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Case-control study of neuropsychiatric symptoms following COVID-19 hospitalization in 2 academic health systems
medRxiv - Psychiatry and Clinical Psychology Pub Date : 2021-07-14 , DOI: 10.1101/2021.07.09.21252353
Victor M. Castro , Jonathan Rosand , Joseph T. Giacino , Thomas H. McCoy , Roy H. Perlis

Neuropsychiatric symptoms may persist following acute COVID-19 illness, but the extent to which these symptoms are specific to COVID-19 has not been established. We utilized electronic health records across 6 hospitals in Massachusetts to characterize cohorts of individuals discharged following admission for COVID-19 between March 2020 and May 2021, and compared them to individuals hospitalized for other indications during this period. Natural language processing was applied to narrative clinical notes to identify neuropsychiatric symptom domains up to 150 days following hospitalization. Among 6,619 individuals hospitalized for COVID-19 drawn from a total of 42,961 hospital discharges, the most commonly documented symptom domains between 31 and 90 days after initial positive test were fatigue (13.4%), mood and anxiety symptoms (11.2%), and impaired cognition (8.0%). In models adjusted for sociodemographic features and hospital course, none of these were significantly more common among COVID-19 patients; indeed, mood and anxiety symptoms were less frequent (adjusted OR 0.72 95% CI 0.64-0.92). Between 91 and 150 days after positivity, most commonly-detected symptoms were fatigue (10.9%), mood and anxiety symptoms (8.2%), and sleep disruption (6.8%), with impaired cognition in 5.8%. Frequency was again similar among non-COVID-19 post-hospital patients, with mood and anxiety symptoms less common (aOR 0.63, 95% CI 0.52-0.75). Neuropsychiatric symptoms were common up to 150 days after initial hospitalization, but occurred at generally similar rates among individuals hospitalized for other indications during the same period. Post-acute sequelae of COVID-19 thus may benefit from standard if less-specific treatments developed for rehabilitation after hospitalization.

中文翻译:

2 个学术卫生系统中 COVID-19 住院后神经精神症状的病例对照研究

急性 COVID-19 疾病后神经精神症状可能持续存在,但尚未确定这些症状在多大程度上是 COVID-19 特有的。我们利用马萨诸塞州 6 家医院的电子健康记录来描述 2020 年 3 月至 2021 年 5 月期间因 COVID-19 入院后出院的个体队列,并将其与在此期间因其他适应症住院的个体进行比较。自然语言处理应用于叙述性临床记录,以识别住院后长达 150 天的神经精神症状域。在从总共 42,961 例出院中抽取的因 COVID-19 住院的 6,619 人中,在初次阳性检测后 31 至 90 天之间最常记录的症状域是疲劳(13.4%)、情绪和焦虑症状(11.2%)、和认知障碍(8.0%)。在根据社会人口学特征和医院病程调整的模型中,这些在 COVID-19 患者中均不明显;事实上,情绪和焦虑症状的发生频率较低(调整后的 OR 0.72 95% CI 0.64-0.92)。在阳性后 91 至 150 天之间,最常见的症状是疲劳 (10.9%)、情绪和焦虑症状 (8.2%) 以及睡眠中断 (6.8%),其中 5.8% 有认知障碍。非 COVID-19 出院后患者的频率再次相似,情绪和焦虑症状不太常见(aOR 0.63,95% CI 0.52-0.75)。神经精神症状在初次住院后 150 天内很常见,但在同一时期因其他适应症住院的个体中发生率大致相似。
更新日期:2021-07-15
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