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广东首例疫情期间出院的新冠肺炎患者的短期和长期预后。

The short-term and long-term prognosis of discharged COVID-19 patients in Guangdong during the first wave of pandemic.

机构信息

Graduate College, Shantou University Medical College, Shantou, 515041, Guangdong, China.

Department of Emergency, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, China.

出版信息

Sci Rep. 2024 Oct 14;14(1):23994. doi: 10.1038/s41598-024-76013-9.

DOI:10.1038/s41598-024-76013-9
PMID:39402204
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11473718/
Abstract

COVID-19 survivors concerning about the rehabilitation and sustained sequelae of Coronavirus Disease 2019 (COVID-19) infection. We aimed to investigate the sequelae of patients' psychological and physical condition and its related factors in the early and late stages. This longitudinal study tracked 281 COVID-19 patients discharged from hospitals in Guangdong, China, for one year. Assessments occurred at 2,4,12,24 and 48 weeks post-discharge. We define 2 weeks, 4 weeks, and 12 weeks as early stage, and 24 weeks and 48 weeks as late stage. Psychological health was measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and Pittsburgh Sleep Quality Index (PSQI) scales. Physical health was assessed through laboratory tests, chest computed tomography (CT) scans, and pulmonary function tests. Data were analyzed using multivariate regression models to evaluate the influence of demographic and clinical variables on health outcomes. COVID-19 survivors exhibited psychological and physical sequelae in both the early and late stages. Compared to the early stage, the proportions of patients with depression (early stage 14.6%, late stage 4.6%), anxiety (early stage 8.9%, late stage 5.3%), PTSD(early stage 3.6%, late stage 0.7%), abnormal liver function (early stage 24.6%, late stage 11.0%), abnormal cardiac function (early stage 10.0%, late stage 7.8%), abnormal renal function (early stage 20.6%, late stage 11.0%) and abnormal pulmonary function (early stage 40.9%, late stage 13.5%) were significantly reduced in the late stage. Factors such as gender, age, severity of COVID-19, hospitalization duration, and various comorbidities were significantly associated with these sequelae. We noticed that psychological and physical sequelae occurred to COVID-19 survivors in short and long stages, and these would gradually decrease as time went on. Male gender, age > 50 years old, severe clinical condition, longer hospitalization time and comorbidity history were related factors that significantly affected the rehabilitation of COVID-19 patients.

摘要

COVID-19 幸存者对康复和持续的 2019 年冠状病毒病(COVID-19)感染后遗症感到担忧。我们旨在调查患者心理和身体状况的后遗症及其相关因素在早期和晚期。这项纵向研究跟踪了 281 名从中国广东医院出院的 COVID-19 患者,为期一年。评估在出院后 2、4、12、24 和 48 周进行。我们将 2 周、4 周和 12 周定义为早期,将 24 周和 48 周定义为晚期。使用患者健康问卷-9(PHQ-9)、广泛性焦虑障碍-7(GAD-7)、DSM-5 创伤后应激障碍检查表(PCL-5)和匹兹堡睡眠质量指数(PSQI)量表来衡量心理健康。通过实验室检查、胸部计算机断层扫描(CT)扫描和肺功能检查评估身体健康。使用多元回归模型分析数据,以评估人口统计学和临床变量对健康结果的影响。COVID-19 幸存者在早期和晚期都表现出心理和身体上的后遗症。与早期相比,患有抑郁症(早期 14.6%,晚期 4.6%)、焦虑症(早期 8.9%,晚期 5.3%)、创伤后应激障碍(早期 3.6%,晚期 0.7%)、肝功能异常(早期 24.6%,晚期 11.0%)、心脏功能异常(早期 10.0%,晚期 7.8%)、肾功能异常(早期 20.6%,晚期 11.0%)和肺功能异常(早期 40.9%,晚期 13.5%)的患者比例显著降低。性别、年龄、COVID-19 严重程度、住院时间和各种合并症等因素与这些后遗症显著相关。我们注意到,COVID-19 幸存者在短时间和长时间内都出现了心理和身体上的后遗症,随着时间的推移,这些后遗症会逐渐减少。男性、年龄>50 岁、严重临床状况、住院时间较长和合并症病史是显著影响 COVID-19 患者康复的相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a46/11473718/2b4673be57cd/41598_2024_76013_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a46/11473718/42ac4f92aa5c/41598_2024_76013_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a46/11473718/42ac4f92aa5c/41598_2024_76013_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a46/11473718/2fb49fe52b28/41598_2024_76013_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a46/11473718/2b4673be57cd/41598_2024_76013_Fig3_HTML.jpg

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