Купить (150 RUB)
сгенерировать QR код
Открытый доступ
Доступ платный или только для Подписчиков
Постковидные когнитивные нарушения, факторы риска их развития и диагностические биомаркеры
https://doi.org/10.33667/2078-5631-2025-15-26-30
Аннотация
Когнитивные нарушения (КН) являются важным проявлением как острого периода COVID-19, так и постковидного синдрома, характеризуются снижением памяти, внимания и расстройством исполнительных функций, которые могут сохраняться или усиливаться спустя месяцы после перенесенной инфекции. Факторы риска развития постковидных КН (ПКН) включают пожилой возраст, женский пол, низкий образовательный и социально-экономический статус, длительную социальную изоляцию, тяжелое течение COVID-19, применение некоторых лекарственных препаратов и сопутствующие заболевания, включая деменцию и патологию сердечно-сосудистой системы. Вакцинация от COVID-19 рассматривается как эффективный способ предотвращения ПКН. Диагностика ПКН основывается на изучении биомаркеров в крови и цереброспинальной жидкости (ЦСЖ), нейровизуализации и нейрофизиологических данных. При наличии ПКН в крови и ЦСЖ могут обнаруживаться антинейрональные антитела, выявляются структурные изменения мозга (уменьшение толщины серого вещества и повреждение тканей в областях памяти и внимания), снижение метаболизма глюкозы в ключевых зонах мозга (по данным ПЭТ-сканирования) и изменения электрической активности мозга (по данным ЭЭГ). КН представляют серьезную проблему для мирового здравоохранения, усугубленную пандемией COVID-19, что требует комплексного подхода к совершенствованию методов диагностики, лечения и реабилитации пациентов.
Об авторах
А. Г. Михеева
ФГБУ «Национальный медицинский исследовательский центр имени В. А. Алмазова» Минздрава России
Россия
Россия
Михеева Анна Геннадьевна, врач-невролог, аспирант кафедры неврологии с клиникой Института медицинского образования
Санкт-Петербург
Т. М. Алексеева
ФГБУ «Национальный медицинский исследовательский центр имени В. А. Алмазова» Минздрава России
Россия
Россия
Алексеева Татьяна Михайловна, д.м.н., зав. кафедрой неврологии с клиникой Института медицинского образования
Санкт-Петербург
Список литературы
1. Soriano J. B., Murthy S., Marshall J. C. et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022; 22 (4): e102–e107. DOI: 10.1016/S 1473-3099 (21) 00703-9
2. Alkodaymi M. S., Omrani O. A., Fawzy N. A. et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect. 2022; 28 (5): 657–666. DOI: 10.1016/j.cmi.2022.01.014
3. Monje M., Iwasaki A. The neurobiology of long COVID. Neuron. 2022; 110 (21): 3484–3496. DOI: 10.1016/j.neuron.2022.10.006
4. Михеева А. Г., Топузова М. П., Михеева М. Г., Алексеева Т. М., Каронова Т. Л. Эмоциональные нарушения в структуре постковидного синдрома. Медицинский совет. 2024; 18 (5): 108–116. DOI: 10.21518/ms2024-148
5. Mikheeva A. G., Topuzova M. P., Mikheeva M. G., Alekseeva T. M., Karonova T. L. Emotional disturbances in postcovid syndrome structure. Meditsinskiy Sovet. 2024; 18 (5): 108–116. DOI: 10.21518/ms2024-148.
