Willi Sandra, Lüthold Renata, Hunt Adam, Hänggi Nadescha Viviane, Sejdiu Donikë, Scaff Camila, Bender Nicole, Staub Kaspar, Schlagenhauf Patricia
University of Zurich, Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Centre for Travel Medicine, Competence Centre for Military Medicine and Biology, Hirschengraben 84, 8001, Zurich, Switzerland; Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
Travel Med Infect Dis. 2021 Mar-Apr;40:101995. doi: 10.1016/j.tmaid.2021.101995. Epub 2021 Feb 22.
There is emerging evidence of long-term sequelae in a considerable proportion of COVID-19 patients after recovery and the spectrum and severity of such sequelae should be systematically reviewed. This review aims to evaluate the available evidence of all intermediate and long-term COVID-19 sequelae affecting formerly healthy adults.
A systematic literature search of Embase, WHO, Scopus, Pubmed, Litcovid, bioRxiv and medRxiv was conducted with a cutoff date of the 17th September 2020 according to PRISMA guidelines and registered in PROSPERO (CRD42020208725). Search terms included "COVID-19", "coronavirus disease 2019", "SARS-CoV-2", "sequelae" and "consequence*". Publications on adult participants, with a confirmed SARS-CoV-2 infection were included. Elderly (>50 years old) and children (<18 years old) were excluded. Bias assessment was performed using a modified Newcastle-Ottawa Scale.
A total of 31 papers were included. Study types included prospective and retrospective cohort studies, cross-sectional studies and case reports. Sequelae persistence since infection spanned 14 days to three months. Sequelae included persistent fatigue (39-73% of assessed persons), breathlessness (39-74%), decrease in quality of life (44-69%), impaired pulmonary function, abnormal CT findings including pulmonary fibrosis (39-83%), evidence of peri-/perimyo-/myocarditis (3-26%), changes in microstructural and functional brain integrity with persistent neurological symptoms (55%), increased incidence of psychiatric diagnoses (5.8% versus 2.5-3.4% in controls), incomplete recovery of olfactory and gustatory dysfunction (33-36% of evaluated persons).
A variety of organ systems are affected by COVID-19 in the intermediate and longer-term after recovery. Main sequelae include post-infectious fatigue, persistent reduced lung function and carditis. Careful follow-up post COVID 19 is indicated to assess and mitigate possible organ damage and preserve life quality.
越来越多的证据表明，相当一部分新冠病毒病（COVID-19）患者康复后存在长期后遗症，应对此类后遗症的范围和严重程度进行系统回顾。本综述旨在评估影响既往健康成年人的所有新冠病毒病中期和长期后遗症的现有证据。
根据PRISMA指南，于2020年9月17日截止日期，对Embase、世界卫生组织（WHO）、Scopus、Pubmed、Litcovid、bioRxiv和medRxiv进行系统文献检索，并在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42020208725）登记。检索词包括“COVID-19”“2019冠状病毒病”“严重急性呼吸综合征冠状病毒2（SARS-CoV-2）”“后遗症”和“后果*”。纳入关于确诊SARS-CoV-2感染的成年参与者的出版物。排除老年人（>50岁）和儿童（<18岁）。使用改良的纽卡斯尔-渥太华量表进行偏倚评估。
共纳入31篇论文。研究类型包括前瞻性和回顾性队列研究、横断面研究和病例报告。感染后后遗症持续时间为14天至3个月。后遗症包括持续疲劳（占评估人群的39%-73%）、呼吸困难（39%-74%）、生活质量下降（44%-69%）、肺功能受损、包括肺纤维化在内的异常CT表现（39%-83%）、心包炎/心肌周围炎/心肌炎证据（3%-26%）、伴有持续性神经症状的脑微结构和功能完整性改变（55%）、精神疾病诊断发病率增加（5.8%，而对照组为2.5%-3.4%）、嗅觉和味觉功能障碍未完全恢复（占评估人群的33%-36%）。
康复后的中期和长期，多种器官系统受到新冠病毒病影响。主要后遗症包括感染后疲劳、持续肺功能下降和心脏炎。建议对新冠病毒病康复者进行仔细随访，以评估和减轻可能的器官损害并维持生活质量。
