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轻症的感染者,更要当心“长期新冠”

轻症的感染者,更要当心“长期新冠”

Sarah Wulf Hanson, The Conversation 2024-01-09
这次对新冠后遗症的系统性跨国分析表明,新冠后遗症可能会对世界各地造成巨大的人力和经济成本。

你得了新冠后遗症吗?图片来源:GETTY IMAGES

本文简要介绍了一项关于新冠后遗症的学术研究。

重要发现:新冠后遗症患者近9成最初为轻症

最近发表在《美国医学会杂志》(Journal of the American Medical Association)上的一项跨国研究显示,即便是轻症的新冠病毒感染者,也有可能患上长期甚至严重影响人体健康的后遗症。

新冠病毒后遗症,或者叫“长期新冠”,是指在首次感染新冠病毒三个月后,相关症状仍在持续或发展。这些症状在发病后至少持续两个月,而且没有其他原因可以解释。

我们发现,在出现新冠后遗症的人中,有90%最初都是所谓的轻症患者,但他们后来却出现了一种或多种后遗症,比如疲劳、气促甚至是脑雾等认知症状,有的甚至影响了日常生活。这些症状对健康的影响甚至不亚于创伤性脑损伤。我们的研究还发现,女性患新冠后遗症的风险是男性的2倍、儿童的4倍。

我们分析了54项研究的数据,这些研究涉及了22个国家的100多万人出现新冠肺炎症状的人。我们统计了其中出现新冠后遗症的患者比例,并研究了后遗症的风险与年龄、性别、住院率等因素的关系。

我们发现,与未住院的患者相比,因为新冠病毒感染而住院的患者出现后遗症的风险更高,症状持续时间也更长。不过由于大多数新冠病毒感染者不需要住院治疗,因此未住院患者中也有很多人出现了后遗症。我们的研究发现,近七分之一的患者在感染一年后仍在受后遗症困扰,研究人员也尚不清楚其中有多少人可能转化为慢性疾病。

新冠后遗症:为什么需要重视

与新冠肺炎相比,我们对新冠后遗症的了解还是相对较少的。

这次对新冠后遗症的系统性跨国分析表明,新冠后遗症可能会对世界各地造成巨大的人力和经济成本。很多患有新冠后遗症的人都是处于工作年龄的成年人。只要几个月不工作,他们就有可能失去收入、生计甚至住房。对于父母等负有养育责任的人,这些后遗症也可能让他们无法照顾自己的家人或爱人。

新冠后遗症的普遍性和严重性,使不少人失去了工作的能力,因此加剧了劳动力短缺。新冠后遗症也可能是导致失业的一个重要原因,而且对女性的影响要严重得多。

我们认为,为新冠后遗症患者找到有效的、可负担的治疗方法,应该是研究人员和研究资助者的首要任务。目前市面上已经有了一些提供特殊护理的新冠后遗症诊所,但他们提供的治疗方法往往十分有限,同时缺乏一致性,而且成本可能也很高昂。

接下来怎么办

新冠后遗症是一种复杂且动态的疾病——有些症状会反复出现,有时还会出现一些新症状。但研究人员还不清楚它们是哪些原因造成的。

虽然我们的研究重点是最常见的三种新冠后遗症症状,因为它们最容易影响日常生活,但新冠后遗症还包括一些其他症状,例如,嗅觉和味觉丧失、失眠、胃肠问题和头痛等等。不过在大多数情况下,这些症状往往与以上三个主要症状一起出现。

至于哪些因素容易使人患上新冠后遗症,目前还有很多悬而未决的问题。比如吸烟、肥胖、二次感染等风险因素是否会加大新冠后遗症的可能性,等等。另外,接种了两针疫苗或者加强针后,是否能够有效预防新冠后遗症,目前尚不清楚。

新冠病毒的变异也带来了一些新的难题。研究人员指出,目前流行的奥密克戎变异毒株的致死率要低于此前的几个毒株,同时它的后遗症风险也低于前几个毒株。但在这方面还需要更多的数据。

我们研究的大多数患者感染的都是奥密克戎变异毒株占据主流之前的几个毒株。作为“全球疾病负担”(Global Burden of Disease)研究的一部分(“全球疾病负担”主要研究世界各国的所有疾病和伤害造成的死亡与残疾情况),我们将继续加强对新冠后遗症的研究,以更清楚地了解奥密克戎成为主要流行毒株后,新冠后遗症的严重性产生了哪些变化。(财富中文网)

