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非新冠病毒呼吸道感染后的多器官后遗症:综述

Multiorgan sequelae following non-COVID-19 respiratory infections: a review.

作者信息

Weckler Barbara Christine, Kutzinski Max, Vogelmeier Claus Franz, Schmeck Bernd

机构信息

Department of Medicine, Pulmonary and Critical Care Medicine, Clinic for Airway Infections, University Medical Centre Marburg, Philipps-University Marburg, Marburg, Germany.

Institute for Lung Research, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps-Universität Marburg, Marburg, Germany.

出版信息

Infection. 2025 Apr 4. doi: 10.1007/s15010-025-02519-7.

Abstract

BACKGROUND

While numerous studies have documented severe and long-term health impacts of COVID-19 infections on various organs, the prolonged multisystemic implications of other acute respiratory infections (ARIs) are poorly understood. This review therefore analyzed currently available studies about these sequelae of ARIs excluding COVID-19.

MAIN BODY

Multiple pathogens causing ARIs are associated with significant long-lasting impairments across various organ systems. Cardiovascular events occur in 10-35% of patients following ARIs, with an elevated risk persisting for 10 years. The stroke incidence ratio increases significantly after ARIs up to 12.3. Pulmonary sequelae are common, including abnormal lung function in 54%, parenchymal opacification in 51%, lung fibrosis in 33-62%, asthma in 30%, and bronchiectasis in 24% of patients. The risk of developing dementia is increased 2.2-fold. Posttraumatic stress disorder, depression, anxiety, and chronic fatigue occur in 15-43%, 15-36%, 14-62%, and 27-75% of patients, respectively. 28-day mortality from CAP with (versus no) additional cardiovascular event is increased to 36% (versus 10%). Long-term mortality from CAP (versus no CAP) remains elevated for years post-infection, with a 1-year, 5-year, and 7-year mortality rate of 17% (versus 4%), 43% (versus 19%), and 53% (versus 24%), respectively. Patients´ quality of life is significantly reduced, with 17% receiving invalidity pensions and 22% retiring within 4 years of severe ARIs.

CONCLUSION

Non-COVID-19 ARIs are associated with clinically relevant, frequent, and long-term sequelae involving multiple organ systems. Further prospective studies are needed.

摘要

背景

虽然众多研究记录了新冠病毒感染对各个器官造成的严重且长期的健康影响,但对于其他急性呼吸道感染(ARI)的长期多系统影响却知之甚少。因此,本综述分析了目前关于排除新冠病毒感染之外的急性呼吸道感染后遗症的现有研究。

正文

多种导致急性呼吸道感染的病原体与各个器官系统的显著长期损害有关。急性呼吸道感染后,10%至35%的患者会发生心血管事件,风险升高持续10年。急性呼吸道感染后中风发病率显著增加,高达12.3。肺部后遗症很常见,包括54%的患者肺功能异常、51%的患者实质浑浊、33%至62%的患者肺纤维化、30%的患者哮喘以及24%的患者支气管扩张。患痴呆症的风险增加2.2倍。创伤后应激障碍、抑郁症、焦虑症和慢性疲劳分别发生在15%至43%、15%至36%、14%至62%和27%至75%的患者中。伴有(相对于无)额外心血管事件的社区获得性肺炎(CAP)患者28天死亡率增至36%(相对于10%)。感染后数年,CAP(相对于无CAP)患者的长期死亡率仍然较高,1年、5年和7年死亡率分别为17%(相对于4%)、43%(相对于19%)和53%(相对于24%)。患者的生活质量显著下降,17%的患者领取病残抚恤金,22%的患者在严重急性呼吸道感染后4年内退休。

结论

非新冠病毒感染的急性呼吸道感染与涉及多个器官系统的临床相关、频繁且长期的后遗症有关。需要进一步开展前瞻性研究。

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