Kev sib tshuam ntawm Pneumonia, txo qis Oxygen Saturation feem pua thiab Kev Tiv Thaiv Kev Tiv Thaiv Kev Tiv Thaiv Kev Nyuaj Siab Kev Nyuaj Siab, Kev ntxhov siab, Thiab Cov tsos mob zoo li mob ntsws ntev vim yog KEVID-19: Txoj hauv kev Nomothetic Network
Mar 18, 2022
e Department of Psychiatry, Kws Qhia Ntawv ntawm Tshuaj, Chulalongkorn University, Bangkok, Thaib teb
Yog xav paub ntxiv:ali.ma@wecistanche.com
TSAB NTAWV
Keeb kwm
COVID-19yog txuam nrogneuropsychiatriccov tsos mob xws li kev nyuaj siab, kev ntxhov siab, thiabChronic fatigue Syndrome (CFS) zoo li thiab cov tsos mob ntawm psychosomatic.
Hom phiaj
Txhawm rau piav qhia txog kev sib koom ua ke ntawm kev nyiam thiab CFS-zoo li cov tsos mob hauvCOVID-19thiab lub hauv siab xamTomography scan anomalies (CCTAs), oxygen saturation (SpO2), interleukin (IL)-6, IL-10, C-Reactive Protein(CRP), albumin, calcium, magnesium, soluble angiotensin-hloov enzyme (ACE2) thiab soluble siab heevglycation cov khoom (sRAGEs).
Txoj kev
Cov biomarkers saum toj no tau soj ntsuam hauv 60COVID-19cov neeg mob thiab 30 tus tswj kev noj qab haus huv uas muaj meaKev paub tseeb ntawm Hamilton Kev Nyuaj Siab (HDRS) thiab Kev ntxhov siab (HAM-A) thiab Fibromyalgia thiabMob nkees (FF) Kev ntsuas ntsuas.
Cov txiaj ntsig
Ib feem tsawg kawg Squares-SEM tsom xam pom tias txhim khu kev qha latent vectors tuaj yeem muab rho tawm los ntawm a) qhov tseem ceebKev nyuaj siab thiab kev ntxhov siab thiab cov tsos mob ntawm kev puas siab puas ntsws (lub cev muaj txiaj ntsig lossis PA-core), b) IL-6, IL-10, CRP, albumin, calcium, thiab sRAGEs (lub cev tiv thaiv kab mob); thiab c) sib txawv CCTAs (xws li av-iavopacities, consolidation, thiab vwm paving) thiab txo qis SpO2 feem pua (qhov mob ntsws). PLS qhia tias 70.0 feem pua ntawm covKev sib txawv hauv PA-core tau piav qhia los ntawm kev rov qab los ntawm kev tiv thaiv kab mob thiab lub ntsws latent vectors.Ib qho "kis-immune-inflammatory (III) core" underpins pneumonia-associated CCTAs, txo qisSpO2 thiab kev tiv thaiv kab mob, thiab III core no piav qhia txog 70 feem pua ntawm qhov sib txawv hauv PA core, thiab ib feem ntawmKev sib txawv hauv melancholia, insomnia, thiab cov tsos mob neurocognitive.
Kev sib tham
Tus kab mob SARS-CoV-2 nrog rau cov kab mob ntsws thiab txo qis SpO2 uas yuav ua rauactivated immune-inflammatory pathways, uas kho cov teebmeem ntawm yav dhau los ntawm PA-core thiab lwm yamCov tsos mob neuropsychiatric vim SARS-CoV-2 kab mob.
Nyem rau Cistanche UK cov khoom
1. Taw qhia
SARS tus mob coronavirus 2 (SARS-CoV-2) cuam tshuam ntau dua 157 lab tus tib neeg thoob ntiaj teb txij thaum lub Kaum Ib Hlis 2020, nrog ntau dua 3.27 lab tus neeg tuag txog rau lub Tsib Hlis 2021 (Coronavirus-Resource-Center, 2021). Tus kab mob SARS-CoV-2 muaj kev kho mob dav dav, xws li kab mob asymptomatic, mob me me, kab mob ua pa nruab nrab, mus rau mob ntsws loj heev nrog ua pa tsis ua haujlwm thiab txawm tuag (Krishnan et al., 2021; Montenegro et al., 2021; Zhou et al., 2020). Kev kuaj mob hauv siab, tshwj xeeb tshaj yog suav tomography scan (CT-scan), yog qhov tseem ceeb rau kev kuaj mob, kev tswj hwm, thiab kev soj ntsuam ntawm COVID{18}} kis kab mob (Fang li al., 2020; Zhang et al., 2020a). Chest xam tomography scan anomalies (CCTAs), suav nrog hauv av-iav opacities (GGOs), pulmonary densification thaj chaw raws li qhov seem seem, pneumonic consolidation, thiab vwm-paving trends tau pom nyob rau hauv 78.3 feem pua ntawm RT-PCR kuaj-zoo COVID{{26 }} cov neeg mob thiab cuam tshuam nrog qis peripheral oxygen saturation (SpO2) (Al-Hakeim li al., 2021). SARS-CoV-2 tuaj yeem ua rau lub cev tsis muaj zog tuaj yeem ua rau lub ntsws pathology (Huang et al., 2020; Hui thiab Zumla, 2019) thiab kev ua haujlwm ntawm lub cev tsis zoo uas yog tshwm sim los ntawm kev raug mob ntawm cov ntaub so ntswg ncaj qha, a cov kab mob inflammatory teb, thiab kev sib koom ua ke ntawm ob qho tib si (Darif li al., 2021). Kev mob ntsws hnyav thiab mob ntsws vim yog COVID-19 nrog rau qib siab ntawm cov cytokines pro-inflammatory xws li interleukin-6 (IL-6) thiab chemokines (Liu li al., 2020a; Mehta et al., 2020).
IL-6 yog ib qho ntawm cov cytokines uas ua rau cov theem mob hnyav teb nrog nce qib ntawm qhov zoo thiab qhov tsis zoo ntawm cov proteins xws li nce qib ntawm C-reactive protein C (CRP) thiab txo qis albumin (Tanaka li al. , 2014). Nws yuav tsum tau lees paub tias IL-6 thiab ntau yam zoo-theem cov proteins muaj kev tiv thaiv kab mob tsis zoo (Maes thiab Carvalho, 2018). SARS-CoV-2 kuj ua rau tso tawm T-helper (Th)− 1 pro-inflammatory thiab Th-2 anti-inflammatory thiab T-regulatory cytokines, xws li IL-10, uas muaj kev tiv thaiv kab mob ntsws (Huang li al., 2020; Lindner li al., 2021). KEVID-19 thiab nce CCTAs yog nrog los ntawm kev nce ntshav IL-6, CRP, thiab IL-10, thiab txo qis albumin thiab oxygen saturation feem pua (SpO2) (Al-Hakeim li al., 2021 ). Tsis tas li ntawd, peb tau kuaj pom cov qib sRAGE (soluble receptor rau qib siab glycation end-products) thiab angiotensin-hloov enzyme 2 (ACE2) hauv COVID-19 cov neeg mob (Al-Hakeim li al., 2021). sRAGEs yog tsim los ntawm proteolysis ntawm extracellular domain ntawm RAGE los yog los ntawm lwm RNA splicing (Sterenczak li al., 2009; Zhang li al., 2008). Kev khi ntawm AGEs rau daim nyias nyias RAGEs pib qhov kev hloov pauv ntawm cov kev hloov pauv ntawm cov kab mob pro-inflammatory (Macaione li al., 2007; Tobon-Velasco li al., 2014) nrog rau cov khoom tsim tawm ntawm IL-6 thiab lwm yam inflammatory mediators (Wang thiab Liu, 2016). sACE2 yog cleaved los ntawm daim nyias nyias-cuam tshuam ACE2 thiab yog li tso tawm mus rau hauv extracellular ib puag ncig (Lambert li al., 2005). Tus kab mob COVID-19 tuaj yeem khi nrog kev sib raug zoo rau tib neeg lub hlwb los ntawm ACE2 receptors ua rau endocytosis ntawm tus kab mob (Pouya li al., 2020; Vlachakis li al., 2020).
