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美國(guó)CDC公布“長(zhǎng)新冠”造成的死亡人數(shù)

ERIN PRATER
2022-12-17

“但這一數(shù)字可能被低估了,?!?

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莉莉·唐斯(Lilly Downs)曾因“長(zhǎng)新冠”進(jìn)出醫(yī)院,。圖中她在丹佛落基山兒童醫(yī)院愛撫工作犬波西(Posey),。圖片來源:HYOUNG CHANG/THE DENVER POST

我們都聽說過“長(zhǎng)新冠”(long COVID),這種神秘的疾病在人們首次感染新冠病毒后會(huì)折磨他們數(shù)周甚至數(shù)月,。但直到現(xiàn)在,,衛(wèi)生當(dāng)局還沒有統(tǒng)計(jì)出有多少死亡病例與“長(zhǎng)新冠”有關(guān)。

一份新發(fā)布的聯(lián)邦報(bào)告顯示,,在疫情的頭兩年半時(shí)間里,,略多于3500名美國(guó)人的死亡證明上包含了“長(zhǎng)新冠”。這是理解新情況的一大突破,。但這一數(shù)字準(zhǔn)確嗎?

這項(xiàng)研究由美國(guó)疾病控制和預(yù)防中心的生命統(tǒng)計(jì)系統(tǒng)進(jìn)行,,研究了將新冠肺炎列為死因的死亡證明,它們都提到了與“長(zhǎng)新冠”相關(guān)的一些關(guān)鍵詞,,包括新冠肺炎急性后遺癥(PASC),、“后新冠”和“新冠長(zhǎng)期癥狀”。死亡病例死亡時(shí)間在2020年1月1日至今年6月30日之間,。

據(jù)報(bào)告,,大多數(shù)與“長(zhǎng)新冠”有關(guān)的死亡病例是白人(近79%)。黑人占此類死亡人數(shù)的10%,其次是西班牙裔(8%),。所有其他種族的死亡人數(shù)不到2%,。

美國(guó)公共衛(wèi)生協(xié)會(huì)執(zhí)行董事喬治?本杰明(Georges Benjamin)博士在接受《財(cái)富》雜志采訪時(shí)表示,3500人這一數(shù)字“可能被低估了”,。這是因?yàn)榇_定這類死亡的方法很粗略,,而且這是疫病早期的情況。報(bào)告稱,,所有“長(zhǎng)新冠”死亡病例都被歸類為新冠肺炎,,因?yàn)椤伴L(zhǎng)新冠”還不是一個(gè)單獨(dú)的死因類別。

他說:“隨著臨床醫(yī)生更好地識(shí)別和記錄與新冠肺炎相關(guān)的死亡(包括急性新冠和長(zhǎng)新冠),,以及“長(zhǎng)新冠”病例的高峰期在整個(gè)系統(tǒng)中被記錄下來,,“長(zhǎng)新冠”造成的死亡人數(shù)將上升。我們還沒有看到這類病例的最高點(diǎn),?!?/p>

約翰斯·霍普金斯衛(wèi)生安全中心的傳染病專家和高級(jí)學(xué)者阿梅什·阿達(dá)爾賈(Amesh Adalja)博士說,對(duì)上述研究很難加以解釋,,因?yàn)樗耙蕾囉谝环N診斷標(biāo)準(zhǔn)不明確的疾病的死亡證明數(shù)據(jù)”,。

“長(zhǎng)新冠”沒有統(tǒng)一的定義,通常被定義為新冠病毒感染后出現(xiàn)或持續(xù)數(shù)周或數(shù)月的新癥狀,。世界衛(wèi)生組織將這種情況定義為首次感染三個(gè)月后出現(xiàn)或持續(xù)的新癥狀,,這些癥狀持續(xù)兩個(gè)月或更長(zhǎng)時(shí)間,沒有其他解釋,。但其他組織,,如美國(guó)疾病控制和預(yù)防中心,有不同的定義,。

阿達(dá)爾賈說,,這樣的數(shù)據(jù)“對(duì)于這樣的事情來說是不可靠的”,并補(bǔ)充說,,很重要的一點(diǎn)是,,要區(qū)分那些直接死于“長(zhǎng)新冠”的患者和那些患有“長(zhǎng)新冠”、但或許死于其他疾病的患者,。

此外,,他補(bǔ)充說,新冠病毒感染重癥患者在康復(fù)后的一段時(shí)間內(nèi)死亡風(fēng)險(xiǎn)可能仍然很高,。但這種死亡可能被,、也可能不被歸類為“長(zhǎng)新冠”,這取決于人們對(duì)這種疾病的定義,。

“要理解這樣的現(xiàn)象,,需要更多的數(shù)據(jù)粒度,。”他說,。

2020年9月,,世界衛(wèi)生組織批準(zhǔn)將“后新冠癥狀”作為一種死因。上述新研究的作者寫道,,但這一類別還沒有在美國(guó)實(shí)施,,并補(bǔ)充說他們的研究將為其實(shí)施鋪平道路。

