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新型冠状病毒肺炎对重症监护病房患者群体的中长期影响:出院后六个月和一年的认知及心理后遗症与生活质量

Medium- and Long-Term Effects of COVID-19 in a Population of Patients Admitted to the Intensive Care Unit: Cognitive and Psychological Sequelae and Quality of Life Six Months and One Year after Discharge.

作者信息

Lavolpe Sara, Beretta Natascia, Bonaldi Sofia, Tronci Stefano, Albano Giovanni, Bombardieri Emilio, Merlo Paola

机构信息

Neurology Unit, Humanitas Gavazzeni, 24125 Bergamo, Italy.

Intensive Care Unit, Humanitas Gavazzeni, 24125 Bergamo, Italy.

出版信息

Healthcare (Basel). 2024 Aug 15;12(16):1624. doi: 10.3390/healthcare12161624.

Abstract

Most researchers have assessed cognitive functions in post-COVID-19 patients by means of screening tools and found cognitive sequelae in addition to anxiety, stress, depression, and a reduced quality of life (QoL). This study was aimed at investigating cognitive and psychological sequelae in patients admitted to the intensive care unit (ICU) six months (t6) and one year (t12) after discharge from the hospital, the impact of critical illness on well-being and QoL, and the protective role of cognitive reserve (CR). Twenty-three ICU patients underwent an extensive neuropsychological test battery at t6 and t12; a healthy control group underwent the same evaluation. Patient scores were compared with control scores: patients reported significantly lower scores in visual-spatial functions, both at t6 (U = 122; = 0.033) and at t12 (U = 70; = 0.003), and higher levels of anxiety (U = 126; = 0.043) and depression (U = 97; = 0.005) at t6; the levels of anxiety decreased at t12, while only depression symptoms persisted (U = 99.5; = 0.025). Regarding the QoL, patients obtained lower scores in the physical component of QoL, both at t6 (U = 72; = 0.008) and at t12 (U = 56.5; = 0.005). Few and moderate correlations emerged between isolated cognitive functions and CR and the length of hospital stay. The results suggest a prevalent visual-spatial involvement, the medium- and long-term persistence of psychological sequelae, and a reduced QoL in ICU patients.

摘要

大多数研究人员通过筛查工具评估了新冠后患者的认知功能,发现除了焦虑、压力、抑郁和生活质量(QoL)下降外,还存在认知后遗症。本研究旨在调查出院后六个月(t6)和一年(t12)入住重症监护病房(ICU)的患者的认知和心理后遗症、危重病对幸福感和生活质量的影响以及认知储备(CR)的保护作用。23名ICU患者在t6和t12时接受了广泛的神经心理测试;一个健康对照组进行了相同的评估。将患者得分与对照组得分进行比较:患者在视觉空间功能方面的得分显著较低,在t6时(U = 122;P = 0.033)和t12时(U = 70;P = 0.003)均如此,且在t6时焦虑(U = 126;P = 0.043)和抑郁(U = 97;P = 0.005)水平较高;t12时焦虑水平下降,而只有抑郁症状持续存在(U = 99.5;P = 0.025)。关于生活质量,患者在生活质量的身体成分方面得分较低,在t6时(U = 72;P = 0.008)和t12时(U = 56.5;P = 0.005)均如此。孤立的认知功能与认知储备以及住院时间之间出现了少量和中等程度的相关性。结果表明,ICU患者普遍存在视觉空间功能障碍、心理后遗症的中长期持续存在以及生活质量下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbaa/11354111/f695df077b1b/healthcare-12-01624-g001.jpg

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