COVID-19 feem ntau cuam tshuam nrog cov tsos mob ntawm kev puas hlwb. Kev nyuaj siab muaj nyob rau hauv 27 feem pua ntawm cov neeg mob tau txais COVID-19, kev ntxhov siab hauv 67 feem pua, thiab kev pw tsaug zog tsis zoo hauv 63 feem pua (Yadav et al., 2021). Lwm txoj kev tshawb fawb tau tshaj tawm tias muaj kev nyuaj siab ntau ntxiv (29.2 feem pua) hauv cov neeg mob uas tau ntsib tus kab mob COVID-19 (Zhang li al., 2020b). Kev ntxhov siab ntau hauv cov neeg mob nrog COVID{10}} cuam tshuam nrog qhov hnyav ntawm tus mob thiab comorbidities (Yadav et al., 2021). Cov teebmeem ntawm COVID-19 ntawm cov tsos mob ntawm lub siab yog feem ntau piav qhia tias yog qhov tshwm sim ntawm kev puas siab puas ntsws. Yog li, tsis yog cov tib neeg uas muaj COVID-19 nkaus xwb tab sis kuj yog cov neeg uas tau ntsib nrog COVID{14}} cov tib neeg muaj tus kab mob no qhia tau tias muaj kev nyuaj siab thiab kev ntxhov siab ntau ntxiv (Cao et al., 2020; Oxley et al., 2020; Wang et al., 2020). Tsis tas li ntawd, kev cais tus kheej thaum lub sijhawm kaw yog cuam tshuam nrog kev nce ntxiv ntawm kev nyuaj siab thiab kev ntxhov siab thiab qhov no tau piav qhia los ntawm kev xav ntawm kev nyob ib leeg (Gualano li al., 2020; Xiao et al., 2020a, b). Cov neeg mob uas muaj kev nyuaj siab loj lossis kev puas siab puas ntsws bipolar qhia tau hais tias muaj kev ntxhov siab ntau ntxiv hauv kev teb rau cov SARS-CoV-2-cov xwm txheej cuam tshuam (Van Rheenen li al., 2020). Xiang et al. (Xiang et al., 2020) tau tshaj tawm tias cov neeg mob COVID-19 feem ntau yuav muaj cov mob neuropsychiatric syndromes vim muaj kev qias neeg cuam tshuam nrog kev mob thiab kev ntxhov siab txog kev kis tus kab mob. Kornilaki (Kornilaki, 2021) tau tshaj tawm tias muaj kev nyuaj siab ntau ntxiv, kev cuam tshuam tsis zoo, thiab kev ntxhov siab yog tshwm sim los ntawm COVID-19 cov tsos mob lossis vim lub xeev cais tawm. Txawm li cas los xij, tam sim no muaj pov thawj tias cov kev xav tsis zoo nrog rau kev nyuaj siab thiab kev ntxhov siab muaj cov organic substrate thiab muaj cov yam ntxwv ntawm kev ua kom lub cev tiv thaiv kab mob (Maes li al., 1990; Maes thiab Carvalho, 2018) suav nrog kev nce qib ntawm kev tiv thaiv thiab tiv thaiv. inflammatory cytokines, thiab mob theem teb raws li qhia los ntawm qib siab CRP thiab txo qis albumin (Maes, 1993; Maes li al., 1993).
Tseem muaj pov thawj tias cov kab mob neuro-immune no muaj kev cuam tshuam rau cov teeb meem grey thiab dawb neuroplasticity, yog li ua rau cov kev hloov pauv biobehavioral yam ntxwv ntawm kev xav tsis zoo (Leonard thiab Maes, 2012). Yog li ntawd, nws yog qhov tsim nyog los tso tawm cov tsos mob ntawm lub siab vim yog COVID-19 kho kom haum tsawg kawg yog ib feem los ntawm txoj hauv kev neuro-immune. Cov neeg uas muaj COVID-19 kuj feem ntau raug kev puas siab puas ntsws, qaug zog lub cev, tsis tshua muaj siab, tsis muaj kev paub txog neurocognitive, mob taub hau, thiab myalgia (Borges ua Nascimento li al., 2020; Liu et al., 2020b; Zhang et al. ., 2020c; Zhu et al., 2020), cov tsos mob uas nco txog Myalgic Encephalomyelitis / chronic fatigue syndrome (ME/CFS) (Maes and Twisk, 2010). Raws li kev xav tsis zoo, cov neeg mob uas muaj ME / CFS qhia cov kab mob neuro-tiv thaiv kab mob nrog nce qib ntawm pro-thiab tiv thaiv cytokines, mob theem teb, thiab ntau yam cim qhia ntawm nitro-oxidative puas tsuaj (Bjørklund li al., 2020b; Morris thiab Mas, 2013). Txawm li cas los xij, tsis muaj kev tshawb fawb tau piav qhia txog txoj hauv kev tiv thaiv kab mob ntawm kev cuam tshuam thiab ME / CFS-zoo li cov tsos mob hauv cov neeg muaj COVID-19. Li no, lub hom phiaj ntawm txoj kev tshawb fawb tam sim no yog los piav qhia txog kev sib koom ua ke ntawm kev cuam tshuam thiab ME / CFS-zoo li cov tsos mob thiab a) CCTAs thiab SpO2, thiab b) IL-6, IL-10, CRP, albumin, calcium, magnesium, sACE2, thiab sRAGE hauv COVID-19. Qhov kev xav tshwj xeeb yog tias lub siab xav thiab ME/CFS-zoo li cov tsos mob hauv COVID-19 yog qhov tseem ceeb thiab cuam tshuam nrog CCTAs, IL-6, IL-10, CRP, sACE2, thiab sRAGEs, thiab Tsis zoo nrog SpO2, albumin, calcium, thiab magnesium.
2. Yam thiab cov txheej txheem
2.1. Cov kawm
2.1.1. Kev ntsuas ntsuas
Tus kws kho mob hlwb laus tau soj ntsuam qhov 21-yam Hamilton Depression Rating Scale (HDRS) qhab nia (Hamilton, 1960). Peb tau soj ntsuam thawj 17 yam khoom los ntsuas qhov mob hnyav, thaum cov khoom 18 (hloov hloov pauv) tau siv hauv cov qhab nia sib xyaw (saib hauv qab). Qhov hnyav ntawm cov tsos mob ntxhov siab tau raug ntsuas los ntawm kev ua haujlwm Hamilton Anxiety Rating Scale (HAM-A) (Hamilton, 1959). Tsis tas li ntawd, peb HDRS thiab ob qhov qhab nia ntawm HAM-A subdomain tau suav raws li tau piav qhia yav dhau los (Almulla li al., 2021). Lub HDRS subdomain yog a) qhov tseem ceeb ntawm cov tsos mob nyuaj siab (qhov tseem ceeb HDRS), uas yog cov txiaj ntsig ntawm kev nyuaj siab thiab kev xav ntawm kev ua txhaum ntxiv rau kev xav tua tus kheej (tab sis tsis muaj kev poob haujlwm thiab kev ua ub no); b) psychosomatic symptom domain (psychosomatic HDRS), uas yog cov sum ntawm kev ntxhov siab vim somatic ntxiv rau somatic tsos mob, gastrointestinal plus somatic tsos mob, general ntxiv rau qhov chaw mos cov tsos mob ntxiv rau hypochondriasis; thiab c) cov tsos mob melancholic (melancholia HDRS), uas yog qhov suav ntawm insomnia lig ntxiv rau psychomotor retardation ntxiv rau diurnal variation ntxiv rau poob phaus. Cov qhab nia ntawm HAM-A subdomain yog a) qhov tseem ceeb ntawm cov tsos mob ntawm kev ntxhov siab (qhov tseem ceeb HAM-A), uas yog cov txiaj ntsig ntawm kev ntxhov siab ntxiv rau kev ntxhov siab ntxiv rau kev ntshai ntxiv rau kev ntxhov siab ntawm kev sib tham; thiab b) HAM-A psychosomatic symptom domain (psychosomatic HAM-A), uas yog cov txiaj ntsig ntawm cov leeg nqaij somatic ntxiv rau cov tsos mob ntawm lub plawv thiab cov tsos mob ntawm plab hnyuv ntxiv rau cov tsos mob genitourinary ntxiv rau cov tsos mob autonomic (tab sis tsis yog cov tsos mob ua pa).
