Centre d'Atenció Primària Les Indianes, Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.
Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
BMC Infect Dis. 2024 Jan 15;24(1):82. doi: 10.1186/s12879-023-08954-x.
Around 10% of people infected by SARS-COV-2 report symptoms that persist longer than 3 months. Little has been reported about sex differences in symptoms and clustering over time of non-hospitalised patients in primary care settings.
This is a descriptive study of a cohort of mainly non-hospitalized patients with a persistence of symptoms longer than 3 months from the clinical onset in co-creation with the Long Covid Catalan affected group using an online survey. Recruitment was from March 2020 to June 2021. Exclusion criteria were being admitted to an ICU, < 18 years of age and not living in Catalonia. We focused on 117 symptoms gathered in 18 groups and performed cluster analysis over the first 21 days of infection, at 22-60 days, and ≥ 3 months.
We analysed responses of 905 participants (80.3% women). Median time between symptom onset and the questionnaire response date was 8.7 months. General symptoms (as fatigue) were the most prevalent with no differences by sex, age, or wave although its frequency decreased over time (from 91.8 to 78.3%). Dermatological (52.1% in women, 28.5% in men), olfactory (34.9% women, 20.9% men) and neurocognitive symptoms (70.1% women, 55.8% men) showed the greatest differences by sex. Cluster analysis showed five clusters with a predominance of Taste & smell (24.9%) and Multisystemic clusters (26.5%) at baseline and _Multisystemic (34.59%) and Heterogeneous (24.0%) at ≥3 months. The Multisystemic cluster was more prevalent in men. The Menstrual cluster was the most stable over time, while most transitions occurred from the Heterogeneous cluster to the Multisystemic cluster and from Taste & smell to Heterogeneous.
General symptoms were the most prevalent in both sexes at three-time cut-off points. Major sex differences were observed in dermatological, olfactory and neurocognitive symptoms. The increase of the Heterogeneous cluster might suggest an adaptation to symptoms or a non-specific evolution of the condition which can hinder its detection at medical appointments. A carefully symptom collection and patients' participation in research may generate useful knowledge about Long Covid presentation in primary care settings.
大约 10%的 SARS-CoV-2 感染者报告的症状持续时间超过 3 个月。关于在初级保健环境中非住院患者的症状和随时间聚类的性别差异，报道甚少。
这是一项与长新冠加泰罗尼亚患者群体共同合作，对主要为非住院患者的队列进行的描述性研究，这些患者的症状持续时间从临床发病开始超过 3 个月。使用在线调查进行招募，招募时间为 2020 年 3 月至 2021 年 6 月。排除标准为入住 ICU、年龄<18 岁和不在加泰罗尼亚居住。我们关注的是 18 组中收集的 117 种症状，并在感染的前 21 天、22-60 天和≥3 个月时进行聚类分析。
我们分析了 905 名参与者（80.3%为女性）的回复。症状出现与问卷调查回复日期之间的中位数时间为 8.7 个月。一般症状（如疲劳）最为常见，且无性别、年龄或波次差异，但其频率随时间降低（从 91.8%降至 78.3%）。皮肤科症状（女性 52.1%，男性 28.5%）、嗅觉症状（女性 34.9%，男性 20.9%）和神经认知症状（女性 70.1%，男性 55.8%）的性别差异最大。聚类分析显示，基线时有五个聚类，以味觉和嗅觉（24.9%）和多系统聚类（26.5%）为主，≥3 个月时有以多系统聚类（34.59%）和异质性聚类（24.0%）为主。男性中多系统聚类更为常见。月经周期是最稳定的，而大多数转换发生在异质性聚类到多系统聚类，以及味觉和嗅觉到异质性聚类。
在三个时间点的截止值，一般症状在两性中最为常见。在皮肤科、嗅觉和神经认知症状方面观察到主要的性别差异。异质性聚类的增加可能表明对症状的适应或病情的非特异性演变，这可能会阻碍在医疗预约中对其的检测。仔细的症状收集和患者参与研究可能会产生关于初级保健环境中长新冠表现的有用知识。
