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Lieberwerth M, Niemeijer A. Lost and changed meaning in life of people with Long Covid: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2289668. [PMID: 38055787 DOI: 10.1080/17482631.2023.2289668] [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: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023] Open
Abstract
Long Covid (LC) has been called the greatest mass-disabling event in human history. For patients, LC not only has implications for quality of life but also for meaning in life: how one's life and the world are understood and what is seen as valuable in one's life. This qualitative empirical study used a Constructivist Grounded Theory approach to investigate the meaning in life of people struggling with LC through ten patient interviews. This study shows that patients lose their prior understanding of life and come to a changed meaning in life, in part due to the experienced (social) isolation and loss of (both physical and cognitive) abilities caused by LC. Moreover, patients struggled with acceptance, uncertainty, and the inherent incomprehensibility and uncontrollability that living with LC entails, though this simultaneously co-existed with hope, optimism and acceptance. Additionally, dimensions of meaning intersect; a patient having some understanding of their illness (dimension of meaning: comprehension) required an understanding Other (dimension of meaning: connection). Emerging from lockdown brought the challenge and isolation of adjusting to chronic illness in society as usual (albeit divided about COVID-19 measures). This study thus offers novel insights regarding changed, present, and sought meaning in life for LC patients.
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Affiliation(s)
| | - Alistair Niemeijer
- Department of Ethics of Care, University of Humanistic Studies, Utrecht, Netherlands
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Smyth N, Ridge D, Kingstone T, Gopal DP, Alwan NA, Wright A, Chaudhry A, Clark S, Band R, Chew-Graham CA. People from ethnic minorities seeking help for long COVID: a qualitative study. Br J Gen Pract 2024:BJGP.2023.0631. [PMID: 38806207 DOI: 10.3399/bjgp.2023.0631] [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: 11/30/2023] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND People from ethnic minority groups are disproportionately affected by COVID-19, less likely to access primary health care, and have reported dissatisfaction with health care. Although the prevalence of long COVID in ethnic minority groups is unclear, such populations are underrepresented in long-COVID specialist clinics and long-COVID lived-experience research, which informed the original long-COVID healthcare guidelines. AIM To understand the lived experiences of long COVID in people from ethnic minority groups. DESIGN AND SETTING Qualitative study of people living with long COVID in the UK. METHOD Semi-structured interviews with people who self-disclosed long COVID were conducted between June 2022 and June 2023 via telephone or video call. Thematic analysis of the data was conducted. People who were living with long COVID, or caring for someone with long COVID, advised on all stages of the research. RESULTS Interviews were conducted with 31 participants representing diverse socioeconomic demographics. Help-seeking barriers included little awareness of long COVID or available support, and not feeling worthy of receiving care. Negative healthcare encounters were reported in primary health care; however, these services were crucial for accessing secondary or specialist care. There were further access difficulties and dissatisfaction with specialist care. Experiences of stigma and discrimination contributed to delays in seeking care and unsatisfactory experiences, resulting in feelings of mistrust in health care. CONCLUSION Empathy, validation of experiences, and fairness in recognition and support of healthcare needs are required to restore trust in health care and improve the experiences of people with long COVID.
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Affiliation(s)
- Nina Smyth
- School of Social Sciences, University of Westminster, London
| | - Damien Ridge
- School of Social Sciences, University of Westminster, London
| | - Tom Kingstone
- School of Medicine, Keele University, Newcastle-under-Lyme, and Research and Innovation Department, Midland Partnership University NHS Foundation Trust, Stafford
| | - Dipesh P Gopal
- Wolfson Institute of Population Health, Queen Mary University of London, London
| | - Nisreen A Alwan
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton
| | - Alexa Wright
- School of Humanities, University of Westminster, London
| | - Ashish Chaudhry
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, and patient advisor
| | - Sophie Clark
- NIHR Applied Research Collaboration Wessex, and School of Health Sciences, University of Southampton, Southampton
| | - Rebecca Band
- NIHR Applied Research Collaboration Wessex, and School of Health Sciences, University of Southampton, Southampton
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Hawke LD, Nguyen ATP, Wang W, Brown EE, Xu D, Deuville S, Goulding S, Ski CF, Rossell SL, Thompson DR, Rodak T, Strudwick G, Castle D. Systematic review of interventions for mental health, cognition and psychological well-being in long COVID. BMJ MENTAL HEALTH 2024; 27:e301133. [PMID: 39384321 DOI: 10.1136/bmjment-2024-301133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 09/13/2024] [Indexed: 10/11/2024]
Abstract
AIMS This systematic review aims to identify and synthesise the publicly available research testing treatments for mental health, cognition and psychological well-being in long COVID. METHODS The following databases and repositories were searched in October-November 2023: Medline, Embase, APA PsycINFO, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Internet, WANFANG Data, Web of Science's Preprint Citation Index, The Cochrane Central Register of Controlled Trials, Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform. Articles were selected if they described participants with long COVID symptoms at least 4 weeks after SAR-CoV-19 infection, reported primary outcomes on mental health, cognition and/or psychological well-being, and were available with at least an English-language summary. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed. RESULTS Thirty-three documents representing 31 studies were included. Seven tested psychosocial interventions, five pharmaceutical interventions, three natural supplement interventions, nine neurocognitive interventions, two physical rehabilitation interventions and five integrated interventions. While some promising findings emerged from randomised controlled trials, many studies were uncontrolled; a high risk of bias and insufficient reporting were also frequent. CONCLUSIONS The published literature on treatments for mental health, cognition and psychological well-being in long COVID show that the interventions are highly heterogeneous and findings are inconclusive to date. Continued scientific effort is required to improve the evidence base. Regular literature syntheses will be required to update and educate clinicians, scientists, interventionists and the long COVID community.
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Affiliation(s)
- Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anh T P Nguyen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Eric E Brown
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Dandan Xu
- Harbin Medical University, Harbin, Heilongjiang, China
| | - Susan Deuville
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Suzie Goulding
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Susan L Rossell
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - David R Thompson
- Queen's University Belfast School of Nursing and Midwifery, Belfast, Northern Ireland, UK
| | - Terri Rodak
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - David Castle
- University of Tasmania, Hobart, Tasmania, Australia
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4
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Naik H, Perlis RH, Tran KC, Staples JA. Self-reported Health Service Utilization and Barriers to Care Among US Adults with a History of Post COVID-19 Condition. J Gen Intern Med 2024:10.1007/s11606-024-09079-w. [PMID: 39375316 DOI: 10.1007/s11606-024-09079-w] [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: 05/03/2024] [Accepted: 09/24/2024] [Indexed: 10/09/2024]
Abstract
BACKGROUND Millions of US adults continue to experience symptoms of post COVID-19 condition (PCC). More data on health service utilization patterns and barriers to care in this population are needed to understand how to care for people with PCC. OBJECTIVE To evaluate health service utilization and barriers to medical care among individuals with a history of PCC compared with other US adults. DESIGN Data were analyzed from the 2022 National Health Interview Survey (NHIS), a nationally representative, cross-sectional survey of the US population. PARTICIPANTS US adults. MAIN MEASURES Health service utilization and the presence of financial and nonfinancial barriers to care in the preceding 12 months. KEY RESULTS There were 24,905 individuals included in the analysis, representing approximately 230 million US adults. The weighted prevalence of those with a history of PCC was 6.9% (95%CI, 6.5-7.3). Compared to other US adults, participants with a history of PCC were more likely to have had an urgent care visit (adjusted odds ratio (aOR) 1.52 [95%CI, 1.34-1.72]), emergency room visit (aOR 1.94 [95%CI 1.71-2.21]), hospitalization (aOR 1.48 [95%CI, 1.24-1.77]), rehabilitation services (aOR 1.35 [95%CI, 1.14-1.60]), home care (aOR 1.55 [95%CI, 1.66-2.26]), mental health counseling (aOR 1.39 [95%CI, 1.17-1.65]), and complementary and integrative medicine services (aOR 1.29 [95%CI, 1.13-1.49]). Furthermore, respondents with a history of PCC were more likely to report at least one financial barrier to care (aOR 1.71 [95%CI, 1.48-1.97]) and at least one nonfinancial barrier (aOR 1.77 [95%CI, 1.56-2.00]). A greater proportion of participants with a history of PCC reported a financial barrier and nonfinancial barrier than adults with most other chronic conditions captured by NHIS. CONCLUSIONS Individuals with a history of PCC were more likely to use a variety of health services and report barriers to medical care. Health systems should consider developing accessible, multidisciplinary care pathways for this population.
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Affiliation(s)
- Hiten Naik
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
- Post-COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada.
- Post-COVID-19 Interdisciplinary Clinical Care Network, Provincial Health Services Authority, 1333 West Broadway, Vancouver, British Columbia, V6H 1G9, Canada.
| | - Roy H Perlis
- Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Karen C Tran
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post-COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
| | - John A Staples
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver, British Columbia, Canada
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Sakel M, Saunders K, Faruqui R, Keene J, Wilkinson D. Living With Spasticity During the COVID-19 Pandemic: A Qualitative Study of Patient, Carer and Physician Experiences. Health Expect 2024; 27:e70032. [PMID: 39311542 PMCID: PMC11418296 DOI: 10.1111/hex.70032] [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: 10/20/2023] [Revised: 08/06/2024] [Accepted: 09/03/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Approximately 4.4 million people in England (8% of the total population) are living with a long-term neurological condition. Within this group of vulnerable individuals, there will be individuals living with severe spasticity that requires regular outpatient treatment with botulinum toxin injection. The closure of outpatient spasticity services during the pandemic impacted individuals who required spasticity treatment and their carers, as well as the specialist clinicians responsible for service delivery. OBJECTIVES We aimed to gain insight into the experiences of individuals living with spasticity, their carers and a clinical spasticity service lead during the pandemic, and to reflect on potential learning for the future. METHODS A qualitative study was designed using semi-structured interviews conducted by telephone. Participants comprised patients living with a long-term neurological condition who attended outpatient spasticity clinics before the start of the pandemic in England, primary carers who accompanied patients attending these clinics and a clinical spasticity service lead. Data were audio recorded, transcribed, anonymised and coded. Data analysis utilised the One Sheet of Paper thematic approach to identify themes, which were discussed and analysed by the interdisciplinary research team and two patient and carer participants. RESULTS Out of the 11 participants recruited, aged 36-77 years, seven comprised people living with spasticity related to a long-term neurological condition, three were carers and one was a clinical spasticity service lead. Six participants were male and five were female. Among the participants, four were stroke survivors, two were living with spinal cord injury and one was living with multiple sclerosis. Analysis revealed six major themes: experience of living with spasticity during the pandemic; impact of the pandemic on patient, carer and clinician health; access to and experience of outpatient clinic appointments; coping strategies during the pandemic; system improvements; and learning from the pandemic period. CONCLUSION These findings contribute research knowledge to a very limited research knowledge base and suggest that there is scope for improving system and service delivery through the allocation of research funding to senior clinicians working in this specialist area.
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Affiliation(s)
- Mohamed Sakel
- East Kent Hospitals University NHS Foundation TrustCanterburyUK
- Central England Rehabilitation Unit, South Warwickshire University NHS Foundation TrustLeamington Spa HospitalWarwickshireUK
| | - Karen Saunders
- Centre for Health Services Studies, School of Social Policy, Sociology and Social Research, Division for the Study of Law, Society and Social JusticeUniversity of KentCanterburyUK
| | - Rafey Faruqui
- Centre for Health Services Studies, School of Social Policy, Sociology and Social Research, Division for the Study of Law, Society and Social JusticeUniversity of KentCanterburyUK
- Department of PsychiatryKent and Medway NHS and Social Care Partnership TrustMaidstoneUK
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Biserni C, De Groot BO, Fuermaier ABM, de Waard D, Enriquez-Geppert S. Post-COVID fatigue: Reduced quality-of-life associated with clinically relevant fatigue in mild disease courses. Neuropsychol Rehabil 2024; 34:1302-1326. [PMID: 38380901 DOI: 10.1080/09602011.2024.2314874] [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: 04/12/2023] [Accepted: 11/20/2023] [Indexed: 02/22/2024]
Abstract
Fatigue is a pervasive symptom experienced by many individuals after COVID-19. Despite its widespread occurrence, fatigue remains a poorly understood and complex phenomenon. Our aim is to evaluate the subjective experience of mental fatigue after COVID-19 and to assess its significance for daily life functioning. In this online questionnaire study (N = 220), the Fatigue Severity Scale (FSS), World Health Organization Quality-of-Life assessment (WHOQoL) and a subjective severity rating of the COVID-19 disease progression were used. For our statistical analyses we utilized independent samples t-tests, one-way ANOVA with post-hoc analyses, and a multiple regression. As expected our findings revealed the COVID group reported significantly higher levels of subjective fatigue compared to the control group. Moreover, there was a significant difference between experienced fatigue across the four severity groups. Participants who had a milder course of disease also experienced severe subjective fatigue. Subjective fatigue explained 40% variance in quality-of-life. In conclusion, severe subjective fatigue appears to be associated with increased self-reported COVID-19 symptom severity and lower quality-of-life but is already observable in milder cases. This underscores, firstly, the importance of considering also less severe cases and, secondly, the need to develop rehabilitation and psychological interventions for fatigue.
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Affiliation(s)
- Chiara Biserni
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Bob O De Groot
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Dick de Waard
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Stefanie Enriquez-Geppert
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, The Netherlands
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Gutman EG, Salvio AL, Fernandes RA, Duarte LA, Raposo-Vedovi JV, Alcaraz HF, Teixeira MA, Passos GF, de Medeiros KQM, Hammerle MB, Pires KL, Vasconcelos CCF, Leon LAA, Figueiredo CP, Alves-Leon SV. Long COVID: plasma levels of neurofilament light chain in mild COVID-19 patients with neurocognitive symptoms. Mol Psychiatry 2024; 29:3106-3116. [PMID: 38678084 PMCID: PMC11449780 DOI: 10.1038/s41380-024-02554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024]
Abstract
It is well known the potential of severe acute respiratory coronavirus type 2 (SARS-CoV-2) infection to induce post-acute sequelae, a condition called Long COVID. This syndrome includes several symptoms, but the central nervous system (CNS) main one is neurocognitive dysfunction. Recently it has been demonstrated the relevance of plasma levels of neurofilament light chain (pNfL), as a biomarker of early involvement of the CNS in COVID-19. The aim of this study was to investigate the relationship between pNfL in patients with post-acute neurocognitive symptoms and the potential of NfL as a prognostic biomarker in these cases. A group of 63 long COVID patients ranging from 18 to 59 years-old were evaluated, submitted to a neurocognitive battery assessment, and subdivided in different groups, according to results. Plasma samples were collected during the long COVID assessment and used for measurement of pNfL with the Single molecule array (SIMOA) assays. Levels of pNfL were significantly higher in long COVID patients with neurocognitive symptoms when compared to HC (p = 0.0031). Long COVID patients with cognitive impairment and fatigue symptoms presented higher pNfL levels when compared to long COVID patients without these symptoms, individually and combined (p = 0.0263, p = 0.0480, and 0.0142, respectively). Correlation analysis showed that levels of cognitive lost and exacerbation of fatigue in the neurocognitive evaluation had a significative correlation with higher pNfL levels (p = 0.0219 and 0.0255, respectively). Previous reports suggested that pNfL levels are related with higher risk of severity and predict lethality of COVID-19. Our findings demonstrate that SARS-CoV-2 infection seems to have a long-term impact on the brain, even in patients who presented mild acute disease. NfL measurements might be useful to identify CNS involvement in long COVID associated with neurocognitive symptoms and to identify who will need continuous monitoring and treatment support.
