Department of Travel Medicine, National Public Health Organization, Athens, Greece.
First Department of Pediatrics, University of Athens, Athens, Greece.
Arch Med Res. 2021 Aug;52(6):575-581. doi: 10.1016/j.arcmed.2021.03.010. Epub 2021 May 4.
Post-COVID syndrome also known as long COVID refers to symptoms persisting for more than three weeks after the diagnosis of COVID-19. We reviewed the current evidence on post-COVID syndrome, focusing on its clinical manifestations and addressing the challenges for its management in primary healthcare. The incidence of post-COVID syndrome is estimated at 10-35%, while for hospitalized patients it may reach 85%. Fatigue is the most common symptom reported in 17.5-72% of post-COVID cases, followed by residual dyspnea with an incidence ranging from 10-40%. Mental problems, chest pain, and olfactory and gustatory dysfunction may affect up to 26, 22 and 11% of patients, respectively. More than one third of patients with post-COVID syndrome have pre-existing comorbidities, hypertension and diabetes mellitus being the most common. Beyond the prolonged duration of symptoms, the scarce published data indicate that most patients with post-COVID syndrome have a good prognosis with no further complications or fatal outcomes reported. Given the clinical spectrum of patients with post-COVID syndrome, most of them will be managed by primary healthcare professionals, in conjunction with pre-existing or new co-morbidities, which, in turn, may increase the burden of COVID-19 on primary healthcare. In conclusion approximately 10% of patients with COVID-19 may have symptoms persisting beyond three weeks, fulfilling the criteria of post-COVID syndrome. Primary healthcare professionals have a key role in the management of patients with post-COVID syndrome. Research is needed to elucidate the pathogenesis, clinical spectrum, and prognosis of post-COVID syndrome.
新冠后遗症(也称为长新冠)是指在 COVID-19 确诊后持续超过 3 周的症状。我们回顾了新冠后遗症的现有证据,重点关注其临床表现,并探讨了在初级保健中管理新冠后遗症的挑战。新冠后遗症的发病率估计在 10-35%之间,而住院患者的发病率可能高达 85%。疲劳是报告最多的症状,在 17.5-72%的新冠后遗症病例中出现,其次是残留呼吸困难,发病率在 10-40%之间。精神问题、胸痛和嗅觉味觉障碍可能分别影响高达 26%、22%和 11%的患者。超过三分之一的新冠后遗症患者存在预先存在的合并症,其中高血压和糖尿病最常见。除了症状持续时间延长外,发表的数据很少表明大多数新冠后遗症患者预后良好,没有报告进一步的并发症或致命后果。鉴于新冠后遗症患者的临床表现谱,他们中的大多数将由初级保健专业人员管理,同时伴有预先存在的或新的合并症,这反过来可能会增加 COVID-19 对初级保健的负担。总之,大约 10%的 COVID-19 患者可能会出现持续超过 3 周的症状,符合新冠后遗症的标准。初级保健专业人员在新冠后遗症患者的管理中发挥着关键作用。需要研究来阐明新冠后遗症的发病机制、临床表现谱和预后。