研究动态
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认知障碍、焦虑和抑郁:与后COVID-19病情恢复有关的Cochrane证据地图。

Cognitive impairment, anxiety and depression: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition.

发表日期:2022 Dec
作者: Claudio Cordani, Vanessa M Young, Chiara Arienti, Stefano G Lazzarini, Matteo J Del Furia, Stefano Negrini, Carlotte Kiekens
来源: European Journal of Physical and Rehabilitation Medicine

摘要:

目前还没有关于后COVID-19情况(PCC)的具体治疗证据。但是,对于其他健康状况中类似症状有效的康复干预措施可以应用于PCC患者。通过系统性综述的概述,我们旨在描述关于认知障碍、焦虑和抑郁症康复干预的Cochrane证据,这些证据可以与PCC有关。我们在Cochrane Library中使用术语“认知障碍”、“抑郁症”、“焦虑症”及其同义词和变异词和“康复”搜索了过去五年的Cochrane系统性综述(CSRs)。我们使用地图提取和总结可用证据。我们将包括的健康状况和干预措施分为组,指出了证据的效果和质量。我们发现在2016年至2021年期间发表了3596个CSRs,其中有17个关于认知障碍和37个关于焦虑和抑郁症。对于认知障碍,我们发现了7个关于中风患者的CSRs,3个针对癌症患者,2个针对帕金森病患者,以及每种其他五种健康状况各一个,每种干预措施都改善了不同的领域,包括锻炼,认知和注意力特定的训练以及计算机认知基础训练(从非常低到高质量的证据)。对于焦虑和抑郁症,我们发现10个包括癌症患者的CSRs,8个针对中风患者,3个针对慢性阻塞性肺疾病患者,以及在其他11种健康状况中的2个或1个。锻炼训练,体育活动和瑜伽等在多种疾病中均取得了显著疗效(非常低到中等质量的证据)。在特定疾病中,我们发现了有效的针刺,动物辅助疗法,芳香疗法,教育方案,基于家庭的多维度康复计划,手动穴位按摩,记忆康复,非侵入性脑刺激,肺康复和远程康复(非常低到中等质量的证据)。这些结果是间接证据的第一步,能够为临床实践和未来研究产生有用的假设。这些结果也成为了目前WHO临床实践指南中针对这些PCC症状的三项推荐的基础。
Currently, no evidence exists on specific treatments for post COVID-19 condition (PCC). However, rehabilitation interventions that are effective for similar symptoms in other health conditions could be applied to people with PCC. With this overview of systematic reviews with mapping, we aimed to describe the Cochrane evidence on rehabilitation interventions proposed for cognitive impairment, anxiety and depression in different health conditions that can be relevant for PCC.We searched the last five years' Cochrane Systematic Review (CSRs) using the terms "cognitive impairment," "depressive disorder," "anxiety disorder," their synonyms and variants, and "rehabilitation" in the Cochrane Library. We extracted and summarized the available evidence using a map. We grouped the included CSRs for health conditions and interventions, indicating the effect and the quality of evidence.We found 3596 CSRs published between 2016 and 2021, and we included 17 on cognitive impairment and 37 on anxiety and depression. For cognitive impairment, we found 7 CSRs on participants with stroke, 3 with cancer, 2 with Parkinson's disease, and one each for five other health conditions. Each intervention improved a different domain, and included exercises, cognitive and attention-specific training, and computerized cognition-based training (from very low to high-quality evidence). For anxiety and depression, we found 10 CSRs including participants with cancer, 8 with stroke, 3 with chronic obstructive pulmonary disease, and 2 or 1 each in 11 other health conditions. Exercise training, physical activity and yoga resulted effective in several pathologies (very low- to moderate-quality evidence). In specific diseases, we found effective acupuncture, animal-assisted therapy, aromatherapy, educational programs, home-based multidimensional survivorship programs, manual acupressure massage, memory rehabilitation, non-invasive brain stimulation, pulmonary rehabilitation, and telerehabilitation (very low- to moderate-quality evidence).These results are the first step of indirect evidence able to generate helpful hypotheses for clinical practice and future research. They served as the basis for the three recommendations on treatments for these PCC symptoms published in the current WHO Guidelines for clinical practice.