Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK.
Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds, Leeds General Infirmary, Leeds, UK.
Lancet. 2024 Aug 17;404(10453):707-724. doi: 10.1016/S0140-6736(24)01136-X. Epub 2024 Jul 31.
Post-COVID-19 condition (also known as long COVID) is generally defined as symptoms persisting for 3 months or more after acute COVID-19. Long COVID can affect multiple organ systems and lead to severe and protracted impairment of function as a result of organ damage. The burden of this disease, both on the individual and on health systems and national economies, is high. In this interdisciplinary Review, with a coauthor with lived experience of severe long COVID, we sought to bring together multiple streams of literature on the epidemiology, pathophysiology (including the hypothesised mechanisms of organ damage), lived experience and clinical manifestations, and clinical investigation and management of long COVID. Although current approaches to long COVID care are largely symptomatic and supportive, recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification might herald a more mechanism-informed and personally tailored approach to clinical care. We also cover the organisation of services for long COVID, approaches to preventing long COVID, and suggestions for future research.
新冠后状况(也称为长新冠)通常被定义为急性新冠后 3 个月或更长时间持续存在的症状。长新冠可能影响多个器官系统,并因器官损伤导致严重和持久的功能障碍。这种疾病对个人、卫生系统和国民经济的负担都很高。在本次跨学科综述中,我们与一位经历过严重长新冠的合著者合作,旨在汇集有关长新冠的流行病学、病理生理学(包括器官损伤的假设机制)、生活体验和临床表现以及临床研究和管理的多个文献流。尽管目前对长新冠的护理主要是对症和支持性的,但临床表型、深度分子谱分析和生物标志物识别方面的最新进展可能预示着对临床护理的一种更基于机制和个性化的方法。我们还介绍了长新冠服务的组织、预防长新冠的方法以及对未来研究的建议。