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Gorenshtein A, Leibovitch L, Liba T, Stern S, Stern Y. Gender Disparities in Neurological Symptoms of Long COVID: A Systematic Review and Meta-Analysis. Neuroepidemiology 2024:1-15. [PMID: 39159607 DOI: 10.1159/000540919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Female gender is a known risk factor for long COVID. With the increasing number of COVID-19 cases, the corresponding number of survivors is also expected to rise. To the best of our knowledge, no systematic review has specifically addressed the gender differences in neurological symptoms of long COVID. METHODS We included studies on female individuals who presented with specific neurological symptoms at least 12 weeks after confirmed COVID-19 diagnosis from PubMed, Central, Scopus, and Web of Science. The search limit was put for after January 2020 until June 15, 2024. We excluded studies that did not provide sex-specific outcome data, those not in English, case reports, case series, and review articles Results: A total of 5,632 eligible articles were identified. This article provides relevant information from 12 studies involving 6,849 patients, of which 3,414 were female. The sample size ranged from 70 to 2,856, with a maximum follow-up period of 18 months. The earliest publication date was September 16, 2021, while the latest was June 11, 2024. The following neurological symptoms had a significant difference in the risk ratio (RR) for female gender: fatigue RR 1.40 (95% confidence interval [CI]: 1.22-1.60, p < 0.001), headache RR 1.37 (95% CI: 1.12-1.67, p = 0.002), brain-fog RR 1.38 (95% CI 1.08-1.76, p = 0.011) depression RR 1.49 (95% CI: 1.2-1.86, p < 0.001), and anosmia RR 1.61 (95% CI: 1.36-1.90, p < 0.001). High heterogenicity was found for fatigue, brain fog, and anxiety due to the diverse methodologies employed in the studies. CONCLUSION Our findings suggest that women are at a higher risk for long-COVID neurological symptoms, including fatigue, headaches, brain fog, depression, and anosmia, compared to men. The prevalence of these symptoms decreases after 1 year, based on limited data from the small number of studies available beyond this period.
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Affiliation(s)
| | | | - Tom Liba
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Shai Stern
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Yael Stern
- Maccabi Healthcare Services, Tel Aviv, Israel
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Brandes LE, Orme D, Bermeo-Ovalle A, Sierra Morales F. Clinical and diagnostic features of long-COVID patients presenting with neurologic symptoms in Chicago. J Neural Transm (Vienna) 2024; 131:961-969. [PMID: 38847905 DOI: 10.1007/s00702-024-02789-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/13/2024] [Indexed: 08/24/2024]
Abstract
Long COVID, a condition characterized by persistent symptoms after COVID-19 infection, is increasingly being recognized worldwide. Neurologic symptoms are frequently reported in survivors of COVID-19, making it crucial to better understand this phenomenon both on a societal scale and for the quality of life of these patients. Between January 1, 2020, and July 31, 2022, Illinois (IL) had a standardized cumulative death rate that ranked it 24th out of the 51 states in the United States (US). However, the US had one of the highest per capita COVID-19 death rates among large, high-income countries. [Bollyky T. et al. 2023] As a result of the increased number of COVID-19 infections, there was a rise in the number of patients experiencing Long COVID. At our neuro-infectious disease clinic in Chicago (IL), we observed an increasing number of patients presenting with cognitive and other neurologic symptoms after contracting COVID-19. Initially, we needed to provide these individuals with a better understanding of their condition and expected outcomes. We were thus motivated to further evaluate this group of patients for any patterns in presentation, neurologic findings, and diagnostic testing that would help us better understand this phenomenon. We aim to contribute to the growing body of research on Long COVID, including its presentation, diagnostic testing results, and outcomes to enlighten the long COVID syndrome. We hypothesize that the neurological symptoms resulting from long COVID persist for over 12 months. We conducted a retrospective analysis of clinical data from 44 patients with long-COVID. Cognitive symptoms were the most common presenting concern. Abnormalities in Montreal Cognitive Assessment, electroencephalogram, serum autoantibody testing, and cerebrospinal fluid were found in minority subsets of our cohort. At 12 months, most patients continue to experience neurologic symptoms, though more than half reported moderate or marked improvement compared to initial presentation. Although most of the patients in this study did not show a consistent occurrence of symptoms suggesting a cohesive underlying etiology, our clinical data demonstrated some features of Long COVID patients in Chicago (IL) that could lead to new research avenues, helping us better understand this syndrome that affects patients worldwide.
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Affiliation(s)
- Lauren E Brandes
- Department of Neurology, Rush University Medical Center, Chicago, USA
| | - Daniel Orme
- Department of Neurology, Rush University Medical Center, Chicago, USA
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Schild AK, Scharfenberg D, Regorius A, Klein K, Kirchner L, Yasemin G, Lülling J, Meiberth D, Schweitzer F, Fink GR, Jessen F, Franke C, Onur OA, Jost ST, Warnke C, Maier F. Six-month follow-up of multidomain cognitive impairment in non-hospitalized individuals with post-COVID-19 syndrome. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01863-3. [PMID: 39048833 DOI: 10.1007/s00406-024-01863-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/03/2024] [Indexed: 07/27/2024]
Abstract
Some people infected with SARS-CoV-2 report persisting symptoms following acute infection. If these persist for over three months, they are classified as post-COVID-19 syndrome (PCS). Although PCS is frequently reported, detailed longitudinal neuropsychological characterization remains scarce. We aimed to describe the trajectory of cognitive and neuropsychiatric PCS symptoms. 42 individuals with persisting cognitive deficits after asymptomatic to mild/moderate acute COVID-19 at study inclusion received neuropsychological assessment at baseline (BL) and follow-up (FU; six months after BL). Assessments included comprehensive testing of five neurocognitive domains, two cognitive screening tests, and questionnaires on depression, anxiety, sleep, fatigue, and health-related quality of life. Results showed high rates of subjective cognitive complaints at BL and FU (95.2% versus 88.1%) without significant change over time. However, objectively measured neurocognitive disorder (NCD) decreased (61.9% versus 42.9%). All cognitive domains were affected, yet most deficits were found in learning and memory, followed by executive functions, complex attention, language, and perceptual motor functions. In individuals with NCD, the first three domains mentioned improved significantly over time, while the last two domains remained unchanged. Cognitive screening tests did not prove valuable in detecting impairment. Neuropsychiatric symptoms remained constant except for quality of life, which improved. This study emphasizes the importance of comprehensive neuropsychological assessment in longitudinal research and provides valuable insights into the trajectory of long-term neuropsychological impairments in PCS. While cognitive performance significantly improved in many domains, neuropsychiatric symptoms remained unchanged.
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Affiliation(s)
- Ann-Katrin Schild
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Daniel Scharfenberg
- Department of Medical Psychology ǀ Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anton Regorius
- Department of Psychology, Clinical Psychology, Experimental Psychopathology, and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Kim Klein
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lukas Kirchner
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Goereci Yasemin
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joachim Lülling
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dix Meiberth
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Finja Schweitzer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gereon R Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Frank Jessen
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Christiana Franke
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Oezguer A Onur
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Stefanie Theresa Jost
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Franziska Maier
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Won JH, Hong Y, Kim S, Lee H. One-year post-acute COVID-19 syndrome and mortality in South Korea: a nationwide matched cohort study using claims data. Front Public Health 2024; 12:1403153. [PMID: 39050601 PMCID: PMC11266063 DOI: 10.3389/fpubh.2024.1403153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
Background Current understanding of post-COVID-19 syndrome in South Korea is primarily based on survey studies or research targeting specific patient groups, such as those hospitalized. Moreover, the majority of relevant studies have been conducted in European and North American populations, which may limit their applicability to the South Korean context. To address this gap, our study explores the one-year outcomes of COVID-19, focusing on the potential post-acute syndrome and all-cause mortality in South Korea. Methods This retrospective cohort study used nationwide claims data in South Korea, including adults aged >18 with records between January 20, 2020, and February 25, 2021. Patients were classified into COVID-19 and non-COVID-19 groups and matched 1:1 based on propensity scores. Primary outcomes were 12-month post-acute COVID-19 syndrome and all-cause mortality. Results The study involved 34,802 matched patients. The COVID-19 group had significantly elevated risks of coagulopathies (OR = 2.70 [2.24, 3.28]; p < 0.001), chronic lower respiratory diseases (OR = 1.96 [1.80, 2.14]; p < 0.001), symptoms of the circulatory and respiratory systems (OR = 1.91 [1.80, 2.04]; p < 0.001), mood disorders (OR = 1.67 [1.51, 1.86]; p < 0.001), cardiac diseases (OR = 1.39 [1.21, 1.59]; p < 0.001), and symptoms of cognition, perception, emotional state, and behavior (OR = 1.15 [1.04, 1.27]; p = 0.005). All-cause mortality was higher in the COVID-19 group during the 6 months (OR = 1.34 [1.06, 1.69]; p = 0.015), but gradually decreased, reaching an OR of 0.996 ([0.83, 1.19]; p = 0.964) at 1 year. Conclusion In South Korea, the 12-month post-acute COVID-19 syndrome includes coagulopathies, respiratory issues, mood disorders, and cardiac diseases. The risk of all-cause mortality post-COVID-19 is heightened for up to 6 months, then significantly decreases and resolves within a year.
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Affiliation(s)
- Jung-Hyun Won
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Yesol Hong
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Siun Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Howard Lee
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- Center for Convergence Approaches in Drug Development, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul, Republic of Korea
- Advanced Institute of Convergence Technology, Suwon, Republic of Korea
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Sk Abd Razak R, Ismail A, Abdul Aziz AF, Suddin LS, Azzeri A, Sha'ari NI. Post-COVID syndrome prevalence: a systematic review and meta-analysis. BMC Public Health 2024; 24:1785. [PMID: 38965510 PMCID: PMC11223303 DOI: 10.1186/s12889-024-19264-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/25/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Since the Coronavirus disease 2019 (COVID-19) pandemic began, the number of individuals recovering from COVID-19 infection have increased. Post-COVID Syndrome, or PCS, which is defined as signs and symptoms that develop during or after infection in line with COVID-19, continue beyond 12 weeks, and are not explained by an alternative diagnosis, has also gained attention. We systematically reviewed and determined the pooled prevalence estimate of PCS worldwide based on published literature. METHODS Relevant articles from the Web of Science, Scopus, PubMed, Cochrane Library, and Ovid MEDLINE databases were screened using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic search process. The included studies were in English, published from January 2020 to April 2024, had overall PCS prevalence as one of the outcomes studied, involved a human population with confirmed COVID-19 diagnosis and undergone assessment at 12 weeks post-COVID infection or beyond. As the primary outcome measured, the pooled prevalence of PCS was estimated from a meta-analysis of the PCS prevalence data extracted from individual studies, which was conducted via the random-effects model. This study has been registered on PROSPERO (CRD42023435280). RESULTS Forty eight studies met the eligibility criteria and were included in this review. 16 were accepted for meta-analysis to estimate the pooled prevalence for PCS worldwide, which was 41.79% (95% confidence interval [CI] 39.70-43.88%, I2 = 51%, p = 0.03). Based on different assessment or follow-up timepoints after acute COVID-19 infection, PCS prevalence estimated at ≥ 3rd, ≥ 6th, and ≥ 12th months timepoints were each 45.06% (95% CI: 41.25-48.87%), 41.30% (95% CI: 34.37-48.24%), and 41.32% (95% CI: 39.27-43.37%), respectively. Sex-stratified PCS prevalence was estimated at 47.23% (95% CI: 44.03-50.42%) in male and 52.77% (95% CI: 49.58-55.97%) in female. Based on continental regions, pooled PCS prevalence was estimated at 46.28% (95% CI: 39.53%-53.03%) in Europe, 46.29% (95% CI: 35.82%-56.77%) in America, 49.79% (95% CI: 30.05%-69.54%) in Asia, and 42.41% (95% CI: 0.00%-90.06%) in Australia. CONCLUSION The prevalence estimates in this meta-analysis could be used in further comprehensive studies on PCS, which might enable the development of better PCS management plans to reduce the effect of PCS on population health and the related economic burden.
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Affiliation(s)
- Ruhana Sk Abd Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Aniza Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia.
- Faculty of Public Health, Universitas Sumatera Utara, Jalan Universitas No. 21 Kampus USU, Medan, North Sumatra, 20155, Indonesia.
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Leny Suzana Suddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi (UiTM) MARA, Sungai Buloh, Selangor, Malaysia
| | - Amirah Azzeri
- Department of Primary Care, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Persiaran Ilmu, Putra Nilai, Nilai, Negeri Sembilan, 71800, Malaysia
| | - Nur Insyirah Sha'ari
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
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Sung S, Kim SH, Kim Y, Bae YS, Chie EK. Exploring depressive symptom trajectories in COVID-19 patients with clinically mild condition in South Korea using remote patient monitoring: longitudinal data analysis. Front Public Health 2024; 12:1265848. [PMID: 38660352 PMCID: PMC11039781 DOI: 10.3389/fpubh.2024.1265848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Background During the height of the COVID-19 pandemic, the Korean government temporarily allowed full scale telehealth care for safety and usability. However, limited studies have evaluated the impact of telehealth by analyzing the physical and/or mental health data of patients with COVID-19 diagnosis collected through telehealth targeting Korean population. Objective This study aimed to identify subgroup of depressive symptom trajectories in patients with clinically mild COVID-19 using collected longitudinal data from a telehealth-based contactless clinical trial. Methods A total of 199 patients with COVID-19 were accrued for contactless clinical trial using telehealth from March 23 to July 20, 2022. Depressive symptoms were measured using the patient health questionnaire-9 on the start day of quarantine, on the final day of quarantine, and 1 month after release from quarantine. Additionally, acute COVID-19 symptoms were assessed every day during quarantine. This study used a latent class mixed model to differentiate subgroups of depressive symptom trajectories and a logistic regression model with Firth's correction to identify associations between acute COVID-19 symptoms and the subgroups. Results Two latent classes were identified: class 1 with declining linearity at a slow rate and class 2 with increasing linearity. Among COVID-19 symptoms, fever, chest pain, and brain fog 1 month after release from quarantine showed strong associations with class 2 (fever: OR, 19.43, 95% CI, 2.30-165.42; chest pain: OR, 6.55, 95% CI, 1.15-34.61; brain fog: OR, 7.03, 95% CI 2.57-20.95). Sleeping difficulty and gastrointestinal symptoms were also associated with class 2 (gastrointestinal symptoms: OR, 4.76, 95% CI, 1.71-14.21; sleeping difficulty: OR, 3.12, 95% CI, 1.71-14.21). Conclusion These findings emphasize the need for the early detection of depressive symptoms in patients in the acute phase of COVID-19 using telemedicine. Active intervention, including digital therapeutics, may help patients with aggravated depressive symptoms.
