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新型冠状病毒肺炎患者症状体验的症状群与症状网络

Symptom clusters and symptom networks of symptom experiences in patients with SARS-CoV-2 infection.

作者信息

Ye Hongmin, Gan Xiuni, Zhou Wen, Gao Yan, Mei Zhechuan, Zheng Qiulan, Luo Xiaoqing, Yuan Chunlan, Wu Yan

机构信息

The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Chongqing Medical University, Chongqing, China.

出版信息

Heliyon. 2024 Nov 19;10(22):e40497. doi: 10.1016/j.heliyon.2024.e40497. eCollection 2024 Nov 30.

Abstract

CONTEXT

Symptom clusters and symptom networks can potentially enhance the precision in managing symptoms. However, limited research has been conducted on the symptom network experienced by patients infected with Severe Acute Respiratory Syndrome Coronavirus 2.

OBJECTIVES

To identify the composition of symptom clusters in SARS-CoV-2 infected patients, establish a symptom network to explore the centrality indices, and investigate independent risk factors influencing the occurrence of symptom clusters.

METHODS

Between February 2022 and June 2023, a total of 418 patients diagnosed with SARS-CoV-2 infection were recruited in the Second Affiliated Hospital of Chongqing Medical University. A symptom questionnaire was utilized to assess three dimensions encompassing a comprehensive range of 40 symptoms. Principal component analysis was employed to identify distinct symptom clusters, while network analysis elucidated the interconnections among these symptoms. Univariate analysis and multiple linear regression analysis were conducted to investigate the factors influencing the manifestation of these symptom clusters.

RESULTS

Eight symptom clusters were identified, namely the nasopharyngeal-related symptom cluster, the circulatory-related symptom cluster, the neural-related symptom cluster, the physical-related symptom cluster, the digestive-related symptom cluster, the respiratory-related symptom cluster, the fever-related symptom cluster, and the sensory-related symptom cluster. The three centrality indices with the highest values were chest tightness (rs = 7.84, rc = 0.013, rb = 6.99), muscle aches (rs = 7.32, rc = 0.013, rb = 2.72), and smell abnormality (rs = 6.56, rc = 0.011, rb = 4.58). Variables including age, gender, income, education, hyperlipidemia, chronic bronchitis, and tumor were associated with the occurrence of these eight symptom clusters.

CONCLUSION

The findings of this study highlight the necessity to explore symptom clusters and symptom networks in order to enhance the effectiveness of symptom management in patients with SARS-CoV-2 infection. Particularly crucial is the evaluation of centrality indices as an integral component of caring for such patients. Early detection of high-risk individuals within each symptom cluster can provide a scientific foundation for developing interventions that will optimize patient prognosis.

摘要

背景

症状群和症状网络可能会提高症状管理的精准度。然而,关于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染患者所经历的症状网络的研究有限。

目的

确定SARS-CoV-2感染患者症状群的组成,建立症状网络以探索中心性指标,并调查影响症状群发生的独立危险因素。

方法

2022年2月至2023年6月期间,重庆医科大学附属第二医院共招募了418例确诊为SARS-CoV-2感染的患者。采用症状问卷评估三个维度,涵盖40种症状。运用主成分分析确定不同的症状群,同时通过网络分析阐明这些症状之间的相互联系。进行单因素分析和多元线性回归分析以研究影响这些症状群表现的因素。

结果

确定了八个症状群,即鼻咽相关症状群、循环相关症状群、神经相关症状群、身体相关症状群、消化相关症状群、呼吸相关症状群、发热相关症状群和感觉相关症状群。中心性指标值最高的三个是胸闷(rs = 7.84,rc = 0.013,rb = 6.99)、肌肉酸痛(rs = 7.32,rc = 0.013,rb = 2.72)和嗅觉异常(rs = 6.56,rc = 0.011,rb = 4.58)。年龄、性别、收入、教育程度、高脂血症、慢性支气管炎和肿瘤等变量与这八个症状群的发生有关。

结论

本研究结果强调了探索症状群和症状网络以提高SARS-CoV-2感染患者症状管理有效性的必要性。特别重要的是评估中心性指标作为护理此类患者的一个组成部分。早期发现每个症状群中的高危个体可为制定优化患者预后的干预措施提供科学依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81b/11625128/29ec410f1b1b/gr1.jpg

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