基于人群的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染后后遗症（PASC）患病率和特征的估计。

Population-Based Estimates of Post-acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection (PASC) Prevalence and Characteristics.

机构信息

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

Clin Infect Dis. 2021 Dec 6;73(11):2055-2064. doi: 10.1093/cid/ciab408.

DOI:10.1093/cid/ciab408

PMID:34007978

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8240848/

Abstract

BACKGROUND: Emerging evidence suggests many people have persistent symptoms after acute coronavirus disease 2019 (COVID-19) illness. Our objective was to estimate the prevalence and correlates of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC). METHODS: We used a population-based probability survey of adults with COVID-19 in Michigan. Living noninstitutionalized adults aged ≥18 in the Michigan Disease Surveillance System with COVID-19 onset through mid-April 2020 were eligible for selection (N = 28 000). Among 2000 selected, 629 completed the survey between June-December 2020. We estimated PASC prevalence, defined as persistent symptoms ≥30 (30-day COVID-19) or ≥60 (60-day COVID-19) days post-COVID-19 onset, overall and by sociodemographic and clinical factors. We used modified Poisson regression to produce adjusted prevalence ratios (aPRs) for potential risk factors. RESULTS: The analytic sample (n = 593) was predominantly female (56.1%), aged ≥45 years (68.2%), and non-Hispanic White (46.3%) or Black (34.8%). Thirty- and 60-day COVID-19 were highly prevalent (52.5% and 35.0%), even among nonhospitalized respondents (43.7% and 26.9%) and respondents reporting mild symptoms (29.2% and 24.5%). Respondents reporting very severe (vs mild) symptoms had 2.25 times higher prevalence of 30-day COVID-19 (aPR, 2.25; 95% CI, 1.46-3.46) and 1.71 times higher prevalence of 60-day COVID-19 (aPR, 1.71; 95% CI: 1.02-2.88). Hospitalized (vs nonhospitalized) respondents had ~40% higher prevalence of both 30-day (aPR, 1.37; 95% CI: 1.12-1.69) and 60-day (aPR, 1.40; 95% CI: 1.02-1.93) COVID-19. CONCLUSIONS: PASC is highly prevalent among cases reporting severe initial symptoms and, to a lesser extent, cases reporting mild and moderate symptoms.

摘要

背景：新出现的证据表明，许多人在急性冠状病毒病 2019（COVID-19）后仍有持续症状。我们的目的是估计严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染后急性后遗症（PASC）的患病率和相关因素。

方法：我们使用密歇根州 COVID-19 的基于人群的概率调查。在密歇根疾病监测系统中，年龄≥18 岁的居住在非机构中的 COVID-19 发病至 2020 年 4 月中旬的成年人有资格入选（N=28000）。在 2000 名入选者中，有 629 名在 2020 年 6 月至 12 月期间完成了调查。我们估计了 PASC 的患病率，定义为 COVID-19 发病后≥30 天（30 天 COVID-19）或≥60 天（60 天 COVID-19）的持续症状，总体和按社会人口统计学和临床因素。我们使用修正泊松回归来计算潜在危险因素的调整后患病率比（aPR）。

结果：分析样本（n=593）主要为女性（56.1%）、年龄≥45 岁（68.2%）、非西班牙裔白人（46.3%）或黑人（34.8%）。30 天和 60 天 COVID-19 的患病率非常高（52.5%和 35.0%），即使在非住院患者（43.7%和 26.9%）和报告轻度症状的患者中（29.2%和 24.5%）也是如此。报告非常严重（与轻度）症状的患者，30 天 COVID-19 的患病率高 2.25 倍（aPR，2.25；95%CI，1.46-3.46），60 天 COVID-19 的患病率高 1.71 倍（aPR，1.71；95%CI：1.02-2.88）。住院（与非住院）患者的 30 天（aPR，1.37；95%CI：1.12-1.69）和 60 天（aPR，1.40；95%CI：1.02-1.93）COVID-19 的患病率均高约 40%。

结论：PASC 在报告严重初始症状的病例中高度流行，在报告轻度和中度症状的病例中流行程度较低。