普通科门诊中 COVID-19 后症状的流行情况和预测因素 - 一项基于登记的全国性研究。
Prevalence and predictors of post-COVID-19 symptoms in general practice - a registry-based nationwide study.
机构信息
Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway.
Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway.
出版信息
BMC Infect Dis. 2023 Oct 25;23(1):721. doi: 10.1186/s12879-023-08727-6.
BACKGROUND
With Norwegian national registry data, we assessed the prevalence of post-COVID-19 symptoms at least 3 months after confirmed infection, and whether sociodemographic factors and pre-pandemic health problems were risk factors for these symptoms.
METHODS
All persons with a positive SARS-CoV-2 PCR test from February 2020 to February 2021 (exposed) were compared to a group without a positive test (unexposed) matched on age, sex, and country of origin. We used Cox regression to estimate hazard ratios (HR) for 18 outcome symptoms commonly described as post-COVID-19 related, registered by GPs. We compared relative risks (RR) for fatigue, memory disturbance, or shortness of breath among exposed and unexposed using Poisson regression models, assessing sex, age, education, country of origin, and pre-pandemic presence of the same symptom and comorbidity as possible risk factors, with additional analyses to assess hospitalisation for COVID-19 as a risk factor among exposed.
RESULTS
The exposed group (N = 53 846) had a higher prevalence of most outcome symptoms compared to the unexposed (N = 485 757), with the highest risk for shortness of breath (HR 2.75; 95%CI 2.59-2.93), fatigue (2.08; 2.00-2.16) and memory disturbance (1.41;1.26-1.59). High HRs were also found for disturbance of smell/taste and hair loss, but frequencies were low. Concerning risk factors, sociodemographic factors were at large similarly associated with outcome symptoms in both groups. Registration of the outcome symptom before the pandemic increased the risk for fatigue, memory disturbance and shortness of breath after COVID-19, but these associations were weaker among exposed. Comorbidity was not associated with fatigue and shortness of breath in the COVID-19 group. For memory disturbance, the RR was slightly increased with the higher comorbidity score both among exposed and unexposed.
CONCLUSION
COVID-19 was associated with a range of symptoms lasting more than three months after the infection.
背景
利用挪威国家登记数据，我们评估了至少在确诊感染后 3 个月时出现的新冠后症状的流行率，以及社会人口学因素和大流行前健康问题是否是这些症状的危险因素。
方法
将 2020 年 2 月至 2021 年 2 月间所有 SARS-CoV-2 PCR 检测阳性者（暴露组）与一组未检测到阳性者（对照组）进行比较，匹配年龄、性别和原籍国。我们使用 Cox 回归估计 18 种常见的新冠后症状的风险比（HR），这些症状由全科医生登记。我们使用泊松回归模型比较暴露组和对照组中疲劳、记忆障碍或呼吸急促的相对风险（RR），评估性别、年龄、教育程度、原籍国以及大流行前是否存在相同症状和合并症作为可能的危险因素，还进行了进一步分析以评估新冠住院治疗是否是暴露组的危险因素。
结果
与对照组（n=485757）相比，暴露组（n=53846）出现大多数结局症状的比例更高，呼吸急促的风险最高（HR 2.75；95%CI 2.59-2.93）、疲劳（2.08；2.00-2.16）和记忆障碍（1.41；1.26-1.59）。嗅觉/味觉障碍和脱发的 HR 也很高，但频率较低。关于危险因素，社会人口学因素在两组中与结局症状的相关性大致相似。大流行前登记的结局症状增加了新冠后疲劳、记忆障碍和呼吸急促的风险，但在暴露组中这些关联较弱。合并症与新冠组的疲劳和呼吸急促无关。对于记忆障碍，在暴露组和对照组中，随着更高的合并症评分，RR 略有增加。
结论
新冠感染与感染后超过三个月的一系列症状有关。
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