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使用丹麦所有 SARS-CoV-2 检测结果和住院数据进行的长达 22 个月随访的 COVID-19 后长期神经学结局。

Long-term neurological outcome after COVID-19 using all SARS-CoV-2 test results and hospitalisations in Denmark with 22-month follow-up.

机构信息

Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.

Departments of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

出版信息

Nat Commun. 2023 Jul 15;14(1):4235. doi: 10.1038/s41467-023-39973-6.

Abstract

Hospitalisation with COVID-19 is associated with an increased risk of neurological sequelae; however, representative nationwide studies comparing to other infections with similar severity and also including milder SARS-CoV-2 infections have been lacking. Using the nationwide Danish registers including all SARS-CoV-2 PCR test results and hospitalisations between March 1, 2020, and December 31, 2021, we estimate the risk of any first neurological disorder diagnosed in inpatient, outpatient, or emergency room settings. We show that positive tests increase the rate of neurological disorders by a hazard ratio of 1.96 (95% confidence interval: 1.88-2.05) compared to individuals not tested and by a hazard ratio of 1.11 (95% confidence interval: 1.07-1.16) compared to individuals with negative tests only. However, there is no evidence that the risk of neurological disorders is higher for individuals who test positive compared to non-COVID-19 infections treated with anti-infective medication. The risk of neurological disorders is increased after COVID-19-hospitalisation compared to no COVID-19 hospital admission; however, these risks are comparable to hospitalisation with other respiratory infections (P value 0.328). In conclusion, COVID-19 is associated with an increased risk of neurological disorders, but no more than that observed after other infections of similar severity.

摘要

COVID-19 住院与神经系统后遗症风险增加相关;然而,缺乏与其他严重程度相似的感染进行比较的全国性代表性研究,也未包括轻症 SARS-CoV-2 感染。我们使用包括 2020 年 3 月 1 日至 2021 年 12 月 31 日期间所有 SARS-CoV-2 PCR 检测结果和住院数据的全国性丹麦登记处,估计在住院、门诊或急诊环境中首次诊断为任何神经系统疾病的风险。我们发现,与未检测者相比,阳性检测者的神经系统疾病发生率风险比为 1.96(95%置信区间:1.88-2.05),与仅阴性检测者相比,风险比为 1.11(95%置信区间:1.07-1.16)。然而,没有证据表明与非 COVID-19 感染经抗感染治疗相比,阳性检测者发生神经系统疾病的风险更高。与无 COVID-19 住院相比,COVID-19 住院后发生神经系统疾病的风险增加;然而,这些风险与其他呼吸道感染相当(P 值 0.328)。总之,COVID-19 与神经系统疾病风险增加相关,但并不高于其他严重程度相似感染后的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78e9/10349860/8c44ecde3de2/41467_2023_39973_Fig1_HTML.jpg

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