新冠康复者认知损害特征及影响因素分析

Characteristics and risk factors of cognitive impairment among COVID-19 survivors

目的 了解新冠康复人群长期认知损害特征并分析影响因素。方法 自2021年10月至11月对武汉市某区2020年感染新冠的康复者进行调查,通过客观评估的蒙特利尔认知评估量表(Montreal Cognitive Assessment, MoCA)和主观报告的认知失败问卷(Cognitive Failures Questionnaire-14,CFQ-14)全面评价新冠康复者认知损害情况,并采用Logistic回归进行影响因素分析。结果 本研究共纳入1000份有效问卷,其中轻型、普通型、重型/危重型分别有875人(87.50%)、40人(4.00%)、85人(8.50%),平均年龄为55.86±13.84岁,55.40%是女性,38.81%为本科及以上学历。新冠康复者中认知损害的比例为15.60%。影响因素分析发现,年龄大于60岁、低学历、急性期诊断为重型或危重型、伴有多个自我报告症状、伴有焦虑和PTSD症状的康复者更容易发生认知损害。结论 新冠感染20个月后,仍有近1/6的康复者存在认知损害,高龄、低学历、急性期病情严重、伴有更多的躯体和精神心理症状的康复者更容易发生认知损害,需要对该重点人群长期随访并进行针对性干预。

Objective To explore long-term characteristics and risk factors of cognitive impairment among COVID-19 survivors.Methods A survey was conducted among survivors infected with COVID-19 in 2020 from Oct.2021 to Nov.2021 in a district of Wuhan.Cognitive function was measured by objective evaluation via the Montreal Cognitive Assessment(MoCA)and subjective evaluation via the Cognitive Failures Questionnaire-14(CFQ-14).Risk factors relative to cognitive impairment were analyzed by logistic regression analysis.Results A total of 1000 survivors with a mean(SD)age of 55.86(13.84)years and 55.40%women were included.38.81%of survivors had a bachelor's degree or higher.Moreover,15.60%of COVID-19 survivors had cognitive impairment.Factors associated with cognitive impairment were older than 60 years,low education,severe acute illness,with more self-reported symptoms,and with anxiety and PTSD symptoms.Conclusion 20 months after recovery,nearly one-sixth of COVID-19 survivors had cognitive impairment.The elderly,those with low educational background,severe illness in the acute phase,and more physical and mental symptoms were more prone to cognitive impairment.Long-term follow-up and targeted intervention were needed for this key population.