长期Covid症状和诊断在初级保健:一个队列研究使用结构化和非结构化数据在健康改善网络初级保健数据库
Anoop D Shah1,2, Anuradhaa Subramanian3, Jadene Lewis1
1Institute of Health Informatics, University College London, London, United Kingdom.
PloS one
|September 26, 2023
概括
许多症状发生在COVID-19感染后12周,但只有少数通常被全科医生 (GPs) 诊断为长期Covid. 这项研究强调了初级保健中的症状负担.
科学领域:
- 医学研究 医学研究
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 长期Covid是COVID-19的一个公认的后果,但在初级保健中症状的范围仍然不太清楚.
- 初级保健记录通常以自由文本形式记录症状,需要先进的分析技术.
研究的目的:
- 为了比较患有和没有COVID-19病史的患者的症状患病率.
- 在初级保健机构中识别与正式的长期COVID诊断相关的症状.
主要方法:
- 使用了健康改善网络 (THIN) 的电子健康记录数据,截至2020年12月.
- 使用自然语言处理 (NLP) 来从自由文本临床笔记中提取89个症状和长期Covid诊断.
- 在COVID-19诊断后12周,在11,015名COVID-19患者和18,098名对照中计算出症状关联的调整后危险比率.
主要成果:
- 有相当数量的症状与感染后至少12周的COVID-19有关,特别是疲劳 (aHR 3.46),呼吸短促 (aHR 2.89),心 (aHR 2.59) 和 (aHR 2.43).
- 仅有一小部分症状,包括呼吸短促,胸痛,疼痛,疲劳,咳和焦虑/抑郁,经常在长期Covid诊断后7天内记录.
- 80%的症状记录是在自由文本中发现的,这强调了NLP在获取临床数据方面的重要性.
结论:
- 初级保健人员遇到许多症状,在COVID-19感染后至少持续12周.
- 一组独特的,有限的症状主要与长期Covid的全科医生 (GP) 诊断有关.
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