Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan.
Department of General Internal Medicine, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan.
J Neurol Sci. 2024 Oct 15;465:123199. doi: 10.1016/j.jns.2024.123199. Epub 2024 Aug 22.
In 2024, the sequalae of the acute phase of coronavirus disease-19 (COVID-19) infection, which include neurological symptoms and are commonly referred to as long COVID or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC), continue to be a substantial health concern; however, similar symptoms are observed in individuals with no previous COVID-19 infection.
This was a single-center, retrospective, descriptive case series study. Data were obtained from patients who visited our outpatient clinic specializing in PASC between June 1, 2021, and May 31, 2023. We compared antibody test results between patients with confirmed acute phase infection and those without. We compared differences in demographic and clinical characteristics between patients with positive results during the acute phase of COVID-19 infection and positive anti-SARS-CoV-2 antibody tests (true-PASC), and those with neither (PASC-mimic).
Of 437 patients diagnosed with PASC according to World Health Organization criteria, 222 underwent COVID-19 antibody tests. Of these, 193 patients (86.9%) had a history of confirmed acute phase infection, whereas 29 (13.1%) did not. Of the former, 186 patients (96.4%) were seropositive for anti-nucleotide SARS-CoV-2 antibodies (true-PASC), whereas 19 of the latter tested seronegative for anti-nucleotide SARS-CoV-2 antibodies (PASC-mimic). There were no significant differences in symptom characteristics between true-PASC and PASC-mimic participants.
It was difficult to identify any clinical features to aid in diagnosing PASC without confirmation of acute COVID-19 infection. The findings indicate the existence of a "PASC-mimic" condition that should be acknowledged and excluded in future PASC-related research studies.
2024 年，新型冠状病毒病-19（COVID-19）感染急性期的后遗症，包括神经系统症状，通常被称为长 COVID 或严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的急性后后遗症（PASC），仍然是一个重大的健康问题；然而，在没有 COVID-19 感染史的个体中也观察到类似的症状。
这是一项单中心、回顾性、描述性病例系列研究。数据来自于 2021 年 6 月 1 日至 2023 年 5 月 31 日期间在我们专门治疗 PASC 的门诊就诊的患者。我们比较了确诊急性感染患者和未感染者的抗体检测结果。我们比较了 COVID-19 感染急性期有阳性结果和抗 SARS-CoV-2 抗体检测阳性（真正的 PASC）的患者与既无阳性结果的患者（PASC 模拟）之间的人口统计学和临床特征差异。
根据世界卫生组织标准诊断为 PASC 的 437 例患者中，有 222 例进行了 COVID-19 抗体检测。其中，193 例（86.9%）有确诊急性感染史，29 例（13.1%）无感染史。在前者中，186 例（96.4%）抗核苷酸 SARS-CoV-2 抗体检测阳性（真正的 PASC），而后者中有 19 例抗核苷酸 SARS-CoV-2 抗体检测阴性（PASC 模拟）。真正的 PASC 和 PASC 模拟患者的症状特征无显著差异。
在未确认急性 COVID-19 感染的情况下，很难识别有助于诊断 PASC 的任何临床特征。研究结果表明存在一种“PASC 模拟”情况，这在未来的 PASC 相关研究中应得到承认和排除。
