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急性感染后 6 个月住院和非住院患者的 COVID-19 后症状。

Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients.

机构信息

Infectious Diseases Division, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.

Department of Medical Sciences, University of Udine, Udine, Italy.

出版信息

Clin Microbiol Infect. 2021 Oct;27(10):1507-1513. doi: 10.1016/j.cmi.2021.05.033. Epub 2021 Jun 7.

Abstract

OBJECTIVES

To assess the prevalence of and factors associated with post-coronavirus disease 2019 (COVID-19) syndrome 6 months after the onset.

METHODS

A bidirectional prospective study. Interviews investigated symptoms potentially associated with COVID-19 6 months after the disease onset of all consecutive adult inpatients and outpatients with COVID-19 attending Udine Hospital (Italy) from March to May 2020. IgG antibodies against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) were also evaluated 6 months after the onset of symptoms, at the time of the interview.

RESULTS

A total of 599 individuals were included (320 female, 53.4%; mean age 53 years, SD 15.8) and interviewed 187 days (22 SD) after onset. The prevalence of post-COVID-19 syndrome was 40.2% (241/599). The presence of IgG antibodies was significantly associated with the occurrence of post-COVID-19 syndrome (OR 2.56, 95% CI 1.48-4.38, p 0.001) and median SARS-CoV-2 IgG titres were significantly higher in patients with post-COVID-19 syndrome than in patients without symptoms (42.1, IQR 17.1-78.4 vs. 29.1, IQR 12.1-54.2 kAU/L, p 0.004). Female gender (OR 1.55, 95% CI 1.05-2.27), a proportional increase in the number of symptoms at the onset of COVID-19 (OR 1.81, 95% CI 1.59-2.05) and ICU admission OR 3.10, 95% CI 1.18-8.11) were all independent risk factors for post-COVID-19 syndrome. The same predictors also emerged in a subgroup of 231 patients with the serological follow-up available at the time of the interview alongside the proportional increase in anti-SARS-CoV-2 IgG (OR 1.01, 95% CI 1.00-1.02, p 0.04).

DISCUSSION

Prospective follow-up could be offered to specific subgroups of COVID-10 patients, to identify typical symptoms and persistently high anti-SARS-CoV-2 IgG titres as a means of early detection of post-COVID-19 long-term sequelae.

摘要

目的

评估新冠病毒疾病(COVID-19)发病 6 个月后新冠后综合征的流行情况及相关因素。

方法

一项双向前瞻性研究。对 2020 年 3 月至 5 月期间在意大利乌迪内医院连续收治的所有成年 COVID-19 住院和门诊患者,在疾病发病后 6 个月进行症状调查,以评估与 COVID-19 相关的潜在症状。同时,在采访时还评估了发病后 6 个月时针对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的 IgG 抗体。

结果

共纳入 599 名患者(320 名女性,53.4%;平均年龄 53 岁,标准差 15.8),在发病后 187 天(22 标准差)进行了采访。新冠后综合征的患病率为 40.2%(241/599)。存在 IgG 抗体与新冠后综合征的发生显著相关(比值比 2.56,95%置信区间 1.48-4.38,p<0.001),且患有新冠后综合征的患者的 SARS-CoV-2 IgG 滴度中位数明显高于无症状患者(42.1,IQR 17.1-78.4 与 29.1,IQR 12.1-54.2 kAU/L,p<0.004)。女性(比值比 1.55,95%置信区间 1.05-2.27)、COVID-19 发病时症状数量的比例增加(比值比 1.81,95%置信区间 1.59-2.05)和 ICU 入院(比值比 3.10,95%置信区间 1.18-8.11)都是新冠后综合征的独立危险因素。在可获得采访时血清学随访的 231 名患者亚组中,同样的预测因素也出现了,且抗 SARS-CoV-2 IgG 呈比例增加(比值比 1.01,95%置信区间 1.00-1.02,p=0.04)。

讨论

可以为特定的 COVID-19 患者亚组提供前瞻性随访,以确定典型症状和持续高 SARS-CoV-2 IgG 滴度,作为早期发现新冠后长期后遗症的手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96d4/8180450/41bc7bd4c6f4/gr1_lrg.jpg

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