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新冠后综合征(长新冠综合征):梅奥诊所多学科诊所的描述和初始患者队列的特征。

Post-COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at Mayo Clinic and Characteristics of the Initial Patient Cohort.

机构信息

Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN.

Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc. 2021 Jul;96(7):1782-1791. doi: 10.1016/j.mayocp.2021.04.024. Epub 2021 May 11.

Abstract

OBJECTIVE

To describe characteristics of a series of patients reporting prolonged symptoms after an infection with coronavirus disease 2019 (COVID-19).

PATIENTS AND METHODS

This study describes the multidisciplinary COVID-19 Activity Rehabilitation Program, established at Mayo Clinic to evaluate and treat patients with post-COVID syndrome, and reports the clinical characteristics of the first 100 patients receiving evaluation and management during the timeframe of June 1, 2020, and December 31, 2020.

RESULTS

The cohort consisted of 100 patients (mean age, 45.4±14.2 years; 68% women; mean body mass index, 30.2 kg/m; presenting a mean of 93 days after infection). Common preexisting conditions were respiratory (23%) and mental health, including depression and/or anxiety (34%). Most (75%) had not been hospitalized for COVID-19. Common presenting symptoms ware fatigue (80%), respiratory complaints (59%), and neurological complaints (59%) followed by subjective cognitive impairment, sleep disturbance, and mental health symptoms. More than one-third of patients (34%) reported difficulties in performing basic activities of daily living. Only 1 in 3 patients had returned to unrestricted work duty at the time of the analysis. For most patients, laboratory and imaging tests showed no abnormalities or were nondiagnostic despite debilitating symptoms. Most patients required physical therapy, occupational therapy, or brain rehabilitation. Face-to-face and virtual care delivery modalities were feasible.

CONCLUSION

Most of the patients did not have COVID-19-related symptoms that were severe enough to require hospitalization, were younger than 65 years, and were more likely to be female, and most had no preexisting comorbidities before severe acute respiratory syndrome coronavirus 2 infection. Symptoms including mood disorders, fatigue, and perceived cognitive impairment resulted in severe negative impacts on resumption of functional and occupational activities in patients experiencing prolonged effects.

摘要

目的

描述一组报告在感染 2019 年冠状病毒病(COVID-19)后症状持续时间延长的患者的特征。

患者和方法

本研究描述了 Mayo 诊所设立的多学科 COVID-19 活动康复计划,用于评估和治疗 COVID-19 后综合征患者,并报告了在 2020 年 6 月 1 日至 2020 年 12 月 31 日期间接受评估和管理的前 100 名患者的临床特征。

结果

该队列包括 100 名患者(平均年龄 45.4±14.2 岁;68%为女性;平均体重指数 30.2kg/m;感染后平均 93 天就诊)。常见的合并症包括呼吸系统疾病(23%)和心理健康问题,包括抑郁和/或焦虑(34%)。大多数(75%)患者未因 COVID-19 住院。常见的首发症状为疲劳(80%)、呼吸系统症状(59%)和神经系统症状(59%),其次是主观认知障碍、睡眠障碍和心理健康症状。超过三分之一的患者(34%)报告日常生活活动困难。在分析时,只有 1/3 的患者恢复了不受限制的工作。对于大多数患者,尽管症状严重,但实验室和影像学检查无异常或无诊断意义。大多数患者需要物理治疗、职业治疗或脑康复治疗。面对面和虚拟护理提供方式可行。

结论

大多数患者的 COVID-19 相关症状没有严重到需要住院治疗的程度,患者年龄小于 65 岁,更可能为女性,大多数患者在感染严重急性呼吸综合征冠状病毒 2 之前没有合并症。情绪障碍、疲劳和感知认知障碍等症状严重影响了患者恢复功能和职业活动的能力。

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