Escoda Thomas, Chiche Laurent, Faralli Hervé, Cohen Frédéric, Halfon Philippe, Pegliasco Hervé, Rebaudet Stanislas
Internal Medicine, European Hospital Marseille, Marseille, France
Internal Medicine, European Hospital Marseille, Marseille, France.
BMJ Open. 2025 Feb 11;15(2):e089136. doi: 10.1136/bmjopen-2024-089136.
This study aims to characterise the diversity of post-COVID-19 physical and mental health outcomes, known as the post-COVID-19 condition (PCC), and the determining factors 3-6 months after acute SARS-CoV-2 infection.
This is a prospective cohort study.
This study took place at the European Hospital of Marseille, France.
Participants include patients with acute COVID-19 treated as inpatients or outpatients.
Interventions include face-to-face assessment of physical and mental health symptoms.
Main outcome measures include symptom scores and scales, as well as paraclinical elements (thoracic CT scan, pulmonary functional tests). Multiple component analysis was used to identify clinical phenotypic clusters of PCC patients, as well as their initial comorbidity groups. A multinomial regression model was used to evaluate the association between the initial comorbidities and disease severity with PCC phenotype.
A total of 210 patients agreed to participate, of which 157 (75%) reported at least one symptom at the 3-6 months visit; mostly asthenia, dyspnoea, psychiatric disorders such as anxiety, depression, post-traumatic stress disorder and cognitive disorders. Four PCC clusters were recognised: (1) paucisymptomatic PCC (n=82, 39%); (2) physical sequelae PCC (n=39, 18.6%), (3) pre-existing pulmonary comorbidities PCC (n=29, 13.8%); and (4) functional somatic and/or mental symptoms PCC (n=60, 28.6%). In addition to their PCC symptoms, the patients in these clusters differed in terms of their demographic characteristics (sex), comorbidities and severity of COVID-19.
The four identified PCC clusters corresponded to distinct and coherent clinical and paraclinical entities, making it possible to consider adapted and personalised prognosis and therapeutic interventions.
本研究旨在描述新冠病毒感染后状况（PCC）这一新冠后身心健康结果的多样性，以及急性SARS-CoV-2感染3至6个月后的决定因素。
这是一项前瞻性队列研究。
本研究在法国马赛的欧洲医院进行。
参与者包括接受住院或门诊治疗的急性新冠肺炎患者。
干预措施包括对身心健康症状进行面对面评估。
主要结局指标包括症状评分和量表，以及辅助临床指标（胸部CT扫描、肺功能测试）。采用多成分分析来识别PCC患者的临床表型集群及其初始合并症组。使用多项回归模型评估初始合并症和疾病严重程度与PCC表型之间的关联。
共有210名患者同意参与，其中157名（75%）在3至6个月的随访中报告了至少一种症状；最常见的是乏力、呼吸困难、焦虑、抑郁、创伤后应激障碍和认知障碍等精神疾病。识别出四个PCC集群：（1）症状轻微的PCC（n = 82，39%）；（2）有身体后遗症的PCC（n = 39，18.6%），（3）存在肺部合并症的PCC（n = 29，13.8%）；以及（4）功能性躯体和/或精神症状的PCC（n = 60，28.6%）。除了PCC症状外，这些集群中的患者在人口统计学特征（性别）、合并症和新冠肺炎严重程度方面也存在差异。
识别出的四个PCC集群对应于不同且连贯的临床和辅助临床实体，从而有可能考虑采用适应性和个性化的预后及治疗干预措施。
