奥密克戎新冠病毒感染与流感住院后的长期多系统后遗症：一项回顾性队列研究。
Long-term multisystemic sequelae post-hospitalisation for Omicron COVID-19 vs influenza: A retrospective cohort study.
作者信息
Wee Liang En, Ho Reen Wan Li, Lim Jue Tao, Chiew Calvin J, Lye David Chien Boon, Tan Kelvin Bryan
机构信息
National Centre for Infectious Diseases, Singapore; Duke-NUS Graduate Medical School, National University of Singapore, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
National Centre for Infectious Diseases, Singapore.
出版信息
Int J Infect Dis. 2025 Sep;158:107946. doi: 10.1016/j.ijid.2025.107946. Epub 2025 Jun 9.
OBJECTIVES
To contrast long-term sequelae post-COVID-19 hospitalisations attributed to Omicron, vs seasonal influenza; stratified by vaccination.
METHODS
Retrospective population-based cohort study in Singapore, including all adult COVID-19 hospitalisations post-Omicron emergence (1 January 2022-3 September 2023), and historical influenza hospitalisations (1 January 2017-3 September 2023). Risks of post-acute diagnoses/symptoms 31-300 days post-COVID-19 hospitalisation, vs influenza, were estimated using overlap-weighted competing-risks-regression, with death as a competing risk.
RESULTS
70,628 COVID-19 hospitalisations and 10,454 influenza hospitalisations were included. Lower overall risk of post-acute cardiac symptoms (adjusted-hazards-ratio, aHR = 0.77 [95% CI = 0.64-0.92]; P < 0.001) was observed following any COVID-19 hospitalisation vs influenza. Similarly, lower risk of any post-acute cardiac diagnosis/symptom (aHR = 0.80 [95% CI = 0.68-0.94]; P < 0.001) was observed following unboosted COVID-19 hospitalisations vs unvaccinated influenza, and lower risk of other cardiac disorders (e.g., heart failure) was observed following boosted COVID-19 hospitalisations vs vaccinated influenza (aHR = 0.58 [95% CI = 0.39-0.86]; P < 0.001), However, risks of post-acute cognitive impairment and fatigue/malaise were significantly higher post-COVID-19 vs influenza (cognition: aHR = 1.34 [95% CI = 1.08-1.68]; P < 0.001; fatigue/malaise: aHR = 1.75 [95% CI = 1.23-2.50]; P < 0.001) and when unboosted COVID-19 was compared against unvaccinated influenza (memory/cognition: aHR = 1.67 [95% CI = 1.27-2.19; P < 0.001]; fatigue/malaise: aHR = 1.77 [95% CI = 1.18-2.64]; P < 0.001).
CONCLUSION
Risks of cognitive impairment/fatigue were increased while risk of cardiac sequelae was significantly lower post-COVID-19 vs influenza in unboosted/unvaccinated individuals. Vaccination for COVID-19/influenza remains important during endemicity.
目的
对比感染奥密克戎毒株后新冠病毒感染住院的长期后遗症与季节性流感的长期后遗症；按疫苗接种情况分层。
方法
在新加坡开展基于人群的回顾性队列研究，纳入奥密克戎毒株出现后（2022年1月1日至2023年9月3日）所有成年新冠病毒感染住院病例，以及历史流感住院病例（2017年1月1日至2023年9月3日）。采用重叠加权竞争风险回归方法，以死亡作为竞争风险，估算新冠病毒感染住院后31至300天与流感相比的急性后诊断/症状风险。
结果
纳入70628例新冠病毒感染住院病例和10454例流感住院病例。与流感相比，任何新冠病毒感染住院后出现急性后心脏症状的总体风险较低（调整后风险比，aHR = 0.77 [95%置信区间 = 0.64 - 0.92]；P < 0.001）。同样，未接种新冠病毒疫苗的住院病例与未接种流感疫苗的病例相比，出现任何急性后心脏诊断/症状的风险较低（aHR = 0.80 [95%置信区间 = 0.68 - 0.94]；P < 0.001），接种新冠病毒疫苗的住院病例与接种流感疫苗的病例相比，出现其他心脏疾病（如心力衰竭）的风险较低（aHR = 0.58 [95%置信区间 = 0.39 - 0.86]；P < 0.001）。然而，与流感相比，新冠病毒感染后急性后认知障碍和疲劳/不适的风险显著更高（认知：aHR = 1.34 [95%置信区间 = 1.08 - 1.68]；P < 0.001；疲劳/不适：aHR = 1.75 [95%置信区间 = 1.23 - 2.50]；P < 0.001），且未接种新冠病毒疫苗的病例与未接种流感疫苗的病例相比也是如此（记忆/认知：aHR = 1.67 [95%置信区间 = 1.27 - 2.19；P < 0.001]；疲劳/不适：aHR = 1.77 [95%置信区间 = 1.18 - 2.64]；P < 0.001）。
结论
在未接种疫苗/未加强接种的个体中，与流感相比，新冠病毒感染后认知障碍/疲劳的风险增加，而心脏后遗症的风险显著降低。在疾病流行期间，新冠病毒/流感疫苗接种仍然很重要。
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