Department of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.
Department of Pediatrics, The University of Texas Medical Branch, Galveston, Texas, USA.
Clin Transl Sci. 2024 Jun;17(6):e13826. doi: 10.1111/cts.13826.
Following SARS-CoV-2 infection, some patients develop lingering neurologic symptoms of post-acute sequelae of COVID-19 (PASC) that commonly include fatigue and "brain fog." PASC symptoms are also linked with reduced growth hormone (GH) secretion, but GH treatment has not been tested to relieve symptoms. We enrolled 13 adults with neurologic PASC symptoms and peak stimulated GH secretion less than 10 ng/mL (glucagon stimulation) in a pilot study to receive 9 months of daily GH injections and an additional 3 months of off-treatment assessment. We compared peak stimulated GH secretion at baseline and 12 months and assessed measures of cognition, metabolism, body composition, and physical performance over the first 6 months of treatment. Patient-reported outcomes of fatigue, quality of life, sleep, and mood were recorded at baseline and compared with timepoints at 6, 9, and 12 months. GH treatment was associated with significantly improved scores for Brief Fatigue Inventory, Multidimensional Fatigue Symptom Inventory, Quality of Life Assessment of Growth Hormone Deficiency in Adults, Profile of Mood States, and Beck Depression Inventory-II, with no significant change in Pittsburgh Sleep Quality Index. Six months of adjunct GH treatment was not associated with significant changes in cognition, body composition, resting energy expenditure, or physical performance. Peak stimulated GH secretion was not altered at 12 months following 9 months of GH treatment. GH treatment significantly improved neurologic symptoms in PASC patients but cognition, sleep, and physical performance were not significantly altered.
在感染 SARS-CoV-2 后，一些患者出现了 COVID-19 后急性后遗症（PASC）的持续神经系统症状，通常包括疲劳和“脑雾”。PASC 症状还与生长激素（GH）分泌减少有关，但尚未测试 GH 治疗是否可以缓解症状。我们招募了 13 名患有神经系统 PASC 症状且峰值刺激 GH 分泌低于 10ng/mL（胰高血糖素刺激）的成年人，进行了一项试点研究，以接受 9 个月的每日 GH 注射和额外的 3 个月停药评估。我们比较了基线和 12 个月时的峰值刺激 GH 分泌，并在治疗的前 6 个月评估认知、代谢、身体成分和身体表现的测量值。在基线和 6、9 和 12 个月时记录了疲劳、生活质量、睡眠和情绪的患者报告结局。GH 治疗与 Brief Fatigue Inventory、Multidimensional Fatigue Symptom Inventory、成人生长激素缺乏症生活质量评估、情绪状态简表和贝克抑郁量表 II 的评分显著改善相关，匹兹堡睡眠质量指数无显著变化。在接受 6 个月的辅助 GH 治疗后，认知、身体成分、静息能量消耗或身体表现没有显著变化。在接受 9 个月的 GH 治疗后 12 个月时，峰值刺激 GH 分泌没有改变。GH 治疗显著改善了 PASC 患者的神经系统症状，但认知、睡眠和身体表现没有显著改变。
