Objectives To determine the clinical sequelae of long covid for a year after infection in patients with mild disease and to evaluate its association with age, sex, SARS-CoV-2 variants, and vaccination status. Design Retrospective nationwide cohort study. Setting Electronic medical records from an Israeli nationwide healthcare organisation. Population 1 913 234 Maccabi Healthcare Services members of all ages who did a polymerase chain reaction test for SARS-CoV-2 between 1 March 2020 and 1 October 2021. Main outcome measures Risk of an evidence based list of 70 reported long covid outcomes in unvaccinated patients infected with SARS-CoV-2 matched to uninfected people, adjusted for age and sex and stratified by SARS-CoV-2 variants, and risk in patients with a breakthrough SARS-CoV-2 infection compared with unvaccinated infected controls. Risks were compared using hazard ratios and risk differences per 10 000 patients measured during the early (30-180 days) and late (180-360 days) time periods after infection. Results Covid-19 infection was significantly associated with increased risks in early and late periods for anosmia and dysgeusia (hazard ratio 4.59 (95% confidence interval 3.63 to 5.80), risk difference 19.6 (95% confidence interval 16.9 to 22.4) in early period; 2.96 (2.29 to 3.82), 11.0 (8.5 to 13.6) in late period), cognitive impairment (1.85 (1.58 to 2.17), 12.8, (9.6 to 16.1); 1.69 (1.45 to 1.96), 13.3 (9.4 to 17.3)), dyspnoea (1.79 (1.68 to 1.90), 85.7 (76.9 to 94.5); 1.30 (1.22 to 1.38), 35.4 (26.3 to 44.6)), weakness (1.78 (1.69 to 1.88), 108.5, 98.4 to 118.6; 1.30 (1.22 to 1.37), 50.2 (39.4 to 61.1)), and palpitations (1.49 (1.35 to 1.64), 22.1 (16.8 to 27.4); 1.16 (1.05 to 1.27), 8.3 (2.4 to 14.1)) and with significant but lower excess risk for streptococcal tonsillitis and dizziness. Hair loss, chest pain, cough, myalgia, and respiratory disorders were significantly increased only during the early phase. Male and female patients showed minor differences, and children had fewer outcomes than adults during the early phase of covid-19, which mostly resolved in the late period. Findings remained consistent across SARS-CoV-2 variants. Vaccinated patients with a breakthrough SARS-CoV-2 infection had a lower risk for dyspnoea and similar risk for other outcomes compared with unvaccinated infected patients. Conclusions This nationwide study suggests that patients with mild covid-19 are at risk for a small number of health outcomes, most of which are resolved within a year from diagnosis. Data supporting the findings of this study came from Maccabi Healthcare Services. Restrictions apply to the availability of these data, and they are therefore not publicly available. Owing to restrictions, these data can be accessed only by request to the authors and/or Maccabi Healthcare Services.

中文翻译：

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轻度 SARS-CoV-2 感染后一年的长期 covid 结果：全国队列研究

目的 确定轻症患者感染后一年的 long covid 临床后遗症，并评估其与年龄、性别、SARS-CoV-2 变异体和疫苗接种状态的关系。设计回顾性全国队列研究。设置来自以色列全国性医疗机构的电子病历。2020 年 3 月 1 日至 2021 年 10 月 1 日期间对 SARS-CoV-2 进行了聚合酶链反应测试的所有年龄段的 1 913 234 名 Maccabi 医疗保健服务成员。主要结果测量 70 个报告的未接种疫苗长期 covid 结果的循证列表的风险感染 SARS-CoV-2 的患者与未感染者匹配，根据年龄和性别进行调整，并按 SARS-CoV-2 变体分层，以及与未接种疫苗的感染对照相比，突破性 SARS-CoV-2 感染患者的风险。使用感染后早期（30-180 天）和晚期（180-360 天）期间测量的每 10 000 名患者的风险比和风险差异来比较风险。结果 Covid-19 感染与早期和晚期嗅觉障碍和味觉障碍风险增加显着相关（风险比 4.59（95% 置信区间 3.63 至 5.80），早期风险差 19.6（95% 置信区间 16.9 至 22.4）； 2.96（2.29～3.82）、11.0（8.5～13.6）晚期）、认知障碍（1.85（1.58～2.17）、12.8（9.6～16.1）；1.69（1.45～1.96）、13.3（9.4～17.3）） 、呼吸困难（1.79（1.68～1.90）、85.7（76.9～94.5）；1.30（1.22～1.38）、35.4（26.3～44.6）、无力（1.78（1.69～1.88）、108.5、98.4～118.6；1.30（1.22）至 1.37), 50.2 (39.4 至 61.1)), 和心悸 (1.49 (1.35 至 1.64), 22.1 (16.8 至 27.4); 1. 16（1.05 至 1.27）、8.3（2.4 至 14.1）），链球菌性扁桃体炎和头晕的风险显着但较低。脱发、胸痛、咳嗽、肌痛和呼吸系统疾病仅在早期阶段显着增加。在 covid-19 的早期阶段，男性和女性患者表现出细微差异，儿童的预后低于成人，但大部分在晚期得到解决。结果在 SARS-CoV-2 变体中保持一致。与未接种疫苗的感染患者相比，接种疫苗的突破性 SARS-CoV-2 感染患者呼吸困难的风险较低，其他结果的风险相似。结论 这项全国性研究表明，轻度 covid-19 患者存在少数健康结果的风险，其中大部分在诊断后一年内得到解决。支持本研究结果的数据来自 Maccabi Healthcare Services。这些数据的可用性受到限制，因此它们不公开。由于限制，这些数据只能通过向作者和/或 Maccabi Healthcare Services 提出请求来访问。