Dirección General de Salud Pública, Canary Islands, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Dirección General de Salud Pública, Canary Islands, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Infect Dis Now. 2023 Aug;53(5):104688. doi: 10.1016/j.idnow.2023.104688. Epub 2023 Feb 28.
The study aimed to assess the association between three predominant SARS-CoV-2 variants (Alpha, Delta, and Omicron) and the risk of developing long COVID (persistence of physical, medical, and cognitive symptoms more than 4 weeks after infection), post-COVID-19 syndrome (symptoms extending beyond 12 weeks), and viral persistence (testing positive beyond 4 weeks despite clinical resolution).
Retrospective study of 325 patients hospitalized for COVID-19 with genomic sequencing information. For each SARS-CoV-2 variant, sample characteristics, frequency of symptoms, and long-term sequelae were compared using Chi-squared test, Fisher's exact test, Kruskal-Wallis test, and Dunn's test as appropriate. Odds ratios (OR) were calculated using logistic regression models to assess the association of risk factors and sequelae.
The adjusted model showed that the Omicron (vs Alpha) variant (OR, 0.30; 95% CI 0.16-0.56), admission to ICU (OR, 1.14; 95% CI 1.05-1.23), and being treated with antiviral or immunomodulatory drugs (OR, 2.01; 95% CI 1.23-3.27) predicted long COVID and post-COVID-19 syndrome. Viral persistence showed no difference between variants.
The Omicron variant was associated with significantly lower odds of developing long-term sequelae from COVID-19 compared with previous variants, while severity of illness indicators increased the risk. Vaccination status, age, sex, and comorbidities were not found to predict sequelae development. This information has implications for both health managers and clinicians when deciding on the appropriate clinical management and subsequent outpatient follow-up of these patients. More studies with non-hospitalized patients are still necessary.
本研究旨在评估三种主要的 SARS-CoV-2 变体（Alpha、Delta 和 Omicron）与长新冠（感染后 4 周以上持续存在身体、医疗和认知症状）、新冠后综合征（症状持续超过 12 周）和病毒持续存在（尽管临床症状已缓解但仍持续检测到病毒超过 4 周）的风险之间的关联。
这是一项对 325 名因 COVID-19 住院并具有基因组测序信息的患者进行的回顾性研究。对于每一种 SARS-CoV-2 变体，使用卡方检验、Fisher 确切检验、Kruskal-Wallis 检验和 Dunn 检验比较样本特征、症状频率和长期后遗症，并使用逻辑回归模型计算比值比（OR）来评估危险因素和后遗症的相关性。
调整模型显示，与 Alpha 变体相比，Omicron 变体（OR，0.30；95%CI，0.16-0.56）、入住 ICU（OR，1.14；95%CI，1.05-1.23）和使用抗病毒或免疫调节药物治疗（OR，2.01；95%CI，1.23-3.27）预测长新冠和新冠后综合征。不同变体之间的病毒持续存在没有差异。
与之前的变体相比，Omicron 变体与新冠后长期后遗症的发生几率显著降低相关，而疾病严重程度指标则增加了发病风险。疫苗接种状况、年龄、性别和合并症与后遗症的发生无关。这些信息对于卫生管理者和临床医生在决定这些患者的适当临床管理和后续门诊随访时具有重要意义。仍需要更多针对非住院患者的研究。
