Long-term consequences of SARS-CoV-2 infection and COVID-19 disease among American Indians: an ambidirectional cohort study in the Cherokee Nation

摘要 在急性COVID-19对患者和医疗保健系统产生直接影响后， 很明显，多达35%的新冠肺炎患者经历了其长期健康后果 感染据报道，这些后果包括心脏相关问题、消化问题、疲劳和 头晕，以及焦虑和抑郁，但症状的全谱及其持续时间仍然是 未知美国印第安人受到COVID大流行的不成比例的影响， 基础疾病加上高COVID-19发病率和死亡率，以及一般健康状况 不等式因此，预计长期症状对该人群的影响也很严重。在 在这项研究中，我们建议检查SARS-CoV-2感染后的长期症状的程度， 居住在切罗基保留地的美国印第安人。鉴于COVID-19的强烈影响， 由于对它在切罗基民族的长期影响缺乏了解， 改善社区对这些患者的管理。这项研究将是第一批评估 美国印第安人群体的长期症状，因此将建立一个先例和框架， 为将来在美洲印第安人群体中的研究做准备。这项研究的总体目标是确定和量化 美国印第安人的长期COVID症状，并制定如何预测的指导方针， 评估和管理这些症状。这是一项双向队列研究，共有200人参加。 回顾性（在过去六个月内进行感染测试）和前瞻性（从 研究开始的时间，以及以后的时间）。使用这种方法，我们将实现我们的目标， SARS-CoV-2阳性与阴性的美国印第安人的症状，预测谁处于 发展这些症状，并最终产生预测和确定谁是最危险的指导方针 从长远来看，受到COVID症状的影响，以及如何在集中管理 专门的医疗保健诊所或通过初级保健提供者。

ABSTRACT Following the immediate effect of acute COVID-19 on patients and healthcare systems, it has now also become apparent that as many as 35% of COVID patients experience long-term health consequences of their infection. These consequences are reported to include heart-related problems, digestive issues, fatigue and dizziness, as well as anxiety and depression, but the full spectrum of symptoms and their duration is still unknown. American Indian people have been disproportionately affected by the COVID pandemic due to underlying medical conditions combined with high COVID-19 incidence and mortality, and general health inequalities. As a result, the impact of long-term symptoms is also expected to be severe in this population. In this study, we propose to examine the extent of long-term symptoms following SARS-CoV-2 infection among American Indian people residing in the Cherokee Nation Reservation. Given the strong impact of COVID-19 and the lack of understanding of its long-term effect in the Cherokee Nation, there is a crucial need for improved management among these patients in the community. This study will be among the first to assess long-term symptoms in an American Indian population and as such will establish a precedent and framework for future studies in the American Indian population. The overall goal of the study is to identify and quantify long-term COVID symptoms among American Indian people and to develop guidelines for how to predict, assess and manage these symptoms. This is an ambidirectional cohort study following a total of 200 persons retrospectively (tested for infection within the past six months) and prospectively (tested for infection from the time the study is initiated, and onwards). Using this approach, we will achieve our aims of identifying long-term symptoms in SARS-CoV-2 positive versus negative American Indian persons, predicting who is at risk of developing these symptoms and ultimately produce guidelines for predicting and identifying who is most at risk of becoming affected by COVID symptoms in the long run and how manage the symptoms either in centralized dedicated healthcare clinics or through primary care providers.