Tib tus kws kho mob laus kuj tau soj ntsuam Fibromyalgia thiab Chronic Fatigue Syndrome Rating (FF) nplai (Zachrisson li al., 2002). Qhov ntsuas no ntsuas 12 FF cov tsos mob, xws li FF1: mob leeg, FF2: cov leeg nro, FF3: qaug zog, FF4: kev nyuaj siab, FF5: tsis nco qab, FF6: chim siab, FF7: kev tu siab, FF8: pw tsaug zog cuam tshuam, FF9: autonomic cuam tshuam, FF10: chim siab plob tsis so tswj, FF11: mob taub hau, thiab FF12: mob khaub thuas-zoo li malaise. Peb siv tag nrho cov txiaj ntsig ntawm txhua yam khoom raws li qhov ntsuas ntawm tag nrho qhov hnyav ntawm lub cev-somatic cov tsos mob (Kanchanatawan li al., 2018). Peb kuj suav cov qhab nia ntawm psychosomatic FF (psychosomatic FF) raws li qhov sib npaug ntawm FF1 ntxiv rau FF2 ntxiv rau FF3 ntxiv rau FF9 ntxiv rau FF10 ntxiv rau FF11 ntxiv rau FF12. Yog li ntawd, peb suav tag nrho cov qhab nia psychosomatic, uas yog z qhab nia ntawm psychosomatic HDRS ntxiv rau z psychosomatic HAM-A ntxiv rau z psychosomatic FF. Ntxiv mus, peb suav z composite cov qhab nia qhia txog kev puas siab puas ntsws raws li z HAM-A yam 5 ntxiv rau z FF4 ntxiv rau z FF5. Thaum kawg, peb kuj suav qhov insomnia z composite qhab nia raws li z HDRS khoom 4, 5, thiab 6 ntxiv rau z HAMA yam 4 ntxiv rau z FF8. Kev kuaj mob ntawm kev haus luam yeeb tsis zoo (TUD) tau tsim los siv DSM-IV-RT cov qauv. Lub cev qhov ntsuas qhov ntsuas (BMI) tau txiav txim siab los ntawm kev faib qhov hnyav hauv kilograms los ntawm qhov siab hauv meters squared.
2.1.2. Kev ntsuas ntawm biomarkers
RT-PCR kuaj tau ua haujlwm los ntawm Applied Biosystems® QuantStudio™ 5 Real-Time PCR System (Thermo Fisher Scientific) muab los ntawm Life Technologies Holdings Pte Ltd. (Marsiling Industrial Estate, Singapore) siv Lyra® Direct SARS-CoV{{4 }} real-time RT PCR Assay kits (Quidel Corporation, CA, USA). Cov khoom siv no muaj qhov ntsuas RT-PCR lub sijhawm tiag tiag rau kev kuaj pom tib neeg SARS-CoV-2 hauv cov kab mob RNA cais tawm ntawm qhov ntswg, nasopharyngeal, lossis oropharyngeal swab specimens. Qhov Assay yog tsim los kuaj pom tus kab mob SARS-CoV-2 tus kab mob uas tsis yog-structural Polyprotein (pp1ab). Cov txheej txheem tau ua raws li teev nyob rau hauv cov khoom siv phau ntawv qhia. CCTAs tau ntsuas siv SOMATOM Concept AS (Siemens, Munchen, Germany). Peb tau siv lub ntiaj teb tus qauv nomenclature (Franquet, 2011; Hansell li al., 2008) los soj ntsuam GGOs, thaj tsam ntawm pulmonary densification txuam nrog latent lesions, pneumonic consolidation, thiab vwm-paving tiam sis (Kwee thiab Kwee, 2020) Tom qab ib hmos yoo mov (tsawg kawg 10 teev) thiab ua ntej noj tshais, peb tau kuaj ntshav thaum 7.30 txog 9.00 teev sawv ntxov cov ntshav Venous (5 mL) raug coj mus rau hauv cov hlab ntsha tsis huv. Cov qauv uas tau raug hemolyzed raug tsis lees paub. Cov ntshav txhaws tau centrifuged rau tsib feeb ntawm 3000 rpm tom qab kaum feeb, thiab cov ntshav tau raug tshem tawm thiab xa mus rau peb lub raj Eppendorf tshiab. IgG thiab IgM tau ntsuas nyob rau hauv cov neeg mob sera thiab tswj kev siv cov tshuaj zoo ACON® COVID-19 IgG/IgM ceev ceev. Cov khoom siv muaj 99.1 feem pua rhiab thiab 98.2 feem pua kev ntseeg. Peb tsuas suav nrog cov neeg mob uas muaj kev kuaj IgM zoo. CRP tau ntsuas qhov zoo thiab ib nrab ntawm cov ntshav hauv tib neeg siv C-Reactive Protein (CRP) latex slide test (Spin react®, Barcelona, Spain). Peb siv Melsin Medical Co. (Jilin, Tuam Tshoj) cov khoom siv ELISA los ntsuas ntshav IL-6, IL-10, sRAGE, thiab sACE2. Tag nrho cov analytes pom ib qho kev ntsuam xyuas CV ntawm <12 feem="" pua.="" biolabo®,="" maizy,="" fabkis,="" muab="" cov="" khoom="" siv="" spectrophotometric="" los="" kuaj="" tag="" nrho="" cov="" calcium,="" albumin,="" thiab="">
2.2. Kev txheeb cais
Peb siv kev tshuaj ntsuam ntawm qhov sib txawv (ANOVA) los xyuas seb puas muaj qhov sib txawv ntawm qhov sib txawv ntawm cov pab pawg kuaj mob. Kev tshuaj xyuas ntawm cov rooj sib tham (χ{{0}}} xeem) tau ua haujlwm los xyuas seb puas muaj kev koom tes tseem ceeb ntawm cov npe sib txawv. Txhawm rau tshuaj xyuas cov koom haum ntawm biomarkers thiab cov qhab nia kho mob peb siv cov kev sib txheeb matrices raws li Pearson's product-moment correlation coefficients. Txhawm rau piav qhia txog kev sib koom ua ke ntawm kev kuaj mob thiab biomarkers, peb siv tus qauv sib txawv ntawm cov kab sib txawv (GLM). Yog li ntawd, peb tau ua kev tiv thaiv kev sib piv sib piv ntawm cov kev kho mob. Kev tshawb pom tsis tseeb tus nqi p-kev kho yog siv los kho rau ntau qhov kev sib piv (Benjamini thiab Hochberg, 1995). Kev txheeb xyuas ntau qhov kev rov qab los tau siv los txiav txim siab qhov tseem ceeb tshaj plaws biomarkers, uas kwv yees qhov ntsuas ntsuas cov qhab nia thaum tso cai rau cov txiaj ntsig ntawm cov ntaub ntawv pej xeem (xws li hnub nyoog thiab kev kawm). Peb siv txoj kev ua haujlwm tsis siv neeg stepwise nrog p-rau- nkag ntawm 0.05 thiab p-rau-tshem tawm ntawm 0.06. Peb tau tshawb xyuas R2 kev hloov pauv, ntau qhov sib txawv (Cook's nrug thiab leverage), homoscedasticity (nrog rau kev kuaj dawb thiab hloov pauv Breusch-Pagan), thiab ntau yam sib txawv (siv kev kam rau siab thiab qhov sib txawv ntawm qhov sib txawv). Tag nrho cov txiaj ntsig ntawm kev ntsuam xyuas rov qab tau raug bootstrapped (5.000 cov qauv) thiab cov txiaj ntsig tom qab tau pom yog tias cov txiaj ntsig tsis sib haum. Txhua qhov kev ntsuam xyuas yog ob-tailed, thiab qhov tseem ceeb tau teeb tsa ntawm p=0.05. Txhua qhov kev txheeb cais tau ua tiav siv IBM SPSS windows version 25, 2017.