6. Ceban F., Ling S., Lui L. M.W. et al. Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis. Brain Behav Immun. 2022; 101: 93–135. DOI: 10.1016/j.bbi.2021.12.020
7. Matias-Guiu J.A., Herrera E., González-Nosti M. et al. Development of criteria for cognitive dysfunction in post-COVID syndrome: the IC–CoDi-COVID approach. Psychiatry Res. 2023; 319: 115006. DOI: 10.1016/j.psychres.2022.115006
8. Amalakanti S., Arepalli K. V.R., Jillella J. P. Cognitive assessment in asymptomatic COVID-19 subjects. Virusdisease. 2021; 32 (1): 146–149. DOI: 10.1007/s13337-021-00663-w
9. Tolentino J. C., Gjorup A. L.T., Schmidt G. J., Schmidt SL. Early attention impairment in a patient with COVID-19. Psychiatry Clin Neurosci. 2021; 75 (2): 66–67. DOI: 10.1111/pcn.13178
10. Beaud V., Crottaz-Herbette S., Dunet V. et al. Pattern of cognitive deficits in severe COVID-19. J Neurol Neurosurg Psychiatry. 2021; 92 (5): 567–568. DOI: 10.1136/jnnp-2020325173
11. Groiss S. J., Balloff C., Elben S. et al. Prolonged Neuropsychological Deficits, Central Nervous System Involvement, and Brain Stem Affection After COVID-19-A Case Series. Front Neurol. 2020; 11: 574004. DOI: 10.3389/fneur.2020.574004
12. Hellmuth J., Barnett T. A., Asken B. M. et al. Persistent COVID-19-associated neurocognitive symptoms in non-hospitalized patients. J Neurovirol. 2021; 27 (1): 191–195. DOI: 10.1007/ s13365-021-00954-4
13. Negrini F., Ferrario I., Mazziotti D. et al. Neuropsychological Features of Severe Hospitalized Coronavirus Disease 2019 Patients at Clinical Stability and Clues for Postacute Rehabilitation. Arch Phys Med Rehabil. 2021; 102 (1): 155–158. DOI: 10.1016/j.apmr.2020.09.376
14. Whiteside D. M., Oleynick V., Holker E. et al. Neurocognitive deficits in severe COVID-19 infection: Case series and proposed model. Clin Neuropsychol. 2021; 35 (4): 799–818. DOI: 10.1080/13854046.2021.1874056
15. Ermis U., Rust M. I., Bungenberg J. et al. Neurological symptoms in COVID-19: a cross-sectional monocentric study of hospitalized patients. Neurol Res Pract. 2021; 3 (1): 17. DOI: 10.1186/s42466-021-00116-1
16. Alemanno F., Houdayer E., Parma A. et al. COVID-19 cognitive deficits after respiratory assistance in the subacute phase: A COVID-rehabilitation unit experience. PLoS One. 2021; 16 (2): e0246590. DOI: 10.1371/journal.pone.0246590
17. Hosp J. A., Dressing A., Blazhenets G. et al. Cognitive impairment and altered cerebral glucose metabolism in the subacute stage of COVID-19. Brain. 2021; 144 (4): 1263–1276. DOI: 10.1093/brain/awab009
18. Méndez R., Balanzá-Martínez V., Luperdi S. C. et al. Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors. J Intern Med. 2021; 290 (3): 621–631. DOI: 10.1111/ joim.13262
19. Miskowiak K. W., Johnsen S., Sattler S. M. et al. Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables. Eur Neuropsychopharmacol. 2021; 46: 39–48. DOI: 10.1016/j.euroneuro.2021.03.019
20. Becker J. H., Lin J. J., Doernberg M. et al. Assessment of Cognitive Function in Patients After COVID-19 Infection. JAMA Netw Open. 2021; 4 (10): e2130645. DOI: 10.1001/jamanetworkopen.2021.30645
21. Ariza M., Cano N., Segura B. et al. Neuropsychological impairment in post-COVID condition individuals with and without cognitive complaints. Front Aging Neurosci. 2022; 14: 1029842. DOI: 10.3389/fnagi.2022.1029842
22. Daroische R., Hemminghyth M. S., Eilertsen T. H. et al. Cognitive Impairment After COVID-19-A Review on Objective Test Data. Front Neurol. 2021; 12: 699582. DOI: 10.3389/ fneur.2021.699582
23. Hartung T. J., Neumann C., Bahmer T. et al. Fatigue and cognitive impairment after COVID-19: A prospective multicentre study. EClinicalMedicine. 2022; 53: 101651. DOI: 10.1016/j.eclinm.2022.101651
