Lalacewar Kwakwalwa Mafi Girma a cikin Marasa lafiya COVID-19 fiye da Marasa lafiyar Alzheimer

Mahimmanci, rahoton na yanzu, wanda aka buga akan layi 13 ga Janairu a cikin Alzheimer's & Dementia: The Journal of the Alzheimer's Association, an gudanar da shi sama da watanni biyu farkon barkewar cutar (Maris-Mayu 2020). Duk wani ƙudiri na ko marasa lafiya da ke da COVID-19 suna cikin haɗarin cutar Alzheimer ta gaba, ko kuma a maimakon su murmure cikin lokaci, dole ne a jira sakamakon binciken na dogon lokaci.

Masu bincike a Makarantar Magunguna ta NYU Grossman suka jagoranta, sabon binciken ya gano mafi girman matakan alamomi bakwai na lalacewar kwakwalwa (neurodegeneration) a cikin marasa lafiya na COVID-19 da alamun cututtukan jijiya fiye da waɗanda ba tare da su ba, kuma mafi girma matakan a cikin marasa lafiya da suka mutu a asibiti fiye da a cikin wadanda aka sallame aka koma gida.

Wani bincike na biyu ya gano cewa wani yanki na alamomin lalacewa a cikin marasa lafiya da ke asibiti tare da COVID-19, a cikin ɗan gajeren lokaci sun fi girma fiye da na marasa lafiya da aka gano da cutar Alzheimer, kuma a cikin yanayi guda sama da ninki biyu. 

"Bincikenmu ya nuna cewa marasa lafiya da ke kwance a asibiti don COVID-19, kuma musamman a cikin waɗanda ke fama da alamun jijiyoyin jini yayin kamuwa da cuta, na iya samun matakan alamun raunin kwakwalwa waɗanda suka kai, ko sama da waɗanda ake gani a cikin marasa lafiya da cutar Alzheimer," in ji marubucin jagora Jennifer A. Frontera, MD, farfesa a Sashen Neurology a Lafiya ta NYU Langone. 

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Binciken na yanzu ya gano marasa lafiya 251 waɗanda, kodayake shekaru 71 akan matsakaita, ba su da wani rikodin ko alamun fahimi ko lalata kafin a kwantar da su a asibiti don COVID-19. An raba waɗannan majiyoyin zuwa ƙungiyoyi tare da kuma ba tare da alamun cututtukan jijiya ba yayin kamuwa da cutar ta COVID-19, lokacin da marasa lafiya ko dai sun murmure kuma aka sallame su, ko kuma suka mutu.

Ƙungiyar binciken kuma, inda zai yiwu, idan aka kwatanta matakan alamomi a cikin ƙungiyar COVID-19 zuwa marasa lafiya a cikin Cibiyar Nazarin Cututtuka ta NYU (ADRC) Clinical Core cohort, nazari mai tsawo, na dogon lokaci a Lafiya na NYU Langone. Babu ɗayan waɗannan marasa lafiya 161 masu kulawa (54 a zahiri na yau da kullun, 54 tare da ƙarancin fahimi, kuma 53 da aka gano suna da cutar Alzheimer) da ke da COVID-19. An auna raunin kwakwalwa ta hanyar amfani da fasaha na kwayoyin halitta guda ɗaya (SIMOA), wanda zai iya bin diddigin matakan jini na mintuna na alamun neurodegeneration a cikin picograms (tiliyan ɗaya na gram) kowace millilita na jini (pg/ml), inda tsofaffin fasahar ba za su iya ba.

Uku daga cikin alamomin binciken - ubiquitin carboxy-terminal hydrolase L1 (UCHL1), jimlar tau, ptau181 - sanannun matakan mutuwa ko nakasar ƙwayoyin cuta, ƙwayoyin da ke ba da damar hanyoyin jijiyoyi don ɗaukar saƙonni. Matakan sarkar haske na neurofilament (NFL) yana ƙaruwa tare da lalacewa ga axon, kari na neurons. Glial fibrillary acidic protein (GFAP) shine ma'auni na lalacewa ga sel glial, wanda ke tallafawa neurons. Amyloid Beta 40 da 42 sune sunadaran da aka sani don haɓakawa a cikin marasa lafiya cutar Alzheimer. Sakamakon binciken da ya gabata yana jayayya cewa jimlar tau da phosphorylated-tau-181 (p-tau) suma takamaiman matakan cutar Alzheimer ne, amma rawar da suke takawa a cikin cutar ya kasance batun muhawara. 

