"长新冠"诊断基础及其对直升机飞行人员作业效能的影响

doi:10.3877/cma.j.issn.2095-655X.2023.03.001

"长新冠"是新型冠状病毒感染(COVID-19)者发病后或无症状感染者确诊后3个月存在的、持续至少2个月，且无法由其他诊断解释的症状。作为2019年冠状病毒感染后部分患者客观存在、多器官系统受累且临床症状多样的综合征，"长新冠"的病理生理学、危险因素和治疗方法尚不明确。但越来越多的证据表明，即使在健康的年轻COVID-19患者中，心脏、肺和凝血功能障碍以及神经精神后遗症也可能发生。这种疾病的潜在表现可能会导致直升机飞行人员作业效能下降，甚至可能导致飞行人员突然丧失能力。鉴于目前"长新冠"对直升机飞行人员的影响鲜有研究，笔者主要从"长新冠"对飞行人员身体各个系统的影响着手，对先前的研究进行总结，旨在厘清"长新冠"的诊断基础以及如何影响飞行人员的作业效能，并从航空卫生保障层面，提出加强"长新冠"直升机飞行人员体检和健康鉴定、做好飞行作业放飞标准把控、飞行全过程卫生监督、疫苗规范化接种、特医食品和营养剂补充及心理综合康复干预的一体化干预措施，为航医做好直升机飞行人员COVID-19康复后的健康保障以及复飞检查提供新思路。

关键词: 长新冠, 作业效能, 疲劳, 认知损伤, 空间定向障碍

Long COVID was defined as a symptom that persisted for at least 2 months after the onset of illness or 3 months after the diagnosis of an asymptomatic person with coronavirus disease 2019 (COVID-19) and could not be explained by other diagnoses. Presently, long COVID, as a syndrome objectively existing in some patients after COVID-19, with multiple organ systems involved and various clinical symptoms, has not yet reached a consensus on the diagnosis. The possible pathophysiology, risk factors, and treatments of long COVID remain unclear, with our current understanding incomplete. Increasing evidences shows that cardiac, pulmonary, and coagulation disorders and neuropsychological sequelae can occur even in healthy young adults with COVID-19. The underlying manifestations may lead to decreased operational effectiveness and potentially cause sudden incapacitation of helicopter aircrews. However, there are few relevant articles on the effect of long COVID on helicopter pilots. Therefore, this article starts with the effect of long COVID on various systems of the body of flying personnel, summarizes previous studies, and aims to clarify the diagnostic basis of long COVID and how it affects the performance of flying personnel. From the perspective of aviation health support, the integrated intervention measures after long COVID are presented concerning strengthening the physical examination and health appraisal of helicopter pilots, controlling flight operation release standards, health supervision throughout the entire flight process, standardized vaccination, supplementation of special medical food and nutrients, and comprehensive psychological rehabilitation intervention. It aims to provide ideas for the health care and re-flight inspection of helicopter flying personnel after recovery from COVID-19 infection.

Key words: Long COVID, Operational efficiency, Fatigue, Cognitive impairment, Spatial disorientation

表1 "长新冠"的常见临床表现

系统	临床表现
呼吸系统	呼吸急促、咳嗽、呼吸困难、胸痛、胸闷等
精神系统	失眠、焦虑、应激、创伤后应激障碍
神经系统	记忆力减退、认知障碍、感觉异常、脑雾、头晕、味觉嗅觉丧失或减退
心血管系统	静息心率增加、心动过速、心悸、低血压、晕厥、直立性心动过速、高血压、心绞痛
胃肠道系统	恶心、腹痛、食欲不振、胃灼热和便秘

表1 "长新冠"的常见临床表现

系统	临床表现
呼吸系统	呼吸急促、咳嗽、呼吸困难、胸痛、胸闷等
精神系统	失眠、焦虑、应激、创伤后应激障碍
神经系统	记忆力减退、认知障碍、感觉异常、脑雾、头晕、味觉嗅觉丧失或减退
心血管系统	静息心率增加、心动过速、心悸、低血压、晕厥、直立性心动过速、高血压、心绞痛
胃肠道系统	恶心、腹痛、食欲不振、胃灼热和便秘

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The diagnostic basis of long COVID and its effects on the operational efficiency for helicopter pilots

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The diagnostic basis of long COVID and its effects on the operational efficiency for helicopter pilots