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Association between post-COVID-19 sleep disturbance and neurocognitive function: a comparative study based on propensity score matching
Association between post-COVID-19 sleep disturbance and neurocognitive function: a comparative study based on propensity score matching
- COVID-19后睡眠紊乱与神经认知功能之间的关系：基于倾向评分匹配方法的研究
- Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) Vol. 26, Issue 2, Pages: 172-184(2025)
- Affiliations：
1.Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
2.Key Laboratory of Mental Health of the Ministry of Education, Guangzhou 510515, China
3.Adai Technology (Beijing) Company Limited, Beijing 100083, China
- Funds：
DOI：10.1631/jzus.B2300831
CLC：- CSTR：
Received：16 November 2023，
Revised：19 March 2024，
Published Online：25 January 2025，
Published：25 February 2025
- Accepted：
杜适序,方乐琴,李元辉等.COVID-19后睡眠紊乱与神经认知功能之间的关系：基于倾向评分匹配方法的研究[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2025,26(02):172-184.
Shixu DU, Leqin FANG, Yuanhui LI, et al. Association between post-COVID-19 sleep disturbance and neurocognitive function: a comparative study based on propensity score matching[J]. Journal of zhejiang university-science b (biomedicine & biotechnology), 2025, 26(2): 172-184.
杜适序,方乐琴,李元辉等.COVID-19后睡眠紊乱与神经认知功能之间的关系：基于倾向评分匹配方法的研究[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2025,26(02):172-184. DOI： 10.1631/jzus.B2300831.
Shixu DU, Leqin FANG, Yuanhui LI, et al. Association between post-COVID-19 sleep disturbance and neurocognitive function: a comparative study based on propensity score matching[J]. Journal of zhejiang university-science b (biomedicine & biotechnology), 2025, 26(2): 172-184. DOI： 10.1631/jzus.B2300831.
摘要
睡眠紊乱和神经认知功能减退是2019冠状病毒病（COVID-19）幸存者常见的主诉，然而既往少有研究关注COVID-19后睡眠紊乱（PCSD）对认知功能的影响。本研究旨在确定PCSD对神经认知功能的影响，并探讨与较差的神经认知功能相关的危险因素。本研究是一项在中国进行的基于网络评估的横断面研究，通过改良版在线综合认知评估（ICA）和数字排序测试（NOT）对神经认知功能进行评估。我们使用倾向性评分匹配（PSM）的方法平衡PCSD组及非PCSD组受试者之间的混杂因素，使用单因素分析评估PCSD对神经认知功能的影响，并使用二元logistic回归探索与较差的神经认知表现相关的危险因素。本研究共纳入8692名COVID-19幸存者，其中48.80%的COVID-19幸存者报告有睡眠紊乱。PSM后匹配了3977对（总共7954名受试者）。单因素分析显示PCSD与更差的ICA和NOT表现相关（
P
<
0.05）。研究结果表明，基础疾病、上呼吸道感染、嗅觉或味觉丧失、严重肺炎和自我报告的认知障碍与PCSD受试者的神经认知功能的恶化相关（
P
<
0.05）；此外，年龄、少数民族和较低的教育水平是PCSD受试者中较差的神经认知表现的独立风险因素（
P
<
0.05）。总之，PCSD与较差的神经认知功能表现相关，我们应该采取适当的预防和干预措施来减少或预防PCSD对神经认知功能产生的潜在不良影响。
Abstract
Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019 (COVID-19) survivors
few studies have focused on the effect of post-COVID-19 sleep disturbance (PCSD) on cognitive function. This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition. This cross-sectional study was conducted via the web-based assessment in Chinese mainland. Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment (ICA) and the Number Ordering Te
st (NOT). Propensity score matching (PSM) was utilized to match the confounding factors between individuals with and without PCSD. Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function. The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression. A total of 8692 individuals with COVID-19 diagnosis were selected for this study. Nearly half (48.80%) of the COVID-19 survivors reported sleep disturbance. After matching by PSM
a total of 3977 pairs (7954 individuals in total) were obtained. Univariate analyses revealed that PCSD was related to worse ICA and NOT performance (
P
<
0.05). Underlying disease
upper respiratory infection
loss of smell or taste
severe pneumonia
and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals (
P
<
0.05). Furthermore
aging
ethnicity (minority)
and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals (
P
<
0.05). PCSD was related to impaired neurocognitive performance. Therefore
appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.
关键词
Keywords
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