From the Department of Population Health, NYU Grossman School of Medicine, New York, NY (KT); Internal Medicine, NYU Langone Health, New York, NY (EK); Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY (YY).
J Am Board Fam Med. 2021 Sep-Oct;34(5):1014-1016. doi: 10.3122/jabfm.2021.05.210122.
COVID-19 affects multiple organ systems causing substantial long-term morbidity. The implications of the Post-Acute Sequelae of SARS-CoV-2 infection, particularly for primary care, remain unknown. This cross-sectional study examines new symptoms reported at primary care encounters during three post-acute follow-up intervals after initial SARS-CoV-2 infection.
Electronic health record data from the NYU Langone COVID Deidentified Dataset were queried for adults with a positive SARS-CoV-2 PCR test, and then restricted to those with a new ICD-10-CM code documented at a post-acute COVID-related primary care follow-up >14 days after testing positive. New diagnoses and the corresponding Clinical Classifications Software Refined categories were assessed at the following intervals: 0.5-3 months ("subacute"), 3-6 months ("prolonged"), and 6-9 months ("persistent").
Out of 3,154 patients, a new ICD-10-CM code was documented among 499 patients (∼16%). Respiratory complaints, including cough, shortness of breath, dyspnea, and hypoxemia, were most common. Malaise and fatigue were reported consistently among 10-13% of patients at all three time-intervals. Musculoskeletal pain, circulatory symptoms, and sleep-wake disorders were also observed at primary care follow-up.
This cross-sectional study provides support of a post-acute COVID syndrome, demonstrating that patients continue to experience symptoms after the acute infection period. Extensive follow-up data allowed for examining new symptoms up to 9 months after initial SARS-CoV-2 infection. Understanding of the course of multi-organ post-acute sequelae is restricted by cross-sectional study design limitations. Standardized, sequelae-related ICD-10-CM codes to specify the type and duration of post-acute COVID-related symptoms would enable better monitoring of the growing number of SARS-CoV-2 infection survivors.
COVID-19 影响多个器官系统，导致大量长期发病。SARS-CoV-2 感染后的急性后期后果的影响，特别是对初级保健的影响，尚不清楚。本横断面研究检查了 SARS-CoV-2 感染后三个急性后期随访间隔内初级保健就诊时报告的新症状。
从 NYU Langone COVID 去识别数据集的电子健康记录中查询了 SARS-CoV-2 PCR 检测呈阳性的成年人记录，然后将其限制在 SARS-CoV-2 检测呈阳性后 14 天以上的急性后期 COVID 相关初级保健随访中有新的 ICD-10-CM 代码记录的患者。在以下间隔评估新诊断和相应的临床分类软件精炼类别：0.5-3 个月（“亚急性”）、3-6 个月（“延长”）和 6-9 个月（“持续”）。
在 3154 名患者中，有 499 名（约 16%）患者记录了新的 ICD-10-CM 代码。呼吸系统症状，包括咳嗽、呼吸急促、呼吸困难和低氧血症，最为常见。在所有三个时间间隔中，10-13%的患者持续报告不适和疲劳。肌肉骨骼疼痛、循环症状和睡眠-觉醒障碍也在初级保健随访中观察到。
这项横断面研究为急性后 COVID 综合征提供了支持，表明患者在急性感染期后仍会出现症状。广泛的随访数据允许在初始 SARS-CoV-2 感染后 9 个月检查新症状。由于横断面研究设计的限制，对多器官急性后期后遗症的病程的了解受到限制。标准化、与后遗症相关的 ICD-10-CM 代码，以指定急性后期 COVID 相关症状的类型和持续时间，将能够更好地监测越来越多的 SARS-CoV-2 感染幸存者。
