Yellumahanthi Durgamani Kishore, Barnett Bethany, Barnett Sarabeth, Yellumahanthi Shushruth
Family Medicine, University of Alabama at Birmingham, Huntsville, USA.
Family Medicine, Family Medicine of Huntsville, Huntsville, USA.
Cureus. 2022 May 4;14(5):e24736. doi: 10.7759/cureus.24736. eCollection 2022 May.
Background Recent studies showed that a significant percentage of people who recovered from coronavirus disease 2019 (COVID-19) had lingering symptoms. Among patients diagnosed with COVID-19 infection, studies showed persistent symptoms both in patients hospitalized and in outpatient settings. In the studies done in the outpatient setting involving mild to moderate COVID-19 patients, there were significant variations regarding the exact percentage of people with lingering symptoms. Also, in the outpatient setting, not many studies were done on COVID-19 patients that assessed risk factors for having lingering symptoms. Given that a large percentage of people infected with COVID-19 infection do not get hospitalized, it is imperative that this lacuna be filled. We believe knowing the details of long-term symptoms of COVID-19 infection both from prevalence and predictors point of view, could allow the physicians, healthcare system and community to better prepare for managing and following these patients. Materials and methods Our study period was within 12 months after the first documented case of COVID-19 occurred in the State of Alabama. Our study population included patients who were diagnosed with a documented case of COVID-19 in this time period and were under the care of a single primary care provider at an ambulatory clinic. Among 80 patients who had documented COVID-19, three left the practice, two declined to participate in the study and three were deceased (two due to COVID-19 and one for other reasons). Therefore, the study population constituted 72 patients. A questionnaire was mailed to all 72 patients to see how many of them had symptoms three months and beyond of having COVID-19 infection. A chart review was conducted for the study participants to assess for "Comorbid conditions", health conditions that were considered conclusively high risk for acute COVID-19 infection by US Center for Disease Control and Prevention (CDC). Results Fifty-three patients responded to the questionnaire; 27 patients (50.9%) reported lingering symptoms beyond three months of diagnosis with COVID-19 infection. The three most common symptoms reported were fatigue (56%), brain fog (48%), and shortness of breath (41%). The results also showed that women are more likely than men to have lingering symptoms. "Elderly" (≥65 years) patients were as likely as 18-64 years old patients to have lingering symptoms and the presence of one or more of the "Comorbid conditions" does not have any bearing on the occurrence of lingering symptoms. Conclusion Future studies should be done in a larger population to assess the findings that our study showed regarding "elderly" age and the presence of one or more "comorbid conditions" being independent variables of the occurrence of prolonged COVID-19 symptoms. We recommend studies be done assessing the prevalence and predictors for the long-term effects of the COVID-19 infection. This knowledge could help in preventing those long-term symptoms from occurring in the first place and also in preparing the patient, the physician and the community in managing the outcomes effectively.
背景 近期研究表明，相当一部分从2019冠状病毒病（COVID-19）康复的人有持续症状。在被诊断为COVID-19感染的患者中，研究显示住院患者和门诊患者均有持续症状。在针对轻至中度COVID-19门诊患者的研究中，有持续症状者的确切比例存在显著差异。此外，在门诊环境中，针对COVID-19患者评估持续症状风险因素的研究并不多。鉴于大量感染COVID-19的人未住院，填补这一空白势在必行。我们认为，从患病率和预测因素的角度了解COVID-19感染的长期症状细节，有助于医生、医疗系统和社区更好地为管理和随访这些患者做好准备。
材料与方法 我们的研究时间段为阿拉巴马州首次记录COVID-19病例后的12个月内。我们的研究人群包括在此期间被诊断为有记录的COVID-19病例且在门诊诊所由单一初级保健提供者护理的患者。在80例有记录的COVID-19患者中，3例退出该医疗机构，2例拒绝参与研究，3例死亡（2例死于COVID-19，1例死于其他原因）。因此，研究人群为72例患者。向所有72例患者邮寄了一份问卷，以了解他们中多少人在感染COVID-19三个月及更长时间后仍有症状。对研究参与者进行了病历审查，以评估“合并症”，即美国疾病控制与预防中心（CDC）确定的急性COVID-19感染的高风险健康状况。
结果 53例患者回复了问卷；27例患者（50.9%）报告在诊断为COVID-19感染三个月后仍有持续症状。报告的三个最常见症状是疲劳（56%）、脑雾（48%）和呼吸急促（41%）。结果还显示，女性比男性更有可能有持续症状。“老年”（≥65岁）患者与18 - 64岁患者有持续症状的可能性相同，且一种或多种“合并症”的存在与持续症状的发生无关。
结论 未来应在更大规模人群中开展研究，以评估我们的研究中关于“老年”年龄以及一种或多种“合并症”作为COVID-19症状延长发生的独立变量的研究结果。我们建议开展研究评估COVID-19感染长期影响的患病率和预测因素。这些知识有助于首先预防那些长期症状的发生，也有助于让患者、医生和社区有效地应对相关后果。
