COVID-19恢复期疲劳发生的临床特征及其危险因素研究

doi:10.12114/j.issn.1007-9572.2023.0421

摘要/Abstract

摘要： 背景感染新型冠状病毒（SARS-CoV-2）后机体将在一段时间内出现体力不足、疲劳、心率加快等症状，当前各研究机构对新型冠状病毒感染（COVID-19）后持续症状和原因没有明确的描述。目的探究COVID-19恢复期疲劳发生特征与其相关症状的关联，为科学防治COVID-19提供数据参考。方法于2022年12月—2023年2月在广州市、武汉市、郑州市的城镇和农村地区开展COVID-19调查，共发放调查问卷750份，回收问卷732份，有效回收率97.6%。732名调查对象中，男356名（48.63%），女376名（51.37%）；平均年龄（35.2±16.0）岁；感染者526名，未感染者206名。本研究使用问卷调查法对调查对象感染情况及临床症状进行统计，使用疲劳量表-14（FS-14）测量调查对象主观疲劳程度，并对测量结果进行差异性分析。采用Pearson相关性分析探讨COVID-19临床特征与疲劳程度的相关性。采用二元Logistic回归分析探讨感染者COVID-19恢复期疲劳发生的危险因素。结果发热是COVID-19最常见的症状，发生率88.97%（468/526）；发热患者平均最高体温为（38.96±1.35）℃。感染者身体疲劳、总体疲劳评分高于未感染者（P<0.05）；女性感染者身体疲劳、精神疲劳、总体疲劳评分高于男性感染者（P<0.05）。Pearson相关性分析结果显示，FS-14总体疲劳评分与最高发热体温（r=0.192，P<0.001）、发热持续时间（r=0.299，P<0.001）、体力恢复时间（r=0.358，P<0.001）呈正相关。二元Logistic回归分析结果显示，发热（OR=1.215，95%CI=1.029~1.434，P=0.022）、心率过快（OR=7.325，95%CI=1.671~32.114，P=0.008）、眼球痛（OR=3.298，95%CI=1.251~8.696，P=0.016）是COVID-19恢复期发生中度以上疲劳的危险因素。结论 COVID-19恢复期疲劳发生率高，女性疲劳程度高于男性。发热、心率过快、眼球痛可能是感染者COVID-19恢复期发生中度以上疲劳的危险因素。

关键词: 新型冠状病毒感染, 疲劳, 身体疲劳, 精神疲劳, 发热, 危险因素

Abstract:

Background

After infection with SARS-CoV-2, the body will experience symptoms such as hyposthenia, fatigue, and accelerated heart rate for a period of time. Current research institutions do not have a clear description of the persistent symptoms and causes of corona virus disease 2019 (COVID-19) .

Objective

To explore the correlation between the characteristics of fatigue and its related symptoms during the recovery period of COVID-19, and provide data reference for the scientific control of COVID-19.

Methods

The survey of COVID-19 was conducted in urban and rural areas of Guangzhou, Wuhan and Zhengzhou from December 2022 to February 2023, a total of 750 questionnaires were distributed and 732 questionnaires were recovered, with an effective rate of 97.6%. Among the 732 respondents, 356 were males (48.63%) and 376 were females (51.37%) ; the average age was (35.2±16.0) years. There were 526 infected individuals and 206 uninfected individuals. The infections and clinical symptoms of the respondents were statistically analyzed by using questionnaires, and the subjective fatigue level was measured using the Fatigue Scale-14 (FS-14), and the measurement results were analyzed for differences. Pearson correlation analysis was used to explore the correlation between clinical characteristics and fatigue levels in COVID-19, and binary Logistic regression analysis was used to explore the risk factors for fatigue in COVID-19.

