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长期新冠:多器官系统症状与体征的全面概述

Long COVID: A Comprehensive Overview of the Signs and Symptoms across Multiple Organ Systems.

作者信息

Merhavy Zachary Isaac, Junor Tiana, Gonzalez Aranice, De Filippis Samantha Michelle, Oveisitork Sarah, Rivera Eliu, Ndukwu Ifeanyi, Bhatara Kanika

机构信息

Ross University School of Medicine, Bridgetown, Barbados.

University of Medicine and Health Sciences, Basseterre, St. Kitts & Nevis.

出版信息

Korean J Fam Med. 2024 Nov;45(6):305-316. doi: 10.4082/kjfm.24.0085. Epub 2024 Nov 20.

Abstract

Long coronavirus disease (COVID), also known as the post-acute sequelae of coronavirus disease 2019 (COVID-19) (PASC), is a significant concern since the end of the COVID-19 pandemic, as it still manifests in individuals with persistent symptoms and complications beyond the acute phase of infection. Defining this disease is challenging, as it manifests as a spectrum of symptoms varying in severity among individuals who have previously tested positive for COVID-19. Long COVID is more prevalent in hospitalized COVID-19 patients and presents in various ways, ranging from pulmonary to extrapulmonary symptoms. This literature review examines the current body of research on long COVID with a focus on its effects on the cardiovascular, hematological, respiratory, renal, and neurological systems with systematically analyzed, peer-reviewed articles retrieved from the PubMed database. There have been several proposed pathophysiological mechanisms by which severe acute respiratory syndrome coronavirus 2 affects the aforementioned organ systems; however, research on the definite mechanisms is lacking, especially when considering the management of long COVID in the perioperative setting. The impact of post-COVID sequelae necessitates individualized management strategies tailored to each symptomatic profile, particularly in patients with comorbidities. The COVID-19 pandemic affected millions of people and had a profound impact on those who developed PASC, lowering their quality of life and increasing potential surgical risks. However, there is still uncertainty regarding the specific risk factors for long COVID and who is most susceptible to it. Further research is required to fill these gaps and explore potential avenues for preventing PASC.

摘要

长期新冠病毒病(COVID),也称为冠状病毒病2019(COVID-19)的急性后遗症(PASC),自COVID-19大流行结束以来一直是一个重大问题,因为它仍然表现在感染急性期后仍有持续症状和并发症的个体中。定义这种疾病具有挑战性,因为它表现为一系列症状,在先前COVID-19检测呈阳性的个体中严重程度各不相同。长期新冠病毒病在住院的COVID-19患者中更为普遍,并且以各种方式出现,从肺部症状到肺外症状。这篇文献综述考察了目前关于长期新冠病毒病的研究主体,重点关注其对心血管、血液、呼吸、肾脏和神经系统的影响,所使用的是从PubMed数据库检索到的经过系统分析和同行评审的文章。对于严重急性呼吸综合征冠状病毒2影响上述器官系统的病理生理机制,已经提出了几种假说;然而,对于确切机制的研究仍然缺乏,尤其是在考虑围手术期长期新冠病毒病的管理时。新冠病毒病后遗症的影响需要针对每个症状特征制定个性化的管理策略,特别是对于患有合并症的患者。COVID-19大流行影响了数百万人,对那些出现PASC的人产生了深远影响,降低了他们的生活质量,并增加了潜在的手术风险。然而,关于长期新冠病毒病的具体风险因素以及谁最易感染它,仍然存在不确定性。需要进一步的研究来填补这些空白,并探索预防PASC的潜在途径。

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