Post-Covid Condition (PCC)

  • 文章类型: Journal Article
    背景:目前尚不清楚COVID-19病后(PCC)认知功能的主观和客观指标是否相关。相关性的程度具有机制和临床意义。
    方法:这是对随机,双盲,安慰剂对照临床试验包含在一个严格表征的PCC患者队列中认知主观和客观测量的基线数据.在这里,我们评估了主客观条件函数之间的关联,根据感知赤字问卷的衡量,20项(PDQ-20)和数字符号替换测试(DSST)和轨迹制作测试(TMT)-A/B,分别。
    结果:共有152名参与者组成基线样本。由于缺少数据,我们的统计分析包括150名自我报告的PDQ-20,147名合并DSST测量的认知功能的个体(Pen/Paper的复合z得分加上在线CogState版本,NcombinedDSST),71人DSST测量的认知功能(笔/纸版),70对于TMT-A测量的认知功能,TMT-B测量的认知功能为70。在调整了年龄之后,性别,和教育,PDQ-20与纸笔DSST(β=-0.003,p=0.002)和TMT-B(β=0.003,p=0.008)评分显著相关,但与TMT-A评分无关(β=-0.001,p=0.751)。
    结论:总体而言,在主观和客观认知功能之间观察到统计学上显著的相关性.为有主观认知功能投诉的PCC患者提供护理的临床医生可以考虑在护理点采取基于测量的认知方法,该方法仅关注患者报告的措施。
    BACKGROUND: It remains unclear whether subjective and objective measures of cognitive function in Post COVID-19 Condition (PCC) are correlated. The extent of correlation has mechanistic and clinical implications.
    METHODS: This post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial contains baseline data of subjective and objective measures of cognition in a rigorously characterized cohort living with PCC. Herein, we evaluated the association between subjective and objective condition function, as measured by the Perceived Deficits Questionnaire, 20-item (PDQ-20) and the Digit Symbol Substitution Test (DSST) and Trails Making Test (TMT)-A/B, respectively.
    RESULTS: A total of 152 participants comprised the baseline sample. Due to missing data, our statistical analyses included 150 for self-reported PDQ-20, 147 individuals for combined DSST-measured cognitive function (composite z-score of the Pen/Paper plus Online CogState Version, NcombinedDSST), 71 for in-person DSST-measured cognitive function (Pen/Paper Version), 70 for TMT-A-measured cognitive function, and 70 for TMT-B-measured cognitive function. After adjusting for age, sex, and education, PDQ-20 was significantly correlated with pen-and-paper DSST (β = -0.003, p = 0.002) and TMT-B (β = 0.003, p = 0.008) scores, but not with TMT-A scores (β = -0.001, p = 0.751).
    CONCLUSIONS: Overall, a statistically significant correlation was observed between subjective and objective cognitive functions. Clinicians providing care for individuals with PCC who have subjective cognitive function complaints may consider taking a measurement-based approach to cognition at the point of care that focuses exclusively on patient-reported measures.
