Периферическая нейропатия
Jul. 21st, 2022 11:47 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
chuka_lisРабота китайцев, на сравнительно небольшой выборке (313 перебоелвших, среди которых только 5% болели тяжело или критически), показывает, что у переболевших ковидом симптоматично, довольно высокий шанс развития периферических нейропатий, моно- (реже) или поли- (чаще). В их выборке таких было 74%. Со временем количество пациентов с нейропатиями росло (например, для генерализованной нейропатии через 6 мес было 66%, через 12- у 77%).
Состояние нервов проверяли электрофизиологическим методом сразу после, через 6 и 12 месяцев после ковида.
Симптомы,относящиеся к неврвной системе, и их выраженность варьируют (а степень повреждения нервов не коррелирует ни с симптоматикой на момент выписки из больницы, ни с тяжестью ковида), но в целом, у переболевших наблюдались: ослабление памяти (у 86%), проблемы со сном, постоянная усталость-бессилие, повышенная тревожность, выпадение волос, мышечная слабость, сухость в горле, которые иногда оставались продолжительное время после ковида.
При этом, оказалось, появление-развитие нейропатии (дегенерация аксонов и демиелинизация нервных волокон) положительно коррелирует с возрастом и более низким титром антител. Впрочем, у них там средний возраст под 50 лет.
Так что ковид это такая вполне себе дверь в рассеянный склероз.
Background: There is a lack of studies on large-sample, medium-, or long-term follow-up data of peripheral neuropathy (PNP) in the COVID-19 survivors. This study evaluated the characteristics and related risk factors of PNP in the medium- and long-term rehabilitation,which provided real-world study data for the complete recovery of COVID-19 patients. Methods: This study was a prospective cohort study of the COVID-19 survivors. We collected data on baseline characteristics, symptoms at onset and after discharge during the 6-month and 12-month follow-up. Peripheral nerves were measured by electromyography and inducible potentiometer. We used multivariable logistic regression to analyze the influencing factors of PNP. Additionally, we compared the difference between the two measurements among the population who completed both measurements. Results: 313 patients were included in the study and all of them underwent nerve conduction study. 67 patients completed two measurements at 6-month and 12-month follow-up. Commonly reported symptoms contained memory loss (86%), hair loss (28%), anxiety (24%), and sleep difficulties (24%). 232 patients (74%) were found with PNP, including 51 (16%) with mononeuropathy and 181 (58%) with generalized PNP. Patients with measurement at 12-month follow-up had a higher prevalence of generalized PNP (p=0.006). For pathological types, 64 (20%) patients had only axonal loss, 67 (21%) had only demyelination, and 101 (32%) had a mixed type. There was no significant difference in the prevalence of accompanying symptoms after discharge between the two groups with or without PNP. After adjustment, age was positively associated with PNP (OR=1.22 per 10-year increase of age, 95% CI, 1.05-1.41). Compared with less than the median amount of IgG at discharge, higher amount of IgG was associated with decreased risk of F-wave abnormality (OR=0.32, 95%CI, 0.11-0.82), but no significant difference in other types of PNP. Conclusions and Relevance: SARS-CoV-2 could cause PNP in hospital survivors with COVID-19, which persisted and was associated with age, education, and IgG antibody at discharge, but had no significant correlation with symptoms after discharge.
Состояние нервов проверяли электрофизиологическим методом сразу после, через 6 и 12 месяцев после ковида.
Симптомы,относящиеся к неврвной системе, и их выраженность варьируют (а степень повреждения нервов не коррелирует ни с симптоматикой на момент выписки из больницы, ни с тяжестью ковида), но в целом, у переболевших наблюдались: ослабление памяти (у 86%), проблемы со сном, постоянная усталость-бессилие, повышенная тревожность, выпадение волос, мышечная слабость, сухость в горле, которые иногда оставались продолжительное время после ковида.
При этом, оказалось, появление-развитие нейропатии (дегенерация аксонов и демиелинизация нервных волокон) положительно коррелирует с возрастом и более низким титром антител. Впрочем, у них там средний возраст под 50 лет.
Так что ковид это такая вполне себе дверь в рассеянный склероз.
Background: There is a lack of studies on large-sample, medium-, or long-term follow-up data of peripheral neuropathy (PNP) in the COVID-19 survivors. This study evaluated the characteristics and related risk factors of PNP in the medium- and long-term rehabilitation,which provided real-world study data for the complete recovery of COVID-19 patients. Methods: This study was a prospective cohort study of the COVID-19 survivors. We collected data on baseline characteristics, symptoms at onset and after discharge during the 6-month and 12-month follow-up. Peripheral nerves were measured by electromyography and inducible potentiometer. We used multivariable logistic regression to analyze the influencing factors of PNP. Additionally, we compared the difference between the two measurements among the population who completed both measurements. Results: 313 patients were included in the study and all of them underwent nerve conduction study. 67 patients completed two measurements at 6-month and 12-month follow-up. Commonly reported symptoms contained memory loss (86%), hair loss (28%), anxiety (24%), and sleep difficulties (24%). 232 patients (74%) were found with PNP, including 51 (16%) with mononeuropathy and 181 (58%) with generalized PNP. Patients with measurement at 12-month follow-up had a higher prevalence of generalized PNP (p=0.006). For pathological types, 64 (20%) patients had only axonal loss, 67 (21%) had only demyelination, and 101 (32%) had a mixed type. There was no significant difference in the prevalence of accompanying symptoms after discharge between the two groups with or without PNP. After adjustment, age was positively associated with PNP (OR=1.22 per 10-year increase of age, 95% CI, 1.05-1.41). Compared with less than the median amount of IgG at discharge, higher amount of IgG was associated with decreased risk of F-wave abnormality (OR=0.32, 95%CI, 0.11-0.82), but no significant difference in other types of PNP. Conclusions and Relevance: SARS-CoV-2 could cause PNP in hospital survivors with COVID-19, which persisted and was associated with age, education, and IgG antibody at discharge, but had no significant correlation with symptoms after discharge.
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Date: 2022-07-30 06:53 pm (UTC)no subject
Date: 2022-07-31 03:52 am (UTC)