Department of Radiation Oncology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
BMC Infect Dis. 2023 Oct 9;23(1):670. doi: 10.1186/s12879-023-08600-6.
With the World Health Organization (WHO) declaring an end to the COVID-19 pandemic, the focus has shifted to understanding and managing long-term post-infectious complications. "Long COVID," characterized by persistent or new onset symptoms extending beyond the initial phase of infection, is one such complication. This study aims to describe the incidence, clinical features and risk profile of long COVID among individuals in a South Indian cohort who experienced post-ChAdOx1 n-Cov-2 vaccine breakthrough infections.
A single-centre hospital-based prospective observational study was conducted from October to December 2021. The study population comprised adult patients (> 18 years) with a confirmed COVID-19 diagnosis who had received at least a single dose of vaccination. Data was collected using a specially tailored questionnaire at week 2, week 6, and week 12 post-negative COVID-19 test. A propensity score based predictive scoring system was developed to assess the risk of long COVID.
Among the 414 patients followed up in the study, 164 (39.6%) reported long COVID symptoms persisting beyond 6 week's post-infection. The presence of long COVID was significantly higher among patients above 65 years of age, and those with comorbidities such as Type II Diabetes Mellitus, hypertension, dyslipidemia, coronary artery disease, asthma, and cancer. Using backwards selection, a reduced model was developed, identifying age (OR 1.053, 95% CI 0.097-1.07, p < 0.001), hypertension (OR 2.59, 95% CI 1.46-4.59, p = 0.001), and bronchial asthma (OR 3.7176, 95% CI 1.24-11.12, p = 0.018) as significant predictors of long COVID incidence. A significant positive correlation was observed between the symptomatic burden and the number of individual comorbidities.
The significant presence of long COVID at 12 weeks among non-hospitalised patients underscores the importance of post-recovery follow-up to assess for the presence of long COVID. The predictive risk score proposed in this study may help identify individuals at risk of developing long COVID. Further research is needed to understand the impact of long COVID on patients' quality of life and the potential role of tailored rehabilitation programs in improving patient outcomes.
随着世界卫生组织（WHO）宣布 COVID-19 大流行结束，人们的关注点已转移到了解和管理感染后的长期并发症上。“长新冠”是一种持续或新出现的症状，在感染初始阶段后仍持续存在，是其中一种并发症。本研究旨在描述在经历 ChAdOx1 n-CoV-2 疫苗突破性感染的南印度队列中，个体出现长新冠的发生率、临床特征和风险特征。
这是一项于 2021 年 10 月至 12 月在单中心医院进行的前瞻性观察性研究。研究人群包括确诊 COVID-19 且至少接种过一剂疫苗的成年患者（>18 岁）。通过专门设计的问卷在 COVID-19 检测转为阴性后的第 2、6、12 周收集数据。采用基于倾向评分的预测评分系统来评估长新冠的风险。
在随访的 414 例患者中，有 164 例（39.6%）报告在感染后 6 周以上仍存在长新冠症状。长新冠的发生在 65 岁以上患者和合并 2 型糖尿病、高血压、血脂异常、冠心病、哮喘和癌症等疾病的患者中明显更高。采用向后选择，建立了一个简化模型，确定年龄（OR 1.053，95%CI 0.097-1.07，p<0.001）、高血压（OR 2.59，95%CI 1.46-4.59，p=0.001）和支气管哮喘（OR 3.7176，95%CI 1.24-11.12，p=0.018）是长新冠发生的显著预测因子。症状负担与单个合并症的数量之间存在显著的正相关。
在非住院患者中，12 周时长新冠的显著存在突显了对康复后进行长新冠评估的重要性。本研究提出的预测风险评分可能有助于识别发生长新冠的风险人群。需要进一步研究来了解长新冠对患者生活质量的影响以及针对康复计划在改善患者预后方面的潜在作用。
