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与长新冠相关的人口统计学和临床因素。

Demographic And Clinical Factors Associated With Long COVID.

机构信息

Zirui Song (

Mia Giuriato, Harvard University.

出版信息

Health Aff (Millwood). 2023 Mar;42(3):433-442. doi: 10.1377/hlthaff.2022.00991.

Abstract

Risk factors for postacute sequelae of SARS-CoV-2 infection ("long COVID") in community-dwelling populations remain poorly understood. Large-scale data, follow-up, comparison groups, and a consensus definition of long COVID are often lacking. Using data from the OptumLabs Data Warehouse on a nationwide sample of commercial and Medicare Advantage enrollees from the period January 2019 through March 2022, we examined demographic and clinical factors associated with long COVID, using two definitions of people who suffer symptoms long after they were first diagnosed with COVID-19 ("long haulers"). We identified 8,329 long haulers using the narrow definition (diagnosis code), 207,537 long haulers using the broad definition (symptom based), and 600,161 non-long haulers (comparison group). On average, long haulers were older and more likely female, with more comorbidities. Among narrow-definition long haulers, the leading risk factors for long COVID included hypertension, chronic lung disease, obesity, diabetes, and depression. Their time between initial COVID-19 diagnosis and diagnosis of long COVID averaged 250 days, with racial and ethnic differences. Broad-definition long haulers exhibited similar risk factors. Distinguishing long COVID from the progression of underlying conditions can be challenging, but further study may advance the evidence base related to the identification, causes, and consequences of long COVID.

摘要

社区居民中 SARS-CoV-2 感染后后遗症(“长新冠”)的风险因素仍知之甚少。缺乏大规模的数据、随访、对照组和长新冠的共识定义。本研究使用 OptumLabs 数据仓库中 2019 年 1 月至 2022 年 3 月期间全国范围内商业和医疗保险优势计划参与者的全国样本数据,使用两种定义(诊断代码的狭义定义和基于症状的广义定义)来研究与长新冠相关的人口统计学和临床因素。我们确定了 8329 名狭义定义的长新冠患者(207537 名广义定义的长新冠患者和 600161 名非长新冠患者(对照组)。平均而言,长新冠患者年龄较大,女性比例较高,合并症更多。在狭义定义的长新冠患者中,长新冠的主要风险因素包括高血压、慢性肺病、肥胖、糖尿病和抑郁症。他们从最初 COVID-19 诊断到长新冠诊断的平均时间为 250 天,存在种族和民族差异。广义定义的长新冠患者也表现出相似的风险因素。将长新冠与潜在疾病的进展区分开来可能具有挑战性,但进一步的研究可能会推进与长新冠的识别、原因和后果相关的证据基础。

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