High Somatization Rates, Frequent Spontaneous Recovery, and a Lack of Organic Biomarkers in Post-Covid-19 Condition

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES Brain and Behavior Pub Date : 2024-10-08 DOI:10.1002/brb3.70087

Anna Tröscher, Patrick Gebetsroither, Marc Rindler, Vincent Böhm, Rainer Dormann, Tim von Oertzen, Anna Heidbreder, Raimund Helbok, Judith Wagner

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Abstract

Introduction

Many patients report neuropsychiatric symptoms after SARS-CoV-2 infection. Data on prevalence of post-COVID-19 condition (PCC) vary due to the lack of specific diagnostic criteria, the report of unspecific symptoms, and reliable biomarkers.

Methods

PCC patients seen in a neurological outpatient department were followed for up to 18 months. Neurological examination, SARS-CoV-2 antibodies, Epstein–Barr virus antibodies, and cortisol levels as possible biomarkers, questionnaires to evaluate neuropsychiatric symptoms and somatization (Patient Health Questionnaires D [PHQ-D]), cognition deficits (Montreal Cognitive Assessment [MoCA]), sleep disorders (ISS, Epworth Sleepiness Scale [ESS]), and fatigue (FSS) were included.

Results

A total of 175 consecutive patients (78% females, median age 42 years) were seen between May 2021 and February 2023. Fatigue, subjective stress intolerance, and subjective cognitive deficits were the most common symptoms. Specific scores were positive for fatigue, insomnia, and sleepiness and were present in 95%, 62.1%, and 44.0%, respectively. Cognitive deficits were found in 2.3%. Signs of somatization were identified in 61%, who also had an average of two symptoms more than patients without somatization. Overall, 28% had a psychiatric disorder, including depression and anxiety. At the second visit (n = 92), fatigue (67.3%) and insomnia (45.5%) had decreased. At visit three (n = 43), symptom load had decreased in 76.8%; overall, 51.2% of patients were symptom-free. Biomarker testing did not confirm an anti-EBV response. SARS-CoV-2-specific immune reactions increased over time, and cortisol levels were within the physiological range.

Conclusion

Despite high initial symptom load, 76.8% improved over time. The prevalence of somatization and psychiatric disorders was high. Our data do not confirm the role of previously suggested biomarkers in PCC patients.

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后科维德-19 状态下的高躯体化率、频繁的自发恢复以及缺乏有机生物标志物。

导言许多患者在感染 SARS-CoV-2 后都会出现神经精神症状。由于缺乏具体的诊断标准、报告的症状不具特异性以及缺乏可靠的生物标志物，有关19型CoVID后病症（PCC）发病率的数据各不相同：方法：对在神经科门诊就诊的 PCC 患者进行长达 18 个月的随访。包括神经系统检查、SARS-CoV-2 抗体、Epstein-Barr 病毒抗体和皮质醇水平作为可能的生物标志物，以及评估神经精神症状和躯体化（患者健康问卷 D [PHQ-D]）、认知障碍（蒙特利尔认知评估 [MoCA]）、睡眠障碍（ISS、Epworth 嗜睡量表 [ESS]）和疲劳（FSS）的问卷：2021 年 5 月至 2023 年 2 月期间，共有 175 名连续患者（78% 为女性，中位年龄 42 岁）接受了治疗。疲劳、主观压力不耐受和主观认知缺陷是最常见的症状。疲劳、失眠和嗜睡的具体评分呈阳性，分别占 95%、62.1% 和 44.0%。2.3% 的患者存在认知障碍。61%的患者有躯体化症状，他们比没有躯体化症状的患者平均多出两种症状。总体而言，28%的患者患有精神障碍，包括抑郁症和焦虑症。第二次就诊时（92 人），疲劳（67.3%）和失眠（45.5%）症状有所减轻。第三次就诊时（43 人），76.8% 的患者症状减轻；总体而言，51.2% 的患者无症状。生物标志物检测并未证实抗 EBV 反应。SARS-CoV-2特异性免疫反应随着时间的推移而增加，皮质醇水平在生理范围内：结论：尽管最初症状较重，但随着时间的推移，76.8%的患者症状有所改善。结论：尽管最初的症状负荷很高，但随着时间的推移，76.8% 的患者症状得到了改善，躯体化和精神障碍的发病率很高。我们的数据并未证实之前提出的生物标志物在 PCC 患者中的作用。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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