COVID-19的长期神经系统结局

纳特梅德

.2022 11 月;28（11）：2406-2415.

 DOI：10.1038/s41591-022-02001-z。 Epub 2022 9 月 22 日。

COVID-19 的长期神经系统结局

徐旭 1,谢燕 1 2 3,齐亚德·阿利 4 5 6 7 8

背景扩大

• 密码： 36138154

•  

• PMCID： PMC9671811

•  

• DOI： 10.1038/s41591-022-02001-z

免费 PMC 文章

全文链接引用

抽象

急性 COVID-19 的神经系统表现特征明确，但尚未对 1 年的急性后神经系统后遗症进行全面评估。在这里，我们使用美国退伍军人事务部的国家医疗保健数据库建立了一个由 154，068 名 COVID-19 患者、5，638，795 名当代对照和 5，859，621 名历史对照组成的队列;我们使用逆概率加权来平衡队列，并估计急性SARS-CoV-2感染后12个月发生神经系统疾病的风险和负担。我们的研究结果表明，在COVID-19的急性后阶段，一系列事件神经系统后遗症的风险增加，包括缺血性和出血性中风、认知和记忆障碍、周围神经系统疾病、阵发性疾病（例如偏头痛和癫痫发作）、锥体外系和运动障碍、心理健康障碍、肌肉骨骼疾病、感觉障碍、格林-巴雷综合征以及脑炎或脑病。我们估计，在12个月时，任何神经系统后遗症的风险比为1.42（95%置信区间1.38，1.47），负担为70.69（95%置信区间63.54，78.01）。即使在急性COVID-19期间不需要住院的人群中，风险和负担也会增加。限制包括主要由白人男性组成的队列。综上所述，我们的研究结果提供了COVID-19患者长期神经系统疾病风险增加的证据。

© 2022.这是美国政府的作品，在美国不受版权保护;外国版权保护可能适用。

Nat Med

. 2022 Nov;28(11):2406-2415.

 doi: 10.1038/s41591-022-02001-z. Epub 2022 Sep 22.

Long-term neurologic outcomes of COVID-19

Evan Xu 1, Yan Xie 1 2 3, Ziyad Al-Aly 4 5 6 7 8

Affiliations expand

• PMID: 36138154

•  

• PMCID: PMC9671811

•  

• DOI: 10.1038/s41591-022-02001-z

Free PMC article

Full text linksCite

Abstract

The neurologic manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of postacute neurologic sequelae at 1 year has not been undertaken. Here we use the national healthcare databases of the US Department of Veterans Affairs to build a cohort of 154,068 individuals with COVID-19, 5,638,795 contemporary controls and 5,859,621 historical controls; we use inverse probability weighting to balance the cohorts, and estimate risks and burdens of incident neurologic disorders at 12 months following acute SARS-CoV-2 infection. Our results show that in the postacute phase of COVID-19, there was increased risk of an array of incident neurologic sequelae including ischemic and hemorrhagic stroke, cognition and memory disorders, peripheral nervous system disorders, episodic disorders (for example, migraine and seizures), extrapyramidal and movement disorders, mental health disorders, musculoskeletal disorders, sensory disorders, Guillain-Barré syndrome, and encephalitis or encephalopathy. We estimated that the hazard ratio of any neurologic sequela was 1.42 (95% confidence intervals 1.38, 1.47) and burden 70.69 (95% confidence intervals 63.54, 78.01) per 1,000 persons at 12 months. The risks and burdens were elevated even in people who did not require hospitalization during acute COVID-19. Limitations include a cohort comprising mostly White males. Taken together, our results provide evidence of increased risk of long-term neurologic disorders in people who had COVID-19.