Gujral Harshmeet Singh, Sahasrabudhe Tushar R, Nirmala M A
Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, IND.
Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Cureus. 2023 Jun 21;15(6):e40717. doi: 10.7759/cureus.40717. eCollection 2023 Jun.
Background Multisystem involvement in coronavirus disease 2019 (COVID-19) is known since the beginning of the pandemic, and post-COVID-19 sequelae have often been reported. The term 'long Covid' encompasses these signs and symptoms. The aim of our study was to study different after-effects which patients endured within 12 months after recovery from acute COVID-19 and to study the various risk predictors. Methods This was a longitudinal observational study of a cohort of 146 patients who recovered from COVID-19 illness. Patients were enrolled during the first four weeks of the onset of their illness, and a monthly follow-up assessment was done for six months that included a detailed history of persistent or new symptoms, new illnesses diagnosed, and complete biochemical, pulmonary, cardiac, neurological and psychiatric evaluation, both objective and subjective. A final follow-up was also done at the end of one year of enrolment. Based on the patient's self-reported history and our multi-system assessment, recorded sequelae were classified according to the involved organ system. These were correlated with possible risk predictors and statistically significant associations were established. Results One hundred and twenty subjects out of 146 total subjects qualified for final analysis. Pulmonary sequelae (48/120; 40%) were the most followed by psychiatric (30/120; 25%), neurological (26/120; 21.7%), and opportunistic infections (7/120; 5.8%). A total of 39/120 (32.1%) cases complained of prolonged dyspnoea. Six out of 120 i.e. 5% of study participants had new-onset diabetes. Twenty-six out of 120 (21.7%) had radiological signs of pulmonary fibrosis. Patients with co-morbidities, older age, higher body mass index, and patients with severe disease were found to be at higher risk of developing these sequelae. Poor nutrition, female gender, and hospitalization were predictors of psychiatric sequelae. Diabetes and liberal steroid use during COVID-19 management were predictors of opportunistic fungal infections. Conclusion This study evaluated post-COVID-19 sequalae in-depth both objectively and subjectively. Some specific predictors for specific sequelae were confirmed on statistical correlation. Long-term follow-up of high-risk persons is therefore recommended after the cure of COVID-19.
背景 自新冠疫情开始以来，就已知2019冠状病毒病（COVID-19）会累及多系统，且经常有关于COVID-19后遗症的报道。“长新冠”一词涵盖了这些体征和症状。我们研究的目的是研究急性COVID-19康复后12个月内患者所经历的不同后遗症，并研究各种风险预测因素。方法 这是一项对146例从COVID-19疾病中康复的患者队列进行的纵向观察性研究。患者在发病后的前四周内入组，并进行了为期六个月的每月随访评估，包括持续或新出现症状的详细病史、新诊断的疾病，以及全面的生化、肺部、心脏、神经和精神评估，包括客观和主观评估。在入组一年结束时还进行了最终随访。根据患者的自我报告病史和我们的多系统评估，将记录的后遗症按照受累器官系统进行分类。将这些后遗症与可能的风险预测因素相关联，并建立了具有统计学意义的关联。结果 146名总受试者中有120名符合最终分析标准。肺部后遗症（48/120；40%）最为常见,其次是精神方面的（30/120；25%）、神经方面的（26/120；21.7%）和机会性感染（7/120；5.8%）。共有39/120（32.1%）例患者主诉呼吸困难持续时间延长。120名患者中有6名（即5%）出现新发糖尿病。120名患者中有26名（21.7%）有肺纤维化的影像学表现。发现患有合并症、年龄较大、体重指数较高以及患有重症的患者发生这些后遗症的风险更高。营养不良、女性性别和住院是精神后遗症的预测因素。糖尿病和COVID-19治疗期间大量使用类固醇是机会性真菌感染的预测因素。结论 本研究对COVID-19后遗症进行了深入的客观和主观评估。通过统计相关性确定了一些特定后遗症的特定预测因素。因此，建议在COVID-19治愈后对高危人群进行长期随访。
