Follow-up of adults with noncritical COVID-19 two months after symptom onset.
Follow-up of adults with noncritical COVID-19 two months after symptom onset.
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DOI：
10.1016/j.cmi.2020.09.052
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Bernard L
中科院分区：
文献类型：
--
作者：
Carvalho-Schneider C;Laurent E;Lemaignen A;Beaufils E;Bourbao-Tournois C;Laribi S;Flament T;Ferreira-Maldent N;Bruyère F;Stefic K;Gaudy-Graffin C;Grammatico-Guillon L;Bernard L
描述2019年成人非危重冠状病毒病患者2个月随访期间的临床演变和症状持续性的预测因素(新冠肺炎)。我们于2020年3月17日至6月3日在图斯大学医院对150例经实时逆转录聚合酶链式反应确诊的非重症新冠肺炎患者进行描述性临床随访(第7天、第30天和第60天)，包括从电子病历和电话中收集的人口统计学、临床和实验室数据。持续症状的定义是在D30或D60出现以下至少一种症状：体重减轻≥5%，严重呼吸困难或无力，胸痛，心悸，嗅觉障碍/失眠，头痛，皮肤体征，关节痛，肌肉痛，消化障碍，发烧或病假。在D30时，68%(103/150)的患者至少有一种症状；在D60时，66%(86/130)的患者有症状，主要是嗅觉障碍/嗅觉障碍：症状出现时59%(89/150)，D30时28%(40/150)，D60时23%(29/130)。呼吸困难在D30和D60分别为36.7%(55/150)和30%(39/130)。在D30和D60分别有一半(74/150)和40%(52/130)的患者报告虚弱。D60的持续症状与年龄40~60岁、入院和症状出现时听诊异常显著相关。在D30，症状出现时严重的新冠肺炎和/或呼吸困难是与持续症状相关的额外因素。在症状出现两个半月后，三分之二的非危重新冠肺炎患者有主诉，主要是嗅觉障碍/嗅觉障碍、呼吸困难或乏力。无论最初的临床表现如何，对新冠肺炎患者的长期医学随访似乎都是必不可少的。
To describe the clinical evolution and predictors of symptom persistence during 2 months' follow-up in adults with noncritical coronavirus disease 2019 (COVID-19). We performed descriptive clinical follow-up (day (D) 7, D30 and D60) of 150 patients with noncritical COVID-19 confirmed by real-time reverse transcriptase PCR at Tours University Hospital from 17 March to 3 June 2020, including demographic, clinical and laboratory data collected from the electronic medical records and by phone call. Persisting symptoms were defined by the presence at D30 or D60 of at least one of the following: weight loss ≥5%, severe dyspnoea or asthenia, chest pain, palpitations, anosmia/ageusia, headache, cutaneous signs, arthralgia, myalgia, digestive disorders, fever or sick leave. At D30, 68% (103/150) of patients had at least one symptom; and at D60, 66% (86/130) had symptoms, mainly anosmia/ageusia: 59% (89/150) at symptom onset, 28% (40/150) at D30 and 23% (29/130) at D60. Dyspnoea concerned 36.7% (55/150) patients at D30 and 30% (39/130) at D60. Half of the patients (74/150) at D30 and 40% (52/130) at D60 reported asthenia. Persistent symptoms at D60 were significantly associated with age 40 to 60 years old, hospital admission and abnormal auscultation at symptom onset. At D30, severe COVID-19 and/or dyspnoea at symptom onset were additional factors associated with persistent symptoms. Up to 2 months after symptom onset, two thirds of adults with noncritical COVID-19 had complaints, mainly anosmia/ageusia, dyspnoea or asthenia. A prolonged medical follow-up of patients with COVID-19 seems essential, whatever the initial clinical presentation.
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