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Affiliation(s)
- Elisa Gouvea Gutman
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
- Clinical Medicine post-graduation program, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andreza Lemos Salvio
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
| | - Renan Amphilophio Fernandes
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
| | - Larissa Araujo Duarte
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
- Clinical Medicine post-graduation program, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jessica Vasques Raposo-Vedovi
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
| | - Helena França Alcaraz
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
| | - Milene Ataíde Teixeira
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil
| | | | | | - Mariana Beiral Hammerle
- Division of Neurology, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, Brazil
| | - Karina Lebeis Pires
- Division of Neurology, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Soniza Vieira Alves-Leon
- Translational Neuroscience Laboratory (LabNet), Biomedical Institute, Federal University of the State of Rio de Janeiro/UNIRIO, Rio de Janeiro, RJ, ZIP CODE 20211-040, Brazil.
- Department of Neurology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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Schwartz CE, Borowiec K, Rapkin BD. The faces of Long-COVID: interplay of symptom burden with socioeconomic, behavioral and healthcare factors. Qual Life Res 2024; 33:2855-2867. [PMID: 39078547 DOI: 10.1007/s11136-024-03739-4] [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] [Accepted: 07/13/2024] [Indexed: 07/31/2024]
Abstract
AIMS The long-term effects of COVID-19 (Long COVID) include 19 symptoms ranging from mild to debilitating. We examined multidimensional correlates of Long COVID symptom burden. METHODS This study focused on participants who reported having had COVID in Spring 2023 (n = 656; 85% female, mean age = 55, 59% college). Participants were categorized into symptom-burden groups using Latent Profile Analysis of 19 Long-COVID symptoms. Measures included demographics; quality of life and well-being (QOL); and COVID-specific stressors. Bivariate and multivariate associations of symptom burden were examined. RESULTS A three-profile solution reflected low, medium, and high symptom burden, aligning with diagnosis confirmation and treatment by a healthcare provider. Higher symptom burden was associated with reporting more comorbidities; being unmarried, difficulty paying bills, being disabled from work, not having a college degree, younger age, higher body mass index, having had COVID multiple times, worse reported QOL, greater reported financial hardship and worry; maladaptive coping, and worse healthcare disruption, health/healthcare stress, racial-inequity stress, family-relationship problems, and social support. Multivariate modeling revealed that financial hardship, worry, risk-taking, comorbidities, health/healthcare stress, and younger age were risk factors for higher symptom burden, whereas social support and reducing substance use were protective factors. CONCLUSIONS Long-COVID symptom burden is associated with substantial, modifiable social and behavioral factors. Most notably, financial hardship was associated with more than three times the risk of high versus low Long-COVID symptom burden. These findings suggest the need for multi-pronged support in the absence of a cure, such as symptom palliation, telehealth, social services, and psychosocial support.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc., Concord, MA, USA.
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., Concord, MA, USA
- Department of Measurement, Evaluation, Statistics, & Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
| | - Bruce D Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Rijpkema C, Knottnerus BJ, van den Hoek R, Bosman L, van Dijk L, Verheij RA, Bos I. Care needs of patients with the post-COVID syndrome in Dutch general practice: an interview study among patients and general practitioners. BMC PRIMARY CARE 2024; 25:355. [PMID: 39342189 PMCID: PMC11439229 DOI: 10.1186/s12875-024-02597-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/13/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND The post-COVID syndrome (PCS) has a large impact on an individual's daily life. The wide variety of symptoms in PCS patients and the fact that it is still relatively new makes it difficult for general practitioners (GPs) to recognize, diagnose and treat patients with PCS, leading to difficulties in assessing and fulfilling healthcare needs. It is largely unknown what the experiences of Dutch patients and GPs are with PCS and, therefore, we gained insight into the different aspects of living with PCS and the associated healthcare needs. METHODS Semi-structured interviews were performed with 13 self-reported PCS patients (varying in sex, age, education, and health literacy) and 6 GPs (varying in gender, age, and type of practice) between January-July 2022. Patients and GPs were most likely unrelated (not in the same practices). The data have been analysed using the Thematic Analysis method. RESULTS Experiences appeared to vary between two types of PCS patients that emerged during the interviews: (1) individuals with good pre-existing health status (PEHS) who are severely affected by PCS and have difficulty recovering and (2) individuals with poorer PEHS whose health became even poorer after COVID-19 infection. The interviews with PCS patients and GPs revealed two main themes, in which the types of patients differed: (1) aspects of living with PCS; individuals with good PEHS mainly experience symptoms when overstimulated, while individuals with poorer PEHS generally feel exhausted continuously. (2) Healthcare experiences; GPs emphasized that individuals with good PEHS seem to benefit from support in distributing their energy by careful planning of daily activities, whereas individuals with poorer PEHS require support in activation. Patients and GPs emphasised the importance of taking patients seriously and acknowledging their symptoms. Finally, the patients interviewed indicated that some GPs doubted the existence of PCS, resulting in insufficient recognition. CONCLUSION Awareness of the differences in needs and experiences of the two types of PCS patients could contribute to more appropriate care. Acknowledgement of PCS by GPs as a real syndrome is important for patients and plays an important role in coping with or recovering from PCS. A multidisciplinary person-centred approach is important and can be coordinated by a GP.
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Affiliation(s)
- Corinne Rijpkema
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands.
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Bart J Knottnerus
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands
| | - Rinske van den Hoek
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lisa Bosman
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands
| | - Liset van Dijk
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands
- Department of PharmacoTherapy, -Epidemiology & -Economics (PTEE), Groningen Research Institute of Pharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | - Robert A Verheij
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Isabelle Bos
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands
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Gardner E, Lockrey A, Stoesser KL, Leiser JP, Brown J, Kiraly B, Ose DJ. Challenges in Receiving Care for Long COVID: A Qualitative Interview Study Among Primary Care Patients About Expectations and Experiences. Ann Fam Med 2024; 22:369-374. [PMID: 39191462 PMCID: PMC11419714 DOI: 10.1370/afm.3145] [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: 11/22/2023] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND For many patients with post-COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient's perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID. METHODS A phenomenological approach guided this analysis. Using purposive sampling, we conducted semistructured interviews with English-speaking, adult primary care patients describing symptoms of long COVID. We deidentified and transcribed the recorded interviews. Transcripts were analyzed using inductive qualitative content analysis. RESULTS This article reports results from 19 interviews (53% female, mean age = 54 years). Patients expected their primary care practitioners (PCPs) to be knowledgeable about long COVID, attentive to their individual condition, and to engage in collaborative processes for treatment. Patients described 2 areas of experiences. First, interactions with clinicians were perceived as positive when clinicians were honest and validating, and negative when patients felt dismissed or discouraged. Second, patients described challenges navigating the fragmented US health care system when coordinating care, treatment and testing, and payment. CONCLUSION Primary care patients' experiences seeking care for long COVID are incongruent with their expectations. Patients must overcome barriers at each level of the health care system and are frustrated by the constant challenges. PCPs and other health care professionals might increase congruence with expectations and experiences through listening, validating, and advocating for patients with long COVID.Annals Early Access article.
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Affiliation(s)
- Elena Gardner
- University of Utah Family and Preventative Medicine, Salt Lake City, Utah
| | - Alex Lockrey
- University of Utah Family and Preventative Medicine, Salt Lake City, Utah
| | - Kirsten L Stoesser
- University of Utah Family and Preventative Medicine, Salt Lake City, Utah
| | - Jennifer P Leiser
- University of Utah Family and Preventative Medicine, Salt Lake City, Utah
| | - Jeanette Brown
- University of Utah Internal Medicine, Salt Lake City, Utah
| | - Bernadette Kiraly
- University of Utah Family and Preventative Medicine, Salt Lake City, Utah
| | - Dominik J Ose
- University of Utah Family and Preventative Medicine, Salt Lake City, Utah
- WHZ Westsächsische Hochschule Zwickau, Faculty of Health and Healthcare Sciences, Zwickau, Germany
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11
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Srirug P, Pongmala C, Mayeedeng B, Yusoh N, Malee S, Udom C. Effect of post COVID-19 on body composition, physical fitness, sleep quality and quality of life among young adults: a cross-sectional study of matched pairs. PeerJ 2024; 12:e18074. [PMID: 39314846 PMCID: PMC11418813 DOI: 10.7717/peerj.18074] [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: 01/19/2024] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
Background Coronavirus 2019 (COVID-19) causes lung tissue inflammation, affects mental health, and disturbs sleep and the musculoskeletal system. This study aimed to investigate the effects of COVID-19 on physical function and quality of life by comparing the body composition, physical fitness, sleep quality and quality of life between Thai young adults with and without post COVID-19 infection. Methods A cross-sectional study was comprised of two matched groups (post COVID-19 group and non COVID-19 group) with 36 participants in each group. Data about body composition, physical fitness, sleep quality and quality of life were collected using the bioelectrical impedance analysis, the 1-min sit-to-stand test, the hand grip strength test, the Pittsburgh sleep quality questionnaire and the EuroQol-5D-5L, respectively. Independent samples T-test, Mann-Whitney U test and Chi-square test were used to compare between the two groups. Results The changes in oxygen saturation and respiratory rate after the physical fitness test and the sleep quality analysis showed a statistically significant difference between the groups with and without post COVID-19 infection (p = 0.006, p = 0.003 and p = 0.003, respectively). However, quality of life and body composition were not significantly different between groups. Conclusions COVID-19 influenced the changes in oxygen saturation and respiratory rate after the physical fitness test and the sleep quality analysis in young adults. The results should be utilized to facilitate physical rehabilitation for COVID-19-infected individuals following infection. Those who have not been infected with COVID-19 must be informed of self-protection measures to avoid contracting the virus.
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Affiliation(s)
- Phatcharawadee Srirug
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thasala, Nakhonsrithammarat, Thailand
- Walailak University, Movement Science and Exercise Research Center, Nakhon Sri Thammarat, Thailand
| | - Chatkaew Pongmala
- Functional Neuroimaging, Cognitive, and Mobility Laboratory, Department of Radiology, University of Michigan, Michigan, United States
| | - Balkis Mayeedeng
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thasala, Nakhonsrithammarat, Thailand
| | - Nurulfatin Yusoh
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thasala, Nakhonsrithammarat, Thailand
| | - Sofiya Malee
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thasala, Nakhonsrithammarat, Thailand
| | - Chadayu Udom
- Department of Physical Therapy, School of Allied Health Sciences, Walailak University, Thasala, Nakhonsrithammarat, Thailand
- Walailak University, Movement Science and Exercise Research Center, Nakhon Sri Thammarat, Thailand
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12
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Karim ZA, Reese RA, Smith AN, Blackadar ME, Arora V, Moore NM, Johnson EA. Positive impact of nutrition in the prevention of peripheral vascular disease and severe acute respiratory syndrome coronavirus 2: review. Front Nutr 2024; 11:1418028. [PMID: 39364158 PMCID: PMC11448360 DOI: 10.3389/fnut.2024.1418028] [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: 04/15/2024] [Accepted: 08/27/2024] [Indexed: 10/05/2024] Open
Abstract
Recent research has shown that there is a link between the trend of cardiovascular disease (CVD), chronic symptoms of SARS-CoV-2 (COVID-19), and medical nutrition therapy. Making positive changes to an individual's lifestyle can help to reduce the symptoms that follow exposure to CVD and COVID-19. Sustainable nutrition and lifestyle changes can positively impact an individual's health. Studies have considered the risk factors associated with the disease, medical history, the link between nutrition and peripheral vascular disease (PVD), symptom management, and the interrelationship between nutrition, COVID-19, and PVD. One study has demonstrated that Western Dietary intake can boost the innate immune system while suppressing humoral response, causing chronic inflammation and poor host defense against viruses. However, further investigation is needed to confirm. Patients with PVD and COVID-19 have experienced a reduction in side effects when prescribed a regimen of medical nutrition therapy, heart-healthy diets, and adequate physical activity before and after symptoms of both diseases appear. This approach has proven to be a protective factor during the combination of both illnesses. Our findings indicate that balanced diet and lifestyle are essential in supporting an optimal immune system that can reduce the risk of virus load in individuals at risk of infection and symptoms from COVID-19 and PVD.
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Affiliation(s)
- Zubair A Karim
- Department of Nutrition and Dietetics, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Rebecca A Reese
- Department of Nutrition and Dietetics, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Adrianne N Smith
- Department of Nutrition and Dietetics, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Madeline E Blackadar
- Department of Nutrition and Dietetics, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Vishal Arora
- Department of Medicine: Cardiology, Wellstar MCG Health, Augusta University, Augusta, GA, United States
| | - Nicole M Moore
- Department of Nutrition and Dietetics, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
| | - Emily A Johnson
- Department of Nutrition and Dietetics, College of Allied Health Sciences, Augusta University, Augusta, GA, United States
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13
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Tambling RR, Hynes KC, Carolan K, Charles D, Moynihan L. The Long-COVID Well-Being Scale (LCOVID-WBS): Development of a nascent measure of long-COVID symptoms and impacts. J Affect Disord 2024; 361:67-73. [PMID: 38810786 DOI: 10.1016/j.jad.2024.05.134] [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: 02/20/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
As is now well-known, COVID-19 is a highly contagious disease, which for some can cause symptoms that last long after initial infection. In 2021, a clinical set of symptoms referred to as long-COVID was identified. For many patients, long-COVID is a confusing and frightening multisystem disease, with the potential for myriad negative psychosocial effects, including significant impacts on employment and mental health, and requiring ongoing care. Research and treatment of long-COVID will be facilitated by a sound measure that addresses aspects of well-being, symptom experiences, and psychosocial impacts among long-COVID patients. The present work addresses this need by presenting the results of the development and preliminary psychometrics for the Long-COVID Well-Being Scale (LCOVID-WBS). In an exploratory factor analysis with a panel of 236 participants, researchers identified four factors: Emotional Strain, Physical Ability Strain, Control of Life, and Overall Evaluation of Health. The nascent measure represents the first step to measuring the impacts of long-COVID.
