孕期感染严重急性呼吸系统综合征冠状病毒 2 (SARS-CoV-2) 后的急性后遗症。

IF 8.3 2区 材料科学 Q1 MATERIALS SCIENCE, MULTIDISCIPLINARY ACS Applied Materials & Interfaces Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI:10.1097/AOG.0000000000005670
Torri D Metz, Harrison T Reeder, Rebecca G Clifton, Valerie Flaherman, Leyna V Aragon, Leah Castro Baucom, Carmen J Beamon, Alexis Braverman, Jeanette Brown, Tingyi Cao, Ann Chang, Maged M Costantine, Jodie A Dionne, Kelly S Gibson, Rachel S Gross, Estefania Guerreros, Mounira Habli, Jennifer Hadlock, Jenny Han, Rachel Hess, Leah Hillier, M Camille Hoffman, Matthew K Hoffman, Brenna L Hughes, Xiaolin Jia, Minal Kale, Stuart D Katz, Victoria Laleau, Gail Mallett, Alem Mehari, Hector Mendez-Figueroa, Grace A McComsey, Jonathan Monteiro, Vanessa Monzon, Megumi J Okumura, Deepti Pant, Luis D Pacheco, Anna Palatnik, Kristy T S Palomares, Samuel Parry, Christian M Pettker, Beth A Plunkett, Athena Poppas, Patrick Ramsey, Uma M Reddy, Dwight J Rouse, George R Saade, Grecio J Sandoval, Frank Sciurba, Hyagriv N Simhan, Daniel W Skupski, Amber Sowles, John M Thorp, Alan T N Tita, Samantha Wiegand, Steven J Weiner, Lynn M Yee, Leora I Horwitz, Andrea S Foulkes, Vanessa Jacoby
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引用次数: 0

摘要

目的估计孕期感染严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)后急性后遗症(PASC)的发病率,并确定相关风险因素的特征:在一项多中心队列研究(NIH RECOVER [Researching COVID to Enhance Recovery] -Pregnancy Cohort)中,2021 年 12 月至 2023 年 9 月期间,美国各地首次感染 SARS-CoV-2 期间怀孕的人在感染后 30 天内或之后的不同时间点进行了登记。主要研究结果是PASC,即根据美国国立卫生研究院(NIH)RECOVER-成人队列先前公布的症状和严重程度,在参与者首次感染SARS-CoV-2至少6个月后的首次研究访问中,得分达到或超过12分。对 PASC 的风险因素进行了评估,包括社会人口学特征、感染 SARS-CoV-2 前的临床特征(基线合并症、感染的三个月、疫苗接种情况)和急性感染的严重程度(按是否需要氧疗分类)。我们采用多变量逻辑回归模型来估计这些特征与 PASC 存在之间的关系:在 1,502 名参与者中,61.1% 在 2021 年 12 月 1 日或之后首次感染 SARS-CoV-2(即在 Omicron 变种占优势期间);51.4% 在感染前已完全接种疫苗;182 人(12.1%)在急性感染后 30 天内入组。首次感染后 10.3 个月(四分位数间距 6.1-21.5)的中位数显示,PASC 患病率为 9.3%(95% CI,7.9-10.9%)。PASC患者最常见的症状是劳累后乏力(77.7%)、疲劳(76.3%)和胃肠道症状(61.2%)。88)、经济困难(自述难以支付费用)(12.5% vs 6.9%,aOR 1.57,95% CI,1.05-2.34)以及急性 SARS-CoV-2 感染期间使用氧气治疗(18.1% vs 8.7%,aOR 1.86,95% CI,1.00-3.44)与 PASC 患病率增加有关:结论:在 NIH RECOVER-Pregnancy Cohort 中,妊娠期感染 SARS-CoV-2 后 10.3 个月的中位 PASC 患病率为 9.3%。主要症状为劳累后乏力、疲倦和胃肠道症状。一些社会经济和临床特征与孕期感染后的 PASC 相关:临床试验注册:ClinicalTrials.gov,NCT05172024。
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Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy.

Objective: To estimate the prevalence of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) after infection with SARS-CoV-2 during pregnancy and to characterize associated risk factors.

Methods: In a multicenter cohort study (NIH RECOVER [Researching COVID to Enhance Recovery]-Pregnancy Cohort), individuals who were pregnant during their first SARS-CoV-2 infection were enrolled across the United States from December 2021 to September 2023, either within 30 days of their infection or at differential time points thereafter. The primary outcome was PASC , defined as score of 12 or higher based on symptoms and severity as previously published by the NIH RECOVER-Adult Cohort, at the first study visit at least 6 months after the participant's first SARS-CoV-2 infection. Risk factors for PASC were evaluated, including sociodemographic characteristics, clinical characteristics before SARS-CoV-2 infection (baseline comorbidities, trimester of infection, vaccination status), and acute infection severity (classified by need for oxygen therapy). Multivariable logistic regression models were fitted to estimate associations between these characteristics and presence of PASC.

Results: Of the 1,502 participants, 61.1% had their first SARS-CoV-2 infection on or after December 1, 2021 (ie, during Omicron variant dominance); 51.4% were fully vaccinated before infection; and 182 (12.1%) were enrolled within 30 days of their acute infection. The prevalence of PASC was 9.3% (95% CI, 7.9-10.9%) measured at a median of 10.3 months (interquartile range 6.1-21.5) after first infection. The most common symptoms among individuals with PASC were postexertional malaise (77.7%), fatigue (76.3%), and gastrointestinal symptoms (61.2%). In a multivariable model, the proportion PASC positive with vs without history of obesity (14.9% vs 7.5%, adjusted odds ratio [aOR] 1.65, 95% CI, 1.12-2.43), depression or anxiety disorder (14.4% vs 6.1%, aOR 2.64, 95% CI, 1.79-3.88) before first infection, economic hardship (self-reported difficulty covering expenses) (12.5% vs 6.9%, aOR 1.57, 95% CI, 1.05-2.34), and treatment with oxygen during acute SARS-CoV-2 infection (18.1% vs 8.7%, aOR 1.86, 95% CI, 1.00-3.44) were associated with increased prevalence of PASC.

Conclusion: The prevalence of PASC at a median time of 10.3 months after SARS-CoV-2 infection during pregnancy was 9.3% in the NIH RECOVER-Pregnancy Cohort. The predominant symptoms were postexertional malaise, fatigue, and gastrointestinal symptoms. Several socioeconomic and clinical characteristics were associated with PASC after infection during pregnancy.

Clinical trial registration: ClinicalTrials.gov , NCT05172024.

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来源期刊
ACS Applied Materials & Interfaces
ACS Applied Materials & Interfaces 工程技术-材料科学:综合
CiteScore
16.00
自引率
6.30%
发文量
4978
审稿时长
1.8 months
期刊介绍: ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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