Lam Ivan Chun Hang, Chai Yi, Man Kenneth Keng Cheung, Lau Wallis Cheuk Yin, Luo Hao, Lin Xiaoyu, Yin Can, Chui Celine Sze Ling, Li Xue, Zhang Qingpeng, Chan Esther Wai Yin, Wan Eric Yuk Fai, Wong Ian Chi Kei
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford OX3 7LD, UK.
J R Soc Med. 2025 Jul 8:1410768251352666. doi: 10.1177/01410768251352666.
ObjectivesTo generate comprehensive evidence on the risk of clinical sequelae involving different organ systems over time after coronavirus disease 2019 (COVID-19) infection.DesignMultinational retrospective cohort study.SettingElectronic medical records from the US, UK, France, Germany and Italy standardised to the Observational Medical Outcomes Partnership Common Data Model.ParticipantsA total of 303,251 individuals with a COVID-19 infection between 1 December 2019 and 1 December 2020 and propensity score matched non-COVID-19 comparators from 22,108,925 eligible candidates.Main outcome measuresIncidence of 73 clinical sequelae involving multiple organ systems including the respiratory, cardiovascular, dermatological and endocrine systems over the short- (0-6 months), medium- (6-12 months) and long-term (1-2 years) after COVID-19 infection. The hazard ratio (HR) and 95% confidence interval (95% CI) of individual disease outcomes were estimated using Cox proportional hazard regression.ResultsIndividuals with COVID-19 incurred a greater risk of clinical sequelae involving multiple organ systems including respiratory (France HR 2.23, 95%CI [2.10,2.37] to Italy 13.13 [11.80,14.63]), cardiovascular (Germany 1.39 [1.30,1.50] to US 1.79 [1.74,1.85]) and dermatological (UK 1.13 [1.01,1.25] to Italy 1.77 [1.42,2.21]) disorder over the short-term. While the risk of clinical sequelae has largely subsided during the medium-term, the risk of cardiovascular- (US 1.16 [1.11,1.21], France 1.10 [1.01,1.19]) and endocrine- (US 1.18 [1.12,1.24], Germany 1.15 [1.03,1.29]) related complications may continue to persist for up to two years.ConclusionsThrough a network of multinational healthcare databases, this study generated comprehensive and robust evidence supporting the extensive multi-organ involvement of post-COVID-19 condition over the short-term period and the subside in risk for most complications over the medium- and long-term.
目的
生成关于2019冠状病毒病（COVID-19）感染后不同时间涉及不同器官系统的临床后遗症风险的全面证据。
设计
多国回顾性队列研究。
设置
来自美国、英国、法国、德国和意大利的电子病历，已标准化为观察性医疗结局合作组织通用数据模型。
参与者
共有303,251名在2019年12月1日至2020年12月1日期间感染COVID-19的个体，以及从22,108,925名符合条件的候选人中通过倾向评分匹配的非COVID-19对照者。
主要结局指标
在COVID-19感染后的短期（0 - 6个月）、中期（6 - 12个月）和长期（1 - 2年）内，涉及包括呼吸、心血管、皮肤和内分泌系统在内的多个器官系统的73种临床后遗症的发生率。使用Cox比例风险回归估计个体疾病结局的风险比（HR）和95%置信区间（95%CI）。
结果
COVID-19感染者在短期内发生涉及多个器官系统临床后遗症的风险更高，包括呼吸系统（法国HR 2.23，95%CI [2.10,2.37]至意大利13.13 [11.80,14.63]）、心血管系统（德国1.39 [1.30,1.50]至美国1.79 [1.74,1.85]）和皮肤系统（英国1.13 [1.01,1.25]至意大利1.77 [1.42,2.21]）疾病。虽然临床后遗症的风险在中期已基本消退，但心血管相关（美国1.16 [1.11,1.21]，法国1.10 [1.01,1.19]）和内分泌相关（美国1.18 [1.12,1.24]，德国1.15 [1.03,1.29]）并发症的风险可能会持续长达两年。
结论
通过多国医疗保健数据库网络，本研究生成了全面而有力的证据，支持COVID-19后状况在短期内广泛累及多个器官，以及大多数并发症在中长期风险消退。
