Background The long‐term sequalae of COVID‐19 remain poorly characterized. We assessed persistent symptoms in previously hospitalized patients with COVID‐19 and assessed potential risk factors. Methods Data were collected from patients discharged from 4 hospitals in Moscow, Russia between 8 April and 10 July 2020. Participants were interviewed via telephone using an ISARIC Long‐term Follow‐up Study questionnaire. Results 2,649 of 4755 (56%) discharged patients were successfully evaluated, at median 218 (IQR 200, 236) days post‐discharge. COVID‐19 diagnosis was clinical in 1291 and molecular in 1358. Most cases were mild, but 902 (34%) required supplemental oxygen and 68 (2.6%) needed ventilatory support. Median age was 56 years (IQR 46, 66) and 1,353 (51.1%) were women. Persistent symptoms were reported by 1247 (47.1%) participants, with fatigue (21.2%), shortness of breath (14.5%) and forgetfulness (9.1%) the most common symptoms and chronic fatigue (25%) and respiratory (17.2%) the most common symptom categories. Female sex was associated with any persistent symptom category OR 1.83 (95% CI 1.55 to 2.17) with association being strongest for dermatological (3.26, 2.36 to 4.57) symptoms. Asthma and chronic pulmonary disease were not associated with persistent symptoms overall, but asthma was associated with neurological (1.95, 1.25 to 2.98) and mood and behavioural changes (2.02, 1.24 to 3.18), and chronic pulmonary disease was associated with chronic fatigue (1.68, 1.21 to 2.32). Conclusions Almost half of adults admitted to hospital due to COVID‐19 reported persistent symptoms 6 to 8 months after discharge. Fatigue and respiratory symptoms were most common, and female sex was associated with persistent symptoms.
Background Previous studies assessing the prevalence of COVID-19 sequelae in adults and children were performed in the absence of an agreed definition. We investigated prevalence of post-COVID-19 condition (PCC) (WHO definition), at 6- and 12-months follow-up, amongst previously hospitalised adults and children and assessed risk factors. Methods Prospective cohort study of children and adults with confirmed COVID-19 in Moscow, hospitalised between April and August, 2020. Two follow-up telephone interviews, using the International Severe Acute Respiratory and Emerging Infection Consortium survey, were performed at 6 and 12 months after discharge. Results One thousand thirteen of 2509 (40%) of adults and 360 of 849 (42%) of children discharged participated in both the 6- and 12-month follow-ups. PCC prevalence was 50% (95% CI 47–53) in adults and 20% (95% CI 16–24) in children at 6 months, with decline to 34% (95% CI 31–37) and 11% (95% CI 8–14), respectively, at 12 months. In adults, female sex was associated with PCC at 6- and 12-month follow-up (OR 2.04, 95% CI 1.57 to 2.65) and (OR 2.04, 1.54 to 2.69), respectively. Pre-existing hypertension (OR 1.42, 1.04 to 1.94) was associated with post-COVID-19 condition at 12 months. In children, neurological comorbidities were associated with PCC both at 6 months (OR 4.38, 1.36 to 15.67) and 12 months (OR 8.96, 2.55 to 34.82) while allergic respiratory diseases were associated at 12 months (OR 2.66, 1.04 to 6.47). Conclusions Although prevalence of PCC declined one year after discharge, one in three adults and one in ten children experienced ongoing sequelae. In adults, females and persons with pre-existing hypertension, and in children, persons with neurological comorbidities or allergic respiratory diseases are at higher risk of PCC.
Рязанский государственный медицинский университет имени академика И.П. Павлова, г. Рязань, Российская Федерация (1) Городская клиническая больница скорой медицинской помощи, г. Рязань, Российская Федерация (2) _____________________________________________________________________________ Обоснование. В последнее время отмечается устойчивый рост заболеваемости желчнокаменной болезнью и ее осложненными формами. Изучение структуры заболеваемости различными формами желчнокаменной болезни позволит оптимизировать и улучшить качество медицинской помощи пациентам с желчнокаменной болезнью. Цель. Изучить эпидемиологию различных форм желчнокаменной болезни на примере Рязанской области. Материалы и методы. В работе использованы итоговые отчеты главного хирурга Рязанской области и ведущих клиник Рязани за последние 6 лет, на основе которых проводился статистический анализ распространенности различных форм желчнокаменной болезни. Результаты. С 2011 по 2016 гг. в лечебных учреждениях Рязанской области было пролечено 15396 пациентов с различными формами желчнокаменной болезни. Из них у 2052 (13,3%) пациентов был холедохолитиаз, из них у 1182 человек (57,6%) имели холедохолитиаз, осложненный стенозирующим дуоденальным папиллитом. В 1641 случае (79,9%) заболевание осложнилось механической желтухой. Самым распространенной операцией по поводу желчнокаменной болезни является лапароскопическая холецистэктомия-89,1% от общего числа холецистэктомий. По поводу холедохолитиаза было проведено 433 оперативных вмешательств и 1608 эндоскопических папиллотомий. 47,1% всех вмешательств составила холедохолитотомия, холедоходуоденостомия-42,9%. 10% от общего числа холедохолитотомий, занимает лапароскопическая холедохолитотомия и ее доля возрастает с каждым годом. Основными причинами летальных исходов у больных осложненными формами желчнокаменной болезни является механическая желтуха с гнойным холангитом и последующим развитием печеночно-почечной недостаточности, холангиогенные абсцессы печени, билиарный панкреатит, панкреонекроз, а также тяжелая сопутствующая патология. Выводы. Желчнокаменная болезнь занимает первое место в структуре заболеваемости больных общехирургического профиля по Рязанской области, а лапароскопическая холецистэктомия-самая распространенная операция в хирургических стационарах. Отмечается рост осложненных форм желчнокаменной болезни и летальности, что требует оптимизировать тактику лечения таких пациентов, а лечение проводить в специализированных стационарах. Ключевые слова: желчнокаменная болезнь, холедохолитиаз, структура заболеваемости, эпидемиология.
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