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医护人员中急性 COVID-19 后遗症的负担及其 30 个月期间的病程——一项前瞻性多中心队列研究的结果

Burden of post-acute COVID-19 sequelae in healthcare workers and its course over a 30-month period-results from a prospective multicentre cohort.

作者信息

Dörr Tamara, Strahm Carol, Güsewell Sabine, Ballouz Tala, Kocan Emina, Cusini Alexia, Goppel Stephan, Grässli Fabian, Möller J Carsten, Puhan Milo A, Risch Lorenz, Ruetti Markus, Schlegel Matthias, Stocker Reto, von Kietzell Matthias, Vuichard-Gysin Danielle, Kuster Stefan P, Kahlert Christian R, Kohler Philipp

机构信息

Division of Infectious Diseases, Infection Prevention and Travel Medicine, Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.

Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.

出版信息

Infection. 2024 Nov 12. doi: 10.1007/s15010-024-02418-3.

Abstract

PURPOSE

As healthcare workers (HCW) have been disproportionally affected by COVID-19, its post-acute sequelae (PASC) in HCW can impact healthcare systems. We assessed the burden and course of PASC in HCW over a 30-month period.

METHODS

In a prospective multicentre HCW cohort in Switzerland, PASC surveys were conducted in 03/2021, 09/2021, 06/2022, 04/2023, and 10/2023. Stratified by viral variant at first infection, the prevalence of PASC symptoms, self-experienced PASC and the Post-COVID Functional Status (PCFS) were analysed cross-sectionally in 10/2023, self-perceived success of therapeutic measures used was assessed. The evolution of PASC symptoms and PCFS in Wild-type and non-Wild-type infected HCW compared to uninfected controls was analysed longitudinally across all surveys.

RESULTS

In cross-sectional analysis, 1704 HCW (median age 47 years, 82.2% female) were included. Thereof, 30.7% reported ≥ 1 PASC symptom in 10/2023, with 115 (6.7%) stating to have or have had PASC. Both were most common after Wild-type infection compared to other variants. Overall, 17/115 (15%) indicated relevant/severe restrictions in their daily activities and of 85 (74%) that tried ≥ 1 measure against their symptoms, 69 (81%) reported having benefitted. Longitudinal analysis (n = 653) showed a significantly higher proportion of Wild-type infected HCW to report PASC symptoms compared to controls in 03/2021 (+ 21%, 95% CI 4-39), with decreasing trend (+ 7%, 95%CI -10-25 in 10/2023). This effect was not evident for non-Wild-type infected HCW.

CONCLUSIONS

Over a 30 month period, overall PASC burden in our HCW cohort decreased, although 1% still experience relevant restrictions in their daily life; Wild-type infected individuals show the highest disease burden.

摘要

目的

由于医护人员受新冠病毒病(COVID-19)的影响尤为严重,其急性后遗症(PASC)会对医疗系统产生影响。我们评估了30个月期间医护人员PASC的负担及病程。

方法

在瑞士一项前瞻性多中心医护人员队列研究中,于2021年3月、2021年9月、2022年6月、2023年4月和2023年10月进行了PASC调查。根据首次感染时的病毒变种分层,于2023年10月对PASC症状的患病率、自我经历的PASC及新冠后功能状态(PCFS)进行横断面分析,评估所采用治疗措施的自我感觉疗效。在所有调查中纵向分析野生型和非野生型感染医护人员与未感染对照相比PASC症状和PCFS的演变情况。

结果

横断面分析纳入了1704名医护人员(中位年龄47岁,82.2%为女性)。其中,30.7%在2023年10月报告有≥1种PASC症状,115人(6.7%)称患有或曾患有PASC。与其他变种相比,野生型感染后这两种情况最为常见。总体而言,115人中的17人(15%)表示日常活动受到相关/严重限制,在尝试了≥1种缓解症状措施的85人(74%)中,69人(81%)称从中受益。纵向分析(n = 653)显示,与对照组相比,野生型感染医护人员在2021年3月报告PASC症状的比例显著更高(+21%,95%CI 4 - 39),呈下降趋势(2023年10月为+7%,95%CI -10 - 25)。这种效应在非野生型感染医护人员中不明显。

结论

在30个月期间,我们医护人员队列中的总体PASC负担有所下降,尽管仍有1%的人日常生活受到相关限制;野生型感染个体的疾病负担最高。

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