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新冠后遗症患者症状治疗方法的使用频率和患者报告的疗效。

Utilization frequency and patient-reported effectiveness of symptomatic therapies in post-COVID syndrome.

机构信息

Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054, Erlangen, Germany.

Post-COVID Center, University Hospital of Erlangen, 91054, Erlangen, Germany.

出版信息

BMC Public Health. 2024 Sep 23;24(1):2577. doi: 10.1186/s12889-024-19951-3.

Abstract

BACKGROUND

To date there is no causal treatment for post-COVID syndrome, leaving symptomatic treatments as the primary recourse. However, the practical implementation and effectiveness of these interventions remain underexplored. This study aimed to investigate the utilization frequency of symptomatic therapies and patient-reported effectiveness across various treatment modalities at a German post-COVID center.

METHODS

As the baseline investigation we conducted a single-cohort retrospective study to analyze the frequency of symptomatic therapies among post-COVID patients who attended the post-COVID center of the University Hospital of Erlangen, between December 2022 to July 2023. Additionally, we administered a follow-up at least 3 months after the initial presentation, using a questionnaire to assess patient-reported improvements in post-COVID symptoms associated with the symptomatic therapies received.

RESULTS

Our study included 200 patients (mean age: 44.6 ± 12.6 years; 69.0% women; mean duration since acute infection: 15.3 ± 8.3 months). Pharmacotherapy was the predominant symptomatic treatment (79.5%), with psychotropic drugs (32.5%) and analgesics (31.5%) being the most frequently prescribed. Over half of the patients (55.5%) utilized vitamins and nutritional supplements. Hospital admission rates to acute care occurred in 35.5% of cases; 33.0% underwent inpatient rehabilitation and 31.0% pursued outpatient psychotherapy. Cardiologists (76.5%), pulmonologists (67.5%), and neurologists (65.5%) were the most consulted specialists. Therapies involving medical devices were infrequently employed (12.0%). In a follow-up questionnaire (response rate: 82.5%, 6.3 ± 2.2 months post-baseline), beta-blockers were the most effective pharmacological intervention with 31.5% of patients reporting strong to very strong symptom improvement, followed by antibiotics (29.6%). Furthermore, 33.0% of the patients perceived plasmapheresis to strongly alleviate symptoms. Only a small proportion of the sample attributed a strong or very strong symptom improvement to outpatient psychotherapy (11.0%).

CONCLUSION

This study provides initial insights into symptomatic therapy utilization and patient-reported symptom improvement in post-COVID syndrome. Further research into symptoms clusters and interdisciplinary collaboration are warranted to comprehensively address the multifaceted physical and psychological symptomatology.

TRIAL REGISTRATION

The study was registered at the German Clinical Trials Register (DRKS-ID: DRKS00033621) on March 20, 2024.

摘要

背景

迄今为止,针对新冠后综合征尚无因果治疗方法,因此只能采用对症治疗。然而,这些干预措施的实际应用和效果仍有待进一步探索。本研究旨在调查德国一家新冠后中心采用各种治疗方法时,对症治疗的使用频率和患者报告的疗效。

方法

作为基线调查,我们进行了一项单队列回顾性研究,分析了 2022 年 12 月至 2023 年 7 月期间在埃尔兰根大学医院新冠后中心就诊的新冠后患者使用对症疗法的频率。此外,我们在初次就诊至少 3 个月后进行了随访,通过问卷调查评估患者报告的与接受的对症治疗相关的新冠后症状改善情况。

结果

本研究纳入了 200 名患者(平均年龄:44.6±12.6 岁;69.0%为女性;急性感染后平均时间:15.3±8.3 个月)。药物疗法是最主要的对症治疗方法(79.5%),其中精神类药物(32.5%)和镇痛药(31.5%)的使用最为广泛。超过一半的患者(55.5%)使用了维生素和营养补充剂。有 35.5%的患者需要住院治疗,其中 33.0%接受了住院康复治疗,31.0%接受了门诊心理治疗。就诊最多的专科医生为心脏病专家(76.5%)、肺病专家(67.5%)和神经科医生(65.5%)。很少使用涉及医疗器械的治疗方法(12.0%)。在后续的问卷调查(回复率:82.5%,基线后 6.3±2.2 个月)中,β受体阻滞剂是最有效的药物干预措施,31.5%的患者报告症状有较强至很强的改善,其次是抗生素(29.6%)。此外,33.0%的患者认为血浆置换可强烈缓解症状。只有一小部分患者(11.0%)认为门诊心理治疗可显著改善症状。

结论

本研究初步探讨了新冠后综合征中对症治疗的使用和患者报告的症状改善情况。需要进一步研究症状群和跨学科合作,以全面解决身体和心理症状的多方面问题。

试验注册

该研究于 2024 年 3 月 20 日在德国临床试验注册处(DRKS-ID:DRKS00033621)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf4/11421202/f293851de58a/12889_2024_19951_Fig1_HTML.jpg

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