目的:已广泛报道了COVID后的病情(或长COVID),但是缺乏基于人群的研究来探索其危险因素之间的关系。我们检查了长COVID,慢性阻塞性肺疾病疫苗接种状况,和吸烟。我们还测试了COPD状态的改善作用。
方法:分析了2022年美国全国行为危险因素监测系统(BRFSS)的数据。我们的主要结果是COVID-19诊断为阳性后的长COVID(是/否)。预测变量为COPD,冠心病,糖尿病,哮喘,身体质量指数,吸烟状况,和COVID-19疫苗接种次数(0-4次)。使用加权多变量逻辑回归模型并校正社会人口统计学因素。回归模型用于探讨COPD状态的改善作用。
结果:幸存者(N=121,379)中LongCOVID的加权患病率为21.8%(95CI:21.4,22.3),以疲倦/疲劳(26.2%[95%:25.1,27.2])为最常见的症状。患有COPD的受访者(aOR:1.71[95CI:1.45,2.02]),当前每日吸烟者(AOR:1.23[95CI:1.01,1.49]),和前吸烟者(OR:1.24[95CI:1.12,1.38])(与从未吸烟的人)患长期COVID的几率更高。然而,接受过三剂(aOR:0.75[95CI:0.65,0.85])和四剂(aOR:0.71[95CI:0.58,0.86])疫苗的受访者(与没有疫苗)的长COVID几率较低。COPD对吸烟与长期COVID之间的关系有改善作用(p值:0.013)。
结论:我们的发现强调了COPD之间的复杂相互作用,吸烟,和长COVID。Further,COVID-19疫苗接种可能对长型COVID具有保护作用。
OBJECTIVE: Post-COVID Conditions (or Long COVID) have been widely reported, but population-based studies exploring the relationship between its risk factors are lacking. We examined the associations between Long COVID, chronic obstructive pulmonary disease [COPD], vaccination status, and cigarette smoking. We also tested for the modifying effect of COPD status.
METHODS: Data from the 2022 US nationwide Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Our primary outcome was Long COVID (Yes/No) after a positive COVID-19 diagnosis. Predictor variables were COPD, coronary heart disease (CHD), diabetes, asthma, body mass index, cigarette smoking status, and number of COVID-19 vaccinations (0-4). Weighted multivariable logistic regression models were used and adjusted for sociodemographic factors. Regression models were used to explore the modifying effects of COPD status.
RESULTS: The weighted prevalence of Long COVID among survivors (N = 121,379) was 21.8% (95%CI: 21.4, 22.3), with tiredness/fatigue (26.2% [95%:25.1, 27.2]) as the most common symptom. Respondents with COPD (aOR: 1.71 [95%CI: 1.45, 2.02]), current daily smokers (aOR: 1.23 [95%CI:1.01, 1.49]), and former smokers (aOR: 1.24 [95%CI:1.12, 1.38]) (vs. never established smokers) had higher odds of Long COVID. However, respondents who had received three (aOR: 0.75 [95%CI:0.65, 0.85]) and four (aOR: 0.71 [95%CI:0.58, 0.86]) vaccine doses (vs. no vaccine) had lower odds of Long COVID. COPD had a modifying effect on the relationship between cigarette smoking and Long COVID (p-value: 0.013).
CONCLUSIONS: Our findings underscore a complex interaction between COPD, cigarette smoking, and Long COVID. Further, COVID-19 vaccination may be protective against Long COVID.