Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece; Divison of Brain Sciences, Imperial College London, London, United Kingdom.
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece.
J Infect. 2021 Jul;83(1):1-16. doi: 10.1016/j.jinf.2021.05.004. Epub 2021 May 14.
"Long COVID", a term coined by COVID-19 survivors, describes persistent or new symptoms in a subset of patients who have recovered from acute illness. Globally, the population of people infected with SARS-CoV-2 continues to expand rapidly, necessitating the need for a more thorough understanding of the array of potential sequelae of COVID-19. The multisystemic aspects of acute COVID-19 have been the subject of intense investigation, but the long-term complications remain poorly understood. Emerging data from lay press, social media, commentaries, and emerging scientific reports suggest that some COVID-19 survivors experience organ impairment and/or debilitating chronic symptoms, at times protean in nature, which impact their quality of life.
METHODS/RESULTS: In this review, by addressing separately each body system, we describe the pleiotropic manifestations reported post COVID-19, their putative pathophysiology and risk factors, and attempt to offer guidance regarding work-up, follow-up and management strategies. Long term sequelae involve all systems with a negative impact on mental health, well-being and quality of life, while a subset of patients, report debilitating chronic fatigue, with or without other fluctuating or persistent symptoms, such as pain or cognitive dysfunction. Although the pathogenesis is unclear, residual damage from acute infection, persistent immune activation, mental factors, or unmasking of underlying co-morbidities are considered as drivers. Comparing long COVID with other post viral chronic syndromes may help to contextualize the complex somatic and emotional sequalae of acute COVID-19. The pace of recovery of different aspects of the syndrome remains unclear as the pandemic began only a year ago.
Early recognition of long-term effects and thorough follow-up through dedicated multidisciplinary outpatient clinics with a carefully integrated research agenda are essential for treating COVID-19 survivors holistically.
“长新冠”是由新冠幸存者创造的术语，描述了一组从急性疾病中康复的患者持续或出现新的症状。在全球范围内，感染 SARS-CoV-2 的人群继续迅速扩大，因此需要更深入地了解新冠的一系列潜在后遗症。急性新冠的多系统方面已经成为了深入研究的课题，但长期并发症仍未得到很好的理解。来自通俗媒体、社交媒体、评论和新兴科学报告的新兴数据表明，一些新冠幸存者经历了器官损伤和/或使人衰弱的慢性症状，有时性质多变，这影响了他们的生活质量。
方法/结果：在这篇综述中，我们通过分别讨论每个身体系统，描述了报告的新冠后多系统表现、它们的推测发病机制和危险因素，并尝试提供关于检查、随访和管理策略的指导。长期后遗症涉及所有系统，对心理健康、幸福感和生活质量产生负面影响，而一部分患者报告了使人衰弱的慢性疲劳，伴有或不伴有其他波动或持续的症状，如疼痛或认知功能障碍。虽然发病机制尚不清楚，但急性感染的残留损伤、持续的免疫激活、心理因素或潜在合并症的显现被认为是驱动因素。将长新冠与其他病毒性慢性综合征进行比较，可以帮助理解急性新冠的复杂躯体和情绪后遗症。由于大流行仅在一年前开始，不同方面的综合征的恢复速度仍不清楚。
早期识别长期影响，并通过专门的多学科门诊，进行彻底的随访，并精心整合研究议程，对于全面治疗新冠幸存者至关重要。
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