24. Baseler H. A., Aksoy M., Salawu A. et al. The negative impact of COVID-19 on working memory revealed using a rapid online quiz. PLoS One. 2022; 17 (11): e0269353. DOI:10.1371/ journal.pone.0269353
25. PHOSP-COVID Collaborative Group. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med. 2022; 10 (8): 761–775. DOI: 10.1016/S 2213-2600 (22) 00127-8
26. Asadi-Pooya A.A., Akbari A., Emami A. et al. Long COVID syndrome-associated brain fog. J Med Virol. 2022; 94 (3): 979–984. DOI: 10.1002/jmv.27404
27. Ortona E., Malorni W. Long COVID: to investigate immunological mechanisms and sex/ gender related aspects as fundamental steps for tailored therapy. Eur Respir J. 2022; 59 (2): 2102245. DOI: 10.1183/13993003.02245-2021
28. Osmanov I. M., Spiridonova E., Bobkova P. et al. Risk factors for post-COVID-19 condition in previously hospitalised children using the ISARIC Global follow-up protocol: a prospective cohort study. Eur Respir J. 2022; 59 (2): 2101341. DOI: 10.1183/13993003.01341-2021
29. Liu Y. H., Wang Y. R., Wang Q. H. et al. Post-infection cognitive impairments in a cohort of elderly patients with COVID-19. Mol Neurodegener. 2021; 16 (1): 48. DOI: 10.1186/ s13024-021-00469-w
30. Politi J., Martín-Sánchez M., Mercuriali L. et al. Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020. Euro Surveill. 2021; 26 (20): 2001138. DOI: 10.2807/15607917.ES.2021.26.20.2001138
31. Manca R., De Marco M., Venneri A. The Impact of COVID-19 Infection and Enforced Prolonged Social Isolation on Neuropsychiatric Symptoms in Older Adults With and Without Dementia: A Review. Front Psychiatry. 2020; 11: 585540. DOI: 10.3389/ fpsyt.2020.585540
32. Bethell J., Aelick K., Babineau J. et al. Social Connection in Long-Term Care Homes: A Scoping Review of Published Research on the Mental Health Impacts and Potential Strategies During COVID-19. J Am Med Dir Assoc. 2021; 22 (2): 228–237.e25. DOI: 10.1016/j. jamda.2020.11.025
33. Simonetti A., Pais C., Jones M. et al. Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions. Front Psychiatry. 2020; 11: 579842. DOI: 10.3389/fpsyt.2020.579842
34. Chen Z. C., Liu S., Gan J. et al. The Impact of the COVID-19 Pandemic and Lockdown on Mild Cognitive Impairment, Alzheimer's Disease and Dementia With Lewy Bodies in China: A 1-Year Follow-Up Study. Front Psychiatry. 2021; 12: 711658. DOI: 10.3389/fpsyt.2021.711658
35. Yazdanpanah N., Rezaei N. Autoimmune complications of COVID-19. J Med Virol. 2022; 94 (1): 54–62. DOI: 10.1002/jmv.27292
36. Mendonça Filho V. C.M., de Oliveira A. G., Maia I. F.V.C. et al. COVID-19 in the nervous system: physiopathology and neurological manifestations. Arq Neuropsiquiatr. 2023; 81 (8): 756–763. DOI: 10.1055/s-0043-1769123
37. Kumar A., Chattopadhyay A., Gupta S. Neuropsychiatric manifestation of the drugs used in the treatment of SARS-2-CoV-2019 (COVID-19) infection and their management: An overview and practice implications. Asian J Psychiatr. 2022; 73: 103101. DOI: 10.1016/j. ajp.2022.103101
38. Kotfis K., van Diem-Zaal I., Williams Roberson S. et al. The future of intensive care: delirium should no longer be an issue. Crit Care. 2022; 26 (1): 200. DOI: 10.1186/s13054-022-04077-y
39. Neelamegam M., Zgibor J., Chen H. et al. The effect of opioids on the cognitive function of older adults: results from the Personality and Total Health through life study. Age Ageing. 2021; 50 (5): 1699–1708. DOI: 10.1093/ageing/afab048
40. Izcovich A., Siemieniuk R. A., Bartoszko J. J. et al. Adverse effects of remdesivir, hydroxychloroquine and lopinavir/ritonavir when used for COVID-19: systematic review and meta-analysis of randomised trials. BMJ Open. 2022; 12 (3): e048502. DOI: 10.1136/ bmjopen-2020–048502
41. Borah P., Deb P. K., Chandrasekaran B. et al. Neurological Consequences of SARS-CoV-2 Infection and Concurrence of Treatment-Induced Neuropsychiatric Adverse Events in COVID-19 Patients: Navigating the Uncharted. Front Mol Biosci. 2021; 8: 627723. DOI: 10.3389/fmolb.2021.627723
