Cornelissen Merel E B, Haarman Myrthe M, Twisk Jos W R, Houweling Laura, Baalbaki Nadia, Sondermeijer Brigitte, Beijers Rosanne J H C G, Gach Debbie, Bloemsma Lizan D, Maitland-van der Zee Anke H
Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Amsterdam Institute for Infection and Immunity, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Biomedicines. 2024 Oct 30;12(11):2493. doi: 10.3390/biomedicines12112493.
Although the coronavirus disease 2019 (COVID-19) pandemic is no longer a public health emergency of international concern, 30% of COVID-19 patients still have long-term complaints. A better understanding of the progression of symptoms after COVID-19 is needed to reduce the burden of the post COVID-19 condition.
This study aims to investigate the progression of symptoms, identify patterns of symptom progression, and assess their associations with patient characteristics.
Within the P4O2 COVID-19 study, patients aged 40-65 years were recruited from five Dutch hospitals. At 3-6 and 12-18 months post COVID-19, medical data were collected, and pulmonary function tests were performed. In between, symptoms were assessed monthly with a questionnaire. Latent class mixed modelling was used to identify symptom progression patterns over time, with multinomial logistic regression to examine associations with patient characteristics.
Eighty-eight patients (aged 54.4 years, 48.9% males) were included. Three trajectories were identified for fatigue and dyspnoea: decreasing, high persistent, and low persistent. The odds of "decreasing fatigue" was higher for never smokers and participants in the lifestyle intervention and lower for those having a comorbidity. The odds of "decreasing dyspnoea" was higher for moderate COVID-19 patients and lifestyle intervention participants and lower for males, mild COVID-19 patients, and those with a higher age.
Three distinct trajectories were identified for fatigue and dyspnoea, delineating patterns of symptom persistence following COVID-19. Sex, age, smoking status, participation in lifestyle interventions and COVID-19 severity were associated with the likelihood of belonging to different trajectories. These findings highlight the heterogeneity of the long-term symptoms experienced by post COVID-19 patients and emphasise the importance of personalised treatment strategies.
尽管2019冠状病毒病（COVID-19）大流行已不再是国际关注的突发公共卫生事件，但仍有30%的COVID-19患者存在长期不适。为减轻COVID-19后状况的负担，需要更好地了解COVID-19后症状的进展情况。
本研究旨在调查症状的进展，确定症状进展模式，并评估其与患者特征的关联。
在P4O2 COVID-19研究中，从荷兰五家医院招募了年龄在40至65岁之间的患者。在COVID-19后3至6个月以及12至18个月时，收集医疗数据并进行肺功能测试。在此期间，每月通过问卷评估症状。使用潜在类别混合模型来确定随时间变化的症状进展模式，并使用多项逻辑回归来检验与患者特征的关联。
纳入了88名患者（年龄54.4岁，男性占48.9%）。确定了疲劳和呼吸困难的三种轨迹：下降型、高持续型和低持续型。从不吸烟者和参加生活方式干预的参与者出现“疲劳减轻”的几率较高，而患有合并症的参与者几率较低。中度COVID-19患者和生活方式干预参与者出现“呼吸困难减轻”的几率较高，而男性、轻度COVID-19患者和年龄较大者几率较低。
确定了疲劳和呼吸困难的三种不同轨迹，描绘了COVID-19后症状持续的模式。性别、年龄、吸烟状况、是否参加生活方式干预以及COVID-19严重程度与属于不同轨迹的可能性相关。这些发现突出了COVID-19后患者长期症状的异质性，并强调了个性化治疗策略的重要性。