Peb tau siv Smart Partial Least Squares (SmartPLS)-SEM txoj kev tsom xam (Ringle li al., 2{{10}}}12) txhawm rau txheeb xyuas ntau cov kauj ruam ntau txoj hauv kev nruab nrab ntawm cov tswv yim sib txawv (biomarkers thiab CCTAs) thiab qhov ntsuas ntsuas ntsuas ntsuas cov qhab nia. Cov tom kawg tau nkag mus ua ib qho latent vector muab rho tawm los ntawm qhov sib txawv tag nrho thiab cov qhab nias subdomain. Cov zis hloov pauv uas tsis tuaj yeem ua ke hauv latent vectors tau nkag los ua ib qho ntsuas. Thawj qhov kev hloov pauv tau nkag mus (yog tias ua tau) ua ib qho latent vector suav nrog CCTAs, GGOs, kev sib koom ua ke lossis lwm yam CCTAS, thiab SpO2 (sau npe tias yog COVID-19 mob ntsws). Cov ntaub ntawv biomarker tau raug txiav txim siab rau (ib nrab) kho cov teebmeem ntawm COVID-19 mob ntsws ntawm cov tsos mob. Cov tswv yim biomarker hloov pauv tau (yog tias ua tau) ua ke hauv ib qho latent vector qhia txog kev tiv thaiv kab mob (xws li IL-6, CRP, IL-10, sRAGE, albumin, calcium), thiab lwm yam biomarkers tau nkag mus ua ib leeg. ntsuas. Cov latent vectors tau conceptualized raws li cov qauv qhia. Peb tau ua tiav SmartPLS tsom xam siv 5.000 bootstrap cov qauv tsuas yog thaum cov qauv sab hauv / sab nrauv ua raws cov ntaub ntawv tshwj xeeb: a) Kev txheeb xyuas Tetrad lees paub tias cov latent vectors tsis raug suav tias yog cov qauv qhia; b) tag nrho haum ntawm txoj kev qauv yog txaus nrog SRMR < 0="" 08;="" c)="" cov="" qauv="" sab="" nrauv="" latent="" vector="" loadings="" yog=""> 0.666 ntawm p < 0.001;="" thiab="" d)="" cov="" latent="" vectors="" qhia="" qhov="" tseeb="" tsim="" siv="" tau="" raws="" li="" qhia="" los="" ntawm="" qhov="" nruab="" nrab="" qhov="" sib="" txawv="" ntawm="" rho="" tawm="" (ave)=""> 0.5, Cronbach's alpha> 0.7, rho_A> 0.8, thiab kev ntseeg tau sib xyaw> 0.7. Yog li ntawd, peb tau ua tiav PLS txoj kev tsom xam ntawm 5.000 bootstrap cov qauv thiab suav cov kev coefficients (nrog p-tus nqi), cov qauv txheej txheem thauj khoom, thiab cov teebmeem tsis ncaj thiab tag nrho. Peb ua haujlwm Blindfolding thiab PLSpredict nrog 10-fold cross-validation los xyuas qhov kev kwv yees ua tau zoo ntawm tus qauv (Shmueli li al., 2019). Kev kwv yees-Oriented Segmentation tsom xam, Kev Ntsuam Xyuas Ntau Pab Pawg, thiab Kev Ntsuas Kev Ntsuas Kev Ntsuas Kev Ntsuas tau raug siv los ntsuas qhov sib txawv ntawm qhov sib txawv.
3. Cov txiaj ntsig
3.1. Socio-demographic thiab cov ntaub ntawv kho mob
Table 1 qhia txog cov ntaub ntawv pej xeem hauv zej zog hauv kev tswj hwm thiab ob tus neeg mob COVID-19 pawg neeg mob tau muab faib ua cov uas ib txwm muaj los txo qis SpO2 tus nqi (Ntau dua lossis sib npaug li 76 feem pua) thiab cov uas muaj SpO2 tus nqi qis heev (< 76%).="" patients="" with="" spo2="" <="" 76%="" are="" somewhat="" older="" than="" the="" other="" groups.="" no="" significant="" differences="" among="" these="" study="" groups="" were="" detected="" in="" bmi,="" education,="" residency,="" marital="" status,="" employment,="" and="" tud.="" patients="" with="" spo2="" <="" 76%="" had="" higher="" total="" cctas,="" ggo,="" consolidation,="" crazy-paving,="" and="" other="" chest="" abnormalities="" than="" covid="" patients="" with="" spo2="" ≥="" 76.="" the="" differences="" in="" ccta,="" crazy-paving,="" and="" other="">
patters tseem ceeb tom qab FDR p-kho (ntawm p=0.0133). Tag nrhoCov neeg mob COVID-19 tau kho nrog vitamin C thiab D thiab zaus notau siab dua hauv kev tswj hwm. Ntau tus neeg mob hauv SpO2 <76 feem="" pua="" ntawm="" pab="">tau kho nrog dexamethasone dua li ntawm> 76 feem pua SpO2 tus neeg mobpab pawg. Tsis muaj qhov sib txawv tseem ceeb hauv kev kho mob nrogFamotidine, Azithromycin, Meropenem, Heparin, thiab Clexane ntawmob pawg COVID-19. Txhua tus neeg mob COVID-19 tau txais kev kho O2 thiabtau txais kev kho mob txhua hnub nrog paracetamol thiab bromhexine.
3.2. Qhov sib txawv hauv biomarkers ntawm CIVID-19 pawg thiab tswj
Table 1 qhia txog kev ntsuas ntawm ntau yam biomarkers nyob rau hauv peb qhov kev tshawb fawb qauv thiab qhia tau hais tias qhov sib txawv ntawm txhua tus biomarkers, uas tseem ceeb heev tom qab p-kho rau FDR (ntawm p=0.0011). Muaj qhov txo qis hauv cov ntshav albumin, calcium, thiab magnesium hauv COVID-19 thiab nce hauv IL-6, CRP, IL-10, sRAGE, qabzib thiab ACE2 piv nrog kev tswj hwm ib txwm muaj. Ntxiv mus, cov ntshav IL-6, ACE2, albumin, magnesium, thiab calcium tau txo qis hauv cov neeg mob nrog SpO2.<76% as="" compared="" with="" patients="" with="" higher="" spo2="" values.="">
3.3. Qhov sib txawv ntawm cov qhab nia kho mob ntawm cov pab pawg kawm
Table 2 qhia txog kev ntsuas ntawm HDRS, HAM-A, thiab FF tag nrho thiab cov qhab nias subdomains hauv ob pawg COVID-19 pawg thiab tswj. Tag nrho FF thiab HAM-A tag nrho thiab cov qhab nias subdomain nrog rau cov lej ntawm tag nrho cov qhab nia psychosomatic, thiab cov qhab nia kev txawj ntse thiab insomnia tau ntau dua hauv cov neeg mob COVID-19 ntau dua li kev tswj hwm. Tag nrho HDRS-17 thiab melancholia HDRS cov qhab nia sib txawv ntawm peb pawg sub thiab nce los ntawm kev tswj → COVID-19 nrog SpO2 Ntau dua lossis sib npaug li 76 feem pua. → COVID-19 nrog SpO2 <76 feem="">
3.4. Kev sib raug zoo ntawm cov qhab nia ntsuas ntsuas thiab biomarkers
Table 3 qhia txog kev sib cuam tshuam ntawm matrix ntawm tag nrho HDRS, FF, thiab HAM-A cov qhab nia thiab CCTAs, SpO2, thiab biomarkers hauv tag nrho pawg kawm. HDRS, FF, thiab HAM-A cov qhab nia tau pom muaj kev sib raug zoo nrog CCTAs, CRP, IL-6, IL-10, sRAGE, thiab ACE2, thiab kev sib cuam tshuam nrog SpO2, albumin, magnesium, thiab calcium. .
