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Maccarone MC, Coraci D, Regazzo G, Sarandria N, Scanu A, Masiero S. Evolution of musculoskeletal symptoms in Long COVID syndrome: a lexical analysis to approach requirements for an interdisciplinary management. Joint Bone Spine 2024; 91:105623. [PMID: 37487957 DOI: 10.1016/j.jbspin.2023.105623] [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] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/26/2023]
Abstract
Long COVID syndrome is characterized by new, returning, or persistent symptoms after the initial SARS-CoV-2 infection. Among the potential long-term effects of COVID-19, several different musculoskeletal symptoms have been reported in many patients with an important impact on quality of life. The rehabilitation needs of Long COVID patients could be dynamic. However, to date there are no studies that have evaluated how the rehabilitation needs of patients with Long COVID syndrome have changed over time. We conducted a literature review to summarize the most recurrent manifestations of the Long COVID syndrome during the three years of the pandemic, as well as the evolution of musculoskeletal symptoms, through lexical analysis. This approach allowed us to investigate the literature, highlighting how the most used words to describe Long COVID symptoms and outcomes have changed over different periods. Our analysis showed an increasing involvement of the musculoskeletal system in Long COVID symptomatology, as evidenced by the progressive growth of fatigue and weakness symptoms over time. In addition, arthralgia has always been associated with Long COVID. The lexical analysis we conducted emphasizes the need for interdisciplinary management, as the symptoms reported are interconnected. Moreover, this novel approach highlights that the Long COVID syndrome can be interpreted as a dynamic entity requiring up-to-date rehabilitative interventions. The worldwide healthcare systems should be founded on multidisciplinary teams to guarantee early and comprehensive rehabilitation to reduce the socio-sanitary burden associated with this syndrome.
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Affiliation(s)
- Maria Chiara Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy.
| | - Daniele Coraci
- Department of Neuroscience, Rehabilitation Unit, University of Padua, Padua, Italy
| | - Gianluca Regazzo
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Nicola Sarandria
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Anna Scanu
- Department of Neuroscience, Rehabilitation Unit, University of Padua, Padua, Italy; Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Stefano Masiero
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy; Department of Neuroscience, Rehabilitation Unit, University of Padua, Padua, Italy
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Maccarone MC, Coraci D, Bernini A, Sarandria N, Valente MR, Frigo AC, Dionyssiotis Y, Masiero S. Sarcopenia prevalence and association with nutritional status in cohort of elderly patients affected by musculoskeletal concerns: a real-life analysis. Front Endocrinol (Lausanne) 2023; 14:1194676. [PMID: 37435492 PMCID: PMC10331423 DOI: 10.3389/fendo.2023.1194676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/13/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction The progressive loss of skeletal muscle mass, strength, and function that frequently occurs as people get older is referred to as sarcopenia. Elderly musculoskeletal aging, sarcopenia, and obesity are all intimately connected. Our study's aim is to investigate the prevalence of sarcopenia in a real cohort of patients over 65 with musculoskeletal conditions referring to a Rehabilitation Unit. The secondary aim of our study is to investigate associations between sarcopenia and alterations in nutritional status and Body Mass Index (BMI). Finally, quality of life and global health has been investigated in our population. Materials and methods From January 2019 to January 2021, 247 patients over 65 years old with musculoskeletal concerns were enrolled and participated in an observational study. As outcome measures, the Mini Nutritional Assessment (MNA), the 12-Item Short Form Health Survey (SF-12), and the Cumulative Illness Rating Scale Severity Index (CIRS-SI) were used. Additionally, measurements of total skeletal muscle mass (SMM) and appendicular muscle mass (ASMM) using bioelectrical impedance analysis, as well as a hand grip strength test of the non-dominant hand were taken. The Mid Upper Arm Circumference (MUAC) and the Calf Circumference (CC) were measured and recorded as further indications of possible sarcopenia. Results A percentage of 46.1% of subjects with overt sarcopenia was found and 10.1% showed a severe sarcopenia. Patients with severe sarcopenia showed significantly lower values of BMI and MNA. Additionally, sarcopenic patients showed significantly lower values in MNA when compared to non-sarcopenic patients. Considering SF-12, only the physical score revealed slight significant differences. In particular, patients affected by probable or severe sarcopenia presented a lower value than non-sarcopenic patients. Concerning MUAC and CC, severe sarcopenic patients showed significant lower values for both the body parts. Conclusion Our study considers a cohort of real-life elderly subjects with musculoskeletal concerns and shows that these subjects are highly susceptible to sarcopenia. Therefore, rehabilitation for elderly patients with musculoskeletal concerns requires to be customized and multidisciplinary. Future research should further investigate these aspects in order to enable the early identification of sarcopenia and the formulation of customized rehabilitative programs. .
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Affiliation(s)
- Maria Chiara Maccarone
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Daniele Coraci
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padua, Italy
| | - Andrea Bernini
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Nicola Sarandria
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Marta Rossella Valente
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
| | - Anna Chiara Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padua, Italy
| | - Yannis Dionyssiotis
- Spinal Cord Injury Rehabilitation Clinic, University of Patras, Patras, Greece
| | - Stefano Masiero
- Physical Medicine and Rehabilitation School, Department of Neuroscience, University of Padova, Padua, Italy
- Department of Neuroscience, Rehabilitation Unit, University of Padova, Padua, Italy
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Sheppard CL, Szigeti Z, Simpson R, Minezes J, Hitzig SL, Mayo A, Robinson LR, Lung M, Wasilewski MB. Implementation considerations for delivering inpatient COVID rehabilitation: A qualitative study. J Eval Clin Pract 2022; 28:971-985. [PMID: 36070223 PMCID: PMC9537784 DOI: 10.1111/jep.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 12/01/2022]
Abstract
RATIONALE Patients recovering from significant COVID-19 infections benefit from rehabilitation; however, aspects of rehabilitative care can be difficult to implement amidst COVID infection control measures. AIMS AND OBJECTIVES We used the Consolidated Framework for Implementation Research (CFIR) to evaluate the rapid implementation of a COVID zone in an in-patient rehabilitation hospital at the onset of the first wave of the pandemic. METHODS Semistructured interviews were conducted with health care providers (n = 12) supporting the COVID zone, as well as with patients (n = 10) who were discharged from the COVID zone and their family caregivers (n = 5). The interviews explored the successes and challenges of working on the unit and the quality of care that was delivered to patients recovering from COVID. RESULTS Rapid implementation of the COVID zone was supported by champions at the middle-management level but challenged by a number of factors, including: conflicting expert opinions on best infection control practices (outer setting), limited flow of information from senior leaders to frontline staff (inner setting), lack of rehabilitation equipment and understanding of how to provide high quality rehabilitative care in this context (intervention characteristics), willingness and self-efficacy of staff working in the COVID zone (individual characteristics) and lack of time to reflect on and assess effectiveness (process). CONCLUSIONS While there was an apparent need for rapid implementation of a COVID rehabilitation zone, senior leadership, middle management and frontline staff faced several challenges. Future evaluations should focus on how to adapt COVID rehabilitation services during fluctuating pandemic restrictions, and to account for rehabilitative needs of people recovering from significant COVID infections.
