Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals.
Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals.
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COVID-19在专业临床服务中的评估：1325个人中的12个月，单一中央的前瞻性研究。
DOI：
10.1136/bmjresp-2021-001041
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发表时间：
2021-11
影响因子：
4.1
通讯作者：
Banerjee A
中科院分区：
文献类型：
--
作者：
Heightman M;Prashar J;Hillman TE;Marks M;Livingston R;Ridsdale HA;Bell R;Zandi M;McNamara P;Chauhan A;Denneny E;Astin R;Purcell H;Attree E;Hishmeh L;Prescott G;Evans R;Mehta P;Brennan E;Brown JS;Porter J;Logan S;Wall E;Dehbi HM;Cone S;Banerjee A
COVID-19后并发症需要同时进行表征和管理，以规划政策和卫生系统应对措施。我们描述了英国首个专门的COVID-19后临床服务的12个月经验，包括住院和非住院患者。在一项单中心观察性分析中，我们报告了2020年4月至2021年4月期间在伦敦大学学院医院接受COVID-19服务后评估的1325名个人的人口统计学、症状、合并症、检查、治疗、功能恢复、专家转诊和康复情况，并按转诊途径进行比较：住院后（PH）、非住院（NH）和急诊后（PED）。与恢复不良或无法恢复全职工作相关的症状采用多变量logistic回归进行评估。评估了1325名个体（PH：547，41.3%; PED：212，16%; NH：566，42.7%）。与PH组和PED组相比，NH组的年龄更小（中位数44.6（35.6-52.8）岁vs 58.3（47.0-67.7）岁和48.5岁（39.4-55.7）岁），女性更有可能（68.2%、43.0%和59.9%），少数族裔的可能性较小（30.9%，52.7%和41.0%）或在症状发作后较晚观察到（中位数（IQR）：194（118-298）天，69（51-111）天和76（55-128）天;所有p<0.0001）。所有组的专科转诊率相似（NH 18.7%，PH 16.1%和PED 18.9%，p=0.452），更可能需要呼吸困难（23.7%，5.5%和15.1%，p<0.001）和疲劳（17.8%，4.8%和8.0%，p<0.001）的支持。住院患者的肺栓塞、持续性肺间质异常和其他器官损害发生率较高。716人（54.0%）报告最佳健康<75%（中位数70%，IQR 55%-85%）。在第一次评估时，不到一半的就业人员可以恢复全职工作。PH和NH患者的COVID-19后症状显著，持续的医疗保健需求和利用率显著。迫切需要对干预措施和以患者为中心的诊断和治疗途径进行试验。
Post-COVID-19 complications require simultaneous characterisation and management to plan policy and health system responses. We describe the 12-month experience of the first UK dedicated post-COVID-19 clinical service to include hospitalised and non-hospitalised patients. In a single-centre, observational analysis, we report the demographics, symptoms, comorbidities, investigations, treatments, functional recovery, specialist referral and rehabilitation of 1325 individuals assessed at the University College London Hospitals post-COVID-19 service between April 2020 and April 2021, comparing by referral route: posthospitalised (PH), non-hospitalised (NH) and post emergency department (PED). Symptoms associated with poor recovery or inability to return to work full time were assessed using multivariable logistic regression. 1325 individuals were assessed (PH: 547, 41.3%; PED: 212, 16%; NH: 566, 42.7%). Compared with the PH and PED groups, the NH group were younger (median 44.6 (35.6–52.8) years vs 58.3 (47.0–67.7) years and 48.5 (39.4–55.7) years), more likely to be female (68.2%, 43.0% and 59.9%), less likely to be of ethnic minority (30.9%, 52.7% and 41.0%) or seen later after symptom onset (median (IQR): 194 (118–298) days, 69 (51–111) days and 76 (55–128) days; all p<0.0001). All groups had similar rates of onward specialist referral (NH 18.7%, PH 16.1% and PED 18.9%, p=0.452) and were more likely to require support for breathlessness (23.7%, 5.5% and 15.1%, p<0.001) and fatigue (17.8%, 4.8% and 8.0%, p<0.001). Hospitalised patients had higher rates of pulmonary emboli, persistent lung interstitial abnormalities and other organ impairment. 716 (54.0%) individuals reported <75% optimal health (median 70%, IQR 55%–85%). Less than half of employed individuals could return to work full time at first assessment. Post-COVID-19 symptoms were significant in PH and NH patients, with significant ongoing healthcare needs and utilisation. Trials of interventions and patient-centred pathways for diagnostic and treatment approaches are urgently required.
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影响因子：
9.1
作者：
Oronsky B;Larson C;Hammond TC;Oronsky A;Kesari S;Lybeck M;Reid TR
通讯作者：
Reid TR
DOI：
10.1016/j.jcmg.2021.04.011
发表时间：
2021-11
期刊：
JACC. Cardiovascular imaging
影响因子：
--
作者：
Joy G;Artico J;Kurdi H;Seraphim A;Lau C;Thornton GD;Oliveira MF;Adam RD;Aziminia N;Menacho K;Chacko L;Brown JT;Patel RK;Shiwani H;Bhuva A;Augusto JB;Andiapen M;McKnight A;Noursadeghi M;Pierce I;Evain T;Captur G;Davies RH;Greenwood JP;Fontana M;Kellman P;Schelbert EB;Treibel TA;Manisty C;Moon JC;COVIDsortium Investigators
通讯作者：
COVIDsortium Investigators
影响因子：
64.8
作者：
Al-Aly, Ziyad;Xie, Yan;Bowe, Benjamin
通讯作者：
Bowe, Benjamin
一项多学科NHS COVID-19服务，用于管理社区中的COVID-19综合征。
影响因子：
3.6
作者：
Parkin A;Davison J;Tarrant R;Ross D;Halpin S;Simms A;Salman R;Sivan M
通讯作者：
Sivan M
影响因子：
15.1
作者：
Raman B;Cassar MP;Tunnicliffe EM;Filippini N;Griffanti L;Alfaro-Almagro F;Okell T;Sheerin F;Xie C;Mahmod M;Mózes FE;Lewandowski AJ;Ohuma EO;Holdsworth D;Lamlum H;Woodman MJ;Krasopoulos C;Mills R;McConnell FAK;Wang C;Arthofer C;Lange FJ;Andersson J;Jenkinson M;Antoniades C;Channon KM;Shanmuganathan M;Ferreira VM;Piechnik SK;Klenerman P;Brightling C;Talbot NP;Petousi N;Rahman NM;Ho LP;Saunders K;Geddes JR;Harrison PJ;Pattinson K;Rowland MJ;Angus BJ;Gleeson F;Pavlides M;Koychev I;Miller KL;Mackay C;Jezzard P;Smith SM;Neubauer S
通讯作者：
Neubauer S