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持续症状常见但无法工作罕见:对芬兰住院新冠患者的一年随访研究

Persisting symptoms common but inability to work rare: a one-year follow-up study of Finnish hospitalised COVID-19 patients.

作者信息

Lindahl Anna L, Aro Miia, Reijula Jere, Puolanne Mervi, Mäkelä Mika J, Vasankari Tuula

机构信息

Department of Pulmonology, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Finnish Lung Health Association (FILHA ry), Helsinki, Finland.

出版信息

Infect Dis (Lond). 2023 Dec;55(12):821-830. doi: 10.1080/23744235.2023.2244586. Epub 2023 Aug 10.

Abstract

BACKGROUND

Difficulties in recovery persisting for months have been reported in patients with severe COVID-19. Our aim was to investigate respiratory and overall recovery one year after hospital discharge.

METHODS

Finnish patients hospitalised due to COVID-19 during the first wave of the pandemic were recruited to a survey of symptoms, quality of life (RAND-36), work status, and health care use one year after hospital discharge. Patients with lung function test and chest x-ray results available from 3-6 months after hospital discharge underwent spirometry and a chest x-ray at one year.

RESULTS

Ninety-six patients responded to the one-year survey, 32 underwent spirometry and 32 a chest x-ray. Of those working full-time before COVID-19, median duration of sick leave was 40 days and 10% had not returned to work at one year. Health-care service use related to COVID-19 after discharge was reported by 79%, 50% using primary care, 34% occupational health care and 32% specialist care, respectively. Tiredness, fatigue, and physical difficulties increased in follow-up ( = 0.022-0.033). Quality of life did not change. Chest x-ray abnormalities decreased in follow-up, with an abnormal chest x-ray in 58% at 3-6 months and 25% at one year. A restrictive spirometry pattern was more common at one year (16 vs. 34%,  = 0.014).

CONCLUSIONS

Prolonged symptoms are common, some patients have decreased lung function, and a small minority of patients still have not returned to work one year after severe COVID-19. This calls for further research into the underlying causes and risk factors for prolonged recovery.

摘要

背景

据报道,重症新冠肺炎患者恢复数月仍存在困难。我们的目的是调查出院一年后患者的呼吸功能及整体恢复情况。

方法

招募在疫情第一波期间因新冠肺炎住院的芬兰患者,在出院一年后对其进行症状、生活质量(RAND-36量表)、工作状态及医疗保健使用情况的调查。出院后3至6个月有肺功能测试和胸部X光检查结果的患者,在一年时接受肺活量测定和胸部X光检查。

结果

96名患者回复了一年期调查,32名接受了肺活量测定,32名接受了胸部X光检查。在新冠肺炎之前全职工作的患者中,病假的中位时长为40天,10%的患者在一年时仍未恢复工作。79%的患者报告出院后使用了与新冠肺炎相关的医疗保健服务,其中50%使用初级保健,34%使用职业保健,32%使用专科护理。随访期间,疲劳、乏力和身体不适有所增加(P=0.022-0.033)。生活质量没有变化。随访期间胸部X光异常情况减少,出院后3至6个月时胸部X光异常的比例为58%,一年时为25%。一年时限制性肺活量测定模式更为常见(16%对34%,P=0.014)。

结论

症状持续时间延长很常见,一些患者肺功能下降,少数患者在重症新冠肺炎一年后仍未恢复工作。这需要进一步研究恢复时间延长的潜在原因和风险因素。

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