■评估后covid-19疾病对成年人的影响。
■对照研究中健康结果的系统评价和荟萃分析。
■从数据库开始到2022年10月20日搜索了两个来源:Cochranecovid-19研究登记册(包括Cochrane中央对照试验登记册,Medline,Embase,clinicalTrials.gov,世界卫生组织国际临床试验注册平台,medRxiv)和WHO的covid-19研究数据库。
■队列研究招募了100多名参与者,对照组和至少12周的随访。根据临床证明有SARS-CoV-2感染的成年人,成像,或包括实验室标准。
■两个独立的审阅者提取了数据。主要结果包括生活质量,在日常活动中的功能,利用资源,恢复率(症状群),以及新医学诊断的发生率。使用随机效应模型汇集数据。使用JoannaBriggs研究所用于队列研究的关键评估工具评估偏倚的风险。
■我们纳入了63项对照队列研究,超过9600万参与者。根据五项研究,我们发现,在6至24个月的随访中,与对照组相比,确诊SARS-CoV-2感染的个体的整体生活质量降低,尽管异质性非常高(EQ-5D量表的平均差-5.28(95%置信区间-7.88~2.68;I2=93.81%).来自十项研究的证据,无法在荟萃分析中汇总,表明与SARS-CoV-2感染相关的功能损害率增加。在重症监护病房随访6至24个月时,与对照组相比,护理的使用增加(风险比2.00(95%置信区间0.69至5.80),五项研究,I2=91.96%)和门诊护理(1.12(1.01至1.24),七项研究,I2=99.51%)。关于持续性症状,有记录的SARS-CoV-2感染的个体在随访时出现两种或两种以上持续性症状的风险增加,尤其是那些与神经集群相关的(即,风险比1.51(95%置信区间1.17至1.93),I2=98.91%)。证据还表明,各种代谢的发病率增加,心血管,神经学,呼吸,血液学和其他事件诊断。
■证据表明SARS-CoV-2感染后出现功能障碍,除了资源的使用和广泛不同的医疗诊断的发生率较高。这些结果应谨慎解释,考虑到研究之间的高度异质性以及与结果测量和参与者流失相关的研究局限性。
■开放科学框架,osf.io/drm39.
UNASSIGNED: To assess the impact of post-covid-19 conditions among adults.
UNASSIGNED: Systematic
review and meta-analysis of health outcomes in controlled studies.
UNASSIGNED: Two sources were searched from database inception to 20 October 2022: Cochrane covid-19 study register (comprising Cochrane Central Register of Controlled Trials, Medline, Embase, clinicalTrials.gov, World Health Organization\'s International Clinical Trials Registry Platform, medRxiv) and WHO\'s covid-19 research database.
UNASSIGNED: Cohort studies recruiting more than 100 participants with a control group and a follow-up of at least 12 weeks were included. Adults who were documented to have SARS-CoV-2 infection based on clinical, imaging, or laboratory criteria were included.
UNASSIGNED: Two independent reviewers extracted data. The main outcomes included quality of life, functionality in daily activities, use of resources, recovery rates (cluster of symptoms), and the incidence of new medical diagnoses. Data were pooled using a random effects model. The risk of bias was assessed with the Joanna Briggs Institute critical appraisal tool for cohort studies.
UNASSIGNED: We included 63 controlled cohort studies, encompassing more than 96 million participants. Based on five studies, we found a reduction in overall quality of life between individuals with confirmed SARS-CoV-2 infection versus controls at six to 24 months follow-up, although heterogeneity was very high (mean difference in EQ-5D scale -5.28 (95% confidence interval -7.88 to 2.68; I2=93.81%). Evidence from ten studies, which could not be pooled in a meta-analysis, indicated that an increased rate of functional impairment associated with SARS-CoV-2 infection. Use of care increased compared with controls at six to 24 months follow-up at intensive care units (risk ratio 2.00 (95% confidence interval 0.69 to 5.80), five studies, I2=91.96%) and in outpatient care (1.12 (1.01 to 1.24), seven studies, I2=99.51%). Regarding persistent symptoms, individuals with documented SARS-CoV-2 infection had an increased risk of having two or more persistent symptoms at follow-up, especially those related to neurological clusters (ie, risk ratio 1.51 (95% confidence interval 1.17 to 1.93), I2=98.91%). Evidence also showed an increased incidence of a wide variety of metabolic, cardiovascular, neurological, respiratory, haematological and other incident diagnoses.
UNASSIGNED: Evidence suggests functional impairment after SARS-CoV-2 infection, in addition to a higher use of resources and a higher incidence of widely varying medical diagnoses. These results should be interpreted with caution, considering the high heterogeneity across studies and study limitations related to outcome measurement and attrition of participants.
UNASSIGNED: Open Science Framework, osf.io/drm39.