使用隐性类分析和患者报告结果措施来识别不同的长期COVID表型:纵向队列研究
Alyson W Wong1,2, Karen C Tran3, Mawuena Binka4,5
1Department of Medicine, University of British Columbia, Vancouver, Canada.
PloS one
|June 2, 2023
概括
鉴定出了三种不同的长期COVID表型,不同的影响生活质量. 这些发现凸显了长期COVID的异质性质,并表明需要个性化治疗策略.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 精神病学是一个精神病学.
背景情况:
- 长期COVID,SARS-CoV-2感染的后急性后续,提出了一个复杂的临床挑战.
- 患者报告的结果测量 (PROM) 对于理解长期COVID症状的多面性质至关重要.
- 确定不同的患者亚组对于有针对性的干预和改善患者结果至关重要.
研究的目的:
- 通过患者报告的结果测量 (PROMs) 来识别不同的长COVID表型.
- 确定已识别的长期COVID表型与生活质量 (QoL) 和肺功能之间的关联.
主要方法:
- 一项纵向队列研究,涉及1344名住院和非住院患者在加拿大不列颠哥伦比亚省的四个后COVID康复诊所.
- 隐性类别分析用于根据基线PROMs对患者进行表型分类,包括疲劳,呼吸不良,咳,焦虑,抑郁和创伤后应激障碍.
- 研究了表型与 QoL (EuroQoL 5维视觉模拟尺度[EQ5D VAS]) 和肺功能 (肺部对一氧化碳的扩散能力[DLCO]) 之间的关联.
主要成果:
- 确定了三种不同的长期COVID表型:第1类 (疲劳和呼吸障碍),第2类 (焦虑和抑郁) 和第3类 (疲劳,呼吸障碍,焦虑和抑郁).
- 与1级和2级相比,3级在症状发作3个月和6个月后表现出明显较低的EQ5D VAS得分 (p<0.001).
- 对于1类和3类,生活质量得分在3到6个月之间有所改善,但在已识别的表型之间没有观察到DLCO的显著差异.
结论:
- 不同的长期COVID表型与症状出现后3个月和6个月的不同生活质量结果有关.
- 鉴定到的表型强调了长期COVID的异质性质,暗示了不同的亚群.
- 这些发现支持为不同长期COVID患者子组开发量身定制的治疗方法.
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