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美国脑卒中幸存者中新冠长期后遗症的流行情况及其决定因素。

Prevalence and determinant of long-term Post-COVID conditions among stroke survivors in the United States.

机构信息

Department of Neurology, College of Medicine, The Pennsylvania State University, Hershey, PA 17033, USA.

Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA, 17033, USA.

出版信息

J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108007. doi: 10.1016/j.jstrokecerebrovasdis.2024.108007. Epub 2024 Sep 18.

Abstract

BACKGROUND

Persistent post-COVID conditions (PCCs) have become inevitable challenges for individuals who have survived COVID. The National Research Plan on Long COVID-19 underscores the priority of addressing post-COVID conditions (PCCs) within specific subgroups of the United States (US) population. This study aimed to investigate the prevalence and factors associated with PCCs among stroke survivors in the US.

METHOD

In this retrospective cross-sectional study, we utilized the Behavioral Risk Factor Surveillance System (BRFSS) 2022 dataset. First, we identified respondents with a positive history of both COVID-19 and stroke. Subsequently, we categorized these respondents based on whether they experienced PCCs and conducted a comparative analysis of their characteristics. Additionally, our study included a comparison of our findings with those among individuals who have survived myocardial infarction (MI) and cancer.

RESULTS

A total of 3999 stroke, 5406 MI, and 10551 cancer survivors were included. The estimated prevalence of PCCs among stroke survivors was 30.6 %, compared to 22.4 %, 29.2 %, and 24.6 % among non-stroke (p < 0.001), MI, and cancer survivors, respectively. Fatigue, dyspnea, and taste/smell loss were the most common primary symptoms. In multivariate regression analysis, female sex (adjusted odds ratio (aOR):1.62, 95 %CI:[1.17-2.24]), stroke-belt residence (aOR:1.67, 95 %CI: [1.13-2.46]), pulmonary disease (aOR:2.12, 95 %CI:[1.53-2.92]), and depression (aOR:1.55, 95 %CI: [1.1-2.2]) were independent factors associated with higher odds of PCCs among stroke survivors. Additionally, age above 64 years was associated with lower odds of PCCs (aOR:0.6, 95 %CI: [0.41-0.86]).

CONCLUSION

Our study highlights a considerable prevalence of PCCs among stroke survivors, particularly among younger women and individuals with other chronic conditions.

摘要

背景

持续性新冠后状况(PCCs)已成为新冠幸存者面临的必然挑战。《美国国家长新冠研究计划》强调了优先解决美国特定人群的新冠后状况(PCCs)的重要性。本研究旨在调查美国中风幸存者中 PCCs 的患病率和相关因素。

方法

本回顾性横断面研究利用了 2022 年行为风险因素监测系统(BRFSS)的数据。首先,我们确定了同时患有 COVID-19 和中风的受访者。随后,我们根据他们是否经历过 PCCs 对这些受访者进行分类,并对他们的特征进行比较分析。此外,我们还将研究结果与心肌梗死(MI)和癌症幸存者进行了比较。

结果

共纳入 3999 例中风、5406 例 MI 和 10551 例癌症幸存者。中风幸存者中 PCCs 的估计患病率为 30.6%,而非中风(p<0.001)、MI 和癌症幸存者中 PCCs 的患病率分别为 22.4%、29.2%和 24.6%。疲劳、呼吸困难和味觉/嗅觉丧失是最常见的主要症状。在多变量回归分析中,女性(调整优势比(aOR):1.62,95%CI:[1.17-2.24])、居住在中风带(aOR:1.67,95%CI:[1.13-2.46])、肺部疾病(aOR:2.12,95%CI:[1.53-2.92])和抑郁(aOR:1.55,95%CI:[1.1-2.2])是中风幸存者中 PCCs 发生的独立危险因素。此外,年龄大于 64 岁与 PCCs 的发生几率较低相关(aOR:0.6,95%CI:[0.41-0.86])。

结论

本研究表明,中风幸存者中 PCCs 的患病率相当高,尤其是年轻女性和伴有其他慢性疾病的患者。

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