Marco Colizzi, Carla Comacchio, Maria De Martino, Maddalena Peghin, Giulia Bontempo, Stefania Chiappinotto, Federico Fonda, Miriam Isola, Carlo Tascini, Matteo Balestrieri, Alvisa Palese
{"title":"COVID-19 引发的神经精神症状在急性感染后可能长期存在：一项为期两年的生物行为风险因素和心理测量结果前瞻性研究。","authors":"Marco Colizzi, Carla Comacchio, Maria De Martino, Maddalena Peghin, Giulia Bontempo, Stefania Chiappinotto, Federico Fonda, Miriam Isola, Carlo Tascini, Matteo Balestrieri, Alvisa Palese","doi":"10.1017/ipm.2023.53","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To assess the prevalence of neuropsychiatric symptoms 2 years after the COVID-19 acute phase and to identify biobehavioral risk factors.</p><p><strong>Methods: </strong>This 2-year prospective study assessed adult individuals with COVID-19 via face-to-face interview and laboratory testing at onset, and via telephone interview at 2-year follow-up. Data collected included COVID-19 severity and management at onset, as well as depression, anxiety, insomnia, cognitive failure, and fatigue at follow-up using standardized assessment tools.</p><p><strong>Results: </strong>Out of 1,067 screened COVID-19 patients, 230 completed the 2-year follow-up (female, 53.5%; aged>40, 80.9%; native Italian, 94.9%; medical comorbidity, 53.5%; chronic medication, 46.3%; moderate to severe COVID-19, 24.9%; hospital admission, 28.7%; ICU, 5.2%). At follow-up, 9.1% had anxiety, 11.3% depression, 9.1% insomnia, 18.3% cognitive failure, and 39.1% fatigue, of clinical relevance. Headache (OR = 2.49, 95% CI = 1.01-6.16, <i>p</i> = 0.048), dyspnea (OR = 2.55, 95% CI = 1.03-6.31, <i>p</i> = 0.043), and number of symptoms (OR = 1.23, 95% CI = 1.01-1.51, <i>p</i> = 0.047) at onset were associated with anxiety at follow-up; dyspnea at onset was associated with depression at follow-up (OR = 2.80, 95% CI = 1.22-6.41, <i>p</i> = 0.015); number of comorbidities at onset was associated with insomnia at follow-up (OR = 1.48, 95% CI = 1.06-2.08, <i>p</i> = 0.022); female gender (OR = 2.39, 95% CI = 1.14-5.00, <i>p</i> = 0.020) and number of symptoms (OR = 1.20, 95% CI = 1.02-1.42, <i>p</i> = 0.026) at onset was associated with cognitive failure at follow-up; number of comorbidities (OR = 1.33, 95% CI = 1.03-1.73, <i>p</i> = 0.029) and symptoms (OR = 1.19, 95% CI = 1.04-1.37, <i>p</i> = 0.013) and raised interleukin 6 levels <i>(</i>OR = 4.02, 95% CI = 1.42-11.36, <i>p</i> = 0.009) at onset was associated with fatigue at follow-up.</p><p><strong>Conclusions: </strong>COVID-19 survivors, especially if female, with preexisting health problems, and with a more severe acute phase, may present with long-lasting neuropsychiatric sequalae, urging interventions to sustain recovery particularly in these higher risk individuals.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-8"},"PeriodicalIF":1.8000,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"COVID-19-induced neuropsychiatric symptoms can persist long after acute infection: a 2-year prospective study of biobehavioral risk factors and psychometric outcomes.\",\"authors\":\"Marco Colizzi, Carla Comacchio, Maria De Martino, Maddalena Peghin, Giulia Bontempo, Stefania Chiappinotto, Federico Fonda, Miriam Isola, Carlo Tascini, Matteo Balestrieri, Alvisa Palese\",\"doi\":\"10.1017/ipm.2023.53\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To assess the prevalence of neuropsychiatric symptoms 2 years after the COVID-19 acute phase and to identify biobehavioral risk factors.</p><p><strong>Methods: </strong>This 2-year prospective study assessed adult individuals with COVID-19 via face-to-face interview and laboratory testing at onset, and via telephone interview at 2-year follow-up. Data collected included COVID-19 severity and management at onset, as well as depression, anxiety, insomnia, cognitive failure, and fatigue at follow-up using standardized assessment tools.</p><p><strong>Results: </strong>Out of 1,067 screened COVID-19 patients, 230 completed the 2-year follow-up (female, 53.5%; aged>40, 80.9%; native Italian, 94.9%; medical comorbidity, 53.5%; chronic medication, 46.3%; moderate to severe COVID-19, 24.9%; hospital admission, 28.7%; ICU, 5.2%). At follow-up, 9.1% had anxiety, 11.3% depression, 9.1% insomnia, 18.3% cognitive failure, and 39.1% fatigue, of clinical relevance. Headache (OR = 2.49, 95% CI = 1.01-6.16, <i>p</i> = 0.048), dyspnea (OR = 2.55, 95% CI = 1.03-6.31, <i>p</i> = 0.043), and number of symptoms (OR = 1.23, 95% CI = 1.01-1.51, <i>p</i> = 0.047) at onset were associated with anxiety at follow-up; dyspnea at onset was associated with depression at follow-up (OR = 2.80, 95% CI = 1.22-6.41, <i>p</i> = 0.015); number of comorbidities at onset was associated with insomnia at follow-up (OR = 1.48, 95% CI = 1.06-2.08, <i>p</i> = 0.022); female gender (OR = 2.39, 95% CI = 1.14-5.00, <i>p</i> = 0.020) and number of symptoms (OR = 1.20, 95% CI = 1.02-1.42, <i>p</i> = 0.026) at onset was associated with cognitive failure at follow-up; number of comorbidities (OR = 1.33, 95% CI = 1.03-1.73, <i>p</i> = 0.029) and symptoms (OR = 1.19, 95% CI = 1.04-1.37, <i>p</i> = 0.013) and raised interleukin 6 levels <i>(</i>OR = 4.02, 95% CI = 1.42-11.36, <i>p</i> = 0.009) at onset was associated with fatigue at follow-up.