van Niekerk Inette, Panieri Monica, Müller Talitha, Mapahla Lovemore, Dzanibe Sonwabile, Day Cascia, Stein Dan J, Peter Jonny
Department of Psychiatry, University of Cape Town, South Africa.
Faculty of Health Sciences, University of Cape Town, South Africa.
Brain Behav Immun Health. 2025 Apr 16;46:100990. doi: 10.1016/j.bbih.2025.100990. eCollection 2025 Jul.
SARS-CoV-2 is a neurotrophic and pro-inflammatory virus, with several acute and more persistent neuropsychiatric sequelae reported. There are limited data from African cohorts and few acute illness biomarkers of persistent neuropsychiatric symptoms.
To examine the association of neuropsychiatric outcomes with clinical illness severity, systemic inflammation, cardiovascular and renin-angiotensin-system (RAS) biomarkers. Second, to determine the prevalence of neuropsychiatric symptoms in a cohort of South African SARS-CoV-2 PCR positive patients at least six months following infection/hospitalization.
SARS-CoV-2 PCR positive patients were recruited prospectively from Cape Town, South Africa, including hospitalized patients from ancestral, beta and delta-dominant COVID-19 waves (pre-vaccine rollout); and asymptomatic/mild SARS-CoV-2 positive patients. The 96-protein O-link inflammation and cardiovascular panels, RAS fingerprinting, and antibody responses were measured in serum samples collected at peak severity and recovery (>3 months post-infection). Telephonic interviews were conducted at least six months post infection/hospitalization. Validated measures employed were: WHO Self-Report Questionnaire (SRQ-20), Generalized Anxiety Disorder Scale (GAD-7), Chalder Fatigue Scale (CFS-11) and Telephonic Montreal Cognitive Assessment (T-MoCA).
Ninety-seven participants completed telephonic interviews. The median (IQR) age was 48 (37-59) years, and 54 % were female. There were no significant associations between neuropsychiatric outcomes and illness severity, systemic inflammation, cardiovascular and/or renin-angiotensin-system (RAS) biomarkers from either peak illness or recovery samples. More than half of this SA COVID-19 cohort had one or more persistent neuropsychiatric symptoms >6 months post vaccine-naïve infection. On the T-MoCA, 44 % of participants showed evidence of cognitive and/or memory impairments.
The high prevalence of persistent neuropsychiatric symptoms in this African cohort supports ongoing attention to long COVID. Acute and early serum protein biomarkers were not associated with persistent neuropsychiatric outcomes post-COVD-19.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是一种嗜神经和促炎病毒，有多项关于急性和更持久的神经精神后遗症的报道。来自非洲队列的数据有限，且关于持续性神经精神症状的急性疾病生物标志物也很少。
研究神经精神结局与临床疾病严重程度、全身炎症、心血管和肾素-血管紧张素系统（RAS）生物标志物之间的关联。其次，确定南非一组SARS-CoV-2 PCR阳性患者在感染/住院至少六个月后的神经精神症状患病率。
前瞻性招募了来自南非开普敦的SARS-CoV-2 PCR阳性患者，包括来自祖传、贝塔和德尔塔主导的新冠疫情浪潮（疫苗推出前）的住院患者；以及无症状/轻症SARS-CoV-2阳性患者。在病情最严重和恢复时（感染后>3个月）采集的血清样本中，检测了96种蛋白质的O-连接炎症和心血管指标、RAS指纹图谱以及抗体反应。在感染/住院至少六个月后进行电话访谈。采用的经过验证的测量方法包括：世界卫生组织自评问卷（SRQ-20）、广泛性焦虑障碍量表（GAD-7）、查尔德疲劳量表（CFS-11）和电话蒙特利尔认知评估（T-MoCA）。
97名参与者完成了电话访谈。年龄中位数（四分位间距）为48（37-59）岁，54%为女性。神经精神结局与疾病严重程度、全身炎症、心血管和/或肾素-血管紧张素系统（RAS）生物标志物之间，在疾病高峰期或恢复样本中均无显著关联。在这个南非新冠病毒感染队列中，超过一半的患者在未接种疫苗感染后6个月以上出现一种或多种持续性神经精神症状。在电话蒙特利尔认知评估中，44%的参与者有认知和/或记忆障碍的迹象。
这个非洲队列中持续性神经精神症状的高患病率支持对长期新冠的持续关注。急性和早期血清蛋白生物标志物与新冠病毒感染后的持续性神经精神结局无关。
