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新型冠状病毒肺炎感染后的小脑炎:基于病例的系统评价与汇总分析

Cerebellitis following COVID-19 infection: A case-based systematic review and pooled analysis.

作者信息

Najdaghi Soroush, Narimani Davani Delaram, Hashemian Mohammadreza, Ebrahimi Narges

机构信息

Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Medical Librarianship and Information Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Heliyon. 2024 Jul 11;10(14):e34497. doi: 10.1016/j.heliyon.2024.e34497. eCollection 2024 Jul 30.

Abstract

BACKGROUND

The COVID-19 pandemic has been linked to neurological complications, including Cerebellitis. This study aims to investigate the clinical features, and consequences of Cerebellitis following COVID-19 infection, informing medical management strategies.

METHODS

A systematic search was conducted through PubMed, Web of Science, Embase, ProQuest, and Cochrane databases from January 2018 to September 12, 2023, on cases post-COVID-19. Demographics, clinical characteristics, and diagnostic techniques were analyzed using descriptive statistics. Chi-Square tests assessed associations between diagnoses and treatments, with visualizations including heatmaps and scatter plots.

RESULTS

After the final Screening, the analysis of 18 cases revealed Cerebellitis post-COVID-19 spanned 9 countries, predominantly from the USA (27.8 %), with a mean patient age of 40.1 years (±24.6). Males comprised 94.4 % of cases. Common underlying conditions included hypertension (22.2 %) and diabetes (11.1 %). Neurological symptoms presented on average 15.15 ± 12.7 days post-COVID-19 infection. A moderate negative correlation (r = -0.358) was observed between age and symptom onset. Blood and CSF biomarkers showed weak correlations with symptom onset intervals. Treatment efficacy varied, with most cases achieving symptom-free outcomes. The Chi-Square test for diagnosis-treatment associations yielded a p-value of 0.089, and for follow-up outcomes, a p-value of 0.283, indicating no significant statistical associations.

CONCLUSION

This systematic review highlights increased reports of Cerebellitis in males in their fourth decade of life, with the highest comorbidities being vascular diseases. Marker assessments show a decrease in CSF protein in half of patients, along with complete recovery following combination treatment with antivirals and steroids in acute Cerebellitis.

摘要

背景

2019冠状病毒病(COVID-19)大流行与包括小脑炎在内的神经系统并发症有关。本研究旨在调查COVID-19感染后小脑炎的临床特征及后果,为医疗管理策略提供依据。

方法

于2018年1月至2023年9月12日通过PubMed、科学网、Embase、ProQuest和Cochrane数据库对COVID-19后的病例进行系统检索。使用描述性统计分析人口统计学、临床特征和诊断技术。卡方检验评估诊断与治疗之间的关联,可视化方法包括热图和散点图。

结果

经过最终筛选,对18例病例的分析显示,COVID-19后的小脑炎病例分布在9个国家,主要来自美国(27.8%),患者平均年龄为40.1岁(±24.6)。男性占病例的94.4%。常见的基础疾病包括高血压(22.2%)和糖尿病(11.1%)。神经系统症状平均在COVID-19感染后15.15±12.7天出现。年龄与症状发作之间存在中度负相关(r = -0.358)。血液和脑脊液生物标志物与症状发作间隔的相关性较弱。治疗效果各不相同,大多数病例实现了无症状结局。诊断与治疗关联的卡方检验p值为0.089,随访结局的p值为0.283,表明无显著统计学关联。

结论

本系统评价强调,40岁左右男性的小脑炎报告有所增加,合并症以血管疾病最为常见。标志物评估显示,一半患者的脑脊液蛋白降低,急性小脑炎患者联合使用抗病毒药物和类固醇治疗后可完全康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d381/11305223/39f15825f1b8/gr1.jpg

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