chuka_lis (chuka_lis) wrote,

Потсковидный синдром

Так еще называют долгий (затяжной) ковид.
Эпидемиологическое исследование англичан на анализе данных по почти 48 тысячам заболевших (из госпитализированных) по сравнению с соответствущим контролем (43 тыс, по возрасту, полу, этносу, сопутсвующим заболеваниям) показало, что выписавшиеся после ковида, раньше и чаще будут вынуждены посетить больницу снова (после выписки) чем контроль. На 1000 человек в течении года, среди выздоровевших от ковида, 766 человек нуждаются в последующем посещении врача (имеется ввиду по очень серьезному поводу), что  в 3.5 раза больше, чем это случалось в контрольной группе. Смертность постковидных после выписки из больницы была 320 на 1000 человек в течении года, что почти в 8 раз больше, чем в контроле. Проблемы с дыханием были у 770 на 1000 человек в год, сбои в работе сердца 126\1000, проблемы с диабетом 127\1000,-   гораздо выше, чем в контроле. Для тех, кому до 70, риски были особенно велики. Более выраженно- для белых. По проблемам с легкими- выше в 10-11 раз ( по сравнению с контролем). Для тех, кому за 70, показатель было выше в "всего лишь" в 5 раз.
Principal findings In the largest study to-date to examine PCSin individuals hospitalised with COVID-19,comprising 47,780COVID-19 cases with matched controls,we describe three major findings.Firstly,COVID-19 hospitalisation was associated with increased risk of readmission and death following discharge,relative tothat inindividuals of similar demographic and clinical profiles over the same period; nearly a third of people post COVID-19 hospital discharge were re-admitted and more than 1 in 10died.Secondly, rates of post-discharge multi-organ dysfunction were elevated in individuals withCOVID-19 compared with those in the matched control group, suggesting extrapulmonary pathophysiology. Diabetes and MAC Ewere particularly common, both when considering all post-discharge events(which may reflect a combination of new-onset cases and exasperation of pre-existing conditions) and only incident cases.Finally, the absolute risk of post-discharge adverse events was greater for individuals aged ≥70 years than<70 years, and for individuals of White ethnic background than in the Non-White group.
With over3million people in the UK having tested positive for COVID-19 at the time of writing,[28]and many more who had the disease but never received a test, our findings suggest that the long-term burden of COVID-related morbidity on hospitals and broader healthcaresystemsis likely to be substantial.PCS comes on a backdrop of healthcare challenges, particularly sustainable high-quality care for long-term conditions: inequalities in health, access and provision; incomplete pathways across community and hospital care; inadequate research translation to clinical practice; and insufficient resources.Our findings across organ systems suggest that the diagnosis, treatment and prevention of PCS will require integrated rather than organ-or disease-specific approaches.
Our results are consistent with hypothesised biological mechanisms associated with respiratory,[18] cardiovascular,[19]metabolic,[20]renal,[10]and hepatic[8]involvement in COVID-19, and extend the early evidence base surrounding
PCS which has been described as being “limited”and generally of low quality.[21]In a more recent study of 1,775 US veterans hospitalised with COVID-19, 20% were readmitted and 9% died within 60 days of discharge
Multi-organ involvement following COVID-19 infection was detected in 201 low-risk individuals in the UK (18% hospitalised with COVID-19), with impairment of the lungs (33%), heart (32%), kidneys (12%) and liver (10%) found to be common.
COVID-19 was associated with increased odds of acute kidney injury, renal replacement therapy, insulin use, pulmonary embolism, stroke, myocarditis, arrythmia, and elevated troponin in US veterans hospitalised with COVID-19 versus a control of seasonal influenzaConclusions: Individuals discharged from hospital following COVID-19 face elevated rates of multi-organ dysfunction compared with background levels, and the increase in risk is neither confined to the elderly nor uniform across ethnicities. The diagnosis, treatment and prevention of PCS require integrated rather than organ- or disease-specific approaches. Urgent research is required to establish risk factors for PCS.

Tags: здоровье, коронавирус, статьи

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