Sun Liang-Liang, Wang Jian, Wang Yu-Sheng, Pan Xiao, Luo Jun, Liu Hua, Jiang Yi-Rou, Zhuang Xin, Lin Liang, Li Gan-Cheng, Zhao Jun-Wei, Wang Wei, Wang Yuan-Jing, Wang Zhi-Hao, Shan Hong-Biao, Chen Shuai-Shuai, Chen Jun-Lin, Xu Zhao-Wei, Bai Yong-Hai, Huang Hai, Xie Wei-Fen
Department of Endocrinology and Metabolism, Changzheng Hospital, Naval Medical University, Shanghai, China.
Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China.
Front Med (Lausanne). 2022 May 11;9:854788. doi: 10.3389/fmed.2022.854788. eCollection 2022.
The long-term impact of COVID-19 on patient health has been a recent focus. This study aims to determine the persistent symptoms and psychological conditions of patients hospitalized with COVID-19 15 months after onset, that patients first developed symptoms. The potential risk factors were also explored.
A cohort of COVID-19 patients discharged from February 20, 2020 to March 31, 2020 was recruited. Follow-ups were conducted using validated questionnaires and psychological screening scales at 15 months after onset to evaluate the patients' health status. The risk factors for long-term health impacts and their associations with disease severity was analyzed.
534 COVID-19 patients were enrolled. The median age of the patients was 62.0 years old (IQR 52.0-70.0) and 295 were female (55.2%). The median time from onset to follow-up was 460.0 (451.0-467.0) days. Sleep disturbance (18.5%, 99/534) and fatigue (17.2%, 92/534) were the most common persistent symptoms. 6.4% (34/534) of the patients had depression, 9.2% (49/534) were anxious, 13.0% (70/534) had insomnia and 4.7% (25/534) suffered from post-traumatic stress disorder (PTSD). Multivariate adjusted logistic regression analysis showed that glucocorticoid use during hospitalization (OR 3.58, 95% CI 1.12-11.44) was significantly associated with an increased risk of fatigue. The OR values for anxiety and sleep disorders were 2.36 (95% CI 1.07-5.20) and 2.16 (95% CI 1.13-4.14) in females to males. The OR value of PTSD was 25.6 (95% CI 3.3-198.4) in patients with persistent symptoms to those without persistent symptoms. No significant associations were observed between fatigue syndrome or adverse mental outcomes and disease severity.
15-month follow-up in this study demonstrated the need of extended rehabilitation intervention for complete recovery in COVID-19 patients.
新型冠状病毒肺炎（COVID-19）对患者健康的长期影响是近期的研究重点。本研究旨在确定COVID-19患者在首次出现症状15个月后住院患者的持续症状和心理状况。同时还探讨了潜在的风险因素。
招募了一组于2020年2月20日至2020年3月31日出院的COVID-19患者。在发病15个月后使用经过验证的问卷和心理筛查量表进行随访，以评估患者的健康状况。分析了长期健康影响的风险因素及其与疾病严重程度的关联。
共纳入534例COVID-19患者。患者的中位年龄为62.0岁（四分位间距52.0 - 70.0），女性295例（55.2%）。从发病到随访的中位时间为460.0（451.0 - 467.0）天。睡眠障碍（18.5%，99/534）和疲劳（17.2%，92/534）是最常见的持续症状。6.4%（34/534）的患者有抑郁，9.2%（49/534）焦虑，13.0%（70/534）有失眠，4.7%（25/534）患有创伤后应激障碍（PTSD）。多因素调整逻辑回归分析显示，住院期间使用糖皮质激素（比值比3.58，95%置信区间1.12 - 11.44）与疲劳风险增加显著相关。女性与男性相比，焦虑和睡眠障碍的比值比分别为2.36（95%置信区间1.07 - 5.20）和2.16（95%置信区间1.13 - 4.14）。有持续症状的患者与无持续症状的患者相比，PTSD的比值比为25.6（95%置信区间3.3 - 198.4）。未观察到疲劳综合征或不良心理结局与疾病严重程度之间存在显著关联。
本研究的15个月随访表明，COVID-19患者需要延长康复干预以实现完全康复。
