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长新冠的特征和预测因素。

Attributes and predictors of long COVID.

机构信息

School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.

MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London, UK.

出版信息

Nat Med. 2021 Apr;27(4):626-631. doi: 10.1038/s41591-021-01292-y. Epub 2021 Mar 10.

Abstract

Reports of long-lasting coronavirus disease 2019 (COVID-19) symptoms, the so-called 'long COVID', are rising but little is known about prevalence, risk factors or whether it is possible to predict a protracted course early in the disease. We analyzed data from 4,182 incident cases of COVID-19 in which individuals self-reported their symptoms prospectively in the COVID Symptom Study app. A total of 558 (13.3%) participants reported symptoms lasting ≥28 days, 189 (4.5%) for ≥8 weeks and 95 (2.3%) for ≥12 weeks. Long COVID was characterized by symptoms of fatigue, headache, dyspnea and anosmia and was more likely with increasing age and body mass index and female sex. Experiencing more than five symptoms during the first week of illness was associated with long COVID (odds ratio = 3.53 (2.76-4.50)). A simple model to distinguish between short COVID and long COVID at 7 days (total sample size, n = 2,149) showed an area under the curve of the receiver operating characteristic curve of 76%, with replication in an independent sample of 2,472 individuals who were positive for severe acute respiratory syndrome coronavirus 2. This model could be used to identify individuals at risk of long COVID for trials of prevention or treatment and to plan education and rehabilitation services.

摘要

关于持续时间较长的 2019 冠状病毒病(COVID-19)症状,即所谓的“长新冠”的报告越来越多,但人们对其流行率、风险因素以及是否有可能在疾病早期预测长期病程知之甚少。我们分析了 COVID-19 症状研究应用程序中前瞻性自我报告症状的 4182 例新发病例的数据。共有 558 名(13.3%)参与者报告了持续≥28 天的症状,189 名(4.5%)报告了持续≥8 周的症状,95 名(2.3%)报告了持续≥12 周的症状。长新冠的特征是疲劳、头痛、呼吸困难和嗅觉丧失,且与年龄增长、体重指数增加和女性性别相关。在疾病的第一周经历超过五个症状与长新冠有关(比值比=3.53(2.76-4.50))。一个可以在 7 天区分短新冠和长新冠的简单模型(总样本量 n=2149)显示出 76%的接受者操作特征曲线下面积,在对 2472 名严重急性呼吸综合征冠状病毒 2 阳性个体的独立样本中进行了复制。该模型可用于识别有长新冠风险的个体,以便进行预防或治疗试验,并规划教育和康复服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e960/7611399/1163a92aba84/EMS131037-f004.jpg

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