Risk factors and incidence of long-COVID syndrome in hospitalized patients: does remdesivir have a protective effect?
Risk factors and incidence of long-COVID syndrome in hospitalized patients: does remdesivir have a protective effect?
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DOI：
10.1093/qjmed/hcab297
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发表时间：
2021-11-26
影响因子：
13.3
通讯作者：
Borre, S.
中科院分区：
文献类型：
--
作者：
Boglione, L.;Meli, G.;Borre, S.
背景：“长冠状病毒综合征”（LCS）的定义仍存在争议，LCS描述的是感染2019冠状病毒病（COVID-19）的住院或非住院患者在病毒清除后症状持续存在。目的：在本研究中，我们研究了一组既往COVID-19患者LCS的患病率和危险因素，并进行了至少6个月的随访。设计：我们进行了一项前瞻性研究，纳入了2020年3月10日至2021年1月15日在我们的传染病中心（意大利Vercelli）入院的出院后至少6个月的所有受COVID-19感染的住院患者。两次随访：出院后1个月和6个月。每次就诊均记录临床、实验室和放射学资料。结果：共纳入449例患者。就诊1时确诊LCS的有322人（71.7%），就诊2时确诊LCS的有206人（45.9%）；根据covid -19后功能状态量表，我们观察到147例患者在第一次就诊时的值为2-3,175例患者的值为> -3；在第2次访问中，133名受试者的得分在2-3到73 bb30之间。在多因素分析中，重症监护病房（ICU）住院时间（OR = 2.551; 95% CI = 1.998 ~ 6.819; P = 0.019）、住院时间（OR = 2.255; 95% CI = 1.018 ~ 6.992; P = 0.016）和瑞德西韦治疗（OR = 0.641; 95% CI = 0.413 ~ 0.782; P < 0.001）是LCS的独立预测因素。结论：瑞德西韦治疗可使LCS率降低35.9%。在随访6个月时，病情严重程度、是否需要入住ICU和住院时间是影响PCS持续的因素。
Background: The definition of 'long-COVID syndrome' (LCS) is still debated and describes the persistence of symptoms after viral clearance in hospitalized or non-hospitalized patients affected by coronavirus disease 2019 (COVID-19).Aim: In this study, we examined the prevalence and the risk factors of LCS in a cohort of patients with previous COVID-19 and followed for at least 6 months of follow-up.Design: We conducted a prospective study including all hospitalized patients affected by COVID-19 at our center of Infectious Diseases (Vercelli, Italy) admitted between 10 March 2020 and 15 January 2021 for at least 6 months after discharge. Two follow-up visits were performed: after 1 and 6 months after hospital discharge. Clinical, laboratory and radiological data were recorded at each visit.Results: A total of 449 patients were included in the analysis. The LCS was diagnosed in 322 subjects at Visit 1 (71.7%) and in 206 at Visit 2 (45.9); according to the post-COVID-19 functional status scale we observed 147 patients with values 2-3 and 175 with values >3 at Visit 1; at Visit 2, 133 subjects had the score between 2-3 and 73 > 3. In multivariate analysis, intensive care unit (ICU) admission (OR = 2.551; 95% CI = 1.998-6.819; P = 0.019), time of hospitalization (OR = 2.255; 95% CI = 1.018-6.992; P = 0.016) and treatment with remdesivir (OR = 0.641; 95% CI = 0.413-0.782; P < 0.001) were independent predictors of LCS.Conclusions: Treatment with remdesivir leads to a 35.9% reduction in LCS rate in follow-up. Severity of illness, need of ICU admission and length of hospital stay were factor associated with the persistence of PCS at 6 months of follow-up.