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Affiliation(s)
- Sumi Sung
- Department of Nursing Science, Research Institute of Nursing Science, Chungbuk National University, Cheongju, Chungcheongbuk-do, Republic of Korea
| | - Su Hwan Kim
- Department of Information Statistics, Gyeongsang National University, Jinju, Gyeongsangnam-do, Republic of Korea
| | - Youlim Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ye Seul Bae
- Division of Healthcare Planning, Bigdata Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eui Kyu Chie
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
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Barilaite E, Watson H, Hocaoglu MB. Understanding Patient-Reported Outcome Measures Used in Adult Survivors Experiencing Long-Term Effects After COVID-19 Infection: A Rapid Review. J Patient Cent Res Rev 2024; 11:36-50. [PMID: 38596351 PMCID: PMC11000699 DOI: 10.17294/2330-0698.2041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Purpose Patient-reported outcome measures (PROMs) are used in individuals experiencing long-term effects from COVID-19 infection, or Long COVID, to evaluate the quality of life and functional status of these individuals. However, little is known about which PROMs are being utilised and the psychometric properties of these PROMs. Our purpose was thus to explore which PROMs are used in Long COVID patients and to discuss the psychometric properties of the PROMs. Methods For this rapid review, a systematic literature search was performed in the PubMed, Embase, and CINAHL databases. The found studies were screened using the PRISMA flowchart. We then performed study quality appraisal and assessed the psychometric properties of the found PROMs. Results Per the systematic literature search and after removal of duplicates, 157 publications were identified for individual screening. After screening and eligibility assessment, 74 articles were selected for our review. In total, 74 PROMs were used and primarily comprised quality of life, fatigue, breathlessness, mental health, and smell/taste issues in COVID "long haulers." Five studies used newly developed, COVID-19-specific PROMs. We assessed the psychometric properties of the 10 most-used PROMs. The majority were found to be reliable and valid instruments. EQ-5D-5L was the most popular and highly rated PROM. Conclusions We assessed PROMs used in Long COVID patients and evaluated their psychometric properties. EQ-5D-5L was the most favourably rated PROM. PROMs addressing mental health issues are crucial in managing anxiety and depression in Long COVID patients. New COVID-specific PROMs assess functional status and smell/taste perception and show great utilisation potential in olfactory training at COVID smell clinics. However, many reviewed PROMs currently lack sufficient analysis of their psychometric properties. Therefore, future research needs to examine these measures.
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Affiliation(s)
- Egle Barilaite
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
| | - Harry Watson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
| | - Mevhibe B Hocaoglu
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
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Lee JE, Kang DH, Kim SY, Kim DK, Lee SI. Clinical Manifestations and Outcomes of Older Patients with COVID-19: A Comprehensive Review. Tuberc Respir Dis (Seoul) 2024; 87:145-154. [PMID: 38368903 PMCID: PMC10990616 DOI: 10.4046/trd.2023.0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/17/2023] [Accepted: 01/13/2024] [Indexed: 02/20/2024] Open
Abstract
The consequences of coronavirus disease 2019 (COVID-19) are particularly severe in older adults with a disproportionate number of severe and fatal outcomes. Therefore, this integrative review aimed to provide a comprehensive overview of the clinical characteristics, management approaches, and prognosis of older patients diagnosed with COVID-19. Common clinical presentations in older patients include fever, cough, and dyspnea. Additionally, preexisting comorbidities, especially diabetes and pulmonary and cardiovascular diseases, were frequently observed and associated with adverse outcomes. Management strategies varied, however, early diagnosis, vigilant monitoring, and multidisciplinary care were identified as key factors for enhancing patient outcomes. Nonetheless, the prognosis remains guarded for older patients, with increased rates of hospitalization, mechanical ventilation, and mortality. However, timely therapeutic interventions, especially antiviral and supportive treatments, have demonstrated some efficacy in mitigating the severe consequences in this age group. In conclusion, while older adults remain highly susceptible to severe outcomes from COVID-19, early intervention, rigorous monitoring, and comprehensive care can play a pivotal role in improving their clinical outcomes.
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Affiliation(s)
- Jeong Eun Lee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Da Hyun Kang
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - So-Yun Kim
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Duk Ki Kim
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Song I Lee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Sirait SRA, Sinaga BYM, Tarigan AP, Wahyuni AS. Factors associated with cognitive impairment and the quality-of-life among COVID-19 survivors working as healthcare workers. NARRA J 2024; 4:e658. [PMID: 38798859 PMCID: PMC11125409 DOI: 10.52225/narra.v4i1.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/18/2024] [Indexed: 05/29/2024]
Abstract
Prolonged physical and mental health changes, known as post-COVID conditions (PCC), could impair the quality-of-life (QoL) of healthcare workers. The aim of this study was to identify factors that contribute to cognitive impairments and QoL among COVID-19 survivors working as healthcare workers. This cross-sectional study involved healthcare workers at Prof. Dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia. The Montreal Cognitive Assessment (MoCA) was used to assess the cognitive function, while the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF) questionnaire was used to evaluate the QoL. Factors associated with cognitive and QoL status were examined using Mann-Whitney and Chi-squared tests. A total of 100 COVID-19 survivors were included in the study, most of whom were female (74%), aged ≤35 years (95%), and were doctors (62%). Only 22% of the participants had a normal BMI, 93% had a history of mild COVID-19, and 54% had one comorbidity. The Overall MoCA score averaged 24.18±2.86, indicating mild cognitive impairment among the groups. The distribution of MoCA scores had similar patterns with no significant differences based on age, gender, comorbidities, BMI, COVID-19 severity, and frequency of COVID-19 infection. Interestingly, the number of vaccine doses received by the participants had a statistically significant associated with MoCA scores of which those receiving more than two doses had higher cognitive scores than those with only two doses (p=0.008). Based on categorized MoCA scores (normal vs cognitive impairment), none assessed factors were not significantly associated with cognitive outcomes. The WHOQOL-BREF scores ranged from 62.5 to 95.5, with a mean±SD of 83.67±7.03. None of the assessed factors were associated with WHOQOL-BREF scores among COVID-19 survivors. These findings highlight the need for further study to explore the protective role of vaccination frequency in cognitive impairment and the factors underlying the resilience in QoL among survivors.
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Affiliation(s)
- Sondang RA. Sirait
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Bintang YM. Sinaga
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Prof. Dr. Chairuddin P Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Amira P. Tarigan
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Pulmonology and Respiratory Medicine, Prof. Dr. Chairuddin P Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia
| | - Arlinda S. Wahyuni
- Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Kwon Y, Park J, An E, Jung S, Kweon K. Impact of Omicron-Variant SARS-CoV-2 Infection on Depression and Anxiety: A Community-Based Study in Korea. Psychiatry Investig 2024; 21:415-421. [PMID: 38695049 PMCID: PMC11065529 DOI: 10.30773/pi.2023.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/26/2023] [Accepted: 01/21/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE This study seeks to evaluate the association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the severity of depression and anxiety in the Korean community during the period dominated by the Omicron variant. METHODS We used data from the 2022 Daejeon Mental Health Survey, involving data of 985 participants aged 19-69 years. The data collected included SARS-CoV-2 infection experience, days post-infection, and depression and anxiety symptoms evaluated using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Questionnaire-7, respectively. Additionally, physical health, social activity status, and sociodemographic characteristics such as gender, age, marital status, educational level, and household income were collected. The association between SARS-CoV-2 infection and depression and anxiety were examined. Further analyses explored association between days post- infection and the severity of depression and anxiety. RESULTS There was no significant correlation between SARS-CoV-2 infection and depression and anxiety in the overall population. Notably, participants under 50 years of age exhibited a transient worsening of depression and anxiety, followed by a decrease in symptoms within 40 days. Participants aged 51 years and older showed no significant change in depression and anxiety. CONCLUSION This study discerned transient effects of Omicron variant infection on depression and anxiety, particularly in younger individuals. A prospective study encompassing a larger sample size is imperative to investigate the influence of SARS-CoV-2 infection on depression and anxiety.
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Affiliation(s)
- Youngsook Kwon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jina Park
- Institute of Brain Research, Chungnam National University, Daejeon, Republic of Korea
| | - Eunkyoung An
- Institute of Brain Research, Chungnam National University, Daejeon, Republic of Korea
| | - Sukyoung Jung
- Chungnam National University Biomedical Research Institute, Daejeon, Republic of Korea
| | - Kukju Kweon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
- Institute of Brain Research, Chungnam National University, Daejeon, Republic of Korea
- Department of Psychiatry, Chungnam National University School of Medicine, Daejeon, Republic of Korea
- Daejeon Regional Mental Health Welfare Center, Daejeon, Republic of Korea
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11
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Demir E, Veizi BGY, Naharci MI. Long-Term Risk of Reduced Cognitive Performance and Associated Factors in Discharged Older Adults with COVID-19: A Longitudinal Prospective Study. Ann Geriatr Med Res 2024; 28:76-85. [PMID: 38225807 PMCID: PMC10982451 DOI: 10.4235/agmr.23.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/23/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Increasing numbers of reports have suggested a deterioration in cognitive performance after recovery from coronavirus disease 2019 (COVID-19), however insufficient information is available regarding long-term brain health and risk factors related to reduced cognitive performance in advanced age. We investigated the prevalence of reduced cognitive performance and its associated factors among older adults after COVID-19. METHODS This prospective observational study enrolled older individuals (aged ≥65 years) hospitalized for COVID-19. Discharged patients were contacted after an average of 15 months and a brief battery was administered during telephone interviews to assess their mental status. RESULTS Among the 174 patients, 77 (44.3%) showed reduced cognitive performance at follow-up. Multivariate analysis revealed that female sex, education level, and increased Deyo/Charlson Comorbidity Index score, which is an objective indicator of chronic disease burden, were independent risk factors for long-term cognitive performance. Depression and anxiety symptoms, assessed using the Patient Health Questionnaire-2 and Generalized Anxiety Disorder 2-item questionnaire at the end of the study, were not associated with reduced cognitive performance. CONCLUSION Our findings provide key insights into discharged older adults with COVID-19 at risk of long-term cognitive impairment, and help to ascertain the factors associated with this problem.
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Affiliation(s)
- Elif Demir
- Department of Internal Medicine, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Betül Gülsüm Yavuz Veizi
- Department of Geriatrics, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Mehmet Ilkin Naharci
- Department of Geriatrics, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
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12
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Seo JW, Kim SE, Kim Y, Kim EJ, Kim T, Kim T, Lee SH, Lee E, Lee J, Seo YB, Jeong YH, Jung YH, Choi YJ, Song JY. Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID. Infect Chemother 2024; 56:122-157. [PMID: 38527781 PMCID: PMC10990882 DOI: 10.3947/ic.2024.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/27/2024] Open
Abstract
"Long COVID" is a term used to describe a condition when the symptoms and signs associated with coronavirus disease 2019 (COVID-19) persist for more than three months among patients infected with COVID-19; this condition has been reported globally and poses a serious public health issue. Long COVID can manifest in various forms, highlighting the need for appropriate evaluation and management by experts from various fields. However, due to the lack of clear clinical definitions, knowledge of pathophysiology, diagnostic methods, and treatment protocols, it is necessary to develop the best standard clinical guidelines based on the scientific evidence reported to date. We developed this clinical guideline for diagnosing and treating long COVID by analyzing the latest research data collected from the start of the COVID-19 pandemic until June 2023, along with the consensus of expert opinions. This guideline provides recommendations for diagnosis and treatment that can be applied in clinical practice, based on a total of 32 key questions related to patients with long COVID. The evaluation of patients with long COVID should be comprehensive, including medical history, physical examination, blood tests, imaging studies, and functional tests. To reduce the risk of developing long COVID, vaccination and antiviral treatment during the acute phase are recommended. This guideline will be revised when there is a reasonable need for updates based on the availability of new knowledge on the diagnosis and treatment of long COVID.
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Affiliation(s)
- Jun-Won Seo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Seong Eun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Eun Jung Kim
- Health, Welfare, Family and Gender Equality Team, National Assembly Research Service, Seoul, Korea
| | - Tark Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Taehwa Kim
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Young-Hoon Jeong
- CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, and Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Yu Jung Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
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13
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Shang Q, Xu K, Ji H, Dai Q, Ju H, Huang H, Hu J, Bao C. Changes in prevalence of anxiety and depression among COVID-19 patients during a two-year recovery period: A systematic review and meta-analysis. J Psychosom Res 2024; 178:111602. [PMID: 38359637 DOI: 10.1016/j.jpsychores.2024.111602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To analyze the temporal trend of anxiety and depression prevalences up to 2 years of follow-up for COVID-19 patients during the recovery period and to compare regional differences. METHODS We performed a systematic review from PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP using keywords such as "COVID-19", "anxiety", "depression", and "cohort study". Meta-analysis was performed to estimate the pooled prevalence of anxiety and depression at five follow-up time intervals. Subgroup analyses were conducted by different regions. RESULTS 34 cohort studies were included in the meta-analyses. The pooled anxiety prevalence rates at 0-1 month, 1-3 months, 3-6 months, 6-12 months and 12-24 months were 18% (95% CI: 11% to 28%), 18% (95% CI: 12% to 28%), 22% (95% CI: 16% to 29%), 15% (95% CI: 11% to 21%), and 10% (95% CI: 0.05% to 20%), respectively, and the pooled depression prevalence rates were 22% (95%CI: 15% to 33%), 19% (95% CI: 13% to 29%), 21% (95% CI: 15% to 28%), 15% (95% CI: 11% to 20%), and 9% (95% CI: 0.4% to 21%) respectively. The prevalence of depression in Asian and non-Asian countries was statistically different at 0-1 month (χ2 = 15.248, P < 0.001) and 1-3 months (χ2 = 28.298, P < 0.001), and prevalence of anxiety was statistically different at 3-6 months (χ2 = 9.986, P = 0.002) and 6-12 months (χ2 = 7.378, P = 0.007). CONCLUSION The prevalence of anxiety and depression in COVID-19 patients generally tends to decrease after 2 years of recovery, but may temporarily increase at 3-6 months. There are regional differences in the changes in prevalence of anxiety and depression.