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Affiliation(s)
| | - Kevin C Hynes
- University of Wisconsin, Stout, United States of America
| | - Kelsi Carolan
- University of Connecticut School of Social Work, United States of America
| | - Doreek Charles
- University of Connecticut School of Social Work, United States of America
| | - Laura Moynihan
- University of Connecticut School of Social Work, United States of America
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14
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Brus IM, Spronk I, Polinder S, Loohuis AGMO, Tieleman P, Heemskerk SCM, Biere-Rafi S, Haagsma JA. Self-perceived barriers to healthcare access for patients with post COVID-19 condition. BMC Health Serv Res 2024; 24:1035. [PMID: 39243076 PMCID: PMC11378429 DOI: 10.1186/s12913-024-11488-w] [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: 03/18/2024] [Accepted: 08/24/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Many patients with post COVID-19 condition (PCC) require healthcare services. However, qualitative studies indicate that patients with PCC encounter many barriers to healthcare access. This cross-sectional study aimed to determine how many PCC patients report barriers to healthcare access and which barriers are reported, and to explore differences between subgroups. METHODS Data were collected via an online survey from 10,462 adult patients with a confirmed or suspected COVID-19 infection in the Netherlands, who experienced persisting symptoms ≥ 3 months after the initial infection. To study self-perceived barriers, a list of eleven possible barriers was used, covering multiple aspects of healthcare access. Differences between subgroups based on sociodemographic characteristics, medical characteristics, PCC symptoms (fatigue, dyspnoea, cognitive problems, anxiety and depression), and healthcare use (general practitioner, paramedical professional, medical specialist, occupational physician and mental health professional) were studied through multivariable multinomial (0 vs. 1 vs. > 1 barrier) and binomial regression analyses (for each individual barrier). RESULTS A total of 83.2% of respondents reported at least one barrier to healthcare access. Respondents reported a median of 2.0 (IQR = 3.0) barriers. The barriers "I didn't know who to turn to for help" (50.9%) and "No one with the right knowledge/skills was available" (36.8%) were most frequently reported. Respondents with younger age, higher educational level, not hospitalized during acute COVID-19 infection, longer disease duration, who had more severe PCC symptoms, and who did not consult an occupational physician or paramedical professional, were more likely to report barriers. Analyses per barrier showed that women were more likely to report financial and help-seeking barriers, while men were more likely to report barriers related to availability of care. Hospitalized respondents were less likely to report barriers related to availability of care, but not less likely to report financial or help-seeking barriers. CONCLUSIONS This study shows that the majority of patients with PCC experiences barriers to healthcare access. Particular attention should be paid to younger, non-hospitalized patients with a long disease duration and severe PCC symptoms. Efforts to remove barriers should focus not only on improving availability of care, but also on helping patients navigate care pathways.
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Affiliation(s)
- Iris M Brus
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, Netherlands.
| | - Inge Spronk
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, Netherlands
| | | | | | - Stella C M Heemskerk
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, Netherlands
| | | | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, Netherlands
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15
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Valdivieso-Martinez B, Lopez-Sanchez V, Sauri I, Diaz J, Calderon JM, Gas-Lopez ME, Lidon L, Philibert J, Lopez-Hontangas JL, Navarro D, Cuenca L, Forner MJ, Redon J. Impact of Long SARS-CoV-2 Omicron Infection on the Health Care Burden: Comparative Case-Control Study Between Omicron and Pre-Omicron Waves. JMIR Public Health Surveill 2024; 10:e53580. [PMID: 39226091 PMCID: PMC11408891 DOI: 10.2196/53580] [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: 10/11/2023] [Revised: 03/17/2024] [Accepted: 05/23/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Following the initial acute phase of COVID-19, health care resource use has escalated among individuals with SARS-CoV-2 infection. OBJECTIVE This study aimed to compare new diagnoses of long COVID and the demand for health services in the general population after the Omicron wave with those observed during the pre-Omicron waves, using similar assessment protocols for both periods and to analyze the influence of vaccination. METHODS This matched retrospective case-control study included patients of both sexes diagnosed with acute SARS-CoV-2 infection using reverse transcription polymerase chain reaction or antigen tests in the hospital microbiology laboratory during the pandemic period regardless of whether the patients were hospitalized. We included patients of all ages from 2 health care departments that cover 604,000 subjects. The population was stratified into 2 groups, youths (<18 years) and adults (≥18 years). Patients were followed-up for 6 months after SARS-CoV-2 infection. Previous vaccination, new diagnoses, and the use of health care resources were recorded. Patients were compared with controls selected using a prospective score matched for age, sex, and the Charlson index. RESULTS A total of 41,577 patients with a history of prior COVID-19 infection were included, alongside an equivalent number of controls. This cohort encompassed 33,249 (80%) adults aged ≥18 years and 8328 (20%) youths aged <18 years. Our analysis identified 40 new diagnoses during the observation period. The incidence rate per 100 patients over a 6-month period was 27.2 for vaccinated and 25.1 for unvaccinated adults (P=.09), while among youths, the corresponding rates were 25.7 for vaccinated and 36.7 for unvaccinated individuals (P<.001). Overall, the incidence of new diagnoses was notably higher in patients compared to matched controls. Additionally, vaccinated patients exhibited a reduced incidence of new diagnoses, particularly among women (P<.001) and younger patients (P<.001) irrespective of the number of vaccine doses administered and the duration since the last dose. Furthermore, an increase in the use of health care resources was observed in both adult and youth groups, albeit with lower figures noted in vaccinated individuals. In the comparative analysis between the pre-Omicron and Omicron waves, the incidence of new diagnoses was higher in the former; however, distinct patterns of diagnosis were evident. Specifically, depressed mood (P=.03), anosmia (P=.003), hair loss (P<.001), dyspnea (<0.001), chest pain (P=.04), dysmenorrhea (P<.001), myalgia (P=.011), weakness (P<.001), and tachycardia (P=.015) were more common in the pre-Omicron period. Similarly, health care resource use, encompassing primary care, specialist, and emergency services, was more pronounced in the pre-Omicron wave. CONCLUSIONS The rise in new diagnoses following SARS-CoV-2 infection warrants attention due to its potential implications for health systems, which may necessitate the allocation of supplementary resources. The absence of vaccination protection presents a challenge to the health care system.
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Affiliation(s)
| | | | - Inma Sauri
- Hospital Clínico de la Comunidad Valenciana (INCLIVA) Research Institute, University of Valencia, Valencia, Spain
| | - Javier Diaz
- Hospital Clínico de la Comunidad Valenciana (INCLIVA) Research Institute, University of Valencia, Valencia, Spain
| | - Jose Miguel Calderon
- Hospital Clínico de la Comunidad Valenciana (INCLIVA) Research Institute, University of Valencia, Valencia, Spain
| | | | - Laura Lidon
- Hospital Clínico de la Comunidad Valenciana (INCLIVA) Research Institute, University of Valencia, Valencia, Spain
| | - Juliette Philibert
- Medical Research Institute, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | - Llanos Cuenca
- Universitat Politècnica de València, Valencia, Spain
| | | | - Josep Redon
- Hospital Clínico de la Comunidad Valenciana (INCLIVA) Research Institute, University of Valencia, Valencia, Spain
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16
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Hazumi M, Miyake M, Kataoka M, Usuda K, Nishi D. Online peer support for mental health in individuals with post-acute sequelae of COVID-19: A pre-post pilot study with mixed methods. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e238. [PMID: 39157302 PMCID: PMC11330590 DOI: 10.1002/pcn5.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/22/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024]
Abstract
Aim This pilot examined the effect of online peer support on mental health problems among individuals with post-acute sequelae of COVID-2019 (PASC). Methods A single-arm pre-post design of online peer-support design consisting of eight sessions of 1 h per week with three to six participants and two facilitators per group was performed. Participants were recruited from online communities, social media, and medical clinics for the PASC between May and August 2023. The degrees of depression, anxiety, loneliness, social withdrawal, and self-esteem were measured pre- and post-intervention. Participants' statements during the sessions were analyzed using thematic analyses. Results Of the 18 participants, three dropped out of the interventions, and 17 (including two participants who dropped out) completed the pre- and post-intervention questionnaires. Depression severity significantly decreased in the paired t-test and linear mixed model. The following interactions were extracted: conveying the same feelings, dealing with difficulties, showing empathy, enhancing the atmosphere, and adapting to suit health conditions. Impressions extracted from participating in the interventions included feelings of emotional support, a sense of bonding, changes in perspective, changes in behaviors or new actions through participation, inadequacy during sessions, and adverse effects associated with participation. Conclusion Online peer support may be helpful in treating depression in individuals with PASC.
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Affiliation(s)
- Megumi Hazumi
- Department of Public Mental Health Research, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
- Department of Sleep-Wake Disorder, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
| | - Michi Miyake
- Department of Public Mental Health Research, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
| | - Mayumi Kataoka
- Department of Public Mental Health Research, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
- Department of Mental Health, Graduate School of Medicine The University of Tokyo Bunkyo-ku Tokyo Japan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
| | - Daisuke Nishi
- Department of Public Mental Health Research, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
- Department of Mental Health, Graduate School of Medicine The University of Tokyo Bunkyo-ku Tokyo Japan
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17
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Milne A, Arnold D, Moore A. Understanding post-hospitalised patients' experiences of long-COVID - the PELCO study. J Health Psychol 2024:13591053241272233. [PMID: 39175159 DOI: 10.1177/13591053241272233] [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: 08/24/2024] Open
Abstract
Despite significant advances in long COVID research, many aspects of the condition remain unknown. There is a persisting need for further research to improve the management of long COVID symptoms. This study aimed to explore the experiences and psychological needs of patients who were previously hospitalised with COVID-19, and who subsequently developed long COVID symptoms. Twelve patients with long COVID were interviewed between October 2021 and June 2022. Transcripts were analysed thematically. An overarching theme of 'Existential Crisis' was developed, incorporating three interconnecting sub-themes: 'Facing Psychological Threat', 'Seeking Legitimisation' and 'Forging a Path Through Uncertainty'. Findings suggest that the psychological impact of emergency hospitalisation for COVID-19 can be severe, particularly for those with ongoing long COVID symptoms, and that early psychological intervention should be available. Our findings also suggest the importance of further planning for future pandemics to ensure the presence of patient advocates during hospitalisation at points of critical decision-making.
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18
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Ateeb M, Haq IU, Zakki SA, Altaf E, Junaid M, Ali M, Rehman AU, Wajid D, Fareed A, Mehmood A. Assessment of the understanding and awareness of bioethics among healthcare professionals in all public and private hospitals of Haripur district, Pakistan: a multicentre cross-sectional study. BMJ Open 2024; 14:e083521. [PMID: 39160104 PMCID: PMC11337700 DOI: 10.1136/bmjopen-2023-083521] [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: 01/13/2024] [Accepted: 07/29/2024] [Indexed: 08/21/2024] Open
Abstract
OBJECTIVE To assess the level of bioethics awareness among healthcare professionals in Pakistan, focusing on the associations with sociodemographic characteristics, training and teaching of ethics, medical ethics practice and specific ethical issues. DESIGN Cross-sectional study. SETTING Public and private hospitals in Haripur, Pakistan. PARTICIPANTS A total of 647 healthcare professionals participated in this study. METHODS This study was conducted between March and May 2023, following Strengthening the Reporting of Observational Studies in Epidemiology checklist criterion, involving healthcare professionals with at least 6 months of experience in patient care practice. Providers under close supervision are advised not to respond to the bioethics knowledge, attitudes and practices survey form due to potential ethical dilemmas. RESULTS Both physicians and non-physicians need to know more about bioethics. There was a significant difference (p<0.05) in ethical training and teaching based on job categories/designations, with ethical views differing greatly by job designation. Specific ethical issues, such as accepting gifts from patients and pharmaceutical companies, referral fees, advising specific products, disclosure of medical errors, patient confidentiality, not informing patients fully about treatment and performing tasks for financial gain, showed significant associations (p<0.05) with healthcare professional's designation. Ethical awareness scores also showed significant differences (p<0.05) based on age, ethnicity, place of posting, professional experience and the organisation's ethical guidelines. CONCLUSION This study highlighted a notable gap in the understanding of certain ethical concerns among healthcare professionals, with nurses showing relatively lower awareness of healthcare practice compared with other professionals. Addressing these issues through targeted training and robust ethical guidelines is critical to improving patient care in Pakistan's healthcare system.
