一家公立多学科健康诊所对新冠病毒病康复者的临床评估

Clinical Evaluation of COVID-19 Survivors at a Public Multidisciplinary Health Clinic.

作者信息

Haagsma Ariele Barreto, Otto Felipe Giaretta, de Sá Vianna Maria Leonor Gomes, Maingue Paula Muller, Muller Andréa Pires, de Oliveira Nayanne Hevelin Dos Santos, Abbott Luísa Arcoverde, da Silva Felipe Paes Gomes, Klein Carolline Konzen, Herzog Débora Marques, Fantin Unruh Julia Carolina Baldo, Schoeler Lucas, Miyasaki Dayane, Soni Jamil Faissal, Stival Rebecca Saray Marchesini, Baena Cristina Pellegrino

机构信息

School of Life Sciences, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, Paraná, Brazil.

Hospital Universitário Cajuru, Curitiba 80050-350, Paraná, Brazil.

出版信息

Biomedicines. 2025 Aug 3;13(8):1888. doi: 10.3390/biomedicines13081888.

Abstract

This study aimed to evaluate sociodemographic factors, features of the acute infection, and post-infection health status in survivors of COVID-19, assessing their association with post-acute COVID-19 syndrome (PACS). A multidisciplinary public clinic in Brazil assessed COVID-19 survivors between June 2020 and February 2022. Patients were classified as having PACS or subacute infection (SI). Data on the history of the acute infection, current symptoms, physical examination, and laboratory findings were collected and analyzed using multivariate models with PACS as the outcome. Among the 113 participants, 63.71% were diagnosed with PACS at a median of 130 days (IQR: 53-196) following acute symptom onset. Admission to the intensive care unit was more frequent among individuals with PACS than those with SI (83.3% vs. 65.0% respectively; = 0.037). Symptoms significantly more prevalent in the PACS group when compared to the SI cohort included hair loss (44.4% vs. 17.1% respectively; = 0.004), lower limb paresthesia (34.7% vs. 9.8% respectively; = 0.003), and slow thinking speed (28.2% vs. 0.0% respectively; < 0.001). Logistic regression revealed that only the time interval between the onset of acute symptoms and the clinical evaluation was independently associated with a PACS diagnosis (β = 0.057; 95% CI: 1.03-1.08; < 0.001). Patients with PACS had a higher frequency of intensive care unit admission compared to those with subacute infection. However, in the multivariate analysis, the severity of the acute infection did not predict the final diagnosis of PACS, which was associated only with the time elapsed since symptom onset.

摘要

本研究旨在评估新冠病毒病(COVID-19)幸存者的社会人口学因素、急性感染特征及感染后健康状况,评估它们与新冠后急性综合征(PACS)的关联。巴西一家多学科公共诊所于2020年6月至2022年2月对COVID-19幸存者进行了评估。患者被分类为患有PACS或亚急性感染(SI)。收集了急性感染病史、当前症状、体格检查和实验室检查结果的数据,并使用以PACS为结果的多变量模型进行分析。在113名参与者中,63.71%在急性症状出现后的中位130天(IQR:53 - 196)被诊断为PACS。PACS患者入住重症监护病房的频率高于SI患者(分别为83.3%和65.0%;P = 0.037)。与SI队列相比,PACS组中显著更常见的症状包括脱发(分别为44.4%和17.1%;P = 0.004)、下肢感觉异常(分别为34.7%和9.8%;P = 0.003)以及思维速度减慢(分别为28.2%和0.0%;P < 0.001)。逻辑回归显示,只有急性症状发作与临床评估之间的时间间隔与PACS诊断独立相关(β = 0.057;95%CI:1.03 - 1.08;P < 0.001)。与亚急性感染患者相比,PACS患者入住重症监护病房的频率更高。然而,在多变量分析中,急性感染的严重程度并不能预测PACS的最终诊断,PACS仅与症状出现后的时间有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80f3/12383876/b8cb0f0dbf0a/biomedicines-13-01888-g001.jpg

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