张文宏团队的最新研究报告长新冠症状及其持续时间

生活百科 2024-11-18 22:01:57 浏览次

研究背景

新冠病毒目前仍呈常态化流行，长新冠等症状可长期影响部分患者生活质量，带来较大公共卫生与社会经济负担。

新型冠状病毒感染目前已呈常态化流行，尽管病毒感染症状通常只持续 2-3 周，但自 2020 年以来，多个报道提示 10% 左右患者在急性期之后会经历持续数月的呼吸困难、疲劳和脑雾等症状[1,2]，世界卫生组织定义其为新冠感染后综合征，即长新冠。据报导，全球罹患长新冠的患者数量仍持续增加。长新冠症状可累及多个器官或系统，造成患者心理和精神障碍对于部分患者更可严重影响患者日常生活，并导致其劳动力的丧失，造成了巨大的公共卫生压力与社会经济负担。

本研究团队自 2022 年启动了完整的长新冠多中心前瞻性队列研究。通过对 21826 名首次感染新冠的患者的流行病学及临床特征分析，发现 8.89% 的患者在感染后 6 个月报告了长新冠症状，且其中约 20-30% 左右患者的症状可在一年的时候持续存在[3]。因此，揭示这些长新冠症状的发生和持续背后的免疫机制具有较大研究价值[3](Emerg Microbes Infect, 2023）。

研究内容

在此之前，团队已经发现长新冠患者中间存在天然免疫通路的活化，且这些患者的临床炎症检测相关指标与长新冠临床和心理症状呈正相关（J Transl Med, 2024）。同时li>[1] Vindegaard N, Benros ME, Lange T, et al. Duration of symptoms in patients with mild COVID-19: follow-up of 23,465 Danish patients. Br J Gen Pract. 2021;71(708):e726-e729.

[2] Nalbandian A, Sehgal K, Gupta A, et al. Post-acute sequelae of SARS-CoV-2 infection: a systematic review. Lancet. 2021;398(10299):705-719.

[3] Wu F, Wang M, Zheng R, et al. Prevalence and risk factors of long-COVID symptoms among patients with the first SARS-CoV-2 infection: results from the CHIC prospective cohort study. Emerg Microbes Infect. 2023;12(1):9-17.

[4] Long QX, Tang XJ, Shi QL, et al. Dysregulated immune response in patients with long-COVID-19. Front Immunol. 2021;12:709825.

[5] López-Gómez A, Arias-Piñeiro P, Moro-García MA, et al. Longitudinal monitoring of T cell subsets in hospitalised COVID-19 patients and their association with clinical outcome. Nat Commun. 2021;12(1):2103.

[6] Manoj S, Karmakar M, Kim S, et al. Distinct humoral immune signature in COVID-19-infected children compared to adults. J Exp Med. 2021;218(7):e20210153.

[7] Wang C, Zhao Y, Hou J, et al. Single-cell RNA sequencing of peripheral blood moNonuclear cells reveals immune alterations in COVID-19 patients with different severity levels. Cell Discov. 2021;7:88.

[8] Manfredi F, Galastri S, Cossu G, et al. Longitudinal analysis of immune dysfunction in COVID-19 patients with post-acute compliCations. EBioMedicine. 2021;69:103474.

[9] Castagnoli R, Votto M, Piccinni MP, et al. Immune system and long-COVID: from pathophysiology to clinical implications. Front Immunol. 2022;13:778230.

[10] Raveendran AV, Dimopoulos N, Daly GA, et al. Long COVID: towards a holistic understanding for patients and providers. Nat Rev Immunol. 2022;22(1):9-17.

[11] Chen J, Rajan J, Ravindran PK, et al. Phenotypic and immunological heterogeneity in long COVID-19: a systematic review and meta-analysis. Nat Med. 2022;28(11):2217-2231.

[12] Zhao Y, Yan T, Cao C, et al. Long-term impact of SARS-CoV-2 on immune cell repertoire and response. Nat Med. 2022;28(11):2232-2234.

[13] Chen CH, Chen YC, Wu HC, et al. Longitudinal immune profiling in a cohort of COVID-19 convalescent patients with persistent symptoms. Nat Commun. 2022;13(1):3300.