2021年 · 第101卷第19期

Neurological and psychiatric sequelae in patients with novel coronavirus pneumonia (COVID-19 for short) have been reported, but more data is needed to adequately assess the impact of COVID-19 on brain health.Lancet PsychiatryRecently published reports show that more than one-third of people cured of COVID-19 develop brain disease, the largest study to date. The study obtained data from the TriNetX electronic health record network (over 8 1 million patients) and used a retrospective cohort study and time-event analysis to assess the incidence of neurological and psychiatric disorders within 6 months of confirmed COVID-19 diagnosis and its association with the severity of the COVID-19 condition. Using a Cox regression model, incidence rates were compared in a cohort of patients with influenza or other respiratory infections matched to propensity scores. The results showed that 236,379 patients diagnosed with COVID-19 (the vast majority were U.S. patients) were followed up for 6 months, and the estimated incidence of neurological or psychiatric disorders was 33.62% (95% CI: 33.17% to 34.07%), of which 12.84% (95% CI: 12.36% ~13.33%) was first diagnosed. For critically ill patients, the estimated incidence of confirmed diagnosis was 46.42% (95% CI: 44.78% to 48.09%), and the estimated incidence of first diagnosis was 25.79% (95% CI：23.50%~28.25%)。 The estimated incidence of intracranial hemorrhage in the cohort of COVID-19 patients was 0.56% (95% CI: 0.50% to 0.63%), and the incidence of ischemic stroke was 2.10% (95% CI: 1.97% to 2.23%), and the incidence of Parkinson's disease was 0.11% (95% CI: 0.08%-0.14%), and the incidence of dementia was 0.67% (95% CI: 0.59%-0.75%), and the incidence of anxiety disorders was 17.39% (95% CI: 17.04% to 17.74%), and the proportion of mental disorders was 1.40% (95% CI：1.30%~1.51%)。 In critically ill patients, the estimated incidence of intracranial hemorrhage was 2.66% (95% CI: 2.24% to 3.16%), and 6.92% (95% CI: 6.17% to 7.76%), and Parkinson's disease was 0.26% (95% CI: 0.15% to 0.45%), dementia was 1.74% (95% CI: 1.31% to 2.30%), and anxiety disorders were 19.15% (95% CI: 17.90%-20.48%), and 2.77% (95% CI：2.31%~3.33%)。 Neurological or psychiatric disorders in COVID-19 patients than in influenza patients [danger ratio of any diagnosis (HR) =1.44; initial diagnosis was 1.78] and patients with other respiratory tract infections (any diagnosisHR=1.16； 1.32 in initial diagnosis). As with morbidity, the risk of patients with more severe COVID-19 is higher (any diagnosisHR=1.58； 2.87 for initial diagnosis).