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与 COVID-19 后急性后遗症相关的既往疾病。

Pre-existing conditions associated with post-acute sequelae of COVID-19.

机构信息

Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.

Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.

出版信息

J Autoimmun. 2023 Feb;135:102991. doi: 10.1016/j.jaut.2022.102991. Epub 2023 Jan 6.

Abstract

Post-acute sequelae of COVID-19 (PASC) are conditions that occur or remain at least 28 days after SARS-CoV-2 infection. While some risk factors for PASC have been identified, little is known about pre-existing conditions that render one susceptible to developing PASC. Data from participants (n = 1224) in a longitudinal COVID-19 cohort study in Arizona were used to investigate comorbid conditions associated with PASC. After adjustment of the models for age, BMI, gender, race, and smoking, the following pre-existing conditions were statistically significantly associated with the development of PASC: asthma (OR = 1.54; 95% CI = 1.10-2.15); chronic constipation (OR = 4.29; 95% CI = 1.15-16.00); reflux (OR = 1.54; 95% CI = 1.01-2.34); rheumatoid arthritis (OR = 3.69; 95%CI = 1.15-11.82); seasonal allergies (OR = 1.56; 95% CI = 1.22-1.98); and depression/anxiety (OR = 1.72; 95% CI = 1.17-2.52). When grouping conditions together, statistically significant associations with PASC were observed for respiratory (OR = 1.47; 95% CI = 1.06-2.14); gastrointestinal (OR = 1.62; 95% CI = 1.16-2.26), and autoimmune conditions (OR = 4.38; 95% CI = 1.59-12.06). After adjustment for severity of acute SARS-CoV-2 infection and depression/anxiety, seasonal allergies (OR = 1.48; 95% CI 1.15-1.91) and autoimmune disease (OR = 3.78; 95% CI - 1.31-10.91) remained significantly associated with risk for PASC. These findings indicate that numerous pre-existing conditions may be associated with an increased risk for the development of PASC. Patients with these conditions should consider taking extra steps to avoid infection.

摘要

COVID-19 的急性后遗症(PASC)是指在 SARS-CoV-2 感染后至少 28 天发生或持续存在的疾病。虽然已经确定了一些 PASC 的危险因素,但对于导致人们易患 PASC 的预先存在的疾病知之甚少。亚利桑那州一项 COVID-19 纵向队列研究的参与者(n=1224)的数据用于调查与 PASC 相关的合并症。在调整模型中的年龄、BMI、性别、种族和吸烟因素后,以下预先存在的疾病与 PASC 的发生呈统计学显著相关:哮喘(OR=1.54;95%CI=1.10-2.15);慢性便秘(OR=4.29;95%CI=1.15-16.00);反流(OR=1.54;95%CI=1.01-2.34);类风湿关节炎(OR=3.69;95%CI=1.15-11.82);季节性过敏(OR=1.56;95%CI=1.22-1.98);和抑郁/焦虑(OR=1.72;95%CI=1.17-2.52)。当将这些疾病分组时,与 PASC 有统计学显著关联的是呼吸道疾病(OR=1.47;95%CI=1.06-2.14);胃肠道疾病(OR=1.62;95%CI=1.16-2.26);和自身免疫性疾病(OR=4.38;95%CI=1.59-12.06)。在调整急性 SARS-CoV-2 感染的严重程度和抑郁/焦虑后,季节性过敏(OR=1.48;95%CI 1.15-1.91)和自身免疫性疾病(OR=3.78;95%CI-1.31-10.91)仍然与 PASC 的发病风险显著相关。这些发现表明,许多预先存在的疾病可能与 PASC 发生的风险增加有关。有这些疾病的患者应考虑采取额外措施来避免感染。

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