Faculty of Health and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands.
Department of Pulmonology, Horacio E. Oduber Hospital, Oranjestad, Aruba.
Clin Med Res. 2023 Jun;21(2):69-78. doi: 10.3121/cmr.2023.1821.
To investigate the pattern and prevalence of persistent symptoms of Post-COVID-19 Syndrome (PCS) at 3, 6, 9, and 18 months after discharge. Associated risk factors were further examined to potentially explain the persistence of these symptoms. A cross-sectional cohort study was conducted at the primary health care facility of Aruba, Dr. Horacio E. Oduber Hospital (HOH). Inclusion criteria were adults hospitalized at HOH for at least one night between March and July 2021 and laboratory-confirmed COVID-19 diagnosis. Exclusion criteria were deceased before the follow-up, not able to mobilize before or after discharge, living outside of Aruba or in nursing homes, and patients with psychosis, dementia, or hospitalized due to unrelated diseases. Eligible and willing participants completed a 20-question survey: a self-reported symptoms questionnaire about symptoms during and after COVID-19 infection, level of dyspnea measurement (mMRC-scale), quality of life measurement (EQ-5D-5E with EuroQoL VAS), and mental well-being (WHO-5). Hospitalization related data were gathered via retrospective analysis of patient records. Chi-square test, logistic regression, and ANOVA analyses were conducted; <0.05 was chosen as level of statistical significance for all analyses. In total, 222 (34.5%) patients were eligible, consenting, and completed the survey. Most participants were interviewed a year or more after their initial COVID-19 infection. Fatigue (37.8%), new-onset dyspnea (38.7%), hair loss (20.3%), and muscle pain (18.0%) were the most frequently reported symptoms at any time post COVID-19 infection. Female participants were found more likely to experience fatigue (<0.05, OR 2.135, 95% CI 1.154-3.949) and new-onset dyspnea (<0.05, OR 2.026 95% CI 1.093-3.756) after initial infection. Participants with one or more respiratory comorbidity were more likely to experience new-onset dyspnea (<0.05, OR 2.681, 95% CI 1.223-5.873). None of the predictor variables was associated with cognitive impairment. This study identified female sex and respiratory comorbidity as crucial risk factors for PCS. Females were also found to have significantly lower health scores. Female participants were more likely to experience fatigue and dyspnea after COVID-19 infection.
调查 COVID-19 后综合征（PCS）患者在出院后 3、6、9 和 18 个月时持续症状的模式和流行率。进一步探讨相关的危险因素，以解释这些症状的持续存在。本研究采用横断面队列研究设计，在阿鲁巴的初级保健机构——霍拉西奥·E·奥杜贝尔医院（HOH）进行。纳入标准为 2021 年 3 月至 7 月期间至少在 HOH 住院一晚且实验室确诊 COVID-19 的成年人。排除标准为随访前死亡、出院前后无法移动、居住在阿鲁巴以外或养老院、患有精神病、痴呆症或因其他疾病住院的患者。符合条件且愿意参加的参与者完成了一份包含 20 个问题的调查问卷：一份关于 COVID-19 感染期间和之后症状的自我报告症状问卷、呼吸困难测量量表（mMRC 量表）、生活质量测量量表（EQ-5D-5E 与 EuroQoL VAS）和心理健康量表（WHO-5）。通过回顾性分析患者病历收集住院相关数据。进行卡方检验、逻辑回归和方差分析；所有分析均选择<0.05 作为统计学显著性水平。共有 222 名（34.5%）患者符合条件、同意并完成了调查。大多数参与者在初次 COVID-19 感染一年或更长时间后接受了采访。疲劳（37.8%）、新发呼吸困难（38.7%）、脱发（20.3%）和肌肉疼痛（18.0%）是 COVID-19 感染后任何时候最常报告的症状。女性参与者在初次感染后更易出现疲劳（<0.05，OR 2.135，95%CI 1.154-3.949）和新发呼吸困难（<0.05，OR 2.026，95%CI 1.093-3.756）。有 1 种或多种呼吸系统合并症的参与者更易出现新发呼吸困难（<0.05，OR 2.681，95%CI 1.223-5.873）。没有预测变量与认知障碍有关。本研究确定女性性别和呼吸系统合并症是 PCS 的关键危险因素。女性的健康评分也明显较低。女性参与者在 COVID-19 感染后更易出现疲劳和呼吸困难。