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Affiliation(s)
- Muhammad Ateeb
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Ijaz ul Haq
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Shahbaz Ahmad Zakki
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Ehtisham Altaf
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Junaid
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Mustafa Ali
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Atif Ur Rehman
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Daniyal Wajid
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Abdullah Fareed
- Department of Public Health and Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Asad Mehmood
- District Health Office Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
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19
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Greenhalgh T, Sivan M, Perlowski A, Nikolich JŽ. Long COVID: a clinical update. Lancet 2024; 404:707-724. [PMID: 39096925 DOI: 10.1016/s0140-6736(24)01136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 05/07/2024] [Accepted: 05/30/2024] [Indexed: 08/05/2024]
Abstract
Post-COVID-19 condition (also known as long COVID) is generally defined as symptoms persisting for 3 months or more after acute COVID-19. Long COVID can affect multiple organ systems and lead to severe and protracted impairment of function as a result of organ damage. The burden of this disease, both on the individual and on health systems and national economies, is high. In this interdisciplinary Review, with a coauthor with lived experience of severe long COVID, we sought to bring together multiple streams of literature on the epidemiology, pathophysiology (including the hypothesised mechanisms of organ damage), lived experience and clinical manifestations, and clinical investigation and management of long COVID. Although current approaches to long COVID care are largely symptomatic and supportive, recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification might herald a more mechanism-informed and personally tailored approach to clinical care. We also cover the organisation of services for long COVID, approaches to preventing long COVID, and suggestions for future research.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK.
| | - Manoj Sivan
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds, Leeds General Infirmary, Leeds, UK
| | | | - Janko Ž Nikolich
- Department of Immunobiology and University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA; The Aegis Consortium for Pandemic-Free Future, University of Arizona Health Sciences, Tucson, AZ, USA
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20
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Kemal LK, Abebe RB, Sendekie AK, Zeleke TK, Mehari EA, Mekonnen GA, Sema FD. Rational prescribing and dispensing of oral dosage forms of medicines to children: an observational study. BMJ Paediatr Open 2024; 8:e002431. [PMID: 39097329 PMCID: PMC11298748 DOI: 10.1136/bmjpo-2023-002431] [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] [Accepted: 06/27/2024] [Indexed: 08/05/2024] Open
Abstract
INTRODUCTION Irrational prescribing and dispensing of oral dosage forms of medicines to paediatric patients are major public health issues, especially in low-income and middle-income countries. Many challenges affect the rational use of oral dosage forms of medicines in children; these include a lack of dosage forms appropriate for the age and a lack of dose flexibility in dosage forms. OBJECTIVES To assess the rational prescribing and dispensing practices of oral dosage forms to children at dispensaries of the University of Gondar Comprehensive and Specialised Hospital (UoGCSH). METHOD A retrospective design for prescribing indicators and a cross-sectional study design to assess rational dispensing were used at the outpatient dispensary units of UoGCSH. A total of 931 oral dosage forms to assess prescribing indicators and 400 for dispensing indicators were used. The data were analysed using the Statistical Package for Social Sciences (SPSS V.26.0, IBM Corporation). Descriptive statistics were used to analyse indicators, and the χ2 test was used to compare indicators between dispensaries. RESULT Out of a total of 931 oral dosage forms for 700 prescriptions, 56.3% were solid oral dosage forms. An average number of oral dosage forms per child was 1.33±0.62. Only 150 (16.13%) (95% CI: 14% to 18.4%) were adequate for the weight of the child. The percentage of oral dosage forms not suitable for the age was 7.1% (66), (95% CI: 5.6% to 8.8%), and about 0.8% (95% CI: 0% to 1.8%) were adequately labelled. Drugs that needed manipulation before administering a single unit were 81 (39.7%), 95% CI: 33.7% to 47.1%. CONCLUSION The proportion of the prescribed medications that were adequate for the weight of the child was low, although the majority of prescriptions' weights were not recorded. Oral dosage forms not suitable for children were prescribed. The proportion of medications that needed manipulation before being administered as a single unit was high.
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Affiliation(s)
- Leila Kenzu Kemal
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rahel Belete Abebe
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tirsit Ketsela Zeleke
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Eden Abetu Mehari
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizework Alemnew Mekonnen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Faisel Dula Sema
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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21
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Laviña SMS, Meija-Samonte MD, Isidro-Lapeña JS, Lacambra BCO, Hipol IGG, Anuran GO. Outcomes and Clinical Profiles of Health Care Workers who Recovered from COVID-19: A Cross-sectional Study on Follow-up and Post-COVID-19 Syndrome. ACTA MEDICA PHILIPPINA 2024; 58:76-80. [PMID: 39166231 PMCID: PMC11330992 DOI: 10.47895/amp.v58i13.8083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
Background Infection from SARS-CoV-2 have transient and long-term complications. Persistent symptoms post-recovery with perceptions of overall physical and mental health status are crucial information to construe on follow-up care. Objective To describe the clinical profile, general, and mental health outcomes of hospital staff who recovered from COVID-19 at follow-up 12 weeks or more post-convalescent. Methods This was a cross-sectional study on follow-up of hospital staff who recovered from COVID-19. Study population included staff or health care workers of a COVID-19 referral tertiary hospital, who had laboratory-confirmed COVID-19 via RT-PCR. Informed consent was obtained through phone calls and google forms. Data collection was through a self-administered, on-line google form or voice-call interviewer-assisted questionnaire. Analysis was done with Stata 17 using frequencies, proportions, and cross-tabulations. Results Persistent symptoms reported several months post-recovery from COVID-19 included fatigue (25%), difficulty of breathing (23%), muscle weakness (16%), nasal congestion (12%), cough (10%), sore throat (5%), anosmia (3%), and ageusia (2%). Symptoms of physical and mental fatigue post-COVID-19 were reported by 25% (N = 93) with extreme fatigue reported by four staff. Fifteen percent (N = 57) reported that they feel that their workload or schedule needed modification after recovery. Feelings of isolation, depression, and anxiety were the most common mental health issues reported. Screening using validated tools showed that depressive symptoms were present in 45% (N = 145) and anxiety in 18% (N = 53). Conclusion Healthcare workers who recovered from COVID-19 for at least 12 weeks or more described their health status as comparable to their overall health one year before the infection. Physical and mental health symptoms reported 12 weeks post-recovery include fatigue, breathlessness, anxiety, and depression and were described in various levels of severity.
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Affiliation(s)
- Shiela Marie S Laviña
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Marishiel D Meija-Samonte
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Josefina S Isidro-Lapeña
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Bea Charise O Lacambra
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Ian Gabrielle G Hipol
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
| | - Geannagail O Anuran
- Department of Family and Community Medicine, Philippine General Hospital, University of the Philippines Manila
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22
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Newlands F, Fox-Smith L, Balakrishnan S, Lord G, Chalder T, Dalrymple E, Ford T, Harnden A, Heyman I, Ladhani SN, Pereira SMP, Segal TY, Stephenson T, Whittaker E, Shafran R. Using a novel methodology to map Post-COVID services for children and young people in England: a web-based systematic search. BMC Health Serv Res 2024; 24:863. [PMID: 39080694 PMCID: PMC11288108 DOI: 10.1186/s12913-024-11283-7] [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: 02/29/2024] [Accepted: 07/04/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Post-COVID Condition (PCC), also known as 'Long COVID,' refers to persistent symptoms following a coronavirus 2 (SARS-CoV-2) infection. The prevalence of PCC in children and adolescents varies, impacting multiple body systems and affecting daily functioning. Specialised paediatric hubs were established in England to address the needs of young individuals with PCC. Additional local services also emerged, yet patients report challenges accessing services. To better understand the landscape of paediatric PCC services, we used a novel methodology using a web-based systematic search. METHODS A web-based search was conducted in July 2023 using DEVONagent Pro. Search terms related to Long COVID and Pediatrics in England. Eligible sources providing information on PCC services for children and young people were included. A supplementary manual search and NHS England Post-COVID Network were also consulted. Data extraction included service location, characteristics, and referral pathways. Population estimates were derived from UK Census data. RESULTS Among 342 identified records, 27 services met eligibility criteria, distributed unevenly across regions. Specialised hubs covered 13 locations, while additional services were concentrated in the South of England and London. Services varied in team composition, age range treated, and support offered. A lack of standardised approaches for paediatric PCC was evident. DISCUSSION We used a novel methodology for systematically mapping online resources, providing valuable insights into service accessibility and aiding the identification of potential gaps. We observed geographical disparities in access to paediatric PCC services and the absence of standardised approaches in managing symptoms. Given the challenges faced by young individuals seeking support for their PCC the need for equitable and standardised care became apparent. The study contributes to closing the research-practice gap and calls for further research to identify effective treatments for paediatric PCC, acknowledging the diversity of reported symptoms and the importance of tailored approaches.
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Affiliation(s)
- Fiona Newlands
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, England, UK.
| | - Lana Fox-Smith
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, England, UK
| | | | - Gareth Lord
- NHS England, Quarry House, Leeds, LS2 7PD, England, UK
| | - Trudie Chalder
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De'Crespigny Park, London, SE5 8AF, England, UK
| | - Emma Dalrymple
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, England, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Anthony Harnden
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, England, UK
| | - Shamez N Ladhani
- Paediatric Infectious Diseases Research Group, St George's University of London, London, England, UK
| | - Snehal M Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, WC1E 6BT, England, UK
| | - Terry Y Segal
- Univerisity College London Hospital, 235 Euston Rd, London, NW1 2BU, England, UK
| | - Terence Stephenson
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, England, UK
| | - Elizabeth Whittaker
- Imperial College Healthcare NHS Trust, The Bays, S Wharf Rd, London, W2 1NY, England, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, England, UK
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23
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Centorbi M, Di Martino G, della Valle C, Iuliano E, Di Claudio G, Mascioli A, Calcagno G, di Cagno A, Buonsenso A, Fiorilli G. Regular Physical Activity Can Counteract LONG COVID Symptoms in Adults over 40. J Funct Morphol Kinesiol 2024; 9:119. [PMID: 39051280 PMCID: PMC11270337 DOI: 10.3390/jfmk9030119] [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: 05/29/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
Three years after the SARS-CoV-19 pandemic, a chronic post-COVID syndrome "LONG COVID" persists, causing fatigue and shortness of breath, along with distress, anxiety, and depression. AIM To assess the impact of physical activity on the management and rehabilitation of LONG COVID, as well as to investigate the persistence of LONG COVID symptomatology in individuals over 40 years, beyond the pandemic. METHODS A total of 1004 participants (aged 53.45 ± 11.35) were recruited through an online snowball sampling strategy to complete a web-based survey. The following questionnaires were administered: Physical Activity Scale for Elderly (PASE), Shortness of Breath Questionnaire (SOBQ), Patient Health Questionnaire-9 item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and Fatigue Scale for Motor and Cognitive Functions (FSMC). RESULTS Significant gender differences were discovered, with women reporting higher symptoms than men (p < 0.001). Significant age differences were also found, with participants under 55 showing higher values than those over 55 (p < 0.001). No significant differences were found between aerobic and mixed physical activity (p > 0.05) while significant results emerged between physical activity groups and the no activity group (p < 0.001). The low-frequency group reported higher symptoms than the high-frequency group (all ps < 0.001). CONCLUSION Regardless of the type of physical activity performed, our survey identified the frequency of training as a crucial factor to overcome LONG COVID symptoms; the challenge lies in overcoming the difficulties due to the persistent feelings of inefficiency and fatigue typical of those who have contracted the infection.
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Affiliation(s)
- Marco Centorbi
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
| | - Giulia Di Martino
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
| | - Carlo della Valle
- Department of Neurosciences, Biomedicine and Movement, University of Verona, 37134 Verona, Italy;
| | - Enzo Iuliano
- Faculty of Psychology, eCampus University, 22060 Novedrate, Italy;
| | - Gloria Di Claudio
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
| | - Amelia Mascioli
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
| | - Giuseppe Calcagno
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
| | - Alessandra di Cagno
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Via Plinio 44, 00193 Rome, Italy
| | - Andrea Buonsenso
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
| | - Giovanni Fiorilli
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (M.C.); (G.D.M.); (G.D.C.); (A.M.); (G.C.); (A.B.); (G.F.)
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24
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Müllenmeister C, El-Sayed I, Heinemann S, Schröder D, Müller F, Hummers E, Stölting A, Happle C, Dopfer-Jablonka A, Marotzki U, Schmachtenberg T. Navigating uncertainty: occupational therapists' experiences of Long COVID management in Germany, Austria and Switzerland. Disabil Rehabil 2024:1-10. [PMID: 38958213 DOI: 10.1080/09638288.2024.2367603] [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: 02/29/2024] [Accepted: 06/09/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Long COVID presents global challenges for healthcare professionals. Occupational therapists responded by seeking effective treatment strategies. The approaches of occupational therapists supporting long-haulers in German-speaking countries remain under-explored. The purpose of this study is to explore how occupational therapists in Germany, Austria and Switzerland navigate and apply profession-specific strategies in the new clinical landscape of Long COVID care. MATERIALS AND METHODS This study used qualitative-descriptive design and content analysis to extract insights from seven semi-structured interviews with occupational therapists in inpatient and outpatient settings from three countries. RESULTS Four overarching themes emerged: how Long COVID was encountered within the scope of occupational therapy, the multifaceted repertoire experts used to support long haulers, triumphs and challenges that emerged in Long COVID treatment, and recommendations and opportunities for occupational therapy practice. The results underscore the complex support needed for long-haulers, achieved through a multifaceted occupational therapy repertoire, incorporating client-centred, occupation-focused, and context-referencing strategies with shared decision-making and collaborative therapy planning. CONCLUSIONS Occupational therapy concepts, with their focus on human occupation, may offer new treatment options and strategies for managing emerging conditions such as Long COVID.
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Affiliation(s)
| | - Iman El-Sayed
- Department of General Practice, University Medical Center, Goettingen, Germany
| | | | - Dominik Schröder
- Department of General Practice, University Medical Center, Goettingen, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center, Goettingen, Germany
- Department of Family Medicine, MI State University, Grand Rapids, MI, USA
| | - Eva Hummers
- Department of General Practice, University Medical Center, Goettingen, Germany
| | - Andrea Stölting
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
| | - Christine Happle
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease Hannover (BREATH), Germany
| | | | - Ulrike Marotzki
- Faculty of Social Work and Health, University of Applied Sciences and Arts Hildesheim, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center, Goettingen, Germany
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25
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Matsuda Y, Sakurada Y, Otsuka Y, Tokumasu K, Nakano Y, Sunada N, Honda H, Hasegawa T, Takase R, Omura D, Ueda K, Otsuka F. Changes in Working Situations of Employed Long COVID Patients: Retrospective Study in Japanese Outpatient Clinic. J Clin Med 2024; 13:3809. [PMID: 38999375 PMCID: PMC11242900 DOI: 10.3390/jcm13133809] [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: 05/14/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
Purpose: The present study aimed to uncover the impact of long COVID on the working situations of Japanese patients. Methods: Changes in the working situations of the patients who visited our long COVID clinic were evaluated from medical records for the aspects of physical status, quality of life (QOL), and mental conditions. Results: Of 846 long COVID patients who visited our clinic from February 2021 to December 2023, 545 employed patients aged between 18 and 65 years were included in this study. A total of 295 patients (54.1%) with long COVID (median age: 43 years, female: 55.6%) experienced changes in their working status. Those patients included 220 patients (40.4%) who took a leave of absence, 53 patients (9.7%) who retired, and 22 patients (4%) with reduced working hours. Most of the patients (93.2%) with changes in working conditions had mild disease severity in the acute phase of COVID-19. The majority of those patients with mild disease severity (58.8%) were infected in the Omicron-variant phase and included 65.3% of the female patients. The major symptoms in long COVID patients who had changes in their working situations were fatigue, insomnia, headache, and dyspnea. Scores indicating fatigue and QOL were worsened in long COVID patients who had changes in their working situations. In addition, 63.7% of the long COVID patients with changes in their working situations had decreases in their incomes. Conclusions: Changes in the working situation of long COVID patients who were employed had a negative impact on the maintenance of their QOL.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Fumio Otsuka
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan; (Y.M.)
