Zhang Hui, Yang Peng, Gu Xiaoying, Sun Ying, Zhang Rongling, Zhang Daitao, Zhang Jiaojiao, Wang Yeming, Ma Chunna, Liu Min, Ma Jiaxin, Li Aili, Wang Yingying, Ma Xiao, Cui Xiaojing, Wang Yimin, Liu Zhibo, Wang Wei, Zheng Zhi, Li Yong, Wu Jin, Wang Quanyi, Cao Bin
National Center for Respiratory Medicine, Beijing, PR China.
State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, PR China.
Lancet Reg Health West Pac. 2025 Mar 13;56:101507. doi: 10.1016/j.lanwpc.2025.101507. eCollection 2025 Mar.
Characterizing the paradigm and impact of long COVID is crucial for addressing this worldwide health challenge. This study aimed to investigate the prevalence of long COVID one year after primary Omicron infection and characterize differences in long-term health consequence between participants with persistent long COVID and those who fully recovered.
This a community-based cross-sectional study conducted from December 2023 to March 2024 at the China-Japan Friendship Hospital and 16 administrative districts in Beijing. 12,789 participants infected with Omicron between December 2022 and January 2023 were recruited through stratified multistage random sampling and included in the final analysis. Of them, 376 participants with persistent long COVID and 229 without long COVID were matched for further physical examinations. The primary outcome was the prevalence of long COVID one year after infection. Secondary outcomes included muscle strength, exercise capacity, health-related quality of life (HRQoL), mental health, work status, laboratory tests, and examinations.
Among 12,789 participants (media [IQR] age, 48.4 [37.3 to 61.4] years; 7817 females [61.1%]), 995 of them (7.8%) experienced long COVID within one year, with 651 (5.1%) having persistent symptoms. Fatigue (598/995 [60.1%]) and post-exertional malaise (367/995 [36.9%]) were the most common symptoms. Brain fog had the lowest resolution proportion as 4.2% within one year. The odds of long COVID increased with reinfections (odds ratios for one reinfection 2.592 [95% CI: 2.188 to 3.061]; two or more: 6.171 [3.227 to 11.557]; all p < 0.001). Participants with persistent long COVID had markedly lower muscle strength (upper-limb: 26.9 ± 12.4 vs. 29.1 ± 14.5 Kg; lower-limb: 40.0 [27.0 to 62.0] vs. 43.0 [28.0 to 59.0] s), worse exercise capacity and poorer HRQoL, and meaningful difference in laboratory tests results compared to those without long COVID. They also exhibited significantly higher proportions of abnormal lung function (FEV %pred<80%: 13.0% vs. 2.0%; DLco %pred<80%: 32.7% vs. 19.9%) and lung imaging abnormalities (23.5% vs. 13.6%).
The considerable health burden of long COVID and the progression of neurological symptoms following Omicron infection warrant close monitoring. Utilizing professional questionnaires and developing reliable diagnostic tools are necessary for improving diagnosis and treatment of long COVID.
This work was supported by Beijing Research Center for Respiratory Infectious Diseases (BJRID2024-012), Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2022-I2M-CoV19-005/CIFMS 2021-I2M-1-048), the National Natural Science Foundation of China (82241056/82200114/82200009), the New Cornerstone Science Foundation.
明确新冠长期症状的模式和影响对于应对这一全球健康挑战至关重要。本研究旨在调查初次感染奥密克戎毒株一年后新冠长期症状的患病率，并描述持续存在新冠长期症状的参与者与完全康复者在长期健康后果方面的差异。
这是一项基于社区的横断面研究，于2023年12月至2024年3月在中国医学科学院中日友好医院及北京市16个行政区开展。通过分层多阶段随机抽样招募了2022年12月至2023年1月期间感染奥密克戎毒株的12789名参与者，并纳入最终分析。其中，376名持续存在新冠长期症状的参与者和229名无新冠长期症状的参与者进行匹配，以进行进一步的体格检查。主要结局是感染一年后新冠长期症状的患病率。次要结局包括肌肉力量、运动能力、健康相关生活质量（HRQoL）、心理健康、工作状态、实验室检查和体格检查。
在12789名参与者中（中位[四分位间距]年龄，48.4[37.3至61.4]岁；7817名女性[61.1%]），其中995人（7.8%）在一年内出现新冠长期症状，651人（5.1%）有持续症状。疲劳（598/995[60.1%]）和运动后不适（367/995[36.9%]）是最常见的症状。脑雾在一年内的缓解比例最低，为4.2%。新冠长期症状的几率随再次感染而增加（一次再次感染的比值比为2.592[95%CI：2.188至3.061]；两次或更多次：6.171[3.227至11.557]；所有p<0.001）。与无新冠长期症状的参与者相比，持续存在新冠长期症状的参与者肌肉力量明显更低（上肢：26.9±12.4 vs. 29.1±14.5 Kg；下肢：40.0[27.0至62.0] vs. 43.0[28.0至59.0]s），运动能力更差，HRQoL更差，实验室检查结果也有显著差异。他们还表现出肺功能异常（FEV%预计值<80%：13.0% vs. 2.0%；DLco%预计值<80%：32.7% vs. 19.9%）和肺部影像学异常（23.5% vs. 13.6%）的比例明显更高。
新冠长期症状带来的巨大健康负担以及奥密克戎感染后神经症状的进展值得密切监测。使用专业问卷并开发可靠的诊断工具对于改善新冠长期症状的诊断和治疗是必要的。
本研究得到了北京呼吸传染病研究中心（BJRID2024 - 012）、中国医学科学院医学与健康科技创新工程（2022 - I2M - CoV19 - 005/CIFMS 2021 - I2M - 1 - 048）、国家自然科学基金（82241056/82200114/82200009）、新基石科学基金的支持。