</p><p><strong>Conclusions: </strong>COVID-19 survivors, especially if female, with preexisting health problems, and with a more severe acute phase, may present with long-lasting neuropsychiatric sequalae, urging interventions to sustain recovery particularly in these higher risk individuals.</p>\",\"PeriodicalId\":46220,\"journal\":{\"name\":\"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-02-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1017/ipm.2023.53\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1017/ipm.2023.53","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估 COVID-19 急性期 2 年后神经精神症状的发生率，并确定生物行为风险因素：评估 COVID-19 急性期 2 年后神经精神症状的发生率，并确定生物行为风险因素：这项为期 2 年的前瞻性研究在 COVID-19 发病时通过面对面访谈和实验室检测对成年 COVID-19 患者进行评估，并在 2 年随访时通过电话访谈进行评估。收集的数据包括发病时 COVID-19 的严重程度和管理情况，以及随访时使用标准化评估工具进行的抑郁、焦虑、失眠、认知障碍和疲劳情况：在 1067 名经过筛查的 COVID-19 患者中，有 230 人完成了为期两年的随访（女性，53.5%；年龄大于 40 岁，80.9%；母语为意大利语，94.9%；合并症，53.5%；长期服药，46.3%；中度至重度 COVID-19，24.9%；入院，28.7%；重症监护室，5.2%）。在随访中，9.1%的患者患有焦虑症，11.3%的患者患有抑郁症，9.1%的患者患有失眠症，18.3%的患者患有认知功能障碍，39.1%的患者患有与临床相关的疲劳症。头痛（OR = 2.49，95% CI = 1.01-6.16，P = 0.048）、呼吸困难（OR = 2.55，95% CI = 1.03-6.31，P = 0.043）和症状数量（OR = 1.23，95% CI = 1.01-1.51，P = 0.047）与随访时的焦虑相关；发病时的呼吸困难与随访时的抑郁相关（OR = 2.80，95% CI = 1.22-6.41，p = 0.015）；发病时的合并症数量与随访时的失眠相关（OR = 1.48，95% CI = 1.06-2.08，p = 0.022）；发病时的女性性别（OR = 2.39，95% CI = 1.14-5.00，p = 0.020）和症状数量（OR = 1.20，95% CI = 1.02-1.42，p = 0.026）与随访时的认知功能衰竭相关；合并症数量（OR = 1.33，95% CI = 1.03-1.73，p = 0.029）和症状（OR = 1.19，95% CI = 1.04-1.37，p = 0.013）以及发病时白细胞介素 6 水平升高（OR = 4.02，95% CI = 1.42-11.36，p = 0.009）与随访时的疲劳相关：结论：COVID-19幸存者，尤其是女性、已有健康问题和急性期较严重的幸存者，可能会出现长期的神经精神后遗症，因此需要采取干预措施，以维持这些高危人群的康复。
COVID-19-induced neuropsychiatric symptoms can persist long after acute infection: a 2-year prospective study of biobehavioral risk factors and psychometric outcomes.
Objectives: To assess the prevalence of neuropsychiatric symptoms 2 years after the COVID-19 acute phase and to identify biobehavioral risk factors.
Methods: This 2-year prospective study assessed adult individuals with COVID-19 via face-to-face interview and laboratory testing at onset, and via telephone interview at 2-year follow-up. Data collected included COVID-19 severity and management at onset, as well as depression, anxiety, insomnia, cognitive failure, and fatigue at follow-up using standardized assessment tools.
Results: Out of 1,067 screened COVID-19 patients, 230 completed the 2-year follow-up (female, 53.5%; aged>40, 80.9%; native Italian, 94.9%; medical comorbidity, 53.5%; chronic medication, 46.3%; moderate to severe COVID-19, 24.9%; hospital admission, 28.7%; ICU, 5.2%). At follow-up, 9.1% had anxiety, 11.3% depression, 9.1% insomnia, 18.3% cognitive failure, and 39.1% fatigue, of clinical relevance. Headache (OR = 2.49, 95% CI = 1.01-6.16, p = 0.048), dyspnea (OR = 2.55, 95% CI = 1.03-6.31, p = 0.043), and number of symptoms (OR = 1.23, 95% CI = 1.01-1.51, p = 0.047) at onset were associated with anxiety at follow-up; dyspnea at onset was associated with depression at follow-up (OR = 2.80, 95% CI = 1.22-6.41, p = 0.015); number of comorbidities at onset was associated with insomnia at follow-up (OR = 1.48, 95% CI = 1.06-2.08, p = 0.022); female gender (OR = 2.39, 95% CI = 1.14-5.00, p = 0.020) and number of symptoms (OR = 1.20, 95% CI = 1.02-1.42, p = 0.026) at onset was associated with cognitive failure at follow-up; number of comorbidities (OR = 1.33, 95% CI = 1.03-1.73, p = 0.029) and symptoms (OR = 1.19, 95% CI = 1.04-1.37, p = 0.013) and raised interleukin 6 levels (OR = 4.02, 95% CI = 1.42-11.36, p = 0.009) at onset was associated with fatigue at follow-up.
Conclusions: COVID-19 survivors, especially if female, with preexisting health problems, and with a more severe acute phase, may present with long-lasting neuropsychiatric sequalae, urging interventions to sustain recovery particularly in these higher risk individuals.
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