Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Korean Med Sci. 2023 Apr 17;38(15):e120. doi: 10.3346/jkms.2023.38.e120.
Long coronavirus disease 2019 (COVID-19) in recovered patients (RPs) is gradually recognized by more people. However, how long it will last and the underlining mechanism remains unclear.
We conducted a prospective follow-up study to evaluate the long-term symptoms and clinical indices of RPs at one-year after discharge from Union Hospital, Wuhan, China between December 2020 to May 2021. We also performed the 16S rRNA sequencing of stool samples from RPs and healthy controls (HCs) and analyzed the correlation between the gut microbiota and long COVID-19.
In total, 187 RPs were enrolled, among them, 84 (44.9%) RPs reported long COVID-19 symptoms at one-year after discharge. The most common long-term symptoms were cardiopulmonary symptoms, including chest tightness after activity (39/187, 20.9%), palpitations on exercise (27/187, 14.4%), sputum (21/187, 11.2%), cough (15/187, 8.0%) and chest pain (13/187, 7.0%), followed by systemic symptoms including fatigue (34/187, 18.2%) and myalgia (20/187, 10.7%), and digestive symptoms including constipation (14/187, 7.5%), anorexia (13/187, 7.0%), and diarrhea (8/187, 4.3%). Sixty-six (35.9%) RPs presented either anxiety or depression (42/187 [22.8%] and 53/187 [28.8%] respectively), and the proportion of anxiety or depression in the long symptomatic group was significantly higher than that in the asymptomatic group (41/187 [50.6%] vs. 25/187 [24.3%]). Compared with the asymptomatic group, scores of all nine 36-Item Short Form General Health Survey domains were lower in the symptomatic group (all < 0.05). One hundred thirty RPs and 32 HCs (non-severe acute respiratory syndrome coronavirus 2 infected subjects) performed fecal sample sequencing. Compared with HCs, symptomatic RPs had obvious gut microbiota dysbiosis including significantly reduced bacterial diversities and lower relative abundance of short-chain fatty acids (SCFAs)-producing salutary symbionts such as group, , , , , and group. Meanwhile, the relative abundance of _group, , and showed decreasing tendencies between HCs, the asymptomatic group, and the symptomatic group.
This study demonstrated the presence of long COVID-19 which correlates with gut microbiota dysbiosis in RPs at one-year after discharge, indicating gut microbiota may play an important role in long COVID-19.
越来越多的人认识到新冠肺炎康复患者（RPs）中存在长期的冠状病毒病 2019（COVID-19）。然而，它将持续多久以及潜在的机制仍不清楚。
我们进行了一项前瞻性随访研究，评估了 2020 年 12 月至 2021 年 5 月期间，中国武汉协和医院出院后一年的 RPs 的长期症状和临床指标。我们还对 RPs 和健康对照者（HCs）的粪便样本进行了 16S rRNA 测序，并分析了肠道微生物群与长 COVID-19 的相关性。
共纳入 187 例 RPs，其中 84 例（44.9%）RPs 在出院后一年出现长 COVID-19 症状。最常见的长期症状是心肺症状，包括活动后胸闷（39/187，20.9%）、运动时心悸（27/187，14.4%）、咳痰（21/187，11.2%）、咳嗽（15/187，8.0%）和胸痛（13/187，7.0%），其次是全身症状，包括疲劳（34/187，18.2%）和肌痛（20/187，10.7%），以及消化症状，包括便秘（14/187，7.5%）、食欲不振（13/187，7.0%）和腹泻（8/187，4.3%）。66 例（35.9%）RPs 出现焦虑或抑郁（42/187 [22.8%] 和 53/187 [28.8%]），在有症状组中，焦虑或抑郁的比例明显高于无症状组（41/187 [50.6%] vs. 25/187 [24.3%]）。与无症状组相比，有症状组所有 9 个 36 项简明健康调查领域的得分均较低（均<0.05）。130 例 RPs 和 32 例 HCs（非严重急性呼吸综合征冠状病毒 2 感染患者）进行了粪便样本测序。与 HCs 相比，有症状的 RPs 存在明显的肠道微生物群失调，包括细菌多样性显著降低，以及产生短链脂肪酸（SCFAs）的有益共生体的相对丰度降低，如群、、、、、和群。同时，在 HCs、无症状组和有症状组之间，_group、和的相对丰度呈下降趋势。
本研究表明，新冠肺炎康复患者在出院后一年存在长 COVID-19，这与肠道微生物群失调有关，表明肠道微生物群可能在长 COVID-19 中发挥重要作用。
