Persistent Symptoms in Adult Patients 1 Year After Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study
Persistent Symptoms in Adult Patients 1 Year After Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study
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DOI：
10.1093/cid/ciab611
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发表时间：
2021-08-23
影响因子：
11.8
通讯作者：
Merle, Uta
中科院分区：
文献类型：
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作者：
Seessle, Jessica;Waterboer, Tim;Merle, Uta
背景 长期新冠肺炎 (Long COVID) 的定义是严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染后症状持续超过 3 个月。为了更好地了解症状的长期病程和病因，我们前瞻性地分析了一组 COVID-19 患者。方法 这项前瞻性、非干预性随访研究纳入了急性 COVID-19 发病 5 个月后的患者。对患者进行随访直至出现 COVID-19 症状后 12 个月（n = 96；32.3% 住院，55.2% 女性），该分析包括症状、生活质量（基于 SF-12 调查）、实验室参数（包括抗核抗体 (ANA) 和 SARS-CoV-2 抗体水平）。结果第12个月时，只有22.9%的患者完全没有症状，最常见的症状是运动能力下降（56.3%）、疲劳（53.1%）、呼吸困难（37.5%）、注意力不集中（39.6%）、找词问题（32.3%）和睡眠问题（26.0%）。女性比男性表现出更多的神经认知症状。在出现 COVID-19 症状后 12 个月，43.6% 的患者中 ANA 滴度≥1:160，并且在 12 个月时 ANA 滴度≥1:160 组的神经认知症状频率显着高于 1 例长期 COVID 症状组，其 SARS-CoV-2 抗体水平没有显着差异，但与无症状患者相比，身心生活质量显着降低。结论 神经认知长期 COVID 症状可能在 COVID-19 症状出现后持续 1 年以上，并显着降低生活质量。一些神经认知症状与 ANA 滴度升高相关。这可能表明自身免疫是长期 COVID 病因学的辅助因素。神经认知长期 COVID 症状在急性 COVID-19 后可能持续至少 1 年，并显着降低生活质量。一些神经认知症状与 ANA 滴度升高相关。这可能表明自身免疫是长期新冠肺炎病因学中的一个辅助因素。
Background Long COVID is defined as the persistence of symptoms beyond 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To better understand the long-term course and etiology of symptoms we analyzed a cohort of patients with COVID-19 prospectively. Methods Patients were included at 5 months after acute COVID-19 in this prospective, noninterventional, follow-up study. Patients followed until 12 months after COVID-19 symptom onset (n = 96; 32.3% hospitalized, 55.2% females) were included in this analysis of symptoms, quality of life (based on an SF-12 survey), laboratory parameters including antinuclear antibodies (ANAs), and SARS-CoV-2 antibody levels. Results At month 12, only 22.9% of patients were completely free of symptoms and the most frequent symptoms were reduced exercise capacity (56.3%), fatigue (53.1%), dyspnea (37.5%), and problems with concentration (39.6%), finding words (32.3%), and sleeping (26.0%). Females showed significantly more neurocognitive symptoms than males. ANA titers were >= 1:160 in 43.6% of patients at 12 months post-COVID-19 symptom onset, and neurocognitive symptom frequency was significantly higher in the group with an ANA titer >= 1:160 versus = 1 long-COVID symptom at 12 months did not differ significantly with respect to their SARS-CoV-2 antibody levels but had a significantly reduced physical and mental life quality compared with patients without symptoms. Conclusions Neurocognitive long-COVID symptoms can persist >= 1 year after COVID-19 symptom onset and reduce life quality significantly. Several neurocognitive symptoms were associated with ANA titer elevations. This may indicate autoimmunity as a cofactor in etiology of long COVID.Neurocognitive long-COVID symptoms can persist at least for 1 year after acute COVID-19 and reduce life quality significantly. Several neurocognitive symptoms were associated with ANA titer elevations. This may indicate autoimmunity as a cofactor in the etiology of long COVID.