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26
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Miller A, Song N, Sivan M, Chowdhury R, Burke MR. Identifying the needs of people with long COVID: a qualitative study in the UK. BMJ Open 2024; 14:e082728. [PMID: 38904135 PMCID: PMC11191788 DOI: 10.1136/bmjopen-2023-082728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/08/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES To identify the needs of people with long COVID (LC) in the UK. DESIGN Qualitative study using the Framework Analysis to analyse focus group discussions. PARTICIPANTS 25 adults with LC aged 19-76 years including 17 men and 8 women. Average disease duration was 80.1 weeks. SETTING Eight focus groups were conducted in April 2023 online and in-person at the University of Leeds (UoL), UK. Recruitment routes included advertisement via Leeds Community Healthcare services, the English National Opera Breathe Programme and within the UoL. RESULTS Three key themes/needs were identified. (Theme 1) Support systems including community groups, disability benefits, clinical services and employment support should be accessible and tailored to the needs of people with LC. (Theme 2) Research should investigate the physiology of symptoms, new clinical tests and treatment interventions to improve clinical understanding of the condition and symptom management. (Theme 3) Societal awareness should be promoted via local and national initiatives to educate the public about the condition and reduce stigma. CONCLUSIONS Participants experienced varied and individual challenges to daily life due to LC. There is a need for government acknowledgement of LC as a disability to ensure people with LC have access to disability support and legal protection. Policy development should be patient-driven and acknowledge the individual needs of people with LC in order to improve their quality of life.
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Affiliation(s)
- Amy Miller
- School of Psychology, University of Leeds, Leeds, UK
| | - Ning Song
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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27
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Caldas B, Portela M, Stelson E, Singer S, Amaral T, Amaral C, Escosteguy C, Martins M, de Andrade CLT, Soares L, Cornish F, Rosenthal M, Aveling EL. Promoting equity, diversity, and inclusion in surveys: insights from a patient-engaged study to assess long COVID health-care needs in Brazil. J Clin Epidemiol 2024; 173:111423. [PMID: 38880435 DOI: 10.1016/j.jclinepi.2024.111423] [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: 03/28/2024] [Revised: 06/01/2024] [Accepted: 06/09/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND OBJECTIVE Long COVID (LC) refers to persistent symptoms after acute COVID-19 infection, which may persist for months or years. LC affects millions of people globally, with substantial impacts on quality of life, employment, and social participation. Ensuring access to effective, patient-centered care for LC demands evidence, grounded in inclusive representation of those affected by the condition. Yet survey studies frequently under-represent people with the most disabling disease presentations and racially and socioeconomically marginalized groups. We aimed to describe a patient-engaged approach to developing a survey to inform public LC health care and to assess its implementation in terms of enabling participation by diverse LC patients in Brazil. METHODS Survey development was iterative, achieved through an interdisciplinary collaboration among researchers including people living with LC, and grounded in 3 guiding principles: (1) evidence-based; (2) inclusive, intersectional, and patient-centered understanding of chronic illness and research participation; and (3) sensitivity to the context of health-care access. RESULTS The product of our collaboration was a longitudinal survey using a questionnaire assessing: LC symptoms; their clinical and functional evolution; and impacts on quality of life, household income, health service access, utilization, and out-of-pocket expenses. We illustrate how we operationalized our 3 principles through survey content, instrument design, and administration. Six hundred fifty-one participants with diverse LC symptoms, demography, and socioeconomic status completed the survey. We successfully included participants experiencing disabling symptoms, Black and mixed race participants, and those with lower education and income. CONCLUSION By centering patient experience, our novel, principles-based approach succeeded in promoting equity, diversity, and inclusion in LC survey research. These principles guiding patient-engaged collaboration have broad transferability. We encourage survey researchers working on chronic illness and in other contexts of marginalization and inequality to adopt them.
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Affiliation(s)
- Bárbara Caldas
- Department of Health Administration and Planning, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
| | - Margareth Portela
- Department of Health Administration and Planning, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Elisabeth Stelson
- Patient-Led Research Collaborative, Calabasas, CA, USA; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sara Singer
- Department of Health Policy, School of Medicine, Stanford University, Stanford, CA, USA
| | - Thatiana Amaral
- Center for Health Sciences and Sports, Universidade Federal do Acre (UFAC), Rio Branco, Brazil
| | - Cledir Amaral
- Instituto Federal do Acre (IFAC), Rio Branco, Brazil
| | - Claudia Escosteguy
- Epidemiology Service, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil
| | - Mônica Martins
- Department of Health Administration and Planning, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Carla Lourenço Tavares de Andrade
- Department of Health Administration and Planning, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Flora Cornish
- Department of Methodology, London School of Economics and Political Science, London, UK
| | - Meredith Rosenthal
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Emma-Louise Aveling
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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28
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Scott HM, Neale S, Harrington E, Hodgson H, Hitch D. Occupational therapy practice for post-acute COVID-19 inpatients requiring rehabilitation. Aust Occup Ther J 2024. [PMID: 38877567 DOI: 10.1111/1440-1630.12976] [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: 10/19/2023] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION COVID-19 caused significant occupational disruption to people's life roles, with some people requiring an inpatient rehabilitation admission. Occupational therapists assessed and treated these patients using previous knowledge of similar conditions due to limited specificity in available guidelines to inform practice. The aim of this study was to investigate current practice with post-acute COVID-19 (PAC) patients within an inpatient rehabilitation setting in Australia, to better understand the role and impact of occupational therapy. METHODS A mixed-method study was conducted, including electronic medical record audits (October 2021 October 2022) and descriptive patient interviews at a large metropolitan subacute service. Descriptive statistics and qualitative analysis were used to summarise and interpret data. CONSUMER AND COMMUNITY INVOLVEMENT No involvement. RESULTS A total of 24 patient electronic medical records were audited, and 10 patient interviews were completed. Three overarching categories were identified within the 685 occasions of occupational therapy service audited-occupational engagement, education provision and discharge planning. Patients identified the value of occupational therapy by reflecting on their lived experiences of engaging with occupational therapists and associated changes in occupational performance between COVID-19 diagnoses and discharge home. CONCLUSION Occupational therapists possess a unique skill set that directly addresses the occupational needs and priorities of PAC patients. This study adds to the growing body of evidence supporting the contribution of occupational therapy to the management of COVID-19; however, further research is needed to develop evidence-based practice resources and advocate for system changes that improve quality of life for COVID-19 patients. PLAIN LANGUAGE SUMMARY During the COVID-19 pandemic, a lot of people got very sick. Some of these people needed more time and support to get better. Occupational therapists were important during this time because they helped these people to do their daily activities again. Because there were not many resources on how to do this, we looked into what occupational therapists were doing to help these people. We looked at patient hospital files and also talked to them to understand this better. We found that occupational therapists focused on three main areas: helping patients do activities that were important to them, teaching them about COVID-19 and helping them plan to leave the hospital. This study shows that occupational therapists are skilled at helping people with COVID-19. But more research is needed to make resources and also help with changing the healthcare system to further help people get better from COVID-19.
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Affiliation(s)
- Hayley M Scott
- Occupational Therapy Lecturer, Institute of Health and Well-Being, Federation University, Melbourne, Australia
- Occupational Therapy Department, Western Health, Melbourne, Australia
| | - Sharon Neale
- Occupational Therapy Department, Western Health, Melbourne, Australia
| | | | - Hayley Hodgson
- Occupational Therapy Department, Western Health, Melbourne, Australia
| | - Danielle Hitch
- School of Health and Social Development, Deakin University and Occupational Therapy Department, Western Health, Melbourne, Australia
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Laestadius LI, Guidry JPD, Wahl MM, Perrin PB, Carlyle KE, Dong X, Gharbo R, Campos-Castillo C. "The dream is that there's one place you go": a qualitative study of women's experiences seeking care from Long COVID clinics in the USA. BMC Med 2024; 22:243. [PMID: 38867247 PMCID: PMC11170900 DOI: 10.1186/s12916-024-03465-1] [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: 02/24/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic. METHODS We conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics. RESULTS Of the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent. CONCLUSIONS While the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices.
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Affiliation(s)
- Linnea I Laestadius
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Jeanine P D Guidry
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Megan M Wahl
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Paul B Perrin
- School of Data Science and Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Kellie E Carlyle
- School of Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiaobei Dong
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Raouf Gharbo
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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van der Feltz-Cornelis CM, Sweetman J, Turk F, Allsopp G, Gabbay M, Khunti K, Williams N, Montgomery H, Heightman M, Lip GYH, Crooks MG, Strain WD, Loveless A, Hishmeh L, Smith N, Banerjee A. Integrated care policy recommendations for complex multisystem long term conditions and long COVID. Sci Rep 2024; 14:13634. [PMID: 38871773 DOI: 10.1038/s41598-024-64060-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 06/05/2024] [Indexed: 06/15/2024] Open
Abstract
The importance of integrated care for complex, multiple long term conditions was acknowledged before the COVID pandemic but remained a challenge. The pandemic and consequent development of Long COVID required rapid adaptation of health services to address the population's needs, requiring service redesigns including integrated care. This Delphi consensus study was conducted in the UK and found similar integrated care priorities for Long COVID and complex, multiple long term conditions, provided by 480 patients and health care providers, with an 80% consensus rate. The resultant recommendations were based on more than 1400 responses from survey participants and were supported by patients, health care professionals, and by patient charities. Participants identified the need to allocate resources to: support integrated care, provide access to care and treatments that work, provide diagnostic procedures that support the personalization of treatment in an integrated care environment, and enable structural consultation between primary and specialist care settings including physical and mental health care. Based on the findings we propose a model for delivering integrated care by a multidisciplinary team to people with complex multisystem conditions. These recommendations can inform improvements to integrated care for complex, multiple long term conditions and Long COVID at international level.
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Affiliation(s)
- Christina M van der Feltz-Cornelis
- Department of Health Sciences, University of York, York, UK.
- Hull York Medical School, (HYMS), University of York, York, UK.
- Institute of Health Informatics, University College London, London, UK.
| | | | - Fidan Turk
- Department of Health Sciences, University of York, York, UK
| | - Gail Allsopp
- Royal College of General Practitioners, London, UK
| | - Mark Gabbay
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Nefyn Williams
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Hugh Montgomery
- Department of Medicine, University College London, London, UK
| | - Melissa Heightman
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Michael G Crooks
- Hull York Medical School, University of Hull, Hull, UK
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Clinical and Biomedical Science and College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Lyth Hishmeh
- PPI Member for STIMULATE-ICP Consortium, London, UK
| | - Natalie Smith
- Department of Health Sciences, University of York, York, UK
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
- Department of Cardiology, University College London Hospitals NHS Trust, London, UK
- Department of Cardiology, Barts Health NHS Trust, London, UK
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Hynes KC, Russell BS, Tambling RR, Park CL, Fendrich M. Subjective Stress Appraisals Over Time: the Evolving Structure of the COVID-19 Stressor Scale. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01694-7. [PMID: 38862829 DOI: 10.1007/s11121-024-01694-7] [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] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
The COVID-19 Stressors Scale measures individuals' appraisals of stressors related to the pandemic. Measurement of perceptions of stressors is necessary to understand the socioemotional impacts of not only the COVID-19 pandemic, but other disasters. The study examined the factor structure of the scale among adults in the U.S. over six time points. A shortened version was used, and the fit was examined over time. The results of the study show contextual appraisals change over time and offer important implications for the measurement of stressfulness of disasters, a critical step in designing and assessing impacts of social programs aimed to reduce the deleterious effects of disasters.
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Affiliation(s)
- Kevin C Hynes
- Counseling, Rehabilitation, and Human Services, University of Wisconsin-Stout, 221 10th Avenue E, Menomonie, WI, 54751, USA.
| | - Beth S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269-1058, USA
| | - Rachel R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269-1058, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd, U-1020, Storrs, CT, 06269-1020, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, 38 Prospect Street, Hartford, CT, 06103, USA
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Binswanger IA, Palmer-Toy DE, Barrow JC, Narwaney KJ, Bruxvoort KJ, Kraus CR, Lyons JA, Lam JA, Glanz JM. Assessing the association between antibody status and symptoms of long COVID: A multisite study. PLoS One 2024; 19:e0304262. [PMID: 38843198 PMCID: PMC11156415 DOI: 10.1371/journal.pone.0304262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
The association between SARS-CoV-2 humoral immunity and post-acute sequelae of COVID-19 (long COVID) remains uncertain. The objective of this population-based cohort study was to assess the association between SARS-CoV-2 seropositivity and symptoms consistent with long COVID. English and Spanish-speaking members ≥ 18 years old with SARS-CoV-2 serologic testing conducted prior to August 2021 were recruited from Kaiser Permanente Southern California and Kaiser Permanente Colorado. Between November 2021 and April 2022, participants completed a survey assessing symptoms, physical health, mental health, and cognitive function consistent with long COVID. Survey results were linked to SARS-CoV-2 antibody (Ab) and viral (RNA) lab results in electronic health records. Weighted descriptive analyses were generated for five mutually exclusive patient groups: (1) +Ab/+RNA; (2) +Ab/- or missing RNA; (3) -Ab/+RNA; (4a) -Ab/-RNA reporting no prior infection; and (4b) -Ab/-RNA reporting prior infection. The proportions reporting symptoms between the +Ab/+RNA and -Ab/+RNA groups were compared, adjusted for covariates. Among 3,946 participants, the mean age was 52.1 years old (SD 15.6), 68.3% were female, 28.4% were Hispanic, and the serologic testing occurred a median of 15 months prior (IQR = 12-18). Three quarters (74.5%) reported having had COVID-19. Among people with laboratory-confirmed COVID-19, there was no association between antibody positivity (+Ab/+RNA vs. -Ab/+RNA) and any symptoms, physical health, mental health, or cognitive function. As expected, physical health, cognitive function, and fatigue were worse, and palpitations and headaches limiting the ability to work were more prevalent among people with laboratory-confirmed prior infection and positive serology (+Ab/+RNA) compared to those without reported or confirmed prior infection and negative serology (-Ab/-RNA/no reported COVID-19). Among people with laboratory-confirmed COVID-19, SARS-CoV-2 serology from practice settings were not associated with long COVID symptoms and health status suggesting limited utility of serology testing for long COVID.
