[Monitoring the development of post-COVID–19 syndrome].

Orv Hetil

1 Semmelweis Egyetem, Általános Orvostudományi Kar, Családorvosi Tanszék Budapest Magyarország.

Published: February 2022

Unlabelled: Összefoglaló. Bevezetés: A SARS-CoV-2-fertőzés elhúzódó tüneteit 4 héten túl poszt-COVID-19-tüneteknek nevezzük, és fennállási idő szerint csoportosítjuk. Célkitűzés: A vizsgálat célja egy háziorvosi körzet megközelítőleg állandó populációjában megfigyelni, hogy adott időintervallumon belül a SARS-CoV-2-fertőzöttek között milyen arányban, milyen jellegű poszt-COVID-19-tünetek alakulnak ki, és mennyi ideig tartanak. Módszer: 282 SARS-CoV-2-beteg tüneteit 2020. szeptember 1. és 2021. szeptember 1. között követtük, 4 hetente, 15-42 héten át - elhúzódó szaglászavar esetén 30-50 héten át -, elsősorban telefonos interjúk segítségével. Eredmények: Egy hónapon túli panaszok a betegek 67%-ában (170 fő) alakultak ki. A leggyakoribb tünet a fáradékonyság (79 fő, 29%) és a szaglászavar volt (74 fő, 27%). Az utóbbi jellemzően nem dohányzók körében lépett fel, és a COVID-19-fertőzöttek 2,5%-ában 43 héten túl is fennmaradt. A fáradékonyság panaszköre a poszt-COVID-19-betegek 46%-át érintette. Ezen betegek szignifikánsan hosszabb időt töltöttek keresőképtelenségi állományban, mint azok, akik nem voltak fáradékonyak (12,3 vs. 19,7 nap). Az enyhe SARS-CoV-2-fertőzést követő súlyos fáradékonysággal küzdő betegek a panaszaikat szindrómaszerűen írták le, melyre jellemző volt a palpitáció, a fáradékonyság, a terhelésre jelentkező légszomj, az alvászavar, a laza széklet és a posturalis panaszok. Ezek átlagosan 19 hét alatt múltak el. Megbeszélés: A poszt-COVID-19-tünetek kialakulása enyhe lefolyás mellett is gyakori, a lefolyás súlyossága sok esetben nincs arányban a poszt-COVID-19-fáradékonyság súlyosságával. A posztakut-COVID-19-fáradékony betegek kórházi kezelést nem igénylő csoportja számos tényező alapján elkülöníthető a posztakut-COVID-19-fáradékony betegek hospitalizált csoportjától. Következtetés: Az enyhe COVID-19-fertőzést is követheti elhúzódó fáradékonyság poszt-COVID-19-tünetként, mely spontán regrediál. SARS-CoV-2-fertőzést követően hosszú távon fennmaradhat szaglászavar, illetve a középsúlyos és súlyos COVID-19-eseteket követően fáradékonyság. Orv Hetil. 2022; 163(9): 335-342.

Introduction: Extended symptoms may develop after a SARS-CoV-2 infection. We refer to these as post-COVID-19 symptoms and they are grouped according to time duration.

Objective: The aim of the study was to follow all COVID-19 infected patients in a family practise, to observe all post-COVID-19 symptoms, symptom development rates and to document how long they last.

Method: 282 SARS-CoV-2 patients were followed mainly through telephone interviews between 01. 09. 2020 and 01. 09. 2021. Post-COVID-19 symptoms were monitored for 15-42 weeks every 4 weeks (30-50 weeks in cases of delayed hypsomia).

Results: Symptoms lasting longer than a month developed in 67% of all patients (170 cases). The most frequent symptoms were fatigue (79 cases, 29%) and hyposmia (74 cases, 27%). The latter mainly developed in non-smokers, affecting 2,5% of all COVID-19 patients beyond 43 weeks. Fatigue affected 46% of all post-COVID-19 patients. Sick leave was significantly longer among these patients (19.7 vs. 12.3 days in patients with no fatigue). Severe post-COVID-19 fatigue in non-hospitalized patients presented in a sydrome-like appearance displaying palpitations, fatigue, dyspnoea, sleep disturbances, loose stools and postural complaints. These regrediated after 19 weeks.

Discussion: Post-COVID-19 symptoms often develop after a mild COVID-19 infection. Severity of COVID-19 infection and severity of post-COVID-19 symptoms often do not correlate. Groups of hospitalized and non-hospitalized post-acute COVID patients with fatigue can be distinguished by many attributes.

Conclusion: Mild COVID-19 infections may also be followed up by severe fatigue, but it spontenaously regrediates. Long-term effects of COVID-19 are permanent hyposmia and fatigue (the latter affect some hospitalized COVID-19 patients). Orv Hetil. 2022; 163(9): 335-342.

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http://dx.doi.org/10.1556/650.2022.32432DOI Listing

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