Infection:肥胖和脂质代谢紊乱增加了长期 COVID-19综合征的发生风险

2022-05-05 xuyihan MedSci原创

研究表明,感染新冠后而得到的COVID-19综合症的许多症状可能是来自于在最初感染冠状病毒时它对人体最重要的神经之一造成的持久性损害而引起的。

截止到到2021年11月,全球已有2.47 亿例新冠确诊病例,超过 500 万患者因新冠病毒病 (COVID-19) 而死亡。即使在一些国家,感染率和因COVID-19住院的患者人数有所下降,但新冠病毒感染的长期后果,也就是通常被称为长期 COVID 综合征 (LCS)的发生率居高不下,严重影响患者的生活质量。LCS 可以影响广泛的器官系统,例如呼吸系统或神经系统,常见的症状包括呼吸急促、疲劳、嗅觉丧失、肌肉无力或认知障碍。来自英国和美利坚合众国的当前数据表明,LCS 的发生率在7%到13.3%之间。LCS 的危险因素还不清楚。因此需要明确定义 LCS 发展的风险因素。因此在本研究中,研究人员使用疾病分析器数据库 (IQVIA),以研究德国 LCS 的患病率并确定临床与其发展相关的因素。

 

我们在疾病分析器数据库 (IQVIA) 中确定了2020年3月1日至2021年3月31日间50402 名 COVID-19 患者,其中包含来自德国 1056 次一般实践的数据。该研究的主要观察结果是具有长 COVID 综合征 (LCS) 的诊断的LCS的患者比例。多变量逻辑回归分析用于确定 LCS 发展的危险因素。

 

在纳入该分析的 50402 名 COVID-19 患者中,1708 名(3.4%)被诊断患有LCS。在多元回归分析中,脂质代谢障碍(OR 1.46, 95% CI 1.28–1.65, p <0.001)和肥胖(OR 1.25, 95% CI 1.08–1.44, p=0.003)确定强风险因素。除了这些代谢因素,患者年龄在 46 至 60 岁之间(与年龄 ≤ 30 岁相比,(OR 1.81 95% CI 1.54–2.13,p <0.001),女性(OR 1.33,95% CI 1.20–1.47,p  < 0.001)以及女性既往哮喘史(OR 1.67, 95% CI 1.39–2.00, p < 0.001)和抑郁症(OR 1.27, 95% CI 1.09–1.47, p =< 0.002)都会导致LCS的发病率增加。

 

本项研究证实脂质代谢紊乱和肥胖代表了 LCS 发展的与年龄无关的风险因素,这表明代谢改变决定了 COVID-19 所有阶段的不利的疾病过程。

 

 

原始出处:

Sven H. Loosen. Et al. Obesity and lipid metabolism disorders determine the risk for development of long COVID syndrome: a cross-sectional study from 50,402 COVID-19 patients. Infection.2022.

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