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Affiliation(s)
- Christine L. Sheppard
- St. John's Rehab Research Program, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada
| | - Zara Szigeti
- St. John's Rehab Research Program, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada
| | - Robert Simpson
- Department of Physical Medicine and Rehabilitation & Rehabilitation Sciences Institute, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - Jacqueline Minezes
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John's RehabSunnybrook Health Sciences CentreTorontoCanada
| | - Sander L. Hitzig
- St. John's Rehab Research Program, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada
- Department of Occupational Science and Occupational Therapy & Rehabilitation Sciences Institute, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - Amanda Mayo
- St. John's Rehab Research Program, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada
- Department of Physical Medicine and Rehabilitation, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - Lawrence R. Robinson
- St. John's Rehab Research Program, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada
- Department of Physical Medicine and Rehabilitation, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - Maria Lung
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St. John's RehabSunnybrook Health Sciences CentreTorontoCanada
| | - Marina B. Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research InstituteSunnybrook Health Sciences CentreTorontoCanada
- Department of Occupational Science and Occupational Therapy & Rehabilitation Sciences Institute, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
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Pazzaglia C, Padua L, Stancanelli C, Fusco A, Loreti C, Castelli L, Imbimbo I, Giovannini S, Coraci D, Vita GL, Vita G. Role of Sport Activity on Quality of Life in Charcot-Marie-Tooth 1A Patients. J Clin Med 2022; 11:jcm11237032. [PMID: 36498606 PMCID: PMC9740468 DOI: 10.3390/jcm11237032] [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: 10/06/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The present study aims to investigate the benefits induced by physical activity/practiced sport in Charcot-Marie-Tooth 1A (CMT1A). Patients were divided into sport and no-sport groups according to their sports performance habit. Thirty-one patients were enrolled, of which 14 practiced sports and 17 did not. Clinical assessments were administered to evaluate disability, self-esteem, depression, quality of life, and pain. Statistical analysis revealed significant differences in terms of gender in the no-sport group compared to the sport group (p = 0.04). Regarding the quality of life, physical function (p = 0.001), general health (p = 0.03), social function (p = 0.04), and mental health (p = 0.006) showed better patterns in the sport group than no-sport group. Moreover, neuropathic pain was reduced in the sport group according to the Neuropathic Pain Symptom Inventory (p = 0.001) and ID-PAIN (p = 0.03). The other administered questionnaires showed no significant differences. Our study confirms that CMT1A patients, who practice sports, with a similar severity of disability, may have a better physical quality of life while suffering less neuropathic pain than their peers who do not practice sports. Results recommend the prescription of sport in CMT1A patients.
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Affiliation(s)
- Costanza Pazzaglia
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Luca Padua
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Claudia Stancanelli
- Nemo Sud Clinical Centre for Neuromuscular Disorders, 98125 Messina, Italy
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, 98100 Messina, Italy
| | - Augusto Fusco
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Claudia Loreti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Letizia Castelli
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Isabella Imbimbo
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Silvia Giovannini
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- UOS Riabilitazione Post-Acuzie, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: (S.G.); (D.C.); Tel.: +39-06-3015-4382 (S.G.)
| | - Daniele Coraci
- Department of Neuroscience, University of Padua, 35121 Padua, Italy
- Correspondence: (S.G.); (D.C.); Tel.: +39-06-3015-4382 (S.G.)
| | - Gian Luca Vita
- Unit of Neurology, Department of Emergency, P.O. Piemonte, IRCCS Centro Neurolesi “Bonino-Pulejo”, 98124 Messina, Italy
| | - Giuseppe Vita
- Nemo Sud Clinical Centre for Neuromuscular Disorders, 98125 Messina, Italy
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, 98100 Messina, Italy
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Discomfort and Pain Related to Protective Mask-Wearing during COVID-19 Pandemic. J Pers Med 2022; 12:jpm12091443. [PMID: 36143228 PMCID: PMC9501271 DOI: 10.3390/jpm12091443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
The SARS-CoV-2 pandemic made the use of facemasks mandatory to prevent contact with the virus. Recent studies have revealed that intensive use of facemasks significantly exacerbated pre-existing headaches and triggered de novo headaches. In our experience, some subjects also complain of symptoms of neuropathic pain in the head/facial regions. Until now, the relationship between neuropathic pain and facemasks has not been documented. The aim of the study is to investigate the occurrence of neuropathic pain related to facemask use. It is a cross-sectional survey using a questionnaire, developed following a commonly accepted outcome research methodology. Participants, both health care and non-health care workers, responded to items included in the questionnaire about the type of facemasks, time and manner of wearing them, side effects such as skin lesions, symptoms of neuropathic pain, etc.
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Salini S, Giovannini S, Covino M, Barillaro C, Acampora N, Gravina EM, Loreti C, Damiano FP, Franceschi F, Russo A. Frailty Network in an Acute Care Setting: The New Perspective for Frail Older People. Diagnostics (Basel) 2022; 12:diagnostics12051228. [PMID: 35626383 PMCID: PMC9140447 DOI: 10.3390/diagnostics12051228] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 02/01/2023] Open
Abstract
The incidence of elderly patients who come to the emergency room is progressively increasing. The specialization of the physician units might not be adequate for the evaluation of this complexity. The present study aimed to present a standard procedure, called ‘The Geriatric Frailty Network’, operating at the Policlinico Gemelli IRCCS Foundation, which is configured specifically for the level II assessment of frail elderly patients. This was a retrospective study in 1191 patients aged over 65, who were evaluated by the Geriatric Frailty Unit directly after emergency department admission for one year. All patients underwent multidimensional geriatric evaluation. Data were collected on demographics, co-morbidity, disease severity, and Clinical Frailty Scale. Among all patients, 723 were discharged directly from the emergency room with early identification of continuity of care path. Globally, 468 patients were hospitalized with an early assessment of frailty that facilitated the discharge process. The geriatric frailty network model aims to assist the emergency room and ward doctor in the prevention of the most common geriatric syndromes and reduce the number of incongruous hospitalizations.
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Affiliation(s)
- Sara Salini
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.B.); (N.A.); (E.M.G.); (C.L.); (A.R.)
- Correspondence: (S.S.); (S.G.)
| | - Silvia Giovannini
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- UOS Riabilitazione Post-Acuzie, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: (S.S.); (S.G.)
| | - Marcello Covino
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.C.); (F.F.)
