Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review.
Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review.
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DOI：
10.1001/jamanetworkopen.2021.28568
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发表时间：
2021-10-01
影响因子：
13.8
通讯作者：
Chinchilli VM
中科院分区：
文献类型：
--
作者：
Groff D;Sun A;Ssentongo AE;Ba DM;Parsons N;Poudel GR;Lekoubou A;Oh JS;Ericson JE;Ssentongo P;Chinchilli VM
COVID-19（PASC）感染的短期和长期急性后后遗症是什么？在这项对57项研究（包括超过25万名COVID-19幸存者）的系统性综述中，大多数后遗症包括精神健康、肺部和神经系统疾病，这些疾病在SARS-CoV-2暴露后6个月以上普遍存在。这些研究结果表明，必须将长期PASC纳入现有的医疗保健系统，特别是在低收入和中等收入国家。本系统性综述评估了COVID-19感染急性期后后遗症的器官系统特异性频率和演变。尚未对COVID-19的短期和长期持续性急性后后遗症（PASC）进行系统评估。PASC的发病率和演变取决于感染时间、受影响的器官系统和组织、疫苗接种状况、病毒变体和地理区域。估计PASC的器官系统特异性频率和演变。检索了2019年12月至2021年3月期间的PubMed（MEDLINE）、Scopus、世界卫生组织冠状病毒疾病全球文献和CoronaCentral数据库。从数据库和引用的参考文献中共识别出2100项研究。纳入了提供儿童和成人PASC数据的研究。遵循系统性综述和荟萃分析的首选报告项目（PRISMA）数据提取指南，并由2名评价者独立进行。使用Newcastle-Ottawa量表对队列研究进行质量评估。主要结果是通过（1）实验室检查，（2）放射病理学和（3）临床体征和症状诊断的PASC频率。PASC按器官系统分类，即神经系统、心血管系统、呼吸系统、消化系统、皮肤系统、耳鼻喉科以及精神健康、全身症状和功能活动性。在总共确定的2100项研究中，有57项研究（250351名COVID-19幸存者）符合入选标准。幸存者的平均（SD）年龄为54.4（8.9）岁，140196（56%）人为男性，197777（79%）人在急性COVID-19期间住院。高收入国家提供了45项研究（79%）。COVID-19幸存者经历至少1次PASC的中位数（IQR）比例为54.0% 1个月时（45.0%-69.0%; 13项研究）（短期），55.0%（34.8%-65.5%; 38项研究）在2 - 5个月（中期），54.0%（31.0%-67.0%; 9项研究）在6个月或以上（长期）。最常见的肺部后遗症、神经系统疾病、精神健康障碍、功能性移动障碍以及全身和全身症状是胸部影像学异常（中位数[IQR]，62.2% [45.8%-76.5%]），难以集中注意力（中位数[IQR]，23.8% [20.4%-25.9%]），广泛性焦虑症（中位数[IQR]，29.6% [14.0%-44.0%]），一般功能障碍（中位数[IQR]，44.0% [23.4%-62.6%]）和疲劳或肌无力（中位数[IQR]，37.5% [25.4%-54.5%]）。其他经常报告的症状包括心脏、皮肤、消化和耳、鼻、喉疾病。在这项系统性综述中，超过一半的COVID-19幸存者在康复后6个月经历了PASC。最常见的PASC涉及功能性运动障碍、肺部异常和精神健康障碍。这些长期PASC效应的发生规模可能超过现有的卫生保健能力，特别是在低收入和中等收入国家。
What are the short-term and long-term postacute sequelae of COVID-19 (PASC) infection? In this systematic review of 57 studies comprising more than 250 000 survivors of COVID-19, most sequelae included mental health, pulmonary, and neurologic disorders, which were prevalent longer than 6 months after SARS-CoV-2 exposure. These findings suggest that long-term PASC must be factored into existing health care systems, especially in low- and middle-income countries. This systematic review estimates organ system–specific frequency and evolution of postacute sequelae of COVID-19 infection. Short-term and long-term persistent postacute sequelae of COVID-19 (PASC) have not been systematically evaluated. The incidence and evolution of PASC are dependent on time from infection, organ systems and tissue affected, vaccination status, variant of the virus, and geographic region. To estimate organ system–specific frequency and evolution of PASC. PubMed (MEDLINE), Scopus, the World Health Organization Global Literature on Coronavirus Disease, and CoronaCentral databases were searched from December 2019 through March 2021. A total of 2100 studies were identified from databases and through cited references. Studies providing data on PASC in children and adults were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for abstracting data were followed and performed independently by 2 