本文作者萨拉·伍尔夫·汉森(Sarah Wulf Hanson)是华盛顿大学全球卫生计量学(Global Health Metrics, University of Washington)的首席研究科学家,西奥·沃斯(Theo Vos)是华盛顿大学卫生计量科学(Health Metric Sciences, University of Washington)的教授。

本文已获知识共享(Creative Commons)组织的许可,转载自The Conversation网站。

译者:朴成奎

本文简要介绍了一项关于新冠后遗症的学术研究。

重要发现:新冠后遗症患者近9成最初为轻症

最近发表在《美国医学会杂志》(Journal of the American Medical Association)上的一项跨国研究显示,即便是轻症的新冠病毒感染者,也有可能患上长期甚至严重影响人体健康的后遗症。

新冠病毒后遗症,或者叫“长期新冠”,是指在首次感染新冠病毒三个月后,相关症状仍在持续或发展。这些症状在发病后至少持续两个月,而且没有其他原因可以解释。

我们发现,在出现新冠后遗症的人中,有90%最初都是所谓的轻症患者,但他们后来却出现了一种或多种后遗症,比如疲劳、气促甚至是脑雾等认知症状,有的甚至影响了日常生活。这些症状对健康的影响甚至不亚于创伤性脑损伤。我们的研究还发现,女性患新冠后遗症的风险是男性的2倍、儿童的4倍。

我们分析了54项研究的数据,这些研究涉及了22个国家的100多万人出现新冠肺炎症状的人。我们统计了其中出现新冠后遗症的患者比例,并研究了后遗症的风险与年龄、性别、住院率等因素的关系。

我们发现,与未住院的患者相比,因为新冠病毒感染而住院的患者出现后遗症的风险更高,症状持续时间也更长。不过由于大多数新冠病毒感染者不需要住院治疗,因此未住院患者中也有很多人出现了后遗症。我们的研究发现,近七分之一的患者在感染一年后仍在受后遗症困扰,研究人员也尚不清楚其中有多少人可能转化为慢性疾病。

新冠后遗症:为什么需要重视

与新冠肺炎相比,我们对新冠后遗症的了解还是相对较少的。

这次对新冠后遗症的系统性跨国分析表明,新冠后遗症可能会对世界各地造成巨大的人力和经济成本。很多患有新冠后遗症的人都是处于工作年龄的成年人。只要几个月不工作,他们就有可能失去收入、生计甚至住房。对于父母等负有养育责任的人,这些后遗症也可能让他们无法照顾自己的家人或爱人。

新冠后遗症的普遍性和严重性,使不少人失去了工作的能力,因此加剧了劳动力短缺。新冠后遗症也可能是导致失业的一个重要原因,而且对女性的影响要严重得多。

我们认为,为新冠后遗症患者找到有效的、可负担的治疗方法,应该是研究人员和研究资助者的首要任务。目前市面上已经有了一些提供特殊护理的新冠后遗症诊所,但他们提供的治疗方法往往十分有限,同时缺乏一致性,而且成本可能也很高昂。

接下来怎么办

新冠后遗症是一种复杂且动态的疾病——有些症状会反复出现,有时还会出现一些新症状。但研究人员还不清楚它们是哪些原因造成的。

虽然我们的研究重点是最常见的三种新冠后遗症症状,因为它们最容易影响日常生活,但新冠后遗症还包括一些其他症状,例如,嗅觉和味觉丧失、失眠、胃肠问题和头痛等等。不过在大多数情况下,这些症状往往与以上三个主要症状一起出现。

至于哪些因素容易使人患上新冠后遗症,目前还有很多悬而未决的问题。比如吸烟、肥胖、二次感染等风险因素是否会加大新冠后遗症的可能性,等等。另外,接种了两针疫苗或者加强针后,是否能够有效预防新冠后遗症,目前尚不清楚。

新冠病毒的变异也带来了一些新的难题。研究人员指出,目前流行的奥密克戎变异毒株的致死率要低于此前的几个毒株,同时它的后遗症风险也低于前几个毒株。但在这方面还需要更多的数据。

我们研究的大多数患者感染的都是奥密克戎变异毒株占据主流之前的几个毒株。作为“全球疾病负担”(Global Burden of Disease)研究的一部分(“全球疾病负担”主要研究世界各国的所有疾病和伤害造成的死亡与残疾情况),我们将继续加强对新冠后遗症的研究,以更清楚地了解奥密克戎成为主要流行毒株后,新冠后遗症的严重性产生了哪些变化。(财富中文网)

本文作者萨拉·伍尔夫·汉森(Sarah Wulf Hanson)是华盛顿大学全球卫生计量学(Global Health Metrics, University of Washington)的首席研究科学家,西奥·沃斯(Theo Vos)是华盛顿大学卫生计量科学(Health Metric Sciences, University of Washington)的教授。

本文已获知识共享(Creative Commons)组织的许可,转载自The Conversation网站。

译者:朴成奎

The Research Brief is a short take about interesting academic work.

