背景:自2019年冠状病毒病(COVID-19)大流行以来,从COVID-19感染中恢复的人数有所增加。后COVID综合征,或PCS,这被定义为在感染期间或之后出现的与COVID-19一致的体征和症状,持续超过12周,并且不能用替代诊断来解释,也得到了关注。我们根据已发表的文献系统地回顾并确定了全球PCS的合并患病率估计值。
方法:来自WebofScience的相关文章,Scopus,PubMed,科克伦图书馆,和OvidMEDLINE数据库使用系统评价和Meta分析指导的系统检索流程的首选报告项目进行筛选。纳入的研究是英文的,发表于2020年1月至2024年4月,将整体PCS患病率作为研究结果之一,纳入确诊为COVID-19的人群,并在COVID感染后12周或更长时间接受评估。作为测量的主要结果,通过对从个别研究中提取的PCS患病率数据的荟萃分析来估计PCS的合并患病率,这是通过随机效应模型进行的。本研究已在PROSPERO(CRD42023435280)上注册。
结果:48项研究符合资格标准,纳入本综述。16个被接受进行荟萃分析,以估计全球PCS的合并患病率,为41.79%(95%置信区间[CI]39.70-43.88%,I2=51%,p=0.03)。根据急性COVID-19感染后不同的评估或随访时间点,PCS患病率估计≥3,≥6th,≥12个月的时间点均为45.06%(95%CI:41.25-48.87%),41.30%(95%CI:34.37-48.24%),和41.32%(95%CI:39.27-43.37%),分别。性别分层的PCS患病率在男性中估计为47.23%(95%CI:44.03-50.42%),在女性中为52.77%(95%CI:49.58-55.97%)。基于大陆地区,欧洲的合并PCS患病率估计为46.28%(95%CI:39.53%-53.03%),美国46.29%(95%CI:35.82%-56.77%),亚洲49.79%(95%CI:30.05%-69.54%),澳大利亚为42.41%(95%CI:0.00%-90.06%)。
结论:本荟萃分析中的患病率估计值可用于对PCS的进一步综合研究,这可能有助于制定更好的PCS管理计划,以减少PCS对人口健康和相关经济负担的影响。
BACKGROUND: Since the Coronavirus disease 2019 (COVID-19) pandemic began, the number of individuals recovering from COVID-19 infection have increased. Post-COVID Syndrome, or PCS, which is defined as signs and symptoms that develop during or after infection in line with COVID-19, continue beyond 12 weeks, and are not explained by an alternative diagnosis, has also gained attention. We systematically reviewed and determined the pooled prevalence estimate of PCS worldwide based on published literature.
METHODS: Relevant articles from the Web of Science, Scopus, PubMed, Cochrane Library, and Ovid MEDLINE databases were screened using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic search process. The included studies were in English, published from January 2020 to April 2024, had overall PCS prevalence as one of the outcomes studied, involved a human population with confirmed COVID-19 diagnosis and undergone assessment at 12 weeks post-COVID infection or beyond. As the primary outcome measured, the pooled prevalence of PCS was estimated from a meta-analysis of the PCS prevalence data extracted from individual studies, which was conducted via the random-effects model. This study has been registered on PROSPERO (CRD42023435280).
RESULTS: Forty eight studies met the eligibility criteria and were included in this review. 16 were accepted for meta-analysis to estimate the pooled prevalence for PCS worldwide, which was 41.79% (95% confidence interval [CI] 39.70-43.88%, I2 = 51%, p = 0.03). Based on different assessment or follow-up timepoints after acute COVID-19 infection, PCS prevalence estimated at ≥ 3rd, ≥ 6th, and ≥ 12th months timepoints were each 45.06% (95% CI: 41.25-48.87%), 41.30% (95% CI: 34.37-48.24%), and 41.32% (95% CI: 39.27-43.37%), respectively. Sex-stratified PCS prevalence was estimated at 47.23% (95% CI: 44.03-50.42%) in male and 52.77% (95% CI: 49.58-55.97%) in female. Based on continental regions, pooled PCS prevalence was estimated at 46.28% (95% CI: 39.53%-53.03%) in Europe, 46.29% (95% CI: 35.82%-56.77%) in America, 49.79% (95% CI: 30.05%-69.54%) in Asia, and 42.41% (95% CI: 0.00%-90.06%) in Australia.
CONCLUSIONS: The prevalence estimates in this meta-analysis could be used in further comprehensive studies on PCS, which might enable the development of better PCS management plans to reduce the effect of PCS on population health and the related economic burden.