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Affiliation(s)
- Qingxiang Shang
- School of Public Health, Nanjing Medical University, Nanjing, PR China
| | - Ke Xu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Hong Ji
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Qigang Dai
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Hao Ju
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Haodi Huang
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Jianli Hu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Changjun Bao
- School of Public Health, Nanjing Medical University, Nanjing, PR China; Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China.
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Rocha RPS, Andrade ACDS, Melanda FN, Muraro AP. Post-COVID-19 syndrome among hospitalized COVID-19 patients: a cohort study assessing patients 6 and 12 months after hospital discharge. CAD SAUDE PUBLICA 2024; 40:e00027423. [PMID: 38381868 PMCID: PMC10877698 DOI: 10.1590/0102-311xpt027423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/22/2023] [Accepted: 10/05/2023] [Indexed: 02/23/2024] Open
Abstract
Post-COVID-19 syndrome involves a variety of symptoms that last more than 12 weeks after COVID diagnosis. This study aimed to analyze post-COVID-19 syndrome among hospitalized COVID-19 patients 6 and 12 months after hospital discharge. This is an ambidirectional cohort study conducted with individuals who were discharged from three main hospitals in the capital of Mato Grosso State, Brazil, between October and December 2021 and January and March 2022. After data collection from medical records, the individuals were interviewed by telephone 6 and 12 months after hospital discharge, when they were asked about the presence of ongoing or new symptoms and when symptom frequency was evaluated according to sociodemographic and economic characteristics hospitalization, and health conditions. Of all 277 medical records evaluated, 259 patients were eligible to participate in the study, 190 patients six months after discharge and 160 patients 12 months after hospital discharge. At six months, 59% were female patients, 40% were aged 60 years or older, and 87.4% reported at least one symptom. At 12 months, 58.7% were female patients, 37.5% were aged 30 to 49 years, and 67.5% reported at least one symptom. Fatigue was the most common symptom 6 and 12 months after hospital discharge (55.3% and 40.6%, respectively), followed by memory problems (36.8%; 20%), and hair loss (26.8%; 11.2%). The prevalence of post-COVID-19 syndrome was higher among patients of older age, lower income, with hypertension, diabetes, and more severe infection during hospitalization. The risk factors for post-COVID-19 syndrome help understand the long-term effects and the importance of monitoring after the acute phase of the disease.
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Affiliation(s)
| | | | | | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, Brasil
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15
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Young TP, Erickson JS, Hattan SL, Guzy S, Hershkowitz F, Steward MD. A Single-Blind, Randomized, Placebo Controlled Study to Evaluate the Benefits and Safety of Endourage Targeted Wellness Formula C Sublingual +Drops in People with Post-Acute Coronavirus Disease 2019 Syndrome. Cannabis Cannabinoid Res 2024; 9:282-292. [PMID: 36252151 DOI: 10.1089/can.2022.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction: Coronavirus Disease 2019 (COVID-19) causes a wide range of symptoms, including death. As persons recover, some continue to experience symptoms described as Post-Acute COVID-19 Syndrome (PACS). The objectives of this study were to measure the efficacy of Formula C™, a cannabidiol (CBD)-rich, whole-flower terpene-rich preparation in managing PACS symptoms. Materials and Methods: This randomized, placebo-controlled, single-blind, open-label crossover study was conducted in 2021. Informed consent was obtained from participants, and they were randomized to two treatment groups. Group 1 (n=15) received blinded active product for 28 days, and Group 2 (n=16) received blinded placebo for 28 days (Treatment Period 1). Both groups crossed over to open-label active product for 28 days (Treatment Period 2) with a safety assessment at day 70. Patient-Reported Outcomes Measurement Information System (PROMIS®) scores and the Patient Global Impression of Change (PGIC) score were used to assess primary and secondary objectives. Safety assessments were also done at each visit. Results: Twenty-four participants completed study, with 8 withdrawals, none related to study product. PGIC and PROMIS scores improved across both groups at day 28. This raised questions about the placebo. A reanalysis of the placebo confirmed absence of CBD and unexpected medical concentration of terpenes. The study continued despite no longer having a true placebo. The improved scores on outcome measures were maintained across the open label treatment period. There were no safety events reported throughout the study. Discussion: For persons with PACS who are nonresponsive to conventional therapies, this study demonstrated symptom improvement for participants utilizing Formula C. In addition, the benefits seen in Group 2 suggest the possibility that non-CBD formulations rich in antioxidants, omega-3, and omega-6 fatty acids, gamma-linoleic acid, and terpenes may also have contributed to the overall improvement of the partial active group through the study. Conclusion: Given that both groups demonstrated improvement, both formulations may be contributing to these findings. Limitations include the small number of participants, the lack of a true placebo, and limited time on study products. Additional studies are warranted to explore both CBD-rich hemp products and hempseed oil as treatment options for PACS. Trial Registration ClinicalTrials.gov Identifier: NCT04828668.
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Affiliation(s)
- Thomas P Young
- Joel S Erickson, MD+Thomas P Young, PhD, NP, Inc., Novato, California, USA
| | - Joel S Erickson
- Joel S Erickson, MD+Thomas P Young, PhD, NP, Inc., Novato, California, USA
| | - Shannon L Hattan
- Joel S Erickson, MD+Thomas P Young, PhD, NP, Inc., Novato, California, USA
| | - Serge Guzy
- ProPharma, Inc., Hillsborough, New Jersey, USA
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16
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Moisoglou I, Katsiroumpa A, Kolisiati A, Vraka I, Kosiara K, Siskou O, Kaitelidou D, Konstantakopoulou O, Katsoulas T, Gallos P, Galanis P. Resilience and Social Support Improve Mental Health and Quality of Life in Patients with Post-COVID-19 Syndrome. Eur J Investig Health Psychol Educ 2024; 14:230-242. [PMID: 38248135 PMCID: PMC10814826 DOI: 10.3390/ejihpe14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
Physical and mental health problems among post-COVID-19 patients are common, even a year after infection. As there is no prior study available, we investigated the impacts of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included the demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4 (PHQ-4), and the EuroQol-5D-3L. The mean age of patients was 44.8 years. The total PHQ-4 score suggested that 32.8% of patients with post-COVID-19 syndrome experienced severe psychological distress, 32.8% experienced moderate distress, 23% experienced mild distress, and 11.5% had no distress. Moreover, 60.7% of patients had anxiety scores of ≥3 and 69.7% had depression scores of ≥3, indicating possible major anxiety or depression disorder. The mean EQ-5D-3L index value was 0.36, and the mean EQ-5D-3L VAS was 54.1. Multivariable analysis identified that resilience and social support reduced anxiety and depression among patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. Our findings suggest that resilience and social support can be protective by reducing anxiety and depression and improving quality of life among patients with post-COVID-19 syndrome. Policymakers should develop and implement healthcare management programs to provide psychological support to these patients.
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Affiliation(s)
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (K.K.); (P.G.)
| | - Antigoni Kolisiati
- Department of Endocrinology and Diabetes Center, General Hospital “G. Gennimatas”, 11527 Athens, Greece;
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece;
| | - Katerina Kosiara
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (K.K.); (P.G.)
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece;
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.K.); (O.K.)
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (D.K.); (O.K.)
| | - Theodoros Katsoulas
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (T.K.); (P.G.)
| | - Parisis Gallos
- Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (T.K.); (P.G.)
| | - Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (K.K.); (P.G.)
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17
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Kim Y, Bae S, Chang HH, Kim SW. Characteristics of long COVID and the impact of COVID-19 vaccination on long COVID 2 years following COVID-19 infection: prospective cohort study. Sci Rep 2024; 14:854. [PMID: 38191556 PMCID: PMC10774352 DOI: 10.1038/s41598-023-50024-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
This prospective cohort study aimed to identify characteristics of long COVID and any potential mitigating effects of COVID-19 vaccinations in patients 24 months following COVID-19 infection. Adult patients diagnosed with COVID-19 between February 17, 2020, and March 24, 2020, were scheduled to visit the study hospital four times (6, 12, 18, and 24 months after infection) to assess their symptoms, quality of life, and mental health. Among the 235 patients, 121 (51.5%) completed the study visits. Of these, 59.5% were female, with a median age of 52 years. Mild to moderate disease severity were identified in 101 (83.4%) patients. A total of 75 participants (62.0%) were still experiencing long COVID symptoms 24 months after acute infection. Fatigue, amnesia, difficulty concentrating, and insomnia were the most common symptoms. The frequency of neuropsychiatric symptoms did not differ based on vaccination status or the number of doses received. Quality of life improved over time for the participants, but 32.2% of respondents still reported anxiety/depression at the end of the study. Overall, our cohort demonstrates that long COVID can persist up to 24 months after COVID-19 infection, affecting mental health and quality of life.
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Affiliation(s)
- Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Sohyun Bae
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Hyun-Ha Chang
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Shin-Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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18
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Kang HY, Ahn HY, Kang MJ, Hur MH. Effects of aromatherapy on sore throat, nasal symptoms and sleep quality in adults infected with COVID-19: A randomized controlled trial. Integr Med Res 2023; 12:101001. [PMID: 38024288 PMCID: PMC10654541 DOI: 10.1016/j.imr.2023.101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Patients with coronavirus disease 2019 (COVID-19) usually complain of fever, cough, and sore throat. This study examined the effects of aromatherapy on sore throat, nasal symptoms, stress, fatigue, and sleep quality by administering it to adults with post-COVID-19 condition. Methods This study was conducted in a randomised controlled design. Its target population were adults who were released from COVID-19 quarantine treatment within 45 days from infection onset and capable of performing daily activities after isolation treatment. The participants were randomised into aromatherapy group (AG) and control group (CG). To test experimental treatment effects, the levels of sore throat, nasal symptoms, stress, fatigue and sleep quality were measured at the baseline (pre-test) and after the trial (post-test), using the numerical rating scale for sore throat, stress and fatigue, the Total Nasal Symptoms Score for nasal symptoms, and the Korean Version of Modified Leeds Sleep Evaluation Questionnaire for quality of sleep. Results After experimental treatment, there was a significant difference in sore throat in AG compared to CG on the 3rd day (t=-2.022 p=0.048) and 4th day (t=-2.450, p=0.017) of treatment. There was also a significant difference in fatigue between AG and CG on the 2nd day(t=-2.748, p=0.008), 3rd day (t=-2.948, p=0.005) and 4th day (t=-3.084, p=0.003) of treatment. There was no significant difference in TNSS, stress, and sleep quality between the two groups after the experimental treatment. Conclusion Inhaling aroma essential oils reduced sore throat and fatigue in adults with post-COVID-19 condition, demonstrating the feasibility of aromatherapy as an effective treatment. Trial registration The study was registered with Clinical Research Information Service (KCT0008029).
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Affiliation(s)
| | | | - Mi-Jung Kang
- College of Nursing, Eulji University, Uijeongbu, Gyeonggi, Republic of Korea
| | - Myung-Haeng Hur
- College of Nursing, Eulji University, Uijeongbu, Gyeonggi, Republic of Korea
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19
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Jang M, Choi D, Choi J, Kwon HJ. Clinical Features and Risk Factors of Post-COVID-19 Condition in Korea. J Prev Med Public Health 2023; 56:431-439. [PMID: 37735829 PMCID: PMC10579640 DOI: 10.3961/jpmph.23.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/11/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES Numerous studies have explored the causes and spread of outbreaks, yet there is a lack of research on post-coronavirus disease 2019 condition (PCC) in Korea. The goal of this study was to identify the various types of PCC and associated factors in discharged patients and to provide directions for the ongoing health management of confirmed patients. METHODS A telephone survey was conducted among 680 coronavirus disease 2019 (COVID-19) patients diagnosed between July 7, 2021 and August 26, 2021, in Dangjin, Chungnam, Korea. A descriptive analysis of characteristics, univariate analysis, and regression were performed using data from basic epidemiological surveys conducted at the time of diagnosis and post-discharge questionnaires. RESULTS Of the 585 patients who responded, 159 (27.2%) developed PCC. Of the 211 patients with no initial symptoms, 27 (12.8%) developed PCC, versus 132 (35.3%) of the 374 patients with initial symptoms. Among the initial symptoms, fever or chills, cough or sputum, loss of smell, and sore throat were associated with PCC. Compared to patients with less than 10 days of hospitalization, those with a hospitalization period of 21 days to 30 days (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 5.2) and 31 days or more (OR, 5.8; 95% CI, 1.9 to 18.1) had a higher risk of PCC. CONCLUSIONS More than a quarter of COVID-19 patients, including those who had no initial symptoms, experienced PCC in Korea. People with the initial symptoms of fever, chills, and respiratory symptoms and those who had prolonged hospital stays had a high risk of PCC.
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Affiliation(s)
- Myungwon Jang
- Epidemic Intelligence Officer, Dangjin City Public Health Center, Dangjin, Korea
| | - Dongkwon Choi
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Korea
| | - Jonghyuk Choi
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Korea
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Ho-Jang Kwon
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Korea
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
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20
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Kumar S, Patidar V, Mudgal SK, Kumar S, Agarwal R, Gupta P, Gaur R, Varshney S. Self-Reported Persistent Symptoms at 18 Months and Above Among COVID-19 Non-hospitalized Patients: A Prospective Cohort Study. Cureus 2023; 15:e43239. [PMID: 37692652 PMCID: PMC10491500 DOI: 10.7759/cureus.43239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
INTRODUCTION Since the beginning of the pandemic in early 2020, there have been numerous reports of symptoms that have lingered due to COVID-19. However, there is a lack of data concerning these persistent symptoms in non-hospitalized patients. This study sought to examine the prevalence of persistent symptoms at 18 months and beyond following the diagnosis of COVID-19 non-hospitalized patients. METHODS A prospective cohort study comprised 212 non-hospitalized adult patients consecutively assessed from data available at tertiary care institutions through telephone interviews. During the interview, participants were routinely questioned about whether they were still experiencing any post-infection symptoms at the time of the study. RESULTS Total 212 took part in the 18-month or longer follow-up survey. The most commonly reported symptoms during the acute phase were fever (n=149, 70.3%), weakness (n=118, 55.7%), and sore throat (n=100, 47.2%). At the 18-month and above follow-up, 167 patients (78.7%) reported at least one symptom continuing. The most common symptom at this time point was fatigue (n=109, 51.4%), followed by joint pain (n=57, 26.8%), and exertional dyspnea (24.5%). The possibility of symptoms returning after an 18-month follow-up and beyond was significantly lower in patients who had taken the COVID-19 vaccine (OR=0.29; 95% CI: 0.112-0.749; p=0.011) and those did not infect a second time (OR=0.232; 95% CI: 0.057-0.93; p=0.04). CONCLUSION The present study reveals that clinical complications persist even at 18 months and beyond during follow-up, with a prevalence similar to earlier follow-up periods, regardless of the severity of the initial COVID-19 infection.
