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Lemogne C, Gouraud C, Ouazana Vedrines C, Pritschkat C, Rotenberg L, Horn M, Cathébras P, Kachaner A, Scherlinger M, de Broucker T, Pignon B, Chauvet-Gelinier JC, Günther S, Gocko X, Pitron V, Ranque B. National committee statement as a missed opportunity to acknowledge the relevance of a biopsychosocial approach in understanding long COVID. J Psychosom Res 2024; 186:111596. [PMID: 38272788 DOI: 10.1016/j.jpsychores.2024.111596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Charles Ouazana Vedrines
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Caroline Pritschkat
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Léa Rotenberg
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Mathilde Horn
- Université de Lille, INSERM, CHU de Lille, U1172, Lille Neuroscience & Cognition, Lille 59000, France.
| | - Pascal Cathébras
- Service de Médecine interne, CHU de Saint-Étienne, hôpital Nord, Saint-Étienne 42055, France.
| | - Alexandra Kachaner
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France; Service de Médecine interne, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France.
| | - Marc Scherlinger
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, Strasbourg 67098, France.
| | - Thomas de Broucker
- Service de Neurologie, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis 93200, France.
| | - Baptiste Pignon
- Université Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Créteil, France.
| | - Jean-Christophe Chauvet-Gelinier
- Service de Psychiatrie Adultes, CHU de Dijon, Dijon, France; INSERM U-1231, Center for Translational and Molecular medicine, University of Burgundy, Dijon, France.
| | - Sven Günther
- Unité d'Explorations Fonctionnelles Respiratoires et du Sommeil, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France; Université Paris Cité, Innovative Therapies in Haemostasis, INSERM UMR_S1140, Paris 75006, France.
| | - Xavier Gocko
- Department of general practice, Faculty of medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France; INSERM UMR 1059, Sainbiose DVH, University of Lyon, Saint-Etienne 42000, France; INSERM CIC-EC 1408, University of Lyon, Saint-Etienne 42000, France.
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris 75004, France; Centre du Sommeil et de la Vigilance-Pathologie Professionnelle, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Brigitte Ranque
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Service de Médecine interne, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France; Unité CASPer, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
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Salzmann S, Herrmann M, Henning M, Schwertner L, Euteneuer F, Goldau L, Bahr C, Berwanger C, Rief W. Side-effect expectations are associated with disability, physical fitness, and somatic symptoms 3 months after post-COVID neurological inpatient rehabilitation. J Psychosom Res 2024; 186:111902. [PMID: 39197231 DOI: 10.1016/j.jpsychores.2024.111902] [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: 06/16/2024] [Revised: 08/07/2024] [Accepted: 08/21/2024] [Indexed: 09/01/2024]
Abstract
INTRODUCTION The COVID-19 pandemic, caused by SARS-CoV-2, has led to long-term health issues known as post-COVID-19 condition, including fatigue and cognitive disruptions. Despite its recognition as a public health concern, the efficacy of therapeutic interventions, especially in neurological rehabilitation, remains unclear. This study examines how treatment expectations are associated with psychological and physical outcomes in post-COVID-19 condition neurological rehabilitation. METHODS In an observational cohort study 61 patients with confirmed post-COVID-19 condition were included. Baseline (T0) data on treatment and side effect expectations were collected, before participants underwent a 4-6 week multidisciplinary rehabilitation program. Primary outcome was illness-related disability (Pain Disability Index). Secondary outcomes included depressive symptoms (PHQ-9), anxiety levels (GAD-7), functional status (PCFS), fatigue (CFS), and physical fitness (6MWT). Regression models analyzed the associations of baseline expectations with outcomes at the end of rehabilitation (T1) and three months post-rehabilitation (T2). RESULTS After adjusting for multiple testing, higher baseline side-effect expectations were associated with greater illness-related disability (β = 0.42, p = 0.007), reduced physical fitness (β = - 0.24, p = 0.04), and more somatic symptoms (β = 0.33, p = 0.006) at follow-up (T2). Positive treatment expectations were associated with poorer functional status (β = 0.35, p = 0.011) at T2. CONCLUSION This study highlights the associations of side-effect expectations with post-COVID-19 condition rehabilitation outcomes. Higher side-effect expectations were associated to poorer outcomes, indicating a nocebo effect. Surprisingly, positive expectations were linked to worse outcomes, possibly due to unrealistic optimism. Managing patient expectations realistically and addressing side-effect concerns seems crucial for optimizing rehabilitation outcomes.
