COVID后嗅觉功能障碍及受损域患者的认知评估
Cognitive assessment of patients with post-COVID olfactory dysfunction and impaired domains.
文献信息
| PMID | 42870121 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | David Dylan García-Meléndez |
| 作者单位 | Department of Neurology, Mancha Centro University Hospital, Alcázar de San Juan, Spain. dgmelendez@sescam.jccm.es. |
| 期刊 | Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology |
| SCI 分区 | Q3 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 持续性嗅觉功能障碍是COVID后综合征（PCS）的常见症状，尤其是在经历过轻度COVID-19的年轻患者中。近期功能神经影像学研究提示，持续性嗅觉损害可能与认知缺陷相关。然而，很少有研究使用标准化神经心理评估来描述该亚组的认知特征。
目的： 评估持续性COVID后嗅觉症状患者中认知缺陷的患病率及其特征。
方法： 这项多中心研究纳入了55例在2021年2月之前COVID-19发病后出现持续性嗅觉功能障碍的PCS患者。参与者接受了使用Sniffin' Sticks测试的嗅觉评估以及一套全面的神经心理评估。
结果： 平均年龄为43.9岁（SD 10.1），平均病程为46.1个月（SD 6.5）。根据基于域的判定标准，67.3%的患者表现出认知损害。在注意力/工作记忆（67.3%）、执行功能（50.9%）和情景记忆（56.4%）中观察到域特异性损害。蒙特利尔认知评估（MoCA）仅检测到9.1%的患者存在异常。对嗅觉减退和嗅觉丧失患者的探索性比较显示，在错误发现率（FDR）校正后没有单变量差异，尽管存在边缘性的事后多变量效应。在FDR校正后，连续性嗅觉表现与两项执行功能指标呈负相关，但在各认知指标之间没有一致的剂量-反应关系。
结论： 在这个选定的队列中，观察到多域认知改变的高患病率。这些发现凸显了简短认知筛查工具的局限性，并提示持续性嗅觉功能障碍与认知之间存在复杂关系。需要进一步的纵向研究。
英文摘要
BACKGROUND: Persistent olfactory dysfunction is a common symptom of post-COVID syndrome (PCS), particularly among younger patients who experienced mild COVID-19. Recent functional neuroimaging studies suggest that persistent olfactory impairment may be associated with cognitive deficits. However, few studies have characterised cognition in this subgroup using standardised neuropsychological assessment.
OBJECTIVES: To assess the prevalence of cognitive deficits and their characteristics in patients with persistent post-COVID olfactory symptoms.
METHODS: This multicentre study included 55 patients with PCS and persistent olfactory dysfunction following COVID-19 onset before February 2021. Participants underwent olfactory evaluation using the Sniffin' Sticks test and a comprehensive battery of neuropsychological assessments.
RESULTS: The mean age was 43.9 years (SD 10.1), with a mean disease duration of 46.1 months (SD 6.5). According to a domain-based criterion, 67.3% of patients showed cognitive impairment. Domain-specific impairment was observed in attention/working memory (67.3%), executive function (50.9%), and episodic memory (56.4%). The Montreal Cognitive Assessment (MoCA) detected abnormalities in only 9.1% of patients. Exploratory comparisons between hyposmic and anosmic patients showed no univariate differences after false discovery rate (FDR) correction, despite a marginal post-hoc multivariate effect. Continuous olfactory performance showed inverse correlations with two executive measures after FDR correction, but no consistent dose-response relationship across cognitive measures.
CONCLUSION: In this selected cohort, a high prevalence of multidomain cognitive alterations was observed. These findings highlight the limitations of brief cognitive screening tools and suggest a complex relationship between persistent olfactory dysfunction and cognition. Further longitudinal studies are warranted.