Qin Shijie, Zhang Yanan, Li Yanhua, Huang Ling, Yang Ting, Si Jiahui, Wang Likui, Zhao Xin, Ma Xiaopeng, Gao George F
Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China.
Innovative Vaccine and Immunotherapy Research Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009, China.
Lancet Reg Health West Pac. 2024 Oct 11;52:101218. doi: 10.1016/j.lanwpc.2024.101218. eCollection 2024 Nov.
Research on long COVID in China is limited, particularly in terms of large-sample epidemiological data and the effects of recent SARS-CoV-2 sub-variants. China provides an ideal study environment owing to its large infection base, high vaccine coverage, and stringent pre-pandemic measures.
This retrospective study used an online questionnaire to investigate SARS-CoV-2 infection status and long COVID symptoms among 74,075 Chinese residents over one year. The relationships between baseline characteristics, vaccination status, pathogenic infection, and long COVID were analyzed using multinomial logistic regression, and propensity matching.
Analysis of 68,200 valid responses revealed that the most frequent long COVID symptoms include fatigue (30.53%), memory decline (27.93%), decreased exercise ability (18.29%), and brain fog (16.87%). These symptoms were less prevalent among those infected only once: fatigue (24.85%), memory decline (18.11%), and decreased exercise ability (12.52%), etc. Women were more likely to experience long COVID, with symptoms varying by age group, except for sleep disorders and muscle/joint pain, which were more common in older individuals. Northern China exhibits a higher prevalence of long COVID, potentially linked to temperature gradients. Risk factors included underlying diseases, alcohol consumption, smoking, and the severity of acute infection (OR > 1, FDR < 0.05). Reinfection was associated with milder symptoms but led to a higher incidence and severity of long COVID (OR > 1, FDR < 0.05). Vaccination, particularly multiple boosters, significantly reduced long-term symptoms by 30%-70% (OR < 1, FDR < 0.05). COVID-19 participants also self-reported more bacterial, influenza and mycoplasma infections, and 8%-10% of patients felt SARS-CoV-2-induced chronic diseases.
This survey provides valuable insights into long COVID situation among Chinese residents, with 10%-30% (including repeated infection) reporting symptoms. Monitoring at-risk individuals based on identified risk factors is essential for public health efforts.
This study was funded by the China Postdoctoral Science Foundation (2022M723344, 2023M743729), Guangdong Basic and Applied Basic Research Foundation (2023A1515110489), and the Bill & Melinda Gates Foundation (INV-027420).
中国对新冠长期症状的研究有限，尤其是在大样本流行病学数据以及新冠病毒近期变异株的影响方面。由于中国感染基数大、疫苗接种率高且疫情前措施严格，提供了一个理想的研究环境。
这项回顾性研究通过在线问卷调查了74075名中国居民在一年多时间里的新冠病毒感染状况和新冠长期症状。使用多项逻辑回归和倾向匹配分析了基线特征、疫苗接种状况、病原体感染与新冠长期症状之间的关系。
对68200份有效回复的分析显示，最常见的新冠长期症状包括疲劳（30.53%）、记忆力下降（27.93%）、运动能力下降（18.29%）和脑雾（16.87%）。这些症状在仅感染过一次的人群中不太普遍：疲劳（24.85%）、记忆力下降（18.11%）和运动能力下降（12.52%）等。女性更易出现新冠长期症状，症状因年龄组而异，不过睡眠障碍和肌肉/关节疼痛在老年人中更常见。中国北方新冠长期症状的患病率较高，可能与温度梯度有关。风险因素包括基础疾病、饮酒、吸烟以及急性感染的严重程度（OR>1，FDR<0.05）。再次感染与较轻的症状相关，但会导致新冠长期症状的发生率和严重程度更高（OR>1，FDR<0.05）。接种疫苗，尤其是多次加强接种，可显著将长期症状降低30%-70%（OR<1，FDR<0.05）。感染新冠的参与者还自述有更多细菌、流感和支原体感染，8%-10%的患者感觉有新冠病毒引发的慢性病。
这项调查为中国居民的新冠长期症状情况提供了有价值的见解，10%-30%（包括重复感染）的人报告有症状。基于已确定的风险因素对高危个体进行监测对公共卫生工作至关重要。
本研究由中国博士后科学基金（2022M723344，2023M743729）、广东省基础与应用基础研究基金（2023A1515110489）以及比尔及梅琳达·盖茨基金会（INV-027420）资助。