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Affiliation(s)
- Suman Kumar
- Microbiology, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Vipin Patidar
- Nursing, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Shiv K Mudgal
- Nursing, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Sanjay Kumar
- Anesthesiology and Critical Care, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Rajat Agarwal
- Cardiothoracic Surgery, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Pratima Gupta
- Microbiology, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Rakhi Gaur
- Nursing, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Saurabh Varshney
- Otolaryngology, All India Institute of Medical Sciences Deoghar, Deoghar, IND
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21
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Kim Y, Bae S, Chang HH, Kim SW. Long COVID prevalence and impact on quality of life 2 years after acute COVID-19. Sci Rep 2023; 13:11207. [PMID: 37433819 PMCID: PMC10336045 DOI: 10.1038/s41598-023-36995-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
There has been an increasing interest in the long-term impact of long COVID. However, only a few studies have investigated the clinical manifestations of long COVID after 24 months of acute infection. In this study, prospective online surveys were conducted in adults previously diagnosed with coronavirus disease 2019 (COVID-19) in South Korea between February 13 and March 13, 2020, at 6, 12, and 24 months after COVID-19. We investigated self-reported symptoms and the EuroQol-5-dimension index. Among 900 individuals enrolled initially, 150 completed all 3 surveys. After excluding the cases of COVID-19 reinfection, 132 individuals were included in the final analysis. Among the 132 participants, 94 (71.2%) experienced symptoms of long COVID. The most frequently reported symptoms were fatigue (34.8%), amnesia (30.3%), concentration difficulties (24.2%), insomnia (20.5%), and depression (19.7%). Notably, no significant differences were noted in the incidence of long COVID at 24 months in terms of the number of vaccinations received. Although the neuropsychiatric quality of life improved over time, it continued to affect 32.7% of participants. Symptoms of long COVID, particularly neuropsychiatric symptoms, tend to persist over time, and COVID-19 vaccination or the number of vaccinations received may not significantly affect the incidence of long COVID.
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Affiliation(s)
- Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Sohyun Bae
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Hyun-Ha Chang
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Shin-Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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22
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Perumal R, Shunmugam L, Naidoo K. Long COVID: An approach to clinical assessment and management in primary care. S Afr Fam Pract (2004) 2023; 65:e1-e10. [PMID: 37427773 PMCID: PMC10331047 DOI: 10.4102/safp.v65i1.5751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 07/11/2023] Open
Abstract
Long COVID is an emerging public health threat, following swiftly behind the surges of acute infection over the course of the COVID-19 pandemic. It is estimated that there are already approximately 100 million people suffering from Long COVID globally, 0.5 million of whom are South African, and for whom our incomplete understanding of the condition has forestalled appropriate diagnosis and clinical care. There are several leading postulates for the complex, multi-mechanistic pathogenesis of Long COVID. Patients with Long COVID may present with a diversity of clinical phenotypes, often with significant overlap, which may exhibit temporal heterogeneity and evolution. Post-acute care follow-up, targeted screening, diagnosis, a broad initial assessment and more directed subsequent assessments are necessary at the primary care level. Symptomatic treatment, self-management and rehabilitation are the mainstays of clinical care for Long COVID. However, evidence-based pharmacological interventions for the prevention and treatment of Long COVID are beginning to emerge. This article presents a rational approach for assessing and managing patients with Long COVID in the primary care setting.
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Affiliation(s)
- Rubeshan Perumal
- Centre for the AIDS Programme of Research in South Africa, Faculty of Medicine, University of KwaZulu-Natal, Durban, South Africa; and Department of Pulmonology, Faculty of Medicine, University of KwaZulu-Natal, Durban.
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23
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Al Meslamani AZ, Sammani N. Assessment of changes in the epidemiology and prognosis of non-SARS-CoV-2 respiratory infections one year after recovery from COVID-19. Respir Investig 2023; 61:445-453. [PMID: 37121115 PMCID: PMC10121141 DOI: 10.1016/j.resinv.2023.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/27/2023] [Accepted: 03/23/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Given its pathophysiology and evidence on its long-term effects, coronavirus disease 2019 (COVID-19) may have altered the incidence, types, and severity of other respiratory infections (RIs). Therefore, this study aimed to evaluate the potential impact of COVID-19 on non-SARS-CoV-2 RIs in COVID-19 survivors. METHODS This cross-sectional study was conducted using a self-administered, online survey from February 2022 to April 2022 in the United Arab Emirates. Participants included adults diagnosed with COVID-19 before February 2021. Those who did not undergo nasopharyngeal swab tests for contraction of other RIs after recovering from COVID-19 were excluded. RESULTS Of the 384 participants, 24.5% were aged 18-24 years, and 55.5% were women. The mean body mass index (BMI) was 29.6 ± 3.7 kg/m2. Among the participants, 34.4% experienced at least one non-SARS-CoV-2 RI after recovering from COVID-19, of which 25.8% reported that the RI lasted longer than those previously, 27.3% sought physician advice, 31.8% reported increased coughing as a symptom of the non-SARS-CoV-2 RI, and 38.6% reported increased sputum. Based on patient responses, the degree of COVID-19 severity was significantly associated with non-SARS-CoV-2 RIs (p = 0.003), and depression was found to be a significant predictor of changes in shortness of breath symptoms (adjusted odds ratio [AOR] = 1.29; 95% confidence interval [CI], 1.17-1.46). CONCLUSIONS The participants of this study reported changes in the duration and severity of non-SARS-CoV-2 RIs after recovering from COVID-19. Further research is needed to confirm these findings, which suggest a need for swift action to protect the public against RIs, particularly seasonal pathogens.
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Affiliation(s)
- Ahmad Z Al Meslamani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates; College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
| | - Nour Sammani
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates; College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
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24
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Sreelakshmi PR, Tandale BV, Jadhav AV, Vaidya RR, Walimbhe AM, Jadhav S. A scoping review of persistent symptoms after COVID infection at different follow-up periods. Indian J Public Health 2023; 67:292-300. [PMID: 37459027 DOI: 10.4103/ijph.ijph_1178_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
The clinical entity termed as long COVID has gained importance in the recent past. As this phenomenon is still evolving, it is important to document the magnitude of the syndrome during different time periods. This scoping review attempts to synthesize evidence generated from longitudinal studies which have follow-up periods beyond 3 months, up to 12 months. The review also documents the reported prevalence of long COVID for the different regions of the World Health Organization. Longitudinal studies published till March 2022 were systematically searched on PubMed, Google Scholar, and medRxiv. Among the identified 594 studies, 48 were included in this review. Data from selected studies were synthesized. The overall pooled prevalence of long COVID was 49% (40%-58%). The pooled estimates after 3 months, 4-6 months, 7-9 months, and 10-12 months were 44% (32%-57%), 50% (43%-57%), 49% (37%-62%), and 54% (46%-62%), respectively. Eastern Mediterranean Region (EMR) had the highest pooled prevalence of 63% (34%-92%] and the South East Asian Region (SEAR) had the least pooled estimate of 15% (10%-21%). The study brings out the high prevalence of long COVID even after 12 months of follow-up. It also shows the regional differences in the reported prevalence of the syndrome. This review highlights the need for well-planned follow-up studies, especially in developing nations to understand the magnitude and the pattern of long COVID-related symptoms as they emerge.
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Affiliation(s)
- P R Sreelakshmi
- Scientist-D, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | | | - Abhijeet V Jadhav
- Scientist E, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Rupali R Vaidya
- Internship Trainee, Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Atul M Walimbhe
- Statistician, Bio-Informatics Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Santoshkumar Jadhav
- Statistician, Bio-Informatics Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
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25
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Santa Cruz A, Mendes-Frias A, Azarias-da-Silva M, André S, Oliveira AI, Pires O, Mendes M, Oliveira B, Braga M, Lopes JR, Domingues R, Costa R, Silva LN, Matos AR, Ângela C, Costa P, Carvalho A, Capela C, Pedrosa J, Castro AG, Estaquier J, Silvestre R. Post-acute sequelae of COVID-19 is characterized by diminished peripheral CD8 +β7 integrin + T cells and anti-SARS-CoV-2 IgA response. Nat Commun 2023; 14:1772. [PMID: 36997530 PMCID: PMC10061413 DOI: 10.1038/s41467-023-37368-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
Several millions of individuals are estimated to develop post-acute sequelae SARS-CoV-2 condition (PASC) that persists for months after infection. Here we evaluate the immune response in convalescent individuals with PASC compared to convalescent asymptomatic and uninfected participants, six months following their COVID-19 diagnosis. Both convalescent asymptomatic and PASC cases are characterised by higher CD8+ T cell percentages, however, the proportion of blood CD8+ T cells expressing the mucosal homing receptor β7 is low in PASC patients. CD8 T cells show increased expression of PD-1, perforin and granzyme B in PASC, and the plasma levels of type I and type III (mucosal) interferons are elevated. The humoral response is characterized by higher levels of IgA against the N and S viral proteins, particularly in those individuals who had severe acute disease. Our results also show that consistently elevated levels of IL-6, IL-8/CXCL8 and IP-10/CXCL10 during acute disease increase the risk to develop PASC. In summary, our study indicates that PASC is defined by persisting immunological dysfunction as late as six months following SARS-CoV-2 infection, including alterations in mucosal immune parameters, redistribution of mucosal CD8+β7Integrin+ T cells and IgA, indicative of potential viral persistence and mucosal involvement in the etiopathology of PASC.
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Affiliation(s)
- André Santa Cruz
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal.
- Clinical Academic Center-Braga, Braga, Portugal.
| | - Ana Mendes-Frias
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Sónia André
- INSERM-U1124, Université Paris Cité, Paris, France
| | | | - Olga Pires
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Marta Mendes
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Bárbara Oliveira
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Marta Braga
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Joana Rita Lopes
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Rui Domingues
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Ricardo Costa
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Luís Neves Silva
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Ana Rita Matos
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Cristina Ângela
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Alexandre Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Carlos Capela
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Department of Internal Medicine, Hospital of Braga, Braga, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Jorge Pedrosa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - António Gil Castro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Jérôme Estaquier
- INSERM-U1124, Université Paris Cité, Paris, France.
- CHU de Québec - Université Laval Research Center, Québec City, Québec, Canada.
| | - Ricardo Silvestre
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
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26
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Jung YH, Ha EH, Park J, Choe KW, Lee WJ, Jo DH. Neurological and Psychiatric Manifestations of Post-COVID-19 Conditions. J Korean Med Sci 2023; 38:e83. [PMID: 36942392 PMCID: PMC10027539 DOI: 10.3346/jkms.2023.38.e83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/14/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND We aimed to investigate the factors associated with neurological manifestations of post-coronavirus disease 2019 (COVID-19) conditions. METHODS We retrospectively collected data from 440 patients who visited our post-COVID-19 clinic more than 4 weeks after severe acute respiratory syndrome coronavirus 2 infection. We analyzed the prevalence of different neurological symptoms (brain fog, memory impairment, headache, and dizziness) and assessed the associated factors. RESULTS Brain fog was the most common symptom, observed in 170 patients (38.6%), followed by headaches (n = 137, 31.1%), dizziness (n = 128, 29%), and memory impairment (n = 104, 23.6%). Brain fog was associated with hyposmia or hypogeusia (odds ratio [OR], 2.54; P < 0.001), Fatigue Severity Scale (FSS) (OR, 1.06; P < 0.001), and Hospital Anxiety and Depression Scale-Anxiety (OR, 1.09; P = 0.037). Memory impairment was associated with sleep problems (OR, 2.83; P < 0.001), FSS (OR, 1.05; P < 0.001), and age (OR, 1.02; P = 0.015). Headache was associated with sleep problems (OR, 2.28; P = 0.001), sex (OR, 1.68; P = 0.042), and FSS (OR, 1.04; P < 0.001). Dizziness was associated with sleep problems (OR, 2.88; P < 0.001), and FSS (OR, 1.04; P < 0.001). The incidence of brain fog (P < 0.001), memory impairment (P < 0.001), dizziness (P = 0.007), and headache (P = 0.045) accompanied by hyposmia and hypogeusia was higher in patients with the aforementioned symptoms than in those without. CONCLUSION This study suggests that there is a relationship between neurological symptoms and other clinical factors, such as fatigue, depression, anxiety, hyposmia, and hypogeusia.
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Affiliation(s)
- Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Eun-Hye Ha
- Department of Pulmonary and Critical Care Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Junli Park
- Department of Family Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Kang Won Choe
- Department of Infectious Disease, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Wang Jun Lee
- The Office of Chief Executive Officer and Chairman, Department of General Surgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
| | - Dong Ho Jo
- Department of Infectious Disease, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
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27
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Tassignon B, Radwan A, Blommaert J, Stas L, Allard SD, De Ridder F, De Waele E, Bulnes LC, Hoornaert N, Lacor P, Lathouwers E, Mertens R, Naeyaert M, Raeymaekers H, Seyler L, Van Binst AM, Van Imschoot L, Van Liedekerke L, Van Schependom J, Van Schuerbeek P, Vandekerckhove M, Meeusen R, Sunaert S, Nagels G, De Mey J, De Pauw K. Longitudinal changes in global structural brain connectivity and cognitive performance in former hospitalized COVID-19 survivors: an exploratory study. Exp Brain Res 2023; 241:727-741. [PMID: 36708380 PMCID: PMC9883830 DOI: 10.1007/s00221-023-06545-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/02/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Long-term sequelae of COVID-19 can result in reduced functionality of the central nervous system and substandard quality of life. Gaining insight into the recovery trajectory of admitted COVID-19 patients on their cognitive performance and global structural brain connectivity may allow a better understanding of the diseases' relevance. OBJECTIVES To assess whole-brain structural connectivity in former non-intensive-care unit (ICU)- and ICU-admitted COVID-19 survivors over 2 months following hospital discharge and correlate structural connectivity measures to cognitive performance. METHODS Participants underwent Magnetic Resonance Imaging brain scans and a cognitive test battery after hospital discharge to evaluate structural connectivity and cognitive performance. Multilevel models were constructed for each graph measure and cognitive test, assessing the groups' influence, time since discharge, and interactions. Linear regression models estimated whether the graph measurements affected cognitive measures and whether they differed between ICU and non-ICU patients. RESULTS Six former ICU and six non-ICU patients completed the study. Across the various graph measures, the characteristic path length decreased over time (β = 0.97, p = 0.006). We detected no group-level effects (β = 1.07, p = 0.442) nor interaction effects (β = 1.02, p = 0.220). Cognitive performance improved for both non-ICU and ICU COVID-19 survivors on four out of seven cognitive tests 2 months later (p < 0.05). CONCLUSION Adverse effects of COVID-19 on brain functioning and structure abate over time. These results should be supported by future research including larger sample sizes, matched control groups of healthy non-infected individuals, and more extended follow-up periods.
