Otsuka Yuki, Tokumasu Kazuki, Nakano Yasuhiro, Honda Hiroyuki, Sakurada Yasue, Sunada Naruhiko, Omura Daisuke, Hasegawa Kou, Hagiya Hideharu, Obika Mikako, Ueda Keigo, Kataoka Hitomi, Otsuka Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN.
Cureus. 2021 Oct 7;13(10):e18568. doi: 10.7759/cureus.18568. eCollection 2021 Oct.
Introduction The long-term clinical course, prognosis, and optimal management of symptoms and conditions after the acute phase of coronavirus disease 2019 (COVID-19) remain to be elucidated. The purpose of this study was to clarify the characteristics of patients referred to a COVID-19 aftercare (CAC) clinic established at a tertiary academic hospital in Japan. Methods This study was a descriptive case series study. All patients who visited the CAC clinic between February 15 and September 17 in 2021 were included. Patients' background, chief complaints, and clinical courses after the onset of COVID-19 were described. Results A total of 87 Japanese patients (median age, 40.0 years; interquartile range [IQR], 26.5-53.0 years; 52.9% women) were referred to the CAC clinic. The median interval between the onset of COVID-19 and the visit to the clinic was 79.0 (IQR, 52.5-112.0) days. Referral sources were hospitals (36 patients), clinics (47 patients), a local healthcare center (3 patients), and other (1 patient). The most common chief complaint was general fatigue (50.4%) followed by dysosmia (28.7%), dysgeusia (26.4%), hair loss (18.4%), headache (17.2%), dyspnea (16.1%), and dyssomnia (13.1%). Respiratory symptoms were common in the early stages of the disease but were less common as the chief complaints when visiting the clinic. On the other hand, neurological, psychiatric, and extremity symptoms were predominant one month after the onset of COVID-19. Conclusions Regardless of the severity in the acute phase, patients visiting our CAC clinic suffered from a variety of symptoms. General physicians skilled in using a comprehensive approach would be optimal to see patients with such complex symptoms.
引言 2019年冠状病毒病（COVID-19）急性期后的长期临床病程、预后以及症状和病症的最佳管理仍有待阐明。本研究的目的是明确转诊至日本一家三级学术医院设立的COVID-19后续护理（CAC）诊所的患者特征。方法 本研究为描述性病例系列研究。纳入了2021年2月15日至9月17日期间就诊于CAC诊所的所有患者。描述了患者的背景、主要症状以及COVID-19发病后的临床病程。结果 共有87名日本患者（中位年龄40.0岁；四分位间距[IQR]为26.5 - 53.0岁；52.9%为女性）转诊至CAC诊所。COVID-19发病至就诊诊所的中位间隔时间为79.0（IQR为52.5 - 112.0）天。转诊来源为医院（36例患者）、诊所（47例患者）、当地医疗中心（3例患者）以及其他（1例患者）。最常见的主要症状是全身疲劳（50.4%），其次是嗅觉减退（28.7%）、味觉障碍（26.4%）、脱发（18.4%）、头痛（17.2%）、呼吸困难（16.1%）和失眠（13.1%）。呼吸道症状在疾病早期较为常见，但就诊时作为主要症状则较少见。另一方面，神经、精神和肢体症状在COVID-19发病后1个月时较为突出。结论 无论急性期的严重程度如何，就诊于我们CAC诊所的患者都存在多种症状。擅长采用综合方法的全科医生最适合诊治有如此复杂症状的患者。