The big idea

Even mild COVID-19 cases can have major and long-lasting effects on people’s health. That is one of the key findings from our recent multicountry study on long COVID-19 – or long COVID – recently published in the Journal of the American Medical Association.

Long COVID is defined as the continuation or development of symptoms three months after the initial infection from SARS-CoV-2, the virus that causes COVID-19. These symptoms last for at least two months after onset with no other explanation.

We found that a staggering 90% of people living with long COVID initially experienced only mild illness with COVID-19. After developing long COVID, however, the typical person experienced symptoms including fatigue, shortness of breath and cognitive problems such as brain fog – or a combination of these – that affected daily functioning. These symptoms had an impact on health as severe as the long-term effects of traumatic brain injury. Our study also found that women have twice the risk of men and four times the risk of children for developing long COVID.

We analyzed data from 54 studies reporting on over 1 million people from 22 countries who had experienced symptoms of COVID-19. We counted how many people with COVID-19 developed clusters of new long-COVID symptoms and determined how their risk of developing the disease varied based on their age, sex and whether they were hospitalized for COVID-19.

We found that patients who were hospitalized for COVID-19 had a greater risk of developing long COVID – and of having longer-lasting symptoms – compared with people who had not been hospitalized. However, because the vast majority of COVID-19 cases do not require hospitalization, many more cases of long COVID have arisen from these milder cases despite their lower risk. Among all people with long COVID, our study found that nearly one out of every seven were still experiencing these symptoms a year later, and researchers don’t yet know how many of these cases may become chronic.

Why it matters

Compared with COVID-19, relatively little is known about long COVID.

Our systematic, multicountry analysis of this condition delivered findings that illuminate the potentially steep human and economic costs of long COVID around the world. Many people who are living with the condition are working-age adults. Being unable to work for many months could cause people to lose their income, their livelihoods and their housing. For parents or caregivers living with long COVID, the condition may make them unable to care for their loved ones.

We think, based on the pervasiveness and severity of long COVID, that it is keeping people from working and therefore contributing to labor shortages. Long COVID could also be a factor in how people losing their jobs has disproportionately affected women.

We believe that finding effective and affordable treatments for people living with long COVID should be a priority for researchers and research funders. Long COVID clinics have opened to provide specialized care, but the treatments they offer are limited, inconsistent and may be costly.

What’s next

Long COVID is a complex and dynamic condition – some symptoms disappear, then return, and new symptoms appear. But researchers don’t yet know why.

While our study focused on the three most common symptoms associated with long COVID that affect daily functioning, the condition can also include symptoms like loss of smell and taste, insomnia, gastrointestinal problems and headaches, among others. But in most cases these additional symptoms occur together with the main symptoms we made estimates for.

There are many unanswered questions about what predisposes people to long COVID. For example, how do different risk factors, including smoking and high body-mass index, influence people’s likelihood of developing the condition? Does getting reinfected with SARS-CoV-2 change the risk for long COVID? Also, it is unclear how protection against long COVID changes over time after a person has been vaccinated or boosted against COVID-19.

COVID-19 variants also present new puzzles. Researchers know that the omicron variant is less deadly than previous strains. Initial evidence shows lower risk of long COVID from omicron compared with earlier strains, but far more data is needed.

Most of the people we studied were infected with the deadlier variants that were circulating before omicron became dominant. We will continue to build on our research on long COVID as part of the Global Burden of Disease study – which makes estimates of deaths and disability due to all diseases and injuries in every country in the world – in order to to get a clearer picture of how COVID-19’s long-term toll shifted once omicron arrived.

Sarah Wulf Hanson, Lead Research Scientist of Global Health Metrics, University of Washington and Theo Vos, Professor of Health Metric Sciences, University of Washington

This article is republished from The Conversation under a Creative Commons license.

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