新冠肺炎德尔塔波后 12-18 个月的长新冠发病率：基于医院的前瞻性登记研究。

Incidence of Long COVID-19 at 12-18 Months Following Delta Wave of Coronavirus Disease 2019: Hospital-based Prospective Registry.

机构信息

DNB Resident, Department of General Medicine, Eternal Hospital, Jaipur, Rajasthan, India.

Chairman, Senior Medical Director, Department of Internal Medicine and Critical Care, Eternal Hospital, Jaipur, Rajasthan, India, Corresponding Author.

出版信息

J Assoc Physicians India. 2024 Oct;72(10):13-18. doi: 10.59556/japi.72.0609.

DOI:10.59556/japi.72.0609

PMID:39390853

Abstract

BACKGROUND AND OBJECTIVE

Long coronavirus disease 2019 (COVID-19) has emerged as an important consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To identify its incidence 12-18 months following hospitalization in patients with COVID-19, we performed a prospective study.

METHODS

Virologically confirmed successive patients with moderate-to-severe COVID-19, hospitalized during the delta wave in India, were recruited. Data on clinical features, investigations, and outcomes were obtained. Long COVID-19 was diagnosed using the European quality of life questionnaire (EQ-5D) and Birmingham symptom burden questionnaire (SBQ) at 12-18-month follow-up.

RESULTS

During the study period (January-July 2021), we evaluated 8,680 suspected COVID-19 patients, of whom 1,641 were confirmed virologically and 388 were hospitalized. Men accounted for 64.4%, individuals aged >60 years for 41.5%, hypertension for 42.8%, diabetes for 38.4%, and cardiovascular disease for 17.3%. At admission, there was a high prevalence of cough (71.1%), fever (86.6%), and oxygen requirement (38.6%). Proning was deployed in 89.2% of cases, nasal cannula in 36.3%, nonrebreather masks in 15.7%, noninvasive ventilation in 14.4%, and invasive ventilation in 16.2%. In-hospital deaths totaled 75 (19.3%), with 310 discharged for home care and eligible for follow-up. At a median follow-up of 15 months, 9 patients had died, 40 were lost to follow-up, and 264 were evaluated. The incidence of Long COVID-19 was 45 [17.0%, 95% confidence of interval (CI) 12.6-21.9%]. The median EQ-5D score was 5.0, with >5 observed in only 11 patients (0.6%). Using the SBQ, new-onset dyspnea on exertion was noted in 13 (4.9%), rest dyspnea in 7 (2.6%), fatigue in 31 (11.7%), feverishness in 18 (6.8%), and low energy in 16 (6.1%). Long COVID-19 was significantly more prevalent in women and older individuals. In Long COVID-19 compared to controls, the mean duration of oxygen requirement (5.46 ± 9.8 vs 2.46 ± 4.5 days, = 0.002), use of nonrebreather masks (17.8 vs 7.3%, = 0.026), noninvasive ventilation (11.1 vs 3.2%, = 0.020), and duration of intensive care unit (ICU) stay (13.5, 8.7-17.3 vs 8.0, 5.0-11.0 days, = 0.028) were significantly higher.

CONCLUSION

The incidence of Long COVID-19 at 12-18 months follow-up is 17.0%. It is significantly higher in women, older age groups, and patients requiring longer oxygenation, nonrebreather oxygen masks, noninvasive respiratory support, and extended stays in the ICU.

摘要

背景与目的

严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引发的长期冠状病毒病 2019（COVID-19）已成为一个重要后果。为了确定 COVID-19 患者住院 12-18 个月后的发病率，我们进行了一项前瞻性研究。

方法

连续招募了在印度德尔塔波期间因中度至重度 COVID-19 住院的病毒学确诊患者。收集了临床特征、检查和结局的数据。在 12-18 个月的随访中，使用欧洲生活质量问卷（EQ-5D）和伯明翰症状负担问卷（SBQ）诊断长 COVID-19。

结果

在研究期间（2021 年 1 月至 7 月），我们评估了 8680 名疑似 COVID-19 患者，其中 1641 名经病毒学证实，388 名住院。男性占 64.4%，年龄＞60 岁的患者占 41.5%，高血压占 42.8%，糖尿病占 38.4%，心血管疾病占 17.3%。入院时，咳嗽（71.1%）、发热（86.6%）和需氧（38.6%）的发生率较高。89.2%的病例采用俯卧位，36.3%采用鼻导管吸氧，15.7%采用无重复呼吸面罩，14.4%采用无创通气，16.2%采用有创通气。住院期间死亡共计 75 例（19.3%），310 例出院居家护理，符合随访条件。中位随访 15 个月时，9 例患者死亡，40 例失访，264 例接受评估。长 COVID-19 的发病率为 45[17.0%，95%置信区间（CI）为 12.6-21.9%]。EQ-5D 评分中位数为 5.0，仅 11 例（0.6%）＞5。使用 SBQ，13 例（4.9%）新出现劳力性呼吸困难，7 例（2.6%）休息时呼吸困难，31 例（11.7%）疲劳，18 例（6.8%）发热，16 例（6.1%）乏力。长 COVID-19 在女性和年龄较大的患者中更为常见。与对照组相比，长 COVID-19 患者需要更长时间的氧气支持（5.46±9.8 vs. 2.46±4.5 天， = 0.002）、使用无重复呼吸面罩（17.8% vs. 7.3%， = 0.026）、无创通气（11.1% vs. 3.2%， = 0.020）和 ICU 住院时间（13.5、8.7-17.3 vs. 8.0、5.0-11.0 天， = 0.028）更长。