口服二甲胺四环素作为肌痛性脑脊髓炎和长COVID患者的一线治疗：一项初步研究。

Q3 Neuroscience

eNeurologicalSci Pub Date : 2024-12-02 DOI:10.1016/j.ensci.2024.100537

Kunihisa Miwa

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引用次数: 0

摘要

背景：肌痛性脑脊髓炎（Myalgic encephalomyelitis， ME）与长时间的新冠肺炎相关，也是抗冠状病毒疫苗接种后的不良后遗症。最近，口服二甲胺四环素治疗已被报道可以改善ME患者的症状，特别是在疾病的初始阶段。方法：对55例“冠状病毒时代”出现的ME患者口服二甲胺四环素（100mg × 2，第一天，随后100mg /d，连用41 d），其中19例为长冠状病毒，5例为冠状病毒疫苗接种后出现不良后遗症。结果：包括恶心和/或头晕在内的急性不良反应导致4例（7%）患者在最初几天停止治疗。在其他51例完成治疗的患者中，观察到良好的效果，包括41例（80%）患者的表现状态评分或日常生活受限活动指数下降≥2分。病程与治疗效果呈负相关（p = 0.02）， 6个月内病程与治疗效果显著相关（27/30,90%,p = 0.02，风险比：3.6,95%可信区间：1.2 ~ 10.6）。18例长冠状病毒感染者中有16例（89%）出现良好疗效。主观症状如疲劳、运动后不适、睡眠不清醒、脑雾、不平衡、站立不耐受和神经性疼痛均有显著改善。结论：口服二甲胺四环素可有效改善ME患者的症状，包括长冠状病毒和冠状病毒后疫苗接种后遗症。它代表了这些患者在初始阶段有效的一线治疗选择。

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Oral minocycline therapy as first-line treatment in patients with Myalgic encephalomyelitis and long COVID: A pilot study

Background

Myalgic encephalomyelitis (ME) is associated with long COVID and also untoward sequelae after anti-coronavirus vaccination. Recently, oral minocycline therapy has been reported to ameliorate symptoms in patients with ME, particularly at the initial stage of the disease.

Methods

Oral minocycline (100 mg × 2 on the first day, followed by 100 mg/day for 41 days) was administered to 55 patients with ME that emerged during the “Corona era,” including 19 patients with long COVID and 5 patients diagnosed with untoward sequalae following coronavirus vaccination.

Results

Acute adverse effects including nausea and/or dizziness caused four (7 %) patients to discontinue treatment in the first few days. Among the other 51 patients who completed therapy, favorable effects were observed, including a decrease in performance status score or index for restricted activities of daily living ≥2 points in 41 (80 %) patients. Disease duration was inversely associated with the favorable therapeutic effects (p = 0.02) and the disease duration within 6 months was significantly associated with the favorable therapeutic effects (27/30, 90 %, p = 0.02, hazard ratio: 3.6, 95 % confidence interval, 1.2–10.6). The favorable effects were observed in 16 (89 %) of 18 patients with long COVID. Significant amelioration of subjective symptoms of fatigue, post-exertional malaise, unrefreshing sleep, brain fog, disequilibrium, orthostatic intolerance, and neuropathic pain were observed.

Conclusions

Oral minocycline was effective at ameliorating symptoms in patients with ME including long COVID and post-coronavirus vaccination sequalae. It represents an effective first-line therapeutic option for these patients in the initial stage.

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来源期刊

eNeurologicalSci Neuroscience-Neurology

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

62 days

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