文摘
摘要目的:检查神经症状轻微COVID-19的自然历史。
背景:各种神经系统表现与COVID-19已报告,主要是在住院病人的回顾性研究。很少有轻微COVID-19患者数据。
设计/方法:自愿参加阿尔伯塔希望COVID-19试验(NCT043296115天,羟氯喹和安慰剂),作为门诊病人进行管理,前瞻性评估不到,1年之后积极的测试。他们完成了详细的神经症状问卷、电话蒙特利尔认知评估(T-MoCA),凯斯勒心理压力量表(K10)和EQ-5D-3L(生活质量)。告密者完成了轻度行为障碍检查表(MBI-C)和线人问卷对认知能力下降(IQCODE)。我们跟踪医疗利用率和神经调查使用医疗记录。
结果:在198名患者(平均年龄:45,IQR: 37-54, 43.9%女性);28(14.1%)存在的神经/精神疾病。179名患者症状评估,139年(77.7%)报告≥1神经症状,最常见的是嗅觉缺失症/味觉障碍(56.3%)、肌痛(42.6%)、头痛(41.8%)。症状通常开始1周内疾病(中位数:6天,差:4 - 8)。大多数解决后不到三;40例(22.3%)报告持续症状在1年,27(15.1%)报告没有改善。持续的症状包括混乱(50%)、头痛(52.5%)、失眠(40%),和抑郁(35%)。身体质量指数,之前神经/精神病史,哮喘,和缺乏全职工作是与神经系统症状的存在和持久性;只在多变量逻辑回归女性性独立相关(优势比:5.04,95% ci: 1.58—-16.1)。持续的症状有更多的住院患者和家庭医生访问,糟MBI-C分数,很少独立仪器日常活动在1年期(77.8%比98.2%,p = 0.005)。 Patients with any or persistent neurological symptoms had greater psychological distress defined as K10≥20(aOR:21.0, 95%CI:1.96–225) and worse quality-of-life ratings(mean EQ-5D VAS:67.0 vs 82.8, p=0.0002). 50.0% of patients had T-MoCA<18 at 3-months versus 42.9% at 1-year; patients reporting memory complaints were more likely to have informant-reported cognitive-behavioural decline (aOR[1-year IQCODE>3.3]:12.7, 95%CI:1.08–150).
结论:神经症状通常是在温和的幸存者COVID-19和坚持五分之一患者1年以后。这些症状与糟patient-reported有关结果。
披露:Ganesh博士已经收到个人薪酬在500 - 4999美元的范围作为顾问MD分析。Ganesh博士已经收到个人薪酬在500 - 4999美元的范围为MyMedicalPanel担任顾问。Ganesh博士已经收到个人薪酬在500 - 4999美元的范围作为Adkins研究小组的顾问。Ganesh博士已经收到个人补偿的范围0 - 499美元为图1作为顾问。Ganesh博士已经收到个人补偿的范围0 - 499美元为DeepBench担任顾问。Ganesh博士已经收到个人补偿的范围为0 - 499美元作为一个编辑,副主编、编辑顾问委员会成员对美国神经学学院(期刊神经病学和神经学:临床实践)。半岛投注体育官网Ganesh博士已经收到个人补偿的范围为0 - 499美元作为一个编辑,副主编、编辑顾问委员会成员为美国心脏协会(日报:中风)。Ganesh博士接到SnapDx股票或所有权权益。Ganesh博士获得了股票或所有权的兴趣TheRounds.com。Ganesh博士已经收到了来自先进的健康分析股票或所有者权益(啊哈健康有限公司)。Ganesh博士的机构已经接到加拿大健康研究院的研究支持。Ganesh博士的机构收到加拿大心血管研究支持的社会。Ganesh博士的机构已经接到艾伯塔创新研究支持。Ganesh已收到博士研究的机构来自卡尔加里大学的临床研究中心的支持。Ganesh博士的机构已收到研究支持创新4健康。Ganesh博士的机构收到INOVAIT新宁研究所的研究支持。Ganesh博士的机构已收到从校园阿尔伯塔省神经科学研究支持。Ganesh博士收到发现或技术知识产权利益有关卫生保健。 Mr. Rosentreter has received intellectual property interests from a discovery or technology relating to health care. Mr. Chen has nothing to disclose. Rahul Mehta has nothing to disclose. Dr. McLeod has nothing to disclose. Dr. Wan has nothing to disclose. Dr. Krett has nothing to disclose. Dr. Mahjoub has nothing to disclose. Dr. Lee has nothing to disclose. The institution of Dr. Metz has received research support from Multiple Sclerosis Society of Canada. The institution of Dr. Metz has received research support from Calgary Health Trust. The institution of Dr. Metz has received research support from Government of Alberta. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. Dr. Smith has received publishing royalties from a publication relating to health care. Dr. Hill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer Ingelheim. Dr. Hill has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sun Pharma. Dr. Hill has received stock or an ownership interest from Circle Neurovascular.
