长期COVID中自我报告的症状和结果的亚现象:一个前性队列研究,使用隐性类分析
Georgios D Kitsios1,2, Shawna Blacka3, Jana J Jacobs4
1Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA kitsiosg@upmc.edu.
BMJ open
|March 14, 2024
概括
研究人员确定了三种不同的COVID-19 (PASC) 亚表型的急性后续症状. 虽然大多数症状都会消失,但有些患者会出现持续的宪法症状或嗅觉/口味功能障碍,需要针对性干预.
科学领域:
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
- 神经学 神经学
背景情况:
- COVID-19 (PASC) 后急性后果是一个复杂的挑战,具有多种自我报告的症状和结果 (SRSOs).
- 鉴别不同的PASC亚表型对于了解疾病负担和开发向治疗至关重要.
研究的目的:
- 在COVID-19 (PASC) 后急性后续症患者中,对自我报告的症状和结果 (SRSOs) 的亚现象类型进行表征.
- 根据症状概况和它们与病毒载荷的关系,识别不同的PASC患者群体.
主要方法:
- 展望性,观察性队列研究,涉及患有PASC的成年人.
- 数据收集包括结构化的电话采访,标准化的临床评估 (心理,神经认知,心肺),以及唾液和便中的SARS-CoV-2RNA量化.
- 使用隐性类分析 (LCA) 来得出不同的PASC亚表型.
主要成果:
- 总共分析了214名PASC患者,报告了中位数为9/16的急性COVID-19后症状.
- 常见的持续性症状包括疲劳,认知障碍和呼吸障碍.
- 隐性类分析揭示了三种PASC亚现象:高负担的结构性症状 (21.9%),持续的嗅觉/口味功能障碍 (20.6%),以及最小的残留症状 (57.5%).
- 亚现象类型的分配与全球健康,康复,就业影响和推来源有显著的相关性.
结论:
- 确定了三种不同的PASC亚现象,突出了不同的症状负担和持续时间.
- 虽然许多PASC症状会消失,但特定的患者群体需要针对高构成性症状负担或持续的嗅觉/口味问题进行有针对性的干预.
- 未来的鉴定和量身定制的治疗策略对于管理这些独特的PASC亚群至关重要.
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