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英国东部地区新冠后综合征的风险因素及医疗服务的进一步利用情况

Post-COVID-19 syndrome risk factors and further use of health services in East England.

作者信息

Debski Maciej, Tsampasian Vasiliki, Haney Shawn, Blakely Katy, Weston Samantha, Ntatsaki Eleana, Lim Mark, Madden Susan, Perperoglou Aris, Vassiliou Vassilios S

机构信息

Norwich Medical School, University of East Anglia, Norwich, United Kingdom.

Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.

出版信息

PLOS Glob Public Health. 2022 Nov 30;2(11):e0001188. doi: 10.1371/journal.pgph.0001188. eCollection 2022.

Abstract

Post-COVID syndrome, defined as symptoms persisting for more than twelve weeks after the diagnosis of COVID-19, has been recognised as a new clinical entity in the context of SARS-CoV-2 infection. This study was conducted to characterise the burden and predictors for post-COVID-19 syndrome in the local population. It was a community-based web-survey study conducted in Norfolk, East England, UK. We sent the survey to patients with confirmed COVID-19 infection by real-time polymerase chain reaction by December 6th, 2020. Questions related to the pre-COVID and post-COVID level of symptoms and further healthcare use. Baseline characteristics were collected from the primary care records. Logistic regression analysis was conducted to establish predictors for post-COVID-19 syndrome and further healthcare utilisation. Of 6,318 patients, survey responses were obtained from 1,487 participants (23.5%). Post-COVID-19 syndrome symptoms were experienced by 774 (52.1%) respondents. Male sex compared to female sex was a factor protective of post-COVID symptoms; relative risk (RR) 0.748, 95% confidence interval (CI), 0.605-0.924. Body mass index was associated with a greater risk of developing post-COVID-19 symptoms (RR 1.031, 95% CI, 1.016-1.047, for 1 kg/m2). A total of 378 (25.4%) people used further health services after their index COVID-19 infection, of whom 277 (73.2%) had post-COVID symptoms. Male sex was negatively associated with the use of further health services (RR 0.618, 95% CI, 0.464-0.818) whereas BMI was positively associated (RR 1.027, 95% CI, 1.009-1.046). Overall, post-COVID-19 symptoms increased the probability of using health services with RR 3.280, 95% CI, 2.540-4.262. This survey of a large number of people previously diagnosed with COVID-19 across East England shows a high prevalence of self-reported post-COVID-19 syndrome. Female sex and BMI were associated with an increased risk of post-COVID-19 syndrome and further utilisation of healthcare.

摘要

新冠后综合征被定义为在新冠病毒病确诊后症状持续超过12周,在严重急性呼吸综合征冠状病毒2感染背景下已被确认为一种新的临床实体。本研究旨在描述当地人群中新冠后综合征的负担及预测因素。这是一项在英国东英格兰诺福克郡开展的基于社区的网络调查研究。我们于2020年12月6日前将调查问卷发送给经实时聚合酶链反应确诊感染新冠病毒病的患者。问题涉及新冠前和新冠后的症状水平以及进一步的医疗服务使用情况。从初级保健记录中收集基线特征。进行逻辑回归分析以确定新冠后综合征及进一步医疗服务利用的预测因素。在6318名患者中,1487名参与者(23.5%)提供了调查回复。774名(52.1%)受访者出现了新冠后综合征症状。男性相较于女性是新冠后症状的一个保护因素;相对危险度(RR)为0.748,95%置信区间(CI)为0.605 - 0.924。体重指数与出现新冠后综合征的风险增加相关(每增加1kg/m²,RR为1.031,95%CI为1.016 - 1.047)。在其首次感染新冠病毒病后,共有378人(25.4%)使用了进一步的医疗服务,其中277人(73.2%)有新冠后症状。男性与使用进一步医疗服务呈负相关(RR为0.618,95%CI为0.464 - 0.818),而体重指数呈正相关(RR为1.027,95%CI为1.009 - 1.046)。总体而言,新冠后综合征使使用医疗服务的概率增加,RR为3.280,95%CI为2.540 - 4.262。这项对东英格兰大量既往确诊新冠病毒病患者的调查显示,自我报告的新冠后综合征患病率很高。女性和体重指数与新冠后综合征风险增加及进一步利用医疗服务相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b2b/10022108/7392eb9bd815/pgph.0001188.g001.jpg

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