Department of Research and Education, Ciro, Horn, The Netherlands
Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Thorax. 2024 Apr 15;79(5):457-464. doi: 10.1136/thorax-2023-220504.
To assess health and activities of daily living (ADL) in SARS-CoV-2-positive adults with and without post-COVID-19 condition (PCC) and compare this with negative tested individuals. Furthermore, different PCC case definitions were compared with SARS-CoV-2-negative individuals.
All adults tested PCR positive for SARS-CoV-2 at the Public Health Service South Limburg (Netherlands) between June 2020 and November 2021 (n=41 780) and matched PCR negative individuals (2:1, on age, sex, year-quarter test, municipality; n=19 875) were invited by email. Health (five-level EuroQol five-dimension (EQ5D) index and EuroQol visual analogue scale (EQVAS)) and ADL impairment were assessed. PCC classification was done using the WHO case definition and five other common definitions.
In total, 8409 individuals (6381 SARS-CoV-2 positive; 53±15 years; 57% female; 9 (7-11) months since test) were included. 39.4% of positives had PCC by the WHO case definition (EQVAS: 71±20; EQ5D index: 0.800±0.191; ADL impairment: 30 (10-70)%) and perceived worse health and more ADL impairment than negatives, that is, difference of -8.50 points (95% CI -9.71 to -7.29; p<0.001) for EQVAS, which decreased by 1.49 points (95% CI 0.86 to 2.12; p<0.001) in individuals with PCC for each comorbidity present, and differences of -0.065 points (95% CI -0.074 to -0.056; p<0.001) for EQ5D index, and +16.72% (95% CI 15.01 to 18.43; p<0.001) for ADL impairment. Health and ADL impairment were similar in negatives and positives without PCC. Replacing the WHO case definition with other PCC definitions yielded comparable results.
Individuals with PCC have substantially worse health and more ADL impairment than negative controls, irrespective of the case definition. Authorities should inform the public about the associated burden of PCC and enable adequate support.
评估 SARS-CoV-2 阳性成年人中伴有和不伴有新冠后疾病（PCC）的健康状况和日常生活活动能力（ADL），并将其与新冠检测阴性个体进行比较。此外，还比较了不同的 PCC 病例定义与 SARS-CoV-2 阴性个体的比较。
所有在 2020 年 6 月至 2021 年 11 月期间在南林堡公共卫生服务（荷兰）PCR 检测 SARS-CoV-2 阳性的成年人（n=41780）和年龄、性别、季度检测、市匹配的 2:1PCR 阴性个体（n=19875）均收到电子邮件邀请。评估健康状况（五个级别的欧洲五维健康量表（EQ5D）指数和 EQ 视觉模拟量表（EQVAS））和 ADL 损伤情况。使用世界卫生组织病例定义和其他五个常见定义对 PCC 进行分类。
共有 8409 人（6381 例 SARS-CoV-2 阳性；53±15 岁；57%为女性；检测后 9（7-11）个月）入组。根据世界卫生组织病例定义，39.4%的阳性患者患有 PCC（EQVAS：71±20；EQ5D 指数：0.800±0.191；ADL 损伤：30（10-70）%），且自我报告的健康状况和 ADL 损伤程度比阴性患者更差，即 EQVAS 差 8.50 分（95%CI-9.71 至-7.29；p<0.001），且每存在一种合并症，EQVAS 降低 1.49 分（95%CI 0.86 至 2.12；p<0.001），EQ5D 指数差 0.065 分（95%CI-0.074 至-0.056；p<0.001），ADL 损伤增加 16.72%（95%CI 15.01 至 18.43；p<0.001）。阴性患者和无 PCC 的阳性患者的健康状况和 ADL 损伤相似。用其他 PCC 定义替代世界卫生组织病例定义，结果相似。
无论采用哪种病例定义，患有 PCC 的患者的健康状况和 ADL 损伤程度均明显差于阴性对照者。有关部门应告知公众 PCC 的相关负担，并提供适当的支持。
