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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02987-8

摘要内容如下：

严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染在许多器官系统中引起冠状病毒病2019（COVID-19）（PASC）的急性后遗症。这些后遗症的风险在感染后长达2年的时间内都有特征，但长期随访有限。在这里，我们建立了一个由135，161名SARS-CoV-2感染者和5，206，835名来自美国退伍军人事务部的对照组成的队列，对他们进行了3年的随访，以评估死亡和PASC的风险。在非住院个体中，死亡风险的增加在感染第一年后不再存在，PASC事件的风险在3年内有所下降，但在第三年仍贡献了每1000人9.6（95%置信区间（CI）:0.4-18.7）个残疾调整生命年（DALYs）。在住院患者中，死亡风险有所下降，但在感染后第三年仍显著升高（发病率比率:1.29（95%CI:1.19-1.40））。事故风险PASC在3年内下降，但在第3年仍存在大量残余风险，导致每1，000人90.0（95%CI:55.2-124.8）的残疾调整寿命年数。总之，我们的研究结果显示，随着时间的推移，风险会降低，但在住院患者中，死亡率和健康损失的负担仍会持续到第三年。

英文原文如下：

Abstracts

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes post-acute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in many organ systems. Risks of these sequelae have been characterized up to 2 years after infection, but longer-term follow-up is limited. Here we built a cohort of 135,161 people with SARS-CoV-2 infection and 5,206,835 controls from the US Department of Veterans Affairs who were followed for 3 years to estimate risks of death and PASC. Among non-hospitalized individuals, the increased risk of death was no longer present after the first year of infection, and risk of incident PASC declined over the 3 years but still contributed 9.6 (95% confidence interval (CI): 0.4-18.7) disability-adjusted life years (DALYs) per 1,000 persons in the third year. Among hospitalized individuals, risk of death declined but remained significantly elevated in the third year after infection (incidence rate ratio: 1.29 (95% CI: 1.19-1.40)). Risk of incident PASC declined over the 3 years, but substantial residual risk remained in the third year, leading to 90.0 (95% CI: 55.2-124.8) DALYs per 1,000 persons. Altogether, our findings show reduction of risks over time, but the burden of mortality and health loss remains in the third year among hospitalized individuals.

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