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芝加哥出现神经系统症状的新冠长期症状患者的临床和诊断特征

Clinical and diagnostic features of long-COVID patients presenting with neurologic symptoms in Chicago.

作者信息

Brandes Lauren E, Orme Daniel, Bermeo-Ovalle Adriana, Sierra Morales Fabian

机构信息

Department of Neurology, Rush University Medical Center, Chicago, USA.

出版信息

J Neural Transm (Vienna). 2024 Aug;131(8):961-969. doi: 10.1007/s00702-024-02789-9. Epub 2024 Jun 7.

Abstract

Long COVID, a condition characterized by persistent symptoms after COVID-19 infection, is increasingly being recognized worldwide. Neurologic symptoms are frequently reported in survivors of COVID-19, making it crucial to better understand this phenomenon both on a societal scale and for the quality of life of these patients. Between January 1, 2020, and July 31, 2022, Illinois (IL) had a standardized cumulative death rate that ranked it 24th out of the 51 states in the United States (US). However, the US had one of the highest per capita COVID-19 death rates among large, high-income countries. [Bollyky T. et al. 2023] As a result of the increased number of COVID-19 infections, there was a rise in the number of patients experiencing Long COVID. At our neuro-infectious disease clinic in Chicago (IL), we observed an increasing number of patients presenting with cognitive and other neurologic symptoms after contracting COVID-19. Initially, we needed to provide these individuals with a better understanding of their condition and expected outcomes. We were thus motivated to further evaluate this group of patients for any patterns in presentation, neurologic findings, and diagnostic testing that would help us better understand this phenomenon. We aim to contribute to the growing body of research on Long COVID, including its presentation, diagnostic testing results, and outcomes to enlighten the long COVID syndrome. We hypothesize that the neurological symptoms resulting from long COVID persist for over 12 months. We conducted a retrospective analysis of clinical data from 44 patients with long-COVID. Cognitive symptoms were the most common presenting concern. Abnormalities in Montreal Cognitive Assessment, electroencephalogram, serum autoantibody testing, and cerebrospinal fluid were found in minority subsets of our cohort. At 12 months, most patients continue to experience neurologic symptoms, though more than half reported moderate or marked improvement compared to initial presentation. Although most of the patients in this study did not show a consistent occurrence of symptoms suggesting a cohesive underlying etiology, our clinical data demonstrated some features of Long COVID patients in Chicago (IL) that could lead to new research avenues, helping us better understand this syndrome that affects patients worldwide.

摘要

长期新冠是一种在新冠病毒感染后出现持续症状的疾病,在全球范围内日益受到关注。新冠病毒感染者的幸存者经常报告出现神经症状,因此,从社会层面以及对这些患者的生活质量而言,更好地了解这一现象至关重要。在2020年1月1日至2022年7月31日期间,伊利诺伊州(IL)的标准化累积死亡率在美国51个州中排名第24位。然而,美国在大型高收入国家中的人均新冠死亡率位居前列。[博利基T.等人,2023年]由于新冠病毒感染人数增加,长期新冠患者的数量也有所上升。在我们位于伊利诺伊州芝加哥的神经传染病诊所,我们观察到感染新冠病毒后出现认知和其他神经症状的患者数量不断增加。最初,我们需要让这些人更好地了解自己的病情和预期结果。因此,我们有动力进一步评估这组患者的症状表现、神经学检查结果和诊断测试中的任何模式,以帮助我们更好地理解这一现象。我们旨在为关于长期新冠的不断增长的研究做出贡献,包括其症状表现、诊断测试结果和预后情况,以阐明长期新冠综合征。我们假设长期新冠导致的神经症状会持续超过12个月。我们对44例长期新冠患者的临床数据进行了回顾性分析。认知症状是最常见的就诊关注点。在我们的队列中,少数亚组在蒙特利尔认知评估、脑电图、血清自身抗体检测和脑脊液检查中发现异常。在12个月时,大多数患者仍有神经症状,但超过一半的患者报告与初始表现相比有中度或明显改善。尽管本研究中的大多数患者并未表现出提示有连贯潜在病因的症状持续出现,但我们的临床数据显示了伊利诺伊州芝加哥长期新冠患者的一些特征,这些特征可能会带来新的研究方向,帮助我们更好地理解这种影响全球患者的综合征。

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