新冠后综合征患病率：系统评价和荟萃分析。

BACKGROUND: Since the Coronavirus disease 2019 (COVID-19) pandemic began, the number of individuals recovering from COVID-19 infection have increased. Post-COVID Syndrome, or PCS, which is defined as signs and symptoms that develop during or after infection in line with COVID-19, continue beyond 12 weeks, and are not explained by an alternative diagnosis, has also gained attention. We systematically reviewed and determined the pooled prevalence estimate of PCS worldwide based on published literature. METHODS: Relevant articles from the Web of Science, Scopus, PubMed, Cochrane Library, and Ovid MEDLINE databases were screened using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic search process. The included studies were in English, published from January 2020 to April 2024, had overall PCS prevalence as one of the outcomes studied, involved a human population with confirmed COVID-19 diagnosis and undergone assessment at 12 weeks post-COVID infection or beyond. As the primary outcome measured, the pooled prevalence of PCS was estimated from a meta-analysis of the PCS prevalence data extracted from individual studies, which was conducted via the random-effects model. This study has been registered on PROSPERO (CRD42023435280). RESULTS: Forty eight studies met the eligibility criteria and were included in this review. 16 were accepted for meta-analysis to estimate the pooled prevalence for PCS worldwide, which was 41.79% (95% confidence interval [CI] 39.70-43.88%, I = 51%, p = 0.03). Based on different assessment or follow-up timepoints after acute COVID-19 infection, PCS prevalence estimated at ≥ 3rd, ≥ 6th, and ≥ 12th months timepoints were each 45.06% (95% CI: 41.25-48.87%), 41.30% (95% CI: 34.37-48.24%), and 41.32% (95% CI: 39.27-43.37%), respectively. Sex-stratified PCS prevalence was estimated at 47.23% (95% CI: 44.03-50.42%) in male and 52.77% (95% CI: 49.58-55.97%) in female. Based on continental regions, pooled PCS prevalence was estimated at 46.28% (95% CI: 39.53%-53.03%) in Europe, 46.29% (95% CI: 35.82%-56.77%) in America, 49.79% (95% CI: 30.05%-69.54%) in Asia, and 42.41% (95% CI: 0.00%-90.06%) in Australia. CONCLUSION: The prevalence estimates in this meta-analysis could be used in further comprehensive studies on PCS, which might enable the development of better PCS management plans to reduce the effect of PCS on population health and the related economic burden.

背景：自 2019 年冠状病毒病（COVID-19）大流行开始以来，感染 COVID-19 后康复的人数有所增加。“新冠后综合征”（PCS），即与 COVID-19 相符的感染期间或之后出现的症状和体征，并持续超过 12 周，且无法用其他诊断来解释，也引起了关注。我们系统地回顾了全球基于已发表文献的 PCS 的汇总患病率估计。

方法：使用循证医学系统综述和荟萃分析指南指导的系统搜索过程，从 Web of Science、Scopus、PubMed、Cochrane Library 和 Ovid MEDLINE 数据库筛选相关文章。纳入的研究为英语，发表于 2020 年 1 月至 2024 年 4 月，其中一项研究结果为总体 PCS 患病率，研究对象为经确诊 COVID-19 且在 COVID 感染后 12 周或之后接受评估的人群。作为主要观察指标，通过从个体研究中提取的 PCS 患病率数据的荟萃分析来估计 PCS 的汇总患病率，采用随机效应模型进行分析。本研究已在 PROSPERO（CRD42023435280）上注册。

结果：48 项研究符合纳入标准并被纳入本综述。其中 16 项研究被纳入荟萃分析以估计全球 PCS 的汇总患病率，为 41.79%（95%置信区间[CI] 39.70-43.88%，I=51%，p=0.03）。基于急性 COVID-19 感染后不同的评估或随访时间点，PCS 患病率在≥第 3 个月、≥第 6 个月和≥第 12 个月时分别估计为 45.06%（95%CI：41.25-48.87%）、41.30%（95%CI：34.37-48.24%）和 41.32%（95%CI：39.27-43.37%）。按性别分层的 PCS 患病率在男性中估计为 47.23%（95%CI：44.03-50.42%），在女性中估计为 52.77%（95%CI：49.58-55.97%）。按大陆区域划分，欧洲、美洲、亚洲和澳大利亚的 PCS 患病率分别估计为 46.28%（95%CI：39.53%-53.03%）、46.29%（95%CI：35.82%-56.77%）、49.79%（95%CI：30.05%-69.54%）和 42.41%（95%CI：0.00%-90.06%）。

结论：荟萃分析中的患病率估计可用于进一步开展 PCS 的综合研究，这可能有助于制定更好的 PCS 管理计划，以减轻 PCS 对人群健康和相关经济负担的影响。