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中国武汉 COVID-19 患者出院 3 年后的健康结局:一项队列研究。

Health outcomes of COVID-19 patients from Wuhan, China 3-year after hospital discharge: a cohort study.

机构信息

Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, People's Republic of China.

Department of Respiratory Medicine, Daping Hospital,Army Medical University, Chongqing, People's Republic of China.

出版信息

BMJ Open. 2024 Aug 17;14(8):e084770. doi: 10.1136/bmjopen-2024-084770.

Abstract

OBJECTIVES

To evaluate changes in health outcomes between years 2 and 3 after discharge following COVID-19 and to identify risk factors for poor health 3-year post-discharge.

DESIGN

This is a multicentre observational cohort study.

SETTING

This study was conducted in two centres from Wuhan, China.

PARTICIPANTS

Eligibility screening has been performed in 3988 discharged laboratory-confirmed adult COVID-19 patients. Exclusion criteria were refusal to participate, inability to contact and death before follow-up. The WHO COVID-19 guidelines on defining disease severity were adopted.

RESULTS

1594 patients participated in the 1-year, 2-year and 3-year follow-ups, including 796 (49.9%) male patients, and 422 (26.5%) patients were classified in the severe disease group. 3 years after discharge, 182 (11.4%) patients still complained of at least one symptom. The most common symptoms were fatigue, myalgia, chest tightness, cough, anxiety, shortness of breath and expectoration. Fatigue or myalgia, the most common symptom cluster, frequently coexisted with chest symptoms and anxiety. Symptom persistence between years 2 and 3 was reported in 70 patients (4.4%) for which intensive care unit (ICU) admission was a risk factor (p=0.038). Of the 1586 patients who completed the chronic obstructive pulmonary disease assessment test (CAT), 97 (6.1%) scored ≥10, with older age being associated with CAT ≥10 (p=0.007).

CONCLUSIONS

Between years 2 and 3 after SARS-CoV-2 infection, most patients returned to an asymptomatic state, and only a few were still symptomatic. ICU admission was a risk factor for symptom persistence.

摘要

目的

评估 COVID-19 出院后 2 至 3 年的健康结果变化,并确定出院后 3 年健康状况不佳的危险因素。

设计

这是一项多中心观察性队列研究。

地点

本研究在中国武汉的两个中心进行。

参与者

对 3988 名已出院的实验室确诊成人 COVID-19 患者进行了资格筛选。排除标准为拒绝参与、无法联系和随访前死亡。采用了世界卫生组织 COVID-19 关于定义疾病严重程度的指南。

结果

1594 名患者参加了 1 年、2 年和 3 年的随访,包括 796 名(49.9%)男性患者,422 名(26.5%)患者被归类为重症组。出院 3 年后,仍有 182 名(11.4%)患者至少有一个症状。最常见的症状是疲劳、肌肉疼痛、胸闷、咳嗽、焦虑、呼吸急促和咳痰。最常见的症状群疲劳或肌肉疼痛,常伴有胸部症状和焦虑。70 名患者(4.4%)报告在 2 年至 3 年之间持续存在症状,入住重症监护病房(ICU)是一个危险因素(p=0.038)。在完成慢性阻塞性肺疾病评估测试(CAT)的 1586 名患者中,有 97 名(6.1%)得分≥10,年龄较大与 CAT≥10 相关(p=0.007)。

结论

在 SARS-CoV-2 感染后 2 至 3 年内,大多数患者恢复到无症状状态,只有少数患者仍有症状。入住 ICU 是症状持续存在的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baf1/11331845/67fb496a55d9/bmjopen-14-8-g001.jpg

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