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  • 文章类型: Systematic Review
    纤维肌痛综合征(FMS),肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)和长COVID(LC)是相似的多症状临床综合征,但每个个体的主要症状不同。在这些情况下,有关于中枢神经系统可能的功能改变的现有和新兴文献。这篇综述旨在综合和评估FMS中静息态定量EEG(qEEG)的文献,ME/CFS和LC,借鉴先前对FMS和ME/CFS的研究,以帮助了解新条件LC的神经病理生理学。系统搜索MEDLINE,Embase,CINHAL,对1994年12月至2023年9月之间发表的文章进行了PsycINFO和WebofScience数据库。在最初确定的2510项研究中,检索到17篇符合所有预定选择标准的文章,特别是评估与健康对照相比,三种情况之一的qEEG变化。所有研究在纽卡斯尔-渥太华量表上得分中等至高质量。低频EEG波段活动下降的总体趋势(delta,theta,和α)和FMS中高频EEGβ活性增加,与ME/CFS中发现的不同。本综述中包含的有限的LC研究主要集中在认知障碍上,并且显示出与FMS和ME/CFS中观察到的模式不一致的混合发现。我们的发现表明FMS和ME/CFS中qEEG脑电波活动的不同模式。需要进一步的研究来探索LC中是否存在具有类似于FMS或ME/CFS的EEG特征的表型。这可以为确定可靠的诊断标记和针对每种临床综合征定制的神经调节疗法的可能靶标提供信息。
    Fibromyalgia Syndrome (FMS), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID (LC) are similar multisymptom clinical syndromes but with difference in dominant symptoms in each individual. There is existing and emerging literature on possible functional alterations of the central nervous system in these conditions. This review aims to synthesise and appraise the literature on resting-state quantitative EEG (qEEG) in FMS, ME/CFS and LC, drawing on previous research on FMS and ME/CFS to help understand neuropathophysiology of the new condition LC. A systematic search of MEDLINE, Embase, CINHAL, PsycINFO and Web of Science databases for articles published between December 1994 and September 2023 was performed. Out of the initial 2510 studies identified, 17 articles were retrieved that met all the predetermined selection criteria, particularly of assessing qEEG changes in one of the three conditions compared to healthy controls. All studies scored moderate to high quality on the Newcastle-Ottawa scale. There was a general trend for decreased low-frequency EEG band activity (delta, theta, and alpha) and increased high-frequency EEG beta activity in FMS, differing to that found in ME/CFS. The limited LC studies included in this review focused mainly on cognitive impairments and showed mixed findings not consistent with patterns observed in FMS and ME/CFS. Our findings suggest different patterns of qEEG brainwave activity in FMS and ME/CFS. Further research is required to explore whether there are phenotypes within LC that have EEG signatures similar to FMS or ME/CFS. This could inform identification of reliable diagnostic markers and possible targets for neuromodulation therapies tailored to each clinical syndrome.
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  • 文章类型: Journal Article
    背景:疲劳是COVID后(PCC)后遗症的突出症状,被称为“长COVID”。\"在这里,我们的目的是确定疲劳对PCC患者心理社会功能的影响。
    方法:该事后分析评估了沃替西汀对疲劳程度的影响,如通过疲劳严重程度量表(FSS)评估的,通过Sheehan残疾量表(SDS)对PCC患者的心理社会功能进行评估。我们还通过Sheehan残疾量表(SDS)评估了FSS在心理社会功能上的变化。这项事后分析从最近发表的一项安慰剂对照研究中获得了数据,该研究评估了沃替西汀对PCC患者客观认知功能的影响。
    结果:本分析包括了144名符合世界卫生组织(WHO)PCC标准的参与者。在8周的沃替西汀治疗结束时,观察到心理社会功能的所有领域都有显着改善。在家庭的治疗终点有显著的组间差异,社会,和工作SDS子类别(p<0.001)。治疗条件时间点和FSS效应对SDS社会(χ2=10.640,p=0.014)和工作(χ2=9.342,p=0.025)类别之间存在统计学上显着的相互作用效应,但对家庭类别(χ2=5.201,p=0.158)。
    结论:这项事后分析表明,沃替西汀治疗可显著改善PCC患者的心理社会功能。我们的结果还表明,心理社会功能的改善是通过疲劳测量的改善显着介导的。我们的结果为确定PCC患者疲劳治疗方法的建议提供了经验支持,目的是更广泛地改善这种常见和严重受损人群的心理社会功能。
    BACKGROUND: Fatigue is a prominent symptom in post-COVID condition (PCC) sequelae, termed \"long COVID.\" Herein, we aim to ascertain the effect of fatigue on psychosocial function in persons living with PCC.
    METHODS: This post hoc analysis evaluated the effects of vortioxetine on measures of fatigue as assessed by the Fatigue Severity Scale (FSS) in psychosocial function as measured by the Sheehan Disability Scale (SDS) in persons with PCC. We also evaluated the change in FSS on psychosocial functioning as measured by the Sheehan Disability Scale (SDS). This post hoc analysis obtained data from a recently published placebo-controlled study evaluating vortioxetine\'s effect on objective cognitive functions in persons living with PCC.