An auna alamomin jini a cikin rukunin masu haƙuri na COVID a cikin ruwan jini (ɓangaren ruwa na jini wanda aka sanya shi toshe), yayin da waɗanda ke cikin binciken Alzheimer an auna su a cikin plasma (ɓangaren jinin ruwa wanda ya rage lokacin da aka hana toshewa). Don dalilai na fasaha, bambancin yana nufin cewa matakan NFL, GFAP, da UCHL1 za a iya kwatanta su tsakanin rukunin COVID-19 da marasa lafiya a cikin binciken Alzheimer, amma duka tau, ptau181, Amyloid beta 40, da amyloid beta 42 za a iya kwatanta su a tsakanin. ƙungiyar masu haƙuri na COVID-19 (alamomin neuro ko a'a; mutuwa ko fitarwa).

Bugu da ari, babban ma'auni na lalacewar ƙwayoyin cuta a cikin marasa lafiya na COVID-19 shine encephalopathy mai guba mai guba, ko TME, tare da alamu daga ruɗewa zuwa suma, kuma ana haifar da shi yayin kamuwa da cuta mai tsanani ta hanyar gubobi da aka haifar yayin da tsarin rigakafi ya wuce gona da iri (sepsis), kodan sun kasa (uremia) , kuma isar da iskar oxygen yana raguwa (hypoxia). Musamman, matsakaicin matsakaicin haɓakar matakan matakan alamomi bakwai don marasa lafiya na asibiti tare da TME idan aka kwatanta da waɗanda ba tare da alamun cututtukan jijiyoyin jiki (siffa 2 a cikin binciken) shine 60.5 bisa dari. Ga alamomi iri ɗaya a cikin rukunin COVID-19, matsakaicin kashi ya karu idan aka kwatanta waɗanda aka yi nasarar sallame su gida daga asibiti da waɗanda suka mutu a asibiti ya kai kashi 124 cikin ɗari.

Saitin binciken na biyu ya fito ne daga kwatanta matakan NFL, GFAP da UCHL1 a cikin maganin marasa lafiya na COVID-19 akan matakan alamomi iri ɗaya a cikin plasma na marasa lafiya na COVID-Alzheimerr (hoto 3). NFL ta kasance sama da ɗan gajeren lokaci 179 bisa dari (73.2 da 26.2 pg/ml) a cikin marasa lafiya na COVID-19 fiye da na marasa lafiyar Alzheimer. GFAP ya kasance sama da kashi 65 cikin ɗari (443.5 da 275.1 pg/ml) a cikin marasa lafiya na COVID-19 fiye da na masu cutar Alzheimer, yayin da UCHL1 ya kasance sama da kashi 13 cikin ɗari (43 da 38.1 pg/ml).

"Raunin da ya faru a cikin kwakwalwa, wanda kuma yana hade da karuwa a cikin wadannan kwayoyin halitta, ba yana nufin cewa majiyyaci zai ci gaba da cutar Alzheimer ko ciwon hauka daga baya ba, amma yana kara haɗarinsa," in ji babban marubuci Thomas M. Wisniewski, MD, Gerald J. da Dorothy R. Friedman Farfesa a cikin Sashen Harkokin Jiki da kuma darektan Cibiyar Ƙwararrun Ƙwararrun Ƙwararru a NYU Langone. "Ko irin wannan dangantakar ta kasance a cikin waɗanda suka tsira daga mummunan COVID-19 tambaya ce da muke buƙatar amsa cikin gaggawa tare da ci gaba da lura da waɗannan marasa lafiya."

Tare da Dr. Frontera da Wisniewski, NYU Langone Mawallafin Lafiya sun haɗa da marubucin farko Allal Boutajangout, Arjun Masurkarm, Yulin Ge, Alok Vedvyas, Ludovic Debure, Andre Moreira, Ariane Lewis, Joshua Huang, Sujata Thawani, Laura Balcer, da Steven Galetta. Hakanan marubuciya ita ce Rebecca Betensky a Makarantar Kiwon Lafiyar Jama'a ta Duniya ta Jami'ar New York. An ba da tallafin wannan binciken ne ta hanyar tallafi daga Cibiyar Kula da tsufa ta COVID-19 3P30AG066512-01.