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新冠后认知障碍和精神健康:一项横断面研究。

Cognitive impairments and mental health of patients with post-COVID-19: A cross-sectional study.

机构信息

Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.

Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany; Post COVID Center of the University Hospital of Erlangen, Germany.

出版信息

J Psychosom Res. 2023 Oct;173:111441. doi: 10.1016/j.jpsychores.2023.111441. Epub 2023 Jul 31.

Abstract

BACKGROUND

Persistent cognitive complaints belong to the most frequent symptoms after COVID-19. This study explored the neuropsychological profile, mental health and risk factors for cognitive impairment in post-COVID-19 patients.

METHODS

The patients were recruited consecutively in the Post COVID Center of the University Hospital of Erlangen between 12/2022 and 05/2023. They underwent an extensive neuropsychological assessment including the Verbal Learning Memory Test (VLMT), the digit span backwards from the Wechsler Memory Scale-Revised (WMS-R), the Trail Making Test (TMT) Part A and B, the d2 Test of Attention and the Regensburger Verbal Fluency Test (RWT). For each cognitive domain we calculated the frequency of age-adjusted scores below the measure-specific norms. Depressive symptoms were measured with the Patient-Health-Questionnaire-9 (PHQ-9). Logistic regression analyses were computed.

RESULTS

In 110 patients (mean age: 42.5 ± 11.9 years; 68.2% women), the most frequent cognitive deficits were observed for verbal fluency, working speed, delayed recall and attention. In almost every cognitive domain high education levels were associated with a decreased risk for cognitive impairment. Higher age was a risk factor for working speed and delayed recall and a protective factor for verbal fluency. Clinically relevant depressive symptoms were associated with an elevated risk for an impairment regarding some cognitive functions.

CONCLUSION

Cognitive dysfunctions were common among the post-COVID-19 patients. Differentiated exploration of cognitive impairments is crucial for a proper characterization of the post-COVID syndrome. In future research parameters of cognitive impairment should be correlated to alterations in biological markers of the disease like markers of immunological and microcirculation change.

摘要

背景

持续性认知主诉属于新冠病毒感染后最常见的症状之一。本研究旨在探索新冠病毒感染后患者的神经心理学特征、心理健康状况和认知障碍的危险因素。

方法

患者于 2022 年 12 月至 2023 年 5 月在埃尔朗根大学医院的新冠后中心连续招募。他们接受了广泛的神经心理学评估,包括词语学习记忆测验(VLMT)、威斯康星卡片分类测验修订版(WMS-R)的数字倒背测验、连线测验 A 和 B、d2 注意力测验和雷根斯堡词语流畅性测验(RWT)。对于每个认知域,我们计算了年龄调整后低于特定测量标准的分数的频率。使用患者健康问卷-9(PHQ-9)测量抑郁症状。计算了逻辑回归分析。

结果

在 110 名患者(平均年龄:42.5±11.9 岁;68.2%为女性)中,最常见的认知缺陷是词语流畅性、工作速度、延迟回忆和注意力。在几乎每个认知域中,较高的教育水平与认知障碍的风险降低相关。较高的年龄是工作速度和延迟回忆的危险因素,是词语流畅性的保护因素。有临床意义的抑郁症状与某些认知功能受损的风险增加相关。

结论

新冠病毒感染后患者的认知功能障碍较为常见。对认知障碍进行差异化探索对于正确描述新冠后综合征至关重要。在未来的研究中,应将认知障碍的参数与疾病的生物标志物改变相关联,如免疫和微循环变化的标志物。

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