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新冠病毒感染状态导致的身体功能差异:来自RECOVER成人队列的横断面分析

Physical Function Differences by COVID-19 Status: A Cross-sectional Analysis From the RECOVER Adult Cohort.

作者信息

Kulik Grace L, Zheng Tianyu, Jolley Sarah E, Ashktorab Hassan, Brim Hassan, Feuerriegel Elen M, Hafner John W, Hess Rachel, Horne Benjamin D, Hornig Mady, Johnson Brandon, Kim C, Laiyemo Adeyinka O, McComsey Grace A, Nikolich Janko Ž, Reid Kayleigh, Scherry John, Sherif Zaki A, Tran Huong G, Verduzco-Gutierrez Monica, West Shelby, Erlandson Kristine M

机构信息

Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.

Population Health Sciences Department, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT 84112 , United States.

出版信息

Phys Ther. 2025 Jul 1;105(7). doi: 10.1093/ptj/pzaf063.

Abstract

IMPORTANCE

Many adults with prior SARS-CoV-2 infection have persistent limitations, but few studies have examined objective physical function impairment that persist longer than 3 months after infection.

OBJECTIVE

The objective was to characterize physical function impairment among adults with and without SARS-CoV-2 infection.

DESIGN

This study was a retrospective, cross-sectional analysis.

SETTING

Researching COVID to Enhance Recovery (RECOVER) initiative, a multi-site observational study in the United States (ClinicalTrials.gov: NCT05172024).

PARTICIPANTS

Participants were adults ≥18 years old with and without SARS-CoV-2 infection.

EXPOSURES

Groups were defined based on COVID-19 status at enrollment: never diagnosed (control), diagnosed with COVID-19 ≤ 12 weeks (recent COVID-19), or > 12 weeks prior to enrollment (remote COVID-19). The RECOVER-Adult Long COVID Index was used to further characterize by Index ≥12 versus 0.

MAIN OUTCOMES/MEASURES: Physical function (main outcome) was assessed by number of repetitions on a 30-second sit-to-stand test (30STS).

RESULTS

30STS assessments at enrollment were available from 11,578 participants. 30STS repetitions were lowest in the remote COVID-19 group (n = 4942) with 11.5 (SD = 4.2) repetitions compared to 12.5 (SD = 4.7) repetitions among controls (n = 1887) or 12.2 (SD = 4.5) in recent COVID-19 (n = 4698). Remote COVID-19, but not recent COVID-19, was associated with lower physical function in the adjusted model (-0.61 repetitions; SD = 0.21). Those with RECOVER Long COVID Research Index ≥12 performed 1.6 (SD = 0.2) fewer repetitions than those with an Index equal 0.

CONCLUSIONS

Physical function impairment did not show clinically meaningful group differences between RECOVER Adult Cohort participants by COVID-19 status, or by Long COVID Index. Individual responses over time or in response to an intervention may be more clinically relevant.

RELEVANCE

In the RECOVER adult cohort, overall physical function differences by time since COVID-19 or by Long COVID Index were small. Individualized assessments are needed to determine functional impairment following COVID-19 diagnosis and subsequent steps for rehabilitation interventions.

摘要

重要性

许多曾感染过严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的成年人存在持续的功能受限情况,但很少有研究调查感染后持续超过3个月的客观身体功能损害。

目的

目的是描述感染和未感染SARS-CoV-2的成年人的身体功能损害情况。

设计

本研究为回顾性横断面分析。

背景

“研究新冠以促进康复”(RECOVER)倡议,一项在美国开展的多中心观察性研究(ClinicalTrials.gov:NCT05172024)。

参与者

参与者为年龄≥18岁、有或无SARS-CoV-2感染的成年人。

暴露因素

根据入组时的2019冠状病毒病(COVID-19)状态定义分组:从未确诊(对照组)、确诊COVID-19≤12周(近期COVID-19)或入组前>12周(既往COVID-19)。使用RECOVER成人长期新冠指数进一步按指数≥12与0进行特征描述。

主要结局/测量指标:身体功能(主要结局)通过30秒坐立试验(30STS)的重复次数进行评估。

结果

11578名参与者有入组时的30STS评估数据。既往COVID-19组(n = 4942)的30STS重复次数最低,为11.5次(标准差=4.2),而对照组(n = 1887)为12.5次(标准差=4.7),近期COVID-19组(n = 4698)为12.2次(标准差=4.5)。在调整模型中,既往COVID-19组,而非近期COVID-19组,与较低的身体功能相关(-0.61次重复;标准差=0.21)。RECOVER长期新冠研究指数≥12的参与者比指数为0的参与者少做1.6次(标准差=0.2)重复动作。

结论

按COVID-19状态或长期新冠指数来看,RECOVER成人队列参与者之间的身体功能损害在临床上未显示出有意义的组间差异。随时间的个体反应或对干预的反应可能在临床上更具相关性。

相关性

在RECOVER成人队列中,自COVID-19感染后的时间或长期新冠指数导致的总体身体功能差异较小。需要进行个体化评估以确定COVID-19诊断后的功能损害以及康复干预的后续步骤。

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