双相情感障碍谱系、甲状腺功能减退及其与长新冠中慢性疲劳/肌痛性脑脊髓炎样综合征的关联：它们能否被确定为早期决定因素？
Bipolar spectrum, hypothyroidism, and their association with chronic fatigue/myalgic encephalomyelitis-like syndrome in long COVID: could they be identified as early determinants?
作者信息
Tusconi Massimo, Dursun Serdar M, Pegreffi Francesco, Aviles Gonzalez Cesar Ivan, Barrui Vanessa, Fornaro Michele, Hurtado Lujan Luz Alba, Camacho Nunez Lina Patricia, Vega Ochoa Arley Denisse, Curcio Felice, Carta Mauro Giovanni, Cossu Giulia
机构信息
University Hospital of Cagliari, Cagliari, Italy.
Neurochemical Research Unit, Department of Psychiatry University of Alberta, Edmonton, AB, Canada.
出版信息
Front Psychiatry. 2025 Aug 28;16:1623288. doi: 10.3389/fpsyt.2025.1623288. eCollection 2025.
BACKGROUND
Long COVID has been increasingly linked to persistent clinical manifestations, including chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). However, the relationship between this syndrome and pre-existing conditions such as bipolar spectrum disorders and hypothyroidism is not yet clearly established. These disorders may influence the regulation of biorhythms and immune function, suggesting a possible role in the predisposition to the development of CFS/ME in the context of long-term COVID-19.
OBJECTIVES
This study investigates the prevalence of hypothyroidism and bipolar spectrum disorders in patients with CFS/ME associated with long-term COVID-19. It compares it with pre-pandemic population data to determine whether these conditions may be predisposing factors.
METHODS
A case-control design was used to select cases from a clinical trial on CFS/ME in long COVID, while controls were extracted from pre-COVID epidemiological databases. Comparative statistical analyses, including chi-square tests and analysis of variance (ANOVA), were performed to assess significant differences in the frequency of these conditions between both groups.
RESULTS
The clinical sample showed significantly higher prevalence rates of hypothyroidism [27.78% vs. 1.14%; odds ratio (OR) = 33.07; 95% confidence interval (CI): 7.10-153.70] and bipolar spectrum disorders (16.67% vs. 0.2%; OR = 138.4; 95% CI: 36.40-526.43) compared to control populations ( < 0.0001 for both). Similarly, individuals screening positive for depressive symptoms (PHQ9 > 9) showed markedly increased odds (55.5% vs. 4.16%; OR = 28.75; 95% CI: 6.52-126.73).
CONCLUSION
The findings suggest that hypothyroidism and bipolar spectrum disorders may act as predisposing factors in the development of CFS/ME in long-term COVID-19. Identifying these clinical antecedents could facilitate early detection and the development of targeted intervention strategies in at-risk populations.
背景
长期新冠已越来越多地与持续的临床表现相关联，包括慢性疲劳综合征/肌痛性脑脊髓炎（CFS/ME）。然而，这种综合征与双相谱系障碍和甲状腺功能减退等既往疾病之间的关系尚未明确确立。这些疾病可能影响生物节律和免疫功能的调节，提示在长期新冠背景下它们在CFS/ME发病易感性中可能发挥作用。
目的
本研究调查与长期新冠相关的CFS/ME患者中甲状腺功能减退和双相谱系障碍的患病率。将其与疫情前的人群数据进行比较，以确定这些疾病是否可能是易感因素。
方法
采用病例对照设计，从一项关于长期新冠中CFS/ME的临床试验中选取病例，而对照则从新冠疫情前的流行病学数据库中提取。进行了包括卡方检验和方差分析（ANOVA）在内的比较统计分析，以评估两组之间这些疾病频率的显著差异。
结果
与对照组相比，临床样本中甲状腺功能减退[27.78%对1.14%；优势比（OR）=33.07；95%置信区间（CI）：7.10 - 153.70]和双相谱系障碍（16.67%对0.2%；OR = 138.4；95% CI：36.40 - 526.43）的患病率显著更高（两者均P<0.0001）。同样，抑郁症状筛查呈阳性（PHQ9>9）的个体的患病几率明显增加（55.5%对4.16%；OR = 28.75；95% CI：6.52 - 126.73）。
结论
研究结果表明，甲状腺功能减退和双相谱系障碍可能是长期新冠中CFS/ME发病的易感因素。识别这些临床前驱因素有助于在高危人群中进行早期检测并制定有针对性的干预策略。
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