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慢性药物使用增加与多重用药——新冠疫情对公共卫生保健的多方面负担

Increase in Chronic Medications and Polypharmacy-The Multifaceted Burden of COVID-19 Disease on Public Health Care.

作者信息

Gallo Antonella, Covino Marcello, Lipari Alice, Pellegrino Simona, Ibba Francesca, Agnitelli Maria Chiara, Tosato Matteo, Landi Francesco, Montalto Massimo

机构信息

Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy.

Department of Emergency Medicine, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy.

出版信息

J Pers Med. 2023 Aug 28;13(9):1321. doi: 10.3390/jpm13091321.

Abstract

The long-term impact of COVID-19 disease is becoming a major global concern. In this retrospective monocentric analysis, we included consecutive subjects admitted to our COVID-19 Post-Acute Care Service for a SARS-CoV-2 infection that occurred between three and twelve months before. A home medication list relative to the period before SARS-CoV-2 infection (baseline) was recorded and compared with that one relative to the time of outpatient visit (follow-up). Drugs were coded according to the Anatomical Therapeutic Chemical Classification (ATC) System. In a total of 2007 subjects, at follow-up, a significant increase with respect to baseline was reported in the total median number of chronic medications (two [0-4] vs. one [0-3]) and in specific ATC-group drugs involving the alimentary, blood, cardiovascular, genitourinary, muscle-skeletal, nervous and respiratory systems. In a multivariate analysis, COVID-19 disease severity and age > 65 years resulted in the best predictors for an increase in the number of medications, while anti-SARS-CoV-2 vaccination played a significant protective role. The long-term care of patients infected by COVID-19 may be more complex than reported so far. Multidisciplinary and integrated care pathways should be encouraged, mainly in older and frailer subjects and for patients experiencing a more severe disease. Vaccination may also represent a fundamental protection against long-term sequelae.

摘要

新冠病毒疾病的长期影响正成为全球主要关注点。在这项回顾性单中心分析中,我们纳入了连续收治到我们新冠病毒感染后急性护理服务中心的患者,这些患者在三至十二个月前感染了严重急性呼吸综合征冠状病毒2(SARS-CoV-2)。记录了与SARS-CoV-2感染前时期(基线)相关的家庭用药清单,并将其与门诊就诊时(随访)的用药清单进行比较。药物根据解剖治疗化学分类(ATC)系统进行编码。在总共2007名受试者中,随访时报告慢性药物总中位数数量(两份[0 - 4]对比一份[0 - 3])以及涉及消化、血液、心血管、泌尿生殖、肌肉骨骼、神经和呼吸系统的特定ATC组药物与基线相比有显著增加。在多变量分析中,新冠病毒疾病严重程度和年龄大于65岁是药物数量增加的最佳预测因素,而接种抗SARS-CoV-2疫苗起到了显著的保护作用。新冠病毒感染患者的长期护理可能比迄今报道的更为复杂。应鼓励采用多学科和综合护理路径,主要针对老年和体弱患者以及患有更严重疾病的患者。接种疫苗也可能是预防长期后遗症的一项基本保护措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2244/10532441/14b8374af46d/jpm-13-01321-g001.jpg

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