Salci Maria Aparecida, Carreira Lígia, Oliveira Natan Nascimento, Pereira Natan David, Covre Eduardo Rocha, Pesce Giovanna Brichi, Oliveira Rosana Rosseto, Höring Carla Franciele, Baccon Wanessa Cristina, Puente Alcaraz Jesús, Santos Giovana Alves, Bolsoni Ludmila Lopes Maciel, Gutiérrez Carmona Andrés, Vissoci João Ricardo Nickenig, Facchini Luiz Augusto, Laranjeira Carlos
Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790, Campus Universitário, Maringá 87020-900, PR, Brazil.
Departamento de Estatística, Universidade Estadual de Maringá, Avenida Colombo, 5790, Campus Universitário, Maringá 87020-900, PR, Brazil.
Healthcare (Basel). 2024 Jul 19;12(14):1443. doi: 10.3390/healthcare12141443.
The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.
感染严重急性呼吸综合征冠状病毒2后症状持续三个月以上被称为“长新冠”。为了更深入地了解症状的病因和长期演变，本研究旨在分析巴西成年人和老年人队列中长新冠的患病率及其相关因素，这些人均在出院十二个月后。对巴西巴拉那州2020年被诊断为新冠病毒病的成年人和老年人队列进行了一项观察性、前瞻性随访研究。出院十二个月后，患者通过电话回答了一份关于在经历新冠急性期三个暴露水平（门诊、内科病房和重症监护病房）后症状持续情况的问卷。根据参与者的特征，计算长新冠的患病率，并进行逻辑回归分析。我们分析了1822名参与者（980名成年人[≥18 - <60岁]和842名老年人[≥60岁]）在三个暴露水平的数据。长新冠的总体患病率为64.2%。在646名成年人（55%；其中326名是女性）和523名老年人（45%；其中284名是女性）中观察到长新冠。女性长期症状的患病率（52%）高于男性。在12个月的随访中，最常见的新冠后状况是神经系统方面的（49.8%），其次是肌肉骨骼方面的（35.1%）和持续性呼吸道症状（26.5%）。男性患长新冠的可能性较小（调整后比值比[aOR]=0.50）。其他决定因素也被认为具有风险，例如存在合并症（aOR = 1.41）。作为成年人且曾住院与长新冠的发生有关。与未住院患者相比，病房患者患长新冠的风险是其两倍（aOR = 2.53），重症监护病房患者患长新冠的风险是其三倍（aOR = 3.56）。出现消化系统（aOR = 1.56）、内分泌系统（aOR = 2.14）、皮肤系统（aOR = 2.51）、肌肉骨骼系统（aOR = 2.76）和心理系统（aOR = 1.66）的临床表现使成年人更易患长新冠。在很大一部分感染严重急性呼吸综合征冠状病毒2的人群中存在长新冠。长新冠症状的出现与疾病暴露水平呈剂量反应关系，急性期严重形式相关的症状患病率更高。
