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住院患者中作为新型冠状病毒感染后急性后遗症预测指标的早期生物标志物:一项为期一年的队列研究。

Early biomarkers in hospitalized patients as predictors of post-acute sequelae of SARS-CoV-2 infection: a one-year cohort study.

作者信息

Nair Chithira V, Krishnakumar Malavika, Gutjahr Georg, Kulirankal Kiran G, Moni Merlin, Sathyapalan Dipu T

机构信息

Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, India.

Department of Health Sciences Research, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

出版信息

BMC Infect Dis. 2025 Mar 24;25(1):398. doi: 10.1186/s12879-025-10619-w.

Abstract

BACKGROUND

Post-acute sequelae of SARS-CoV-2 infection (PASC) represent a significant challenge in patient care, with symptoms persisting beyond three month's post-recovery. This study aimed to evaluate the incidence of PASC at one year post-COVID-19 and identify predictive biomarkers and comorbidities for effective risk stratification.

METHODS

A cohort of 120 adult patients, including 50 intensive care and 70 non-intensive care patients, was followed up at two weeks, six weeks, and one-year post-discharge using structured questionnaires. The study integrated comorbidities and laboratory biomarkers to forecast the risk for PASC.

RESULTS

The median age of participants was 56 years, with 40% having moderate to severe comorbidities. A year post-recovery, 32.8% exhibited post COVID-19 conditions. The most common symptoms were constitutional (16%), respiratory (8.4%), and neuropsychiatric (2.5%). Bayesian network analysis indicated significant correlations between constitutional symptoms, rehospitalisation, and biomarkers including C-reactive protein, lactate-dehydrogenase, ferritin, and albumin.

CONCLUSION

This study highlights the prolonged impact of PASC, one-year post infection. It highlights the role of specific biomarkers such as C-reactive protein, lactate-dehydrogenase, ferritin, and albumin in tailoring individual patient care by advancing understanding in post-COVID-19 symptoms prediction. Our findings support the need for further research to refine these insights, which are pivotal for the ongoing care of patients in the aftermath of COVID-19.

摘要

背景

2019冠状病毒病感染后急性后遗症(PASC)给患者护理带来了重大挑战,症状在康复后三个月仍持续存在。本研究旨在评估COVID-19感染后一年时PASC的发病率,并确定有效的风险分层预测生物标志物和合并症。

方法

对120名成年患者进行队列研究,其中包括50名重症监护患者和70名非重症监护患者,在出院后两周、六周和一年使用结构化问卷进行随访。该研究综合了合并症和实验室生物标志物来预测PASC的风险。

结果

参与者的中位年龄为56岁,40%患有中度至重度合并症。康复一年后,32.8%的患者表现出COVID-19后状况。最常见的症状为全身性症状(16%)、呼吸道症状(8.4%)和神经精神症状(2.5%)。贝叶斯网络分析表明,全身性症状、再次住院与包括C反应蛋白、乳酸脱氢酶、铁蛋白和白蛋白在内的生物标志物之间存在显著相关性。

结论

本研究强调了感染一年后PASC的长期影响。它强调了C反应蛋白、乳酸脱氢酶、铁蛋白和白蛋白等特定生物标志物在通过加深对COVID-19后症状预测的理解来定制个性化患者护理方面的作用。我们的研究结果支持进一步研究以完善这些见解的必要性,这些见解对于COVID-19后患者的持续护理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0ac/11931858/451c754b25cb/12879_2025_10619_Fig1_HTML.jpg

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