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Christian Barillaro
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.B.); (N.A.); (E.M.G.); (C.L.); (A.R.)
| | - Nicola Acampora
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.B.); (N.A.); (E.M.G.); (C.L.); (A.R.)
| | - Ester Manes Gravina
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.B.); (N.A.); (E.M.G.); (C.L.); (A.R.)
| | - Claudia Loreti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.B.); (N.A.); (E.M.G.); (C.L.); (A.R.)
| | - Francesco Paolo Damiano
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Francesco Franceschi
- Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.C.); (F.F.)
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Russo
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.B.); (N.A.); (E.M.G.); (C.L.); (A.R.)
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FETER NATAN, CAPUTO EDUARDOL, DORING IGORR, LEITE JAYNES, CASSURIAGA JÚLIA, REICHERT FELIPEF, SILVA MARCELOCDA, ROMBALDI AIRTONJ. Longitudinal study about the impact of COVID-19 pandemic in a southern Brazilian state: the PAMPA cohort. AN ACAD BRAS CIENC 2022. [DOI: 10.1590/0001-3765202220201718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- NATAN FETER
- Programa de Pós-Graduação em Educação Física, Brazil; Grupo de Estudos em Epidemiologia da Atividade Física (GEEAF), Brazil; School of Human Movement and Nutrition Sciences, Australia
| | - EDUARDO L. CAPUTO
- Programa de Pós-Graduação em Educação Física, Brazil; Grupo de Estudos em Epidemiologia da Atividade Física (GEEAF), Brazil
| | - IGOR R. DORING
- Grupo de Estudos em Epidemiologia da Atividade Física (GEEAF), Brazil
| | | | | | - FELIPE F. REICHERT
- Programa de Pós-Graduação em Educação Física, Brazil; Grupo de Estudos em Epidemiologia da Atividade Física (GEEAF), Brazil
| | - MARCELO C. DA SILVA
- Programa de Pós-Graduação em Educação Física, Brazil; Grupo de Estudos em Epidemiologia da Atividade Física (GEEAF), Brazil
| | - AIRTON J. ROMBALDI
- Programa de Pós-Graduação em Educação Física, Brazil; Grupo de Estudos em Epidemiologia da Atividade Física (GEEAF), Brazil
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Developing Pulmonary Rehabilitation for COVID-19: Are We Linked with the Present Literature? A Lexical and Geographical Evaluation Study Based on the Graph Theory. J Clin Med 2021; 10:jcm10245763. [PMID: 34945063 PMCID: PMC8706076 DOI: 10.3390/jcm10245763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic is a severe ongoing global emergency. Despite high rates of asymptomatic patients, in many cases, the infection causes a rapid decline in pulmonary function due to an acute respiratory distress-like syndrome, leading to multi-organ failure and death. To date, recommendations about rehabilitation on COVID-19 are based on clinical data derived from other similar lung diseases. Rehabilitation literature lacks a standard taxonomy, limiting a proper evaluation of the most effective treatments for patients after COVID-19 infection. In this study, we assessed the clinical and rehabilitative associations and the geographical area involved in interstitial lung diseases (ILD) and in COVID-19, by a mathematical analysis based on graph theory. We performed a quantitative analysis of the literature in terms of lexical analysis and on how words are connected to each other. Despite a large difference in timeframe (throughout the last 23 years for ILD and in the last 1.5 years for COVID-19), the numbers of papers included in this study were similar. Our results show a clear discrepancy between rehabilitation proposed for COVID-19 and ILD. In ILD, the term “rehabilitation” and other related words such as “exercise” and “program” resulted in lower values of centrality and higher values of eccentricity, meaning relatively less importance of the training during the process of care in rehabilitation of patients with ILD. Conversely, “rehabilitation” was one of the most cited terms in COVID-19 literature, strongly associated with terms such as “exercise”, “physical”, and “program”, entailing a multidimensional approach of the rehabilitation for these patients. This could also be due to the widespread studies conducted on rehabilitation on COVID-19, with Chinese and Italian researchers more involved. The assessment of the terms used for the description of the rehabilitation may help to program shared rehabilitation knowledge and avoid literature misunderstandings.
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Abstract
Coronavirus disease 2019 (COVID-19) is an infection caused by the severe acute respiratory syndrome-coronavirus-2 virus that led to a pandemic. Acute manifestations of COVID-19 include fever, cough, dyspnea, respiratory failure, pneumonitis, anosmia, thromboembolic events, cardiogenic shock, renal injury, ischemic strokes, encephalitis, and cutaneous eruptions, especially of hands or feet. Prolonged symptoms, unpredictable recoveries, and chronic sequelae (long COVID) sometimes emerge even for some people who survive the initial illness. Sequelae such as fatigue occasionally persist even for those with only mild to moderate cases. There is much to learn about postacute COVID-19 dyspnea, anosmia, psychosis, thyroiditis, cardiac arrhythmia, and/or multisystem inflammatory response syndrome in children. Determining prognoses is imprecise. Examining patient databases about those who have survived COVID-19 is warranted. Multidisciplinary teams are assessing such disease databases to better understand longer-term complications and guide treatment.
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Hokkoku K, Erra C, Cuccagna C, Coraci D, Gatto DM, Glorioso D, Padua L. Intensive Care Unit-Acquired Weakness and Positioning-Related Peripheral Nerve Injuries in COVID-19: A Case Series of Three Patients and the Latest Literature Review. Brain Sci 2021; 11:1177. [PMID: 34573198 PMCID: PMC8470888 DOI: 10.3390/brainsci11091177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023] Open
Abstract
A subgroup of COVID-19 patients requires intensive respiratory care. The prolonged immobilization and aggressive treatments predispose these patients to develop intensive care unit-acquired weakness (ICUAW). Furthermore, this condition could increase the chance of positioning-related peripheral nerve injuries. On the basis of the latest literature review, we describe a case series of three patients with COVID-19 who developed ICUAW complicated by positioning-related peripheral nerve injuries Every patient presented sensorimotor axonal polyneuropathy and concomitant myopathy in electrophysiological studies. Furthermore, muscle MRI helped the diagnosis of ICUAW, showing massive damage predominantly in the proximal muscles. Notably, nerve ultrasound detected positioning-related peripheral nerve injuries, even though the concomitant ICUAW substantially masked their clinical features. During the acute phase of severe COVID-19 infection, most medical attention tends to be assigned to critical care management, and neuromuscular complications such as ICUAW and positioning-related peripheral nerve injuries could be underestimated. Hence, when starting post-ICU care for COVID-19 cases, the combination of electrophysiological and imaging studies will aid appropriate evaluation on the patients with COVID-19-related ICUAW.
