不同 SARS-CoV-2 株引起的长新冠比较：系统评价和荟萃分析。

Comparison of Long COVID-19 Caused by Different SARS-CoV-2 Strains: A Systematic Review and Meta-Analysis.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China.

Institute for Global Health and Development, Peking University, No. 5, Yiheyuan Road, Haidian District, Beijing 100871, China.

出版信息

Int J Environ Res Public Health. 2022 Nov 30;19(23):16010. doi: 10.3390/ijerph192316010.

DOI:10.3390/ijerph192316010

PMID:36498103

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9736973/

Abstract

Although many studies of long COVID-19 were reported, there was a lack of systematic research which assessed the differences of long COVID-19 in regard to what unique SARS-CoV-2 strains caused it. As such, this systematic review and meta-analysis aims to evaluate the characteristics of long COVID-19 that is caused by different SARS-CoV-2 strains. We systematically searched the PubMed, EMBASE, and ScienceDirect databases in order to find cohort studies of long COVID-19 as defined by the WHO (Geneva, Switzerland). The main outcomes were in determining the percentages of long COVID-19 among patients who were infected with different SARS-CoV-2 strains. Further, this study was registered in PROSPERO (CRD42022339964). A total of 51 studies with 33,573 patients was included, of which three studies possessed the Alpha and Delta variants, and five studies possessed the Omicron variant. The highest pooled estimate of long COVID-19 was found in the CT abnormalities (60.5%; 95% CI: 40.4%, 80.6%) for the wild-type strain; fatigue (66.1%; 95% CI: 42.2%, 89.9%) for the Alpha variant; and ≥1 general symptoms (28.4%; 95% CI: 7.9%, 49.0%) for the Omicron variant. The pooled estimates of ≥1 general symptoms (65.8%; 95% CI: 47.7%, 83.9%) and fatigue were the highest symptoms found among patients infected with the Alpha variant, followed by the wild-type strain, and then the Omicron variant. The pooled estimate of myalgia was highest among patients infected with the Omicron variant (11.7%; 95%: 8.3%, 15.1%), compared with those infected with the wild-type strain (9.4%; 95%: 6.3%, 12.5%). The pooled estimate of sleep difficulty was lowest among the patients infected with the Delta variant (2.5%; 95%: 0.2%, 4.9%) when compared with those infected with the wild-type strain (24.5%; 95%: 17.5%, 31.5%) and the Omicron variant (18.7%; 95%: 1.0%, 36.5%). The findings of this study suggest that there is no significant difference between long COVID-19 that has been caused by different strains, except in certain general symptoms (i.e., in the Alpha or Omicron variant) and in sleep difficulty (i.e., the wild-type strain). In the context of the ongoing COVID-19 pandemic and its emerging variants, directing more attention to long COVID-19 that is caused by unique strains, as well as implementing targeted intervention measures to address it are vital.

摘要

虽然有许多关于长新冠的研究报告，但缺乏系统研究来评估不同的 SARS-CoV-2 株引起的长新冠之间的差异。因此，本系统评价和荟萃分析旨在评估不同 SARS-CoV-2 株引起的长新冠的特征。我们系统地检索了 PubMed、EMBASE 和 ScienceDirect 数据库，以找到世界卫生组织（瑞士日内瓦）定义的长新冠的队列研究。主要结果是确定不同 SARS-CoV-2 株感染患者中长新冠的百分比。此外，本研究已在 PROSPERO（CRD42022339964）中注册。共有 51 项研究纳入了 33573 名患者，其中 3 项研究涉及 Alpha 和 Delta 变体，5 项研究涉及 Omicron 变体。野生型菌株的 CT 异常（60.5%；95%CI：40.4%，80.6%）、Alpha 变体的疲劳（66.1%；95%CI：42.2%，89.9%）和 Omicron 变体的≥1 种一般症状（28.4%；95%CI：7.9%，49.0%）的最高汇总估计值。感染 Alpha 变体的患者中≥1 种一般症状（65.8%；95%CI：47.7%，83.9%）和疲劳的汇总估计值最高，其次是野生型菌株，然后是 Omicron 变体。感染 Omicron 变体的患者肌痛的汇总估计值最高（11.7%；95%：8.3%，15.1%），与感染野生型菌株的患者相比（9.4%；95%：6.3%，12.5%）。与感染野生型菌株（24.5%；95%：17.5%，31.5%）和 Omicron 变体（18.7%；95%：1.0%，36.5%）相比，Delta 变体感染患者的睡眠困难汇总估计值最低（2.5%；95%：0.2%，4.9%）。本研究结果表明，不同菌株引起的长新冠之间除了某些一般症状（即 Alpha 或 Omicron 变体）和睡眠困难（即野生型菌株）外，没有显著差异。在当前 COVID-19 大流行及其新兴变体的背景下，关注不同菌株引起的长新冠，并实施有针对性的干预措施来解决这一问题至关重要。