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Affiliation(s)
- B Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - A Radwan
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium
| | - J Blommaert
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - L Stas
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Interfaculty Center for Data Processing and Statistics, Core Facility Statistics and Methodology, Vrije Universiteit Brussel, Brussels, Belgium
| | - S D Allard
- Infectious Diseases Unit, Department of Internal Medicine, UZ Brussel, Jette, Belgium
| | - F De Ridder
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - E De Waele
- Intensive Care Unit, UZ Brussel, Jette, Belgium
| | - L C Bulnes
- Brain, Body and Cognition Research Group, Faculty of Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - N Hoornaert
- Infectious Diseases Unit, Department of Internal Medicine, UZ Brussel, Jette, Belgium
| | - P Lacor
- Infectious Diseases Unit, Department of Internal Medicine, UZ Brussel, Jette, Belgium
| | - E Lathouwers
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - R Mertens
- Infectious Diseases Unit, Department of Internal Medicine, UZ Brussel, Jette, Belgium
| | - M Naeyaert
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - H Raeymaekers
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - L Seyler
- Infectious Diseases Unit, Department of Internal Medicine, UZ Brussel, Jette, Belgium
| | - A M Van Binst
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - L Van Imschoot
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - L Van Liedekerke
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - J Van Schependom
- Artificial Intelligence and Modelling in Clinical Science, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels, Belgium
| | - P Van Schuerbeek
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - M Vandekerckhove
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - R Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- BruBotics, Vrije Universiteit Brussel, Brussels, Belgium
- Strategic Research Program 'Exercise and the Brain in Health & Disease: The Added Value of Human-Centered Robotics', Vrije Universiteit Brussel, Brussels, Belgium
| | - S Sunaert
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium
- Department of Radiology, UZ Leuven, Leuven, Belgium
| | - G Nagels
- Artificial Intelligence and Modelling in Clinical Science, Vrije Universiteit Brussel, Brussels, Belgium
| | - J De Mey
- Department of Radiology and Magnetic Resonance, UZ Brussel, Jette, Belgium
| | - K De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
- BruBotics, Vrije Universiteit Brussel, Brussels, Belgium.
- Strategic Research Program 'Exercise and the Brain in Health & Disease: The Added Value of Human-Centered Robotics', Vrije Universiteit Brussel, Brussels, Belgium.
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28
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Fernández-Ortega MÁ, Ponce-Rosas ER, Muñiz-Salinas DA, Rodríguez-Mendoza O, Nájera Chávez P, Sánchez-Pozos V, Dávila-Mendoza R, Barrell AE. Cognitive dysfunction, diabetes mellitus 2 and arterial hypertension: Sequelae up to one year of COVID-19. Travel Med Infect Dis 2023; 52:102553. [PMID: 36805019 PMCID: PMC9981335 DOI: 10.1016/j.tmaid.2023.102553] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Covid symptoms reflect its multisystem nature, in addition to its positive relationship between the severity of the condition and the severity of the long COVID. OBJECTIVE To identify the factors associated with the prevalence of SEQUELAE DUE TO COVID-19 one year after their hospital discharge due to severe pneumonia. METHOD Longitudinal, analytical, prospective and comparative study. 71 covid-19 pneumonia survivors were followed. Two telephone interviews were conducted to each patient; the first at 5 months of discharge and the second at 12 months from the mentioned date. We included questions of 40 symptoms, in addition to the questioning of diabetes mellitus and/or systemic hypertension with a mentioned onset during the hospitalization or after hospital discharge due to COVID-19. RESULTS Of the 37 patients without complications and without comorbidities prior to hospitalization, 11 (29.7%) developed arterial hypertension during or after discharge and 17 (45.9%) developed diabetes mellitus before five months. Short-term memory loss was an upward sequel in the two measurements, 24.3% and 41.9% respectively. CONCLUSIONS Type 2 diabetes mellitus and high blood pressure detected at five months was temporary and reversed in many cases at twelve months. It will be important to deepen the study of brain damage and cognitive dysfunction, characterized by memory loss.
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Affiliation(s)
- Miguel Á Fernández-Ortega
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
| | - Efrén R Ponce-Rosas
- Subdivisión de Medicina Familiar, División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Daniel A Muñiz-Salinas
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Omar Rodríguez-Mendoza
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Paola Nájera Chávez
- Hospital Regional "Lic. Adolfo López Mateos". Instituto de Seguridad y Servicios Sociales de Los Trabajadores Del Estado. Ciudad de México, Mexico
| | - Verónica Sánchez-Pozos
- Servicio de Cirugía Maxilofacial, Hospital Regional "Lic. Adolfo López Mateos". Instituto de Seguridad y Servicios Sociales de Los Trabajadores Del Estado, Ciudad de México, Mexico
| | - Rocío Dávila-Mendoza
- Subdivisión de Medicina Familiar, División de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Alan E Barrell
- Dirección Médica, Productos Farmacéuticos, S.A. de C.V, Ciudad de México, Mexico
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Mudgal SK, Gaur R, Rulaniya S, T L, Agarwal R, Kumar S, Varshney S, Sharma S, Bhattacharya S, Kalyani V. Pooled Prevalence of Long COVID-19 Symptoms at 12 Months and Above Follow-Up Period: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e36325. [PMID: 37077615 PMCID: PMC10108372 DOI: 10.7759/cureus.36325] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 03/19/2023] Open
Abstract
Current data suggests that coronavirus disease 2019 (COVID-19) survivors experience long-lasting problems. It is not yet understood how long these symptoms last. The goal of this study was to compile all the data that was currently available to evaluate COVID-19's long-term effects at 12 months and above. We looked for studies published by December 15, 2022, in PubMed and Embase that discussed follow-up findings for COVID-19 survivors who had been alive for at least a year. A random-effect model was carried out to determine the combined prevalence of different long-COVID symptoms. The Joanna Briggs Institute tool was used to assess the risk of bias for the included studies, and the I2 statistics were used to evaluate the heterogeneity. After reviewing 3,209 studies, 46 were deemed admissible, with an aggregate COVID-19 population of 17976. At 12 months and above, 57% of patients reported a minimum of one symptom, and the five most prevalent symptoms were: dyspnea on exertion (34%, 95% CI 0.2; 0.94); difficulty in concentration (32%, 95% CI 0.16; 0.52); fatigue (31%, 95% CI 0.22; 0.40); frailty (31%, 95% CI 0.06; 0.78); and arthromyalgia (28%, 95% CI 0.09; 0.6). The findings of the present study showed that at 12 months and beyond, a sizable fraction of COVID-19 survivors still have lasting symptoms that impair several body systems. Long-COVID patients require an urgent understanding of pathophysiological processes and the development of tailored treatments.
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Affiliation(s)
- Shiv K Mudgal
- College of Nursing, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Rakhi Gaur
- College of Nursing, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Satyaveer Rulaniya
- College of Nursing, All India Institute of Medical Sciences Jodhpur, Jodhpur, IND
| | - Latha T
- College of Nursing, All India Institute of Medical Sciences Kalyani, West Bengal, IND
| | - Rajat Agarwal
- Department of Cardiothoracic Surgery, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Subodh Kumar
- Department of Pharmacology, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Saurabh Varshney
- Department of Otolaryngology, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Suresh Sharma
- College of Nursing, All India Institute of Medical Sciences Jodhpur, Jodhpur, IND
| | - Sudip Bhattacharya
- Department of Community Medicine, All India Institute of Medical Sciences Deoghar, Deoghar, IND
| | - Vasantha Kalyani
- College of Nursing, All India Institute of Medical Sciences Deoghar, Deoghar, IND
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30
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Yan MZ, Yang M, Lai CL. Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis and Management. Viruses 2023; 15:v15020533. [PMID: 36851746 PMCID: PMC9964207 DOI: 10.3390/v15020533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved through history and symptomatology that cannot be explained by an alternative diagnosis. However, the heavy reliance on subjective reporting is prone to reporting errors. Besides, there is no unified diagnostic assessment tool to classify the clinical severity of patients. This leads to significant difficulties when managing patients in terms of public resource utilization, clinical progression monitorization and rehabilitation plan formulation. This narrative review aims to review current evidence of diagnosis based on triple assessment: clinical symptomatology, biochemical analysis and imaging evidence. Further assessment tools can be developed based on triple assessment to monitor patient's clinical progression, prognosis and intervals of monitoring. It also highlights the high-risk features of patients for closer and earlier monitoring. Rehabilitation programs and related clinical trials are evaluated; however, most of them focus on cardiorespiratory fitness and psychiatric presentations such as anxiety and depression. Further research is required to establish an objective and comprehensive assessment tool to facilitate clinical management and rehabilitation plans.
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Affiliation(s)
- Michael Zhipeng Yan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
- Correspondence: (M.Z.Y.); (C.-L.L.)
| | - Ming Yang
- Department of Ophthalmology, The University of Hong Kong, Hong Kong SAR, China
| | - Ching-Lung Lai
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China
- Correspondence: (M.Z.Y.); (C.-L.L.)
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31
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Fjelltveit EB, Blomberg B, Kuwelker K, Zhou F, Onyango TB, Brokstad KA, Elyanow R, Kaplan IM, Tøndel C, Mohn KGI, Özgümüş T, Cox RJ, Langeland N. Symptom Burden and Immune Dynamics 6 to 18 Months Following Mild Severe Acute Respiratory Syndrome Coronavirus 2 Infection (SARS-CoV-2): A Case-control Study. Clin Infect Dis 2023; 76:e60-e70. [PMID: 35959897 PMCID: PMC9384725 DOI: 10.1093/cid/ciac655] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/13/2022] [Accepted: 08/10/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The burden and duration of persistent symptoms after nonsevere coronavirus disease 2019 (COVID-19) remains uncertain. This study aimed to assess postinfection symptom trajectories in home-isolated COVID-19 cases compared with age- and time- matched seronegative controls, and investigate immunological correlates of long COVID. METHODS A prospective case-control study included home-isolated COVID-19 cases between February 28 and April 4, 2020, and followed for 12 (n = 233) to 18 (n = 149) months, and 189 age-matched severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-naive controls. We collected clinical data at baseline, 6, 12, and 18 months postinfection, and blood samples at 2, 4, 6, and 12 months for analysis of SARS-CoV-2-specific humoral and cellular responses. RESULTS Overall, 46% (108/233) had persisting symptoms 12 months after COVID-19. Compared with controls, adult cases had a high risk of fatigue (27% excess risk, sex, and comorbidity adjusted odds ratio [aOR] 5.86; 95% confidence interval [CI], 3.27-10.5), memory problems (21% excess risk; aOR 7.42; CI, 3.51-15.67), concentration problems (20% excess risk; aOR 8.88; 95% CI, 3.88-20.35), and dyspnea (10% excess risk; aOR 2.66; 95% CI, 1.22-5.79). The prevalence of memory problems increased overall from 6 to 18 months (excess risk 11.5%; 95% CI, 1.5-21.5; P = .024) and among women (excess risk 18.7%; 95% CI, 4.4-32.9; P = .010). Longitudinal spike immunoglobulin G was significantly associated with dyspnea at 12 months. The spike-specific clonal CD4+ T-cell receptor β depth was significantly associated with both dyspnea and number of symptoms at 12 months. CONCLUSIONS This study documents a high burden of persisting symptoms after mild COVID-19 and suggests that infection induced SARS-CoV-2-specific immune responses may influence long-term symptoms.
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Affiliation(s)
- Elisabeth B Fjelltveit
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Bjørn Blomberg
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Advisory Unit for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kanika Kuwelker
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Fan Zhou
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Therese B Onyango
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Karl A Brokstad
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Safety, Chemistry and Biomedical Laboratory Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Ian M Kaplan
- Adaptive Biotechnologies, Seattle, Washington, USA
| | - Camilla Tøndel
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Kristin G I Mohn
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Türküler Özgümüş
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rebecca J Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Advisory Unit for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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32
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Ahmad I, Edin A, Granvik C, Kumm Persson L, Tevell S, Månsson E, Magnuson A, Marklund I, Persson IL, Kauppi A, Ahlm C, Forsell MNE, Sundh J, Lange A, Cajander S, Normark J. High prevalence of persistent symptoms and reduced health-related quality of life 6 months after COVID-19. Front Public Health 2023; 11:1104267. [PMID: 36817925 PMCID: PMC9932930 DOI: 10.3389/fpubh.2023.1104267] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
Background The long-term sequelae after COVID-19 constitute a challenge to public health and increased knowledge is needed. We investigated the prevalence of self-reported persistent symptoms and reduced health-related quality of life (HRQoL) in relation to functional exercise capacity, 6 months after infection, and explored risk factors for COVID-19 sequalae. Methods This was a prospective, multicenter, cohort study including 434 patients. At 6 months, physical exercise capacity was assessed by a 1-minute sit-to-stand test (1MSTST) and persistent symptoms were reported and HRQoL was evaluated through the EuroQol 5-level 5-dimension (EQ-5D-5L) questionnaire. Patients with both persistent symptoms and reduced HRQoL were classified into a new definition of post-acute COVID syndrome, PACS+. Risk factors for developing persistent symptoms, reduced HRQoL and PACS+ were identified by multivariable Poisson regression. Results Persistent symptoms were experienced by 79% of hospitalized, and 59% of non-hospitalized patients at 6 months. Hospitalized patients had a higher prevalence of self-assessed reduced overall health (28 vs. 12%) and PACS+ (31 vs. 11%). PACS+ was associated with reduced exercise capacity but not with abnormal pulse/desaturation during 1MSTST. Hospitalization was the most important independent risk factor for developing persistent symptoms, reduced overall health and PACS+. Conclusion Persistent symptoms and reduced HRQoL are common among COVID-19 survivors, but abnormal pulse and peripheral saturation during exercise could not distinguish patients with PACS+. Patients with severe infection requiring hospitalization were more likely to develop PACS+, hence these patients should be prioritized for clinical follow-up after COVID-19.