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Affiliation(s)
- Keiichi Hokkoku
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
- Department of Neurology, Teikyo University School of Medicine, Tokyo 173-8605, Japan
| | - Carmen Erra
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Cristina Cuccagna
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Daniele Coraci
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
| | - Dario Mattia Gatto
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
- Department of Orthopaedics and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Davide Glorioso
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
- Department of Orthopaedics and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luca Padua
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (K.H.); (C.E.); (D.C.); (D.M.G.); (D.G.); (L.P.)
- Department of Orthopaedics and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Szwedowski D, Ambroży J, Grabowski R, Dallo I, Mobasheri A. Diagnosis and treatment of the most common neuropathies following knee injuries and reconstructive surgery - A narrative review. Heliyon 2021; 7:e08032. [PMID: 34611563 PMCID: PMC8477214 DOI: 10.1016/j.heliyon.2021.e08032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/06/2021] [Accepted: 09/16/2021] [Indexed: 01/09/2023] Open
Abstract
The main nerves in the knee region are the tibial nerve, the common peroneal nerve, and the saphenous nerve. These three nerves innervate the lower leg and foot, providing sensory and motor function. The large sciatic nerve splits just above the knee to form the tibial and common peroneal nerves. The tibial nerve travels down in the posterior region, while the common peroneal nerve runs around the lateral side of the knee and runs down the front of the leg to the foot. Although all these nerves can be affected by injuries of the knee, the infrapatellar branch of the saphenous nerve (IPBSN) and the common peroneal nerve (CPN) are most affected. In this narrative review we focus on neuropathies associated with nerves located in the region of the knee joint in the context of their injuries and possible iatrogenic damage during reconstructive surgery.
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Affiliation(s)
- Dawid Szwedowski
- Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation, Milan, Italy
| | - Jarosław Ambroży
- Lesser Poland Orthopedic and Rehabilitation Hospital, Krakow, Poland
| | - Radosław Grabowski
- Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation, Milan, Italy
- Department of Orthopaedics and Traumatology, Medical University of Lodz, Lodz, Poland
| | - Ignacio Dallo
- Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation, Milan, Italy
| | - Ali Mobasheri
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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12
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Padua L, Fredda G, Coraci D, Reale G, Glorioso D, Loreti C, Pecchioli C, Bernabei R. COVID-19 and hospital restrictions: physical disconnection and digital re-connection in disorders of consciousness. Brain Inj 2021; 35:1134-1142. [PMID: 34495807 DOI: 10.1080/02699052.2021.1972335] [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: 10/20/2022]
Abstract
Purpose: The coronavirus disease 2019 (COVID-19) pandemic forced hospitals to adopt tighter restrictions, the most impacting is no access to visitors. Disorder of consciousness (DOC) due to severe acquired brain injury is a condition needing neurorehabilitation and the role of relatives is essential, hence besides physical "disconnection" digital "re-connection" is crucial. We aimed to assess whether digital communication benefits in patients with DOC, considering the sensorial and emotional deprivation due to the COVID-19 emergency lock-down.Methods: For eleven consecutive patients with DOC admitted to our Intensive Neurorehabilitation Care (mean age: 45; females: 9), two observers registered neurobehavioral changes during a video-calls with their relatives. Heart-rate variability was measured before and during the calls. The video-call was performed by using two displays of different sizes: tablet (T-video-call) and large screen (LS-Video-call).Results: The video-calls impacted on the patients' vigilance and in the relationship with relatives. Moreover, positively impacted on their relatives. The current results showed significant greater impact on patients during the LS-video-call than when they are exposed to T-video-call.Conclusions: During the COVID-19 pandemic, besides the physical disconnection to stop the contagion spread, a "digital re-connection" is needed for all and especially for fragile population groups as patients with DOC.
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Affiliation(s)
- Luca Padua
- Department of Orthopaedics and Geriatrics, Università Cattolica Del Sacro Cuore, Rome, Italy.,UOC High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Fredda
- UOS Clinical Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniele Coraci
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Giuseppe Reale
- UOC High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Glorioso
- Department of Orthopaedics and Geriatrics, Università Cattolica Del Sacro Cuore, Rome, Italy.,UOC High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Loreti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Roberto Bernabei
- Department of Orthopaedics and Geriatrics, Università Cattolica Del Sacro Cuore, Rome, Italy.,Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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13
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He Y, Bai X, Zhu T, Huang J, Zhang H. What can the neurological manifestations of COVID-19 tell us: a meta-analysis. J Transl Med 2021; 19:363. [PMID: 34425827 PMCID: PMC8381866 DOI: 10.1186/s12967-021-03039-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model. Results A total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.
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Affiliation(s)
- Yuanyuan He
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Xiaojie Bai
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Tiantian Zhu
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Jialin Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Hong Zhang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China.
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14
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Drat-Gzubicka J, Pyszora A, Budzyński J, Currow D, Krajnik M. Is Neuropathic Pain a Good Marker of Peripheral Neuropathy in Hospice Patients with Advanced Cancer? The Single Center Pilot Study. Diagnostics (Basel) 2021; 11:diagnostics11081377. [PMID: 34441311 PMCID: PMC8391735 DOI: 10.3390/diagnostics11081377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/17/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
Neuropathic pain (NP) affects approximately 30% of patients with advanced cancer. The prevalence of neuropathic pain related to peripheral neuropathy (NP-RPN) in these patients is not known. The aim of the study was to evaluate NP-RPN prevalence in hospice patients and to find out whether the absence of this pain is sufficient to rule out peripheral neuropathy. The study included a total of 76 patients with advanced cancer who were cared for at inpatient hospices. All patients were asked about shooting or burning pain (of the feet and hands), were examined systematically for sensory deficits and had a nerve conduction study performed. NP-RPN was found in 29% of the patients. Electrophysiologically-diagnosed peripheral neuropathy was found in 79% of patients, and the diagnostic electrophysiological criteria for neuropathy were met by one half of the patients without NP-RPN. The severity of NP-RPN was correlated with the clinically assessed severity of sensory neuropathy and the Karnofsky score, but was not correlated with the intensity of the clinical signs of motor neuropathy. The presence of NP-RPN did not reflect greater prevalence of motor and sensory abnormalities in neurological and electrophysiological examinations. The absence of NP-RPN did not rule out polyneuropathy in hospice patients.
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Affiliation(s)
- Joanna Drat-Gzubicka
- Neurology Department, Specialist Hospital, ul. Leśna 10, 89-606 Chojnice, Poland
- Correspondence:
| | - Anna Pyszora
- Department of Palliative Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (A.P.); (M.K.)
| | - Jacek Budzyński
- Department of Vascular and Internal Diseases, Collegium Medicum in Bydgoszcz, Jan Biziel University Hospital No 2, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168 Bydgoszcz, Poland;
| | - David Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, 2007 Ultimo, Australia;
| | - Małgorzata Krajnik
- Department of Palliative Care, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland; (A.P.); (M.K.)
