新冠后综合征:发生率、临床谱及对基层医疗专业人员的挑战。
Post-COVID Syndrome: Incidence, Clinical Spectrum, and Challenges for Primary Healthcare Professionals.
机构信息
Department of Travel Medicine, National Public Health Organization, Athens, Greece.
First Department of Pediatrics, University of Athens, Athens, Greece.
出版信息
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。
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