Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Clinical Study Center, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.
BMC Public Health. 2023 Aug 21;23(1):1587. doi: 10.1186/s12889-023-16524-8.
Most of the previous studies on health sequelae of COVID-19 are uncontrolled cohorts and include a relatively short follow-up. This population-based multi-center cohort study examined health consequences among individuals about 1 to 1.5 years after SARS-CoV-2 infection compared with non-infected.
The study population consisted of adults (≥ 18 years) from four municipalities particularly affected by the COVID-19 pandemic in the year 2020 who completed a detailed follow-up questionnaire on health-related topics. Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (May to December 2020). Outcomes assessed at follow-up (October 2021 to January 2022; mean: 452 days) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health, and subjective memory impairment. Logistic and linear regression models were adjusted for baseline sociodemographic and lifestyle characteristics (age, sex, municipality, education, smoking, body mass index), pre-existing health conditions (chronic disease/health problem, health-related activity limitation, depressive/anxiety disorder), and follow-up time.
Among 4817 participants, 350 had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Those with an infection statistically significantly more often reported 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (12.8% vs. 3.4%, OR 4.11), shortness of breath (23.0% vs. 9.5%, 3.46), pain when breathing (4.7% vs. 1.9%, 2.36), fatigue (36.9% vs. 26.1%, 1.76), weakness in legs (12.8% vs. 7.8%, 1.93), myalgia/joint pain (21.9% vs. 15.1%, 1.53) and cough (30.8% vs. 24.8%, 1.34) and 3 out of 6 groups of incident diseases: liver/kidney (2.7% vs. 0.9%, 3.70), lung (3.2% vs. 1.1%, 3.50) and cardiovascular/metabolic (6.5% vs. 4.0%, 1.68) diseases. Those with an infection were significantly more likely to report poor subjective health (19.3% vs. 13.0%, 1.91), memory impairment (25.7% vs. 14.3%, 2.27), and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected.
Even after more than one year, individuals with SARS-CoV-2 infection showed an increased risk of various health complaints, functional limitations, and worse subjective well-being, pointing toward profound health consequences of SARS-CoV-2 infection relevant for public health.
大多数关于 COVID-19 健康后遗症的先前研究都是未对照的队列研究，随访时间相对较短。这项基于人群的多中心队列研究调查了 2020 年 COVID-19 大流行期间四个直辖市的成年人（≥18 岁）在 SARS-CoV-2 感染后约 1 至 1.5 年的健康后果，与未感染者相比。
研究人群包括来自四个直辖市的成年人（≥18 岁），他们在 2020 年特别受到 COVID-19 大流行的影响，完成了一份关于健康相关主题的详细随访问卷。暴露是 SARS-CoV-2 感染状况（基于 IgG 抗体、PCR 检测或 COVID-19 医生诊断）基线（2020 年 5 月至 12 月）。在随访中评估的结局（2021 年 10 月至 2022 年 1 月；平均：452 天）包括复发性或持续性健康投诉、新发病例、健康相关生活质量（PROMIS-29）、主观健康和主观记忆障碍。逻辑回归和线性回归模型调整了基线社会人口统计学和生活方式特征（年龄、性别、直辖市、教育、吸烟、体重指数）、预先存在的健康状况（慢性疾病/健康问题、健康相关活动受限、抑郁/焦虑障碍）和随访时间。
在 4817 名参与者中，350 人在基线时有 SARS-CoV-2 感染，4467 人在基线或随访期间没有感染或感染。感染的人在随访时更经常报告 18 项复发性或持续性健康投诉中的 7 项：嗅觉/味觉障碍（12.8%对 3.4%，OR 4.11）、呼吸急促（23.0%对 9.5%，3.46）、呼吸时疼痛（4.7%对 1.9%，2.36）、疲劳（36.9%对 26.1%，1.76）、腿部无力（12.8%对 7.8%，1.93）、肌肉疼痛/关节疼痛（21.9%对 15.1%，1.53）和咳嗽（30.8%对 24.8%，1.34）以及 6 组新发疾病中的 3 组：肝脏/肾脏（2.7%对 0.9%，3.70）、肺部（3.2%对 1.1%，3.50）和心血管/代谢（6.5%对 4.0%，1.68）疾病。感染的人更有可能报告较差的主观健康（19.3%对 13.0%，1.91）、记忆障碍（25.7%对 14.3%，2.27）和疲劳和身体功能领域的 PROMIS-29 平均得分更差。
即使在一年多之后，SARS-CoV-2 感染的人仍表现出各种健康投诉、功能障碍和较差的主观幸福感的风险增加，这表明 SARS-CoV-2 感染对公共卫生具有深远的健康影响。
