Department of Pneumology, Ospedale Maggiore della Carità University Hospital, Novara, Italy.
Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
Minerva Med. 2022 Feb;113(1):158-171. doi: 10.23736/S0026-4806.21.07594-7. Epub 2021 Dec 3.
Coronavirus disease 19 (COVID-19) is an infectious disease caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have plenty of data about the clinical features of the disease's acute phase, while little is known about the long-term consequences on survivors.
We aimed to review systematically emerging evidence about clinical and functional consequences of COVID-19 pneumonia months after hospital discharge.
Current evidence supports the idea that a high proportion of COVID-19 survivors complain of symptoms months after the acute illness phase, being fatigue and reduced tolerance to physical effort the most frequently reported symptom. The strongest association for these symptoms is with the female gender, while disease severity seems less relevant. Respiratory symptoms are associated with a decline in respiratory function and, conversely, seem to be more frequent in those who experienced a more severe acute pneumonia. Current evidence highlighted a persistent motor impairment which is, again, more prevalent among those survivors who experienced a more severe acute phase of the disease. Additionally, the persistence of symptoms is a primary determinant of mental health outcome, with anxiety, depression, sleep disturbances, and post-traumatic stress symptoms being commonly reported in COVID-19 survivors.
Current literature highlights the importance of a multidisciplinary approach to Coronavirus Disease 19 since the sequelae appear to involve different organs and systems. Given the pandemic outbreak's size, this is a critical public health issue: a better insight on this topic should inform clinical decisions about the modalities of follow-up for COVID-19 survivors.
新型冠状病毒病(COVID-19)是一种由新型急性严重呼吸道综合征冠状病毒 2(SARS-CoV-2)引起的传染病。我们有大量关于该病急性期临床特征的数据,而对幸存者的长期后果知之甚少。
我们旨在系统地回顾 COVID-19 肺炎患者出院后数月的临床和功能后果的新出现证据。
目前的证据支持这样一种观点,即相当一部分 COVID-19 幸存者在急性疾病阶段数月后会抱怨症状,最常报告的症状是疲劳和对体力活动的耐受性降低。这些症状与女性性别关系最密切,而疾病严重程度似乎不太相关。呼吸系统症状与呼吸功能下降有关,相反,在那些经历过更严重急性肺炎的患者中,呼吸系统症状更为常见。目前的证据强调了存在持续的运动障碍,而且在那些经历过更严重急性疾病阶段的幸存者中更为常见。此外,症状的持续存在是心理健康结果的主要决定因素,COVID-19 幸存者常报告焦虑、抑郁、睡眠障碍和创伤后应激症状。
目前的文献强调了对新型冠状病毒病采取多学科方法的重要性,因为后遗症似乎涉及不同的器官和系统。鉴于此次大流行的规模,这是一个关键的公共卫生问题:对这一主题的更深入了解应有助于为 COVID-19 幸存者的随访方式提供临床决策依据。