Pakan Rachel, Hadidchi Roham, Al-Ani Yousef, Piskun Hannah, Duong Katie S, Henry Sonya, Wang Stephen, Maurer Carine W, Duong Tim Q
Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA.
Department of Neurology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Diagnostics (Basel). 2024 Dec 10;14(24):2774. doi: 10.3390/diagnostics14242774.
BACKGROUND/OBJECTIVES: Although COVID-19 has been linked to worse outcomes in patients with neurological disorders, its impact on those with essential tremor (ET) remains unclear. To investigate clinical outcomes of ET patients with and without COVID-19 three and a half years post-pandemic.
1074 ET patients were evaluated in this retrospective study in the Montefiore Health System from January 2016 to July 2023. Comparisons between ET patients with and without a positive SARS-CoV-2 polymerase chain reaction test were made. Outcomes included post-index date major adverse cardiovascular events (MACEs), new-onset sleep disturbances, fatigue, dyspnea, first-time fall, new-onset anxiety, new-onset depression, headache, new-onset imbalance, new-onset mild cognitive impairment, and all-cause mortality, adjusted hazard ratios (aHR) adjusting for covariates were calculated.
ET patients with COVID-19 had higher prevalence of pre-existing type-2 diabetes, depression, and anxiety compared to ET patients without COVID-19. COVID-19 was significantly associated with higher risk of MACEs, (aHR = 2.39 [1.49, 3.82]), new-onset sleep disturbance, (aHR = 2.12 [1.44, 3.13]), fatigue, (aHR = 1.83 [1.27, 2.65]), dyspnea, (aHR = 1.98 [1.40, 2.80]), first-time fall, (aHR = 4.76 [2.24, 10.14]), new-onset anxiety, (aHR = 3.66 [2.02, 6.64]), and new-onset depression, (aHR = 2.38 [1.20, 4.70]). COVID-19 was not associated with all-cause mortality.
In patients with ET, COVID-19 significantly increases the risk of several long-term adverse health outcomes, but not mortality.
背景/目的：尽管新冠病毒病（COVID-19）与神经系统疾病患者的不良预后有关，但其对特发性震颤（ET）患者的影响仍不明确。为了调查疫情爆发三年半后感染和未感染COVID-19的ET患者的临床结局。
在这项回顾性研究中，于2016年1月至2023年7月期间在蒙特菲奥里医疗系统对1074例ET患者进行了评估。对SARS-CoV-2聚合酶链反应检测呈阳性和阴性的ET患者进行了比较。结局包括索引日期后的主要不良心血管事件（MACE）、新发睡眠障碍、疲劳、呼吸困难、首次跌倒、新发焦虑、新发抑郁、头痛、新发平衡障碍、新发轻度认知障碍和全因死亡率，并计算了调整协变量后的调整风险比（aHR）。
与未感染COVID-19的ET患者相比，感染COVID-19的ET患者患2型糖尿病、抑郁和焦虑的既往患病率更高。COVID-19与MACE风险显著升高相关（aHR = 2.39 [1.49, 3.82]）、新发睡眠障碍（aHR = 2.12 [1.44, 3.13]）、疲劳（aHR = 1.83 [1.27, 2.65]）、呼吸困难（aHR = 1.98 [1.40, 2.80]）、首次跌倒（aHR = 4.76 [2.24, 10.14]）、新发焦虑（aHR = 3.66 [2.02, 6.64]）和新发抑郁（aHR = 2.38 [1.20, 4.70]）。COVID-19与全因死亡率无关。
在ET患者中，COVID-19显著增加了几种长期不良健康结局的风险，但与死亡率无关。