根據(jù)本月發(fā)表在《柳葉刀》附屬雜志上的一項(xiàng)具有里程碑意義的研究,,近一半的新冠肺炎幸存者(包括兒童和成人)在四個(gè)月后仍有持續(xù)的癥狀,。研究者們對(duì)針對(duì)近75萬名既往新冠肺炎病毒感染者的近200項(xiàng)研究進(jìn)行了分析。

根據(jù)美國(guó)人口普查局今年夏天收集的數(shù)據(jù),,近20%的美國(guó)成年人(估計(jì)有5000萬人)報(bào)告患有“長(zhǎng)新冠”。

許多專家認(rèn)為,,“長(zhǎng)新冠”最好被定義為新冠肺炎病毒感染后出現(xiàn)的慢性疲勞綜合征樣癥狀,,類似于感染皰疹、萊姆病甚至埃博拉病毒后可能出現(xiàn)的其他病毒后綜合征,。他們說,,其他后新冠并發(fā)癥,如器官損傷和重癥監(jiān)護(hù)后綜合征,,不應(yīng)被定義為“長(zhǎng)新冠”,。(財(cái)富中文網(wǎng))

譯者:中慧言-王芳

我們都聽說過“長(zhǎng)新冠”(long COVID),這種神秘的疾病在人們首次感染新冠病毒后會(huì)折磨他們數(shù)周甚至數(shù)月,。但直到現(xiàn)在,,衛(wèi)生當(dāng)局還沒有統(tǒng)計(jì)出有多少死亡病例與“長(zhǎng)新冠”有關(guān)。

一份新發(fā)布的聯(lián)邦報(bào)告顯示,,在疫情的頭兩年半時(shí)間里,,略多于3500名美國(guó)人的死亡證明上包含了“長(zhǎng)新冠”。這是理解新情況的一大突破,。但這一數(shù)字準(zhǔn)確嗎?

這項(xiàng)研究由美國(guó)疾病控制和預(yù)防中心的生命統(tǒng)計(jì)系統(tǒng)進(jìn)行,,研究了將新冠肺炎列為死因的死亡證明,它們都提到了與“長(zhǎng)新冠”相關(guān)的一些關(guān)鍵詞,,包括新冠肺炎急性后遺癥(PASC),、“后新冠”和“新冠長(zhǎng)期癥狀”。死亡病例死亡時(shí)間在2020年1月1日至今年6月30日之間,。

據(jù)報(bào)告,,大多數(shù)與“長(zhǎng)新冠”有關(guān)的死亡病例是白人(近79%)。黑人占此類死亡人數(shù)的10%,,其次是西班牙裔(8%),。所有其他種族的死亡人數(shù)不到2%,。

美國(guó)公共衛(wèi)生協(xié)會(huì)執(zhí)行董事喬治?本杰明(Georges Benjamin)博士在接受《財(cái)富》雜志采訪時(shí)表示,3500人這一數(shù)字“可能被低估了”,。這是因?yàn)榇_定這類死亡的方法很粗略,,而且這是疫病早期的情況。報(bào)告稱,,所有“長(zhǎng)新冠”死亡病例都被歸類為新冠肺炎,,因?yàn)椤伴L(zhǎng)新冠”還不是一個(gè)單獨(dú)的死因類別。

他說:“隨著臨床醫(yī)生更好地識(shí)別和記錄與新冠肺炎相關(guān)的死亡(包括急性新冠和長(zhǎng)新冠),,以及“長(zhǎng)新冠”病例的高峰期在整個(gè)系統(tǒng)中被記錄下來,,“長(zhǎng)新冠”造成的死亡人數(shù)將上升。我們還沒有看到這類病例的最高點(diǎn),?!?/p>

約翰斯·霍普金斯衛(wèi)生安全中心的傳染病專家和高級(jí)學(xué)者阿梅什·阿達(dá)爾賈(Amesh Adalja)博士說,對(duì)上述研究很難加以解釋,,因?yàn)樗耙蕾囉谝环N診斷標(biāo)準(zhǔn)不明確的疾病的死亡證明數(shù)據(jù)”,。

“長(zhǎng)新冠”沒有統(tǒng)一的定義,通常被定義為新冠病毒感染后出現(xiàn)或持續(xù)數(shù)周或數(shù)月的新癥狀,。世界衛(wèi)生組織將這種情況定義為首次感染三個(gè)月后出現(xiàn)或持續(xù)的新癥狀,,這些癥狀持續(xù)兩個(gè)月或更長(zhǎng)時(shí)間,沒有其他解釋,。但其他組織,,如美國(guó)疾病控制和預(yù)防中心,有不同的定義,。

阿達(dá)爾賈說,,這樣的數(shù)據(jù)“對(duì)于這樣的事情來說是不可靠的”,并補(bǔ)充說,,很重要的一點(diǎn)是,,要區(qū)分那些直接死于“長(zhǎng)新冠”的患者和那些患有“長(zhǎng)新冠”、但或許死于其他疾病的患者,。

