Postacute sequelae of COVID-19 at 2 years

被引:157
作者
Bowe, Benjamin [1 ]
Xie, Yan [1 ,2 ,3 ]
Al-Aly, Ziyad [1 ,2 ,4 ,5 ,6 ]
机构
[1] VA St Louis Hlth Care Syst, Clin Epidemiol Ctr, Res & Dev Serv, St Louis, MO 63106 USA
[2] Vet Res & Educ Fdn St Louis, St Louis, MO 63106 USA
[3] VA St Louis Hlth Care Syst, Clin Epidemiol Ctr, Res & Dev Serv, Div Pharmacoepidemiol, St Louis, MO USA
[4] Washington Univ, Sch Med, Dept Med, St Louis, MO 63130 USA
[5] VA St Louis Hlth Care Syst, Med Serv, Nephrol Sect, St Louis, MO 63106 USA
[6] Washington Univ\, Inst Publ Hlth, St Louis, MO 63130 USA
关键词
D O I
10.1038/s41591-023-02521-2
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Analysis of data from the US Department of Veterans Affairs showed that 2 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, risk for most postacute sequelae remained elevated in people who were hospitalized with COVID-19 but was attenuated in nonhospitalized individuals. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to postacute sequelae in multiple organ systems, but evidence is mostly limited to the first year postinfection. We built a cohort of 138,818 individuals with SARS-CoV-2 infection and 5,985,227 noninfected control group from the US Department of Veterans Affairs and followed them for 2 years to estimate the risks of death and 80 prespecified postacute sequelae of COVID-19 (PASC) according to care setting during the acute phase of infection. The increased risk of death was not significant beyond 6 months after infection among nonhospitalized but remained significantly elevated through the 2 years in hospitalized individuals. Within the 80 prespecified sequelae, 69% and 35% of them became not significant at 2 years after infection among nonhospitalized and hospitalized individuals, respectively. Cumulatively at 2 years, PASC contributed 80.4 (95% confidence interval (CI): 71.6-89.6) and 642.8 (95% CI: 596.9-689.3) disability-adjusted life years (DALYs) per 1,000 persons among nonhospitalized and hospitalized individuals; 25.3% (18.9-31.0%) and 21.3% (18.2-24.5%) of the cumulative 2-year DALYs in nonhospitalized and hospitalized were from the second year. In sum, while risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection.
引用
收藏
页码:2347 / +
页数:28
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