Huang Jiecheng, Fan Yuxuan, Wang Yongshun, Liu Jingjin
The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China.
Department of Rehabilitation, Tongji Hospital Affiliated to Tongji University, Tongji University School of Medicine, Shanghai, China.
Open Med (Wars). 2025 Jan 9;20(1):20241067. doi: 10.1515/med-2024-1067. eCollection 2025.
Some of the millions of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have developed new sequelae after recovering from the initial disease, termed post-acute sequelae of coronavirus disease 2019 (PASC). One symptom is anxiety, which is likely due to three etiologies: brain structural changes, neuroendocrine disruption, and neurotransmitter alterations. This review provides an overview of the current literature on the pathophysiological pathways linking coronavirus disease 2019 to anxiety, as well as the possible mechanisms of action in which an increasingly scrutinized treatment method, enhanced external counter-pulsation (EECP), is able to alleviate anxiety. SARS-CoV-2 triggers increased inflammatory cytokine production, as well as oxidative stress; these processes contribute to the aforementioned three etiologies. The potential treatment approach of EECP, involving sequenced inflation and deflation of specifically-placed airbags, has become of increasing interest, as it has been found to alleviate PASC-associated anxiety by improving patient cardiovascular function. These functional improvements were achieved by EECP stimulating anti-inflammatory and pro-angiogenic processes, as well as improving endothelial cell function and coronary blood flow, partially via counteracting against the negative effects of SARS-CoV-2 infection on the renin-angiotensin-aldosterone system. Therefore, EECP could promote both psychosomatic and cardiac rehabilitation. Further research, though, is still needed to fully determine its benefits and mechanism of action.
数百万感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者中，一些人在从最初的疾病中康复后出现了新的后遗症，称为2019冠状病毒病急性后遗症（PASC）。其中一种症状是焦虑，这可能归因于三种病因：脑结构改变、神经内分泌紊乱和神经递质改变。本综述概述了目前关于将2019冠状病毒病与焦虑联系起来的病理生理途径的文献，以及一种越来越受关注的治疗方法——增强型体外反搏（EECP）能够缓解焦虑的可能作用机制。SARS-CoV-2会引发炎症细胞因子产生增加以及氧化应激；这些过程导致了上述三种病因。EECP的潜在治疗方法，包括对特定放置的气囊进行顺序充气和放气，已越来越受到关注，因为已发现它通过改善患者心血管功能来缓解与PASC相关的焦虑。这些功能改善是通过EECP刺激抗炎和促血管生成过程，以及改善内皮细胞功能和冠状动脉血流来实现的，部分是通过抵消SARS-CoV-2感染对肾素-血管紧张素-醛固酮系统的负面影响。因此，EECP可以促进身心康复和心脏康复。不过，仍需要进一步研究来全面确定其益处和作用机制。
