Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 "long haulers".
Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 "long haulers".
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DOI：
10.1002/acn3.51350
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发表时间：
2021-05
影响因子：
5.3
通讯作者：
Koralnik IJ
中科院分区：
文献类型：
--
作者：
Graham EL;Clark JR;Orban ZS;Lim PH;Szymanski AL;Taylor C;DiBiase RM;Jia DT;Balabanov R;Ho SU;Batra A;Liotta EM;Koralnik IJ
大多数SARS-CoV-2感染者从不需要住院治疗。然而，有些人会出现长期症状。我们试图描述非住院Covid-19“长途运输者”的神经系统表现谱。这是一项前瞻性研究，研究对象为2020年5月至11月期间在我们的Neuro-Covid-19诊所就诊的前100名连续患者（50名SARS-CoV-2实验室阳性（SARS-CoV-2+）和50名实验室阴性（SARS-CoV-2-）个体）。由于早期大流行测试的局限性，如果患者符合美国传染病协会的Covid-19症状，从未因肺炎或低氧血症住院，并且神经系统症状持续超过6周，则将其纳入研究。我们记录了神经系统症状的频率，并分析了患者报告的生活质量指标和标准化认知评估。平均年龄为43.2 ± 11.3岁，70%为女性，48%通过电话访视进行评价。最常见的合并症是抑郁/焦虑（42%）和自身免疫性疾病（16%）。主要神经系统表现为：“脑雾”（81%）、头痛（68%）、麻木/刺痛（60%）、味觉障碍（59%）、嗅觉丧失（55%）和肌痛（55%），只有嗅觉丧失在SARS-CoV-2+患者中比SARS-CoV-2-患者更常见（37/50 [74%] vs. 18/50 [36%]; p < 0.001）。此外，85%的人也感到疲劳。发病时间与主观康复印象无相关性。两组患者在认知和疲劳领域的生活质量均受损。与人口统计学匹配的美国人群相比，SARS-CoV-2+患者在注意力和工作记忆认知任务中表现较差（T评分分别为41.5 [37，48.25]和43 [37.5，48.75];均p < 0.01）。未住院的新型冠状病毒“长途运输者”经历了显著和持续的“脑雾”和疲劳，影响了他们的认知和生活质量。
Most SARS‐CoV‐2‐infected individuals never require hospitalization. However, some develop prolonged symptoms. We sought to characterize the spectrum of neurologic manifestations in non‐hospitalized Covid‐19 “long haulers”. This is a prospective study of the first 100 consecutive patients (50 SARS‐CoV‐2 laboratory‐positive (SARS‐CoV‐2+) and 50 laboratory‐negative (SARS‐CoV‐2‐) individuals) presenting to our Neuro‐Covid‐19 clinic between May and November 2020. Due to early pandemic testing limitations, patients were included if they met Infectious Diseases Society of America symptoms of Covid‐19, were never hospitalized for pneumonia or hypoxemia, and had neurologic symptoms lasting over 6 weeks. We recorded the frequency of neurologic symptoms and analyzed patient‐reported quality of life measures and standardized cognitive assessments. Mean age was 43.2 ± 11.3 years, 70% were female, and 48% were evaluated in televisits. The most frequent comorbidities were depression/anxiety (42%) and autoimmune disease (16%). The main neurologic manifestations were: “brain fog” (81%), headache (68%), numbness/tingling (60%), dysgeusia (59%), anosmia (55%), and myalgias (55%), with only anosmia being more frequent in SARS‐CoV‐2+ than SARS‐CoV‐2‐ patients (37/50 [74%] vs. 18/50 [36%]; p < 0.001). Moreover, 85% also experienced fatigue. There was no correlation between time from disease onset and subjective impression of recovery. Both groups exhibited impaired quality of life in cognitive and fatigue domains. SARS‐CoV‐2+ patients performed worse in attention and working memory cognitive tasks compared to a demographic‐matched US population (T‐score 41.5 [37, 48.25] and 43 [37.5, 48.75], respectively; both p < 0.01). Non‐hospitalized Covid‐19 “long haulers” experience prominent and persistent “brain fog” and fatigue that affect their cognition and quality of life.
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DOI：
10.1016/j.jstrokecerebrovasdis.2020.105542
发表时间：
2021-03
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
Batra A;Clark JR;LaHaye K;Shlobin NA;Hoffman SC;Orban ZS;Colton K;Dematte JE;Sorond FA;Koralnik IJ;Liotta EM
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影响因子：
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DOI：
10.1016/s2666-5247(20)30172-5
发表时间：
2021-01
期刊：
The Lancet. Microbe
影响因子：
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Cevik M;Tate M;Lloyd O;Maraolo AE;Schafers J;Ho A
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DOI：
10.1016/j.socscimed.2020.113426
发表时间：
2021-01
期刊：
Social science & medicine (1982)
影响因子：
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作者：
Callard F;Perego E
通讯作者：
Perego E