Clinic of Pulmonology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye.
Clinical Psychology, Neurovia Neuropsychiatry Clinic, İstanbul, Türkiye.
Tuberk Toraks. 2023 Dec;71(4):378-389. doi: 10.5578/tt.20239606.
While there is sufficient information about acute COVID-19, which can cause a multisystemic and fatal disease, post-COVID syndrome and risk factors for this condition remain poorly known. We aimed to identify postCOVID symptoms and risk factors for chronic post-COVID syndrome through this study.
This prospective cross-sectional study was conducted on 254 out of 384 COVID-19 patients admitted to our COVID-19 polyclinic between February and April 2021. The patients were questioned with a list of 37 symptoms at the fifth and twelfth weeks after disease onset via phone review, and their acute post-COVID (APC) and chronic post-COVID (CPC) symptoms were recorded. Data on risk factors were collected from the hospital's medical records system. Associations between symptom count in the CPC phase and age, sex, hospitalization, RT-PCR result, specific radiological findings, comorbidities, and long-term medications were evaluated.
Two hundred twenty-one patients had APC symptoms, and 138 patients had CPC symptoms. While the most common symptom was fatigue at week five, it was hair loss at week 12. Symptoms were observed significantly less in the CPC phase than in the APC phase (Z= -12.301, p= 0.00). Female sex and the presence of specific radiological findings were significantly associated with the occurrence of CPC symptoms (p= 0.03, p= 0.00, respectively). Long-term use of angiotensin-2 receptor blockers (ARBs) was correlated with a low symptom count in the CPC phase (p= 0.00).
Female sex and the presence of specific radiological findings were risk factors for developing CPC. Long-term use of ARBs was associated with a low chronic post-COVID symptom burden. A substantial cluster of multisystemic symptoms was observed in both phases, and this condition highlights the requirement for customized outpatient management that includes long-term follow-up and treatment of COVID-19 patients. Identifying the high-risk patients that will develop persistent symptoms can guide this management.
虽然有足够的信息可以了解急性 COVID-19，这种疾病可能会导致多系统疾病和致命疾病，但 COVID-19 后综合征及其发病风险因素仍知之甚少。我们旨在通过这项研究确定 COVID-19 后综合征的症状和发病风险因素。
这项前瞻性的横断面研究在 2021 年 2 月至 4 月期间在我们的 COVID-19 综合诊所收治的 384 例 COVID-19 患者中进行，其中 254 例纳入研究。通过电话回顾，在疾病发病后第 5 周和第 12 周，使用 37 项症状清单对患者进行询问，并记录他们的急性 COVID-19 后（APC）和慢性 COVID-19 后（CPC）症状。从医院的病历系统中收集风险因素数据。评估 CPC 期症状计数与年龄、性别、住院、RT-PCR 结果、特定放射学发现、合并症和长期用药之间的关系。
221 例患者有 APC 症状，138 例患者有 CPC 症状。虽然第五周最常见的症状是疲劳，但第 12 周是脱发。CPC 期的症状明显少于 APC 期（Z= -12.301，p= 0.00）。女性性别和特定放射学发现与 CPC 症状的发生显著相关（p= 0.03，p= 0.00，分别）。长期使用血管紧张素-2 受体阻滞剂（ARBs）与 CPC 期症状计数低相关（p= 0.00）。
女性性别和特定放射学发现是发生 CPC 的风险因素。长期使用 ARBs 与慢性 COVID-19 后症状负担低相关。在两个阶段都观察到了大量的多系统症状，这一情况强调了需要对 COVID-19 患者进行定制的门诊管理，包括长期随访和治疗。识别出可能持续存在症状的高风险患者，可以指导这种管理。