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15
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Wasilewski MB, Cimino SR, Kokorelias KM, Simpson R, Hitzig SL, Robinson L. Providing Rehabilitation to Patients Recovering from COVID-19: A Scoping Review. PM R 2021; 14:239-258. [PMID: 34240576 PMCID: PMC8441670 DOI: 10.1002/pmrj.12669] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 11/08/2022]
Abstract
Objective To synthesize the nature and extent of research on rehabilitation care provision to patients with COVID‐19. Specifically, we aimed to (1) describe the impact of COVID on patients and associated rehabilitation needs, (2) outline the adaptations and preparations required to enable the provision of COVID rehabilitation, (3) describe the types of rehabilitation services and treatments provided to COVID patients, and (4) identify barriers and facilitators to delivering COVID rehabilitation. Literature Survey We searched Medline, PsychINFO, Embase, and CINAHL on June 26, 2020 using key words such as “rehabilitation,” “physical medicine,” “allied health professionals,” and variations of “COVID.” The search was updated on October 13, 2020. We included articles published in English and that focused on some aspect of COVID rehabilitation for adults. We excluded articles focused on pediatric populations and those not focused (or minimally focused) on rehabilitation for COVID patients. Methodology Data were charted based on article type (ie, primary data, secondary data, guidelines). Key information extracted included (1) COVID sequelae; (2) rehabilitation adaptations; (3) structure, function, and content of rehabilitation services/programs; (4) facilitators and/or barriers to providing COVID rehabilitation; and (5) recommendations for COVID rehabilitation programming. Data were synthesized narratively. Synthesis In total, 128 articles were included in the review that reported primary data (n = 33), secondary data (n = 82), and clinical practice/patient self‐management guidelines (n = 13). Evidence begins to suggest that rehabilitation is necessary and valuable for addressing COVID‐related declines in health, function, and well‐being. Most articles recommended that an individualized rehabilitation program be provided across the continuum of care by an interdisciplinary team of professionals and that the nature and extent of rehabilitation be informed by the care setting and COVID severity. Most issues that challenged COVID rehabilitation delivery were directly addressed by the facilitators and adaptations identified. Conclusions Future recommendations include a greater emphasis on the psychosocial aspects of COVID rehabilitation, inclusion of families in rehabilitation planning, and the use of qualitative approaches to complement clinical data.
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16
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Lim SG, Jung SH, Huh JH. Visual Algorithm of VR E-Sports for Online Health Care. Healthcare (Basel) 2021; 9:healthcare9070824. [PMID: 34209695 PMCID: PMC8304166 DOI: 10.3390/healthcare9070824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
The need for non-face-to-face online health care has emerged through the era of "untact". However, there is a lack of standardization work and research cases on the exercise effect of immersive content. In this study, the possibility of the exercise effect of VR e-sports among e-sports cases were presented through a visual algorithm analysis. In addition, the evaluation criteria were established. The research method compares and analyzes e-sports cases and VR e-sports cases by applying existing evaluation research cases. It also sets up a new evaluation standard. As for the analysis result, the device immersion method and interaction range were set through an algorithm analysis; FOV and frame immersion were set through typification; the user recognition method and interaction method were set through the visual diagram. Then, each derived result value was quantified and a new evaluation criterion was proposed.
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Affiliation(s)
- Sang-Guk Lim
- School of Culture Contents, Youngsan University, Busan 48015, Korea;
| | - Se-Hoon Jung
- School of Creative Convergence, Andong National University, Andong 36729, Korea
- Correspondence: (S.-H.J.); (J.-H.H.)
| | - Jun-Ho Huh
- Department of Data Science, (National) Korea Maritime and Ocean University, Busan 49112, Korea
- Correspondence: (S.-H.J.); (J.-H.H.)
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17
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Pastorino R, Loreti C, Giovannini S, Ricciardi W, Padua L, Boccia S. Challenges of Prevention for a Sustainable Personalized Medicine. J Pers Med 2021; 11:jpm11040311. [PMID: 33923579 PMCID: PMC8073054 DOI: 10.3390/jpm11040311] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023] Open
Abstract
The development and implementation of the approaches of personalized medicine for disease prevention are still at infancy, although preventive activities in healthcare represent a key pillar to guarantee health system sustainability. There is an increasing interest in finding informative markers that indicate the disease risk before the manifestation of the disease (primary prevention) or for early disease detection (secondary prevention). Recently, the systematic collection and study of clinical phenotypes and biomarkers consented to the advance of Rehabilomics in tertiary prevention. It consents to identify relevant molecular and physiological factors that can be linked to plasticity, treatment response, and natural recovery. Implementation of these approaches would open avenues to identify people at high risk and enable new preventive lifestyle interventions or early treatments targeted to their individual genomic profile, personalizing prevention and rehabilitation. The integration of personalized medicine into prevention may benefit citizens, patients, healthcare professionals, healthcare authorities, and industry, and ultimately will seek to contribute to better health and quality of life for Europe’s citizens.
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Affiliation(s)
- Roberta Pastorino
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (S.B.)
| | - Claudia Loreti
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.G.); (L.P.)
- Correspondence:
| | - Silvia Giovannini
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.G.); (L.P.)
| | - Walter Ricciardi
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Luca Padua
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (S.G.); (L.P.)
- Dipartimento di Scienze Geriatriche e Ortopediche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.P.); (S.B.)
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
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18
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Giovannini S, Coraci D, Brau F, Galluzzo V, Loreti C, Caliandro P, Padua L, Maccauro G, Biscotti L, Bernabei R. Neuropathic Pain in the Elderly. Diagnostics (Basel) 2021; 11:diagnostics11040613. [PMID: 33808121 PMCID: PMC8066049 DOI: 10.3390/diagnostics11040613] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Neuropathic pain due to a lesion or a disease of the somatosensory system often affects older people presenting several comorbidities. Moreover, elderly patients are often poly-medicated, hospitalized and treated in a nursing home with a growing risk of drug interaction and recurrent hospitalization. Neuropathic pain in the elderly has to be managed by a multidimensional approach that involves several medical, social and psychological professionals in order to improve the quality of life of the patients and, where present, their relatives.
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Affiliation(s)
- Silvia Giovannini
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Correspondence: ; Tel.: +39-063015-4341
| | - Daniele Coraci
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Department of Neurosciences, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Fabrizio Brau
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Vincenzo Galluzzo
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Claudia Loreti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
| | - Pietro Caliandro
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
| | - Luca Padua
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giulio Maccauro
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lorenzo Biscotti
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Presiding Officer of Geriatric Care Promotion and Development Centre (C.E.P.S.A.G), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roberto Bernabei
- Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (D.C.); (F.B.); (V.G.); (C.L.); (P.C.); (L.P.); (G.M.); (L.B.); (R.B.)
