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弥合差距:识别和管理新冠后状况的策略。

Bridging the gap: strategies for recognizing and managing post-COVID conditions.

作者信息

Khan Muhammad H, Becker Richard C

机构信息

Division of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH, United States.

Division of Cardiovascular Health and Disease, University of Cincinnati Medical Center, Cincinnati, OH, United States.

出版信息

Front Med (Lausanne). 2024 Nov 19;11:1395420. doi: 10.3389/fmed.2024.1395420. eCollection 2024.

DOI:10.3389/fmed.2024.1395420
PMID:39635598
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11615723/
Abstract

Post-COVID conditions (PCC), pose significant challenges for healthcare providers, employers, community leaders, and patients because of their wide-ranging, fluctuating, or persisting symptoms without well-established diagnostic tests to secure a diagnosis. Estimates suggest that up to 20-30% of adults recovering from COVID-19 develop PCC, potentially affecting millions or tens of millions of people in the United States alone. The ongoing endemic coupled with the prevalence of PCC underscores an urgent need for awareness and an understanding of potentially associated conditions, long-term management strategies, and cost-effective screening approaches for cardiovascular health. Individuals experiencing PCC present with a wide array of symptoms. Prevalence of chronic conditions such as post-infectious pulmonary fibrosis, cardiomyopathy, and accelerated coronary artery, cerebrovascular, and peripheral vascular disease further emphasizes the need for community-wide policies and practices. Screening for PCC is recommended, particularly among high-risk individuals, including those with comorbid conditions and exposure to specific SARS-CoV-2 variants, to facilitate early diagnosis, counseling, targeted interventions, and improved quality of life. The aim of this review is to highlight the urgent need for awareness, understanding and management of PCC, focusing on development of screening strategies and targeted interventions to help facilitate early diagnosis and enhance the quality of life for affected individuals. In our view early detection and management of PCC not only improves the quality of life but also improves psychosocial health. Patient-centered approaches, standardized screening tools, and initiatives aimed at enhancing understanding and treatment options, such as the RECOVER and N3C programs, are essential for effective management of PCC.

摘要

新冠后状况(PCC)给医疗服务提供者、雇主、社区领袖和患者带来了重大挑战,因为其症状广泛、波动或持续存在,且缺乏成熟的诊断测试来确诊。据估计,高达20%-30%从新冠中康复的成年人会出现PCC,仅在美国就可能影响数百万甚至数千万人。持续的地方流行以及PCC的普遍存在凸显了迫切需要提高对潜在相关病症的认识、了解长期管理策略以及采用具有成本效益的心血管健康筛查方法。出现PCC的个体表现出各种各样的症状。慢性疾病如感染后肺纤维化、心肌病以及加速的冠状动脉、脑血管和外周血管疾病的普遍存在进一步强调了制定全社区政策和做法的必要性。建议对PCC进行筛查,特别是在高危个体中,包括患有合并症和接触特定SARS-CoV-2变体的个体,以促进早期诊断、咨询、有针对性的干预并改善生活质量。本综述的目的是强调迫切需要提高对PCC的认识、理解和管理,重点是制定筛查策略和有针对性的干预措施,以帮助促进早期诊断并提高受影响个体的生活质量。我们认为,早期发现和管理PCC不仅能改善生活质量,还能改善心理社会健康。以患者为中心的方法、标准化筛查工具以及旨在增强理解和治疗选择的举措,如RECOVER和N3C项目,对于有效管理PCC至关重要。