Symptoms and risk factors for long COVID in non-hospitalized adults.
Symptoms and risk factors for long COVID in non-hospitalized adults.
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DOI：
10.1038/s41591-022-01909-w
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发表时间：
2022-08
期刊：
影响因子：
82.9
通讯作者：
Haroon, Shamil
中科院分区：
文献类型：
--
作者：
Subramanian, Anuradhaa;Nirantharakumar, Krishnarajah;Hughes, Sarah;Myles, Puja;Williams, Tim;Gokhale, Krishna M.;Taverner, Tom;Chandan, Joht Singh;Brown, Kirsty;Simms-Williams, Nikita;Shah, Anoop D.;Singh, Megha;Kidy, Farah;Okoth, Kelvin;Hotham, Richard;Bashir, Nasir;Cockburn, Neil;Lee, Siang Ing;Turner, Grace M.;Gkoutos, Georgios V.;Aiyegbusi, Olalekan Lee;McMullan, Christel;Denniston, Alastair K.;Sapey, Elizabeth;Lord, Janet M.;Wraith, David C.;Leggett, Edward;Iles, Clare;Marshall, Tom;Price, Malcolm J.;Marwaha, Steven;Davies, Elin Haf;Jackson, Louise J.;Matthews, Karen L.;Camaradou, Jenny;Calvert, Melanie;Haroon, Shamil
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染与一系列影响日常功能的持续症状有关，称为COVID-19后病症或长期COVID。我们使用英国初级保健数据库临床实践研究Datalink Aurum进行了一项回顾性匹配队列研究，以确定与非住院成人中确诊的SARS-CoV-2感染超过12周相关的症状以及与持续症状相关的风险因素。我们选择了486，149名确诊为SARS-CoV-2感染的成年人和1，944，580名没有记录的SARS-CoV-2感染证据的倾向评分匹配的成年人。结果包括115个个体症状，以及长期COVID，根据世界卫生组织临床病例定义，长期COVID定义为33个症状的复合结果。使用考克斯比例风险模型估计结局的校正风险比（aHR）。12周后，共有62种症状与SARS-CoV-2感染显著相关。最大aHR为嗅觉丧失（aHR 6.49，95% CI 5.02-8.39）、脱发（3.99，3.63-4.39）、打喷嚏（2.77，1.40-5.50）、射精困难（2.63，1.61-4.28）和性欲减退（2.36，1.61-3.47）。在感染SARS-CoV-2的患者队列中，长期COVID的风险因素包括女性，属于少数民族，社会经济贫困，吸烟，肥胖和广泛的合并症。研究发现，罹患长期COVID的风险也会随着年龄的下降而沿着增加。SARS-CoV-2感染与大量症状相关，这些症状与一系列社会人口统计学和临床风险因素相关。对英国初级保健记录的回顾性分析揭示了与SARS-CoV-2感染相关的个体症状，这些症状在感染后持续12周或更长时间，以及与发展长期COVID相关的风险因素。
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook a retrospective matched cohort study using a UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine symptoms that are associated with confirmed SARS-CoV-2 infection beyond 12 weeks in non-hospitalized adults and the risk factors associated with developing persistent symptoms. We selected 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 propensity score-matched adults with no recorded evidence of SARS-CoV-2 infection. Outcomes included 115 individual symptoms, as well as long COVID, defined as a composite outcome of 33 symptoms by the World Health Organization clinical case definition. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the outcomes. A total of 62 symptoms were significantly associated with SARS-CoV-2 infection after 12 weeks. The largest aHRs were for anosmia (aHR 6.49, 95% CI 5.02–8.39), hair loss (3.99, 3.63–4.39), sneezing (2.77, 1.40–5.50), ejaculation difficulty (2.63, 1.61–4.28) and reduced libido (2.36, 1.61–3.47). Among the cohort of patients infected with SARS-CoV-2, risk factors for long COVID included female sex, belonging to an ethnic minority, socioeconomic deprivation, smoking, obesity and a wide range of comorbidities. The risk of developing long COVID was also found to be increased along a gradient of decreasing age. SARS-CoV-2 infection is associated with a plethora of symptoms that are associated with a range of sociodemographic and clinical risk factors. A retrospective analysis of primary care records in the United Kingdom reveals individual symptoms associated with SARS-CoV-2 infections, which persisted for 12 weeks or more after infection, as well as risk factors associated with developing long COVID.
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