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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19
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da Silva TD, de Oliveira PM, Dionizio JB, de Santana AP, Bahadori S, Dias ED, Ribeiro CM, Gomes RDA, Ferreira M, Ferreira C, de Moraes ÍAP, Silva DMM, Barnabé V, de Araújo LV, Santana HBR, Monteiro CBDM. Comparison Between Conventional Intervention and Non-immersive Virtual Reality in the Rehabilitation of Individuals in an Inpatient Unit for the Treatment of COVID-19: A Study Protocol for a Randomized Controlled Crossover Trial. Front Psychol 2021; 12:622618. [PMID: 33716889 PMCID: PMC7943618 DOI: 10.3389/fpsyg.2021.622618] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The new human coronavirus that leads to COVID-19 (coronavirus disease 2019) has spread rapidly around the world and has a high degree of lethality. In more severe cases, patients remain hospitalized for several days under treatment of the health team. Thus, it is important to develop and use technologies with the aim to strengthen conventional therapy by encouraging movement, physical activity, and improving cardiorespiratory fitness for patients. In this sense, therapies for exposure to virtual reality (VR) are promising and have been shown to be an adequate and equivalent alternative to conventional exercise programs. Aim: This is a study protocol with the aim of comparing the conventional physical therapy intervention with the use of a non-immersive VR software during COVID-19 hospitalization. Methods: Fifty patients hospitalized with confirmed diagnosis of COVID-19 will be divided in two groups under physiotherapy treatment using conventional or VR intervention: Group A: participants with COVID-19 will start the first day of the protocol with VR tasks in the morning and then in the second period, in the afternoon, will perform the conventional exercises (n = 25) and Group B: participants with COVID-19 will start the first day with conventional exercises in the morning and in the second period, in the afternoon, will perform activity with VR (n = 25). All participants will be evaluated with different motor and physiologic scales before and after the treatment to measure improvements. Conclusion: Considering the importance of benefits from physical activity during hospitalization, VR software shows promise as a potential mechanism for improving physical activity. The results of this study may provide new insights into hospital rehabilitation. Trial Registration:ClinicalTrials.gov, identifier: NCT04537858. Registered on 01 September 2020.
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Affiliation(s)
- Talita Dias da Silva
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Faculdade de Medicina da Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Patricia Mattos de Oliveira
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Serviço de Fisioterapia do Hospital São Paulo, Universidade Federal de São Paulo (HSP UNIFESP), São Paulo, Brazil
| | - Josiane Borges Dionizio
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Serviço de Fisioterapia do Hospital São Paulo, Universidade Federal de São Paulo (HSP UNIFESP), São Paulo, Brazil
| | - Andreia Paiva de Santana
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Serviço de Fisioterapia do Hospital São Paulo, Universidade Federal de São Paulo (HSP UNIFESP), São Paulo, Brazil
| | - Shayan Bahadori
- Executive Business Centre, Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom
| | - Eduardo Dati Dias
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Cinthia Mucci Ribeiro
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Renata de Andrade Gomes
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Marcelo Ferreira
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Celso Ferreira
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Íbis Ariana Peña de Moraes
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Deise Mara Mota Silva
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Viviani Barnabé
- Faculdade de Medicina da Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Luciano Vieira de Araújo
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | | | - Carlos Bandeira de Mello Monteiro
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
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20
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Tan BH, Liu JM, Gui Y, Wu S, Suo JL, Li YC. Neurological involvement in the respiratory manifestations of COVID-19 patients. Aging (Albany NY) 2021; 13:4713-4730. [PMID: 33582654 PMCID: PMC7906194 DOI: 10.18632/aging.202665] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
The peculiar features of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), are challenging the current biological knowledge. Early in Feb, 2020, we suggested that SARS-CoV-2 may possess neuroinvasive potential similar to that of many other coronaviruses. Since then, a variety of neurological manifestations have been associated with SARS-CoV-2 infection, which was supported in some patients with neuroimaging and/or cerebrospinal fluid tests. To date, at least 27 autopsy studies on the brains of COVID-19 patients can be retrieved through PubMed/MEDLINE, among which neuropathological alterations were observed in the brainstem in 78 of 134 examined patients, and SARS-CoV-2 nucleic acid and viral proteins were detected in the brainstem in 16/49 (32.7%) and 18/71 (25.3%) cases, respectively. To shed some light on the peculiar respiratory manifestations of COVID-19 patients, this review assessed the existing evidence about the neurogenic mechanism underlying the respiratory failure induced by SARS-CoV-2 infection. Acknowledging the neurological involvement has important guiding significance for the prevention, treatment, and prognosis of SARS-CoV-2 infection.
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Affiliation(s)
- Bai-Hong Tan
- Laboratory Teaching Center of Basic Medicine, Norman Bethune Health Science Center of Jilin University, Jilin, China
| | - Jia-Mei Liu
- Department of Histology and Embryology, College of Basic Medical Sciences, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China
| | - Yue Gui
- Department of Histology and Embryology, College of Basic Medical Sciences, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China
| | - Shuang Wu
- Department of Histology and Embryology, College of Basic Medical Sciences, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China
| | - Jia-Le Suo
- Department of Histology and Embryology, College of Basic Medical Sciences, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China
| | - Yan-Chao Li
- Department of Histology and Embryology, College of Basic Medical Sciences, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China
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21
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Ferraro F, Calafiore D, Dambruoso F, Guidarini S, de Sire A. COVID-19 related fatigue: Which role for rehabilitation in post-COVID-19 patients? A case series. J Med Virol 2020; 93:1896-1899. [PMID: 33295637 DOI: 10.1002/jmv.26717] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Francesco Ferraro
- Section of Neuromotor Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Dario Calafiore
- Section of Neuromotor Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Francesca Dambruoso
- Section of Neuromotor Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Sergio Guidarini
- Section of Neuromotor Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Alessandro de Sire
- Department of Health Sciences, Physical and Rehabilitative Medicine, University of Eastern Piedmont, Novara, Italy.,Rehabilitation Unit, Mons. L. Novarese Hospital, Vercelli, Italy
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22
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Deprescribing in older adults during COVID-19 pandemic; Opportunity or risk? Res Social Adm Pharm 2020; 17:1024-1025. [PMID: 33288419 PMCID: PMC7704332 DOI: 10.1016/j.sapharm.2020.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 11/22/2022]
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23
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Abstract
Before the current pandemic, there had been two global epidemics from major coronavirus outbreaks since the turn of the century: severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Both epidemics left survivors with fatigue, persistent shortness of breath, reduced quality of life and a significant burden of mental health problems.It is likely that some of the chronic problems encountered by survivors of SARS and MERS may be relevant for medical planning of the services required for survivors of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2. Given the similarities between the diseases, the recovery and rehabilitation of the survivors of COVID-19 is likely to be focused around cardiopulmonary sequelae, fatigue and the psychological burden of COVID-19, but in a much larger population.
