Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study.
Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study.
复制标题
DOI：
10.1016/s2352-4642(22)00022-0
复制
发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Ladhani SN
中科院分区：
文献类型：
--
作者：
Stephenson T;Pinto Pereira SM;Shafran R;de Stavola BL;Rojas N;McOwat K;Simmons R;Zavala M;O'Mahoney L;Chalder T;Crawley E;Ford TJ;Harnden A;Heyman I;Swann O;Whittaker E;CLoCk Consortium;Ladhani SN
我们描述了一个非住院的，11-17岁的青少年PCR证实的SARS-CoV-2感染的国家样本与匹配的PCR阴性青少年相比的COVID后的病理学。在这项全国性队列研究中，来自英国公共卫生数据库的11-17岁青少年在2021年1月至3月期间对SARS-CoV-2检测呈阳性，并按检测月份，年龄，性别和地理区域与检测阴性的青少年相匹配。测试后3个月，联系青少年的子样本以完成详细的问卷调查，收集PCR测试时（回顾性）和完成问卷调查时（前瞻性）的人口统计学数据及其身心健康状况。我们比较了测试阳性组和测试阴性组之间的症状，并使用潜在类别分析来评估基线和3个月时的身体症状是否以及如何在参与者中聚集。本研究已在ISRCTN注册中心注册（ISRCTN 34804192）。在2021年1月1日至2021年3月31日期间，接触了23 048名检测呈阳性的青少年和27 798名检测呈阴性的青少年，6804名青少年（3065名检测呈阳性，3739名检测呈阴性）完成了问卷（应答率13.4%）。在PCR检测中，1084例（35.4%）检测阳性和309例（8.3%）检测阴性有症状，936例（30.5%）检测阳性组和231例（6.2%）检测阴性组有三种或三种以上症状。检测后3个月，2038例（66.5%）检测阳性和1993例（53.3%）检测阴性有任何症状，928例（30.3%）检测阳性组和603例（16.2%）检测阴性组有三种或三种以上症状。在测试后3个月，测试阳性组中最常见的症状是疲劳（1196 [39·0%]），头痛（710例[23.2%]）和呼吸短促（717例[23.4%]），而在测试阴性组中，疲劳（911例[24.4%]）、头痛（530例[14.2%]）和其他（未指明; 590例[15.8%]）。潜在类别分析确定了两个类别，其特征在于很少或多种症状。在多症状分类中，检测阳性组的估计概率为29.6%（95%CI 27.4 - 31.7），检测阴性组为19.3%（17.7 - 21.0）（风险比1.53; 95%CI 1.35 - 1.70）。多重症状类别在PCR结果阳性者中比阴性者更常见，在女孩中比男孩中更常见，在15-17岁的青少年中比在11-14岁的青少年中更常见，并且在测试前身心健康状况较低的青少年中更常见。SARS-CoV-2检测呈阳性的青少年与检测阴性的青少年有相似的症状，但在PCR检测时和3个月后，单一症状，特别是多种症状的患病率更高。临床医生应该考虑影响功能的多种症状，并识别不同的症状群。多种多样的症状表明，将需要多方面的干预，心理和身体健康症状同时发生，反映了它们的密切关系。英国卫生和社会保健部，作为国家卫生研究所，以及英国研究和创新。
We describe post-COVID symptomatology in a non-hospitalised, national sample of adolescents aged 11–17 years with PCR-confirmed SARS-CoV-2 infection compared with matched adolescents with negative PCR status. In this national cohort study, adolescents aged 11–17 years from the Public Health England database who tested positive for SARS-CoV-2 between January and March, 2021, were matched by month of test, age, sex, and geographical region to adolescents who tested negative. 3 months after testing, a subsample of adolescents were contacted to complete a detailed questionnaire, which collected data on demographics and their physical and mental health at the time of PCR testing (retrospectively) and at the time of completing the questionnaire (prospectively). We compared symptoms between the test-postive and test-negative groups, and used latent class analysis to assess whether and how physical symptoms at baseline and at 3 months clustered among participants. This study is registered with the ISRCTN registry (ISRCTN 34804192). 23 048 adolescents who tested positive and 27 798 adolescents who tested negative between Jan 1, 2021, and March 31, 2021, were contacted, and 6804 adolescents (3065 who tested positive and 3739 who tested negative) completed the questionnaire (response rate 13·4%). At PCR testing, 1084 (35·4%) who tested positive and 309 (8·3%) who tested negative were symptomatic and 936 (30·5%) from the test-positive group and 231 (6·2%) from the test-negative group had three or more symptoms. 3 months after testing, 2038 (66·5%) who tested positive and 1993 (53·3%) who tested negative had any symptoms, and 928 (30·3%) from the test-positive group and 603 (16·2%) from the test-negative group had three or more symptoms. At 3 months after testing, the most common symptoms among the test-positive group were tiredness (1196 [39·0%]), headache (710 [23·2%]), and shortness of breath (717 [23·4%]), and among the test-negative group were tiredness (911 [24·4%]), headache (530 [14·2%]), and other (unspecified; 590 [15·8%]). Latent class analysis identified two classes, characterised by few or multiple symptoms. The estimated probability of being in the multiple symptom class was 29·6% (95% CI 27·4–31·7) for the test-positive group and 19·3% (17·7–21·0) for the test-negative group (risk ratio 1·53; 95% CI 1·35–1·70). The multiple symptoms class was more frequent among those with positive PCR results than negative results, in girls than boys, in adolescents aged 15–17 years than those aged 11–14 years, and in those with lower pretest physical and mental health. Adolescents who tested positive for SARS-CoV-2 had similar symptoms to those who tested negative, but had a higher prevalence of single and, particularly, multiple symptoms at the time of PCR testing and 3 months later. Clinicians should consider multiple symptoms that affect functioning and recognise different clusters of symptoms. The multiple and varied symptoms show that a multicomponent intervention will be required, and that mental and physical health symptoms occur concurrently, reflecting their close relationship. UK Department of Health and Social Care, in their capacity as the National Institute for Health Research, and UK Research and Innovation.