此外,,他補(bǔ)充說,新冠病毒感染重癥患者在康復(fù)后的一段時(shí)間內(nèi)死亡風(fēng)險(xiǎn)可能仍然很高,。但這種死亡可能被,、也可能不被歸類為“長(zhǎng)新冠”,這取決于人們對(duì)這種疾病的定義,。

“要理解這樣的現(xiàn)象,,需要更多的數(shù)據(jù)粒度?!彼f,。

2020年9月,,世界衛(wèi)生組織批準(zhǔn)將“后新冠癥狀”作為一種死因。上述新研究的作者寫道,,但這一類別還沒有在美國(guó)實(shí)施,,并補(bǔ)充說他們的研究將為其實(shí)施鋪平道路。

根據(jù)本月發(fā)表在《柳葉刀》附屬雜志上的一項(xiàng)具有里程碑意義的研究,,近一半的新冠肺炎幸存者(包括兒童和成人)在四個(gè)月后仍有持續(xù)的癥狀,。研究者們對(duì)針對(duì)近75萬名既往新冠肺炎病毒感染者的近200項(xiàng)研究進(jìn)行了分析。

根據(jù)美國(guó)人口普查局今年夏天收集的數(shù)據(jù),,近20%的美國(guó)成年人(估計(jì)有5000萬人)報(bào)告患有“長(zhǎng)新冠”,。

許多專家認(rèn)為,“長(zhǎng)新冠”最好被定義為新冠肺炎病毒感染后出現(xiàn)的慢性疲勞綜合征樣癥狀,,類似于感染皰疹,、萊姆病甚至埃博拉病毒后可能出現(xiàn)的其他病毒后綜合征。他們說,,其他后新冠并發(fā)癥,,如器官損傷和重癥監(jiān)護(hù)后綜合征,不應(yīng)被定義為“長(zhǎng)新冠”,。(財(cái)富中文網(wǎng))

譯者:中慧言-王芳

We’ve all heard of long COVID, the mysterious ailment that plagues people for weeks and months after they first become infected with the virus still gripping the world. But health authorities haven’t tallied how many deaths were related to it—until now.

A newly released federal report shows that long COVID was included on the death certificates of slightly more than 3,500 Americans in the first two and a half years of the pandemic. It’s a breakthrough for understanding the new condition. But is the number accurate?

The study, performed by the U.S. Centers for Disease Control and Prevention’s Vital Statistics System, examined death certificates that listed COVID as the cause of death with keywords referring to long COVID, including post-acute sequelae of COVID-19 (PASC), “post COVID,” and “l(fā)ong haul COVID.” The deaths occurred between Jan. 1, 2020, and June 30 of this year.

The majority of deaths with long COVID ties were reported among white people (nearly 79%). Black people accounted for 10% of such deaths, followed by Hispanic people (8%). All other racial groups comprised less than 2% of such deaths.

The 3,500 figure is “probably an undercount,” Dr. Georges Benjamin, executive director of the American Public Health Association, told Fortune. That’s because the method to determine such deaths is crude, and the fact that it’s early in the history of the disease. All long COVID deaths were coded for COVID because a cause-of-death code for long COVID hasn’t been implemented, according to the report.

“Long COVID deaths will go up as clinicians get better at identifying and recording COVID-related deaths (both acute and long COVID), and as the peak of long COVID cases moves through the system,” he said. “We have not yet seen the peak in cases of long COVID.”

Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security, said the study is difficult to interpret because it “relies on death certificate data for a condition that has nebulous diagnostic criteria.”

There is no agreed-upon definition of long COVID, generally defined as new symptoms that occur or persist after a COVID infection and last for weeks or months. The World Health Organization defines the condition as the continuation or development of new symptoms three months after the initial infection, with those symptoms lasting for two or more months, without other explanation. But other organizations like the CDC have definitions that vary.

Such data is “not reliable for something like this,” Adalja said, adding that it’s important to distinguish deaths due to long COVID from deaths among individuals with long COVID.

Additionally, the risk of death in those with a severe COVID infection may remain high for a period of time after they recover, he added. But such a death may or may not be classified as a long COVID death, depending on one’s definition of the condition.

“There needs to be much more granularity to be able to understand a phenomenon like this,” he said.

In September 2020, the WHO approved a cause-of-death code for post-COVID conditions. It hasn’t been implemented in the U.S., the authors wrote, adding that their new study will pave the way for its implementation.

Almost half of COVID survivors—both children and adults—had lingering symptoms four months later, according to a landmark study published this month in an affiliate journal of The Lancet. Researchers performed an analysis of nearly 200 studies on prior COVID patients involving nearly 750,000 people around the globe.

Nearly 20% of American adults who’ve had COVID—an estimated 50 million—report having long COVID symptoms, according to data collected by the U.S. Census Bureau this summer.

Many experts contend that long COVID is best defined as a chronic-fatigue-syndrome-like condition that develops after COVID illness, similar to other post-viral syndromes that can occur after infection with herpes, Lyme disease, and even Ebola. Other post-COVID complications, like organ damage and post–intensive-care syndrome, should not be defined as long COVID, they say.

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