长期COVID的全球流行,其亚型和风险因素:更新的系统审查和元分析
Yiren Hou1, Tian Gu2, Zhouchi Ni1
1Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
Open forum infectious diseases
|September 29, 2025
概括
长期COVID影响全球36%,在南美洲的比例更高. 关键的风险因素包括未接种疫苗,Omicron前变种感染和女性性别.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 长期COVID是一种严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 感染后的持续性疾病,对全球健康构成重大挑战.
- 了解其流行率,亚型和风险因素对于有效的管理和预防策略至关重要.
研究的目的:
- 评估长期COVID及其各种亚型和症状的全球流行情况.
- 评估已识别的风险因素对长期COVID的发展的影响.
主要方法:
- 一项超级系统性审查和对2021年7月至2024年5月期间发表的429项研究的元分析.
- 数据使用随机效应模型与DerSimonian-Laird估计器进行了聚合.
- 评估了偏差风险,以确保研究质量.
主要成果:
- 长期COVID的全球综合流行率为36% (95%CI,33%-40%),南美报告的最高率为51%).
- 患病率随着时间的推移而持续,在感染后1年以下的35%,在感染后1-2年46%的患病率.
- 最常见的亚型包括一般疲劳 (20%),呼吸 (20%),心理 (18%) 和神经 (16%).
- 确定的关键风险因素是未接种COVID-19疫苗 (OR,2.09),感染了Omicron前变种 (OR,1.74),以及女性性别 (OR,1.56).
结论:
- 长期COVID仍然是SARS-CoV-2感染后普遍存在的全球健康问题.
- 流行率估计的显著异质性需要经过精心设计,具有全球代表性的随访研究,并使用一致的测量工具.
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