Zakaria Dianne, Demers Alain, Cheta Nicholas, Aziz Samina, Abdullah Peri
Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada.
Can J Public Health. 2025 Apr;116(2):290-308. doi: 10.17269/s41997-024-00958-7. Epub 2024 Nov 1.
We aimed to characterize the burden of post COVID-19 condition (PCC) among adults in Canada and identify factors associated with its occurrence, severity, and resolution.
We used self-report data from a population-based cross-sectional probability survey of adults in Canada conducted between April and August 2022. Incidence and prevalence of PCC were estimated using confirmed infections, as well as confirmed and suspected combined. Multivariable modeling using confirmed cases identified associated factors.
As of August 2022, 17.2% (95% CI 15.7, 18.8) of adults with confirmed infections and 16.7% (95% CI 15.5, 18.0) of adults with confirmed or suspected infections experienced PCC, translating to 3.3% (95% CI 3.0, 3.6) and 4.4% (95% CI 4.1, 4.8) of all adults, respectively. Age less than 65 years (aORs of 1.75 to 2.14), more pre-existing comorbidities (aORs of 1.75 to 3.57), and a more severe initial infection (aORs of 3.52 to 9.69) were all associated with higher odds of PCC, while male sex at birth (aOR = 0.54, 95% CI 0.41, 0.70), identifying as Black (aOR = 0.23, 95% CI 0.11, 0.51), and being infected after 2020 (aORs of 0.24 to 0.55) were associated with lower odds. Those residing in a rural area (aOR = 2.31, 95% CI 1.35, 3.93), or reporting a disability (aOR = 2.87, 95% CI 1.14, 7.25), pre-existing chronic lung condition (aOR = 5.47, 95% CI 1.85, 16.12) or back problem (aOR = 2.34, 95% CI 1.26, 4.36), or PCC headache (aOR = 2.47, 95% CI 1.60, 3.83) or weakness (aOR = 2.27, 95% CI 1.41, 3.68) had higher odds of greater limitations in daily activities, while males had lower odds (aOR = 0.54, 95% CI 0.34, 0.85). Two or more pre-existing chronic conditions (aHRs from 0.33 to 0.38), or PCC symptoms relating to the heart (aHR = 0.25, 95% CI 0.07, 0.90), brain fog (aHR = 0.44, 95% CI 0.23, 0.86), or stress/anxiety (aHR = 0.48, 95% CI 0.24, 0.96) were associated with a decreased rate of symptom resolution.
Over the first two and a half years of the pandemic, a substantial proportion of infected adults in Canada reported PCC. Females and people with comorbidities were disproportionately impacted.
我们旨在描述加拿大成年人中新冠后状况（PCC）的负担，并确定与其发生、严重程度和缓解相关的因素。
我们使用了2022年4月至8月对加拿大成年人进行的基于人群的横断面概率调查中的自我报告数据。使用确诊感染病例以及确诊和疑似病例合并数据来估计PCC的发病率和患病率。使用确诊病例进行多变量建模以确定相关因素。
截至2022年8月，确诊感染的成年人中有17.2%（95%置信区间15.7，18.8），确诊或疑似感染的成年人中有16.7%（95%置信区间15.5，18.0）经历了PCC，分别相当于所有成年人的3.3%（95%置信区间3.0，3.6）和4.4%（95%置信区间4.1，4.8）。年龄小于65岁（调整后的比值比为1.75至2.14）、更多的既往合并症（调整后的比值比为1.75至3.57）以及更严重的初始感染（调整后的比值比为3.52至9.69）均与PCC的较高几率相关，而出生时为男性（调整后的比值比=0.54，95%置信区间0.41，0.70）、自我认定为黑人（调整后的比值比=0.23，95%置信区间0.11，0.51）以及2020年后感染（调整后的比值比为0.24至0.55）与较低几率相关。居住在农村地区的人（调整后的比值比=2.31，95%置信区间1.35，3.93），或报告有残疾的人（调整后的比值比=2.87，95%置信区间1.14，7.25）、既往有慢性肺部疾病（调整后的比值比=5.47，95%置信区间1.85，16.12）或背部问题（调整后的比值比=2.34，95%置信区间1.26，4.36），或患有PCC头痛（调整后的比值比=2.47，95%置信区间1.60，3.83）或虚弱（调整后的比值比=2.27，95%置信区间1.41，3.68）的人在日常活动中受到更大限制的几率更高，而男性的几率较低（调整后的比值比=0.54，95%置信区间0.34，0.85）。两种或更多的既往慢性病（风险比从0.33至0.38），或与心脏相关的PCC症状（风险比=0.25，95%置信区间0.07，0.90）、脑雾（风险比=0.44，95%置信区间0.23，0.86）或压力/焦虑（风险比=0.48，95%置信区间0.24，0.96）与症状缓解率降低相关。
在疫情的头两年半时间里，加拿大相当一部分感染的成年人报告了PCC。女性和患有合并症的人受到的影响尤为严重。