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Affiliation(s)
- Stefan Salzmann
- Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany; Medical Psychology, Health and Medical University Erfurt, Erfurt, Germany.
| | - Mirko Herrmann
- Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany
| | - Markus Henning
- Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany
| | - Lisa Schwertner
- Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany
| | - Frank Euteneuer
- Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Berlin, Berlin, Germany
| | - Lara Goldau
- Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Celine Bahr
- Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Christoph Berwanger
- Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany
| | - Winfried Rief
- Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
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Dempsey B, Blake HA, Madan I, Stevelink SAM, Greenberg N, Raine R, Rafferty AM, Bhundia R, Wessely S, Lamb D. Post COVID-19 syndrome among 5248 healthcare workers in England: longitudinal findings from NHS CHECK. Occup Environ Med 2024; 81:471-479. [PMID: 39358009 DOI: 10.1136/oemed-2024-109621] [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: 05/23/2024] [Accepted: 09/08/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVES The objectives of this study were to examine post COVID-19 syndrome (PCS) among healthcare workers (HCWs) in England and explore risk factors for the condition. METHODS Data were collected by National Health Service (NHS) CHECK, a longitudinal study exploring HCWs' mental and physical well-being during and after the COVID-19 pandemic. NHS CHECK collected data at four timepoints: the baseline survey between April 2020 and January 2021, and then three follow-up surveys at approximately 6, 12 and 32 months post baseline. PCS data were collected at 12 and 32 months, while risk factor data were from baseline. HCWs were asked what COVID-19 symptoms they experienced and for how long and were classified as having PCS if they had any symptom for ≥12 weeks. Multilevel regressions were used to examine risk factors for PCS. RESULTS This study included 5248 HCWs. While 33.6% (n=1730) reported prolonged COVID-19 symptoms consistent with PCS, only 7.4% (n=385) reported a formal diagnosis of PCS. Fatigue, difficult concentrating, insomnia and anxiety or depression were the most common PCS symptoms. Baseline risk factors for reporting PCS included screening for common mental disorders, direct contact with COVID-19 patients, pre-existing respiratory illnesses, female sex and older age. CONCLUSIONS While a third of HCWs reported prolonged COVID-19 symptoms consistent with PCS, a smaller percentage reported a formal diagnosis of the condition. We replicate findings that direct contact with COVID-19 patients, older age, female sex, pre-existing respiratory illness and symptoms of common mental disorders are associated with increased risk of PCS.
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Affiliation(s)
- Brendan Dempsey
- Department of Primary Care and Population Health, University College London, London, UK
| | - Helen A Blake
- Department of Primary Care and Population Health, University College London, London, UK
| | - Ira Madan
- Guys and St Thomas NHS Foundation Trust, London, UK
| | - Sharon A M Stevelink
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Neil Greenberg
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rosalind Raine
- Department of Primary Care and Population Health, University College London, London, UK
| | - Anne-Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Rupa Bhundia
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Simon Wessely
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Danielle Lamb
- Department of Primary Care and Population Health, University College London, London, UK
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4
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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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Cathébras P, Ranque B, Lemogne C. [From "medically unexplained symptoms" to "persistent somatic symptoms": A welcome paradigm shift]. Rev Med Interne 2024; 45:531-534. [PMID: 39244243 DOI: 10.1016/j.revmed.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Affiliation(s)
- Pascal Cathébras
- Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne, France.
| | - Brigitte Ranque
- Service de médecine interne, hôpital européen Georges-Pompidou, AP-HP, Paris, France; Center for Research in Epidemiology and StatisticS (CRESS), université Paris Cité et université Sorbonne Paris Nord, Inserm, INRAE, 75004 Paris, France
| | - Cédric Lemogne
- Center for Research in Epidemiology and StatisticS (CRESS), université Paris Cité et université Sorbonne Paris Nord, Inserm, INRAE, 75004 Paris, France; Service de psychiatrie de l'adulte, hôpital Hôtel-Dieu, AP-HP, 75004 Paris, France
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6
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Rudroff T. Frontal-striatal glucose metabolism and fatigue in patients with multiple sclerosis, long COVID, and COVID-19 recovered controls. Exp Brain Res 2024; 242:2125-2136. [PMID: 38970653 DOI: 10.1007/s00221-024-06882-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] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/20/2024] [Indexed: 07/08/2024]
Abstract
This study compared brain glucose metabolism using FDG-PET in the caudate nucleus, putamen, globus pallidus, thalamus, and dorsolateral prefrontal cortex (DLPFC) among patients with Long COVID, patients with fatigue, people with multiple sclerosis (PwMS) patients with fatigue, and COVID recovered controls. PwMS exhibited greater hypometabolism compared to long COVID patients with fatigue and the COVID recovered control group in all studied brain areas except the globus pallidus (effect size range 0.7-1.5). The results showed no significant differences in glucose metabolism between patients with Long COVID and the COVID recovered control group in these regions. These findings suggest that long COVID fatigue may involve non-CNS systems, neurotransmitter imbalances, or psychological factors not captured by FDG-PET, while MS-related fatigue is associated with more severe frontal-striatal circuit dysfunction due to demyelination and neurodegeneration. Symmetrical standardized uptake values (SUVs) between hemispheres in all groups imply that fatigue in these conditions may be related to global or network-level alterations rather than hemisphere-specific changes. Future studies should employ fine-grained analysis methods, explore other brain regions, and control for confounding factors to better understand the pathophysiology of fatigue in MS and long COVID. Longitudinal studies tracking brain glucose metabolism in patients with Long COVID could provide insights into the evolution of metabolic patterns as the condition progresses.
