Durant Edward J, Warton E Margaret, Skarbinski Jacek, Siqueiros Marcos H, Cholleti S Madhavi, Vinson David R, Mark Dustin G, DiLena Daniel D, Rauchwerger Adina S, Reed Mary E, Ballard Dustin W
Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States of America.
The Permanente Medical Group, Pleasanton, California, United States of America.
PLoS One. 2025 Sep 9;20(9):e0331370. doi: 10.1371/journal.pone.0331370. eCollection 2025.
Research on Post-acute sequelae of COVID (PASC) has focused on the prevalence of symptoms, leaving gaps in our understanding of predictors of health care seeking.
To identify clinical and sociodemographic characteristics associated with PASC care seeking.
Retrospective cohort study of adult patients with COVID-19 diagnosis between January 1, 2021 and June 30, 2022 in a community-based comprehensive health care delivery system at 21 hospitals and medical clinics in Northern California. Primary outcome was one or more PASC care seeking encounters at least 28 days after COVID-19 diagnosis in unadjusted and multivariate analyses.
Of 600,295 surviving COVID patients, 3,797 (0.63%) had PASC care encounters. Female sex (RR 1.29, 95% CI 1.20-1.39), non-Hispanic White race, age 40-49 years (RR 2.35, 95% CI 2.08-2.66), more severe acute COVID illness, including an ED visit (RR 4.41, 95% CI 3.92-4.96), and severe depression (RR 1.69, 95% CI 1.32-2.16) were associated with PASC care. COVID immunization (RR 0.79, 95% CI 0.72-0.85), metformin use among diabetic patients (RR 0.74, 95% CI 0.64-0.84), and diagnosis during Omicron predominance (RR 0.54, 95% CI 0.49-0.60) were associated with lower PASC care.
Higher illness severity, medical comorbidities, and infection during the Delta and pre-Delta periods were associated with PASC care seeking. COVID immunization and metformin were associated with lower PASC care seeking. These findings could be useful in understanding the patterns and burden of care seeking for a new disease entity.
关于新冠后遗症（PASC）的研究主要集中在症状的患病率上，在我们对寻求医疗保健的预测因素的理解方面存在空白。
确定与寻求PASC医疗保健相关的临床和社会人口学特征。
对2021年1月1日至2022年6月30日期间在北加利福尼亚州21家医院和诊所的社区综合医疗保健系统中被诊断为新冠的成年患者进行回顾性队列研究。主要结局是在未调整和多变量分析中，新冠诊断后至少28天内有一次或多次寻求PASC医疗保健的就诊经历。
在600295名存活的新冠患者中，3797人（0.63%）有寻求PASC医疗保健的就诊经历。女性（风险比1.29，95%置信区间1.20 - 1.39）、非西班牙裔白人、40 - 49岁年龄组（风险比2.35，95%置信区间2.08 - 2.66）、更严重的急性新冠疾病，包括急诊就诊（风险比4.41，95%置信区间3.92 - 4.96）以及重度抑郁症（风险比1.69，95%置信区间1.32 - 2.16）与寻求PASC医疗保健相关。新冠疫苗接种（风险比0.79，95%置信区间0.72 - 0.85）、糖尿病患者使用二甲双胍（风险比0.74，95%置信区间0.64 - 0.84）以及在奥密克戎占主导期间的诊断（风险比0.54，95%置信区间0.49 - 0.60）与较低的寻求PASC医疗保健相关。
更高的疾病严重程度、合并症以及在德尔塔和德尔塔之前时期的感染与寻求PASC医疗保健相关。新冠疫苗接种和二甲双胍与较低的寻求PASC医疗保健相关。这些发现可能有助于理解一种新疾病实体的寻求医疗保健模式和负担。
