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SARS-CoV-2 感染期间和感染后肌肉骨骼疼痛及医疗保健利用情况:一项横断面研究。

Musculoskeletal pain during and after SARS-CoV-2 infection and healthcare utilization: a cross-sectional study.

机构信息

Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.

Anhanguera Faculty, Rio Grande, Rio Grande do Sul, Brazil.

出版信息

BMC Musculoskelet Disord. 2023 Aug 29;24(1):685. doi: 10.1186/s12891-023-06794-z.

Abstract

BACKGROUND

The COVID-19 pandemic necessitated the reorganization of health services to cater to the needs of individuals affected by the virus.

OBJECTIVE

This study aimed to examine the association between musculoskeletal pain during and after SARS-CoV-2 infection and the utilization of health services among adults in southern Brazil.  METHODS: A cross-sectional study was conducted with individuals aged 18 years and older, who were diagnosed with COVID-19 between December 2020 and March 2021. Questionnaires were electronically collected using tablets through the REDCap platform via phone calls. The health service utilization outcomes assessed included Primary Health Care, general practitioners, private emergency care, and specialized services. The exposure variable was the presence of musculoskeletal pain during and after SARS-CoV-2 infection in different regions, such as cervical, upper limbs, thoracic, lumbar, and lower limbs. Poisson regression analysis was employed to assess the relationship between health service utilization during and after SARS-CoV-2 infection and musculoskeletal pain during and after the infection with SARS-CoV-2 among adults in southern Brazil. Data were analyzed using the Stata 16.1 statistical package.  RESULTS: A total of 2,919 individuals were interviewed. Overall, individuals with musculoskeletal pain were found to utilize health services approximately 15 percentage points higher when compared to those without musculoskeletal pain. In adjusted analysis, individuals who reported musculoskeletal pain during and after SARS-CoV-2 infection were up to twice as likely to use health services. Among them, the emergency care unit was the most frequently used service, particularly in those with pain in the lower limbs (RP=2.19, 95% CI 1.66-2.87) and thoracic region (RP=2.04, 95% CI 1.47-2.84). Notably, the highest magnitudes of association were observed with emergency care units, specialist doctors, and specialized services, especially neurologists, who were two to three times more likely to be sought, followed by pulmonologists.  CONCLUSION: Health service utilization was significantly associated with musculoskeletal pain during and after SARS-CoV-2 infection. All regions, except for the cervical region, showed a correlation with the use of Primary Health Care. The thoracic region featured an association with pulmonologists and emergency room utilization. Additionally, health services like emergency care units, specialist doctors, and specialized services, including cardiologists and neurologists, were commonly utilized across all regions in southern Brazil.

摘要

背景

COVID-19 大流行促使医疗服务进行重组,以满足受病毒影响人群的需求。

目的

本研究旨在探讨巴西南部成年人在感染 SARS-CoV-2 期间和之后出现肌肉骨骼疼痛与卫生服务利用之间的关系。

方法

本横断面研究纳入了 2020 年 12 月至 2021 年 3 月期间被诊断为 COVID-19 的 18 岁及以上成年人。通过电话使用平板电脑通过 REDCap 平台在线收集问卷。评估的卫生服务利用结果包括初级保健、全科医生、私人急诊护理和专科服务。暴露变量是 SARS-CoV-2 感染期间和之后不同部位(如颈部、上肢、胸部、腰部和下肢)的肌肉骨骼疼痛。采用泊松回归分析评估巴西南部成年人在感染 SARS-CoV-2 期间和之后出现肌肉骨骼疼痛与感染 SARS-CoV-2 期间和之后利用卫生服务之间的关系。使用 Stata 16.1 统计软件包进行数据分析。

结果

共访谈了 2919 人。总体而言,与无肌肉骨骼疼痛者相比,有肌肉骨骼疼痛者使用卫生服务的比例约高 15 个百分点。在调整分析中,报告在感染 SARS-CoV-2 期间和之后出现肌肉骨骼疼痛的个体使用卫生服务的可能性增加了近两倍。其中,急诊是最常用的服务,尤其是下肢(RR=2.19,95%CI 1.66-2.87)和胸部(RR=2.04,95%CI 1.47-2.84)疼痛者。值得注意的是,与急诊、专科医生和专科服务(尤其是神经科医生)的关联幅度最大,这些医生被寻求的可能性是普通医生的两到三倍,其次是肺病专家。

结论

卫生服务利用与 SARS-CoV-2 感染期间和之后的肌肉骨骼疼痛显著相关。除颈部区域外,所有区域均与初级保健利用相关。胸部区域与肺病专家和急诊室的使用相关。此外,巴西南部所有地区都普遍使用了急诊、专科医生和专科服务(包括心脏病专家和神经科医生)。

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