Population-Based Estimates of Post-acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection (PASC) Prevalence and Characteristics
Population-Based Estimates of Post-acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection (PASC) Prevalence and Characteristics
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DOI：
10.1093/cid/ciab408
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发表时间：
2021-12-01
影响因子：
11.8
通讯作者：
Fleischer, Nancy L.
中科院分区：
文献类型：
--
作者：
Hirschtick, Jana L.;Titus, Andrea R.;Fleischer, Nancy L.
背景新出现的证据表明，许多人在2019年急性冠状病毒病（COVID-19）患病后出现持续症状。我们的目的是评估严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染（PASC）后急性后遗症的患病率和相关因素。我们对密歇根州的成年COVID-19患者进行了基于人群的概率调查。在密歇根州疾病监测系统中，截至2020年4月中旬发生COVID-19的18岁非住院成年人有资格入选（N = 28 000）。在2000名入选者中，有629人在2020年6月至12月期间完成了调查。我们估计了PASC患病率，定义为COVID-19发病后30天（30天COVID-19）或>= 60天（60天COVID-19）的持续症状，总体以及社会人口统计学和临床因素。我们使用改良泊松回归来计算潜在危险因素的校正患病率（aPR）。分析样本（n = 593）主要为女性（56.1%），年龄≥ 45岁（68.2%），非西班牙裔白色（46.3%）或黑人（34.8%）。30天和60天的COVID-19流行率很高（52.5%和35.0%），即使在未住院的受访者（43.7%和26.9%）和报告轻度症状的受访者（29.2%和24.5%）中也是如此。报告非常严重（与轻度）症状的受访者的30天COVID-19患病率高出2.25倍（aPR，2.25; 95% CI，1.46-3.46），60天COVID-19患病率高出1.71倍（aPR，1.71; 95% CI：1.02-2.88）。住院（与非住院）受访者的30天（aPR，1.37; 95% CI：1.12-1.69）和60天（aPR，1.40; 95% CI：1.02-1.93）COVID-19患病率均高出40%。PASC在报告严重初始症状的病例中高度流行，在较小程度上，报告轻度和中度症状的病例中高度流行。
Background. Emerging evidence suggests many people have persistent symptoms after acute coronavirus disease 2019 (COVID-19) illness. Our objective was to estimate the prevalence and correlates of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC).Methods. We used a population-based probability survey of adults with COVID-19 in Michigan. Living noninstitutionalized adults aged 18 in the Michigan Disease Surveillance System with COVID-19 onset through mid-April 2020 were eligible for selection (N = 28 000). Among 2000 selected, 629 completed the survey between June-December 2020. We estimated PASC prevalence, defined as persistent symptoms 30 (30-day COVID-19) or >= 60 (60-day COVID-19) days post-COVID-19 onset, overall and by sociodemographic and clinical factors. We used modified Poisson regression to produce adjusted prevalence ratios (aPRs) for potential risk factors.Results. The analytic sample (n = 593) was predominantly female (56.1%), aged >= 45 years (68.2%), and non-Hispanic White (46.3%) or Black (34.8%). Thirty- and 60-day COVID-19 were highly prevalent (52.5% and 35.0%), even among nonhospitalized respondents (43.7% and 26.9%) and respondents reporting mild symptoms (29.2% and 24.5%). Respondents reporting very severe (vs mild) symptoms had 2.25 times higher prevalence of 30-day COVID-19 (aPR, 2.25; 95% CI, 1.46-3.46) and 1.71 times higher prevalence of 60-day COVID-19 (aPR, 1.71; 95% CI: 1.02-2.88). Hospitalized (vs nonhospitalized) respondents had similar to 40% higher prevalence of both 30-day (aPR, 1.37; 95% CI: 1.12-1.69) and 60-day (aPR, 1.40; 95% CI: 1.02-1.93) COVID-19.Conclusions. PASC is highly prevalent among cases reporting severe initial symptoms and, to a lesser extent, cases reporting mild and moderate symptoms.