长期COVID综合征的多学科中心护理-回顾性队列研究

IF 2.5 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL American Journal of Medicine Pub Date : 2025-01-01 Epub Date: 2023-05-22 DOI:10.1016/j.amjmed.2023.05.002
Joseph Bailey, Bianca Lavelle, Janet Miller, Millenia Jimenez, Patrick H Lim, Zachary S Orban, Jeffrey R Clark, Ria Tomar, Amy Ludwig, Sareen T Ali, Grace K Lank, Allison Zielinski, Ruben Mylvaganam, Ravi Kalhan, Malek El Muayed, R Kannan Mutharasan, Eric M Liotta, Jacob I Sznajder, Charles Davidson, Igor J Koralnik, Marc A Sala
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引用次数: 0

摘要

背景:2019冠状病毒病(COVID-19)后持续的多器官症状被称为“长COVID”或“SARS-CoV-2感染后急性后遗症”。这些临床表现的复杂性在大流行早期构成了挑战,因为需要形成不同的流动模式来管理涌入的患者。人们对在多学科后covid中心寻求治疗的患者的特征和结果知之甚少。方法:我们对2020年5月至2022年2月期间在伊利诺伊州芝加哥的多学科COVID-19综合中心评估的患者进行了回顾性队列研究。根据急性COVID-19的严重程度,分析专科门诊使用率和临床检测结果。结果:我们评估了1802例急性COVID-19发病中位时间为8个月的患者,其中住院后350例,非住院患者1452例。在12个专科诊所的2361例初次就诊患者中,神经内科1151例(48.8%),肺科591例(25%),心脏病科284例(12%)。在接受测试的患者中,742/916(81%)报告生活质量下降,284/553(51%)有认知功能障碍,195/434(44.9%)有肺功能改变,249/299(83.3%)有胸部计算机断层扫描异常,14/116(12.1%)有心律监测心率升高。认知功能障碍和肺功能障碍的发生频率与急性COVID-19的严重程度相关。SARS-CoV-2检测呈阳性的非住院患者的发现与阴性或无检测结果的患者相似。结论:我们的多学科COVID-19综合中心的经验表明,长期COVID患者经常出现神经、肺部和心脏异常,他们经常使用多名专家。住院后和非住院组的差异表明这些人群中长COVID的致病机制不同。
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Multidisciplinary Center Care for Long COVID Syndrome-A Retrospective Cohort Study.

Background: Persistent multi-organ symptoms after coronavirus disease 2019 (COVID-19) have been termed "long COVID" or "post-acute sequelae of SARS-CoV-2 infection." The complexity of these clinical manifestations posed challenges early in the pandemic as different ambulatory models formed out of necessity to manage the influx of patients. Little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers.

Methods: We performed a retrospective cohort study of patients evaluated at our multidisciplinary comprehensive COVID-19 center in Chicago, Ill, between May 2020 and February 2022. We analyzed specialty clinic utilization and clinical test results according to severity of acute COVID-19.

Results: We evaluated 1802 patients a median of 8 months from acute COVID-19 onset, including 350 post-hospitalization and 1452 non-hospitalized patients. Patients were seen in 2361 initial visits in 12 specialty clinics, with 1151 (48.8%) in neurology, 591 (25%) in pulmonology, and 284 (12%) in cardiology. Among the patients tested, 742/916 (81%) reported decreased quality of life, 284/553 (51%) had cognitive impairment, 195/434 (44.9%) had alteration of lung function, 249/299 (83.3%) had abnormal computed tomography chest scans, and 14/116 (12.1%) had elevated heart rate on rhythm monitoring. Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19. Non-hospitalized patients with positive SARS-CoV-2 testing had findings similar to those with negative or no test results.

Conclusions: The experience at our multidisciplinary comprehensive COVID-19 center shows common utilization of multiple specialists by long COVID patients, who harbor frequent neurologic, pulmonary, and cardiologic abnormalities. Differences in post-hospitalization and non-hospitalized groups suggest distinct pathogenic mechanisms of long COVID in these populations.

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来源期刊
American Journal of Medicine
American Journal of Medicine 医学-医学:内科
CiteScore
6.30
自引率
3.40%
发文量
449
审稿时长
9 days
期刊介绍: The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.
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