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COVID-19 住院幸存者出院后长达 24 个月的危重症和非危重症患者的纵向医学亚专科随访。

Longitudinal medical subspecialty follow-up of critically and non-critically ill hospitalized COVID-19 survivors up to 24 months after discharge.

机构信息

Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 E 210th St, Bronx, NY, 10467, USA.

Renaissance School of Medicine at Stony, Brook University, Stony Brook, New York, USA.

出版信息

Intern Emerg Med. 2023 Mar;18(2):477-486. doi: 10.1007/s11739-023-03195-x. Epub 2023 Jan 31.

Abstract

Medical specialty usage of COVID-19 survivors after hospital discharge is poorly understood. This study investigated medical specialty usage at 1-12 and 13-24 months post-hospital discharge in critically ill and non-critically ill COVID-19 survivors. This retrospective study followed ICU (N = 89) and non-ICU (N = 205) COVID-19 survivors who returned for follow-up within the Stony Brook Health System post-hospital discharge. Follow-up data including survival, hospital readmission, ongoing symptoms, medical specialty care use, and ICU status were examined 1-12 and 13-24 months after COVID-19 discharge. "New" (not previously seen) medical specialty usage was also identified. Essentially all (98%) patients survived. Hospital readmission was 34%, but functional status scores at discharge were not associated with hospital readmission. Many patients reported ongoing [neuromuscular (50%) respiratory (39%), chronic fatigue (35%), cardiovascular (30%), gastrointestinal (28%), neurocognitive (22%), genitourinary (22%), and mood-related (13%)] symptoms at least once 1-24 months after discharge. Common specialty follow-ups included cardiology (25%), vascular medicine (17%), urology (17%), neurology (16%), and pulmonology (14%), with some associated with pre-existing comorbidities and with COVID-19. Common new specialty visits were vascular medicine (11%), pulmonology (11%), and neurology (9%). ICU patients had more symptoms and follow-ups compared to the non-ICU patients. This study reported high incidence of persistent symptoms and medical specialty care needs in hospitalized COVID-19 survivors 1-24 months post-discharge. Some specialty care needs were COVID-19 related or exacerbated by COVID-19 disease while others were associated with pre-existing medical conditions. Longer follow-up studies of COVID-19 survivor medical care needs are necessary.

摘要

COVID-19 幸存者出院后的医学专业使用情况了解甚少。本研究调查了危重症和非危重症 COVID-19 幸存者出院后 1-12 个月和 13-24 个月的医学专业使用情况。这项回顾性研究跟踪了在斯通布鲁克卫生系统出院后返回随访的 ICU(N=89)和非 ICU(N=205)COVID-19 幸存者。随访数据包括生存、医院再入院、持续症状、医学专业护理使用情况和 ICU 状态,分别在 COVID-19 出院后 1-12 个月和 13-24 个月进行检查。还确定了“新”(以前未见过)的医学专业使用情况。几乎所有(98%)患者都存活下来。医院再入院率为 34%,但出院时的功能状态评分与医院再入院无关。许多患者报告出院后至少在 1-24 个月内持续存在[神经肌肉(50%)、呼吸(39%)、慢性疲劳(35%)、心血管(30%)、胃肠道(28%)、神经认知(22%)、泌尿生殖(22%)和情绪相关(13%)]症状。常见的专科随访包括心脏病学(25%)、血管医学(17%)、泌尿科(17%)、神经病学(16%)和肺病学(14%),其中一些与先前存在的合并症和 COVID-19 有关。常见的新专科就诊是血管医学(11%)、肺病学(11%)和神经病学(9%)。与非 ICU 患者相比,ICU 患者的症状和随访更多。本研究报告了 COVID-19 幸存者出院后 1-24 个月持续存在症状和医疗专业护理需求的高发生率。一些专科护理需求与 COVID-19 相关或由 COVID-19 疾病加重,而另一些则与先前存在的医疗条件有关。需要对 COVID-19 幸存者的医疗护理需求进行更长时间的随访研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2240/9887251/a8aa0c74da5a/11739_2023_3195_Fig1_HTML.jpg

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