Post-acute sequelae of SARS-CoV-2 infection in nursing homes: Do not forget the most vulnerable.
Post-acute sequelae of SARS-CoV-2 infection in nursing homes: Do not forget the most vulnerable.
复制标题
疗养院中SARS-COV-2感染后急性后遗症：不要忘记最脆弱的人。
DOI：
10.1111/jgs.17760
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发表时间：
2022-05
影响因子：
6.3
通讯作者：
Boockvar, Kenneth S.
中科院分区：
文献类型：
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作者：
Weerahandi, Himali;Rao, Mana;Boockvar, Kenneth S.
在当前疫情大流行初期，许多人预计 COVID-19 的表现会像大多数其他呼吸道病毒性疾病一样，引起急性疾病，最多几周后就会痊愈。然而，现在有一篇关于长期新冠病毒或 SARS-CoV-2 感染 (PASC)1 综合征急性后遗症的文献迅速涌现，其中患者在初次诊断出新冠病毒 (COVID-19) 后的几周到几个月内可能会在身体、认知和心理健康方面经历显着的限制。目前尚不清楚这些后遗症是否与 SARS-CoV-2 本身造成的损害（一种病毒后综合症、长期住院导致的身体状况不佳或重症监护后综合症）直接相关。 PASC 的发病率、患病率、轨迹和危险因素也是未知的。目前，人们越来越担心，如果这种综合症得不到认识或得到充分治疗，将会引发随后的公共卫生危机。 2 众所周知，熟练护理机构的居民遭受了 COVID-19 的不成比例的影响，病死率很高，但人们对这一特定患者群体中的 PASC 知之甚少。与社区中的 PASC 患者一样，居住在疗养院的 3 名 COVID-19 幸存者可能有新的补充氧气需求，并且因急性 COVID-19 导致严重虚弱，因此需要较高的康复需求，并需要额外的护理人员支持日常生活活动 (ADL)。鉴于 COVID-19 可能对某些患者造成严重的肺部损伤，因此还不确定它是否会对先前存在的医疗状况（例如慢性阻塞性肺病）产生协同不利影响。此外，目前表征 PASC 综合征特征的数据主要是神经功能障碍和持续疲劳的症状。 PASC 是否可以改变轻度认知障碍、阿尔茨海默病和相关痴呆或其他类型痴呆患者的病程仍不清楚。临床隔离要求造成的长期社会限制可能会影响认知能力。社会限制也显着影响疗养院居民的整体生活质量。先前的研究表明，在社区居住的老年人中，COVID-19 大流行对身体机能恶化和跌倒结果产生了全球性影响，特别是对于那些活动水平减少和社会孤立的老年人。 4 这些观察结果在疗养院居民中可能更为明显。此外，鉴于受损的老年人对疫苗接种的免疫反应可能存在差异，人们对免疫接种如何调节 PASC 的发生和进展知之甚少，特别是在疗养院居民中。尽管疗养院居民的 COVID-19 疫苗接种率相对较高
In the early days of the current pandemic, many expected that COVID-19 would behave like most other respiratory viral illnesses—causing an acute illness that would resolve after, at most, a couple of weeks. However, there is a now a rapidly emerging literature on long COVID or a post-acute sequelae of SARS-CoV-2 infection (PASC) 1 syndrome in which patients may experience significant limitations in physical, cognitive, and mental health for several weeks to months after the initial COVID-19 diagnosis. It is unclear whether these sequelae are directly related to damage caused by SARS-CoV-2 itself, a postviral syndrome, deconditioning from prolonged hospital stays or post-intensive care syndrome. Also unknown about PASC are its incidence, prevalence, trajectory, and risk factors. Presently, there is growing concern that there will be a subsequent public health crisis if this syndrome is not recognized or adequately treated. 2 While it is well known that residents of skilled nursing facilities have endured a disproportionate impact from COVID-19 with high case fatality rates, little is known about PASC in this specific patient population. Like PASC patients in the community, 3 survivors of COVID-19 residing in nursing homes may have new supplemental oxygen requirements and significant debilitation from acute COVID-19, resulting in high rehabilitation needs and need for additional caregiver support for activities of daily living (ADLs). It is also uncertain whether COVID-19 has synergistic adverse effects on preexisting medical conditions, such as chronic obstructive pulmonary disease, given the severe lung damage that it can cause in some patients. Furthermore, current data characterizing PASC syndrome profiles are dominated by symptoms of neurological dysfunction and persistent fatigue. Whether PASC may alter the disease course of patients with mild cognitive impairment, Alzheimer's disease and related dementia, or other types of dementia remains unknown. Prolonged social confinement imposed by clinical isolation requirements may affect cognitive faculties. Social confinement also significantly impacts a nursing home resident's overall quality of life. Prior work has indicated that in community-dwelling older adults, the COVID-19 pandemic has had a global effect on worsened physical functioning and fall outcomes, notably in those with reduced activity levels and social isolation. 4 These observations will likely be more apparent in nursing home residents. In addition, little is known about how immunization might modulate the development and progression of PASC, particularly in nursing home residents—given the likely differential immune response to vaccination in impaired older adults. Though COVID-19 vaccination rates among nursing home residents are relatively high in
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DOI：
10.1016/s1473-3099(21)00460-6
发表时间：
2022-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Antonelli M;Penfold RS;Merino J;Sudre CH;Molteni E;Berry S;Canas LS;Graham MS;Klaser K;Modat M;Murray B;Kerfoot E;Chen L;Deng J;Österdahl MF;Cheetham NJ;Drew DA;Nguyen LH;Pujol JC;Hu C;Selvachandran S;Polidori L;May A;Wolf J;Chan AT;Hammers A;Duncan EL;Spector TD;Ourselin S;Steves CJ
通讯作者：
Steves CJ
影响因子：
6.3
作者：
Hoffman, Geoffrey J.;Malani, Preeti N.;Kullgren, Jeffrey T.
通讯作者：
Kullgren, Jeffrey T.
影响因子：
6.3
作者：
Li, Yue;Cen, Xi;Temkin-Greener, Helena
通讯作者：
Temkin-Greener, Helena
影响因子：
13.8
作者：
Beauchamp MK;Joshi D;McMillan J;Erbas Oz U;Griffith LE;Basta NE;Kirkland S;Wolfson C;Raina P;Canadian Longitudinal Study on Aging (CLSA) Team
通讯作者：
Canadian Longitudinal Study on Aging (CLSA) Team
DOI：
10.1016/s0140-6736(23)00810-3
发表时间：
2023-06-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
通讯作者：
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