3.5. Kev twv ua ntej ntawm Hamilton kev nyuaj siab ntsuas qhov ntsuas (HDRS) cov qhab nia
Cov txiaj ntsig ntawm ntau qhov regression ntawm HDRS tag nrho thiab subdomain cov qhab nia ntawm qhov ntsuas biomarkers raws li qhov sib txawv ntawm cov khoom sib txawv tau nthuav tawm hauv Table 4. Regression #1 qhia tau hais tias 72.6 feem pua ntawm qhov sib txawv hauv tag nrho HDRS cov qhab nia tuaj yeem piav qhia los ntawm kev rov qab los ntawm sRAGE thiab CCTA. (tag nrho cov zoo txuam) thiab SpO2 (inversely txuam). Regression #2 qhia tau hais tias 65.7 feem pua ntawm qhov sib txawv ntawm tag nrho HDRS cov qhab nia tuaj yeem piav qhia los ntawm kev thim rov qab ntawm sRAGE (zoo) thiab calcium (tsis zoo). Ib feem tseem ceeb ntawm qhov sib txawv hauv cov qhab nia HDRS tseem ceeb (39.5 feem pua) tuaj yeem piav qhia los ntawm kev rov qab los ntawm IL-6 (zoo) thiab calcium (inversely). Regression #4 qhia tau hais tias 43.3 feem pua ntawm qhov sib txawv ntawm cov tsos mob psychosomatic HDRS tuaj yeem piav qhia los ntawm kev rov qab los ntawm CCTA thiab IL-10 (ob qho tib si zoo). Fig. 1 qhia txog ib feem ntawm qhov kev hloov pauv ntawm cov qhab nia psychosomatic HDRS ntawm CCTAs qhov tseem ceeb tom qab kho rau IL-10. Tsis tas li ntawd, IL-10 thiab CRP tau piav qhia 30.8 feem pua ntawm qhov sib txawv hauv cov qhab nia HDRS psychosomatic (Regression #5). Ib feem tseem ceeb ntawm qhov sib txawv (36.2 feem pua) hauv cov qhab nia melancholia HDRS tuaj yeem piav qhia los ntawm kev rov qab los ntawm calcium thiab SpO2.
3.6. Kev twv ua ntej ntawm FF scale cov qhab nia
Table 5 qhia cov txiaj ntsig ntawm ntau qhov kev ntsuam xyuas rov qab nrog FF tag nrho thiab cov qhab nias subdomain raws li qhov sib txawv thiab cov biomarkers raws li kev piav qhia. Peb pom tias 64.3 feem pua ntawm qhov sib txawv ntawm tag nrho cov qhab nia FF tuaj yeem piav qhia los ntawm kev rov qab los ntawm IL-6 thiab sRAGE (ob leeg zoo) thiab SpO2 (tsis zoo) (Regression #1). Regression #2 qhia tau hais tias 59.8 feem pua ntawm qhov sib txawv hauv FF tag nrho cov qhab nia tuaj yeem piav qhia los ntawm kev rov qab los ntawm sRAGE, CRP, thiab IL-6 (tag nrho qhov zoo) thiab calcium (inversely). Regression #3 tau pom tias 61.6 feem pua ntawm qhov sib txawv ntawm cov tsos mob ntawm psychosomatic FF tuaj yeem piav qhia los ntawm kev rov qab los ntawm IL-6 thiab sRAGE (ob leeg inversely) thiab SpO2 (zoo). Daim duab 2 qhia txog ib feem ntawm qhov kev hloov pauv ntawm cov qhab nia psychosomatic FF ntawm SpO2 tom qab kho rau IL-6 thiab sRAGE. Regression #4 tau qhia tias 56.3 feem pua ntawm cov tsos mob ntawm psychosomatic FF tuaj yeem piav qhia los ntawm kev rov qab los ntawm IL-6 thiab sRAGE (zoo) thiab calcium (inversely). Regression #5 tau pom tias 46.2 feem pua ntawm qhov sib txawv ntawm cov qhab nia qaug zog tuaj yeem piav qhia los ntawm kev thim rov qab ntawm sRAGE (zoo) thiab SpO2 (inversely). Regression #6 tau qhia tias 47.0 feem pua ntawm qhov sib txawv ntawm cov qhab nia qaug zog tuaj yeem piav qhia los ntawm kev rov qab los ntawm CRP thiab sRAGE (zoo) thiab calcium (tsis zoo).
3.7. Kev twv ua ntej ntawm HAM-A qhab nia
Table 6 qhia cov txiaj ntsig ntawm ntau qhov kev rov qab los ntawm HAM-A tag nrho thiab cov qhab nias subdomain ntawm qib biomarker thaum tso cai rau cov teebmeem ntawm cov ntaub ntawv pej xeem. Regression #1 qhia tau hais tias 68.0 feem pua ntawm qhov sib txawv ntawm tag nrho HAM-A cov qhab nia tuaj yeem piav qhia los ntawm kev rov qab los ntawm sRAGE thiab GGO (ob qho tib si zoo), thiab SpO2 thiab calcium (ob leeg inversely). Daim duab 3 qhia txog ib nrab regression ntawm tag nrho HAM-A ntawm sRAGE qib. Kev sib xyaw ua ke ntawm sRAGE (zoo) thiab calcium (tsis zoo) tau piav qhia 62.1 feem pua ntawm qhov sib txawv hauv tag nrho cov qhab nia HAM-A (Regression #2). sRAGE thiab GGO piav qhia 48.9 feem pua ntawm qhov sib txawv hauv cov qhab nia HAM-A tseem ceeb (Regression #3) thiab sRAGE thiab calcium tau piav qhia 43.7 feem pua ntawm qhov sib txawv hauv cov qhab nia HAM-A tseem ceeb (regression #4). Regression #5 qhia tau hais tias sRAGE thiab GGO (ob leeg zoo) thiab calcium (tsis zoo) tau piav qhia 41.9 feem pua ntawm qhov sib txawv hauv cov qhab nia psychosomatic HAM-A. Hauv regression #6 peb pom tias 38.3 feem pua ntawm qhov sib txawv ntawm cov qhab nia psychosomatic HAM-A tuaj yeem piav qhia los ntawm sRAGE (zoo) thiab calcium (tsis zoo). Thaum kawg, peb kuj tau tshuaj xyuas qhov kev rov qab los ntawm cov lej ntawm tag nrho cov tsos mob psychosomatic ntawm biomarkers thiab pom tias sRAGE thiab GGO (zoo) thiab SpO2 (inversely) tau piav qhia 62.9 feem pua ntawm nws qhov sib txawv.
