Bamps Laurence, Armenti Jean-Philippe, Bojan Mirela, Grandbastien Bruno, von Garnier Christophe, Du Pasquier Renaud, Desgranges Florian, Papadimitriou-Olivgeris Matthaios, Alberio Lorenzo, Preisig Martin, Schwitter Jurg, Guery Benoit
Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Service of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
J Clin Med. 2023 Apr 3;12(7):2673. doi: 10.3390/jcm12072673.
Long-lasting symptoms after SARS-CoV-2 infection have been described many times in the literature and are referred to as Long COVID. In this prospective, longitudinal, monocentric, observational study, we collected the health complaints of 474 patients (252 ambulatory and 222 hospitalized) at Lausanne University Hospital 1 year after COVID-19 diagnosis. Using a self-reported health survey, we explored cardiopulmonary, vascular, neurological, and psychological complaints. Our results show that age, Charlson comorbidity index, and smoking habits were associated with hospital admission. Regarding the vascular system, we found that having had thromboembolism before SARS-CoV-2 infection was significantly associated with a higher risk of recurrence of thromboembolism at 1 year. In the neurologic evaluation, the most frequent symptom was fatigue, which was observed in 87.5% of patients, followed by "feeling slowed down", headache, and smell disturbance in 71.5%, 68.5%, and 60.7% of cases, respectively. Finally, our cohort subjects scored higher overall in the STAI, CESD, Maastricht, and PSQI scores (which measure anxiety, depression, fatigue, and sleep, respectively) than the healthy population. Using cluster analysis, we identified two phenotypes of patients prone to developing Long COVID. At baseline, CCS score, prior chronic disease, stroke, and atrial fibrillation were associated with Long COVID. During COVID infection, mechanical ventilation and five neurological complaints were also associated with Long COVID. In conclusion, this study confirms the wide range of symptoms developed after COVID with the involvement of all the major systems. Early identification of risk factors associated with the development of Long COVID could improve patient follow-up; nevertheless, the low specificity of these factors remains a challenge to building a systematic approach.
新型冠状病毒肺炎（SARS-CoV-2）感染后的长期症状在文献中已有多次描述，被称为“长新冠”。在这项前瞻性、纵向、单中心观察性研究中，我们收集了洛桑大学医院474例患者（252例门诊患者和222例住院患者）在新冠病毒病（COVID-19）确诊1年后的健康问题。通过一项自我报告的健康调查，我们探究了心肺、血管、神经和心理方面的问题。我们的结果表明，年龄、查尔森合并症指数和吸烟习惯与住院有关。关于血管系统，我们发现，在感染SARS-CoV-2之前有过血栓栓塞史与1年后血栓栓塞复发风险较高显著相关。在神经学评估中，最常见的症状是疲劳，87.5%的患者出现该症状，其次是“感觉迟钝”、头痛，分别有71.5%、68.5%的病例出现嗅觉障碍，60.7%的病例出现嗅觉减退。最后，我们队列中的受试者在状态特质焦虑量表（STAI）、流调中心抑郁量表（CESD）、马斯特里赫特量表和匹兹堡睡眠质量指数（PSQI）评分（分别用于测量焦虑、抑郁、疲劳和睡眠）上的总体得分高于健康人群。通过聚类分析，我们确定了两种易患“长新冠”的患者表型。在基线时，累积疾病严重程度评分（CCS）、既往慢性病、中风和心房颤动与“长新冠”有关。在新冠病毒感染期间，机械通气和五种神经学问题也与“长新冠”有关。总之，本研究证实了新冠病毒感染后出现的广泛症状涉及所有主要系统。早期识别与发生“长新冠”相关的危险因素可以改善患者随访；然而，这些因素的低特异性仍然是建立系统方法的一个挑战。
