Estrada-Codecido Jose, Chan Adrienne K, Andany Nisha, Lam Philip W, Nguyen Melody, Pinto Ruxandra, Simor Andrew, Daneman Nick
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Assoc Med Microbiol Infect Dis Can. 2022 Sep 27;7(3):208-219. doi: 10.3138/jammi-2022-0013. eCollection 2022 Sep.
The pandemic has affected hundreds of millions of people; early reports suggesting high rates of prolonged symptoms may be prone to selection bias.
In a program caring for all SARS-CoV-2 positive inpatients and outpatients between March to October 2020, and offering universal 90-day follow-up, we compared those who died prior to 90 days, not responding to follow-up, declining, or accepting follow-up. Among those seen or declining follow-up, we determined the prevalence and predictors of persistent symptoms.
Among 993 patients, 21 (2.1%) died prior to 90 days, 506 (50.9%) did not respond, 260 (26.1%) declined follow-up because they were well, and 206 (20.7%) were fully assessed. Of 466 who responded to follow-up inquiry, 133 (28.5%) reported ≥1 persistent symptom, including constitutional (15.5%), psychiatric (14.2%), rheumatologic (13.1%), neurologic (13.1%), cardiorespiratory (12.0%), and gastrointestinal (1.7%). Predictors differed for each symptom type. Any persistent symptom was more common in older patients (adjusted odds ratio [aOR] 1.11, 95% CI 1.04 to 1.18/5 years), those diagnosed in hospital (aOR 2.03, 95% CI 1.24 to 3.33) and those with initial constitutional and rheumatologic symptoms. Patients not responding to follow-up were younger and healthier at baseline.
Persistent symptoms are common and diverse 3 months post-COVID-19 but are likely over-estimated by most reports.
这场大流行已影响数亿人；早期报告显示长时间症状发生率高，可能存在选择偏倚。
在一个于2020年3月至10月期间照顾所有新冠病毒阳性住院和门诊患者并提供90天全程随访的项目中，我们比较了在90天前死亡、未回应随访、拒绝或接受随访的患者。在那些接受或拒绝随访的患者中，我们确定了持续症状的患病率和预测因素。
在993名患者中，21名（2.1%）在90天前死亡，506名（50.9%）未回应，260名（26.1%）因感觉良好而拒绝随访，206名（20.7%）接受了全面评估。在466名回应随访询问的患者中，133名（28.5%）报告有≥1种持续症状，包括全身性（15.5%）、精神性（14.2%）、风湿性（13.1%）、神经性（13.1%）、心肺性（12.0%）和胃肠道性（1.7%）。每种症状类型的预测因素有所不同。任何持续症状在老年患者中更常见（调整优势比[aOR]为1.11，95%置信区间为1.04至1.18/每5年）、在医院确诊的患者中（aOR为2.03，95%置信区间为1.24至3.33）以及有初始全身性和风湿性症状的患者中。未回应随访的患者在基线时更年轻、更健康。
新冠后3个月持续症状常见且多样，但很可能被大多数报告高估。
