脂肪变性肝病、严重COVID-19与COVID-19后综合征认知障碍之间的可能联系

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-10-01 Epub Date: 2025-04-10 DOI:10.1007/s15010-025-02531-x

Philipp A Reuken, Freya Wagner, Kathrin Finke, Christina Lemhöfer, Christian Puta, Sven Stengel, André Scherag, Jan-Christoph Lewejohann, Andreas Stallmach, Stefanie Quickert

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引用次数: 0

摘要

目的：脂肪变性肝病（SLD）在过去十年中变得越来越普遍，不仅与心脏代谢疾病有关，而且与心理症状（抑郁、疲劳）有关。这些症状在covid - 19后综合征（PCS）中也很常见。因此，本研究的目的是分析PCS患者的SLD负担。方法：采用瞬态弹性成像、神经认知评估结构化问卷和血样分析等方法，对我院门诊新冠肺炎后所有PCS患者进行系统筛查。没有PCS和没有已知肝脏疾病的对照组也被招募并用同样的方法进行评估。结果：纳入PCS患者560例，健康对照103例。两个队列中SLD的总体患病率都很高（57%对53%）。PCS合并SLD的患者多为男性（41比24%），年龄较大（52比44岁），有更多的心脏代谢疾病（87.0比46.4%）。认知功能障碍在PCS患者中与SLD的相关性高于无SLD组（OR: 1.68, CI: 1.14-2.46, p = 0.008）。SLD的存在与严重COVID-19住院相关（OR: 2.91, CI: 1.85-4.56, p）结论：SLD与PCS患者严重COVID-19和认知功能障碍相关。需要进行纵向研究，以评估肝脂肪变性的作用、急性感染后调节的发展（例如SARS-CoV-2），并区分sld相关症状和PCS。

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Possible link between steatotic liver diseases, severe COVID-19 and cognitive impairment in post-COVID-19 syndrome.

Purpose: Steatotic liver diseases (SLD) have become more prevalent over the last decade and are associated not only with cardiometabolic diseases but also with psychological symptoms (depression, fatigue). These symptoms are also common in post-COVID syndrome (PCS). Therefore, the aim of the study was to analyze the burden of SLD in PCS patients.

Methods: We systematically screened all PCS patients from our post-COVID outpatient clinic using transient elastography, structured questionnaires for neurocognitive evaluation and blood sample analysis. Controls without PCS and without known liver diseases were also recruited and assessed with the same approach.

Results: 560 PCS patients and 103 healthy controls were included. The overall prevalence of SLD was high in both cohorts (57 vs. 53%). PCS patients with SLD were more frequently male (41 vs. 24%), older (52 vs. 44 years) and had more cardiometabolic diseases (87.0 vs. 46.4%). Cognitive impairment was more related to SLD in PCS patients than in the no-SLD group (OR: 1.68, CI: 1.14-2.46, p = 0.008). The presence of SLD was related to severe COVID-19 with hospitalization (OR: 2.91, CI: 1.85-4.56, p < 0.001). Within 1 year of the follow-up, 152 of 289 patients described a resolution in PCS irrespective of the presence or absence of SLD (log-rank p = 0.96).

Conclusions: SLD is associated with severe COVID-19 and cognitive dysfunction in PCS. Longitudinal studies are needed to assess the role of hepatic steatosis, development of post-acute infection regulation (e.g., SARS-CoV-2) and to differentiate between SLD-associated symptoms and PCS.

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.