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肌痛性脑脊髓炎/慢性疲劳综合征在新冠病毒2型感染(PASC)的急性后遗症中很常见:来自新冠后多学科诊所的结果

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic.

作者信息

Bonilla Hector, Quach Tom C, Tiwari Anushri, Bonilla Andres E, Miglis Mitchell, Yang Phillip C, Eggert Lauren E, Sharifi Husham, Horomanski Audra, Subramanian Aruna, Smirnoff Liza, Simpson Norah, Halawi Houssan, Sum-Ping Oliver, Kalinowski Agnieszka, Patel Zara M, Shafer Robert William, Geng Linda N

机构信息

Department of Medicine, Stanford University, Stanford, CA, United States.

Department of Molecular, Cell and Developmental Biology, University of Michigan, Ann Arbor, MI, United States.

出版信息

Front Neurol. 2023 Feb 24;14:1090747. doi: 10.3389/fneur.2023.1090747. eCollection 2023.

Abstract

BACKGROUND

The global prevalence of PASC is estimated to be present in 0·43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well-defined.

METHODS

We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) phenotype.

FINDINGS

The median age was 47 years, 59.0% were female; 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black. Only 12.7% required hospitalization. Seventy-two (53.5%) patients had no known comorbid conditions. Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12. The most common symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent fit the criteria for ME/CFS, majority were female, and obesity (BMI > 30 Kg/m) ( = 0.00377895) and worse functional status ( = 0.0110474) were significantly associated with ME/CFS.

INTERPRETATIONS

Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19. One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.

摘要

背景

据估计,全球PASC的患病率为0.43%,根据世界卫生组织对全球4.7亿例COVID-19感染的估计,约有2亿人出现长期COVID症状。尽管如此,其临床特征仍未明确。

方法

我们从一家COVID-19后诊所的140例PASC患者中收集了回顾性数据,内容包括人口统计学、风险因素、疾病严重程度(分为1级轻度至5级重度)、功能状态,以及29种症状和主成分症状聚类分析。采用医学研究所(IOM)2015年标准来确定脑脊髓炎/慢性疲劳综合征(ME/CFS)表型。

研究结果

中位年龄为47岁,59.0%为女性;49.3%为白人,17.2%为西班牙裔,14.9%为亚洲人,6.7%为黑人。只有12.7%的患者需要住院治疗。72例(53.5%)患者没有已知的合并症。45例(33.9%)患者功能严重受损。症状的中位持续时间为285.5天,症状数量为12种。最常见的症状是疲劳(86.5%)、运动后不适(82.8%)、脑雾(81.2%)、睡眠未恢复精力(76.7%)和无精打采(74.6%)。43%的患者符合ME/CFS标准,大多数为女性,肥胖(BMI>30 Kg/m)(P = 0.00377895)和较差的功能状态(P = 0.0110474)与ME/CFS显著相关。

解读

在我们诊所接受评估的大多数PASC患者没有合并症,也没有因急性COVID-19住院。三分之一的患者功能状态严重下降。约43%的患者为ME/CFS亚型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2964/9998690/3699fbebd8fd/fneur-14-1090747-g0001.jpg

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