Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.
JAMA Netw Open. 2022 Feb 1;5(2):e2147053. doi: 10.1001/jamanetworkopen.2021.47053.
New symptoms and conditions can develop following SARS-CoV-2 infection. Whether they occur more frequently among persons with SARS-CoV-2 infection compared with those without is unclear.
To compare the prevalence of new diagnoses of select symptoms and conditions between 31 and 150 days after testing among persons who tested positive vs negative for SARS-CoV-2.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed aggregated electronic health record data from 40 health care systems, including 338 024 persons younger than 20 years and 1 790 886 persons aged 20 years or older who were tested for SARS-CoV-2 during March to December 2020 and who had medical encounters between 31 and 150 days after testing.
International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes were used to capture new symptoms and conditions that were recorded 31 to 150 days after a SARS-CoV-2 test but absent in the 18 months to 7 days prior to testing. The prevalence of new symptoms and conditions was compared between persons with positive and negative SARS-CoV-2 tests stratified by age (20 years or older and young than 20 years) and care setting (nonhospitalized, hospitalized, or hospitalized and ventilated).
A total of 168 701 persons aged 20 years or older and 26 665 younger than 20 years tested positive for SARS-CoV-2, and 1 622 185 persons aged 20 years or older and 311 359 younger than 20 years tested negative. Shortness of breath was more common among persons with a positive vs negative test result among hospitalized patients (≥20 years: prevalence ratio [PR], 1.89 [99% CI, 1.79-2.01]; <20 years: PR, 1.72 [99% CI, 1.17-2.51]). Shortness of breath was also more common among nonhospitalized patients aged 20 years or older with a positive vs negative test result (PR, 1.09 [99% CI, 1.05-1.13]). Among hospitalized persons aged 20 years or older, the prevalence of new fatigue (PR, 1.35 [99% CI, 1.27-1.44]) and type 2 diabetes (PR, 2.03 [99% CI, 1.87-2.19]) was higher among those with a positive vs a negative test result. Among hospitalized persons younger than 20 years, the prevalence of type 2 diabetes (PR, 2.14 [99% CI, 1.13-4.06]) was higher among those with a positive vs a negative test result; however, the prevalence difference was less than 1%.
In this cohort study, among persons hospitalized after a positive SARS-CoV-2 test result, diagnoses of certain symptoms and conditions were higher than among those with a negative test result. Health care professionals should be aware of symptoms and conditions that may develop after SARS-CoV-2 infection, particularly among those hospitalized after diagnosis.
在 SARS-CoV-2 感染后可能会出现新的症状和病症。但尚不清楚与 SARS-CoV-2 阴性者相比，SARS-CoV-2 阳性者中这些新病症的发生频率是否更高。
比较 SARS-CoV-2 检测后 31 至 150 天内，检测结果阳性者与阴性者之间某些选定症状和病症新诊断的发生率。
设计、地点和参与者：本队列研究分析了来自 40 个医疗保健系统的汇总电子健康记录数据，包括 338024 名 20 岁以下和 1790886 名 20 岁或以上在 2020 年 3 月至 12 月期间接受 SARS-CoV-2 检测且在检测后 31 至 150 天内有医疗接触的患者。
使用国际疾病分类，第十次修订版，临床修正码来捕捉 SARS-CoV-2 检测后 31 至 150 天记录但在检测前 18 个月至 7 天内不存在的新症状和病症。按年龄（20 岁或以上和 20 岁以下）和护理环境（非住院、住院或住院并通气）对 SARS-CoV-2 检测阳性和阴性者进行分层，比较新症状和病症的发生率。
共有 168701 名 20 岁或以上和 26665 名 20 岁以下的患者 SARS-CoV-2 检测结果为阳性，1622185 名 20 岁或以上和 311359 名 20 岁以下的患者 SARS-CoV-2 检测结果为阴性。与 SARS-CoV-2 检测结果阴性者相比，住院患者中 SARS-CoV-2 检测阳性者更常出现呼吸急促（≥20 岁：患病率比 [PR]，1.89 [99%CI，1.79-2.01]；<20 岁：PR，1.72 [99%CI，1.17-2.51]）。与 SARS-CoV-2 检测结果阴性者相比，20 岁或以上非住院患者中 SARS-CoV-2 检测阳性者也更常出现呼吸急促（PR，1.09 [99%CI，1.05-1.13]）。在住院患者中，与 SARS-CoV-2 检测结果阴性者相比，SARS-CoV-2 检测结果阳性者的新疲劳（PR，1.35 [99%CI，1.27-1.44]）和 2 型糖尿病（PR，2.03 [99%CI，1.87-2.19]）的发生率更高。在 20 岁以下住院患者中，与 SARS-CoV-2 检测结果阴性者相比，2 型糖尿病（PR，2.14 [99%CI，1.13-4.06]）的发生率更高，但差异小于 1%。
在这项队列研究中，与 SARS-CoV-2 检测结果阴性者相比，在 SARS-CoV-2 检测结果阳性且住院的患者中，某些症状和病症的诊断率更高。医护人员应注意 SARS-CoV-2 感染后可能出现的症状和病症，尤其是在诊断后住院的患者。