3.8. Cov txiaj ntsig ntawm PLS tsom xam
Daim duab 4 qhia txog thawj PLS qauv ua rau ntawm 5.000 bootstrap qauv. Melancholia, kev paub txog cov tsos mob, thiab kev pw tsaug zog tsis tuaj yeem suav nrog hauv tib lub latent vector (vim muaj kev thauj khoom tsawg) thiab, yog li ntawd, tau nkag los ua ib qho ntsuas. Ib qho latent vector tuaj yeem raug muab rho tawm los ntawm cov qhab nia HDRS thiab HAM-A tseem ceeb thiab peb qhov kev puas siab puas ntsws ib yam nkaus (labeled physio-effective lossis PA-core). Peb kuj tuaj yeem muab tag nrho cov biomarkers rau hauv ib qho latent vector (labeled raws li kev tiv thaiv kab mob), tshwj tsis yog sACE2 thiab magnesium uas tau nkag los ua ib qho ntsuas. Peb muaj peev xwm rho tawm ib qho latent vector los ntawm CCTAs, vwm paving, consolidation, GGO, thiab lwm yam CCTAs, SpO2, thiab kis kab mob (ib tug zoo PCR test thiab IgM antibodies), sau npe COVID-19 mob ntsws. Kev tsim kho kev ntseeg tau ntawm peb qhov latent vectors yog qhov zoo nrog AVE > 0.655, Cronbach > 0.881, rho A > 0.873, thiab kev ntseeg siab sib xyaw > {{15} }.904. Cov qauv sab nrauv loadings ntawm peb lub latent vectors yog > 0.721 ntawm p < 0.0001.="" tus="" qauv="" haum="" zoo="" nrog="" srmr="0.050." cta="" tau="" pom="" tias="" cov="" qauv="" sab="" nrauv="" tsis="" raug="" qhia="" raws="" li="" cov="" qauv="" xav="" tau.="" kev="" tsim="" kho="" cov="" khoom="" siv="" hluav="" taws="" xob="" tsis="" sib="" xws="" ntawm="" lub="" cev="" tiv="" thaiv="" kab="" mob="" (0.387)="" thiab="" pa-core="" (0.449)="" latent="" vectors="" tau="" ntau="" tshaj="" qhov="" tsim="" nyog.="" tag="" nrho="" cov="" ntsiab="" lus="" tsis="" sib="" xws="" tau="" txais="" raws="" li="" qhia="" los="" ntawm="" cov="" txiaj="" ntsig="" ntawm="" kev="" tshawb="" fawb="" kev="" tshawb="" fawb="" kev="" tshawb="" fawb="" kev="" tshawb="" fawb,="" kev="" ntsuas="" kev="" ntsuas="" kev="" ntsuas,="" thiab="" kev="" ntsuam="" xyuas="" ntau="" pab="" pawg.="" q2="" kev="" kwv="" yees="" qhov="" tseem="" ceeb="" ntawm="" txhua="" qhov="" kev="" tsim="" qauv="" tau="" zoo="" uas="" qhia="" tias="" lawv="" ua="" tau="" zoo="" tshaj="" qhov="" kev="" ntsuas="" tsis="" zoo="" tshaj="" plaws.="" peb="" pom="" tias="" 70.0="" feem="" pua="" ntawm="" qhov="" sib="" txawv="" hauv="" pa-core="" tau="" piav="" qhia="" los="" ntawm="" kev="" rov="" qab="" los="" ntawm="" kev="" tiv="" thaiv="" kab="" mob="" thiab="" kab="" mob="" ntsws="" latent="">
Peb pom tias lub cev tiv thaiv kab mob tau piav qhia 29.2 feem pua ntawm qhov sib txawv ntawm melancholia thiab 9.7 feem pua ntawm qhov sib txawv ntawm cov tsos mob paub. Ntxiv mus, 28.7 feem pua ntawm qhov sib txawv ntawm insomnia tau piav qhia los ntawm kev mob ntsws thiab BMI (ob qho tib si muaj txiaj ntsig zoo). Ib feem loj ntawm qhov sib txawv ntawm lub cev tiv thaiv kab mob (62.0 feem pua ) tau piav qhia los ntawm kab mob ntsws latent vector. Muaj qhov cuam tshuam loj heev ntawm qhov kawg ntawm PA-core (t=4.74, p < 0="" 001),="" melancholia="" (t="" {{="" 13}}.50,="" p="">< 0.="" }.="" latent="" vector.="" daim="" duab="" 5="" qhia="" txog="" qhov="" thib="" ob="" pls="" txoj="" kev="" tsom="" xam="" uas="" peb="" tau="" muab="" cov="" kab="" mob="" tiv="" thaiv="" kab="" mob="" thiab="" cov="" kab="" mob="" ntsws="" ntsws="" ua="" ke="" rau="" hauv="" ib="" qho="" latent="" vector="" hu="" ua="" tus="" kab="" mob-immune-inflammatory="" (iii)="" core.="" tus="" qauv="" haum="" (srmr="0.051)" yog="" qhov="" tsim="" nyog="" thiab="" kev="" tsim="" kho="" kev="" ntseeg="" tau="" txaus="" nrog="" ave="0.613," cronbach="0.947," rho="" a=""> 0.954, thiab kev ntseeg tau sib xyaw> 0.953 thiab tag nrho III core loadings yog tag nrho> 0.701 (tshwj tsis yog IL-6) ntawm p < 0.0001.="" cov="" vector="" no="" tsis="" yog="" qhia="" yuam="" kev="" raws="" li="" tus="" qauv="" cuam="" tshuam.="" peb="" pom="" tias="" qhov="" iii="" core="" no="" tau="" kwv="" yees="" pa-core="" thiab="" lwm="" cov="" cim="" qhia="" ib="">
4. Kev sib tham
4.1. COVID-19, cov tsos mob thiab kev puas siab puas ntsws
Thawj qhov kev tshawb pom tseem ceeb ntawm txoj kev tshawb no yog tias COVID-19 cuam tshuam nrognce qib ntawm kev nyiam (xws li kev nyuaj siab tseem ceeb thiab kev ntxhov siab thiab melancholia) thiab cov tsos mob ntawm psychosomatic FF nrog rau kev paub txog cov tsos mob thiab insomnia. Vim tias peb tsis suav nrog cov neeg mob uas muaj kev nyuaj siab loj, kev puas siab puas ntsws bipolar, thiab kev ntxhov siab, lub koom haum no tuaj yeem piav qhia tau zoo tshaj plaws xws li kev nyuaj siab, kev ntxhov siab, thiab kev puas siab puas ntsws (lossis ME / CFS-zoo li) cov tsos mob vim yog COVID-19. Cov kev tshawb pom no txuas ntxiv cov lus ceeb toom tau hais hauv peb Cov Lus Taw Qhia piav qhia txog qhov tshwm sim ntawm cov tsos mob ntawm cov neeg muaj COVID-19. Kev nyuaj siab tau pom tias muaj nyob hauv 8.3 feem pua rau 48.3 feem pua ntawm COVID-19 cov neeg mob (Gao li al., 2020; Huang thiab Zhao, 2020; Ozamiz-Etxebarria et al., 2020). Lwm cov kev tshawb fawb kuj tau tshaj tawm txog kev nce qib ntawm kev nyuaj siab, kev nyuaj siab, ntshai, pw tsaug zog tsis zoo, thiab kev tua tus kheej hauv cov neeg mob nrog COVID-19 (Luo li al., 2020; Qiu li al., 2020). Cov neeg mob uas muaj tus kab mob (los yog xav tias yuav kis tau) nrog COVID-19 tuaj yeem muaj kev xav thiab kev coj cwj pwm zoo xws li kev ntshai, kev ntxhov siab, kev nyob ib leeg, ntxhov siab, insomnia, lossis ntxhov siab (Shigemura li al., 2020). Hauv COVID-19 cov neeg mob, nce qib ntawm kev qaug zog tau pom nrog qhov muaj nyob nruab nrab ntawm 17.5 feem pua (Simani li al., 2021) thiab 53.6 feem pua (Qi li al., 2020). Kev qaug zog ntev kuj yog cov tsos mob tseem ceeb ntawm qhov ntev (kawg) COVID-19 syndrome (Islam et al., 2020) (D'ecary et al., 2021). Txawm li cas los xij, peb txoj kev tshawb fawb qhia tau hais tias nyob rau theem mob hnyav ntawm COVID-19, qhov tshwm sim ntawm kev cuam tshuam (suav nrog cov tsos mob tseem ceeb ntawm kev nyuaj siab thiab kev ntxhov siab tseem ceeb) thiab cov tsos mob ntawm psychosomatic FF muaj kev cuam tshuam loj heev thiab cov tsos mob no teb rau COVID-19 Tsis tas li ntawd yog cov tsos mob ntawm melancholia, kev paub txog cov tsos mob, thiab insomnia.
