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新冠长期症状的临床和健康结局:一项系统性综述

Long-COVID-19 clinical and health outcomes: an umbrella review.

作者信息

Li Hu, Xia Jin, Bennett Dimitri, Roque Fatima, Bam Rujuta A, Tavares Ana Bárbara Tadeu, Gokhale Mugdha, Ida Fidelia, Rhee Jinnie Jiwon, Soriano Gabarro Montse, Song Yiqing

机构信息

Gilead Sciences Inc., 333 Lakeside Drive, Foster City, CA 94404, USA.

Takeda Development Center Americas, Inc., Cambridge, MA, USA.

出版信息

Ther Adv Infect Dis. 2023 Sep 13;10:20499361231198335. doi: 10.1177/20499361231198335. eCollection 2023 Jan-Dec.

Abstract

BACKGROUND

A growing interest in long-term sequelae of COVID-19 has prompted several systematic literature reviews (SLRs) to evaluate long-COVID-19 effects. However, many of these reviews lack in-depth information on the timing, duration, and severity of these conditions.

OBJECTIVES

Our aim was to synthesize both qualitative and quantitative evidence on prevalence and outcomes of long-term effect of COVID-19 through an umbrella review.

DESIGN

Umbrella review of relevant SLRs on long-COVID-19 in terms of prolonged symptoms and clinical conditions, and comprehensively synthesized the latest existing evidence.

DATA SOURCES AND METHODS

We systematically identified and appraised prior systematic reviews/meta-analyses using MEDLINE, Embase, and Cochrane database of systematic review from 2020 to 2021 following the preferred reporting items for systematic reviews and meta-analyses guidance. We summarized and categorized all relevant clinical symptoms and outcomes in adults with COVID-19 using the Medical Dictionary for Regulatory Activities System Organ Class (MedDRA SOC).

RESULTS

We identified 967 systematic reviews/meta-analyses; 36 were retained for final data extraction. The most prevalent SOC were social circumstances (40%), blood and lymphatic system disorders (39%), and metabolism and nutrition disorder (38%). The most frequently reported SOC outcomes within each MedDRA category were poor quality of life (59%), wheezing and dyspnea (19-49%), fatigue (30-64%), chest pain (16%), decreased or loss of appetite (14-17%), abdominal discomfort or digestive disorder (12-18%), arthralgia with or without myalgia (16-24%), paresthesia (27%) and hair loss (14-25%), and hearing loss or tinnitus (15%).

CONCLUSION

This study confirmed a high prevalence of several long COVID-19 outcomes according to the MedDRA categories and indicated that the majority of evidence was rated as moderate to low.

REGISTRATION

The review was registered at PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022303557).

摘要

背景

对新冠病毒病(COVID-19)长期后遗症的兴趣日益浓厚,促使进行了多项系统文献综述(SLR)来评估新冠长期症状。然而,其中许多综述缺乏关于这些病症的发生时间、持续时间和严重程度的深入信息。

目的

我们的目的是通过一项综合性综述,综合关于COVID-19长期影响的患病率和结局的定性和定量证据。

设计

对关于新冠长期症状和临床病症的相关SLR进行综合性综述,并全面综合最新的现有证据。

数据来源和方法

我们按照系统综述和Meta分析的首选报告项目指南,使用MEDLINE、Embase和Cochrane系统综述数据库,系统地识别和评估2020年至2021年之前的系统综述/Meta分析。我们使用《监管活动医学词典系统器官分类》(MedDRA SOC)对所有患有COVID-19的成年人的相关临床症状和结局进行总结和分类。

结果

我们识别出967项系统综述/Meta分析;36项被保留用于最终数据提取。最常见的SOC是社会情况(40%)、血液和淋巴系统疾病(39%)以及代谢和营养紊乱(38%)。每个MedDRA类别中最常报告的SOC结局是生活质量差(59%)、喘息和呼吸困难(19 - 49%)、疲劳(30 - 64%)、胸痛(16%)、食欲减退或丧失(14 - 17%)、腹部不适或消化系统疾病(12 - 18%)、伴或不伴肌痛的关节痛(16 - 24%)、感觉异常(27%)和脱发(14 - 25%)以及听力损失或耳鸣(15%)。

结论

本研究根据MedDRA类别证实了几种新冠长期症状的高患病率,并表明大多数证据的评级为中等至低等。

注册

该综述已在国际前瞻性系统综述注册库(PROSPERO)(https://www.crd.york.ac.uk/prospero/)注册(CRD42022303557)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7fd/10501084/3141899ec655/10.1177_20499361231198335-fig2.jpg

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