ischemic lesions/infarctions in the cerebrum, cerebellum, and brainstem. A systematic search was performed in December 2022 on PubMed, Web of Science, and Embase using a pre-established search criterion related to history of, or active COVID-19 with CSVD pathology in adults. From a pool of 161 studies, 59 met eligibility criteria and were included. Microbleeds and ischemic lesions had a strong predilection for the corpus callosum and subcortical/deep white matter in COVID-19 patients, suggesting a distinct CSVD pathology. These findings have important implications for clinical practice and biomedical research as COVID-19 may independently, and through exacerbation of age-related mechanisms, contribute to increased incidence of CSVD.
脑小血管病（CSVD）是血管性认知障碍的主要原因，并与 COVID-19 相关。然而，在 COVID-19 患者中经常与 CSVD 病理共存的致病因素可能会影响脑血管并发症的发生。因此，尚未发现将 COVID-19 与 CSVD 联系起来的机制，并且需要将其与年龄相关的合并症（如高血压）以及急性感染期间的医疗干预区分开来。我们旨在评估急性和恢复期 COVID-19 患者的 CSVD，并通过评估大脑、小脑和脑干中微出血和缺血性病变/梗死的定位，将 COVID-19 相关的脑血管病理与上述致病因素区分开来。我们于 2022 年 12 月在 PubMed、Web of Science 和 Embase 上使用与成人 COVID-19 病史或活动性 COVID-19 合并 CSVD 病理相关的预先设定的搜索标准进行了系统搜索。从 161 项研究中，有 59 项符合入选标准并被纳入。微出血和缺血性病变在 COVID-19 患者中强烈倾向于胼胝体和皮质下/深部白质，表明存在独特的 CSVD 病理。这些发现对临床实践和生物医学研究具有重要意义，因为 COVID-19 可能会通过独立地、并通过加剧与年龄相关的机制，导致 CSVD 的发病率增加。
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