Aleksandra Đ Ilić, Vladimir Galić, Vojislava Bugarski Ignjatović, Željka Nikolašević, Dmitar Vlahović, Goran Knezović, Jasmina Boban, Duško Kozić, Željko Živanović
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引用次数: 0
摘要
COVID-19是一种全身性感染,可导致内皮功能障碍,导致重症病例。虽然血管并发症有充分的文献记载,但它们对血管结构、功能和认知的影响尚不清楚。这项横断面研究探讨了轻度、中度和重度COVID-19患者的血管和认知差异,研究了全球认知表现与血管参数之间的相关性。该研究包括83名工作年龄患者(30-65岁,男女),他们在6-12个月内从COVID-19中康复。他们按严重程度分组:轻度(门诊,无氧支持),中度(住院,常规氧治疗)和重度(住院,高级氧治疗)。排除包括先前存在的认知或神经疾病、严重动脉粥样硬化、恶性肿瘤和先前接种过COVID-19疫苗。采用蒙特利尔认知评估(MoCA)测试评估整体认知功能,同时采用双超声和经颅多普勒评估血管参数-颈动脉内膜-中膜厚度(IMT)、β硬度指数(β指数)、平均流速(mv)、屏气后最大流速(MV-BH)和屏气指数(BHI)。重症患者颈动脉僵硬度最高,脑血管反应性最差。MoCA评分没有明显的组间差异,23-40%有轻度认知障碍。轻度组MoCA评分与β指数呈负相关(ρ=—0.453;p = 0.034),重度组MVs与MoCA呈正相关(ρ= 0.414; p = 0.028)。在轻度病例中,动脉僵硬和认知障碍之间的关联表明,SARS-CoV-2的持久影响,而不是先前存在的疾病。这些发现强调了颈动脉僵硬是covid -19后认知障碍的关键因素,强调了早期风险识别和及时干预。
Cognitive and vascular (dys)function after COVID-19.
COVID-19 is a systemic infection that causes endothelial dysfunction, contributing to severe cases. While vascular complications are well-documented, their impact on vascular structure, function, and cognition remains unclear. This cross-sectional study explored vascular and cognitive differences across patients with mild, moderate, and severe COVID-19, examining correlations between global cognitive performance and vascular parameters. This study included 83 working-age patients (30-65 years, both sexes) who recovered from COVID-19 within 6-12 months. They were grouped by severity: mild (outpatients, no oxygen support), moderate (hospitalized, conventional oxygen therapy), and severe (hospitalized, advanced oxygen therapy). Exclusions included pre-existing cognitive or neurological conditions, significant atherosclerosis, malignancies, and prior COVID-19 vaccination. Global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) test, while vascular parameters - carotid intima-media thickness (IMT), beta stiffness index (β index), mean flow velocity (MVs), maximum velocity after breath-holding (MV-BH), and breath-holding index (BHI) - were evaluated using duplex ultrasound and transcranial Doppler. Patients with severe COVID-19 had the highest carotid stiffness and poorest cerebrovascular reactivity. While MoCA scores showed no significant group differences, 23-40% had mild cognitive impairment. MoCA scores negatively correlated with β index in mild group (ρ=--0.453; p = 0.034), while MVs positively correlated with MoCA in severe cases (ρ = 0.414; p = 0.028). The association between arterial stiffness and cognitive impairment in mild cases, suggests lasting effects of SARS-CoV-2 rather than pre-existing conditions. These findings highlight carotid stiffness as a key factor in post-COVID-19 cognitive impairment, emphasizing early risk identification for timely intervention.
期刊介绍:
The Journal of NeuroVirology (JNV) provides a unique platform for the publication of high-quality basic science and clinical studies on the molecular biology and pathogenesis of viral infections of the nervous system, and for reporting on the development of novel therapeutic strategies using neurotropic viral vectors. The Journal also emphasizes publication of non-viral infections that affect the central nervous system. The Journal publishes original research articles, reviews, case reports, coverage of various scientific meetings, along with supplements and special issues on selected subjects.
The Journal is currently accepting submissions of original work from the following basic and clinical research areas: Aging & Neurodegeneration, Apoptosis, CNS Signal Transduction, Emerging CNS Infections, Molecular Virology, Neural-Immune Interaction, Novel Diagnostics, Novel Therapeutics, Stem Cell Biology, Transmissable Encephalopathies/Prion, Vaccine Development, Viral Genomics, Viral Neurooncology, Viral Neurochemistry, Viral Neuroimmunology, Viral Neuropharmacology.