42. Levaillant M., Wathelet M., Lamer A. et al. Impact of COVID-19 pandemic and lockdowns on the consumption of anxiolytics, hypnotics and antidepressants according to age groups: a French nationwide study. Psychol Med. 2023; 53 (7): 2861–2867. DOI: 10.1017/S 0033291721004839
43. Zhou J., Liu C., Sun Y. et al. Cognitive disorders associated with hospitalization of COVID-19: Results from an observational cohort study. Brain Behav Immun. 2021; 91: 383–392. DOI: 10.1016/j.bbi.2020.10.019
44. Godeau D., Petit A., Richard I. et al. Return-to-work, disabilities and occupational health in the age of COVID-19. Scand J Work Environ Health. 2021; 47 (5): 408–409. DOI: 10.5271/sjweh.3960
45. Rogers J. P., Chesney E., Oliver D. et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020; 7 (7): 611–627. DOI: 10.1016/S 2215-0366 (20) 30203-0
46. Vindegaard N., Benros M. E. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020; 89: 531–542. DOI: 10.1016/j.bbi.2020.05.048
47. Ward C. F., Figiel G. S., McDonald W. M. Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly. Am J Geriatr Psychiatry. 2020; 28 (8): 808–811. DOI: 10.1016/j.jagp.2020.05.013
48. Pandharipande P. P., Girard T. D., Jackson J. C. et al. Long-term cognitive impairment after critical illness. N Engl J Med. 2013; 369 (14): 1306–16. DOI: 10.1056/NEJMoa1301372
49. Gao P., Liu J., Liu M. Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022; 19 (19): 12422. DOI: 10.3390/ijerph191912422
50. Marshall M. The four most urgent questions about long COVID. Nature. 2021; 594 (7862): 168–170. DOI: 10.1038/d41586-021-01511-z
51. Franke C., Boesl F., Goereci Y. et al. Association of cerebrospinal fluid brain-binding autoantibodies with cognitive impairment in post-COVID-19 syndrome. Brain Behav Immun. 2023; 109: 139–143. DOI: 10.1016/j.bbi.2023.01.006
52. Apple A. C., Oddi A., Peluso M. J. et al. Risk factors and abnormal cerebrospinal fluid associate with cognitive symptoms after mild COVID-19. Ann Clin Transl Neurol. 2022; 9 (2): 221–226. DOI: 10.1002/acn3.51498
53. Douaud G., Lee S., Alfaro-Almagro F. et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature. 2022; 604 (7907): 697–707. DOI: 10.1038/s41586-022-04569-5
54. Cecchetti G., Agosta F., Canu E. et al. Cognitive, EEG, and MRI features of COVID-19 survivors: a 10-month study. J Neurol. 2022; 269 (7): 3400–3412. DOI: 10.1007/s00415-022-11047-5
55. Rothstein T. L. Cortical Grey matter volume depletion links to neurological sequelae in post COVID-19 «long haulers». BMC Neurol. 2023; 23 (1): 22. DOI: 10.1186/s12883-023-03049-1
56. Miskowiak K. W., Bech J. L., Henriksen A. C. et al. Cerebral Metabolic Rate of Glucose and Cognitive Tests in Long COVID Patients. Brain Sci. 2022; 13 (1): 23. DOI: 10.3390/ brainsci13010023
57. Furlanis G., Buoite Stella A., Biaduzzini F. et al. Cognitive deficit in post-acute COVID-19: an opportunity for EEG evaluation? Neurol Sci. 2023; 44 (5): 1491–1498. DOI: 10.1007/s10072-023-06615-0
58. Damiano R. F., Guedes B. F., de Rocca C. C. et al. Cognitive decline following acute viral infections: literature review and projections for post-COVID-19. Eur Arch Psychiatry Clin Neurosci. 2022; 272 (1): 139–154. DOI: 10.1007/s00406-021-01286-4
Рецензия
Для цитирования:
Михеева А.Г., Алексеева Т.М. Постковидные когнитивные нарушения, факторы риска их развития и диагностические биомаркеры. Медицинский алфавит. 2025;(15):26-30. https://doi.org/10.33667/2078-5631-2025-15-26-30
For citation:
Mikheeva А.G., Alekseeva T.M. Postcovid cognitive decline, its risk factors and diagnostic biomarkers. Medical alphabet. 2025;(15):26-30. (In Russ.) https://doi.org/10.33667/2078-5631-2025-15-26-30
Просмотров:
19
Послать статью по эл. почте 