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Affiliation(s)
- Ingrid A. Binswanger
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, United States of America
- Colorado Permanente Medical Group, Aurora, Colorado, United States of America
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Bernard J. Tyson School of Medicine, Pasadena, California, United States of America
| | - Darryl E. Palmer-Toy
- Southern California Permanente Medical Group Regional Reference Laboratories, North Hollywood & Chino Hills, California, United States of America
| | - Jennifer C. Barrow
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, United States of America
| | - Komal J. Narwaney
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, United States of America
| | - Katia J. Bruxvoort
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Courtney R. Kraus
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, United States of America
| | - Jason A. Lyons
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, United States of America
| | - Jessica A. Lam
- Department of Clinical Analysis at Southern California Permanente Medical Group, California, CA, United States of America
| | - Jason M. Glanz
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, United States of America
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, United States of America
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Younes S. The role of nutrition on the treatment of Covid 19. HUMAN NUTRITION & METABOLISM 2024; 36:200255. [DOI: 10.1016/j.hnm.2024.200255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2024]
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MacEwan SR, Rahurkar S, Tarver WL, Forward C, Eramo JL, Teuschler L, Gaughan AA, Rush LJ, Stanwick S, McConnell E, Schamess A, McAlearney AS. Patient Experiences Navigating Care Coordination For Long COVID: A Qualitative Study. J Gen Intern Med 2024; 39:1294-1300. [PMID: 38308155 PMCID: PMC11169119 DOI: 10.1007/s11606-024-08622-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/09/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Little is known about how to best evaluate, diagnose, and treat long COVID, which presents challenges for patients as they seek care. OBJECTIVE Understand experiences of patients as they navigate care for long COVID. DESIGN Qualitative study involving interviews with patients about topics related to seeking and receiving care for long COVID. PARTICIPANTS Eligible patients were at least 18 years of age, spoke English, self-identified as functioning well prior to COVID infection, and reported long COVID symptoms continued to impact their lives at 3 months or more after a COVID infection. APPROACH Patients were recruited from a post-COVID recovery clinic at an academic medical center from August to September 2022. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. KEY RESULTS Participants (n=21) reported experiences related to elements of care coordination: access to care, evaluation, treatment, and ongoing care concerns. Some patients noted access to care was facilitated by having providers that listened to and validated their symptoms; other patients reported feeling their access to care was hindered by providers who did not believe or understand their symptoms. Patients reported confusion around how to communicate their symptoms when being evaluated for long COVID, and they expressed frustration with receiving test results that were normal or diagnoses that were not directly attributed to long COVID. Patients acknowledged that clinicians are still learning how to treat long COVID, and they voiced appreciation for providers who are willing to try new treatment approaches. Patients expressed ongoing care concerns, including feeling there is nothing more that can be done, and questioned long-term impacts on their aging and life expectancy. CONCLUSIONS Our findings shed light on challenges faced by patients with long COVID as they seek care. Healthcare systems and providers should consider these challenges when developing strategies to improve care coordination for patients with long COVID.
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Affiliation(s)
- Sarah R MacEwan
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Saurabh Rahurkar
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Willi L Tarver
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
- Division of Cancer Prevention and Control, The Ohio State University, Columbus, OH, USA
| | - Cortney Forward
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Jennifer L Eramo
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Lauren Teuschler
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Alice A Gaughan
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Laura J Rush
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Stacy Stanwick
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Erin McConnell
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Andrew Schamess
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Ann Scheck McAlearney
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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Jones F, Domeny A, Fish J, Leggat F, Patel I, McRae J, Rowe C, Busse ME. Using co-design methods to develop new personalised support for people living with Long Covid: The 'LISTEN' intervention. Health Expect 2024; 27:e14093. [PMID: 38783782 PMCID: PMC11116943 DOI: 10.1111/hex.14093] [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: 03/28/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Many Covid-19 survivors are living with unresolved, relapsing and remitting symptoms and no 'one size' of treatment is likely to be effective for everyone. Supported self-management for the varied symptoms of Long Covid (LC) is recommended by the National Institute for Health and Care Excellence in the United Kingdom. We aimed to develop a new personalised support intervention for people living with LC using a structured co-design framework to guide replication and evaluation. METHODS We used the improvement methodology, Experience-Based Co-Design, in an accelerated form to harness the collective experiences of people with LC. Incorporating evidence from 'Bridges Self-Management' (Bridges) an approach in which healthcare professionals (HCPs)are trained to support knowledge, confidence and skills of individuals living with long term conditions. Co-designed resources are also central to Bridges. Adults who self-identified as living with or recovered from LC, from England or Wales, aged 18 years and over were recruited, and HCPs, with experience of supporting people with LC. Participants took part in a series of small co-design group meetings and larger mixed meetings to agree priorities, core principles and generate resources and intervention content. RESULTS People with LC (n = 28), and HCPs (n = 9) supported co-design of a book (hard-copy and digital form) to be used in 1:1 support sessions with a trained HCP. Co-design stages prioritised stories about physical symptoms first, and psychological and social challenges which followed, nonlinear journeys and reconceptualising stability as progress, rich descriptions of strategies and links to reputable advice and support for navigating healthcare services. Co-design enabled formulation of eight core intervention principles which underpinned the training and language used by HCPs and fidelity assessments. CONCLUSION We have developed a new personalised support intervention, with core principles to be used in one-to-one sessions delivered by trained HCPs, with a new co-designed book as a prompt to build personalised strategies and plans using narratives, ideas, and solutions from other people with LC. Effectiveness and cost effectiveness of the 'LISTEN' intervention will be evaluated in a randomised controlled trial set within the context of the updated Framework for Developing and Evaluating Complex Interventions. PATIENT AND PUBLIC CONTRIBUTION The LISTEN Public and Patient Involvement (PPI) group comprised seven people living with LC. They all contributed to the design of this study and five members were part of a larger co-design community described in this paper. They have contributed to this paper by interpreting stages of intervention design and analysis of results. Three members of our PPI group are co-authors of this paper.
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Affiliation(s)
- Fiona Jones
- Population Health Research InstituteSt George's University of LondonLondonUK
- Bridges Self‐ManagementLondonUK
| | - Anne Domeny
- Bridges Self‐ManagementLondonUK
- LISTEN Lived Experience Advisory GroupLondonUK
| | - Jessica Fish
- Department of Clinical Neuropsychology and Clinical Health PsychologySt George's University Hospitals NHS Foundation TrustLondonUK
- Mental Health and Wellbeing, School of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Fiona Leggat
- Population Health Research InstituteSt George's University of LondonLondonUK
| | - Ian Patel
- LISTEN Lived Experience Advisory GroupLondonUK
| | - Jackie McRae
- Centre for Allied Health, Institute for Medical, Biomedical and Allied EducationSt George's University of LondonLondonUK
| | - Carol Rowe
- LISTEN Lived Experience Advisory GroupLondonUK
| | - Monica E. Busse
- Centre For Trials Research, School of MedicineCardiff UniversityCardiffWalesUK
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Kalfas M, Jolley C, Hart N, Rafferty GF, Duncan EL, Nicholson T, Ashworth M, Brewin D, Barrett B, Witard OC, Ridge D, Chalder T. Exploring the Experiences of Living With the Post-COVID Syndrome: A Qualitative Study. Health Expect 2024; 27:e14108. [PMID: 38898594 PMCID: PMC11186847 DOI: 10.1111/hex.14108] [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: 12/04/2023] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Many people experience persistent symptoms for more than 12 weeks following SARS-CoV-2 infection, which is known as post-COVID-19 condition (PCS) or Long COVID (LC). PCS can impair people's quality of life and daily functioning. However, there is a lack of in-depth research exploring the PCS patient journey, as well as gendered aspects of patients' experiences. METHODS Nineteen semi-structured qualitative interviews were conducted with people living with PCS in the United Kingdom (13 women, 6 men). Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis. RESULTS Five main themes were identified: 'Symptom dismissal', 'Lack of information and support', 'Life before and after Long COVID', 'Psychological impact' and 'Acceptance'. A shift overtime to self-management of symptoms was evident. These themes represent different stages of patients' PCS journey. Narratives indicated that women highlighted dismissal by healthcare professionals (HCPs), which was not as prominent in men's narratives. In addition, women went into more detail about the psychological impact of PCS compared to men. CONCLUSION Women with PCS reported symptom dismissal by HCPs, which may have delayed their diagnosis and negatively affected their well-being. We were not able to explore the experiences of people from non-conforming gender groups. Raising awareness of these issues among HCPs, particularly general practitioners, could improve patient care in PCS. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement consisted of people who took part in the interviews and commented on the themes' interpretation and study conclusions.
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Affiliation(s)
- Michail Kalfas
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Caroline Jolley
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
- King's College Hospital NHS Foundation TrustLondonUK
| | - Nicholas Hart
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
- Lane Fox Clinical Respiratory Physiology Research CentreGuy's & St Thomas's NHS Foundation TrustLondonUK
| | - Gerrard F. Rafferty
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
| | - Emma L. Duncan
- Department of Twin Research and Genetic EpidemiologyKing's College LondonLondonUK
- Guy's & St Thomas's NHS Foundation TrustLondonUK
| | - Timothy Nicholson
- Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Mark Ashworth
- School of Life Course & Population Sciences, King's College LondonGuy's CampusLondonUK
| | - Debbie Brewin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Barbara Barrett
- School of Life Course & Population Sciences, King's College LondonGuy's CampusLondonUK
| | - Oliver C. Witard
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
| | - Damien Ridge
- School of Social SciencesUniversity of WestminsterLondonUK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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Fisher KA, Mazor KM, Epstein MM, Goldthwait L, Abu Ghazaleh H, Zhou Y, Crawford S, Marathe J, Linas BP. Long COVID awareness and receipt of medical care: a survey among populations at risk for disparities. Front Public Health 2024; 12:1360341. [PMID: 38873310 PMCID: PMC11173587 DOI: 10.3389/fpubh.2024.1360341] [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: 12/22/2023] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction The COVID-19 pandemic has been characterized by disparities in disease burden and medical care provision. Whether these disparities extend to long COVID awareness and receipt of medical care is unknown. We aimed to characterize awareness of long COVID and receipt of medical care for long COVID symptoms among populations who experience disparities in the United States (US). Methods We conducted a cross-sectional survey among a national sample of US adults between January 26-February 5, 2023. We surveyed approximately 2,800 adults drawn from the Ipsos probability-based KnowledgePanel® who identify as White, Black, or Hispanic, with over-sampling of Black, Hispanic, and Spanish-proficient adults. Awareness of long COVID was assessed with the question, "Have you heard of long COVID? This is also referred to as post-COVID, Long-haul COVID, Post-acute COVID-19, or Chronic COVID." Respondents reporting COVID-19 symptoms lasting longer than 1 month were classified as having long COVID and asked about receipt of medical care. Results Of the 2,828 respondents, the mean age was 50.4 years, 52.8% were female, 40.2% identified as Hispanic, 29.8% as Black, and 26.7% as White. 18% completed the survey in Spanish. Overall, 62.5% had heard of long COVID. On multivariate analysis, long COVID awareness was lower among respondents who identified as Black (OR 0.64; 95% CI 0.51, 0.81), Hispanic and completed the survey in English (OR 0.59; 95% CI 0.46, 0.76), and Hispanic and completed the survey in Spanish (OR 0.31, 95% C.I. 0.23, 0.41), compared to White respondents (overall p < 0.001). Long COVID awareness was also associated with educational attainment, higher income, having health insurance, prior history of COVID-19 infection, and COVID-19 vaccination. Among those reporting symptoms consistent with long COVID (n = 272), 26.8% received medical care. Older age, longer symptom duration and greater symptom impact were associated with receipt of medical care for long COVID symptoms. Of those who received care, most (77.8%) rated it as less than excellent on a 5-point scale. Discussion This survey reveals limited awareness of long COVID and marked disparities in awareness according to race, ethnicity, and language. Targeted public health campaigns are needed to raise awareness.
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Affiliation(s)
- Kimberly A. Fisher
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Kathleen M. Mazor
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Mara M. Epstein
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Lydia Goldthwait
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Hiba Abu Ghazaleh
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Yanhua Zhou
- Division of Health Systems Science, Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Sybil Crawford
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA, United States
| | - Jai Marathe
- Boston Medical Center, Boston, MA, United States
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Benjamin P. Linas
- Boston Medical Center, Boston, MA, United States
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
- Boston University School of Public Health, Boston, MA, United States
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Sunkersing D, Ramasawmy M, Alwan NA, Clutterbuck D, Mu Y, Horstmanshof K, Banerjee A, Heightman M. What is current care for people with Long COVID in England? A qualitative interview study. BMJ Open 2024; 14:e080967. [PMID: 38760030 PMCID: PMC11107429 DOI: 10.1136/bmjopen-2023-080967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/01/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE To investigate current care for people with Long COVID in England. DESIGN In-depth, semistructured interviews with people living with Long COVID and Long COVID healthcare professionals; data analysed using thematic analysis. SETTING National Health Service England post-COVID-19 services in six clinics from November 2022 to July 2023. PARTICIPANTS 15 healthcare professionals and 21 people living with Long COVID currently attending or discharged (18 female; 3 male). RESULTS Health professionals and people with lived experience highlighted the multifaceted nature of Long COVID, including its varied symptoms, its impact on people's lives and the complexity involved in managing this condition. These impacts encompass physical, social, mental and environmental dimensions. People with Long COVID reported barriers in accessing primary care, as well as negative general practitioner consultations where they felt unheard or invalidated, though some positive interactions were also noted. Peer support or support systems proved highly valuable and beneficial for individuals, aiding their recovery and well-being. Post-COVID-19 services were viewed as spaces where overlooked voices found validation, offering more than medical expertise. Despite initial challenges, healthcare providers' increasing expertise in diagnosing and treating Long COVID has helped refine care approaches for this condition. CONCLUSION Long COVID care in England is not uniform across all locations. Effective communication, specialised expertise and comprehensive support systems are crucial. A patient-centred approach considering the unique complexities of Long COVID, including physical, mental health, social and environmental aspects is needed. Sustained access to post-COVID-19 services is imperative, with success dependent on offering continuous rehabilitation beyond rapid recovery, acknowledging the condition's enduring impacts and complexities.
