西西河

主题:【讨论】长新冠主要是心理作用?请大家讨论、批判 -- 学步桥

共:💬25 🌺152
全看树展主题 · 分页首页 上页
/ 2
下页 末页
家园 死了好多老人,不也会降低医保负担吗?
家园 扎心了,桥上老师。
家园 长期降低,短期增加吧

少了20万老人,长期医保社保肯定负担小了,但患病期间治疗抢救的费用肯定大幅增加,所以这三两年的死亡是给医保增加负担的。长期的影响慢慢看吧。

德国未来退休年龄延长到67,退了休生点病治上几年,过了70再赶上个瘟疫万一没了,这辈子光奉献(医保社保)了😭

家园 我感觉国内部分舆论背后逻辑是这样的

比如八十来岁老人,他们本来就要日常大把吃药,动不动去趟医院,核磁CT胃镜各种检查,时不时搞个抢救。更不要说那些躺着,天天需要人护理的。这些都在花医保的钱。而得了新冠,无非是把最后走前那一次花费提前。你说的新冠抢救花一大笔是对的;但是癌症、心血管等等花的也不少啊。新冠死了就省的下次花癌症抢救的钱了。这些早死的人,通过这种方式会节约大量资源。对医保是长痛不如短痛了。

话有点难听,但是绝没有针对你在德国的朋友的意思,咱们只是客观的算账。

家园 我们说的是一回事

你说的是长期,我说的是短期,不冲突,如果只计算死掉的老人带来的影响,短期费用肯定是上涨的,长期应该是减少的。

而且这是只计算死者的影响,如果加上染病但没死的那些就很难讲了,本来60的人没什么毛病,得过一次有可能身体素质下降了,长期花费的医保就要增加了。

德国今年4月开始取消了全国性的防疫规定,仅就我个人的感觉,今年夏天病假的人明显多了,比20,21年多,比疫情前也多。

通宝推:大爆炸,大爆炸,
家园 你看你看,“广州医学专家:新冠“后遗症”可能来自于心理因素” -- 补充帖

这睁着眼睛说瞎话的本事,真是从西方学来的“先进”经验呐。

马丁雅克的儿子,长新冠的病例清清楚楚的放在那里,这些专家们就敢信口雌黄。

家园 再回复学步兄,上次的回复有问题

上次我抱怨没有关于中国人的数据,这是错误的。

2020年6月武汉金银潭医院张定宇和中日友好医院曹彬等在《柳叶刀》上就发过关于新冠长期影响的跟踪随访性论文。

论文的形式很好,分别对1700多例新冠患者进行了6月及1年的跟踪随访。这是很宝贵的数据。

=====

现在媒体上有长新冠(The long covid-19)、新冠后遗症、新冠长期症状等多种名词。

从外国直译过来的“长新冠”一般对应“新冠长期症状”,新冠后遗症与前两者有较大差别。

现在行业协会没有给出明确的定义,世卫组织倒是给了给定义:新冠3月后仍有新冠症状,持续两月的就算。当然,这个定义还是有问题,它没明确说什么是“新冠症状”,只说包含疲劳、呼吸短促、认知功能障碍等。

张定宇他们的文章追踪的主要是疲劳、肌肉无力、睡眠障碍、焦虑抑郁等症状。

=====

唯一的问题是,张定宇他们的病例是新冠原始毒株,现在是奥密克戎主流行。关于奥密克戎新冠长期症状,确实还需要数据。

通宝推:学步桥,
家园 我抄下来,还没时间读

今天恰好有事。

6M:

Findings: In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 (IQR 47·0-65·0) years and 897 (52%) were men. The follow-up study was done from June 16, to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 (175·0-199·0) days. Fatigue or muscle weakness (63%, 1038 of 1655) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1617) of patients. The proportions of median 6-min walking distance less than the lower limit of the normal range were 24% for those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5-6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5-6, and median CT scores were 3·0 (IQR 2·0-5·0) for severity scale 3, 4·0 (3·0-5·0) for scale 4, and 5·0 (4·0-6·0) for scale 5-6. After multivariable adjustment, patients showed an odds ratio (OR) 1·61 (95% CI 0·80-3·25) for scale 4 versus scale 3 and 4·60 (1·85-11·48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0·88 (0·66-1·17) for scale 4 versus scale 3 and OR 1·77 (1·05-2·97) for scale 5-6 versus scale 3 for anxiety or depression, and OR 0·74 (0·58-0·96) for scale 4 versus scale 3 and 2·69 (1·46-4·96) for scale 5-6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with estimated glomerular filtration rate (eGFR) 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up.

Interpretation: At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery.

12M:

Findings: 1276 COVID-19 survivors completed both visits. The median age of patients was 59·0 years (IQR 49·0-67·0) and 681 (53%) were men. The median follow-up time was 185·0 days (IQR 175·0-198·0) for the 6-month visit and 349·0 days (337·0-361·0) for the 12-month visit after symptom onset. The proportion of patients with at least one sequelae symptom decreased from 68% (831/1227) at 6 months to 49% (620/1272) at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterised by mMRC score of 1 or more, slightly increased from 26% (313/1185) at 6-month visit to 30% (380/1271) at 12-month visit (p=0·014). Additionally, more patients had anxiety or depression at 12-month visit (26% [331/1271] at 12-month visit vs 23% [274/1187] at 6-month visit; p=0·015). No significant difference on 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. Compared with men, women had an odds ratio of 1·43 (95% CI 1·04-1·96) for fatigue or muscle weakness, 2·00 (1·48-2·69) for anxiety or depression, and 2·97 (1·50-5·88) for diffusion impairment. Matched COVID-19 survivors at 12 months had more problems with mobility, pain or discomfort, and anxiety or depression, and had more prevalent symptoms than did controls.

Interpretation: Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up, and had returned to their original work and life. The health status in our cohort of COVID-19 survivors at 12 months was still lower than that in the control population.

家园 这篇文章貌似在被调查

具体细节不清楚

家园 有人向《柳叶刀》反映6月和1年的一个数据前后对不上

编辑部已发了关注声明,作者也有了回应,具体细节还未公布。总之,现在有瑕疵需要作者解释。

全看树展主题 · 分页首页 上页
/ 2
下页 末页


有趣有益,互惠互利;开阔视野,博采众长。
虚拟的网络,真实的人。天南地北客,相逢皆朋友

Copyright © cchere 西西河