輕癥的感染者，更要當心“長期新冠”
Sarah Wulf Hanson, The Conversation
2023-01-09
你得了新冠后遺癥嗎？圖片來源：GETTY IMAGES
本文簡要介紹了一項關于新冠后遺癥的學術研究。
重要發(fā)現(xiàn)：新冠后遺癥患者近9成最初為輕癥
最近發(fā)表在《美國醫(yī)學會雜志》（Journal of the American Medical Association）上的一項跨國研究顯示，即便是輕癥的新冠病毒感染者，也有可能患上長期甚至嚴重影響人體健康的后遺癥。
新冠病毒后遺癥，或者叫“長期新冠”，是指在首次感染新冠病毒三個月后，相關癥狀仍在持續(xù)或發(fā)展。這些癥狀在發(fā)病后至少持續(xù)兩個月，而且沒有其他原因可以解釋。
我們發(fā)現(xiàn)，在出現(xiàn)新冠后遺癥的人中，有90%最初都是所謂的輕癥患者，但他們后來卻出現(xiàn)了一種或多種后遺癥，比如疲勞、氣促甚至是腦霧等認知癥狀，有的甚至影響了日常生活。這些癥狀對健康的影響甚至不亞于創(chuàng)傷性腦損傷。我們的研究還發(fā)現(xiàn)，女性患新冠后遺癥的風險是男性的2倍、兒童的4倍。
我們分析了54項研究的數據，這些研究涉及了22個國家的100多萬人出現(xiàn)新冠肺炎癥狀的人。我們統(tǒng)計了其中出現(xiàn)新冠后遺癥的患者比例，并研究了后遺癥的風險與年齡、性別、住院率等因素的關系。
我們發(fā)現(xiàn)，與未住院的患者相比，因為新冠病毒感染而住院的患者出現(xiàn)后遺癥的風險更高，癥狀持續(xù)時間也更長。不過由于大多數新冠病毒感染者不需要住院治療，因此未住院患者中也有很多人出現(xiàn)了后遺癥。我們的研究發(fā)現(xiàn)，近七分之一的患者在感染一年后仍在受后遺癥困擾，研究人員也尚不清楚其中有多少人可能轉化為慢性疾病。
新冠后遺癥：為什么需要重視
與新冠肺炎相比，我們對新冠后遺癥的了解還是相對較少的。
這次對新冠后遺癥的系統(tǒng)性跨國分析表明，新冠后遺癥可能會對世界各地造成巨大的人力和經濟成本。很多患有新冠后遺癥的人都是處于工作年齡的成年人。只要幾個月不工作，他們就有可能失去收入、生計甚至住房。對于父母等負有養(yǎng)育責任的人，這些后遺癥也可能讓他們無法照顧自己的家人或愛人。
新冠后遺癥的普遍性和嚴重性，使不少人失去了工作的能力，因此加劇了勞動力短缺。新冠后遺癥也可能是導致失業(yè)的一個重要原因，而且對女性的影響要嚴重得多。
我們認為，為新冠后遺癥患者找到有效的、可負擔的治療方法，應該是研究人員和研究資助者的首要任務。目前市面上已經有了一些提供特殊護理的新冠后遺癥診所，但他們提供的治療方法往往十分有限，同時缺乏一致性，而且成本可能也很高昂。
接下來怎么辦
新冠后遺癥是一種復雜且動態(tài)的疾病——有些癥狀會反復出現(xiàn)，有時還會出現(xiàn)一些新癥狀。但研究人員還不清楚它們是哪些原因造成的。
雖然我們的研究重點是最常見的三種新冠后遺癥癥狀，因為它們最容易影響日常生活，但新冠后遺癥還包括一些其他癥狀，例如，嗅覺和味覺喪失、失眠、胃腸問題和頭痛等等。不過在大多數情況下，這些癥狀往往與以上三個主要癥狀一起出現(xiàn)。
至于哪些因素容易使人患上新冠后遺癥，目前還有很多懸而未決的問題。比如吸煙、肥胖、二次感染等風險因素是否會加大新冠后遺癥的可能性，等等。另外，接種了兩針疫苗或者加強針后，是否能夠有效預防新冠后遺癥，目前尚不清楚。
新冠病毒的變異也帶來了一些新的難題。研究人員指出，目前流行的奧密克戎變異毒株的致死率要低于此前的幾個毒株，同時它的后遺癥風險也低于前幾個毒株。但在這方面還需要更多的數據。
我們研究的大多數患者感染的都是奧密克戎變異毒株占據主流之前的幾個毒株。作為“全球疾病負擔”（Global Burden of Disease）研究的一部分（“全球疾病負擔”主要研究世界各國的所有疾病和傷害造成的死亡與殘疾情況），我們將繼續(xù)加強對新冠后遺癥的研究，以更清楚地了解奧密克戎成為主要流行毒株后，新冠后遺癥的嚴重性產生了哪些變化。（財富中文網）
本文作者薩拉·伍爾夫·漢森（Sarah Wulf Hanson）是華盛頓大學全球衛(wèi)生計量學（Global Health Metrics, University of Washington）的首席研究科學家，西奧·沃斯（Theo Vos）是華盛頓大學衛(wèi)生計量科學（Health Metric Sciences, University of Washington）的教授。
本文已獲知識共享（Creative Commons）組織的許可，轉載自The Conversation網站。
譯者：樸成奎
本文簡要介紹了一項關于新冠后遺癥的學術研究。