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Affiliation(s)
- Oliver O'Sullivan
- Defence Medical Rehabilitation Centre Stanford Hall, Stanford-on-Sour, UK oliver.o'
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24
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Sun T, Guo L, Tian F, Dai T, Xing X, Zhao J, Li Q. Rehabilitation of patients with COVID-19. Expert Rev Respir Med 2020; 14:1249-1256. [PMID: 32799694 DOI: 10.1080/17476348.2020.1811687] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION In 2020, due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), coronavirus disease (COVID-19) has become a pandemic. As of 11 August 2020, the cumulative number of confirmed cases worldwide had reached 19 million, with 700,000 reported deaths, indicating this pandemic's significant global impact. AREAS COVERED We reviewed the application of rehabilitation therapy in the clinical treatment of COVID-19 patients. A systematic search was performed using PubMed, Springer, CNKI, and Wanfang Data of database up to 1 August 2020. The search terms included the English terms and their Chinese equivalents: 'COVID-19,' 'ARDS,' 'rehabilitation,' 'critically ill patients,' 'physiotherapy,' 'respiratory rehabilitation,' 'traditional Chinese medicine,' and 'psychotherapy.' EXPERT OPINION Rehabilitation research concerning patients with COVID-19 remains ongoing. Rehabilitation guidance for such patients with COVID-19 is based on previous experience. However, as different patients have differing degrees of dysfunction, personalized plans need to be designed according to the patients' age, sex, lifestyle, hobbies, occupation, and physical conditions. The rapid development of remote devices that can monitor patients' real-time physical conditions post-discharge may encourage better adherence to rehabilitation training.
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Affiliation(s)
- Tiantian Sun
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China
| | - Liyun Guo
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China
| | - Fei Tian
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China.,Shanghai University of Sport , Shanghai, China
| | - Tiantian Dai
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China
| | - Xiaohong Xing
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China
| | - Junqing Zhao
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China
| | - Qiang Li
- Department of Rehabilitation Medicine, Heping Hospital Affiliated of Changzhi Medical College , Changzhi, China
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25
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Demeco A, Marotta N, Barletta M, Pino I, Marinaro C, Petraroli A, Moggio L, Ammendolia A. Rehabilitation of patients post-COVID-19 infection: a literature review. J Int Med Res 2020; 48:300060520948382. [PMID: 32840156 PMCID: PMC7450453 DOI: 10.1177/0300060520948382] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/17/2020] [Indexed: 11/15/2022] Open
Abstract
Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Given the lack of guidelines in English on the rehabilitation of these patients, we conducted a review of the most recent reports. We performed this literature review using the principal research databases and included randomized trials, recommendations, quasi-randomized or prospective controlled clinical trials, reports, guidelines, field updates, and letters to the editor. We identified 107 studies in the database search, among which 85 were excluded after screening the full text or abstract. In total, 22 studies were finally included. The complexity of the clinical setting and the speed of spread of the severe acute respiratory syndrome coronavirus 2, which leads to rapid occupation of beds in the intensive care unit, make it necessary to discharge patients with COVID-19 who have mild symptoms as soon as possible. For these reasons, it is necessary to formulate rehabilitation programs for these patients, to help them restore physical and respiratory function and to reduce anxiety and depression, particularly patients with comorbidities and those who live alone or in rural settings, to restore a good quality of life.
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Affiliation(s)
- A. Demeco
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - N. Marotta
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - M. Barletta
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - I. Pino
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - C. Marinaro
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - A. Petraroli
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - L. Moggio
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Antonio Ammendolia
- Department of Surgical and Medical Sciences,
University of Catanzaro “Magna Graecia”, Catanzaro, Italy
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26
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Curci C, Pisano F, Bonacci E, Camozzi DM, Ceravolo C, Bergonzi R, De Franceschi S, Moro P, Guarnieri R, Ferrillo M, Negrini F, de Sire A. Early rehabilitation in post-acute COVID-19 patients: data from an Italian COVID-19 Rehabilitation Unit and proposal of a treatment protocol. Eur J Phys Rehabil Med 2020; 56:633-641. [PMID: 32667150 DOI: 10.23736/s1973-9087.20.06339-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic is quickly spreading, putting under heavy stress health systems worldwide and especially Intensive Care Units (ICU). Rehabilitation Units have a crucial role in reducing disability in order to reintroduce patients in the community. AIM The aim of this study is to characterize pulmonary function and disability status and to propose an early rehabilitation protocol in a cohort of post-acute COVID-19 patients admitted to an Italian Rehabilitation Unit. DESIGN Cross-sectional observational study. SETTING Inpatients Rehabilitation Unit. POPULATION Post-acute COVID-19 patients. METHODS Demographic, anamnestic and clinical characteristics, laboratory exams and medical imaging findings were collected for the entire cohort. Outcome measures evaluated at the admission in Rehabilitation Unit were: type of respiratory supports needed, fraction of inspired oxygen (FiO<inf>2</inf>), partial pressure of oxygen (PaO<inf>2</inf>), FiO<inf>2</inf>/PaO<inf>2</inf>, Barthel Index (BI), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-Minute Walking Test (6-MWT). Furthermore, we proposed an early rehabilitation protocol for COVID-19 patients based on baseline FiO2. RESULTS We included 32 post-acute COVID-19 patients (22 male and 10 female), mean aged 72.6±10.9 years. BI was 45.2±27.6, with patients in need of higher FiO<inf>2</inf> (≥40%) showing lower values: 39.6±25.7 vs. 53.3±29.3. All patients had grade 4 or 5 on the mMRC Dyspnea Scale. Only 14 COVID-19 patients were able to walk (43.7%). 6-MWT was feasible in 6 (18.8%) patients with a mean distance of 45.0±100.6 meters. CONCLUSIONS Taken together, our findings suggest that post-acute COVID-19 patients suffered from dyspnea and shortness of breath even for minimal activities, with a resulting severe disability, and only a few of them were able to perform 6-MWT with poor results. An early rehabilitation protocol was proposed according to the baseline conditions of the patients. CLINICAL REHABILITATION IMPACT This study could provide an accurate description of COVID-19 sub-acute patients admitted to a Rehabilitation Unit along with a proposal of treatment to help physicians to tailor the best possible rehabilitative treatment.
