长新冠：一项关于风险因素、康复及生活质量的四年前瞻性队列研究。

Long COVID-19: a Four-Year prospective cohort study of risk factors, recovery, and quality of life.

作者信息

Kamal Sanaa M, Al Qahtani Mohammed S, Al Aseeri Ali, Naghib Mohey El Deen Mohamed, Al Mazroua Adul Majeed Mazroua, Alshamrani Abdulaziz M M, Al Mazroua Mohamed Mazroua, AlHarbi Faisal S F

机构信息

Department of Internal Medicine, Prince Sattam Abdulaziz University College of Medicine, Kharj, Kingdom of Saudi Arabia.

Department of Family Medicine, King Saud Medical City Academy, Riyadh, Kingdom of Saudi Arabia.

出版信息

BMC Infect Dis. 2025 Aug 30;25(1):1082. doi: 10.1186/s12879-025-11468-3.

DOI:10.1186/s12879-025-11468-3

PMID:40883696

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12398010/

Abstract

PURPOSE

Long COVID-19 is a growing public health concern, but its long-term burden and predictors remain underexplored, particularly in underrepresented populations.

METHODS

This four-year prospective cohort study was conducted in Saudi Arabia, enrolling adults with confirmed acute COVID-19 from multiple affiliated healthcare centers between March 2020 and March 2024. Of 1,521 screened patients, 816 were enrolled and followed for up to four years (median: 24 months). Per WHO criteria, participants were classified as having long COVID-19 ( = 238) or resolved infection ( = 578). Demographics, comorbidities, vaccination, reinfection, and acute illness severity were recorded. Health-related quality of life (HRQoL) was assessed using SF-36 and EQ-5D-5 L. Logistic regression identified predictors of long COVID-19, and Cox proportional hazards models evaluated time to recovery.

RESULTS

Fatigue (57.1%), post-exertional malaise (45.8%), cough (41.2%), and cognitive dysfunction (30.7%) were the most common persistent symptoms. Female sex (adjusted OR 11.11; 95% CI: 4.48–26.24) and diabetes mellitus (adjusted OR 14.3; 95% CI: 7.0–29.4) independently predicted long COVID-19. Delayed recovery was associated with female sex (aHR 3.36; 95% CI: 1.85–6.10), diabetes (aHR 1.57; 95% CI: 1.00–2.46), reinfection (aHR 1.86; 95% CI: 1.05–3.29), and hospitalization (aHR 1.08; 95% CI: 1.01–1.16). HRQoL scores remained significantly lower at 6 and 12 months. In the long COVID-19 group, 38.7% of patients normally resumed work within 12 months, compared to 82.3% in the resolved COVID-19 group.

CONCLUSIONS

Nearly 29% of post-acute COVID-19 patients developed long COVID-19 in this Middle Eastern cohort. Female sex, diabetes, reinfection, and hospitalization predicted delayed recovery. Persistent symptoms and impaired HRQoL highlight the need for early risk stratification and structured post-COVID care.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12879-025-11468-3.

摘要

目的

新冠后综合征（Long COVID-19）日益引起公众健康关注，但其长期负担和预测因素仍未得到充分研究，尤其是在代表性不足的人群中。

方法

这项为期四年的前瞻性队列研究在沙特阿拉伯进行，纳入了2020年3月至2024年3月期间多家附属医疗中心确诊的急性新冠病毒感染成年患者。在1521名筛查患者中，816名被纳入研究并随访长达四年（中位数：24个月）。根据世界卫生组织标准，参与者被分类为患有新冠后综合征（n = 238）或感染已康复（n = 578）。记录了人口统计学、合并症、疫苗接种、再次感染和急性疾病严重程度。使用SF-36和EQ-5D-5L评估健康相关生活质量（HRQoL）。逻辑回归确定了新冠后综合征的预测因素，Cox比例风险模型评估了恢复时间。

结果

疲劳（57.1%）、劳累后不适（45.8%）、咳嗽（41.2%）和认知功能障碍（30.7%）是最常见的持续症状。女性（调整后OR 11.11；95% CI：4.48–26.24）和糖尿病（调整后OR 14.3；95% CI：7.0–29.4）独立预测新冠后综合征。恢复延迟与女性（aHR 3.36；95% CI：1.85–6.10）、糖尿病（aHR 1.57；95% CI：1.00–2.46）、再次感染（aHR 1.86；95% CI：1.05–3.29）和住院（aHR 1.08；95% CI：1.01–1.16）相关。在6个月和12个月时，HRQoL评分仍显著较低。在新冠后综合征组中，38.7%的患者在12个月内正常恢复工作，而在感染已康复的新冠组中这一比例为82.3%。