Michael Gottlieb , Huihui Yu , Ji Chen , Erica S. Spatz , Nicole L. Gentile , Rachel E. Geyer , Michelle Santangelo , Caitlin Malicki , Kristyn Gatling , Sharon Saydah , Kelli N. O'Laughlin , Kari A. Stephens , Joann G. Elmore , Lauren E. Wisk , Michelle L'Hommedieu , Robert M. Rodriguez , Juan Carlos C. Montoy , Ralph C. Wang , Kristin L. Rising , Efrat Kean , Robert A. Weinstein
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引用次数: 0
Abstract
Background
Although short-term outcomes of Long COVID have been described, longer-term physical and mental health outcomes of Long COVID are less well-established. This study sought to assess differences in long-term physical and mental health outcomes extending up to three years among those with current, resolved, and no Long COVID, as well as duration of Long COVID and vaccination status.
Methods
This was a prospective, multisite, study of participants with SARS-CoV-2 infection from 12/7/2020-8/29/2022, with data collected through 4/2/2024. Surveys included validated tools for physical and mental health. Data were analyzed by Long COVID status (never-had, resolved, current), Long COVID duration and vaccination status.
Findings
Of 3663 participants, 2604 (71.1%) never had Long COVID, 994 (27.1%) reported current Long COVID, and 65 (1.8%) reported resolved Long COVID. Compared to never having Long COVID, current Long COVID had lower/worse scores for Patient-Reported Outcomes Measurement Information System (PROMIS) version 29 Physical (7.8; 95% confidence interval [CI] 7.3–8.3) and Mental Health (9.4; 95% CI 8.8–10.1) and higher likelihood of moderate-to-high stress (adjusted odds ratio [aOR]: 2.0; 95% CI 1.6–2.4), moderate-to-high loneliness (aOR: 1.6; 95% CI 1.4–2.0), moderate-to-severe fatigue (aOR: 3.0; 95% CI 2.5–3.7), insufficient activity (aOR for Speedy Nutrition and Physical Activity Assessment ≤4: 0.6; 95% CI 0.5–0.7; aOR for Exercise Vital Sign ≤150 min/week: 0.7, 95% CI 0.6–1.0), and worse dyspnea (aOR: 5.0; 95% CI 4.3–5.8). Resolved Long COVID had lower scores for PROMIS Physical by 2.0 (95% CI 0.2–3.8) and Mental Health by 2.3 (95% CI 0.2–4.4) than the never-had-Long COVID cohort. Number of COVID-19 vaccinations was associated with better outcomes across all measures.
Interpretation
Among participants followed up to 3 years after initial infection, those with current Long COVID had worse physical and mental health outcomes. The majority of those with Long COVID did not resolve, with less than 2% having resolved Long COVID. The resolved Long COVID cohort had moderately worse physical and mental health compared with those never-having-Long COVID. COVID-19 vaccination was associated with better outcomes.
虽然已经描述了长冠状病毒病的短期结果，但长冠状病毒病的长期身心健康结果尚不清楚。本研究旨在评估当前、已解决和未长期COVID患者长达三年的长期身心健康结果的差异，以及长期COVID持续时间和疫苗接种状况。方法：这是一项前瞻性、多地点的研究，研究对象是2020年7月12日至2022年8月29日期间的SARS-CoV-2感染患者，数据收集时间为2024年2月4日。调查包括用于身心健康的有效工具。数据按长期COVID状态（从未有过、已解决、当前）、长期COVID持续时间和疫苗接种状态进行分析。在3663名参与者中，2604名（71.1%）从未患过长状冠，994名（27.1%）报告当前患有长状冠，65名（1.8%）报告已解决长状冠。与从未患过Long COVID相比，当前的Long COVID在患者报告的结果测量信息系统（PROMIS）第29版物理(7.8；95%置信区间[CI] 7.3-8.3)和心理健康(9.4；95% CI 8.8-10.1)和较高的中高压力可能性(调整优势比[aOR]: 2.0；95% CI 1.6 - 2.4)，中度至高度孤独感(aOR: 1.6；95% CI 1.4-2.0)，中度至重度疲劳(aOR: 3.0；95% CI 2.5-3.7)，活动不足(快速营养和身体活动评估的aOR≤4:0.6；95% ci 0.5-0.7；运动生命体征≤150分钟/周的aOR: 0.7, 95% CI 0.6-1.0)和更严重的呼吸困难(aOR: 5.0；95% ci 4.3-5.8)。与从未长过的COVID队列相比，解决的长COVID在PROMIS身体评分上低2.0分（95% CI 0.2-3.8），心理健康评分低2.3分（95% CI 0.2-4.4）。在所有措施中，COVID-19疫苗接种次数与更好的结果相关。在首次感染后随访3年的参与者中，目前长期COVID的参与者身心健康状况较差。大多数长COVID患者没有解决，只有不到2%的人解决了长COVID。与那些没有长期COVID的人相比，已解决的长期COVID队列的身心健康状况略差。COVID-19疫苗接种与更好的结果相关。资助疾病控制和预防中心。
期刊介绍：
The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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