新冠后症状的患病率、潜在类别模式及功能影响：2024年智利两座城市的基于人群的横断面研究

文献信息

中文摘要

引言： 新冠感染后状况影响全球约6%的个体。大多数证据基于住院患者，且来自疫苗接种覆盖率相对较低的国家。本研究估计智利（一个疫苗接种覆盖率高的国家）基于人群样本中与新冠感染后相符症状的患病率，并探索症状模式。此外，研究还考察这些症状与日常活动以及人口学、社会和临床因素的关联。
方法： 2024年5月在智利两座城市开展了一项横断面研究，纳入来自随机抽取家庭的654名参与者（应答率88.5%），年龄≥7岁。收集了持续≥3个月的十种新冠后症状。采用潜在类别分析识别症状模式。
结果： 在277名确诊COVID-19的参与者中，114人报告至少一种持续≥3个月的症状。至少一种新冠后症状的人群加权患病率在一般人群中为17.4%，在既往感染COVID-19的个体中为40.7%。在有新冠后症状者中，40.1%报告日常活动减少。探索出三个类别：类别1（38.4%）以疲劳、味觉丧失/嗅觉丧失和肌肉/关节疼痛为特征；类别2（40.7%）以心肺症状为主；类别3（20.9%）为多系统症状。类别三与更高的合并症频率（尤其是糖尿病）、住院、多次COVID-19发作以及原住民身份相关。类别2和类别3独立地与较年轻年龄和糖尿病相关，类别2还额外与较低教育程度和较低BMI相关，而类别3还额外与原住民身份相关。
结论： 这项基于人群的研究揭示了至少一种新冠后症状的沉重负担，不同的症状类别凸显了量身定制干预措施的必要性。这些发现强调了有针对性的公共卫生政策和个人化临床方法的重要性，尤其是对影响生活质量的重症症状类别，并为全球理解新冠感染后状况贡献了来自拉丁美洲的关键数据。

英文摘要

INTRODUCTION: Post-COVID-19 condition affects approximately 6% of individuals globally. Most evidence is based on hospitalized patients and is from countries with relatively low vaccination coverage. This study estimates the prevalence of symptoms compatible with post-COVID-19 and explores symptom patterns in a population-based sample from Chile, a country with high vaccination coverage. Moreover, it examines their associations with daily activities and demographic, social, and clinical factors.
METHODS: A cross-sectional study was conducted in May 2024 in two Chilean Cities, involving 654 participants (88.5% response rate) aged ≥ seven years, from randomly selected households. Ten post-COVID-19 symptoms that persisted for ≥ three months were collected. Latent class analysis identified symptom patterns.
RESULTS: Among 277 participants with a confirmed COVID-19 diagnosis, 114 reported at least one symptom lasting ≥ 3 months. Population-weighted prevalence of at least one post-COVID-19 symptom was 17.4% in the general population and 40.7% among individuals with prior COVID-19. Among those with post-COVID-19 symptoms, 40.1% reported a reduction in daily activities. Three classes were explored: class 1 (38.4%) characterized by fatigue, ageusia/anosmia, and muscular/joint pain; class 2 (40.7%) with predominant cardiorespiratory symptoms; and class 3 (20.9%) with multisystemic symptoms. Class three was associated with a higher frequency of comorbidities (particularly diabetes), hospitalization, multiple COVID-19 episodes, and Aboriginal affiliation. Classes 2 and 3 were independently associated with younger age and diabetes, class 2 was additionally associated with lower educational attainment and lower BMI, while class 3 was additionally associated with Aboriginal affiliation.
CONCLUSIONS: This population-based study reveals a substantial burden of at least one post-COVID-19 symptom, with distinct symptom classes highlighting the need for tailored interventions. These findings underscore the importance of targeted public health policies and personalized clinical approaches, particularly for severe symptom classes that impact quality of life and contribute critical data from Latin America to the global understanding of post-COVID-19 condition.