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Affiliation(s)
- Irma Ahmad
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Alicia Edin
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | | | - Lowa Kumm Persson
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Staffan Tevell
- Department of Infectious Diseases, Karlstad Hospital, Karlstad, Sweden
- Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Emeli Månsson
- Centre for Clinical Research, Region Västmanland—Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden
| | - Anders Magnuson
- Center for Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ingela Marklund
- Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Ida-Lisa Persson
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Anna Kauppi
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | | | - Josefin Sundh
- Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anna Lange
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Sara Cajander
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johan Normark
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
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33
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Matsuoka N, Mizutani T, Kawakami K. Symptom Profile of Patients With Post-COVID-19 Conditions and Influencing Factors for Recovery. J Clin Med Res 2023; 15:116-126. [PMID: 36895625 PMCID: PMC9990724 DOI: 10.14740/jocmr4855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/16/2023] [Indexed: 03/04/2023] Open
Abstract
Background The aim of the study was to examine the factors that influence the improvement of post-coronavirus disease 2019 (COVID-19) symptoms. Methods We investigated the biomarkers and post-COVID-19 symptoms status of 120 post-COVID-19 symptomatic outpatients (44 males and 76 females) visiting our hospital. This study was a retrospective analysis, so we analyzed the course of symptoms only for those who could follow the progress of the symptoms for 12 weeks. We analyzed the data including the intake of zinc acetate hydrate. Results The main symptoms that remained after 12 weeks were, in descending order: taste disorder, olfactory disorder, hair loss, and fatigue. Fatigue was improved in all cases treated with zinc acetate hydrate 8 weeks later, exhibiting a significant difference from the untreated group (P = 0.030). The similar trend was observed even 12 weeks later, although there was no significant difference (P = 0.060). With respect to hair loss, the group treated with zinc acetate hydrate showed significant improvements 4, 8, and 12 weeks later, compared with the untreated group (P = 0.002, P = 0.002, and P = 0.006). Conclusion Zinc acetate hydrate may improve fatigue and hair loss as symptoms after contracting COVID-19.
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Affiliation(s)
- Norihiro Matsuoka
- Jyoto Hospital, 2-11-22, Hanaten-higashi, Tsurumi-ku, Osaka-shi, Osaka 538-0044, Japan
| | - Takuo Mizutani
- Jyoto Hospital, 2-11-22, Hanaten-higashi, Tsurumi-ku, Osaka-shi, Osaka 538-0044, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
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34
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Štěpánek L, Nakládalová M, Janošíková M, Štěpánek L, Kabrhelová K, Boriková A. Predictors and characteristics of post-acute COVID-19 syndrome in healthcare workers. Infect Dis (Lond) 2023; 55:125-131. [PMID: 36285402 DOI: 10.1080/23744235.2022.2136750] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Post-acute COVID-19 syndrome (PCS) is a multisystem disorder degrading the quality of life. The study determined characteristics and predictors of PCS in unvaccinated healthcare workers (HCWs) suffering from PCS based on a comparison with their fully recovered counterparts. METHODS 305 HCWs were examined at least 12 weeks post COVID-19 symptom onset to obtain data about their acute phase of COVID-19 and current health status and tested for complete blood count, C-reactive protein (CRP), electrophoresis of plasma proteins and SARS-CoV-2-specific immunoglobulin (Ig) G and M. RESULTS 181 (59.3%) HCWs reported persisting symptoms attributable to PCS during the examination and 124 (40.7%) HCWs stated no symptoms. In the entire sample, the mean CRP level slightly exceeded the normal range (6.63 mg/L, 95% confidence interval [CI] 5.96-7.3) while all other laboratory results were within the normal range. No statistically significant differences in laboratory results were revealed between both subgroups except for the mean Ig levels, which were higher in HCWs with PCS. The average number of symptoms of PCS was 1.9 (median 2). The most frequent symptoms of PCS were fatigue that interfered with daily life (47.5%), shortness of breath (38.1%), muscle or joint aches (16%), loss of smell (14.9%), headache (14.9%) and sleep disorders (11%). The only statistically significant predictors of PCS were female sex (odds ratio [OR] 1.48, 95% CI 1.059-2.067, p = .022) and increasing age (OR 1.04, 95% CI 1.01-1.07, p = .008). CONCLUSIONS PCS appears to be a prevalent condition determined by female sex and increasing age.
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Affiliation(s)
- Ladislav Štěpánek
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Marie Nakládalová
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Magdaléna Janošíková
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lubomír Štěpánek
- Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kateřina Kabrhelová
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Alena Boriková
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
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35
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Mazurkiewicz I, Chatys-Bogacka Z, Slowik J, Klich-Raczka A, Fedyk-Lukasik M, Slowik A, Wnuk M, Drabik L. Fatigue after COVID-19 in non-hospitalized patients according to sex. Brain Behav 2023; 13:e2849. [PMID: 36620918 PMCID: PMC9927850 DOI: 10.1002/brb3.2849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Limited evidence exists on sex differences in post-COVID fatigue among non-hospitalized patients. Therefore, aim of the study was to evaluate the course of chronic fatigue symptoms in non-hospitalized subjects with the SARS-CoV-2 infection, according to sex. METHODS Patients and staff from the University Hospital in Krakow anonymously and retrospectively completed neuropsychological questionnaire that included eight symptoms of chronic fatigue syndrome. The presence of these symptoms was assessed before COVID-19 and 0-4, 4-12, and >12 weeks postinfection. The inclusion criteria were as follows: age 18 or more years, >12 weeks since the onset of the SARS-CoV-2 infection, and diagnosis confirmed by the RT-PCR from anasopharyngeal swab. RESULTS We included 303 patients (79.53% women, 47.52% medical personnel) assessed retrospectively after a median of 30 (interquartile range: 23-35) weeks since the onset of symptoms. A higher prevalence of at least one chronic fatigue symptom was found in females in all time intervals after the onset of COVID-19 compared to males (p < .036). Women, compared to men, more often experienced persistent fatigue, not caused by effort and persisting after rest (for <4 weeks, odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.13-4.73; for 4-12 weeks, OR = 1.95, 95% CI: 1.06-3.61), non-restorative sleep (for <4 weeks, OR = 2.17, 95% CI: 1.23-3.81; for >12 weeks, OR = 1.95, 95% CI: 1.03-3.71), and sore throat (for <4 weeks, OR = 1.97, 95% CI: 1.03-3.78; for 4-12 weeks, OR = 2.76, 95% CI: 1.05-7.27). Sex differences in headache, arthralgia, and prolonged postexercise fatigue were observed only during the first 4 weeks (OR = 2.59, 95% CI: 1.45-4.60, OR = 2.97, 95% CI: 1.02-8.64, and OR = 1.87, 95% CI: 1.01-3.51, respectively). There were no differences between women and men in myalgia and self-reported lymph node enlargement. CONCLUSIONS The course of post-COVID fatigue differs significantly between sexes in non-hospitalized individuals with COVID-19, with women more often suffering from persistent fatigue, not caused by effort and persisting after rest, non-restorative sleep, and sore throat.
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Affiliation(s)
| | - Zaneta Chatys-Bogacka
- Department of Neurology, University Hospital in Krakow, Krakow, Poland.,Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Joanna Slowik
- Department of Periodontology, Preventive Dentistry and Oral Medicine, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Alicja Klich-Raczka
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.,Department of Internal Medicine and Geriatrics, University Hospital in Krakow, Krakow, Poland
| | - Malgorzata Fedyk-Lukasik
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Slowik
- Department of Neurology, University Hospital in Krakow, Krakow, Poland.,Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Wnuk
- Department of Neurology, University Hospital in Krakow, Krakow, Poland.,Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Leszek Drabik
- Department of Pharmacology, Jagiellonian University Medical College, Krakow, Poland.,Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland
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36
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Ghosn J, Bachelet D, Livrozet M, Cervantes-Gonzalez M, Poissy J, Goehringer F, Gandonniere CS, Maillet M, Bani-Sadr F, Martin-Blondel G, Tattevin P, Launay O, Surgers L, Dudoignon E, Liegeon G, Zucman D, Joseph C, Senneville E, Yelnik C, Roger PM, Faure K, Gousseff M, Cabié A, Duval X, Chirouze C, Laouénan C. Prevalence of post-acute coronavirus disease 2019 symptoms twelve months after hospitalization in participants retained in follow-up: analyses stratified by gender from a large prospective cohort. Clin Microbiol Infect 2023; 29:254.e7-254.e13. [PMID: 36191847 PMCID: PMC9523945 DOI: 10.1016/j.cmi.2022.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/05/2022] [Accepted: 08/30/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Persistent post-acute coronavirus disease 2019 (COVID-19) symptoms (PACSs) have been reported up to 6 months after hospital discharge. Herein we assessed the symptoms that persisted 12 months (M12) after admission for COVID-19 in the longitudinal prospective national French coronavirus disease cohort. METHODS Hospitalized patients with a confirmed virological diagnosis of COVID-19 were enrolled. Follow-up was planned until M12 after admission. Associations between persistence of ≥3 PACSs at M12 and clinical characteristics at admission were assessed through logistic regression according to gender. RESULTS We focused on participants enrolled between 24 January 2020 and 15 July 2020, to allow M12 follow-up. The M12 data were available for 737 participants. Median age was 61 years, 475 (64%) were men and 242/647 (37%) were admitted to intensive care units during the acute phase. At M12, 27% (194/710) of the participants had ≥3 persistent PACS, mostly fatigue, dyspnoea and joint pain. Among those who had a professional occupation before the acute phase, 91 out of 339 (27%) were still on sick leave at M12. Presence of ≥3 persistent PACS was associated with female gender, both anxiety and depression, impaired health-related quality of life and Medical Muscle Research Council Scale <57. Compared with men, women more often reported presence of ≥3 persistent PACSs (98/253, 39% vs. 96/457, 21%), depression and anxiety (18/152, 12% vs. 17/268, 6% and 33/156, 21% vs. 26/264, 10%, respectively), impaired physical health-related quality of life (76/141, 54% vs. 120/261, 46%). Women had less often returned to work than men (77/116, 66% vs. 171/223, 77%). CONCLUSIONS One fourth of the individuals admitted to hospital for COVID-19 still had ≥3 persistent PACSs at M12 post-discharge. Women reported more often ≥3 persistent PACSs, suffered more from anxiety and depression and had less often returned to work than men.
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Affiliation(s)
- Jade Ghosn
- Université Paris Cité, INSERM, IAME UMR 1137, Paris, France,AP-HP.Nord, Service des maladies infectieuses et tropicales, Hôpital Bichat, Paris, France
| | - Delphine Bachelet
- INSERM, Centre d’Investigation clinique 1425, Hôpital Bichat, Paris, France,AP-HP.Nord, Département d'Epidémiologie Biostatistique et Recherche Clinique, Hôpital Bichat, Paris, France
| | - Marine Livrozet
- Université Paris Cité, INSERM, PARCC, CIC1418; DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Minerva Cervantes-Gonzalez
- Université Paris Cité, INSERM, IAME UMR 1137, Paris, France,AP-HP.Nord, Service des maladies infectieuses et tropicales, Hôpital Bichat, Paris, France,AP-HP.Nord, Département d'Epidémiologie Biostatistique et Recherche Clinique, Hôpital Bichat, Paris, France
| | - Julien Poissy
- Université de Lille, INSERM U128, CHU Lille, Pôle de réanimation, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - François Goehringer
- Service des maladies infectieuses, CHRU-Nancy, Université de Lorraine, Nancy, France
| | | | - Mylène Maillet
- Service de Maladies Infectieuses – Médecine Interne, Centre Hospitalier Annecy Genevois, Epagny Metz Tessy, France
| | - Firouzé Bani-Sadr
- CHU Reims, Service des Maladies Infectieuses et Tropicales, Reims, France
| | - Guillaume Martin-Blondel
- Service des Maladies Infectieuses et Tropicales, CHU de Toulouse, & Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM UMR1291 - CNRS UMR5051 - Université Toulouse III, Toulouse, France
| | - Pierre Tattevin
- Hôpital Pontchaillou, Maladies Infectieuses et Réanimation, CHU Rennes, France
| | - Odile Launay
- Université Paris Cité, CIC Cochin-Pasteur, AP-HP, Hôpital Cochin, INSERM CIC1417, Paris, France
| | - Laure Surgers
- GHU APHP.Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France,Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris, France
| | - Emmanuel Dudoignon
- AP-HP.Nord, Hôpital Saint-Louis, Service d'anesthésie-réanimation-CTB, DMU PARABOL, Université Paris Cité, Paris, France
| | - Geoffroy Liegeon
- AP-HP.Nord, Hôpital Saint-Louis, Service des Maladies Infectieuses et Tropicales, Université Paris Cité, Paris, France
| | - David Zucman
- Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | - Cédric Joseph
- CHU Amiens-Picardie, Service des Maladies Infectieuses et Tropicales; EA 4294, AGIR, Jules Verne Picardy University, Amiens, France
| | - Eric Senneville
- Service des Maladies Infectieuses, Hôpital de Tourcoing, France
| | - Cécile Yelnik
- Département de Médecine Interne et Immunologie Clinique, CHU Lille, France
| | - Pierre-Marie Roger
- Centre Hospitalier Universitaire de Guadeloupe, UMR 1058 Pathogenesis and Control of Chronic and Emerging Infections, Guadeloupe, France
| | - Karine Faure
- Service de Maladies Infectieuses, CHU, Lille, France
| | - Marie Gousseff
- Service de Médecine Interne, Maladies Infectieuses et Hématologie, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - André Cabié
- CHU de Martinique, Fort-de-France; PCCEI, Univ Montpellier, Univ Antilles, INSERM, EFS, Montpellier; and INSERM CIC1424, Fort-de-France, France
| | - Xavier Duval
- Université Paris Cité, INSERM, IAME UMR 1137, Paris, France,INSERM, Centre d’Investigation clinique 1425, Hôpital Bichat, Paris, France
| | - Catherine Chirouze
- Chrono-environnement UMR6249, CNRS, Université Bourgogne Franche-Comté; CHU Besançon, service de maladies infectieuses et tropicales, Besançon, France
| | - Cédric Laouénan
- Université Paris Cité, INSERM, IAME UMR 1137, Paris, France; INSERM, Centre d'Investigation clinique 1425, Hôpital Bichat, Paris, France; AP-HP.Nord, Département d'Epidémiologie Biostatistique et Recherche Clinique, Hôpital Bichat, Paris, France.
