COVID-19 后的持续症状:澳大利亚关于长期 COVID 的分层随机健康调查。

IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Alex Holmes, Lance Emerson, Louis B Irving, Emma Tippett, Jeffrey M Pullin, Julie Young, David A Watters, Adina Hamilton
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引用次数: 0

摘要

目的确定冠状病毒病2019(COVID-19)后持续症状对澳大利亚人群的影响:我们在全州范围内对确诊感染过急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的成年人(COVID-19 阳性组)及其密切接触者(对照组)进行了分层随机抽样健康调查。样本来自维多利亚州 COVID-19 数据库,时间跨度为 2020 年 1 月至 2022 年 10 月。2022 年 9 月至 2023 年 4 月期间,从 12 688 名调查对象中收集了数据(COVID-19 阳性组 11 174 人,对照组 1514 人):主要结果指标:持续新症状、恢复情况以及日常功能,使用有效问卷调查疲劳、神经认知症状、焦虑、抑郁和生活质量:感染后平均 12.6 个月,COVID-19 阳性组中有 4560 名受访者(39.1%;95% CI,37.9-40.3%)报告了至少一种持续性新症状,而对照组中有 216 名受访者(20.8%;95% CI,18.5-23.1%)报告了至少一种持续性新症状。共有 1656 名受访者(14.2%;95% CI,13.4-15.0%)被归类为临床长期慢性阻塞性肺病患者,其标准是至少有一种持续的新症状,并且在感染三个月后痊愈率低于 80%。在患有临床长期 COVID 的受访者中,有 535 人(3.2%;95% CI,2.6-3.8%)在感染 12 个月后表示在日常活动方面至少存在中度问题。感染时间较短的受访者出现临床长期 COVID 的比例较低。女性、40-49 岁、感染严重程度、慢性疾病、既往焦虑或抑郁是临床长期 COVID 的风险因素。临床长COVID风险降低的相关因素包括:与祖先病毒株占优势时相比,奥米克龙株占优势时的感染和德尔塔株占优势时的感染:结论:COVID-19 病毒感染后出现持续症状很常见,但感染毒性较低的毒株时发病率较低。虽然长效 COVID 基本上可以在初级保健中得到控制,但少数有持续症状和功能受损的患者可能需要专科护理途径,其有效性应成为未来研究的重点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Persistent symptoms after COVID-19: an Australian stratified random health survey on long COVID

Persistent symptoms after COVID-19: an Australian stratified random health survey on long COVID

Objective

To determine the impact of persistent symptoms after coronavirus disease 2019 (COVID-19) in an Australian population.

Design, setting, participants

We conducted a statewide health survey of a stratified random sample of adults who had had a confirmed acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19-positive group) and their close contacts (control group). The sample was drawn from Victoria's COVID-19 database between January 2020 and October 2022. Data were collected from 12 688 survey respondents between September 2022 and April 2023 (11 174 in the COVID-19-positive group and 1514 in the control group).

Main outcome measures

Persistent new symptoms, recovery, and daily function using validated questionnaires for fatigue, neurocognitive symptoms, anxiety, depression and quality of life.

Results

At a mean of 12.6 months after infection, 4560 respondents in the COVID-19-positive group (39.1%; 95% CI, 37.9–40.3%) reported at least one persistent new symptom, compared with 216 respondents in the control group (20.8%; 95% CI, 18.5–23.1%). A total of 1656 respondents (14.2%; 95% CI, 13.4–15.0%) were classified as having clinical long COVID using the criteria of at least one persistent new symptom and less than 80% recovery three months after the infection. Of the respondents with clinical long COVID, 535 (3.2%; 95% CI, 2.6–3.8%) reported at least moderate problems with usual activities at 12 months after their infection. The proportion of respondents with clinical long COVID was lower for those with more recent infections. The risk factors for clinical long COVID were female sex, age 40–49 years, infection severity, chronic illness, and past anxiety or depression. Factors associated with a decreased risk of having clinical long COVID included infection when the Omicron strain was dominant and infection when the Delta strain was dominant, as compared with when the ancestral strain of the virus was dominant.

Conclusion

Persistent symptoms after COVID-19 are common, though with a lower incidence following infection from less virulent strains. Although long COVID can be largely managed in primary care, a minority of people who have persistent symptoms and impaired function may require specialist care pathways, the effectiveness of which should be a focus of future research.

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来源期刊
Medical Journal of Australia
Medical Journal of Australia 医学-医学:内科
CiteScore
9.40
自引率
5.30%
发文量
410
审稿时长
3-8 weeks
期刊介绍: The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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