Tsis tas li ntawd, nws pom tias qhov tseem ceeb ntawm kev nyuaj siab, kev ntxhov siab tseem ceeb, thiab cov tsos mob ntawm psychosomatic FF yog tib lub hauv paus ntsiab lus thiab, yog li ntawd, cov tsos mob no yog qhov tshwm sim ntawm tib lub hauv paus tshwm sim, uas tuaj yeem piav qhia tau zoo tshaj yog "physio affective core" . Nws yog qhov nthuav kom nco ntsoov tias qhov tseem ceeb no kuj tau tsim nyob rau hauv schizophrenia, kev nyuaj siab loj, ME / CFS, thiab somatoform tsis meej (Anderson thiab Maes, 2014; Kanchanatawan li al., 2019; Maes et al., 2021). Ntawm qhov tod tes, melancholia, insomnia, thiab cov tsos mob ntawm kev txawj ntse tsis yog cov tseem ceeb ntawm lub cev muaj txiaj ntsig zoo. Raws li tau piav qhia hauv Kev Taw Qhia, kev sib raug zoo ntawm COVID-19 thiab cov tsos mob cuam tshuam thiab kev puas siab puas ntsws feem ntau yog kev xav raws li qhov tshwm sim ntawm kev puas siab puas ntsws nrog rau kev qias neeg uas cuam tshuam nrog kev kis tus kab mob, kev ntxhov siab txog kev cuam tshuam ntawm kev kis tus kab mob, kev sib raug zoo. Kev cais tawm thiab txo qis hauv kev paub txog kev sib raug zoo, thiab kev poob haujlwm txuas nrog kev sib cais lossis kev kaw cia (Benke li al., 2020; Brooks li al., 2020; Kornilaki, 2021; Xiang et al., 2020). Txawm li cas los xij, raws li peb yuav tham hauv nqe lus hauv qab no, lub cev muaj txiaj ntsig zoo rau lub cev, cov tsos mob melancholic thiab kev paub, thiab kev pw tsaug zog yog qhov tshwm sim ntawm kev kis tus kab mob, mob ntsws, thiab kev tiv thaiv kab mob hauv COVID-19.
TSEEM CEEB_HAMA: Cov tsos mob ntawm kev ntxhov siab tseem ceeb ntawm Hamilton Anxiety Rating Scale.
4.2. Cov teebmeem ntawm mob ntsws rau cov tsos mob thiab kev puas siab puas ntsws
Qhov thib ob tseem ceeb ntawm txoj kev tshawb no yog qhov sib txawv CCTAs thiab txo qis SpO2 feem pua tau cuam tshuam nrog cov tsos ntawm lub cev muaj txiaj ntsig zoo nrog rau melancholia, kev paub txog cov tsos mob, thiab insomnia. Ntau (txog 70 feem pua) RT-PCR kuaj pom muaj tus kab mob COVID-19 cov neeg mob qhia CCTAs (Adams li al., 2020), uas qhia tias mob ntsws, mob ntsws, mob ntsws, thiab mob ntsws (Sadhukhan li al., 2020) . Hauv peb txoj kev tshawb fawb, qhov muaj CCTAs muaj kev cuam tshuam nrog kev txo qis SpO2 qhia tias mob ntsws thiab mob ntsws yuav ua rau cov pa oxygen tsis txaus, uas feem ntau txo qis hauv COVID-19 cov neeg mob thiab tshwj xeeb tshaj yog cov neeg mob hnyav dua (Dai et al., 2020; Luks and Swenson, 2020). Silent hypoxia yog ib qho ntawm cov tsos mob tseem ceeb ntawm COVID{11}}, txawm tias nws tsis yog thawj tus tsos mob (Bouttell li al., 2020). Hauv kev tshawb fawb tsis ntev los no, qhov txawv txav ntawm lub ntsws radiography xws li muaj ob sab opacities, multifocal opacities, los yog ib qho chaw sab sauv lossis nruab nrab opacity tau cuam tshuam nrog kev xav tau oxygen ntxiv (Ong li al., 2021).
Muaj qee qhov pov thawj tias mob ntsws thiab mob ntsws muaj feem xyuam nrog cov tsos mob ntawm kev nyuaj siab loj (Adams li al., 2008; Seminog and Goldacre, 2013). Tsis tas li ntawd, cov neeg mob uas muaj mob ntsws comorbid thiab kev nyuaj siab qhia tau tias kev kho mob tsis zoo li piv rau cov neeg mob uas tsis muaj kev nyuaj siab (Kao et al., 2014). Ntawm qhov tod tes, kev nyuaj siab kuj yog ib qho kev pheej hmoo ntawm kev mus pw hauv tsev kho mob vim mob ntsws (Davydow li al., 2014). Raws li American Lung Association, tsis muaj zog, qaug zog, cov tsos mob ntawm plab hnyuv, neurocognitive impairments, thiab tsis qab los noj mov yog cov tsos mob ntawm mob ntsws (Niederman li al., 1993). Cov ntshav qis qis lossis hypoxemia tseem cuam tshuam nrog kev nyuaj siab thiab qaug zog (Zhao li al., 2017).
TSEEM CEEB_HAMA: Cov tsos mob ntawm kev ntxhov siab tseem ceeb ntawm Hamilton Anxiety Rating Scale.
PH_FF: Psychosomatic tsos mob ntawm Fibromyalgia thiab Chronic Fatigue Rating Scale (FF).
4.3. Cov teebmeem ntawm mob ntsws yog ib nrab kho los ntawm kev tiv thaiv kab mob
Qhov thib peb qhov kev tshawb pom loj ntawm txoj kev tshawb no yog tias cov teebmeem ntawm kev mob ntsws thiab txo qis SpO2 ntawm lub cev muaj txiaj ntsig zoo yog qee qhov kev sib kho los ntawm kev tiv thaiv kab mob thiab cov kab mob ntsws kuj tseem muaj kev cuam tshuam ncaj qha rau cov tub ntxhais no, qhia tias lwm cov txheej txheem tsis kho los ntawm kev tiv thaiv kab mob. kev ua kom muaj kev cuam tshuam. Tsis tas li ntawd, cov teebmeem ntawm kev mob ntsws ntawm kev paub thiab melancholia yog kev kho kom haum xeeb los ntawm kev tiv thaiv kab mob. Hauv txoj kev tshawb fawb tam sim no, cov tshuaj tiv thaiv kab mob tau pom zoo raws li cov ntsiab lus tseem ceeb ntawm cov ntshav plasma qib IL-6, IL-10, CRP, sRAGE (tag nrho cov nce), albumin, thiab calcium (ob leeg tuag). Peb cov txiaj ntsig tau qhia tias theem mob hnyav thiab lub cev tiv thaiv kab mob hauv COVID-19 cuam tshuam nrog lub cev muaj txiaj ntsig zoo. Tam sim no muaj pov thawj tias muaj kev puas siab puas ntsws thiab ME / CFS nrog lub cev tiv thaiv kab mob (Bjørklund li al., 2020a; Gerwyn thiab Maes, 2017; Morris thiab Maes, 2013) thiab tias qhov kawg thiab nws qhov tshwm sim tuaj yeem piav qhia cov tsos mob ntawm tus kab mob. physio-affective core and cognitive impairments (Kanchanatawan li al., 2019; Leonard and Maes, 2012; Morris and Maes, 2013). Interestingly, plasma qib ntawm IL-6 thiab IL{14}} nyob rau theem mob hnyav ntawm tus kab mob kis tau raug pom los kwv yees qhov kev mob tshwm sim ntawm kev qaug zog (Russell li al., 2019). Hauv peb txoj kev tshawb fawb, cov calcium uas txo qis yog lwm qhov ntawm lub cev tiv thaiv kab mob latent vector hauv COVID{16}} uas cuam tshuam nrog lub cev muaj zog.