reviewers. Quality was assessed using the Newcastle-Ottawa Scale for cohort studies. The main outcome was frequency of PASC diagnosed by (1) laboratory investigation, (2) radiologic pathology, and (3) clinical signs and symptoms. PASC were classified by organ system, ie, neurologic; cardiovascular; respiratory; digestive; dermatologic; and ear, nose, and throat as well as mental health, constitutional symptoms, and functional mobility. From a total of 2100 studies identified, 57 studies with 250 351 survivors of COVID-19 met inclusion criteria. The mean (SD) age of survivors was 54.4 (8.9) years, 140 196 (56%) were male, and 197 777 (79%) were hospitalized during acute COVID-19. High-income countries contributed 45 studies (79%). The median (IQR) proportion of COVID-19 survivors experiencing at least 1 PASC was 54.0% (45.0%-69.0%; 13 studies) at 1 month (short-term), 55.0% (34.8%-65.5%; 38 studies) at 2 to 5 months (intermediate-term), and 54.0% (31.0%-67.0%; 9 studies) at 6 or more months (long-term). Most prevalent pulmonary sequelae, neurologic disorders, mental health disorders, functional mobility impairments, and general and constitutional symptoms were chest imaging abnormality (median [IQR], 62.2% [45.8%-76.5%]), difficulty concentrating (median [IQR], 23.8% [20.4%-25.9%]), generalized anxiety disorder (median [IQR], 29.6% [14.0%-44.0%]), general functional impairments (median [IQR], 44.0% [23.4%-62.6%]), and fatigue or muscle weakness (median [IQR], 37.5% [25.4%-54.5%]), respectively. Other frequently reported symptoms included cardiac, dermatologic, digestive, and ear, nose, and throat disorders. In this systematic review, more than half of COVID-19 survivors experienced PASC 6 months after recovery. The most common PASC involved functional mobility impairments, pulmonary abnormalities, and mental health disorders. These long-term PASC effects occur on a scale that could overwhelm existing health care capacity, particularly in low- and middle-income countries.
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影响因子：
13.8
作者：
Bellan M;Soddu D;Balbo PE;Baricich A;Zeppegno P;Avanzi GC;Baldon G;Bartolomei G;Battaglia M;Battistini S;Binda V;Borg M;Cantaluppi V;Castello LM;Clivati E;Cisari C;Costanzo M;Croce A;Cuneo D;De Benedittis C;De Vecchi S;Feggi A;Gai M;Gambaro E;Gattoni E;Gramaglia C;Grisafi L;Guerriero C;Hayden E;Jona A;Invernizzi M;Lorenzini L;Loreti L;Martelli M;Marzullo P;Matino E;Panero A;Parachini E;Patrucco F;Patti G;Pirovano A;Prosperini P;Quaglino R;Rigamonti C;Sainaghi PP;Vecchi C;Zecca E;Pirisi M
通讯作者：
Pirisi M
DOI：
10.1056/nejmoa2109072
发表时间：
2021-10-14
期刊：
The New England journal of medicine
影响因子：
--
作者：
Bergwerk M;Gonen T;Lustig Y;Amit S;Lipsitch M;Cohen C;Mandelboim M;Levin EG;Rubin C;Indenbaum V;Tal I;Zavitan M;Zuckerman N;Bar-Chaim A;Kreiss Y;Regev-Yochay G
通讯作者：
Regev-Yochay G
影响因子：
4.6
作者：
D'Cruz, Rebecca F.;Waller, Michael D.;Jolley, Caroline J.
通讯作者：
Jolley, Caroline J.
影响因子：
5.1
作者：
Chiesa-Estomba, C. M.;Lechien, J. R.;Saussez, S.
通讯作者：
Saussez, S.
影响因子：
64.8
作者：
Al-Aly, Ziyad;Xie, Yan;Bowe, Benjamin
通讯作者：
Bowe, Benjamin