Results

Fever was the most common symptom of COVID-19, accounting for 88.97% (468/526), the average maximum fever temperature in febrile patients was (38.96±1.35) ℃. The physical fatigue and overall fatigue scores of infected individuals were higher than those of uninfected individuals (P<0.05). The scores of physical fatigue, mental fatigue and overall fatigue of female infected individuals were higher than those of male infected individuals (P<0.05). Pearson correlation analysis showed that the total fatigue score of FS-14 was positively correlated with the maximum fever temperature (r=0.192, P<0.001), fever duration (r=0.299, P<0.001) and physical recovery time (r=0.358, P<0.001). The results of binary Logistic regression analysis showed that fever (OR=1.215, 95%CI=1.029-1.434, P=0.022), the accelerated heart rate (OR=7.325, 95%CI=1.671-32.114, P=0.008), and ocular pain (OR=3.298, 95%CI=1.251-8.696, P=0.016) were risk factors for fatigue above moderate in COVID-19 during recovery period.

Conclusion

The fatigue symptoms of COVID-19 are obvious during the recovery period, with females had higher levels of fatigue than males. Accelerated heart rate, ocular pain, and elevated maximum fever temperature may be risk factors for fatigue above moderate in COVID-19 during recovery period.

Key words: COVID-19, Fatigue, Physical fatigue, Mental fatigue, Fever, Risk factors

李自栋,朱琳. COVID-19恢复期疲劳发生的临床特征及其危险因素研究[J]. 中国全科医学, 2024, 27(15): 1849-1854. DOI: 10.12114/j.issn.1007-9572.2023.0421.
LI Zidong,ZHU Lin. Clinical Characteristics and Risk Factors of Fatigue in COVID-19 during Recovery Period[J]. Chinese General Practice, 2024, 27(15): 1849-1854. DOI: 10.12114/j.issn.1007-9572.2023.0421.

图/表 6

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症状	发生人数	症状	发生人数
发热	468（88.97）	寒冷	114（21.67）
咳嗽	317（60.27）	嗅觉丧失	113（21.48）
头痛	306（58.17）	喉咙瘙痒	88（16.73）
流涕	272（51.71）	眼球痛	77（14.64）
肌肉无力	267（50.76）	心率过快	66（12.55）
肌肉酸痛	257（48.86）	呼气性呼吸困难	65（12.36）
喉咙痛	199（37.83）	胸部窒息	58（11.03）
鼻炎	170（32.32）	恶心呕吐	51（9.70）
咳痰	164（31.18）	气促	34（6.46）
味觉丧失	140（26.62）	腹泻	33（6.27）
关节痛	133（25.29）	矢气增加	27（5.13）

症状	发生人数	症状	发生人数
发热	468（88.97）	寒冷	114（21.67）
咳嗽	317（60.27）	嗅觉丧失	113（21.48）
头痛	306（58.17）	喉咙瘙痒	88（16.73）
流涕	272（51.71）	眼球痛	77（14.64）
肌肉无力	267（50.76）	心率过快	66（12.55）
肌肉酸痛	257（48.86）	呼气性呼吸困难	65（12.36）
喉咙痛	199（37.83）	胸部窒息	58（11.03）
鼻炎	170（32.32）	恶心呕吐	51（9.70）
咳痰	164（31.18）	气促	34（6.46）
味觉丧失	140（26.62）	腹泻	33（6.27）
关节痛	133（25.29）	矢气增加	27（5.13）

感染情况	人数	身体疲劳评分	精神疲劳评分	总体疲劳评分
未感染者	206	4.03±2.54	2.10±1.68	6.13±3.54
感染者	526	5.81±2.71	2.09±1.54	7.90±3.52
t值		7.81	-0.12	5.85
P值		<0.001	0.903	<0.001

感染情况	人数	身体疲劳评分	精神疲劳评分	总体疲劳评分
未感染者	206	4.03±2.54	2.10±1.68	6.13±3.54
感染者	526	5.81±2.71	2.09±1.54	7.90±3.52
t值		7.81	-0.12	5.85
P值		<0.001	0.903	<0.001

性别	人数	身体疲劳评分	精神疲劳评分	总体疲劳评分
男性	247	5.51±2.83	1.91±1.47	7.41±3.65
女性	279	6.07±2.56	2.24±1.57	8.31±3.32
t值		-2.38	-2.50	-2.94
P值		0.018	0.013	0.003