TY -的盟Meza-Torres Bernardo盟——Delanerolle Gayathri AU - Okusi,塞西莉亚盟——市长Nikhil AU - Anand, Sneha AU -麦,杰克AU - Gatenby,皮尔斯AU - Glampson,本盟-查普曼,马丁盟——Curcin瓦萨号非盟- Mayer, Erik盟——快乐,马克•格林哈尔希盟——特丽莎AU -德莱尼,布伦丹盟- de Lusignan西蒙PY - 2022 DA - 2022/8/16 TI -差异与长后COVID社区和医院感染临床表现与全因死亡率和协会:英语前哨网络数据库研究乔- JMIR公共卫生Surveill SP - e37668六世- 8 - 8 KW -医疗记录系统KW -电脑KW -系统化的医学术语KW -急性COVID-19综合症KW -表型KW - COVID-19 KW - post-COVID-19综合症KW -长COVID KW -种族KW -社会阶层千瓦全科医生KW -数据的准确性KW -数据提取KW -生物医学本体KW - SARS-CoV-2 KW -住院AB -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)。结果:共5.63%(416505 / 7396702)患者被编码诊断为COVID-19感染，1.83%(7623/ 416505)患者被诊断或转诊为长冠。 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. SN - 2369-2960 UR - https://publichealth.www.mybigtv.com/2022/8/e37668 UR - https://doi.org/10.2196/37668 UR - http://www.ncbi.nlm.nih.gov/pubmed/35605170 DO - 10.2196/37668 ID - info:doi/10.2196/37668 ER -