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Affiliation(s)
- David Sunkersing
- Institute of Health Informatics, University College London, London, UK
| | - Mel Ramasawmy
- Institute of Health Informatics, University College London, London, UK
| | - Nisreen A Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Donna Clutterbuck
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yi Mu
- Institute of Health Informatics, University College London, London, UK
| | | | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
| | - Melissa Heightman
- University College London Hospitals NHS Foundation Trust, London, UK
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Cooper K, Duncan E, Hart-Winks E, Cowie J, Shim J, Stage E, Tooman T, Alexander L, Love A, Morris JH, Ormerod J, Preston J, Swinton P. Exploring the perceptions and experiences of community rehabilitation for Long COVID from the perspectives of Scottish general practitioners' and people living with Long COVID: a qualitative study. BMJ Open 2024; 14:e082830. [PMID: 38749696 PMCID: PMC11097876 DOI: 10.1136/bmjopen-2023-082830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES To explore the experience of accessing Long COVID community rehabilitation from the perspectives of people with Long COVID and general practitioners (GPs). DESIGN Qualitative descriptive study employing one-to-one semistructured virtual interviews analysed using the framework method. SETTING Four National Health Service Scotland territorial health boards. PARTICIPANTS 11 people with Long COVID (1 male, 10 female; aged 40-65 (mean 53) and 13 GPs (5 male, 8 female). RESULTS Four key themes were identified: (1) The lived experience of Long COVID, describing the negative impact of Long COVID on participants' health and quality of life; (2) The challenges of an emergent and complex chronic condition, including uncertainties related to diagnosis and management; (3) Systemic challenges for Long COVID service delivery, including lack of clear pathways for access and referral, siloed services, limited resource and a perceived lack of holistic care, and (4) Perceptions and experiences of Long COVID and its management, including rehabilitation. In this theme, a lack of knowledge by GPs and people with Long COVID on the potential role of community rehabilitation for Long COVID was identified. Having prior knowledge of rehabilitation or being a healthcare professional appeared to facilitate access to community rehabilitation. Finally, people with Long COVID who had received rehabilitation had generally found it beneficial. CONCLUSIONS There are several patient, GP and service-level barriers to accessing community rehabilitation for Long COVID. There is a need for greater understanding by the public, GPs and other potential referrers of the role of community rehabilitation professionals in the management of Long COVID. There is also a need for community rehabilitation services to be well promoted and accessible to the people with Long COVID for whom they may be appropriate. The findings of this study can be used by those (re)designing community rehabilitation services for people with Long COVID.
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Affiliation(s)
- Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Edward Duncan
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | - Erin Hart-Winks
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Julie Cowie
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Joanna Shim
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Emma Stage
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Tricia Tooman
- NMAHP Research Unit, University of Stirling, Stirling, UK
| | | | | | | | | | - Jenny Preston
- NMAHP Research Unit, University of Stirling, Stirling, UK
- Occupational Therapy, NHS Ayrshire and Arran, Irvine, UK
| | - Paul Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
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Fang C, Baz SA, Sheard L, Carpentieri JD. "They seemed to be like cogs working in different directions": a longitudinal qualitative study on Long COVID healthcare services in the United Kingdom from a person-centred lens. BMC Health Serv Res 2024; 24:406. [PMID: 38561719 PMCID: PMC10986002 DOI: 10.1186/s12913-024-10891-7] [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: 11/17/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has presented significant challenges to the already over-stretched healthcare system in the United Kingdom (UK). These challenges are particularly pronounced for people living with the novel condition of Long COVID (LC) as they often face persistent and fluctuating symptoms, encountering prolonged uncertainty when seeking medical support. Despite a growing understanding of the healthcare challenges associated with LC, existing qualitative studies have predominantly focused on individual experiences rather than examining the structural aspects of healthcare. METHODS A longitudinal qualitative study with 80 participants and 12 healthcare practitioners was conducted in the UK to explore the healthcare experiences of those with LC. In total, 178 interviews (with attrition) were collected across two rounds, from November 2021 to March 2022, and from June to October 2022. RESULTS Embracing a person-centred framework that recognises and nurtures interconnected individual, relational, and existential needs, we investigated healthcare experiences related to LC across primary, secondary, and specialist integrated care. Using this perspective, we identified three overarching themes. Theme 1 addresses the persistent hurdle of accessing primary care as the initial point of contact for LC healthcare; Theme 2 underscores the complexity of navigating secondary care; and Theme 3 encapsulates the distinctive challenges of developing LC integrated care. These themes are interlinked, as people with LC often had to navigate or struggle between the various systems, with practitioners seeking to collaborate across the breadth of their professional responsibilities. CONCLUSION From a person-centred approach, we were able to identify the needs of those affected by lasting LC symptoms and comprehend how health services intricately influence these needs. The focus on healthcare systems also captures the nuanced impact that continuing healthcare struggles can have on people's identity. As such, our findings provide evidence to inform a more effective and sustainable delivery of person-centred care for people with LC across various healthcare settings and over time.
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Affiliation(s)
- Chao Fang
- Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, UK.
| | | | - Laura Sheard
- Department of Health Sciences, University of York, York, UK
| | - J D Carpentieri
- Department of Education, Practice and Society, Institute of Education, University College London, London, UK
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Clutterbuck D, Ramasawmy M, Pantelic M, Hayer J, Begum F, Faghy M, Nasir N, Causer B, Heightman M, Allsopp G, Wootton D, Khan MA, Hastie C, Jackson M, Rayner C, Brown D, Parrett E, Jones G, Clarke R, Mcfarland S, Gabbay M, Banerjee A, Alwan NA. Barriers to healthcare access and experiences of stigma: Findings from a coproduced Long Covid case-finding study. Health Expect 2024; 27:e14037. [PMID: 38634418 PMCID: PMC11024953 DOI: 10.1111/hex.14037] [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: 12/21/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND AND AIM Long Covid is often stigmatised, particularly in people who are disadvantaged within society. This may prevent them from seeking help and could lead to widening health inequalities. This coproduced study with a Community Advisory Board (CAB) of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid. METHODS An active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England. Interviews explored the barriers to care and the stigma faced by participants and were analysed thematically. This study forms part of the STIMULATE-ICP Collaboration. FINDINGS Twenty-three interviews were completed. Participants reported limited awareness of what Long Covid is and the available pathways to management. There was considerable self-doubt among participants, sometimes reinforced by interactions with healthcare professionals (HCPs). Participants questioned their deservedness in seeking healthcare support for their symptoms. Hesitancy to engage with healthcare services was motivated by fear of needing more investigation and concerns regarding judgement about the ability to carry out caregiving responsibilities. It was also motivated by the complexity of the clinical presentation and fear of all symptoms being attributed to poor mental health. Participants also reported trying to avoid overburdening the health system. These difficulties were compounded by experiences of stigma and discrimination. The emerging themes reaffirmed a framework of epistemic injustice in relation to Long Covid, where creating, interpreting and conveying knowledge has varied credibility based on the teller's identity characteristics and/or the level of their interpretive resources. CONCLUSION We have codeveloped recommendations based on the findings. These include early signposting to services, dedicating protected time to listening to people with Long Covid, providing a holistic approach in care pathways, and working to mitigate stigma. Regardless of the diagnosis, people experiencing new symptoms must be encouraged to seek timely medical help. Clear public health messaging is needed among communities already disadvantaged by epistemic injustice to raise awareness of Long Covid, and to share stories that encourage seeking care and to illustrate the adverse effects of stigma. PATIENT OR PUBLIC CONTRIBUTION This study was coproduced with a CAB made up of 23 members including HCPs, people with lived experience of Long Covid and other stakeholders.
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Affiliation(s)
- Donna Clutterbuck
- School of Primary CarePopulation Sciences and Medical EducationUniversity of SouthamptonSouthamptonUK
| | - Mel Ramasawmy
- Institute of Health InformaticsUniversity College LondonLondonUK
| | - Marija Pantelic
- Brighton and Sussex Medical SchoolUniversity of SussexFalmerUK
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | - Jasmine Hayer
- PPIE Co‐applicant for STIMULATE‐ICPLondonUK
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
| | - Fauzia Begum
- University Hospitals of Derby and Burton NHS Foundation TrustDerbyshireUK
| | - Mark Faghy
- Clinical Exercise and Rehabilitation Research CentreUniversity of DerbyDerbyUK
| | - Nayab Nasir
- Department of Health and Social CareOffice for Health Improvement and DisparitiesUK
| | | | | | | | - Dan Wootton
- Clinical Infection Microbiology and ImmunologyUniversity of LiverpoolLiverpoolUK
- Liverpool University Hospitals NHS Foundation TrustLiverpoolUK
| | - M. Asad Khan
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
- Manchester University Hospitals NHS Foundation TrustManchesterUK
| | - Claire Hastie
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
- Long Covid Support CharityLondonUK
| | - Monique Jackson
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
| | - Clare Rayner
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
| | - Darren Brown
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
- Chelsea and Westminster Hospital NHS Foundation TrustLondonUK
| | - Emily Parrett
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
| | - Geraint Jones
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
| | - Rowan Clarke
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
| | - Sammie Mcfarland
- Member of the Community Advisory Board as person with lived experience of Long CovidSouthamptonUK
- Long Covid Kids CharitySalisburyUK
| | - Mark Gabbay
- NIHR Applied Research Collaboration North West CoastLiverpoolUK
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
| | - Amitava Banerjee
- Institute of Health InformaticsUniversity College LondonLondonUK
| | - Nisreen A. Alwan
- School of Primary CarePopulation Sciences and Medical EducationUniversity of SouthamptonSouthamptonUK
- University Hospital Southampton NHS Foundation TrustSouthamptonUK
- NIHR Applied Research Collaboration WessexSouthamptonUK
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Ren J, Gao Q, Zhou X, Chen L, Guo W, Feng K, Huang T, Cai YD. Identification of key gene expression associated with quality of life after recovery from COVID-19. Med Biol Eng Comput 2024; 62:1031-1048. [PMID: 38123886 DOI: 10.1007/s11517-023-02988-8] [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: 07/06/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Post-acute sequelae of COVID-19 (PASC) is a persistent complication of severe acute respiratory syndrome coronavirus 2 infection that includes symptoms, such as fatigue, cognitive impairment, and respiratory distress. These symptoms severely affect the quality of life of patients after their recovery from COVID-19. In this study, a group of machine learning algorithms analyzed the whole blood RNA-seq data from patients with different PASC levels. The purpose of this analysis was to identify the gene markers associated with PASC and the special expression patterns for different PASC levels. By comparing the quality of life of patients after the acute phase of COVID-19 and before the disease, samples in the dataset were divided into three groups, namely, "Better," "The Same," and "Worse." Each patient was represented by the expression levels of 58,929 genes. The machine learning-based workflow included six feature-ranking algorithms, incremental feature selection (IFS), and four classification algorithms. The feature ranking algorithms were in charge of assessing feature importance, whereas IFS with classification algorithms were used to extract essential genes and to construct efficient classifiers and classification rules. The expression of top genes in the results was associated with the immune response to viral infection, which is supported by the published literature. For example, patients with low CCDC18 expression and high CPED1 expression had good quality of life, whereas those with low CDC16 expression had poor quality of life.
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Affiliation(s)
- JingXin Ren
- School of Life Sciences, Shanghai University, Shanghai, 200444, China
| | - Qian Gao
- Department of Pharmacy, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - XianChao Zhou
- Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lei Chen
- College of Information Engineering, Shanghai Maritime University, Shanghai, 201306, China
| | - Wei Guo
- Key Laboratory of Stem Cell Biology, Shanghai Jiao Tong University School of Medicine (SJTUSM) & Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai, 200030, China
| | - KaiYan Feng
- Department of Computer Science, Guangdong AIB Polytechnic College, Guangzhou, 510507, China
| | - Tao Huang
- Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Yu-Dong Cai
- School of Life Sciences, Shanghai University, Shanghai, 200444, China.
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Al-Jabr H, Windle K, Clifton A, Thompson DR, Castle DJ, Ski CF. Patient experiences of the Long COVID-Optimal Health Programme: a qualitative interview study in community settings. BJGP Open 2024; 8:BJGPO.2023.0137. [PMID: 37907337 PMCID: PMC11169993 DOI: 10.3399/bjgpo.2023.0137] [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: 07/20/2023] [Revised: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Long COVID (LC) symptoms persist 12 weeks or more beyond the acute infection. To date, no standardised diagnostic or treatment pathways exist. However, a holistic approach has been recommended. This study explored participants' experiences of a Long COVID-Optimal Health Programme (LC-OHP); a psychoeducational self-efficacy programme. AIM To explore perceptions and experiences of people with LC regarding the LC-OHP and identify suggestions to further improve the programme. DESIGN & SETTING Qualitative study with patients with LC recruited through community settings. METHOD This study is part of a wider randomised controlled trial. Eligible participants were aged ≥18 years, have LC, and attended a minimum of five LC-OHP sessions plus a booster session. We interviewed those randomised to the intervention group. Interviews were conducted by an independent researcher and thematically analysed to identify common, emerging themes. RESULTS Eleven participants were interviewed, mostly women from a White British ethnic group (n = 10). Four main themes were identified, reflecting programme benefits and suggestions for improvement. The programme demonstrated potential for assisting patients in managing their LC, including physical health and mental wellbeing. Participants found the programme to be flexible and provided suggestions to adapting it for future users. CONCLUSION Findings support the acceptability of the LC-OHP to people living with LC. The programme has shown several benefits in supporting physical health and mental wellbeing. Suggestions made to further adapt the programme and improve its delivery will be considered for future trials.
