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新冠长期症状及其风险因素:一项初级保健领域的横断面研究

Symptoms and Risk Factors for Long COVID: A Cross-Sectional Study in Primary Care.

作者信息

Ferreira Assel Muratovna Shigayeva, Ferreira Flávia Emília Leite de Lima, Alverga Caio César Ferreira, Nascimento João Agnaldo do, de Carvalho André Luís Bonifácio, de Freitas Gabriel Rodrigues Martins, de Moraes João Aurílio Cardoso, Rocha Izabele da Silva, Silva Lucas Tomaz da, Alves Beatriz Carolinny Pereira da Silva, de Oliveira Cleidilaine Ramos, Cardoso José Ricardo Araujo, Anacleto Ruth Maria Mendonça, Pernambuco Leandro

机构信息

Center of Medical Sciences, Federal University of Pernambuco, Recife, Brazil.

Center of Health Sciences, Federal University of Paraiba, Joao Pessoa, Brazil.

出版信息

J Med Virol. 2025 Sep;97(9):e70579. doi: 10.1002/jmv.70579.

DOI:10.1002/jmv.70579
PMID:40880174
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12396170/
Abstract

This study aimed to determine the occurrence and risk factors for persistent symptoms after mild to moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients who presented in primary care during the 2021 pandemic. A retrospective cross-sectional survey was conducted in six public family health care units in Joao Pessoa, Brazil. A questionnaire with a set of 18 validated clinical outcomes was used to assess prolonged symptoms beyond 3 months of duration in 226 adults who had confirmed SARS-CoV-2 infection. Binary logistic regression models were used to estimate adjusted odds ratios (aOR) and risk factors for Long COVID. A total of 16 outcomes were significantly associated with Long COVID. The largest aOR were estimated for short-term memory loss, anxiety, and loss of attention. The risk factors for Long COVID included ≥ 5 symptoms (15.82, 7.33-34.15, p < 0.0001), female sex (aOR: 1.91, 95% CI: 1.03-3.53, p = 0.032), age 40-49 years (3.45, 1.14-10.51, p = 0.029), and age 70+ years (4.0, 1.01-15.51, p = 0.045). Findings highlight a high frequency of persistent symptoms in adults who initially had non-severe SARS-CoV-2 infection, who are predominantly of working age, and who did not present multiple comorbidities. This study supports the need for assessing clinical outcomes and risk factors on Long COVID in primary care using routinely recorded clinical outcomes.

摘要

本研究旨在确定2021年大流行期间在初级保健机构就诊的轻度至中度严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染患者持续症状的发生率及风险因素。在巴西若昂佩索阿的六个公共家庭医疗保健单位进行了一项回顾性横断面调查。使用一份包含18项经过验证的临床结果的问卷,对226名确诊感染SARS-CoV-2的成年人持续3个月以上的症状进行评估。采用二元逻辑回归模型估计新冠长期症状的调整比值比(aOR)和风险因素。共有16项结果与新冠长期症状显著相关。短期记忆丧失、焦虑和注意力不集中的aOR估计值最高。新冠长期症状的风险因素包括≥5种症状(15.82,7.33 - 34.15,p < 0.0001)、女性(aOR:1.91,95%CI:1.03 - 3.53,p = 0.032)、40 - 49岁(3.45,1.14 - 10.51,p = 0.029)以及70岁及以上(4.0,1.01 - 15.51,p = 0.045)。研究结果凸显了最初感染非重症SARS-CoV-2、主要为工作年龄且无多种合并症的成年人中持续症状的高发生率。本研究支持在初级保健中使用常规记录的临床结果评估新冠长期症状的临床结果和风险因素的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/2bd82cd2c374/JMV-97-e70579-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/68337f5b3899/JMV-97-e70579-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/2d302cbfbd92/JMV-97-e70579-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/2bd82cd2c374/JMV-97-e70579-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/68337f5b3899/JMV-97-e70579-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/2d302cbfbd92/JMV-97-e70579-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb63/12396170/2bd82cd2c374/JMV-97-e70579-g003.jpg

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本文引用的文献

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Mechanisms of long COVID and the path toward therapeutics.长新冠的发病机制和治疗方法研究进展。
Cell. 2024 Oct 3;187(20):5500-5529. doi: 10.1016/j.cell.2024.07.054. Epub 2024 Sep 25.
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The persistence of SARS-CoV-2 in tissues and its association with long COVID symptoms: a cross-sectional cohort study in China.在中国进行的一项横断面队列研究显示,SARS-CoV-2 在组织中的持续存在及其与长新冠症状的关联。
Lancet Infect Dis. 2024 Aug;24(8):845-855. doi: 10.1016/S1473-3099(24)00171-3. Epub 2024 Apr 22.
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Risk factors associated with post-acute sequelae of SARS-CoV-2: an N3C and NIH RECOVER study.
与 SARS-CoV-2 急性后期后遗症相关的风险因素:N3C 和 NIH RECOVER 研究。
BMC Public Health. 2023 Oct 25;23(1):2103. doi: 10.1186/s12889-023-16916-w.
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Prevalence and risk factors for persistent symptoms after COVID-19: a systematic review and meta-analysis.新冠病毒病后持续症状的患病率及危险因素:一项系统评价与荟萃分析
Clin Microbiol Infect. 2024 Mar;30(3):328-335. doi: 10.1016/j.cmi.2023.10.016. Epub 2023 Oct 20.
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Chronic inflammation, neutrophil activity, and autoreactivity splits long COVID.慢性炎症、中性粒细胞活性和自身反应性将长新冠一分为二。
Nat Commun. 2023 Jul 14;14(1):4201. doi: 10.1038/s41467-023-40012-7.
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Risk factors associated with limited functional status among out-of-hospital patients 30 days and one year after a diagnosis of COVID-19: a cohort study.与 COVID-19 诊断后 30 天和 1 年时处于院外的患者的有限功能状态相关的风险因素:一项队列研究。
Sci Rep. 2023 Mar 3;13(1):3584. doi: 10.1038/s41598-023-30674-0.
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The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis.住院和非住院人群中“长新冠”的患病率及长期健康影响:一项系统评价与荟萃分析
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