背景:目前,大量住院冠状病毒感染性疾病-2019(COVID-19)患者符合临床出院标准并已出院.对后遗症和群体免疫知之甚少,影响COVID-19幸存者生活质量和安全性的两个重要因素。方法:从武汉市四家医疗机构出院的COVID-19患者,中国,为了记录和调查可能的COVID-19后后遗症和群体免疫。出院后,患者向方仓收容所医院报告,进行了为期14天的强制性临床监测。从这些庇护所医院获释后,患者返回家中进行自我隔离。实时定量PCR(RT-qPCR)用于严重急性呼吸综合征相关冠状病毒2(SARS-CoV-2)的检测。基于胶体金的免疫层析试纸条测定(ICGSA)用于抗SARS-CoV-2免疫球蛋白G(IgG)和免疫球蛋白M(IgM)抗体测试。这项研究的数据来自病例报告,医疗记录,和自我报告。结果:共有3,677名COVID-19幸存者[中位年龄=59岁,四分位距(IQR)=47-68,范围=10-98;55.5%的女性]从武汉的四家医院出院,中国,在2020年1月18日至3月29日期间,随访时间中位数为144天(IQR=135-157).随访期间,976例(26.5%)患者至少有一次COVID-19后后遗症。老年COVID-19幸存者(年龄≥60岁)与青年COVID-19幸存者(年龄<60岁;相对危险度=1.05,95%CI=1.02-1.10,p=0.007)相比,老年COVID-19幸存者出现COVID-19后遗症的发生率略有增加。随访期间,抗SARS-CoV-2IgG的大幅减少(88.0%,95%CI=84.2-90.4)和IgM(93.2%,观察到95%CI=88.5-96.4)抗体。在这些COVID-19幸存者中,1.2%(n=45)的SARS-CoV-2阳性,1.0%(n=37)的患者在随访期间死亡。在随访中死亡的人中,70.3%为男性,IgG和IgM均为阴性,除了一个IgG阳性的人.结论:我们的研究记录了COVID-19后的重要后遗症,这些后遗症损害了COVID-19幸存者的多器官系统功能,表明这种疾病的长期影响将对幸存者的生活质量产生负面影响,继续给医疗保健系统带来压力,并导致长时间的生产力损失。此外,女性和抗SARS-CoV-2免疫可能在COVID-19感染后的生存中起重要作用。
Background: Currently, a large number of hospitalized coronavirus infectious disease-2019 (COVID-19) patients have met the clinical discharge criteria and have been discharged. Little is known about the sequelae and herd immunity, two important factors influencing the life quality and safety of COVID-19 survivors. Methods: Discharged COVID-19 patients from four medical facilities in Wuhan, China, were followed in order to record and investigate possible post-COVID-19 sequelae and herd immunity. After hospital discharge, patients reported to Fangcang shelter hospitals for an initial 14-day period of mandatory clinical monitoring. After release from these shelter hospitals, patients returned home for self-quarantine. Real-time quantitative PCR (RT-qPCR) was used for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) detection. Colloidal gold-based immunochromatographic strip assay (ICGSA) was used for anti-SARS-CoV-2 immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody testing. The data for this study are derived from case reports, medical records, and self-reports. Results: A total of 3,677 COVID-19 survivors [median age = 59 years, interquartile range (IQR) = 47-68, range = 10-98; 55.5% female] who were released from four hospitals in Wuhan, China, between January 18 and March 29, 2020 were followed for a median of 144 days (IQR = 135-157). During follow-up, 976 (26.5%) patients had at least one post-COVID-19 sequela. The incidence of post-COVID-19 sequelae among elderly COVID-19 survivors (age ≥60 years) was slightly increased compared to that of young COVID-19 survivors (age <60 years; relative risk = 1.05, 95% CI = 1.02-1.10, p = 0.007). During follow-up, a dramatic reduction of anti-SARS-CoV-2 IgG (88.0%, 95% CI = 84.2-90.4) and IgM (93.2%, 95% CI = 88.5-96.4) antibodies was observed. Among these COVID-19 survivors, 1.2% (n = 45) retested positive for SARS-CoV-2 and 1.0% (n = 37) died during follow-up. Of those who died during follow-up, 70.3% were male and all were negative for both IgG and IgM, except for one person who was IgG-positive. Conclusions: Our study documents significant post-COVID-19 sequelae that impair functions of multiple organ systems in COVID-19 survivors, suggesting that the long-term effects of this disease will negatively impact survivors\' quality of life, continue to strain health care systems, and result in extended periods of lost productivity. Furthermore, female gender and anti-SARS-CoV-2 immunity may play an essential role in the survival after COVID-19 infection.