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Golzari-Sorkheh M, Weaver DF, Reed MA. COVID-19 as a Risk Factor for Alzheimer's Disease. J Alzheimers Dis 2023; 91:1-23. [PMID: 36314211 DOI: 10.3233/jad-220800] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Severe acute respiratory disease coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic. Although a primarily respiratory disease, recent reports indicate that it also affects the central nervous system (CNS). Over 25% of COVID-19 patients report neurological symptoms such as memory loss, anosmia, hyposmia, confusion, and headaches. The neurological outcomes may be a result of viral entry into the CNS and/or resulting neuroinflammation, both of which underlie an elevated risk for Alzheimer's disease (AD). Herein, we ask: Is COVID-19 a risk factor for AD? To answer, we identify the literature and review mechanisms by which COVID-19-mediated neuroinflammation can contribute to the development of AD, evaluate the effects of acute versus chronic phases of infection, and lastly, discuss potential therapeutics to address the rising rates of COVID-19 neurological sequelae.
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Affiliation(s)
| | - Donald F Weaver
- Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Department of Chemistry, University of Toronto, Toronto, ON, Canada.,Department of Pharmaceutical Chemistry, University of Toronto, Toronto, ON, Canada
| | - Mark A Reed
- Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
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38
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Osipova NN, At'kova EO, Akimova DD, Dmitrieva EV, Bardenshtein LM. [Structure and dynamics of depressive disorders in patients with a new coronavirus infection]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:96-100. [PMID: 38127708 DOI: 10.17116/jnevro202312311296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To analyze the dynamics of depressive disorders in patients who underwent COVID-19. MATERIAL AND METHODS The study included female patients (n=30) with mean age 35.4±3.0 years, who received inpatient treatment of depressive spectrum symptoms in accordance with ICD-10 rubrics F31-F34 and who have undergone COVID-19 (U04.9, U07.1, U07.2). Clinical-psychopathological and statistical methods were used. RESULTS Among all patients, who underwent inpatient treatment for affective disorders, the most common symptoms were: low mood (96.7%), anxiety (83.3%), decreased interest in daily activities (40%), loss of appetite (36.7%). In patients who have had depressive symptoms before COVID-19, an increase in the number of affective spectrum symptoms (suicidal thoughts - 83.3%), as well as in asthenic manifestations in the form of increased fatigue (60%), sleep disorders (73.3%), feelings of fatigue, weakness (60%), emotional lability (40%). CONCLUSION In patients with depressive disorders who underwent COVID-19, hypothymia is most often accompanied by anxiety, suicidal thoughts, as well as asthenic manifestations in the form of fatigue, sleep disturbances, and emotional lability. An increase in the number of asthenic spectrum symptoms in patients with depressive disorders may indicate a possible link between COVID-19 and affective pathology. The impact of coronavirus infection on the structure and dynamics of depressive disorders requires further study, taking into account the severity of affective symptoms, the impact of psychopharmacotherapy, and the severity of the infectious disease.
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Affiliation(s)
- N N Osipova
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - E O At'kova
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - D D Akimova
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - E V Dmitrieva
- Smolensk State University of Medicine, Smolensk, Russia
| | - L M Bardenshtein
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Fluoxetine plus lithium for treatment of mental health impairment in Long Covid. DISCOVER MENTAL HEALTH 2023; 3:1. [PMID: 36618714 PMCID: PMC9810252 DOI: 10.1007/s44192-022-00027-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023]
Abstract
Purposes (1) To summarize the mental conditions that may accompany persistent symptoms following acute infection by SARS-CoV-2, often termed Long Covid; (2) to formulate treatment based upon the brain cells that are dominantly affected. Methods (1) Review the reports relating to the mental symptoms occurring in Long Covid. (2) Review the drugs that address the brain cells affected in Long Covid, and suggest pharmacotherapy for those patients whose response to psychotherapy is suboptimal. Results Long Covid affects ~ 10% of patients infected by SARS-CoV-2, and mental symptoms affect ~ 20% of persons with Long Covid. The brain cell-types that have been demonstrated as dominantly affected in Long Covid are astrocytes, oligodendrocytes, neurons, endothelial cells/pericytes, and microglia. Lithium and fluoxetine each address all of those four cell-types. Low dosage of each is likely to be well-tolerated and to cause neither clinically important adverse events (AE) nor serious adverse events (SAE). Conclusion For those patients whose response to psychotherapy is suboptimal, lithium and fluoxetine should be administered in combination for both depth of benefit and reduction of dosages.
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Ausserhofer D, Mahlknecht A, Engl A, Piccoliori G, Pfitscher G, Silbernagl P, Giacomoni F, Pycha R, Lombardo S, Gärtner T, Mian M, Meier H, Wiedermann CJ, Keim R. Relationship between depression, anxiety, stress, and SARS-CoV-2 infection: a longitudinal study. Front Psychol 2023; 14:1116566. [PMID: 37213392 PMCID: PMC10197902 DOI: 10.3389/fpsyg.2023.1116566] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/06/2023] [Indexed: 05/23/2023] Open
Abstract
Objectives We aimed to (1) describe the course of the emotional burden (i.e., depression, anxiety, and stress) in a general population sample during the coronavirus pandemic in 2020 and 2021 and (2) explore the association between emotional burden and a serologically proven infection with SARS-CoV-2. Study design This longitudinal study involved a sample of community-dwelling persons aged ≥14 years from the general population of South Tyrol (Province of Bolzano-Bozen, Northern Italy). Data were collected at two stages over a 1-year period in 2020 and 2021. Methods Persons were invited to participate in a survey on socio-demographic, health-related and psychosocial variables (e.g., age, chronic diseases, Depression Anxiety Stress Scale, DASS-21), as well as in the serological testing for of SARS-CoV-2-specific immunoglobulins. Results In 2020, 855 (23.8%) out of 3,600 persons participated; in 2021, 305 (35.7%) out of 855 were tested again. We observed a statistically significant decrease in mean DASS-21 scores for depression, stress, and total scores between 2020 and 2021, yet not for anxiety. Persons with a confirmed SARS-CoV-2-infection between the first and second data collection exhibited increased emotional burden compared to those without SARS-CoV-2-infection. The odds of participants with a self-reported diagnosis of mental disorder for future infection with SARS-CoV-2 was almost four times higher than that of participants without mental disorders (OR:3.75; 95%CI:1.79-7.83). Conclusion Our findings support to the hypothesis of a psycho-neuroendocrine-immune interplay in COVID-19. Further research is necessary to explore the mechanisms underlying the interplay between mental health and SARS-CoV-2 infections.
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Affiliation(s)
- Dietmar Ausserhofer
- Institute of General Practice and Public Health, College of Health Care-Professions Claudiana, Bolzano-Bozen, Italy
- Claudiana Research, College of Health Care-Professions Claudiana, Bolzano-Bozen, Italy
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, College of Health Care-Professions Claudiana, Bolzano-Bozen, Italy
| | - Adolf Engl
- Institute of General Practice and Public Health, College of Health Care-Professions Claudiana, Bolzano-Bozen, Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, College of Health Care-Professions Claudiana, Bolzano-Bozen, Italy
| | - Gernot Pfitscher
- Hospital of Bressanone-Brixen (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bressanone-Brixen, Italy
| | - Philipp Silbernagl
- Hospital of Bressanone-Brixen (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bressanone-Brixen, Italy
| | - Francesca Giacomoni
- Hospital of Bressanone-Brixen (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bressanone-Brixen, Italy
| | - Roger Pycha
- Hospital of Bressanone-Brixen (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bressanone-Brixen, Italy
| | - Stefano Lombardo
- Statistical Institute of the Province of Bolzano (ASTAT), Bolzano-Bozen, Italy
| | - Timon Gärtner
- Statistical Institute of the Province of Bolzano (ASTAT), Bolzano-Bozen, Italy
| | - Michael Mian
- Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano-Bozen, Italy
| | - Horand Meier
- Clinical Governance Unit, Administration of the Autonomous Province of Bolzano-Bozen, Bolzano-Bozen, Italy
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, College of Health Care-Professions Claudiana, Bolzano-Bozen, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Roland Keim
- Hospital of Bressanone-Brixen (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bressanone-Brixen, Italy
- *Correspondence: Roland Keim,
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Takakura K, Suka M, Kajihara M, Koido S. Clinical features, therapeutic outcomes, and recovery period of long COVID. J Med Virol 2023; 95:e28316. [PMID: 36412057 PMCID: PMC10108287 DOI: 10.1002/jmv.28316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 11/23/2022]
Abstract
To characterize the clinical features of long COVID, 286 patients who received care in our outpatient clinic for long COVID from May to December 2021 were surveyed. The recovery periods of each symptom and the key factors contributing to early recovery were statistically analysed. The median age of the patients was 35.8 years, with 137 men and 149 women. The median number of symptoms was 2.8. The most frequent symptoms were respiratory manifestations (52.1%), followed by fatigue (51.4%). Respiratory symptoms, fatigue, and headache/arthralgia were major complaints in the initial phase, whereas hair loss was a major complaint in the late phase, suggesting that the chief complaint of patients with long COVID may vary temporally. The best treatment outcome was observed for pulmonary symptoms, and hair loss had the worst outcome. COVID-19 severity, the number of manifestations, and the delay in starting treatment exerted a negative effect on the recovery period of long COVID. In addition, the smoking habit was an independent risk factor for slowing the recovery period from long COVID. This study provides insights into the clinical course of each manifestation and therapeutic options with a more certain future of long COVID to meet the unmet medical needs.
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Affiliation(s)
- Kazuki Takakura
- Department of Internal Medicine, UnMed Clinic Motomachi, Yokohama, Kanagawa, Japan
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Mikio Kajihara
- Department of Internal Medicine, Kajihara Clinic, Hiratsuka, Kanagawa, Japan
| | - Shigeo Koido
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, The Jikei University Kashiwa Hospital, Chiba, Japan
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42
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Chen S, Cardinal RN, Auckland K, Gräf S, O'Brien JT, Underwood BR. Risk Factors for Longer-Term Mortality in Discharged Patients with Dementia and SARS-CoV-2 Infection: A Matched Case-Control Study. J Alzheimers Dis 2023; 92:295-309. [PMID: 36744344 DOI: 10.3233/jad-221093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Persisting symptoms and increased mortality after SARS-CoV-2 infection has been described in COVID-19 survivors. OBJECTIVE We examined longer-term mortality in patients with dementia and SARS-CoV-2 infection. METHODS A retrospective matched case-control study of 165 patients with dementia who survived an acute hospital admission with COVID-19 infection, and 1325 patients with dementia who survived a hospital admission but without SARS-CoV-2 infection. Potential risk factors investigated included socio-demographic factors, clinical features, and results of investigations. Data were fitted using a Cox proportional hazard model. RESULTS Compared to patients with dementia but without SARS-CoV-2 infection, people with dementia and SARS-CoV-2 infection had a 4.4-fold risk of death (adjusted hazard ratio [aHR] = 4.44, 95% confidence interval [CI] 3.13-6.30) even beyond the acute phase of infection. This excess mortality could be seen up to 125 days after initial recovery but was not elevated beyond this time. Risk factors for COVID-19-associated mortality included prescription of antipsychotics (aHR = 3.06, 95% CI 1.40-6.69) and benzodiazepines (aHR = 3.00, 95% CI 1.28-7.03). Abnormalities on investigation associated with increased mortality included high white cell count (aHR = 1.21, 95% CI 1.04-1.39), higher absolute neutrophil count (aHR = 1.28, 95% CI 1.12-1.46), higher C-reactive protein (aHR = 1.01, 95% CI 1.00-1.02), higher serum sodium (aHR = 1.09, 95% CI 1.01-1.19), and higher ionized calcium (aHR = 1.03, 95% CI 1.00-1.06). The post-acute COVID mortality could be modeled for the first 120 days after recovery with a balanced accuracy of 87.2%. CONCLUSION We found an increased mortality in patients with dementia beyond the acute phase of illness. We identified several investigation results associated with increased mortality, and increased mortality in patients prescribed antipsychotics or benzodiazepines.
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Affiliation(s)
- Shanquan Chen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Rudolf N Cardinal
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | | | | | - Stefan Gräf
- Department of Medicine, University of Cambridge, Cambridge, UK.,Departmentof Haematology, University of Cambridge, Cambridge, UK.,NIHR BioResource for Translational Research, Cambridge, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, UK
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Kim SW. COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons? J Korean Med Sci 2022; 37:e356. [PMID: 36573388 PMCID: PMC9792262 DOI: 10.3346/jkms.2022.37.e356] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
The first coronavirus disease 2019 (COVID-19) outbreak in Daegu city was overcome by efforts, including; 1) prompt isolation and quarantine action by local government with cooperative help from expert groups and the central government, 2) high-intensity social distancing and active cooperation of citizens, 3) admission of asymptomatic and mild patients in 'residential treatment centers', and 4) use of a telephone scoring system for the allocation of patients, with a mortality rate of 2.5%. A continuous suppression policy with test, tracing, and treatment (3 Ts) was implemented as an active response to the initial outbreaks in Korea. With the introduction of vaccines and therapeutic agents, the COVID-19 crisis had improved. Recently, the omicron variant was responsible for most domestic outbreaks, albeit with a low mortality rate (0.1%). Since the omicron outbreak, a damage mitigation policy has been implemented, focusing on protecting vulnerable groups. In the future, preparation including below are needed; 1) improving the national public health emergency response system, 2) strengthening the crisis response capacity of local governments, 3) cooperation between public healthcare and private healthcare, and 4) establishing a resilient medical response system.
