Association of Self-reported COVID-19 Infection and SARS-CoV-2 Serology Test Results With Persistent Physical Symptoms Among French Adults During the COVID-19 Pandemic
Association of Self-reported COVID-19 Infection and SARS-CoV-2 Serology Test Results With Persistent Physical Symptoms Among French Adults During the COVID-19 Pandemic
复制标题
DOI：
10.1001/jamainternmed.2021.6454
复制
发表时间：
2021-11-08
影响因子：
39
通讯作者：
Lemogne, Cedric
中科院分区：
文献类型：
--
作者：
Matta, Joane;Wiernik, Emmanuel;Lemogne, Cedric
这项对来自法国constance队列的个体进行的横断面研究评估了是否认为自己感染了SARS-CoV-2、血清学检测证实感染了COVID-19，或两者兼而有之，与普通成年人中通常归因于长期COVID的持续身体症状有关。在COVID-19大流行期间，相信自己感染了COVID-19并经SARS-CoV-2血清学检测证实确实感染了COVID-19，这与持续的身体症状有关吗？在这项对2019冠状病毒病大流行期间以人群为基础的法国constance队列的26823名成年人进行的横断面分析中，自我报告的COVID-19感染与大多数持续的身体症状相关，而实验室证实的COVID-19感染仅与嗅觉缺失相关。这些关联与自我评估的健康状况或抑郁症状无关。研究结果表明，COVID-19感染后持续的身体症状不应自动归因于SARS-CoV-2；可能需要进行完整的医学评估，以防止将症状错误地归因于病毒。在感染SARS-CoV-2后，许多患者会出现持续的身体症状，这可能会影响他们的生活质量。关于这些症状的原因的信念可能会影响他们的感知并促进适应不良的健康行为。目的探讨新冠肺炎大流行期间普通人群自我报告感染情况和SARS-CoV-2血清学检测结果与持续躯体症状（如疲劳、呼吸困难或注意力障碍）的相关性。本横断面分析的参与者是来自2012年至2019年法国基于人群的constance队列的26823人，他们参加了巢式SAPRIS和SAPRIS- sero调查。在2020年5月至11月期间，使用酶联免疫吸附法检测抗sars - cov -2抗体。在2020年12月至2021年1月期间，参与者报告了他们是否认为自己在过去4周内经历了COVID-19感染，并出现了持续至少8周的身体症状。在完成血清学检测后才报告首次感染COVID-19的参与者被排除在外。在包括自我报告的COVID-19感染和血清学检测结果并调整年龄、性别、收入和教育水平的模型中，计算每个持续症状作为结果的Logistic回归。结果35 852名被邀请参加研究的志愿者中，有26 823名（74.8%）资料完整纳入本研究（平均[SD]年龄49.4[12.9]岁，女性13 731名[51.2%]）。自我报告的感染与持续的身体症状呈正相关，除了听力障碍（优势比为1.45,95% CI为0.82-2.55）和睡眠问题（优势比为1.14,95% CI为0.89-1.46）外，优势比为1.39 （95% CI为1.03-1.86）至16.37 （95% CI为10.21-26.24）。即使将分析限制在将症状归因于COVID-19感染的参与者中，SARS-COV-2血清学检测结果阳性仅与持续性嗅觉缺失呈正相关（优势比为2.72；95% CI为1.66-4.46）。进一步调整自我评估的健康状况或抑郁症状也得出了类似的结果。信念与血清学检验结果无显著交互作用。这项基于人群的大型法国队列横断面分析的结果表明，COVID-19感染后持续的身体症状可能与认为感染了SARS-CoV-2的信念相关，而不是与实验室确诊的COVID-19感染相关。这一领域的进一步研究应考虑可能不是SARS-CoV-2病毒特有的潜在机制。为了防止将其他疾病误认为是“长冠状病毒”，可能需要对这些患者进行医学评估。
This cross-sectional study of individuals from the French CONSTANCES cohort assesses whether the belief in having been infected with SARS-CoV-2, having serological test-confirmed COVID-19 infection, or both are associated with persistent physical symptoms often attributed to long COVID in the general adult population.Question Are the belief in having had COVID-19 infection and actually having had the infection as verified by SARS-CoV-2 serology testing associated with persistent physical symptoms during the COVID-19 pandemic? Findings In this cross-sectional analysis of 26 823 adults from the population-based French CONSTANCES cohort during the COVID-19 pandemic, self-reported COVID-19 infection was associated with most persistent physical symptoms, whereas laboratory-confirmed COVID-19 infection was associated only with anosmia. Those associations were independent from self-rated health or depressive symptoms. Meaning Findings suggest that persistent physical symptoms after COVID-19 infection should not be automatically ascribed to SARS-CoV-2; a complete medical evaluation may be needed to prevent erroneously attributing symptoms to the virus.Importance After an infection by SARS-CoV-2, many patients present with persistent physical symptoms that may impair their quality of life. Beliefs regarding the causes of these symptoms may influence their perception and promote maladaptive health behaviors. Objective To examine the associations of self-reported COVID-19 infection and SARS-CoV-2 serology test results with persistent physical symptoms (eg, fatigue, breathlessness, or impaired attention) in the general population during the COVID-19 pandemic. Design, Setting, and Participants Participants in this cross-sectional analysis were 26 823 individuals from the French population-based CONSTANCES cohort, included between 2012 and 2019, who took part in the nested SAPRIS and SAPRIS-SERO surveys. Between May and November 2020, an enzyme-linked immunosorbent assay was used to detect anti-SARS-CoV-2 antibodies. Between December 2020 and January 2021, the participants reported whether they believed they had experienced COVID-19 infection and had physical symptoms during the previous 4 weeks that had persisted for at least 8 weeks. Participants who reported having an initial COVID-19 infection only after completing the serology test were excluded. Main Outcomes and Measures Logistic regressions for each persistent symptom as the outcome were computed in models including both self-reported COVID-19 infection and serology test results and adjusting for age, sex, income, and educational level. Results Of 35 852 volunteers invited to participate in the study, 26 823 (74.8%) with complete data were included in the present study (mean [SD] age, 49.4 [12.9] years; 13 731 women [51.2%]). Self-reported infection was positively associated with persistent physical symptoms, with odds ratios ranging from 1.39 (95% CI, 1.03-1.86) to 16.37 (95% CI, 10.21-26.24) except for hearing impairment (odds ratio, 1.45; 95% CI, 0.82-2.55) and sleep problems (odds ratio, 1.14; 95% CI, 0.89-1.46). A serology test result positive for SARS-COV-2 was positively associated only with persistent anosmia (odds ratio, 2.72; 95% CI, 1.66-4.46), even when restricting the analyses to participants who attributed their symptoms to COVID-19 infection. Further adjusting for self-rated health or depressive symptoms yielded similar results. There was no significant interaction between belief and serology test results. Conclusions and Relevance The findings of this cross-sectional analysis of a large, population-based French cohort suggest that persistent physical symptoms after COVID-19 infection may be associated more with the belief in having been infected with SARS-CoV-2 than with having laboratory-confirmed COVID-19 infection. Further research in this area should consider underlying mechanisms that may not be specific to the SARS-CoV-2 virus. A medical evaluation of these patients may be needed to prevent symptoms due to another disease being erroneously attributed to "long COVID."