急性 COVID-19 脑病与季节性甲型流感相关脑病的比较

IF 0.4 4区 医学 Q4 PEDIATRICS
Jialu Xu, Wei Li, Yilin Zhu, Jiajin Wang, Haifeng Li
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引用次数: 0

摘要

目的比较急性冠状病毒病 2019(COVID-19)脑病和季节性甲型流感病毒(IAV)相关脑病患儿的临床表现和神经生物学特征。研究方法我们对浙江大学医学院附属儿童医院2022年12月15日至2023年1月15日期间诊断为COVID-19脑病的患者和2017年11月至2023年3月期间诊断为IAV相关性脑病的18岁以下儿童进行了回顾性队列研究。研究结果本研究共纳入34例COVID-19急性脑病患者和37例IAV相关性脑病患者。在 COVID-19 ICU 组和中重度组均观察到脑脊液(CSF)多形细胞和 CSF 葡萄糖升高,以及单核细胞和 TNF-α 下调。与 IAV 组相比,COVID-19 组患者的中位年龄更小(P < 0.001),出现神经症状的中位时间更短(P < 0.001)。IAV 组中有更多患者出现意识改变(P < 0.001)并被送入重症监护室(P < 0.001)。因此,IAV 组的重症病例也更多一些(P = 0.007)。脑成像显示,急性坏死性脑病主要出现在 IAV 组(P = 0.038)。血液参数方面,IAV 组白细胞水平较低(P = 0.003),CD4 表达较低(P = 0.047)。COVID-19组的随机血糖(P = 0.001)、D二聚体(P = 0.004)和细胞因子IL-2(P = 0.005)较低,而IFN-γ(P = 0.013)显著较高。结论甲型流感病毒相关脑病的表现更为严重。然而,IFN-γ在COVID-19脑病中可能是一种保护性细胞因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Acute COVID-19 Encephalopathy with Seasonal Influenza A-Associated Encephalopathy
Objectives: To compare the clinical presentations and neurobiological features in children with acute Coronavirus disease 2019 (COVID-19) encephalopathy and Seasonal influenza A virus (IAV)-associated encephalopathy. Methods: We conducted a retrospective cohort study on patients diagnosed with COVID-19 encephalopathy between December 15, 2022, and January 15, 2023, and children diagnosed with IAV-associated encephalopathy between November 2017 and March 2023, who were less than 18 years old at the Children’s Hospital, Zhejiang University School of Medicine. Results: A total of 34 patients with acute COVID-19 encephalopathy and 37 patients with IAV-associated encephalopathy were included in this study. Elevation of cerebrospinal fluid (CSF) pleocytosis and CSF glucose, as well as downregulation of monocyte and TNF-α, were observed in both the COVID-19 ICU group and the moderate & severe group. The median age was younger (P < 0.001) and the median time for the occurrence of neurological symptoms was shorter (P < 0.001) in the COVID-19 group compared with the IAV group. More patients in the IAV group had altered levels of consciousness (P < 0.001) and were admitted to the ICU (P < 0.001). Consequently, more severe cases were observed in the IAV group (P = 0.007). Brain imaging showed a predominance appearance of acute necrotizing encephalopathy in the IAV group (P = 0.038). Regarding blood parameters, leukomonocyte levels were lower in the IAV group (P = 0.003) with lower expression of CD4 (P = 0.047). Random blood glucose (P = 0.001), D dimer (P = 0.004), and cytokine IL-2 (P = 0.005) were lower in the COVID-19 group, while IFN-γ (P = 0.013) was significantly higher. Conclusions: Influenza A virus-associated encephalopathy presented more severe manifestations. However, IFN-γ may act as a protective cytokine in COVID-19 encephalopathy.
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来源期刊
CiteScore
0.90
自引率
20.00%
发文量
75
审稿时长
6-12 weeks
期刊介绍: Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.
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