Morgan Sandra, Smith James M, Thomas Bini, Moreno Maria, Visovsky Constance, Beckie Theresa
University of South Florida, Tampa, USA.
University of Connecticut, Storrs, USA.
Clin Nurs Res. 2025 May;34(3-4):195-212. doi: 10.1177/10547738251314076. Epub 2025 Jan 28.
The most frequently reported post-coronavirus disease of 2019 (COVID-19) symptoms include shortness of breath, fatigue, and cognitive disturbances, with reports of persistent dyspnea ranging between 26% and 41%. There is an urgent need to understand the risk factors and predictors for persistent COVID-19 dyspnea in individuals at all levels of COVID-19 illness severity, to enable the implementation of targeted interventions for those likely to be most affected with persistent dyspnea. Thus, the purpose of this systematic review is to explore the risk factors and predictors that are associated with persistent dyspnea in the post-COVID-19 population. This review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and registered prospectively in PROSPERO as CRD42023466713. A search strategy was conducted across , and databases, that included studies conducted from 2020 to March 2024. The Covidence platform was used for screening studies, scoring methodologic quality, and performing data extraction using a two-step independent review process. This review included 33 studies, addressing 83,920 participants across 20 countries. The strongest predictive risk factors for persistent dyspnea included the following: female sex, elevated body mass index, pulmonary comorbidities, pre-existing anxiety and depression, pre-COVID-19 physical limitations, the severity of the COVID-19 illness, and socioeconomic differences. Potential risk factors included increased age, smoking history, and COVID-19 variant type. The presence of biomarkers for persistent dyspnea in the post-COVID-19 population can be used by clinicians to prospectively identify those individuals who should be flagged. Early identification may then be leveraged for timely referral for prophylactic and rehabilitative interventions for dyspnea. A personalized plan to target those risk factors that are modifiable should follow.
2019冠状病毒病（COVID-19）最常报告的症状包括呼吸急促、疲劳和认知障碍，持续性呼吸困难的报告发生率在26%至41%之间。迫切需要了解COVID-19疾病严重程度各层次个体中持续性COVID-19呼吸困难的风险因素和预测指标，以便能够对可能受持续性呼吸困难影响最大的人群实施有针对性的干预措施。因此，本系统评价的目的是探讨与COVID-19后人群持续性呼吸困难相关的风险因素和预测指标。本评价按照系统评价和Meta分析的首选报告项目指南进行，并前瞻性地在国际前瞻性系统评价注册库（PROSPERO）中注册为CRD42023466713。在多个数据库中进行了检索策略，包括2020年至2024年3月开展的研究。使用Covidence平台筛选研究、评估方法学质量，并采用两步独立评审流程进行数据提取。本评价纳入了33项研究，涉及20个国家的83920名参与者。持续性呼吸困难最强的预测风险因素包括：女性、体重指数升高、肺部合并症、既往焦虑和抑郁、COVID-19前身体受限、COVID-19疾病严重程度以及社会经济差异。潜在风险因素包括年龄增加、吸烟史和COVID-19病毒变异类型。COVID-19后人群中持续性呼吸困难生物标志物的存在可被临床医生用于前瞻性识别那些应被标记的个体。然后可利用早期识别结果及时转诊，以便对呼吸困难进行预防性和康复性干预。接下来应制定针对那些可改变的风险因素的个性化计划。
