%0期刊文章%@ 2369-2960 %I JMIR出版物%V 8% 卡塔尔世界杯8强波胆分析N 8% P e37668% T社区和医院感染后长冠状病毒临床表现的差异及其与全因死亡率的关系:英国哨岗网络数据库研究梅萨-托雷斯，贝尔纳多，德兰诺勒，加亚特丽，奥库西，塞西莉亚，马约尔，尼希尔，阿南德，斯尼哈，杰克，盖顿比，皮尔，格拉姆森，本，查普曼，马丁，库辛，瓦萨，梅耶，埃里克，乔伊，马克，格林哈尔，特丽莎，德莱尼，布兰登，德卢西南，西蒙+纳菲尔德初级保健健康科学系，牛津大学，鹰楼，沃尔顿韦尔路，牛津，OX2 6ED，英国，44 01865 616600，simon.delusignan@phc.ox.ac.uk %K病历系统%K计算机化%K系统化医学术语%K急性后COVID-19综合征%K表型%K COVID-19 %K后COVID-19 %K长COVID %K种族%K社会阶层%K全科医生%K数据准确性%K数据提取%K生物医学本体%K SARS-CoV-2 %K住院%D 2022 %7 16.8.2022 %9原始论文%J JMIR公共卫生监测%G英语%X背景:大多数关于长COVID (COVID-19感染症状超过4周)的研究都集中在最初发病住院的人身上。长冠病毒被认为在英国初级保健电子记录中被低估了。目的:我们试图确定COVID-19感染后初级保健患者会出现哪些症状，以及未住院患者的症状是否不同，以及COVID后长期死亡率。方法:我们使用来自牛津大学-皇家全科医师研究和监测中心(N=7,396,702)具有全国代表性的初级保健哨站队列的常规数据，应用预定义的长冠状病毒表型，并根据指标感染是发生在医院还是社区进行分组。我们纳入了2020年3月1日至2021年4月1日的COVID-19感染病例。我们对国家统计局预先指定的长COVID症状进行了前后分析，将指数感染后1至6个月出现的症状与1年前的同一月份进行了比较。我们进行了logistic回归分析，引用95% ci的优势比(ORs)。 Results: In total, 5.63% (416,505/7,396,702) and 1.83% (7623/416,505) of the patients had received a coded diagnosis of COVID-19 infection and diagnosis of, or referral for, long COVID, respectively. People with diagnosis or referral of long COVID had higher odds of presenting the prespecified symptoms after versus before COVID-19 infection (OR 2.66, 95% CI 2.46-2.88, for those with index community infection and OR 2.42, 95% CI 2.03-2.89, for those hospitalized). After an index community infection, patients were more likely to present with nonspecific symptoms (OR 3.44, 95% CI 3.00-3.95; P<.001) compared with after a hospital admission (OR 2.09, 95% CI 1.56-2.80; P<.001). Mental health sequelae were more strongly associated with index hospital infections (OR 2.21, 95% CI 1.64-2.96) than with index community infections (OR 1.36, 95% CI 1.21-1.53; P<.001). People presenting to primary care after hospital infection were more likely to be men (OR 1.43, 95% CI 1.25-1.64; P<.001), more socioeconomically deprived (OR 1.42, 95% CI 1.24-1.63; P<.001), and with higher multimorbidity scores (OR 1.41, 95% CI 1.26-1.57; P<.001) than those presenting after an index community infection. All-cause mortality in people with long COVID was associated with increasing age, male sex (OR 3.32, 95% CI 1.34-9.24; P=.01), and higher multimorbidity score (OR 2.11, 95% CI 1.34-3.29; P<.001). Vaccination was associated with reduced odds of mortality (OR 0.10, 95% CI 0.03-0.35; P<.001). Conclusions: The low percentage of people recorded as having long COVID after COVID-19 infection reflects either low prevalence or underrecording. The characteristics and comorbidities of those presenting with long COVID after a community infection are different from those hospitalized. This study provides insights into the presentation of long COVID in primary care and implications for workload. %M 35605170 %R 10.2196/37668 %U https://publichealth.www.mybigtv.com/2022/8/e37668 %U https://doi.org/10.2196/37668 %U http://www.ncbi.nlm.nih.gov/pubmed/35605170