厄瓜多尔成人COVID-19患者症状、感知康复与功能健康的六个月轨迹

文献信息

中文摘要

背景/目的： 关于急性COVID-19后状态的大多数纵向证据来自高收入国家的住院患者，对中低收入环境中社区样本的了解较少。本研究考察了确诊COVID-19的厄瓜多尔成人在六个月内感知康复、症状负担、总体健康感知和功能困难的变化。方法：在厄瓜多尔基多的一项前瞻性观察性队列中，120名实验室确诊COVID-19的成人分别在基线（诊断后四周内）以及基线评估后三个月和六个月接受评估；91人完成了全部三次评估。西班牙语版ISARIC随访调查涵盖39种症状、感知康复、EQ-5D-5L和EQ-VAS，以及六项Washington Group功能条目，并针对COVID前时期和当前状态进行回顾性评分。分析为探索性和描述性，所有p值均为名义值且未针对多重比较进行调整。结果：参与者的感知完全康复有所改善（χ2 = 15.24，p < 0.001），感知总体健康也有所改善（F(2, 178) = 5.80，p = 0.004）。胸痛、心悸、肌无力、意识模糊、耳鸣和腹泻在随访期间下降。六个月时，仍有37.4%报告头痛，35.2%报告疲劳，35.2%报告意识模糊或注意力不集中，25.3%报告睡眠障碍。在EQ-5D-5L各维度中，仅疼痛/不适有所改善（p = 0.012）。视力、行走、记忆和沟通从COVID前到基线下降，并在基线与六个月之间改善；未直接比较COVID前与六个月水平。结论：六个月内的康复是渐进的但不完全，相当一部分少数人在六个月时仍报告持续或反复症状。这些发现描述的是确诊COVID-19后的急性期后症状负担，而非正式诊断的COVID-19后状态。

英文摘要

Background/Objectives: Most longitudinal evidence on post-acute COVID-19 comes from hospitalized patients in high-income countries and less is known about community samples in low- and middle-income settings. This study examined changes in perceived recovery, symptom burden, general health perception, and functional difficulties over six months in Ecuadorian adults with confirmed COVID-19. Methods: In a prospective observational cohort in Quito, Ecuador, 120 adults with laboratory-confirmed COVID-19 were assessed at baseline (within four weeks of diagnosis) and again three and six months after the baseline assessment; 91 completed all three assessments. The Spanish-language ISARIC follow-up survey covered 39 symptoms, perceived recovery, the EQ-5D-5L and EQ-VAS, and six Washington Group functioning items rated retrospectively for the pre-COVID period and currently. Analyses were exploratory and descriptive, and all p-values are nominal and unadjusted for multiple comparisons. Results: Participants' perceived complete recovery improved (χ2 = 15.24, p < 0.001), as did perceived general health (F(2, 178) = 5.80, p = 0.004). Chest pain, palpitations, muscle weakness, confusion, tinnitus, and diarrhea declined over follow-up. At six months, 37.4% still reported headaches, 35.2% fatigue, 35.2% confusion or inattention, and 25.3% sleep disturbance. Among EQ-5D-5L domains, only pain/discomfort improved (p = 0.012). Vision, walking, memory, and communication declined from pre-COVID to baseline and improved between baseline and six months; pre-COVID and six-month levels were not compared directly. Conclusions: Recovery over six months was gradual but incomplete, with a substantial minority reporting ongoing or recurrent symptoms at six months. These findings describe post-acute symptom burden following confirmed COVID-19 rather than formally diagnosed post-COVID-19 condition.