本文由小咖机器人翻译整理

期刊来源：N Engl J Med

原文链接：https://doi.org/10.1056/NEJMoa2311330

摘要内容如下：

背景

由重症急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019年冠状病毒病（COVID-19）后的认知症状已得到广泛认可。客观可测量的认知缺陷是否存在以及持续多长时间尚不清楚。

方法

在英格兰的一项研究中，我们邀请了80万名成年人来完成一项认知功能的在线评估。我们估计了八项任务的整体认知得分。我们假设感染后持续症状（持续时间≥12周）的参与者会有客观可测量的整体认知缺陷，并且在这些参与者中会观察到执行功能和记忆的损害，特别是在那些报告近期记忆力差或思考或集中注意力困难（“脑雾”）的参与者中。

结果

在开始在线认知评估的141583名参与者中，有112964人完成了评估。在多元回归分析中，与未感染SARS-CoV-2或未确诊感染的非CoVID-19组相比，症状在不到4周或至少12周内缓解的CoVID-19康复组参与者在整体认知方面存在类似的小缺陷（分别为-0.23 SD[95%置信区间{CI}，-0.33至-0.13]和-0.24 SD[95%CI，-0.36至-0.12]）；与NO-COVID-19组相比，在具有未解决的持续症状的参与者中观察到更大的缺陷（-0.42 SD；95%置信区间，-0.53至-0.31）。在原始病毒或B.1.7变异体占主导地位期间感染SARS-CoV-2的参与者比感染较晚变异体的参与者有更大的缺陷（例如，B.1.7变异体对B.1.529变异体的-0.17 SD；95%CI，-0.20至-0.13），并且住院的参与者比没有住院的参与者（例如，重症监护室入院，-0.35 SD；95%置信区间，-0.49至-0.20）。分析的结果与倾向分数匹配分析的结果相似。在具有未解决的持续症状的组与NO-COVID-19组的比较中，记忆、推理和执行功能任务与最大缺陷相关（-0.33至-0.20 SD）；这些任务与近期症状的相关性很弱，包括记忆力差和脑雾。未报告任何不良事件。

结论

COVID-19后持续症状缓解的参与者客观测量的认知功能与症状持续时间较短的参与者相似，尽管持续时间较短的COVID-19在恢复后仍与小的认知缺陷相关。认知缺陷的长期持续性和任何临床意义仍不确定。（由国家卫生和保健研究所和其他机构资助）。

英文原文如下：

Abstracts

BACKGROUND  Cognitive symptoms after coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are well-recognized. Whether objectively measurable cognitive deficits exist and how long they persist are unclear.

METHODS  We invited 800,000 adults in a study in England to complete an online assessment of cognitive function. We estimated a global cognitive score across eight tasks. We hypothesized that participants with persistent symptoms (lasting ≥12 weeks) after infection onset would have objectively measurable global cognitive deficits and that impairments in executive functioning and memory would be observed in such participants, especially in those who reported recent poor memory or difficulty thinking or concentrating ("brain fog").

RESULTS  Of the 141,583 participants who started the online cognitive assessment, 112,964 completed it. In a multiple regression analysis, participants who had recovered from Covid-19 in whom symptoms had resolved in less than 4 weeks or at least 12 weeks had similar small deficits in global cognition as compared with those in the no-Covid-19 group, who had not been infected with SARS-CoV-2 or had unconfirmed infection (-0.23 SD [95% confidence interval {CI}, -0.33 to -0.13] and -0.24 SD [95% CI, -0.36 to -0.12], respectively); larger deficits as compared with the no-Covid-19 group were seen in participants with unresolved persistent symptoms (-0.42 SD; 95% CI, -0.53 to -0.31). Larger deficits were seen in participants who had SARS-CoV-2 infection during periods in which the original virus or the B.1.1.7 variant was predominant than in those infected with later variants (e.g., -0.17 SD for the B.1.1.7 variant vs. the B.1.1.529 variant; 95% CI, -0.20 to -0.13) and in participants who had been hospitalized than in those who had not been hospitalized (e.g., intensive care unit admission, -0.35 SD; 95% CI, -0.49 to -0.20). Results of the analyses were similar to those of propensity-score-matching analyses. In a comparison of the group that had unresolved persistent symptoms with the no-Covid-19 group, memory, reasoning, and executive function tasks were associated with the largest deficits (-0.33 to -0.20 SD); these tasks correlated weakly with recent symptoms, including poor memory and brain fog. No adverse events were reported.

CONCLUSIONS  Participants with resolved persistent symptoms after Covid-19 had objectively measured cognitive function similar to that in participants with shorter-duration symptoms, although short-duration Covid-19 was still associated with small cognitive deficits after recovery. Longer-term persistence of cognitive deficits and any clinical implications remain uncertain. (Funded by the National Institute for Health and Care Research and others.).

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