未满足社会需求的患者患严重长期 COVID-19 症状和神经精神后遗症的风险更高。

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela.

机构信息

Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.

Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.

出版信息

Sci Rep. 2024 Apr 2;14(1):7743. doi: 10.1038/s41598-024-58430-y.

DOI:10.1038/s41598-024-58430-y

PMID:38565574

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10987523/

Abstract

This study investigated long COVID of patients in the Montefiore Health System COVID-19 (CORE) Clinics in the Bronx with an emphasis on identifying health related social needs (HRSNs). We analyzed a cohort of 643 CORE patients (6/26/2020-2/24/2023) and 52,089 non-CORE COVID-19 patients. Outcomes included symptoms, physical, emotional, and cognitive function test scores obtained at least three months post-infection. Socioeconomic variables included median incomes, insurance status, and HRSNs. The CORE cohort was older age (53.38 ± 14.50 vs. 45.91 ± 23.79 years old, p < 0.001), more female (72.47% vs. 56.86%, p < 0.001), had higher prevalence of hypertension (45.88% vs. 23.28%, p < 0.001), diabetes (22.86% vs. 13.83%, p < 0.001), COPD (7.15% vs. 2.28%, p < 0.001), asthma (25.51% vs. 12.66%, p < 0.001), lower incomes (53.81% vs. 43.67%, 1 quintile, p < 0.001), and more unmet social needs (29.81% vs. 18.49%, p < 0.001) compared to non-CORE COVID-19 survivors. CORE patients reported a wide range of severe long-COVID symptoms. CORE patients with unmet HRSNs experienced more severe symptoms, worse ESAS-r scores (tiredness, wellbeing, shortness of breath, and pain), PHQ-9 scores (12.5 (6, 17.75) vs. 7 (2, 12), p < 0.001), and GAD-7 scores (8.5 (3, 15) vs. 4 (0, 9), p < 0.001) compared to CORE patients without. Patients with unmet HRSNs experienced worse long-COVID outcomes compared to those without.

摘要

这项研究调查了在布朗克斯的蒙蒂菲奥里健康系统 COVID-19（CORE）诊所接受治疗的长新冠患者的健康相关社会需求（HRSN），并重点关注识别这些需求。我们分析了一个由 643 名 CORE 患者（2020 年 6 月 26 日至 2023 年 2 月 24 日）和 52,089 名非 CORE COVID-19 患者组成的队列。研究结果包括感染至少三个月后获得的症状、身体、情绪和认知功能测试分数。社会经济变量包括中位数收入、保险状况和 HRSN。CORE 队列的年龄较大（53.38 ± 14.50 岁比 45.91 ± 23.79 岁，p < 0.001），女性比例更高（72.47%比 56.86%，p < 0.001），高血压患病率更高（45.88%比 23.28%，p < 0.001）、糖尿病（22.86%比 13.83%，p < 0.001）、COPD（7.15%比 2.28%，p < 0.001）、哮喘（25.51%比 12.66%，p < 0.001），收入较低（53.81%比 43.67%，1 个五分位数，p < 0.001），未满足的社会需求较多（29.81%比 18.49%，p < 0.001）。与非 CORE COVID-19 幸存者相比，CORE 患者报告了广泛的严重长新冠症状。未满足 HRSN 的 CORE 患者经历了更严重的症状、更差的 ESAS-r 评分（疲劳、幸福感、呼吸急促和疼痛）、PHQ-9 评分（12.5（6，17.75）比 7（2，12），p < 0.001）和 GAD-7 评分（8.5（3，15）比 4（0，9），p < 0.001）。与未满足 HRSN 的 CORE 患者相比，满足 HRSN 的患者经历了更差的长新冠结局。