长期COVID地图:美国各地的空间和社会不平等
medRxiv : the preprint server for health sciences
|September 5, 2025
概括
在Omicron出现后,长期COVID风险增加,内陆地区的发病率更高. 经济脆弱性和获得医疗保健等社会人口因素推动了这些差异,需要针对性的公共卫生干预措施.
科学领域:
- 流行病学
- 公共卫生
- 健康上的差异
背景情况:
- 长期COVID (后COVID疾病) 影响了美国人口的很大一部分.
- 长期COVID的时间空间分布和风险因素仍未得到充分理解.
- 社会人口差异和像Omicron这样的病毒变种可能会影响长期COVID的流行.
研究的目的:
- 描述美国长期COVID发病的时间空间模式.
- 调查Omicron变种对长期COVID风险的影响.
- 确定与长期COVID差异相关的社会人口因素.
主要方法:
- 从国家COVID队列协作 (N3C) (2021-2024) 分析了560万个COVID-19病例和41694个长期COVID病例.
- 在Omicron出现之前和之后的时间趋势分析.
- 使用莫兰 I 和 Getis-Ord Gi* 统计数据进行空间分析.
- 贝叶斯空间随机效应模型评估与经济脆弱性,医疗保健和流动性的关联.
主要成果:
- 与Omicron前的病例 (204/10,000例) 相比,Omicron后出现的长期COVID病例增加了248例.
- 在Omicron后,空间相关性显著增加 (48.8%的县).
- 高风险的长期COVID地区集中在内陆;低风险地区集中在东海岸.
- 与经济脆弱性,有限的医疗保健和流动性限制密切相关的发生率.
结论:
- 长期的COVID表现出显著的时空和社会人口差异.
- 奥米克朗变种的出现与发病率增加和空间聚类相关.
- 针对性的公共卫生干预对于公平的长期COVID诊断,护理和资源分配至关重要,尤其是在脆弱的地区.
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