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Covid）”和新冠肺炎后遺癥是一回事嗎？有沒有方法可以治愈“長期新冠肺炎Long Covid”？我們有什么需要注意的地方？大多數(shù)人在感染新冠病毒后兩到三周內(nèi)康復，長的四到十二周康復（或者病死），但一些人會在數(shù)周到數(shù)月內(nèi)出現(xiàn)新的癥狀或持續(xù)表現(xiàn)出癥狀，似乎患上了一種影響多個系統(tǒng)的炎癥性疾病。人們將首次感染新冠病毒后經(jīng)過 12 周或更長時間還存在的、新發(fā)的或復發(fā)的一系列疑似關系到新冠病毒的健康問題組合稱為 Post-COVID Conditions、Long Covid 等。Post-COVID Conditions 可以影響所有年齡的患者，老年人發(fā)病率高于年輕人，女性發(fā)病率高于男性[1]（這類似自身免疫性疾?。??；颊咄ǔ蟾娼?jīng)歷了以下部分癥狀的不同組合：呼吸困難或氣短，身體虛弱，精神疲憊，輕微運動就感到疲勞和/或癥狀加重，心臟問題（可以是心悸、胸悶、心臟肥大、局灶性心臟纖維化、冠狀動脈硬化、急性心肌梗塞），難以思考或集中注意力（俗稱“腦霧”），心情沮喪，部分記憶丟失，出現(xiàn)過去沒有的恐懼癥，癲癇發(fā)作，持續(xù)咳嗽，關節(jié)痛、肌肉痛、胸痛、胃痛、頭痛、喉嚨痛等疼痛，腹瀉，失眠，發(fā)燒，惡心、嘔吐、食欲不振，站立時頭暈，皮疹，情緒變化，嗅覺或味覺異常甚至喪失，月經(jīng)周期改變，尿血、便血，下肢和眼睛周圍腫脹，不同程度的腎損傷[2]?；颊咭呀?jīng)報告的不同癥狀約有 200 種，一個人身上可以有幾種到十幾種。這些癥狀可能會隨著患者的身體狀況或精神狀況惡化而加重。2021 年，美國殘疾人法案 (ADA) 將限制人的一項或多項主要生命活動（吃喝拉撒睡、器官與系統(tǒng)功能等）的 Post-COVID Conditions 視為殘疾，可歸類為身體障礙或精神障礙。Post-COVID Conditions 可能歸因于病毒或病毒的碎片還在組織內(nèi)持續(xù)存在、病毒本身和免疫系統(tǒng)對身體造成的的損傷引起了持續(xù)炎癥和內(nèi)分泌調(diào)節(jié)受損。肺、心臟、腦受到的一些損傷的恢復速度緩慢，可能留下未正常修復的組織。新冠病毒在重癥患者身上引起的多器官效應可以導致復雜的、難以修復的器官損傷，在非重癥患者身上亦可引起比人們預料得更深刻的破壞，還可能涉及改變腸道微生物群。新冠病毒引起的免疫性睪丸炎等自身免疫性疾病和中風等嚴重問題當然也能造成持續(xù)的影響，可以持續(xù)終生。有些人，主要是兒童，被新冠病毒感染后出現(xiàn)多系統(tǒng)炎癥綜合征 (MIS)，美國 CDC 認為這也會導致 Post-COVID Conditions。重癥監(jiān)護后綜合征 (PICS，人在 ICU 表現(xiàn)出的、出院后仍可存續(xù)的一系列健康問題） 可以導致虛弱、思維和判斷能力下降。人們可能因患病、住院、孤獨、憂郁、目睹非日常的大量死亡等而患上創(chuàng)傷后應激障礙 (PTSD)，其癥狀可能被人們與身體癥狀混為一談。本就患有抑郁癥或酗酒、使用精神藥物的人受到的影響可能更大。由于病因不明確、情況復雜，目前沒有針對 Post-COVID Conditions 的特異性治療方法，可以診斷并使用抗炎藥等對癥治療，并尋求精神醫(yī)學支持、補充營養(yǎng)素。最好的防御方法顯然還是不要感染新冠病毒。部分研究顯示接種 2 劑新冠疫苗會降低 Post-COVID Conditions 的發(fā)病率一半左右。參考^https://www.ijidonline.com/article/S1201-9712(21)00434-3/fulltext^急性腎損傷的發(fā)生率估計為 2.1% 至 29%，這可能致命。?https://jasn.asnjournals.org/content/32/11/2851編輯于 2022-01-05 12:16關注者245被瀏覽565,882"}