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Affiliation(s)
- Hiyam Al-Jabr
- Primary Community and Social Care, University of Keele, Keele, UK
- Midlands Partnership University NHS Foundation Trust, St Georges Hospital, Stafford, UK
| | - Karen Windle
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Andrew Clifton
- School of Health and Sports Sciences, University of Suffolk, Ipswich, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Department of Psychiatry, University of Tasmania, Tasmania, Australia
- Centre for Mental Health Service Innovation, Tasmania, Australia
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Turk F, Sweetman J, Chew‐Graham CA, Gabbay M, Shepherd J, van der Feltz‐Cornelis C. Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study. Health Expect 2024; 27:e14008. [PMID: 38481384 PMCID: PMC10938067 DOI: 10.1111/hex.14008] [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: 12/20/2023] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Long Covid is an emerging long-term condition, with those affected raising concerns about lack of healthcare support. OBJECTIVE We conducted a qualitative study to identify facilitators and barriers to healthcare access for people with Long Covid, aiming to enhance our understanding of the specific nature of these barriers and how patient experiences may vary. SETTING AND PARTICIPANTS In the context of the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) Delphi study, a nationally distributed online survey was conducted. Eight patients and eight healthcare practitioners (HCP) were interviewed via telephone or video call. Framework analysis, sensitised by the candidacy theory, was used to identify barriers and facilitators over four levels of access to care. RESULTS Three themes were identified: (i) patients' efforts to navigate emerging pathways for Long Covid, (ii) the patient-HCP interaction and (iii) service resources and structural constraints. Barriers to specialist care included long waiting times, communication gaps across services and a lack of continuity in care. Facilitators included collaborative, patient-centred approaches, patients' active role in their healthcare and blended approaches for appointments. The perspectives of both patients and HCPs largely aligned. DISCUSSION The candidacy framework was valuable in understanding the experiences of people with Long Covid seeking access to healthcare. Individuals perceived themselves as eligible for care, but they often encountered obstacles in obtaining the expected level of care or, in some cases, did not receive it at all. Our findings are discussed in the context of the candidacy model through multiple processes of identification, negotiation, permeability and appearances at health services. These themes seem to be especially important for the emerging new pathway model and are relevant to both primary and secondary care. CONCLUSIONS This study highlights that despite these interviews being conducted two years after the start of the COVID-19 pandemic, people with Long Covid still struggle to access healthcare, emphasising the ongoing need to provide equitable timely healthcare access for people with Long Covid. PATIENT OR PUBLIC CONTRIBUTION People with Long Covid advised on all stages of this research.
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Affiliation(s)
- Fidan Turk
- Department of Health SciencesUniversity of YorkYorkUK
| | | | | | - Mark Gabbay
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR ARC NWCLiverpoolUK
| | | | - Christina van der Feltz‐Cornelis
- Department of Health SciencesUniversity of YorkYorkUK
- Hull York Medical School (HYMS)University of YorkYorkUK
- Institute of Health InformaticsUniversity College LondonLondonUK
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Estebanez‐Pérez M, Martín‐Valero R, Pastora‐Estebanez P, Pastora‐Bernal J. Experiences of people with Long Covid with a digital physiotherapy intervention: A qualitative study. Health Expect 2024; 27:e13993. [PMID: 38590093 PMCID: PMC11002316 DOI: 10.1111/hex.13993] [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: 11/24/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 04/10/2024] Open
Abstract
PURPOSE Long Covid syndrome is a multiorgan condition with multiple sequelae affecting quality of life, capacity to work and daily activities. The advantages that new technologies can offer are presented as an opportunity in the current healthcare framework. OBJECTIVE This research aimed to explore people with Long Covid's experiences with a digital physiotherapy practice intervention, during four weeks. METHODS Qualitative semistructured interviews were conducted by video call. Thirty-two Long Covid participants were invited to join an in-depth interview once the intervention was completed. Participants were queried on their intervention experiences and perceptions, as well as any lifestyle changes made, as a result of receiving digital physiotherapy practice. The interviews were transcribed and analysed using inductive qualitative content analysis. RESULTS In-depth qualitative analysis has revealed four themes that reflect participants' perceptions of digital physiotherapy intervention. The helpfulness of the exercises, interaction with the physiotherapist, the domestic use of technology and the future of digital health practice were the topics highlighted by Long Covid participants. Some improvements have been suggested including video sounds and the need to introduce face-to-face sessions. Participants stated that interventions were helpful and superior to printed exercise sheets, mobile phone apps and usual care received. This intervention did not present major barriers, highlighting the importance of personalized care and continuity in the provision of health services. CONCLUSION The digital physiotherapy practice is perceived by people with Long Covid as an appropriate method for the care of their health needs. Participants stated the need for this type of intervention in the public health system, where it would eliminate waiting lists, facilitate accessibility and improve existing care. PATIENT AND PUBLIC CONTRIBUTION Participants contributed to the interpretation of the data acquired in the interview. CLINICAL TRIAL REGISTRATION Trial registration NCT04742946.
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Affiliation(s)
- María‐José Estebanez‐Pérez
- Department of Physiotherapy, Faculty of Health ScienceUniversity of MalagaMálagaSpain
- Department of PhysiotherapyFaculty of Health Science, University of GranadaMelillaSpain
| | - Rocío Martín‐Valero
- Department of Physiotherapy, Faculty of Health ScienceUniversity of MalagaMálagaSpain
| | - Pablo Pastora‐Estebanez
- Department of Economy, Faculty of Economic and Business SciencesUniversity of MálagaMálagaSpain
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Leggat FJ, Heaton-Shrestha C, Fish J, Siriwardena AN, Domeney A, Rowe C, Patel I, Parsons J, Blair J, Jones F. An exploration of the experiences and self-generated strategies used when navigating everyday life with Long Covid. BMC Public Health 2024; 24:789. [PMID: 38481230 PMCID: PMC10938753 DOI: 10.1186/s12889-024-18267-6] [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: 05/17/2023] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Around one in ten people who contract Covid-19 report ongoing symptoms or 'Long Covid'. Without any known interventions to cure the condition, forms of self-management are routinely prescribed by healthcare professionals and described by people with the condition. However, there is limited research exploring what strategies are used to navigate everyday life with Long Covid, and experiences that initiate development of these strategies. Our study aimed to explore the range and influence of self-generated strategies used by people with Long Covid to navigate everyday life within the context of their own condition. METHODS Forming part of the Long Covid Personalised Self-managemenT support co-design and EvaluatioN (LISTEN) project, we conducted a qualitative study using narrative interviews with adults who were not hospitalised with Covid-19. Participants aged over 18 years, who self-identified with Long Covid, were recruited from England and Wales. Data were analysed with patient contributors using a reflexive thematic analysis. RESULTS Eighteen participants (mean age = 44 years, SD = 13 years) took part in interviews held between December 2021 and February 2022. Themes were constructed which depicted 1) the landscape behind the Long Covid experience and 2) the everyday experience of participants' Long Covid. The everyday experience comprised a combination of physical, emotional, and social factors, forming three sub-themes: centrality of physical symptoms, navigating 'experts' and the 'true colour' of personal communities, and a rollercoaster of psychological ambiguity). The third theme, personal strategies to manage everyday life was constructed from participants' unique presentations and self-generated solutions to manage everyday life. This comprised five sub-themes: seeking reassurance and knowledge, developing greater self-awareness through monitoring, trial and error of 'safe' ideas, building in pleasure and comfort, and prioritising 'me'. CONCLUSIONS Among this sample of adults with Long Covid, their experiences highlighted the unpredictable nature of the condition but also the use of creative and wide ranging self-generated strategies. The results offer people with Long Covid, and healthcare professionals supporting them, an overview of the collective evidence relating to individuals' self-management which can enable ways to live 'better' and regain some sense of identity whilst facing the impact of a debilitating, episodic condition. TRIAL REGISTRATION LISTEN ISRCTN36407216.
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Affiliation(s)
- Fiona J Leggat
- Population Health Research Institute, St George's, University of London, London, England, UK
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, England, UK
| | - Celayne Heaton-Shrestha
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, England, UK
| | - Jessica Fish
- Department of Clinical Neuropsychology & Clinical Health Psychology, St George's University Hospitals NHS Foundation Trust, London, England, UK
- Mental Health & Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | | | - Anne Domeney
- LISTEN Lived Experience Advisory Group, London, UK
- Bridges Self-Management, London, England, UK
| | - Carol Rowe
- LISTEN Lived Experience Advisory Group, London, UK
| | - Ian Patel
- LISTEN Lived Experience Advisory Group, London, UK
| | | | - John Blair
- LISTEN Lived Experience Advisory Group, London, UK
| | - Fiona Jones
- Population Health Research Institute, St George's, University of London, London, England, UK.
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, England, UK.
- Bridges Self-Management, London, England, UK.
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Andersen IC, Nissen N, Agerskov H, Beck M, Bodtger U, Tang L, Skou ST, Simonÿ C. Searching for a brighter future-Lived experiences of ongoing recovery processes following COVID-19 infection. Scand J Caring Sci 2024; 38:114-125. [PMID: 37817358 DOI: 10.1111/scs.13213] [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: 11/09/2022] [Revised: 08/08/2023] [Accepted: 09/03/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Research in Denmark indicates that approximately 30% of people with confirmed COVID-19 infection experience at least one physical symptom 6-12 months after the acute infection. The lived experiences of undergoing prolonged recovery processes and how these processes unfold need further attention. AIM To contribute in-depth knowledge about recovery, as experienced over time by people living with the post COVID-19 condition. METHODS Within a qualitative research design, nine women and six men were interviewed. Ten of them gave a follow-up interview. Prompt cards and participant-generated photographs were included. A phenomenological-hermeneutic approach inspired by Ricoeur's theory of interpretation guided the data analysis. FINDINGS Living with long-term health problems associated with the post COVID-19 condition involved recovery processes where participants struggled with reduced capacity, new unpredictability and uncertainty in everyday life. Participants continuously searched for improvement and aimed for regaining former health and well-being. Lack of knowledge, acknowledgement and support made it difficult to find clear directions for improvement. Participants created a protective shield and struggled, often jointly with family and friends, to cope with bodily, cognitive, emotional, existential and social challenges. Over time, some participants realised that they might not be able to fully return to their earlier habitus. However, some of them gained a new foothold and sense of hope for the future. CONCLUSION This study provides in-depth insight into the experience of changing and open-ended recovery processes while living with the post COVID-19 condition. Over time, some participants learned to rebuild their lives, adapting to their reduced capacities. Future care and rehabilitation models for these patients must address the complex and challenging nature of recovery processes associated with living with post-COVID-19 condition.
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Affiliation(s)
- Ingrid C Andersen
- Department of Medicine, Naestved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
| | - Nina Nissen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
| | - Hanne Agerskov
- Department of Nephrology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Malene Beck
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
| | - Uffe Bodtger
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
| | - Lars Tang
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
| | - Søren T Skou
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Charlotte Simonÿ
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved, Slagelse and Ringsted Hospitals, Region Zealand, Denmark
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Wheibe E, Dalkin BH, Meltzer HC, Russ-Sellers R, Grier JT. The Multisystem effects of Long COVID Syndrome and Potential Benefits of Massage Therapy in Long COVID Care. Int J Ther Massage Bodywork 2024; 17:19-42. [PMID: 38486840 PMCID: PMC10911825 DOI: 10.3822/ijtmb.v17i1.767] [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] [Indexed: 03/17/2024] Open
Abstract
Background A major complication of infection with Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, is the potential for Long COVID Syndrome. While the pathophysiology of Long COVID Syndrome has yet to be described, the disease presentation is characterized by long-term symptoms with debilitating effects on human health. A better understanding of Long COVID symptomology may open up new avenues for patient treatment such as massage therapy. Methods From the PubMed database, cohort studies that examined post-infection COVID sequelae published between January 1st, 2021 and April 30th, 2021 were selected to investigate patient demographics and symptoms. A review of massage therapy literature since 2000 in conjunction with identified Long COVID symptoms was performed. Results This systematic review identified 17 cohort studies across the world that investigated the symptomatology of patients suffering from post-COVID sequelae in multiple organ systems. We identified the pulmonary and nervous systems to be the organ systems most affected with post-COVID sequelae, with PTSD, fatigue, dyspnea, cough, sleep disturbances, loss of smell, abdominal pain, and decreased appetite as the most common symptoms reported by >20% of Long COVID patients. Massage therapy was historically found to provide benefits to patients experiencing similar symptoms to those identified in Long COVID. Conclusions Recognizing the need for new approaches to treatment for Long COVID Syndrome, we identify massage therapy as a potential therapeutic treatment to positively impact the organ systems affected by Long COVID, especially the high-incident symptoms, and improve patient quality of life.
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Affiliation(s)
- Elias Wheibe
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Benjamin H. Dalkin
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Haley C. Meltzer
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | | | - Jennifer T. Grier
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
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Finch F, Parker P, Nollett C, Burns S. The novel application of the Lightning Process to treat Long COVID in primary care - Case report. Explore (NY) 2024; 20:248-252. [PMID: 38176975 DOI: 10.1016/j.explore.2023.08.009] [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: 07/21/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 01/06/2024]
Abstract
As a result of the COVID-19 pandemic, Long COVID (LC) is now prevalent in many countries. Little evidence exists regarding how this chronic condition should be treated, but guidelines suggest for most people it can be managed symptomatically in primary care. The Lightning Process is a trademarked positive psychology focused self-management programme which has shown to be effective in reducing fatigue and accompanying symptoms in other chronic conditions including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Here we outline its novel application to two patients with LC who both reported improvements in fatigue and a range of physical and emotional symptoms post-treatment and at 3 months follow-up.
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Affiliation(s)
| | - P Parker
- London Metropolitan University, UK
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Sirotiak Z, Thomas EBK, Wade NG, Brellenthin AG. Associations between forgiveness and physical and mental health in the context of long COVID. J Psychosom Res 2024; 178:111612. [PMID: 38367371 DOI: 10.1016/j.jpsychores.2024.111612] [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: 10/05/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Forgiveness has been positively associated with health in those with functional disorders. This cross-sectional study examined the relationships among dimensions of forgiveness and physical and mental health in individuals with and without long COVID. METHODS Adults (N = 4316) in the United States took part in an online survey study detailing long COVID presence, physical and mental health, and trait forgiveness. T-tests were performed to assess differences in types of trait forgiveness between individuals with and without long COVID. Linear regression models assessed the contribution of demographic covariates and forgiveness subscales to the physical and mental health of individuals with and without long COVID. RESULTS Of 4316 participants, 379 (8.8%) reported current long COVID. Participants were an average age of 43.7, and most identified as female (51.9%), white (87.8%), and non-Hispanic/Latino (86.6%). Individuals with long COVID reported significantly less forgiveness of self (p < 0.001, d = 0.33), forgiveness of others (p = 0.004, d = 0.16), and forgiveness of situations (p < 0.001, d = 0.34) than those without long COVID. Among the long COVID sample, forgiveness of self and situations were positively associated with mental health (p < 0.05), but not physical health (p > 0.05). Forgiveness of others was negatively associated with both physical and mental health (p < 0.05). CONCLUSION Forgiveness may be an important consideration in understanding health among individuals with long COVID, emphasizing the importance of developing a multifaceted understanding of the condition.
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Affiliation(s)
- Zoe Sirotiak
- Iowa State University, Department of Kinesiology, USA; University of Iowa, Department of Psychological and Brain Sciences, USA
| | - Emily B K Thomas
- University of Iowa, Department of Psychological and Brain Sciences, USA
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