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Affiliation(s)
- Claudio Curci
- Neurorehabilitation Unit, San Marco Polyclinic Hospital, San Donato Groups, Zingonia, Bergamo, Italy
| | - Fabrizio Pisano
- Neurorehabilitation Unit, San Marco Polyclinic Hospital, San Donato Groups, Zingonia, Bergamo, Italy
| | - Eleonora Bonacci
- Pulmonary Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy
| | - Danila M Camozzi
- Neurorehabilitation Unit, San Marco Polyclinic Hospital, San Donato Groups, Zingonia, Bergamo, Italy
| | - Claudia Ceravolo
- Orthopedic Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy
| | - Roberto Bergonzi
- Orthopedic Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy
| | - Silvia De Franceschi
- Orthopedic Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy
| | - Paolo Moro
- Orthopedic Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy
| | - Rodolfo Guarnieri
- Pulmonary Rehabilitation Unit, San Marco Polyclinic Hospital, San Donato Group, Zingonia, Bergamo, Italy
| | - Martina Ferrillo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy - .,Rehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy
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27
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Cheah IK, Halliwell B. Could Ergothioneine Aid in the Treatment of Coronavirus Patients? Antioxidants (Basel) 2020; 9:E595. [PMID: 32646061 PMCID: PMC7402156 DOI: 10.3390/antiox9070595] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/25/2020] [Accepted: 07/02/2020] [Indexed: 01/08/2023] Open
Abstract
Infection with SARS-CoV-2 causes the coronavirus infectious disease 2019 (COVID-19), a pandemic that has, at present, infected more than 11 million people globally. Some COVID-19 patients develop a severe and critical illness, spurred on by excessive inflammation that can lead to respiratory or multiorgan failure. Numerous studies have established the unique array of cytoprotective properties of the dietary amino acid ergothioneine. Based on studies in a range of in vitro and in vivo models, ergothioneine has exhibited the ability to modulate inflammation, scavenge free radicals, protect against acute respiratory distress syndrome, prevent endothelial dysfunction, protect against ischemia and reperfusion injury, protect against neuronal damage, counteract iron dysregulation, hinder lung and liver fibrosis, and mitigate damage to the lungs, kidneys, liver, gastrointestinal tract, and testis, amongst many others. When compiled, this evidence suggests that ergothioneine has a potential application in the treatment of the underlying pathology of COVID-19. We propose that ergothioneine could be used as a therapeutic to reduce the severity and mortality of COVID-19, especially in the elderly and those with underlying health conditions. This review presents evidence to support that proposal.
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Affiliation(s)
- Irwin K. Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117596, Singapore;
- Life Science Institute, Neurobiology Programme, Centre for Life Sciences, National University of Singapore, Singapore 117456, Singapore
| | - Barry Halliwell
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117596, Singapore;
- Life Science Institute, Neurobiology Programme, Centre for Life Sciences, National University of Singapore, Singapore 117456, Singapore
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28
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de Sire A, Andrenelli E, Negrini F, Negrini S, Ceravolo MG. Systematic rapid living review on rehabilitation needs due to COVID-19: update as of April 30th, 2020. Eur J Phys Rehabil Med 2020; 56:354-360. [DOI: 10.23736/s1973-9087.20.06378-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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29
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Li Y, Bai W, Hashikawa T. Response to Commentary on "The neuroinvasive potential of SARS-CoV-2 may play a role in the respiratory failure of COVID-19 patients". J Med Virol 2020; 92:707-709. [PMID: 32246783 PMCID: PMC7228344 DOI: 10.1002/jmv.25824] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/04/2023]
Abstract
In a recent review, we have suggested a neuroinvasive potential of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and its possible role in the causation of acute respiratory failure of coronavirus disease 2019 (COVID‐19) patients (J Med Viol doi: 10.1002/jmv.25728), based upon the clinical and experimental data available on the past SARS‐CoV‐1 and the recent SARS‐CoV‐2 pandemic. In this article, we provide new evidence recently reported regarding the neurotropic potential of SARS‐CoV‐2 and respond to several comments on our previously published article. In addition, we also discuss the peculiar manifestations of respiratory failure in COVID‐19 patients and the possible involvement of nervous system. New evidence has been available for the neurotropism of SARS‐CoV‐2. Muscular injuries and reduced sensitivity of nerves may play a role in the respiratory failure. Potential neuroinvasion of SARS‐CoV‐2 indicates a possible involvement of central factors.
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Affiliation(s)
- Yan‐Chao Li
- Department of Histology and Embryology, College of Basic Medical SciencesNorman Bethune College of Medicine, Jilin UniversityChangchunJilinChina
| | - Wan‐Zhu Bai
- Institute of Acupuncture and MoxibustionChina Academy of Chinese Medical ScienceBeijingChina
| | - Tsutomu Hashikawa
- Neural Architecture, Advanced Technology Development Group, RIKEN Brain Science InstituteSaitamaJapan
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30
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Petraglia F, Chiavilli M, Zaccaria B, Nora M, Mammi P, Ranza E, Rampello A, Marcato A, Pessina F, Salghetti A, Costantino C, Frizziero A, Fanzaghi P, Faverzani S, Bergamini O, Allegri S, Rodà F, Brianti R. Rehabilitative treatment of patients with COVID-19 infection: the P.A.R.M.A. evidence based clinical practice protocol. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020169. [PMID: 33525225 PMCID: PMC7927566 DOI: 10.23750/abm.v91i4.10629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The impact of the SARS-CoV-2 on the National Health System (NHS) required a reorganization of the various levels of care, which also involved the rehabilitation reality. AIM OF THE WORK A clinical practice review of the literature was conducted to provide operational-rehabilitation guidelines adapted to the local reality and to the recent corporate reorganization in the context of the COVID-19 emergency. METHODS A practice review of the available scientific evidence was regularly conducted from the start of the COVID-19 pandemic to periodically update the clinical practice guidelines. Articles that met the following inclusion criteria were included: studies conducted on human adult subjects with COVID-19 infection, undergoing rehabilitation in any hospitalization setting. RESULTS The results of this clinical practice update were periodically discussed with colleagues and collaborators in a multi-professional team, in order to guarantee a good clinical practice protocol, named P.A.R.M.A. CONCLUSIONS The P.A.R.M.A. protocol is the result of a periodic review literature update, which has allowed us to take charge of patients affected by COVID-19 according to the most up-to-date clinical evidences, guaranteeing a shared and uniform treatment within a local reality in an era of health emergency.
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Affiliation(s)
- Federica Petraglia
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Marco Chiavilli
- Department of Medicine and Surgery, University of Parma, Italy
| | - Barbara Zaccaria
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Monica Nora
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Patrizia Mammi
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Elena Ranza
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Anais Rampello
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Antonio Marcato
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Fabio Pessina
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Annamaria Salghetti
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Cosimo Costantino
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy, Department of Medicine and Surgery, University of Parma, Italy
| | - Antonio Frizziero
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy, Department of Medicine and Surgery, University of Parma, Italy
| | - Patrizia Fanzaghi
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Silvia Faverzani
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Ottavia Bergamini
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Stefania Allegri
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
| | - Francesca Rodà
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy, Department of Medicine and Surgery, University of Parma, Italy
| | - Rodolfo Brianti
- Rehabilitation Medicine Service, Rehabilitation Geriatrics Department of the NHS-University Hospital of Parma, Parma, Italy
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