COVID-19 后急性后果的高维特征
Ziyad Al-Aly1,2,3,4,5, Yan Xie6,7,8, Benjamin Bowe6,7,8
1Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA. zalaly@gmail.com.
Nature
|April 22, 2021
概括
长期的COVID会影响幸存者,导致严重的健康损失. 这包括呼吸系统问题,神经疾病,心理健康状况以及增加的医疗保健使用,影响多个器官系统.
科学领域:
- 传染性疾病
- 公共卫生
- 临床医学
背景情况:
- 已知COVID-19的急性表现,但长期健康后果 (后果) 尚不清楚.
- 了解COVID-19后急性后果对于管理患者康复和医疗保健系统规划至关重要.
研究的目的:
- 系统地识别和描述幸存者在COVID-19诊断后6个月发生的健康状况,药物使用和实验室异常.
- 分析急性COVID-19的严重程度与后急性病变的风险之间的关系.
主要方法:
- 使用美国退伍军人事务部的国家医疗保健数据库进行全面分析.
- 在COVID-19幸存者中采用高维度方法识别诊断,药物使用和实验室异常 (诊断后≥30天).
- 评估了多个器官系统和治疗剂使用的事件后果,结果与急性感染严重程度相关 (非住院,住院,ICU).
主要成果:
- 在诊断后30天内,COVID-19幸存者面临死亡风险增加和医疗资源利用率更高.
- 包括呼吸,神经系统,神经认知,精神健康,代谢,心血管和胃肠道疾病.
- 观察到疼痛药,抗抑郁药,抗焦虑药,抗高血压药和口服低血糖药的使用增加,以及各器官系统的实验室异常.
- 随着COVID-19初始感染的严重程度而增加的后续病变的明显风险梯度.
结论:
- COVID-19 幸存者经历了相当大的肺和肺外健康损失负担,超过了急性疾病.
- 调查结果强调需要积极的卫生系统规划和多学科护理策略,以减轻COVID-19后患者的慢性健康损失.
- 这项研究强调了COVID-19的长期,多系统性影响,需要持续的研究和患者支持.
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