Txo cov calcium uas tsis tshua muaj tshwm sim nyob rau hauv COVID-19 uas tsis yog mob hnyav thiab mob hnyav (Di Filippo li al., 2021; Pal et al., 2020) thiab feem ntau cuam tshuam nrog kev mob hnyav (Sun et al., 2020; Yang et al., 2021). Ntxiv mus, cov calcium uas tsis tshua muaj feem cuam tshuam nrog qhov hnyav ntawm ARS (Sun et al., 2020) thiab cov lus teb inflammatory (Di Filippo li al., 2021, 2020). Cov calcium uas qis dua tuaj yeem pom thaum kis kab mob vim tias albumin, uas txo qis thaum lub sijhawm mob hnyav, khi calcium thiab vim cov kab mob tuaj yeem siv Ca2 ntxiv cov cim (Deng li al., 2012; Nieto-Torres li al., 2015; Zhou et ib., 2009). Kev txo qis calcium feem ntau pom nyob rau hauv cov neeg mob uas muaj kev cuam tshuam thiab cuam tshuam nrog qhov hnyav ntawm kev nyuaj siab thiab kev puas siab puas ntsws (Al-Dujaili li al., 2019). Hypocalcemia yog nrog los ntawm ntau yam kev puas siab puas ntsws xws li cov leeg nro, mob thiab cramps, kev paub tsis meej, thiab cov tsos mob plawv thiab ua pa (Bove-Fenderson thiab Mannstadt, 2018).
Txawm hais tias magnesium yog ib feem khi rau albumin thiab txo qis hauv peb cov neeg mob COVID-19, tshwj xeeb tshaj yog nyob rau hauv cov neeg uas muaj cov txiaj ntsig SpO2 qis heev, tsis muaj kev koom tes nrog lub cev muaj txiaj ntsig zoo lossis lwm yam tsos mob tuaj yeem pom tom qab txiav txim siab lub luag haujlwm ntawm tiv thaiv kab mob. Txawm li cas los xij, magnesium tsis muaj peev xwm tuaj yeem ua rau qaug zog, qaug zog, qaug zog, tsis qab los noj mov, loog, mob leeg, cov tsos mob zoo li fibromyalgia, kev nyuaj siab, thiab txob taus (Ismail li al., 2018). Raws li tau piav qhia hauv Kev Taw Qhia, kev khi ntawm AGEs rau RAGEs ntawm daim nyias nyias pib lub cev tiv thaiv kab mob nrog kev tsim tawm ntawm IL-6 thiab lwm yam cytokines (Macaione li al., 2007; Tobon- Velasco li al., 2014; Wang thiab Liu, 2016), thiab cov lus teb no kho tsis tau tsuas yog kev mob xwb, tab sis kuj tseem muaj cell proliferation, migration, apoptosis, thiab microtubule stabilization (Xie li al., 2013) thiab qhov no piav qhia tias txoj hauv kev RAGE yog qhov tseem ceeb hauv COVID{{12} } kev nce qib (Yalcin Kehribar li al., 2021). Kev nce qib ntawm sRAGEs hauv COVID{14}} tuaj yeem piav qhia los ntawm proteolysis ntawm extracellular domain ntawm RAGE (Sterenczak li al., 2009; Zhang et al., 2008), qhia tias nce qib sRAGE plasma hauv COVID{{17 }} tuaj yeem cuam tshuam qhov nthuav qhia ntawm daim nyias nyias RAGEs. Interestingly, sRAGEs muaj cov tshuaj tiv thaiv kab mob los ntawm attenuating qhov khi rau daim nyias nyias RAGE (Oczypok li al., 2017; Sternberg li al., 2008; Yang et al., 2014). Hauv kev nyuaj siab loj thiab kev puas siab puas ntsws bipolar, sRAGE qib tau qis dua li piv nrog kev tswj hwm (Emanuele li al., 2011), qhia tias qib qis tuaj yeem ua rau muaj kev tiv thaiv kab mob hauv lub siab tsis zoo. Yog li ntawd, qhov nce qib sRAGE hauv peb txoj kev tshawb fawb yog tej zaum qhov qhia txog kev tiv thaiv kab mob hauv COVID-19, es tsis yog kev kho mob los ntawm kev mob ntsws rau ntawm lub cev muaj txiaj ntsig. Hypoxia tuaj yeem txhim kho ACE2 cov noob qhia thiab qib protein ntau hauv lub ntsws thiab lub raum uas tuaj yeem ua rau muaj qhov hnyav ntawm COVID-19 (Shenoy li al., 2020).
Txawm li cas los xij, qib ACE2 nce ntxiv hauv peb txoj kev tshawb fawb tsis cuam tshuam nrog cov qhab nia cuam tshuam lossis kev puas siab puas ntsws tom qab txiav txim siab txog lub luag haujlwm ntawm lub cev tiv thaiv kab mob. Qhov tseem ceeb, peb qhov kev soj ntsuam PLS tau pom tias ib qho "cov kab mob tiv thaiv kab mob tsis zoo" cuam tshuam rau kev mob ntsws ntsws uas cuam tshuam nrog kev mob ntsws, txo qis SpO2 thiab kev tiv thaiv kab mob thiab hais tias cov tub ntxhais kawm no piav qhia txog 70 feem pua ntawm qhov sib txawv hauv lub cev-somatic core, thiab ib feem ntawm lub cev. qhov sib txawv hauv melancholia (31.1 feem pua), insomnia (30 feem pua thaum sib koom nrog BMI) thiab kev puas siab puas ntsws neurocognitive (8.8%). Yog li ntawd, peb tuaj yeem txiav txim siab tias tus kab mob SARS-CoV-2 mob hnyav feem ntau yog nrog los ntawm kev mob ntsws thiab txo qis SpO2 uas ob leeg paub tias yuav ua rau muaj kev tiv thaiv kab mob (Sadhukhan li al., 2020) thiab tias qhov tshwm sim ntau ntxiv. Cov tsos mob neuropsychiatric hauv COVID-19 yuav tsum raug ntaus nqi tsawg kawg yog ib feem ntawm tus kab mob-immune-inflammatory core ntawm COVID-19. Ntxiv mus, SARS-CoV-2 tuaj yeem kis tau rau lub hlwb, ua rau muaj mob neuroinflammation (Pan et al., 2020) thiab qhov no ntseeg tau tias yog lwm qhov ntawm cov tsos mob neuropsychiatric suav nrog kev qaug zog ntev tom qab rov zoo (Mandal et al., 2021).
5. Cov kev txwv
6. Cov lus xaus
Nov yog peb cov khoom tiv thaiv kev qaug zog! Nyem rau daim duab kom paub ntau ntxiv!
Cov ntaub ntawv
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