诊断、管理和研究农村和未得到充分服务人群中儿童和青少年的 Long-COVID 综合征。

IF 5.8 2区 医学 Q1 ALLERGY Annals of Allergy Asthma & Immunology Pub Date : 2024-11-01 DOI:10.1016/j.anai.2024.08.028
Jessica Snowden MD, MS, MHPTT , Kathryn Weakley MD
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引用次数: 0

摘要

可以说,COVID-19 大流行对农村和其他历来难以接触到的人群影响最大。农村和服务不足社区的家庭感染 COVID-19 的比例高于其他群体的同龄人,发病率和死亡率也不成比例。如果不精心设计和实施资源,这些地区的儿童也有可能受到 SARS-CoV-2 感染长期后遗症(如 "长 COVID "综合症)的严重影响。COVID-19 感染的频率和严重程度增加;获得医疗保健和支持服务的机会减少;环境和社会结构因素加剧了 COVID-19 的急性后遗症(PASC);可能使 COVID 后遗症问题复杂化的健康疾病的基线频率增加,如肥胖症、哮喘、糖尿病和精神疾病的发病率增加,所有这些都使资源匮乏地区的儿童和青少年面临巨大风险。遗憾的是,这些地区的儿童和青少年在临床研究中的代表性历来不足。以农村和服务不足社区的参与者为对象的研究不仅发表较少,而且这些研究往往质量较低,随机对照试验和多中心研究也较少。这种差距不仅剥夺了农村和服务不足地区的人们获得最前沿治疗的机会,而且还可能导致 "循证 "解决方案无法推广,因为这些解决方案无法在受 Long COVID 等多种健康问题严重影响的地区实施。这些因素极大地阻碍了我们为服务不足的社区提供适当医疗服务的能力。本综述将讨论 COVID-19 在农村和服务不足社区的影响,以及在为这些地区的儿童和青少年设计循证长 COVID 解决方案时必须考虑的因素。
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Diagnosing, managing, and studying long-COVID syndromes in children and adolescents in rural and underserved populations
The COVID-19 pandemic has arguably had its greatest impact in rural and other historically hard-to-reach populations. Families in rural and underserved communities experienced COVID-19 infections at a higher rate than did their peers in other groups and experienced disproportionate morbidity and mortality. Without careful design and implementation of resources, children in these areas are also at risk of being disproportionately affected by long-term sequelae of SARS-CoV-2 infections, such as “long COVID” syndromes. Increased frequency and severity of COVID-19 infections, decreased access to health care and supporting services, environmental and social structure factors that exacerbate post-acute sequelae of COVID-19, and increased baseline frequency of health disorders that may complicate post-COVID issues, such as higher rates of obesity, asthma, diabetes, and mental health disorders, all place children and adolescents in under-resourced areas at significant risk. Unfortunately, children and adolescents in these areas have been historically under-represented in clinical research. Not only are fewer studies published with participants in rural and underserved communities, but these studies more often exhibit lower quality, with fewer randomized controlled trials and multicenter studies. This gap not only deprives people in rural and underserved areas of the country of access to cutting-edge therapy, but it also risks “evidence-based” solutions that are not generalizable because they cannot be implemented in the areas disproportionately affected by many health conditions such as long COVID. These factors significantly impede our ability to provide appropriate medical care for underserved communities. This review will discuss the impact of COVID-19 in rural and underserved communities and the factors that must be considered in designing evidence-based long-COVID solutions for children and adolescents in these areas.
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来源期刊
CiteScore
6.50
自引率
6.80%
发文量
437
审稿时长
33 days
期刊介绍: Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
期刊最新文献
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