Bek L Martine, Berentschot Julia C, Heijenbrok-Kal Majanka H, Huijts Susanne, van Genderen Michel E, Vlake J Hans, van Bommel Jasper, Aerts Joachim G J V, Ribbers Gerard M, van den Berg-Emons Rita J G, Hellemons Merel E
Department of Rehabilitation Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Joint first authors.
ERJ Open Res. 2022 Oct 24;8(4). doi: 10.1183/23120541.00355-2022. eCollection 2022 Oct.
A large proportion of patients experience a wide range of sequelae after acute COVID-19, especially after severe illness. The long-term health sequelae need to be assessed. Our objective was to longitudinally assess persistence of symptoms and clusters of symptoms up to 12 months after hospitalisation for COVID-19 and to assess determinants of the main persistent symptoms.
In this multicenter prospective cohort study patients with COVID-19 are followed up for 2 years with measurements at 3, 6, 12 and 24 months after hospital discharge. Here, we present interim results regarding persistent symptoms up to 12 months.
We included 492 patients; mean±sd age was 60.2±10.7 years, 335 (68.1%) were males, median length of hospital stay was 11 (6.0-27.0) days. At 3 months after discharge 97.0% of the patients had at least one persisting symptom, this declined to 95.5% and 92.0% at 6 and 12 months, respectively (p=0.010). Muscle weakness, exertional dyspnoea, fatigue, and memory and concentration problems were the most prevalent symptoms with rates over 50% during follow-up. Over time, muscle weakness, hair loss and exertional dyspnoea decreased significantly (p<0.001), while other symptoms such as fatigue, concentration and memory problems, anosmia and ageusia persisted. Symptoms from the physical and respiratory cluster declined significantly over time, in contrast to the fatigue and cognitive symptom clusters.
The majority of patients experienced COVID-19 sequelae up to 12 months after severe infection. Whereas physical and respiratory symptoms showed slow gradual decline, fatigue and cognitive symptoms did not evidently resolve over time.
很大一部分患者在感染新型冠状病毒肺炎(COVID-19)急性期后,尤其是重症感染后,会出现各种各样的后遗症。需要对这些长期健康后遗症进行评估。我们的目的是纵向评估COVID-19住院后长达12个月的症状持续情况和症状群,并评估主要持续症状的决定因素。
在这项多中心前瞻性队列研究中,对COVID-19患者进行了2年的随访,在出院后3、6、12和24个月进行测量。在此,我们展示了长达12个月的持续症状的中期结果。
我们纳入了492例患者;平均年龄±标准差为60.2±10.7岁,335例(68.1%)为男性,住院中位时长为11(6.0 - 27.0)天。出院后3个月时,97.0%的患者至少有1种持续症状,在6个月和12个月时分别降至95.5%和92.0%(p = 0.010)。肌肉无力、运动性呼吸困难、疲劳以及记忆力和注意力问题是最常见的症状,随访期间发生率超过50%。随着时间推移,肌肉无力、脱发和运动性呼吸困难显著减轻(p < 0.001),而疲劳、注意力和记忆力问题、嗅觉丧失和味觉丧失等其他症状持续存在。身体和呼吸症状群的症状随时间显著减轻,与疲劳和认知症状群不同。
大多数患者在严重感染COVID-19后长达12个月都有后遗症。身体和呼吸症状呈缓慢逐渐减轻趋势,而疲劳和认知症状并未随时间明显缓解。