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新冠后遗症:元凶新冠的陌生幽灵。

Post-COVID Syndrome: The Stranger Ghost of Culprit COVID-19.

机构信息

Professor Emeritus, Sawai Man Singh Medical College and attached Hospitals; Vice Chancellor, Rajasthan University of Health Sciences;Corresponding Author.

Junior Specialist, Department of Medical & Health, Government of India, Jaipur, Rajasthan.

出版信息

J Assoc Physicians India. 2023 Feb;71(2):11-12. doi: 10.5005/japi-11001-0193.

Abstract

BACKGROUND

Post-COVID syndromes are the most abundant sequel of coronavirus disease of 2019 (COVID-19) infection, which affects millions of people around the whole world. There is a significant difference observed during the acute phase as well as during the post-COVID period between patients hospitalized with (alpha, delta, or omicron) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant. In the present scenario, when most people are vaccinated, COVID-19 disease is less likely, but the remnants of previous COVID-19 infections are still a vast health burden.

MATERIALS AND METHODS

This prospective, observational, comparative, and analytical study included a total of 3,840 COVID-19-infected patients who visited the hospital. We included 1,150 patients of alpha variants, 1,845 patients of delta variants, and 815 patients of omicron variants, from June 2020 to November 2020, March 2021 to July 2021, and January 2022 to May 2022, respectively. All medical data of the study population, including hospital stay and vaccination status, were collected, and all patients were followed up for 6 months of duration. All collected data were compiled and analyzed to compare the post-COVID thrombotic and other events among different variants of COVID-19.

RESULTS

Patients infected during the delta variant are the most symptomatic at onset (higher prevalence of fever, dyspnea, cough, myalgia, headache, or gastrointestinal problems) than those infected with the alpha or omicron variant (p < 0.01). A total of 2,830 patients (7.48%) [1,520 (82.38%) of delta variant, 598 (73.37%) of omicron variant, and 712 (60.34%) of omicron variant] developed post-COVID syndrome during their follow-up period out of 3,220 enrolled patients and the difference was statistically significant when compared among variants (p < 0.05). In this study, the highly prevalent post-COVID syndrome was mucormycosis (11.41%), followed by new-onset diabetes (9.89%), pulmonary fiosis (7.67%), ischemic heart disease (6.46%), ain stroke (3.29%), and other thromboembolic disorders (2.37%).

CONCLUSION

COVID-19-associated onset symptoms during the delta variant were more severe and highly prevalent, while neurological symptoms (aguesia and anosmia) were more common during the alpha variant. Patients infected with the delta variant of COVID-19 are more prone to develop post-COVID-associated complications with minimal risk in the omicron variant and intermediate risk in the alpha variant. Long COVID-19 requires specific attention for management, irrespective of the SARS-CoV-2 variant.

摘要

背景

新冠后综合征是 2019 年冠状病毒病(COVID-19)感染最常见的后遗症,影响着全球数百万人。在感染严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的阿尔法、德尔塔或奥密克戎变异株的住院患者中,无论是在急性期还是新冠后时期,都观察到了显著的差异。在目前的情况下,大多数人都接种了疫苗,COVID-19 疾病的可能性较小,但以前 COVID-19 感染的残余仍然是一个巨大的健康负担。

材料和方法

本前瞻性、观察性、对照和分析性研究共纳入了 3840 名感染 COVID-19 的患者。我们纳入了 2020 年 6 月至 11 月、2021 年 3 月至 7 月、2022 年 1 月至 5 月期间感染阿尔法变异株的 1150 例患者、感染德尔塔变异株的 1845 例患者和感染奥密克戎变异株的 815 例患者。收集了研究人群的所有医疗数据,包括住院时间和疫苗接种情况,并对所有患者进行了为期 6 个月的随访。所有收集的数据都进行了编译和分析,以比较不同 COVID-19 变异株之间的新冠后血栓形成和其他事件。

结果

感染德尔塔变异株的患者在发病时症状最明显(发热、呼吸困难、咳嗽、肌痛、头痛或胃肠道问题的患病率较高),高于感染阿尔法或奥密克戎变异株的患者(p < 0.01)。在 3220 名入组患者中,共有 2830 名(7.48%)[1520 名(82.38%)感染德尔塔变异株,598 名(73.37%)感染奥密克戎变异株,712 名(60.34%)感染奥密克戎变异株]在随访期间出现新冠后综合征,不同变异株之间的差异具有统计学意义(p < 0.05)。在这项研究中,最常见的新冠后综合征是毛霉菌病(11.41%),其次是新发糖尿病(9.89%)、肺纤维化(7.67%)、缺血性心脏病(6.46%)、脑梗塞(3.29%)和其他血栓栓塞性疾病(2.37%)。

结论

在德尔塔变异株中,COVID-19 相关发病症状更为严重且普遍,而在阿尔法变异株中,神经症状(味觉和嗅觉丧失)更为常见。感染 COVID-19 德尔塔变异株的患者更容易发生新冠后相关并发症,奥密克戎变异株的风险最小,阿尔法变异株的风险中等。长新冠需要特别注意管理,无论 SARS-CoV-2 变异株如何。

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