    RESULTS: One hundred forty-four participants meeting World Health Organization (WHO) criteria for PCC were included in this analysis. At the end of 8 weeks of vortioxetine treatment, significant improvement of all domains was observed for psychosocial functioning. There was a significant between-group difference at treatment endpoint in the family, social, and work SDS subcategories (p < 0.001). There was a statistically significant interaction effect between the treatment condition time point and FSS effect on the SDS social (χ2 = 10.640, p = 0.014) and work (χ2 = 9.342, p = 0.025) categories but a statistically insignificant effect on the family categories ((χ2 = 5.201, p = 0.158)).
    CONCLUSIONS: This post hoc analysis suggests that vortioxetine treatment significantly improves psychosocial function in persons with PCC. Our results also indicate that the improvement in psychosocial function was significantly mediated by improvement in measures of fatigue. Our results provide empirical support for recommendations to identify therapeutics for fatigue in persons living with PCC with a broader aim to improve psychosocial function in this common and severely impaired population.
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  • 文章类型: Randomized Controlled Trial
    新冠肺炎后疾病(PCC)很常见,发病率很高。PCC的风险因素包括年龄增长,女性性别,肥胖,和糖尿病。对治疗知之甚少,炎症,PCC。在882名确诊SARS-CoV-2感染的个体中,参与了一项关于COVID-19恢复期血浆(CCP)与对照血浆的随机试验,并提供了可用的生物样本和症状数据,早期CCP治疗之间的联系,细胞因子水平,并对PCC进行了评估。在基线时评估细胞因子和趋化因子水平,第14天和第90天使用多重夹心免疫测定(MesoScaleDiscovery)。在第90天评估任何自我报告的PCC症状的存在。CCP治疗之间的关联,细胞因子水平,和PCC使用多变量逻辑回归模型进行检查。882名参与者中有三分之一出现了第90天的PCC症状,最常见的是疲劳(14.5%)和失语症(14.5%)。细胞因子水平从基线下降到第90天。在多变量分析中,女性(调整后的赔率比[AOR]=2.69[1.93-3.81]),年龄较大(AOR=1.32[1.17-1.50]),IL-6基线水平升高(AOR=1.59[1.02-2.47])与PCC的发展独立相关。与晚期CCP治疗相比,接受早期CCP治疗(症状发作后≤5天)的患者发生PCC的几率显着降低。重要性大约20%的SARS-CoV-2感染者经历了长期的健康影响,根据PCC的定义。然而,目前尚不清楚是否有任何与PCC相关的早期生物标志物,或者早期干预治疗是否可以降低PCC的风险.在一项随机临床试验的二次分析中,这项研究表明,在SARS-CoV-2门诊患者中,感染时IL-6的增加与PCC的几率增加相关.此外,在早期治疗的个体中,在症状发作的5天内,COVID-19恢复期血浆,校正其他人口统计学和临床特征后,PCC的几率有降低的趋势.应考虑未来的治疗研究,以评估早期治疗和抗IL-6治疗对PCC发展的影响。
    OBJECTIVE: Approximately 20% of individuals infected with SARS-CoV-2 experienced long-term health effects, as defined PCC. However, it is unknown if there are any early biomarkers associated with PCC or whether early intervention treatments may decrease the risk of PCC. In a secondary analysis of a randomized clinical trial, this study demonstrates that among outpatients with SARS-CoV-2, increased IL-6 at time of infection is associated with increased odds of PCC. In addition, among individuals treated early, within 5 days of symptom onset, with COVID-19 convalescent plasma, there was a trend for decreased odds of PCC after adjusting for other demographic and clinical characteristics. Future treatment studies should be considered to evaluate the effect of early treatment and anti-IL-6 therapies on PCC development.
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