Nature Medicine—新冠后遗症重磅发现：新冠肺炎后1年内各种神经内科疾病风险显著增加，如脑血管病、痴呆、运动障碍等

2022-11-23 14:03

即使在急性COVID-19期间不需要住院治疗的人群中，风险和负担也会增加。总之，他们的结果提供了新冠肺炎患者长期神经系统疾病风险增加的证据。

中文摘要

急性COVID-19的神经系统表现具有很好的特征，但科学家尚未对1年后的神经系统后遗症进行全面评估。在这里，研究人员使用美国退伍军人事务部的国家医疗数据库建立了154068名新冠肺炎患者、5638795名对照和5859621名历史对照的队列进行了研究；他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。他们的结果表明，在新冠肺炎急性期后，一系列神经系统后遗症的风险将增加，包括缺血性和出血性中风、认知和记忆障碍、周围神经障碍、发作性疾病（例如偏头痛和癫痫）、锥体外系和运动障碍、精神障碍、肌肉骨骼障碍、感觉障碍、格林-巴利综合征和脑炎或脑病。他们估计，12个月时，每1000人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%置信间隔63.54，78.01）。即使在急性COVID-19期间不需要住院治疗的人群中，风险和负担也会增加。总之，他们的结果提供了新冠肺炎患者长期神经系统疾病风险增加的证据。

英文摘要

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.

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