新冠疫情对肌痛性脑脊髓炎/慢性疲劳综合征样疾病患病率的影响：一项横断面调查。

Impact of COVID-19 on myalgic encephalomyelitis/chronic fatigue syndrome-like illness prevalence: A cross-sectional survey.

机构信息

Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, United States of America.

Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.

出版信息

PLoS One. 2024 Sep 18;19(9):e0309810. doi: 10.1371/journal.pone.0309810. eCollection 2024.

DOI:10.1371/journal.pone.0309810

PMID:39292671

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11410243/

Abstract

BACKGROUND

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can be triggered by infectious agents including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the impact of the coronavirus disease 2019 (COVID-19) pandemic on ME/CFS prevalence is not well characterized.

METHODS

In this population-based cross-sectional study, we enrolled a stratified random sample of 9,825 adult participants in the Kaiser Permanente Northern California (KPNC) integrated health system from July to October 2022 to assess overall ME/CFS-like illness prevalence and the proportion that were identified following COVID-19 illness. We used medical record and survey data to estimate the prevalence of ME/CFS-like illness based on self-reported symptoms congruent with the 2015 Institute of Medicine ME/CFS criteria. History of COVID-19 was based on a positive SARS-CoV-2 nucleic acid amplification test or ICD-10 diagnosis code in the medical record, or self-report of prior COVID-19 on a survey.

RESULTS

Of 2,745,374 adults in the eligible population, an estimated 45,892 (95% confidence interval [CI]: 32,869, 58,914) or 1.67% (CI 1.20%, 2.15%) had ME/CFS-like illness. Among those with ME/CFS-like illness, an estimated 14.12% (CI 3.64%, 24.6%) developed the illness after COVID-19. Among persons who had COVID-19, those with ME/CFS-like illness after COVID-19 were more likely to be unvaccinated and to have had COVID-19 before June 1, 2021. All persons with ME/CFS-like illness had significant impairment in physical, mental, emotional, social, and occupational functioning compared to persons without ME/CFS-like illness.

CONCLUSIONS

In a large, integrated health system, 1.67% of adults had ME/CFS-like illness and 14.12% of all persons with ME/CFS-like illness developed it after COVID-19. Though COVID-19 did not substantially increase ME/CFS-like illness in the KPNC population during the study time period, ME/CFS-like illness nevertheless affects a notable portion of this population and is consistent with estimates of ME/CFS prevalence in other populations. Additional attention is needed to improve awareness, diagnosis, and treatment of ME/CFS.

摘要

背景

肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）可由包括严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）在内的感染因子引发。然而，COVID-19 大流行对 ME/CFS 流行率的影响尚未得到充分描述。

方法

在这项基于人群的横断面研究中，我们于 2022 年 7 月至 10 月期间，从 Kaiser Permanente Northern California（KPNC）综合医疗系统中招募了一个分层随机的 9825 名成年参与者样本，以评估总体 ME/CFS 样疾病的流行率以及 COVID-19 疾病后确定的比例。我们使用病历和调查数据，根据与 2015 年医学研究所 ME/CFS 标准相符的自我报告症状，估计 ME/CFS 样疾病的流行率。COVID-19 病史基于 SARS-CoV-2 核酸扩增检测或病历中的 ICD-10 诊断代码阳性，或调查中报告的既往 COVID-19。

结果

在符合条件的人群中，估计有 2745374 名成年人中，有 45892 人（95%置信区间 [CI]：32869，58914）或 1.67%（CI 1.20%，2.15%）患有 ME/CFS 样疾病。在患有 ME/CFS 样疾病的患者中，估计有 14.12%（CI 3.64%，24.6%）在 COVID-19 后出现该疾病。在患有 COVID-19 的患者中，COVID-19 后患有 ME/CFS 样疾病的患者更可能未接种疫苗，且 COVID-19 发生在 2021 年 6 月 1 日之前。与无 ME/CFS 样疾病的患者相比，所有患有 ME/CFS 样疾病的患者在身体、心理、情绪、社会和职业功能方面均存在显著障碍。

结论

在一个大型综合医疗系统中，有 1.67%的成年人患有 ME/CFS 样疾病，所有 ME/CFS 样疾病患者中有 14.12%在 COVID-19 后出现该疾病。虽然 COVID-19 在研究期间并未显著增加 KPNC 人群中的 ME/CFS 样疾病，但 ME/CFS 样疾病仍然影响着这部分人群中的相当一部分人，与其他人群中的 ME/CFS 流行率估计一致。需要进一步关注以提高对 ME/CFS 的认识、诊断和治疗。