Yasir Shahwar, Jin Yu, Razzaq Fuleah A, Caballero-Moreno Antonio, Galán-García Lidice, Ren Peng, Valdes-Sosa Mitchell, Rodriguez-Labrada Roberto, Bringas-Vega Maria L, Valdes-Sosa Pedro A
Joint China-Cuba Laboratory for Neurotechnology and Bioengineering (JCCLNB), The Clinical Hospital of Chengdu Brain Science Institute, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China.
Servicio de Psiquiatria Galigarcia, Hospital Nacional, La Habana, Cuba.
Front Neurosci. 2024 Jan 8;17:1249282. doi: 10.3389/fnins.2023.1249282. eCollection 2023.
The severity of the pandemic and its consequences on health and social care systems were quite diverse and devastating. COVID-19 was associated with an increased risk of neurological and neuropsychiatric disorders after SARS-CoV-2 infection. We did a cross-sectional study of 3 months post-COVID consequences of 178 Cuban subjects. Our study has a unique CUBAN COVID-19 cohort of hospitalized COVID-19 patients and healthy subjects. We constructed a latent variable for pre-health conditions (PHC) through Item Response Theory (IRT) and for post-COVID neuropsychiatric symptoms (Post-COVID-NPS) through Factor Analysis (FA). There seems to be a potential causal relationship between determinants of CIBD and post-COVID-NPS in hospitalized COVID-19 patients. The causal relationships accessed by Structural Equation Modeling (SEM) revealed that PHC ( < 0.001) and pre-COVID cognitive impairments ( < 0.001) affect the severity of COVID-19 patients. The severity of COVID-19 eventually results in enhanced post-COVID-NPS ( < 0.001), even after adjusting for confounders (age, sex, and pre-COVID-NPS). The highest loadings in PHC were for cardiovascular diseases, immunological disorders, high blood pressure, and diabetes. On the other hand, sex ( < 0.001) and pre-COVID-NPS including neuroticism ( < 0.001), psychosis ( = 0.005), cognition ( = 0.036), and addiction ( < 0.001) were significantly associated with post-COVID-NPS. The most common neuropsychiatric symptom with the highest loadings includes pain, fatigue syndrome, autonomic dysfunctionalities, cardiovascular disorders, and neurological symptoms. Compared to healthy people, COVID-19 patients with pre-health comorbidities or pre-neuropsychiatric conditions will have a high risk of getting severe COVID-19 and long-term post-COVID neuropsychiatric consequences. Our study provides substantial evidence to highlight the need for a complete neuropsychiatric follow-up on COVID-19 patients (with severe illness) and survivors (asymptomatic patients who recovered).
疫情的严重程度及其对卫生和社会护理系统的影响各不相同且具有毁灭性。新型冠状病毒肺炎(COVID-19)与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染后神经和神经精神障碍风险增加有关。我们对178名古巴受试者感染COVID-19三个月后的后果进行了横断面研究。我们的研究有一个独特的古巴COVID-19队列,包括住院的COVID-19患者和健康受试者。我们通过项目反应理论(IRT)构建了一个健康前状况(PHC)的潜在变量,并通过因子分析(FA)构建了COVID-19后神经精神症状(COVID-19后NPS)的潜在变量。在住院的COVID-19患者中,炎症性肠病(CIBD)的决定因素与COVID-19后NPS之间似乎存在潜在的因果关系。通过结构方程模型(SEM)得出的因果关系表明,健康前状况(<0.001)和COVID-19前认知障碍(<0.001)会影响COVID-19患者的严重程度。即使在调整了混杂因素(年龄、性别和COVID-19前NPS)后,COVID-19的严重程度最终也会导致COVID-19后NPS加重(<0.001)。健康前状况中负荷最高的是心血管疾病、免疫紊乱、高血压和糖尿病。另一方面,性别(<0.001)和COVID-19前NPS,包括神经质(<0.001)、精神病(=0.005)、认知(=0.036)和成瘾(<0.001)与COVID-19后NPS显著相关。负荷最高的最常见神经精神症状包括疼痛、疲劳综合征、自主神经功能障碍、心血管疾病和神经症状。与健康人相比,有健康前合并症或神经精神疾病前状况的COVID-19患者发生严重COVID-19和长期COVID-19后神经精神后果的风险更高。我们的研究提供了大量证据,强调了对COVID-19患者(重症患者)和幸存者(康复的无症状患者)进行全面神经精神随访的必要性。