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完全接种 COVID-19 疫苗超过 6 周的患者的报告结局:临床突破病例的经历。

Patient-Reported Outcomes for Fully Vaccinated COVID-19 Patients Over 6 Weeks: The Experiences of Clinical Breakthrough Cases.

机构信息

Center for Outcomes Research and Education (CORE), Providence St. Joseph Health, 5251 NE Glisan Street, Portland, OR, USA.

Providence Research Network, 1801 Lind Ave SW, Renton, WA, USA.

出版信息

Patient. 2023 Mar;16(2):105-116. doi: 10.1007/s40271-022-00605-8. Epub 2022 Nov 7.

Abstract

BACKGROUND

While coronavirus disease 2019 (COVID-19) vaccines have high rates of efficacy, fully vaccinated individuals can become infected with COVID-19. Among this population, symptoms tend to be less severe and shorter lasting. Less is known about how vaccinated individuals who contract COVID-19 experience the disease through patient-reported outcomes (PROs) and how this changes over time.

OBJECTIVE

The aim of this study was to describe the physical, mental, and social health PROs for fully vaccinated individuals who contracted COVID-19 over a 6-week period.

DESIGN

Prospective design using the Patient-Reported Outcomes Measurement Information System short-form (PROMIS-10) collected through a mobile application-based platform.

PARTICIPANT

1114 fully vaccinated patients who tested positive for COVID-19 at a large US health system and engaged with the study on or after 1 March 2021 and reported onset of illness prior to 1 November 2021.

MAIN MEASURES

Global physical and mental health PROMIS-10 T-scores for the 6-week period, component PROMIS-10 questions for the 6-week period, and component PROMIS-10 questions restricted to a subset of participants for the first month to measure individual recovery were analyzed.

KEY RESULTS

Mean global physical and mental health T-scores increased over time and remained within one standard deviation of the population mean. At baseline, at least 40% of participants reported good health for all component questions except Fatigue (25%), and the proportion reporting good health increased over time for all questions, with the largest improvements in Fatigue (25.5 to 67.5%), Pain (59.1 to 82.8%), and Emotional Problems (42.3 to 62.5%). Over the first month, the greatest positive changes in individual recovery were observed for Fatigue (65.0%), Pain (53.0%), and Emotional Problems (41.1%); at least 30% of respondents reported no change in at least one category, and the greatest decreases were for Usual Social Activities (23.9%), Social Satisfaction (23.2%), and Mental Health (21.8%).

CONCLUSIONS

This study provides an important step towards better understanding the impact of 'breakthrough' COVID-19 infections on clinically engaged, fully vaccinated patients' physical and mental health to improve support for their treatment and recovery.

摘要

背景

虽然 2019 年冠状病毒病(COVID-19)疫苗的有效性很高,但完全接种疫苗的人仍可能感染 COVID-19。在这部分人群中,症状往往较轻且持续时间较短。对于接种疫苗后感染 COVID-19 的患者如何通过患者报告的结果(PROs)来体验疾病,以及随着时间的推移如何变化,人们了解较少。

目的

本研究旨在描述在 6 周内感染 COVID-19 的完全接种疫苗个体的身体、心理和社会健康 PROs。

设计

前瞻性设计,使用通过移动应用程序平台收集的患者报告的结果测量信息系统简表(PROMIS-10)。

参与者

2021 年 3 月 1 日或之后在一家美国大型医疗系统中检测出 COVID-19 呈阳性并参与研究的 1114 名完全接种疫苗的患者,且报告在 2021 年 11 月 1 日之前发病。

主要措施

6 周期间的全球身体和心理健康 PROMIS-10 T 评分、6 周期间的 PROMIS-10 成分问题以及用于测量个体康复的第一个月内的 PROMIS-10 成分问题子集的评分。

主要结果

平均全球身体和心理健康 T 评分随时间增加,并保持在人群平均值的一个标准差内。在基线时,至少 40%的参与者报告所有成分问题的健康状况良好,除疲劳(25%)外,所有问题的健康状况报告均随时间增加,疲劳(25.5%至 67.5%)、疼痛(59.1%至 82.8%)和情绪问题(42.3%至 62.5%)的改善最大。在第一个月内,个体康复方面最大的积极变化见于疲劳(65.0%)、疼痛(53.0%)和情绪问题(41.1%);至少 30%的受访者报告在至少一个类别中没有变化,最大的下降见于日常社交活动(23.9%)、社交满意度(23.2%)和心理健康(21.8%)。

结论

本研究为更好地了解“突破性”COVID-19 感染对接受临床治疗的完全接种疫苗患者身体和心理健康的影响提供了重要步骤,以改善对其治疗和康复的支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c82/9911501/19197cf763ab/40271_2022_605_Fig1_HTML.jpg

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