初级保健中管理的中度严重新型冠状病毒2型下呼吸道感染成人患者的长期预后:前瞻性队列研究

Long-term prognosis of adults with moderately severe SARS-CoV-2 lower respiratory tract infection managed in primary care: Prospective cohort study.

作者信息

Platteel Tamara N, Koelmans Johannes C, Cianci Daniela, Broers Natasha J H, de Bont Eefje G P M, Cals Jochen W L, Venekamp Roderick P, Verheij Theo J M

机构信息

Department of General Practice & Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

出版信息

Eur J Gen Pract. 2025 Dec;31(1):2501306. doi: 10.1080/13814788.2025.2501306. Epub 2025 Jun 2.

Abstract

BACKGROUND

Information about the incidence of persisting symptoms after COVID-19 and its impact on patients treated in primary care are scarce.

OBJECTIVES

To determine differences in health-related quality of life (HRQoL) and symptomatology between adults with and without SARS-CoV-2 moderately severe lower respiratory tract infection (LRTI) in the 12 months following their primary care visit.

METHODS

Prospective cohort study in 35 Dutch practices. Individuals aged ≥18 years who presented to their general practitioner (GP) with a moderately severe LRTI during the first COVID-19 waive in The Netherlands (March-June 2020,  = 277; 268 (97%) with complete follow-up) were included between September and December 2020, then underwent serology testing (participants, GPs and study personnel remained blinded for serology outcomes during study conduct) and completed baseline and follow-up questionnaires. Main outcome measures: (1) SF-36 scores, and (2) risk of persisting symptoms during 12 months follow-up.

RESULTS

The change in SF-36 PSC ( = 0.13), MCS ( = 0.30) during 12 months follow-up did not differ between SARS-CoV-2 serology positive and negative participants after adjusting for sex, age, BMI, diabetes, and chronic pulmonary conditions. The risk of any persisting symptom during 12 months follow-up did not significantly differ between the groups (aHR 0.61, 95% CI 0.33-1.15), nor did the risk of individual symptoms.

CONCLUSIONS

In the 12 months following their moderately severe LRTI, primary care patients with and without confirmed SARS-CoV-2 infection had a comparable HRQoL profile. A substantial proportion of participants reported persisting symptoms, indicating that persisting symptoms can occur following LRTIs irrespective of causative pathogen.

摘要

背景

关于新冠病毒感染后持续症状的发生率及其对初级保健中接受治疗患者的影响的信息匮乏。

目的

确定在初级保健就诊后12个月内,患有和未患有中度严重严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)下呼吸道感染(LRTI)的成年人在健康相关生活质量(HRQoL)和症状方面的差异。

方法

在35家荷兰医疗机构开展前瞻性队列研究。2020年9月至12月纳入了年龄≥18岁、在荷兰首次新冠疫情期间(2020年3月至6月)因中度严重LRTI就诊于全科医生(GP)的个体(n = 277;268例(97%)完成随访),随后进行血清学检测(研究期间参与者、全科医生和研究人员对血清学结果保持盲态)并完成基线和随访问卷。主要结局指标:(1)SF-36评分,以及(2)12个月随访期间持续症状的风险。

结果

在调整性别、年龄、体重指数、糖尿病和慢性肺部疾病后,SARS-CoV-2血清学阳性和阴性参与者在12个月随访期间的SF-36身体成分总结(PCS)(β = 0.13)、心理成分总结(MCS)(β = 0.30)变化无差异。两组在12个月随访期间出现任何持续症状的风险无显著差异(调整后风险比[aHR] 0.61,95%置信区间[CI] 0.33 - 1.15),个体症状的风险也无差异。

结论

在中度严重LRTI后的12个月内,确诊或未确诊SARS-CoV-2感染的初级保健患者的HRQoL概况相当。相当一部分参与者报告有持续症状,表明无论致病病原体如何,LRTI后都可能出现持续症状。

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