PDF(Pubmed)
Abstract：
UNASSIGNED: Neuropsychiatric symptoms associated with long COVID are a growing concern. A proposed pathophysiology is increased inflammatory mediators. There is evidence that typical serotonergic antidepressants have limited efficacy in the presence of inflammation. Although ketamine has shown promise in MDD, there is limited evidence supporting the use of ketamine to treat depressive symptoms associated with long COVID.
UNASSIGNED: This case took place on an inpatient psychiatry unit in a Canadian hospital. The patient was admitted with a 10-month history of worsening depression and suicidality following infection with COVID-19. Depressive symptoms and suicidal ideation were assessed throughout treatment using the Montgomery-Asberg Depression Rating Scale (MADRS). Written informed consent was obtained prior to data collection. This patient received 4 doses of intranasal ketamine which resulted in rapid improvement of depressive symptoms and complete resolution of suicidality with no major adverse events.
UNASSIGNED: There is evidence to support long COVID symptoms result from dysregulated inflammatory processes. The presence of inflammation in patients with MDD has correlated to poor outcomes with first-line antidepressants. It has been demonstrated that IV ketamine is associated with decreased inflammatory mediators and proportional decrease in depressive symptoms.
UNASSIGNED: Intranasal ketamine in this case was effective at treating depressive symptoms and suicidal ideation associated with long COVID. This is consistent with available data that demonstrates ketamine\'s efficacy in reducing inflammatory mediators associated with neuropsychiatric symptoms. Therefore, ketamine may be a potential therapeutic option to treat long COVID and persistent depressive symptoms.
UNASSIGNED: This case took place on an inpatient psychiatry unit in a Canadian hospital. The patient was admitted with a 10-month history of worsening depression and suicidality following infection with COVID-19. Depressive symptoms and suicidal ideation were assessed throughout treatment using the Montgomery-Asberg Depression Rating Scale (MADRS). Written informed consent was obtained prior to data collection. This patient received 4 doses of intranasal ketamine which resulted in rapid improvement of depressive symptoms and complete resolution of suicidality with no major adverse events.
UNASSIGNED: There is evidence to support long COVID symptoms result from dysregulated inflammatory processes. The presence of inflammation in patients with MDD has correlated to poor outcomes with first-line antidepressants. It has been demonstrated that IV ketamine is associated with decreased inflammatory mediators and proportional decrease in depressive symptoms.
UNASSIGNED: Intranasal ketamine in this case was effective at treating depressive symptoms and suicidal ideation associated with long COVID. This is consistent with available data that demonstrates ketamine\'s efficacy in reducing inflammatory mediators associated with neuropsychiatric symptoms. Therefore, ketamine may be a potential therapeutic option to treat long COVID and persistent depressive symptoms.
摘要：
■与长期COVID相关的神经精神症状越来越令人担忧。提出的病理生理学是增加的炎症介质。有证据表明，典型的5-羟色胺能抗抑郁药在炎症存在下的疗效有限。尽管氯胺酮在MDD中显示出了希望，支持使用氯胺酮治疗与长期COVID相关的抑郁症状的证据有限。
■这个病例发生在加拿大一家医院的精神科病房。该患者因感染COVID-19后抑郁和自杀恶化10个月病史而入院。使用Montgomery-Asberg抑郁量表（MADRS）评估整个治疗过程中的抑郁症状和自杀意念。在数据收集之前获得书面知情同意书。该患者接受了4剂鼻内氯胺酮，导致抑郁症状的快速改善和自杀倾向的完全缓解，没有重大不良事件。
有证据支持长期的COVID症状是由炎症过程失调引起的。MDD患者炎症的存在与一线抗抑郁药的不良预后相关。已经证明IV氯胺酮与炎症介质的减少和抑郁症状的成比例减少有关。
■在这种情况下，鼻内氯胺酮可有效治疗与长期COVID相关的抑郁症状和自杀意念。这与证明氯胺酮在减少与神经精神症状相关的炎症介质方面的功效的现有数据一致。因此,氯胺酮可能是治疗长期COVID和持续抑郁症状的潜在治疗选择。
■这个病例发生在加拿大一家医院的精神科病房。该患者因感染COVID-19后抑郁和自杀恶化10个月病史而入院。使用Montgomery-Asberg抑郁量表（MADRS）评估整个治疗过程中的抑郁症状和自杀意念。在数据收集之前获得书面知情同意书。该患者接受了4剂鼻内氯胺酮，导致抑郁症状的快速改善和自杀倾向的完全缓解，没有重大不良事件。
有证据支持长期的COVID症状是由炎症过程失调引起的。MDD患者炎症的存在与一线抗抑郁药的不良预后相关。已经证明IV氯胺酮与炎症介质的减少和抑郁症状的成比例减少有关。
■在这种情况下，鼻内氯胺酮可有效治疗与长期COVID相关的抑郁症状和自杀意念。这与证明氯胺酮在减少与神经精神症状相关的炎症介质方面的功效的现有数据一致。因此,氯胺酮可能是治疗长期COVID和持续抑郁症状的潜在治疗选择。
