Alex Holmes, Lance Emerson, Louis B Irving, Emma Tippett, Jeffrey M Pullin, Julie Young, David A Watters, Adina Hamilton
{"title":"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。","authors":"Alex Holmes, Lance Emerson, Louis B Irving, Emma Tippett, Jeffrey M Pullin, Julie Young, David A Watters, Adina Hamilton","doi":"10.5694/mja2.52473","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To determine the impact of persistent symptoms after coronavirus disease 2019 (COVID-19) in an Australian population.</p>\n </section>\n \n <section>\n \n <h3> Design, setting, participants</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Main outcome measures</h3>\n \n <p>Persistent new symptoms, recovery, and daily function using validated questionnaires for fatigue, neurocognitive symptoms, anxiety, depression and quality of life.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":null,"pages":null},"PeriodicalIF":6.7000,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52473","citationCount":"0","resultStr":"{\"title\":\"Persistent symptoms after COVID-19: an Australian stratified random health survey on long COVID\",\"authors\":\"Alex Holmes, Lance Emerson, Louis B Irving, Emma Tippett, Jeffrey M Pullin, Julie Young, David A Watters, Adina Hamilton\",\"doi\":\"10.5694/mja2.52473\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To determine the impact of persistent symptoms after coronavirus disease 2019 (COVID-19) in an Australian population.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design, setting, participants</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main outcome measures</h3>\\n \\n <p>Persistent new symptoms, recovery, and daily function using validated questionnaires for fatigue, neurocognitive symptoms, anxiety, depression and quality of life.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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. 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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.
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.