后 COVID 综合征的医学和心理因素:人的认知和情感领域的失调

M. Matiash, Yuriy Galanta
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摘要

这项研究的问题是,由于 SARS-CoV-2 引起的 COVID-19 大流行,许多人出现了感染后的长期症状,即 COVID 后综合征。这种疾病的特征是在感染 SARS-CoV-2 后持续 3 至 12 周以上的衰弱性疲劳、神经认知困难、肌肉疼痛和虚弱,以及抑郁和广泛性焦虑症(GAD)。在这些症状中,神经认知和精神方面的后果,包括注意力和记忆力障碍、焦虑和抑郁症状,由于对公众健康的重大影响,已成为现代医疗保健专业人员关注的焦点。在这方面,评估工具在早期筛查 COVID-19 长期病程引起的认知变化方面发挥着至关重要的作用。这包括蒙特利尔认知评估(MoCA)等一般认知评估工具,以及更具体的评估工具,即用于筛查、诊断和监测抑郁症状的患者健康问卷(PHQ-9)和用于评估焦虑症和筛查广泛性焦虑症的 GAD-7 评估工具。研究的目的是确定后 COVID 综合征对人们认知和情感领域的影响,并提出克服其后果的建议。研究样本由 70 名感染 COVID-19 的患者组成。根据 COVID-19 的严重程度分类,他们被分为三组,即第一组--轻度;第二组--中度;第三组--重度。患者的检查结果显示,根据 MoCA,所有受访者的认知障碍程度都较低。这表明需要心理支持和临床护理。PHQ-9 的得分显示,在 15 名(21%)轻度 COVID-19 患者和 30 名(43%)中度患者中,轻度抑郁占主导地位。然而,根据该问卷,重度 COVID-19 患者的抑郁程度为中度。结果显示,病情越严重,患者的抑郁程度越高。GAD-7 量表显示,15 名(21%)轻度 COVID-19 患者和 30 名(43%)中度 COVID-19 患者患有中度广泛性焦虑症。相反,使用同一问卷进行的研究结果显示,25 名(36%)重度 COVID-19 患者的广泛性焦虑症程度为一般。根据 GAD-7 量表得出的结果显示,COVID-19 的程度越严重,患者的广泛性焦虑症程度就越高。为克服与 COVID-19 后综合征相关的认知和情绪障碍,我们提出了一些特别建议。
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The medical and psychological components of post-COVID syndrome: disorders of the cognitive and emotional sphere of a person
The problem of the study is that due to the COVID-19 pandemic caused by SARS-CoV-2, many people experience post-infectious long-term symptoms, namely post-COVID syndrome. This disease is characterized by persistent debilitating fatigue, neurocognitive difficulties, muscle pain and weakness, as well as depression, and generalized anxiety disorder (GAD) that lasts for more than 3 to 12 weeks after SARS-CoV-2 infection. Among these symptoms, neurocognitive and psychiatric consequences, including attention and memory impairment, symptoms of anxiety and depression, have become the main focus of attention of modern healthcare professionals due to their significant impact on public health. In this regard, assessment tools play a crucial role in the early screening of cognitive changes caused by the prolonged course of COVID-19. This includes general cognitive assessment tools such as the Montreal Cognitive Assessment (MoCA) and more specific ones, namely the Patient Health Questionnaire (PHQ-9) for screening, diagnosing and monitoring depression symptoms and the GAD-7 for assessing anxiety and screening for generalized anxiety disorder. The aim of the study was to determine the impact of post-COVID syndrome on the cognitive and emotional sphere of people, as well as to develop recommendations for overcoming its consequences. The study sample consisted of 70 patients who had contracted COVID-19. They were divided into three groups, according to the COVID-19 classification by the severity, namely: group 1 — mild; group 2 — moderate and group 3 — severe. The results of the patient examinations showed that according to the MoCA, all respondents had a low level of cognitive impairment. This indicates the need for psychological support and clinical care. The score on the PHQ-9 demonstrated that in 15 (21 %) patients with mild COVID-19 and in 30 (43 %) with moderate course, mild depression prevailed. However, according to this questionnaire, patients with severe COVID-19 are characterized by moderate depression. The results showed that the more severe the disease, the higher the level of depression in patients. The GAD-7 scale showed that 15 (21 %) patients with mild COVID-19 and 30 (43 %) patients with moderate course were characterized by a moderate level of generalized anxiety disorder. Instead, the results of the study using the same questionnaire showed that 25 (36 %) patients with severe COVID-19 had an average level of generalized anxiety disorder. The results obtained according to the GAD-7 scale show that the more severe the degree of COVID-19, the higher the level of generalized anxiety disorder in patients. Special recommendations have been proposed to overcome cognitive and emotional disturbances associated with post-COVID syndrome.
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