Pisaturo Mariantonietta, Russo Antonio, Grimaldi Pierantonio, Monari Caterina, Imbriani Simona, Gjeloshi Klodian, Ricozzi Carmen, Astorri Roberta, Curatolo Caterina, Palladino Roberta, Caruso Francesco, Ambrisi Francesca, Onorato Lorenzo, Coppola Nicola
Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Infectious Diseases Unit, AOU Luigi Vanvitelli, 80131 Naples, Italy.
Biomedicines. 2025 Jun 9;13(6):1414. doi: 10.3390/biomedicines13061414.
: PASC is a potentially debilitating clinical condition consisting of different general symptoms experienced by about 10% of patients with previous SARS-CoV-2 infection. Our study analyses a cohort of patients with a history of hospitalization for COVID-19 and aims to evaluate prognostic factors for experiencing PASC and to investigate the characteristics of patients experiencing PASC symptoms. : This is an observational, monocentric retrospective study including all adult patients admitted to our COVID unit from 28 February 2020 to 30 April 2022, discharged alive, and having performed at least one follow-up visit at our post-COVID outpatient clinic after a minimum of three months from discharge. Patients who experienced persistent clinical manifestations or the development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation, were defined as having PASC. : A total of 429 patients were discharged alive from our COVID Unit and 244 patients performed at least one follow-up visit in our outpatient clinic. Of these, 134 patients did not experience PASC, while 110 patients experienced PASC. Long-COVID patients were more frequently female (43.6% vs. 31.3%, = 0.048), more frequently presented throat pain and headache at hospital admission (respectively 8.9% vs. 2.5%, = 0.041 and 15.8% vs. 5%, = 0.007), and were more likely to have a history of type 2 diabetes mellitus (25.5% vs. 13%, =0.013). At the multivariable analysis, female gender, type 2 diabetes, and headache at admission were factors associated with PASC. All 46 patients who performed at least two different admissions in our outpatient clinic were divided in two groups: the first including the 16 patients who experienced a reduction or a resolution of symptoms related to COVID-19, the second comprising the 30 patients who experienced clinical worsening or persisting symptoms. Smoking habit was more represented among patients with stable or worsening symptoms (42.3% vs. 7.7%, = 0.042); myalgias at admission were more frequent in the clinical worsening group (27.6% vs. 0%, = 0.039); and a larger amount of patients who reported neuropsychiatric symptoms and respiratory symptoms were in the stable or worsening PASC symptoms group. : In conclusion, this study underscores the complexity of PASC, identifying female sex, Type 2 diabetes, and certain acute COVID-19 symptoms as potential predisposing factors for its development. PASC still represents a substantial public health challenge, and ongoing efforts are essential to better understand its underlying mechanisms and improve patient outcomes.
新冠后综合征（PASC）是一种可能使人衰弱的临床病症，约10%曾感染过SARS-CoV-2的患者会出现各种不同的全身症状。我们的研究分析了一组有新冠病毒病（COVID-19）住院史的患者，旨在评估出现PASC的预后因素，并调查出现PASC症状患者的特征。 ：这是一项观察性、单中心回顾性研究，纳入了2020年2月28日至2022年4月30日期间入住我们新冠病房、存活出院且在出院至少三个月后在我们的新冠后门诊进行了至少一次随访的所有成年患者。在初次感染SARS-CoV-2三个月后出现持续临床表现或出现新症状，且这些症状持续至少两个月且无其他解释的患者被定义为患有PASC。 ：共有429名患者从我们的新冠病房存活出院，244名患者在我们的门诊进行了至少一次随访。其中，134名患者未出现PASC，而110名患者出现了PASC。新冠后综合征患者女性更为常见（43.6%对31.3%，P = 0.048），入院时咽痛和头痛更为常见（分别为8.9%对2.5%，P = 0.041和15.8%对5%，P = 0.007），且更有可能有2型糖尿病史（25.5%对13%，P = 0.013）。在多变量分析中，女性、2型糖尿病和入院时头痛是与PASC相关的因素。在我们门诊至少进行过两次不同入院治疗的所有46名患者被分为两组：第一组包括16名新冠相关症状减轻或缓解的患者，第二组包括30名临床症状恶化或症状持续的患者。稳定或症状恶化的患者中吸烟习惯更为常见（42.3%对7.7%，P = 0.042）；临床症状恶化组入院时肌痛更为常见（27.6%对0%，P = 0.039）；报告有神经精神症状和呼吸道症状的患者中，更多患者处于PASC症状稳定或恶化组。 ：总之，本研究强调了PASC的复杂性，确定女性、2型糖尿病和某些急性COVID-19症状是其发生的潜在易感因素。PASC仍然是一个重大的公共卫生挑战，持续努力对于更好地理解其潜在机制和改善患者预后至关重要。