重要發(fā)現(xiàn)：新冠后遺癥患者近9成最初為輕癥
最近發(fā)表在《美國醫(yī)學會雜志》（Journal of the American Medical Association）上的一項跨國研究顯示，即便是輕癥的新冠病毒感染者，也有可能患上長期甚至嚴重影響人體健康的后遺癥。
新冠病毒后遺癥，或者叫“長期新冠”，是指在首次感染新冠病毒三個月后，相關癥狀仍在持續(xù)或發(fā)展。這些癥狀在發(fā)病后至少持續(xù)兩個月，而且沒有其他原因可以解釋。
我們發(fā)現(xiàn)，在出現(xiàn)新冠后遺癥的人中，有90%最初都是所謂的輕癥患者，但他們后來卻出現(xiàn)了一種或多種后遺癥，比如疲勞、氣促甚至是腦霧等認知癥狀，有的甚至影響了日常生活。這些癥狀對健康的影響甚至不亞于創(chuàng)傷性腦損傷。我們的研究還發(fā)現(xiàn)，女性患新冠后遺癥的風險是男性的2倍、兒童的4倍。
我們分析了54項研究的數據，這些研究涉及了22個國家的100多萬人出現(xiàn)新冠肺炎癥狀的人。我們統(tǒng)計了其中出現(xiàn)新冠后遺癥的患者比例，并研究了后遺癥的風險與年齡、性別、住院率等因素的關系。
我們發(fā)現(xiàn)，與未住院的患者相比，因為新冠病毒感染而住院的患者出現(xiàn)后遺癥的風險更高，癥狀持續(xù)時間也更長。不過由于大多數新冠病毒感染者不需要住院治療，因此未住院患者中也有很多人出現(xiàn)了后遺癥。我們的研究發(fā)現(xiàn)，近七分之一的患者在感染一年后仍在受后遺癥困擾，研究人員也尚不清楚其中有多少人可能轉化為慢性疾病。
新冠后遺癥：為什么需要重視
與新冠肺炎相比，我們對新冠后遺癥的了解還是相對較少的。
這次對新冠后遺癥的系統(tǒng)性跨國分析表明，新冠后遺癥可能會對世界各地造成巨大的人力和經濟成本。很多患有新冠后遺癥的人都是處于工作年齡的成年人。只要幾個月不工作，他們就有可能失去收入、生計甚至住房。對于父母等負有養(yǎng)育責任的人，這些后遺癥也可能讓他們無法照顧自己的家人或愛人。
新冠后遺癥的普遍性和嚴重性，使不少人失去了工作的能力，因此加劇了勞動力短缺。新冠后遺癥也可能是導致失業(yè)的一個重要原因，而且對女性的影響要嚴重得多。
我們認為，為新冠后遺癥患者找到有效的、可負擔的治療方法，應該是研究人員和研究資助者的首要任務。目前市面上已經有了一些提供特殊護理的新冠后遺癥診所，但他們提供的治療方法往往十分有限，同時缺乏一致性，而且成本可能也很高昂。
接下來怎么辦
新冠后遺癥是一種復雜且動態(tài)的疾病——有些癥狀會反復出現(xiàn)，有時還會出現(xiàn)一些新癥狀。但研究人員還不清楚它們是哪些原因造成的。
雖然我們的研究重點是最常見的三種新冠后遺癥癥狀，因為它們最容易影響日常生活，但新冠后遺癥還包括一些其他癥狀，例如，嗅覺和味覺喪失、失眠、胃腸問題和頭痛等等。不過在大多數情況下，這些癥狀往往與以上三個主要癥狀一起出現(xiàn)。
至于哪些因素容易使人患上新冠后遺癥，目前還有很多懸而未決的問題。比如吸煙、肥胖、二次感染等風險因素是否會加大新冠后遺癥的可能性，等等。另外，接種了兩針疫苗或者加強針后，是否能夠有效預防新冠后遺癥，目前尚不清楚。
新冠病毒的變異也帶來了一些新的難題。研究人員指出，目前流行的奧密克戎變異毒株的致死率要低于此前的幾個毒株，同時它的后遺癥風險也低于前幾個毒株。但在這方面還需要更多的數據。
我們研究的大多數患者感染的都是奧密克戎變異毒株占據主流之前的幾個毒株。作為“全球疾病負擔”（Global Burden of Disease）研究的一部分（“全球疾病負擔”主要研究世界各國的所有疾病和傷害造成的死亡與殘疾情況），我們將繼續(xù)加強對新冠后遺癥的研究，以更清楚地了解奧密克戎成為主要流行毒株后，新冠后遺癥的嚴重性產生了哪些變化。（財富中文網）
本文作者薩拉·伍爾夫·漢森（Sarah Wulf Hanson）是華盛頓大學全球衛(wèi)生計量學（Global Health Metrics, University of Washington）的首席研究科學家，西奧·沃斯（Theo Vos）是華盛頓大學衛(wèi)生計量科學（Health Metric Sciences, University of Washington）的教授。
本文已獲知識共享（Creative Commons）組織的許可，轉載自The Conversation網站。
譯者：樸成奎
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.
財富中文網所刊載內容之知識產權為財富媒體知識產權有限公司及/或相關權利人專屬所有或持有。未經許可，禁止進行轉載、摘編、復制及建立鏡像等任何使用。
