新冠病毒病康复后认知康复的人口统计学、临床特征及结果:病例系列

Demographics, Clinical Characteristics, and Outcomes of a Post-Coronavirus-19 Sample After Cognitive Rehabilitation: A Case Series.

作者信息

Farr Ellen, Esterov Dmitry, Kassmeyer Blake A, Lennon Ryan J, Bergquist Thomas F

机构信息

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.

Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN.

出版信息

Arch Rehabil Res Clin Transl. 2024 Nov 28;7(1):100409. doi: 10.1016/j.arrct.2024.100409. eCollection 2025 Mar.

Abstract

The Coronavirus-19 pandemic has infected millions of people, resulting in ongoing symptoms now described as post-acute sequelae of SARS-COV2 infection (PASC). Persistent neurologic and behavioral sequelae including fatigue, depression, anxiety, sleep disorders, headache, memory loss, and cognitive complaints are common. Although there is increasing evidence related to treatment of physical symptoms such as fatigue through physical rehabilitation practices, to date there is very limited evidence about the efficacy of various treatment regimens directed at nonphysical symptoms such as cognitive concerns and behavioral sequelae. This case series discusses a series of 13 patients with PASC who underwent individualized multidisciplinary outpatient cognitive rehabilitation at a quaternary medical center. In this patient population, the median age was 46 years (Q1, Q3: 41, 50), 77% were women, and 85% were White. The median time from infection to treatment was 229 days (Q1, Q3: 117, 367) and median length of stay in the program was 4.9 months (Q1, Q3: 3.1, 6.3). A history of depression and anxiety was found in 38% and 46% of this population, respectively. On admission and at discharge, the Mayo-Portland Adaptability Inventory-4 Participation Index, the Satisfaction with Life Scale, the Patient Health Questionnaire-9, and the Neurobehavioral Symptom Inventory-22 were completed. After individualized outpatient cognitive therapy, no clear benefit was seen in any of the outcome measures. The ongoing investigation is important to better understand which approaches will benefit these patients.

摘要

新型冠状病毒肺炎大流行已感染数百万人,导致出现目前被称为新冠病毒感染急性后遗症(PASC)的持续症状。持续的神经和行为后遗症很常见,包括疲劳、抑郁、焦虑、睡眠障碍、头痛、记忆力减退和认知问题。尽管有越来越多的证据表明通过物理康复措施可治疗疲劳等身体症状,但迄今为止,针对认知问题和行为后遗症等非身体症状的各种治疗方案的疗效证据非常有限。本病例系列讨论了13例在一家四级医疗中心接受个体化多学科门诊认知康复治疗的PASC患者。在这个患者群体中,中位年龄为46岁(第一四分位数,第三四分位数:41岁,50岁),77%为女性,85%为白人。从感染到治疗的中位时间为229天(第一四分位数,第三四分位数:117天,367天),在该项目中的中位住院时间为4.9个月(第一四分位数,第三四分位数:3.1个月,6.3个月)。分别有38%和46%的人群有抑郁和焦虑病史。在入院时和出院时,完成了梅奥-波特兰适应性量表-4参与指数、生活满意度量表、患者健康问卷-9和神经行为症状量表-22。经过个体化门诊认知治疗后,在任何一项结局指标中均未发现明显益处。正在进行的调查对于更好地了解哪些方法将使这些患者受益很重要。

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