新冠后肌痛性脑脊髓炎的发病率和患病率：来自观察性RECOVER-成人研究的报告
Incidence and Prevalence of Post-COVID-19 Myalgic Encephalomyelitis: A Report from the Observational RECOVER-Adult Study.
作者信息
Vernon Suzanne D, Zheng Tianyu, Do Hyungrok, Marconi Vincent C, Jason Leonard A, Singer Nora G, Natelson Benjamin H, Sherif Zaki A, Bonilla Hector Fabio, Taylor Emily, Mullington Janet M, Ashktorab Hassan, Laiyemo Adeyinka O, Brim Hassan, Patterson Thomas F, Akintonwa Teresa T, Sekar Anisha, Peluso Michael J, Maniar Nikita, Bateman Lucinda, Horwitz Leora I, Hess Rachel
机构信息
Bateman Horne Center, 24 S 1100 E Suite 205, Salt Lake City, UT, USA.
Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA.
出版信息
J Gen Intern Med. 2025 Apr;40(5):1085-1094. doi: 10.1007/s11606-024-09290-9. Epub 2025 Jan 13.
BACKGROUND
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may occur after infection. How often people develop ME/CFS after SARS-CoV-2 infection is unknown.
OBJECTIVE
To determine the incidence and prevalence of post-COVID-19 ME/CFS among adults enrolled in the Researching COVID to Enhance Recovery (RECOVER-Adult) study.
DESIGN, SETTING, AND PARTICIPANTS: RECOVER-Adult is a longitudinal observational cohort study conducted across the U.S. We included participants who had a study visit at least 6 months after infection and had no pre-existing ME/CFS, grouped as (1) acute infected, enrolled within 30 days of infection or enrolled as uninfected who became infected (n=4515); (2) post-acute infected, enrolled greater than 30 days after infection (n=7270); and (3) uninfected (1439).
MEASUREMENTS
Incidence rate and prevalence of post-COVID-19 ME/CFS based on the 2015 Institute of Medicine ME/CFS clinical diagnostic criteria.
RESULTS
The incidence rate of ME/CFS in participants followed from time of SARS-CoV-2 infection was 2.66 (95% CI 2.63-2.70) per 100 person-years while the rate in matched uninfected participants was 0.93 (95% CI 0.91-10.95) per 100 person-years: a hazard ratio of 4.93 (95% CI 3.62-6.71). The proportion of all RECOVER-Adult participants that met criteria for ME/CFS following SARS-CoV-2 infection was 4.5% (531 of 11,785) compared to 0.6% (9 of 1439) in uninfected participants. Post-exertional malaise was the most common ME/CFS symptom in infected participants (24.0%, 2830 of 11,785). Most participants with post-COVID-19 ME/CFS also met RECOVER criteria for long COVID (88.7%, 471 of 531).
LIMITATIONS
The ME/CFS clinical diagnostic criteria uses self-reported symptoms. Symptoms can wax and wane.
CONCLUSION
ME/CFS is a diagnosable sequela that develops at an increased rate following SARS-CoV-2 infection. RECOVER provides an unprecedented opportunity to study post-COVID-19 ME/CFS.
背景
肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）可能在感染后出现。感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后有多少人会患上ME/CFS尚不清楚。
目的
确定参与“研究新冠以促进康复（成人组）”（RECOVER-Adult）研究的成年人中新冠后ME/CFS的发病率和患病率。
设计、设置和参与者：RECOVER-Adult是一项在美国开展的纵向观察性队列研究。我们纳入了在感染后至少6个月进行过一次研究访视且此前无ME/CFS病史的参与者，分为三组：（1）急性感染组，在感染后30天内入组或入组时未感染但后来感染的（n = 4515）；（2）急性感染后组，在感染后30天以上入组（n = 7270）；（3）未感染组（1439）。
测量指标
根据2015年医学研究所的ME/CFS临床诊断标准，评估新冠后ME/CFS的发病率和患病率。
结果
从SARS-CoV-2感染时开始随访的参与者中，ME/CFS的发病率为每100人年2.66例（95%置信区间2.63 - 2.70），而匹配的未感染参与者的发病率为每100人年0.93例（95%置信区间0.91 - 10.95）：风险比为4.93（95%置信区间3.62 - 6.71）。在所有RECOVER-Adult参与者中，感染SARS-CoV-2后符合ME/CFS标准的比例为4.5%（11785人中的531人），而未感染参与者中这一比例为0.6%（1439人中的9人）。运动后不适是感染参与者中最常见的ME/CFS症状（24.0%，11785人中的2830人）。大多数新冠后ME/CFS参与者也符合“长期新冠”的RECOVER标准（88.7%，531人中的471人）。
局限性
ME/CFS临床诊断标准采用自我报告症状。症状可能会有波动。
结论
ME/CFS是一种可诊断的后遗症，在SARS-CoV-2感染后发病率增加。RECOVER为研究新冠后ME/CFS提供了前所未有的机会。
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