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Affiliation(s)
- Shin-Woo Kim
- Division of Infectious Disease, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
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Ishii S, Sugiyama A, Ito N, Miwata K, Kitahara Y, Okimoto M, Kurisu A, Abe K, Imada H, Akita T, Kubo T, Nagasawa A, Nakanishi T, Takafuta T, Kuwabara M, Tanaka J. The role of discrimination in the relation between COVID-19 sequelae, psychological distress, and work impairment in COVID-19 survivors. Sci Rep 2022; 12:22218. [PMID: 36564428 PMCID: PMC9782263 DOI: 10.1038/s41598-022-26332-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Perceived discrimination and work impairment are commonly observed in COVID-19 survivors, but their relationship has not been well understood. We aimed to evaluate the role of discrimination in the development of psychological distress and work impairment in COVID-19 survivors. From April 2020 to November 2021, 309 patients were recruited at two designated COVID-19 hospitals in Japan. Participants completed a standardized questionnaire including COVID-19 sequelae, psychological distress, impairments in work performance and perceived discrimination. The majority of participants (62.5%) experienced one or more COVID-19 sequelae. Psychological distress was observed in 36.9% and work impairment in 37.9%. In multivariate logistic regression analyses, COVID-19 sequelae and discrimination were associated with both psychological distress and work impairment. Mediation analysis demonstrated that the direct effect of sequelae on work impairment was non-significant after accounting for psychological distress, suggesting that the effect of sequelae on work impairment was mainly mediated through psychological distress. These findings were replicated in a subgroup analysis limited to patients with mild COVID-19. We conclude that discrimination plays an important role in the development of psychological distress and work impairment, and that both discrimination and psychological distress should be targets of intervention in COVID-19 survivors.
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Affiliation(s)
- Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Aya Sugiyama
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Noriaki Ito
- Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Kei Miwata
- Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | | | - Mafumi Okimoto
- Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Akemi Kurisu
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kanon Abe
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hirohito Imada
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | | | - Masao Kuwabara
- Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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Abstract
BACKGROUND Long haulers have been recently reported after contracting coronavirus disease (COVID-19). In the present study, we aimed to screen for the neuropsychiatric signs detected <1 to >6 months after infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to determine whether vaccination has an effect on them. METHODS An online survey was conducted among participants who had been diagnosed with laboratory-confirmed SARS-CoV-2 infection. The clinical signs and durations of neuropsychiatric complaints and their correlations to sex, age, severity of COVID-19 signs, and vaccination status were screened. RESULTS A total of 2218 individuals, including 1358 females and 860 males, with an age range of 12-70 years, submitted their responses. The respondents experienced cognitive dysfunction, mood alteration, depression, tinnitus, sleep disorders, and loss of taste and smell, with prevalence rates ranging from 18.9% (tinnitus) to 63.9% (loss of taste and smell). Of the respondents, 2.2-7.7% confirmed the persistence of symptoms for >6 months. Tinnitus was the least common complaint, and only 2.2% of the study participants had tinnitus for >6 months. Meanwhile, mood alteration persisted for >6 months in 7.6% of the study participants. More respondents who received two doses of BNT162b2 vaccine showed persistent symptoms than those in the other groups. Disease severity and female sex were identified as potential determinants of the development and persistency of such symptoms. CONCLUSION Post-COVID neuropsychiatric symptoms were present in considerable percentages of the study participants with SARS-CoV-2 infection, persisting for >6 months in up to 7.6% of the participants.
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Psychiatric and neurological complications of long COVID. J Psychiatr Res 2022; 156:349-360. [PMID: 36326545 PMCID: PMC9582925 DOI: 10.1016/j.jpsychires.2022.10.045] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 08/23/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
COVID-19 was primarily considered a pulmonary disease with extrapulmonary manifestations. As the pandemic spread, there has been growing evidence that the disease affects various organs/systems, including the central and peripheral nervous systems. Accumulation of clinical data demonstrates that in a large population of survivors impairments in the function of one or more organs may persist for a long time, a phenomenon commonly known as post COVID or long COVID. Fatigue and cognitive dysfunction, such as concentration problems, short-term memory deficits, general memory loss, a specific decline in attention, language and praxis abilities, encoding and verbal fluency, impairment of executive functions, and psychomotor coordination, are amongst the most common and debilitating features of neuropsychatric symptoms of post COVID syndrome. Several patients also suffer from compromised sleep, depression, anxiety and post-traumatic stress disorder. Patients with long COVID may demonstrate brain hypometabolism, hypoperfusion of the cerebral cortex and changes in the brain structure and functional connectivity. Children and adolescents represent a minority of COVID-19 cases, so not surprisingly data on the long-term sequelae after SARS-CoV-2 infections in these age groups are scarce. Although the pathogenesis, clinical characteristics, epidemiology, and risk factors of the acute phase of COVID-19 have been largely explained, these areas are yet to be explored in long COVID. This review aims to provide an update on what is currently known about long COVID effects on mental health.
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Hogberg HT, Lam A, Ohayon E, Shahbaz MA, Clerbaux LA, Bal-Price A, Coecke S, Concha R, De Bernardi F, Edrosa E, Hargreaves AJ, Kanninen KM, Munoz A, Pistollato F, Saravanan S, Garcia-Reyero N, Wittwehr C, Sachana M. The Adverse Outcome Pathway Framework Applied to Neurological Symptoms of COVID-19. Cells 2022; 11:cells11213411. [PMID: 36359807 PMCID: PMC9658029 DOI: 10.3390/cells11213411] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 12/15/2022] Open
Abstract
Several reports have shown that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential to also be neurotropic. However, the mechanisms by which SARS-CoV-2 induces neurologic injury, including neurological and/or psychological symptoms, remain unclear. In this review, the available knowledge on the neurobiological mechanisms underlying COVID-19 was organized using the AOP framework. Four AOPs leading to neurological adverse outcomes (AO), anosmia, encephalitis, stroke, and seizure, were developed. Biological key events (KEs) identified to induce these AOs included binding to ACE2, blood–brain barrier (BBB) disruption, hypoxia, neuroinflammation, and oxidative stress. The modularity of AOPs allows the construction of AOP networks to visualize core pathways and recognize neuroinflammation and BBB disruption as shared mechanisms. Furthermore, the impact on the neurological AOPs of COVID-19 by modulating and multiscale factors such as age, psychological stress, nutrition, poverty, and food insecurity was discussed. Organizing the existing knowledge along an AOP framework can represent a valuable tool to understand disease mechanisms and identify data gaps and potentially contribute to treatment, and prevention. This AOP-aligned approach also facilitates synergy between experts from different backgrounds, while the fast-evolving and disruptive nature of COVID-19 emphasizes the need for interdisciplinarity and cross-community research.
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Affiliation(s)
- Helena T. Hogberg
- National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27518, USA
- Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence: (H.T.H.); (M.S.)
| | - Ann Lam
- Green Neuroscience Laboratory, Neurolinx Research Institute, San Diego, CA 92111, USA
- Physicians Committee for Responsible Medicine, Washington, DC 20016, USA
| | - Elan Ohayon
- Green Neuroscience Laboratory, Neurolinx Research Institute, San Diego, CA 92111, USA
- Institute for Green & Open Sciences, Toronto, ON M6J 2J4, Canada
| | - Muhammad Ali Shahbaz
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | | | - Anna Bal-Price
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy
| | - Sandra Coecke
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy
| | - Rachel Concha
- Green Neuroscience Laboratory, Neurolinx Research Institute, San Diego, CA 92111, USA
| | - Francesca De Bernardi
- Division of Otorhinolaryngology, Department of Biotechnologies and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy
| | - Eizleayne Edrosa
- Green Neuroscience Laboratory, Neurolinx Research Institute, San Diego, CA 92111, USA
| | - Alan J. Hargreaves
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Katja M. Kanninen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, 70211 Kuopio, Finland
| | - Amalia Munoz
- European Commission, Joint Research Centre (JRC), 2440 Geel, Belgium
| | | | - Surat Saravanan
- Centre for Predictive Human Model Systems Atal Incubation Centre-Centre for Cellular and Molecular Biology, Hyderabad 500039, India
| | - Natàlia Garcia-Reyero
- Environmental Laboratory, US Army Engineer Research & Development Center, Vicksburg, MS 39180, USA
| | - Clemens Wittwehr
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy
| | - Magdalini Sachana
- Environment Health and Safety Division, Environment Directorate, Organisation for Economic Cooperation and Development (OECD), 75016 Paris, France
- Correspondence: (H.T.H.); (M.S.)
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McNaughton CD, Austin PC, Sivaswamy A, Fang J, Abdel-Qadir H, Daneman N, Udell JA, Wodchis WP, Mostarac I, Lee DS, Atzema CL. Post-acute health care burden after SARS-CoV-2 infection: a retrospective cohort study. CMAJ 2022; 194:E1368-E1376. [PMID: 36252983 PMCID: PMC9616149 DOI: 10.1503/cmaj.220728] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The post-acute burden of health care use after SARS-CoV-2 infection is unknown. We sought to quantify the post-acute burden of health care use after SARS-CoV-2 infection among community-dwelling adults in Ontario by comparing those with positive and negative polymerase chain reaction (PCR) test results for SARS-CoV-2 infection. METHODS We conducted a retrospective cohort study involving community-dwelling adults in Ontario who had a PCR test between Jan. 1, 2020, and Mar. 31, 2021. Follow-up began 56 days after PCR testing. We matched people 1:1 on a comprehensive propensity score. We compared per-person-year rates for health care encounters at the mean and 99th percentiles, and compared counts using negative binomial models, stratified by sex. RESULTS Among 531 702 matched people, mean age was 44 (standard deviation [SD] 17) years and 51% were female. Females who tested positive for SARS-CoV-2 had a mean of 1.98 (95% CI 1.63 to 2.29) more health care encounters overall per-person-year than those who had a negative test result, with 0.31 (95% CI 0.05 to 0.56) more home care encounters to 0.81 (95% CI 0.69 to 0.93) more long-term care days. At the 99th percentile per-person-year, females who tested positive had 6.48 more days of hospital admission and 28.37 more home care encounters. Males who tested positive for SARS-CoV-2 had 0.66 (95% CI 0.34 to 0.99) more overall health care encounters per-person-year than those who tested negative, with 0.14 (95% CI 0.06 to 0.21) more outpatient encounters and 0.48 (95% CI 0.36 to 0.60) long-term care days, and 0.43 (95% CI -0.67 to -0.21) fewer home care encounters. At the 99th percentile, they had 8.69 more days in hospital per-person-year, with fewer home care (-27.31) and outpatient (-0.87) encounters. INTERPRETATION We found significantly higher rates of health care use after a positive SARS-CoV-2 PCR test in an analysis that matched test-positive with test-negative people. Stakeholders can use these findings to prepare for health care demand associated with post-COVID-19 condition (long COVID).
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Affiliation(s)
- Candace D McNaughton
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont.
| | - Peter C Austin
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Atul Sivaswamy
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Jiming Fang
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Husam Abdel-Qadir
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Nick Daneman
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Jacob A Udell
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Walter P Wodchis
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Ivona Mostarac
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Douglas S Lee
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
| | - Clare L Atzema
- ICES Central (McNaughton, Austin, Sivaswamy, Fang, Abdel-Qadir, Daneman, Udell, Wodchis, Lee, Atzema); Sunnybrook Research Institute (McNaughton, Austin, Daneman, Mostarac, Atzema); Sunnybrook Health Sciences Centre (McNaughton, Daneman, Atzema); Department of Medicine (McNaughton, Abdel-Qadir, Daneman, Udell, Lee, Atzema), and Institute of Health Policy, Management and Evaluation (Austin, Abdel-Qadir, Udell, Wodchis, Atzema), University of Toronto; Peter Munk Cardiac Centre (Abdel-Qadir, Udell, Lee), Toronto General Hospital; Division of Cardiology (Abdel-Qadir, Udell), Women's College Hospital; Department of Medical Imaging (Lee), and Division of Cardiology (Abdel-Qadir, Udell, Lee), University Health Network, University of Toronto; Ted Rogers Centre for Heart Research (Abdel-Qadir, Lee); Institute for Better Health, Trillium Health Partners, Toronto, Ont
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Kim Y, Kim SE, Kim T, Yun KW, Lee SH, Lee E, Seo JW, Jung YH, Chong YP. Preliminary Guidelines for the Clinical Evaluation and Management of Long COVID. Infect Chemother 2022; 54:566-597. [PMID: 36196612 PMCID: PMC9533168 DOI: 10.3947/ic.2022.0141] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
Long-lasting coronavirus disease 2019 (COVID-19) symptoms beyond 12 weeks, the so-called 'long COVID' have been increasingly reported worldwide. Long COVID can be manifested in various forms, and there is an increasing demand for proper assessment and management. However, it is challenging when trying to determine the best-practice standards of care based on the current evidence because there is no internationally agreed clinical definition or clear treatment pathway. Therefore, the present guidelines have been drafted to provide advice on diagnosis and management based on the latest updated available evidence and the consensus of expert opinion. So far, no standard test and drug treatment can be strongly recommended for patients with long COVID because of a lack of evidence. The present guidelines provide advice based on 12 key questions, including appropriate interventions for long COVID that can be used in clinical practice. Continuous careful observation and studies related to long COVID are needed for the long-term impact of COVID-19 and proper management for long COVID to be determined.
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Affiliation(s)
- Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Seong Eun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Tark Kim
- Divison of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jun-Won Seo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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50
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Senjam SS, Balhara YPS, Kumar P, Nischal N, Manna S, Madan K, Ahmed NH, Gupta N, Vashist P, Guleria R. A Comprehensive Assessment of Self-Reported Post COVID-19 Symptoms Among Beneficiaries of Hospital Employee Scheme at a Tertiary Healthcare Institution in Northern India. Int J Gen Med 2022; 15:7355-7372. [PMID: 36164285 PMCID: PMC9509009 DOI: 10.2147/ijgm.s381070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients and Methods Results Conclusion
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Affiliation(s)
- Suraj Singh Senjam
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
- Correspondence: Suraj Singh Senjam, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India, Tel +91-011-2659-3032; +91 9968856431, Email
| | - Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Pameshwar Kumar
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Neeraj Nischal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Souvik Manna
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karan Madan
- Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nishat Hussain Ahmed
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Noopur Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Vashist
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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