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Affiliation(s)
- Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, E432 Field House, Iowa City, IA, 52242, USA.
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
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Claessens G, Gerritzen I, van Osch F, van den Bergh JP, Verberne D, Gach D, van Balen E, van Heugten CM. Prevalence and predictors of persistent cognitive and psychological symptoms in non-hospitalized post-COVID-19 patients seeking care at an outpatient post-COVID-19 clinic. Front Psychol 2024; 15:1396963. [PMID: 39193035 PMCID: PMC11347444 DOI: 10.3389/fpsyg.2024.1396963] [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: 03/06/2024] [Accepted: 07/15/2024] [Indexed: 08/29/2024] Open
Abstract
Introduction There is still much uncertainty about why some people develop persistent cognitive and mental health problems after SARS-CoV-2 infection and require additional care while others do not. In this study, we investigated the cognitive and psychological outcomes of non-hospitalized post-COVID-19 patients referred to an outpatient post-COVID-19 clinic for persistent symptoms more than 3 months after infection. Additionally, we aimed to explore the influence of demographic, physical, and personal factors on these outcomes. Methods This cross-sectional study was conducted at an outpatient post-COVID-19 clinic located at a prominent clinical teaching hospital in the Netherlands. Participants included non-hospitalized patients referred between 2020 and 2022, more than 3 months after SARS-CoV-2 infection, experiencing persistent symptoms. Main outcome measures included levels of anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress symptoms (PTSS) (Post-traumatic Stress Symptoms Checklist 14), and cognitive symptoms (Checklist for Cognitive and Emotional Consequences). Data analysis employed Spearman correlation and hierarchical multiple regression analyses. Results A total of 265 patients (61% female; mean age of 51.7 ± 13.7 years) were included in the study, with an average of 7.6 ± 4.5 months following SARS-CoV-2 infection. Among them, 104 patients (40%) reported high levels of anxiety, 111 patients (43%) showed high levels depressive symptoms, and 71 patients (31%) demonstrated high levels of PTSS. Additionally, 200 patients (79%) reported experiencing more than 2 cognitive symptoms. Bivariate analyses indicated associations between psychiatric history and increased cognitive and psychological symptoms. Multivariate analyses revealed positive associations between physical symptoms and cognitive and psychological symptoms, and catastrophizing thoughts were associated with higher anxiety levels (β = 0.217, p < 0.001). Conversely, positive refocusing was associated with lower depressive symptoms (β = -0.325, p < 0.001), PTSS (β = -0.290, p < 0.001), and cognitive symptoms (β = -0.220, p < 0.001). Discussion Among non-hospitalized COVID-19 patients seeking care for persistent symptoms, approximately one-third reported high levels of psychological symptoms, and more than three-quarter experienced cognitive symptoms. Physical symptoms, psychiatric history, and a tendency to catastrophize were identified as potential risk factors for persistent psychological and cognitive symptoms. Conversely, positive refocusing demonstrated a protective effect. These findings contribute to the understanding of long-term COVID-19 outcomes and emphasize the importance of integrating a biopsychosocial perspective into treatment approaches.
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Affiliation(s)
- Gisela Claessens
- Department of Medical Psychology, VieCuri Medical Center, Venlo, Netherlands
| | - Iris Gerritzen
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, Netherlands
| | - Frits van Osch
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Joop P. van den Bergh
- Department of Internal Medicine, VieCuri Medical Center, Venlo, Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center +, Maastricht, Netherlands
| | - Daan Verberne
- Department of Medical Psychology, VieCuri Medical Center, Venlo, Netherlands
| | - Debbie Gach
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Eric van Balen
- Department of Medical Psychology, VieCuri Medical Center, Venlo, Netherlands
| | - Caroline M. van Heugten
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, Netherlands
- Limburg Brain Injury Center, Maastricht University, Maastricht, Netherlands
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Hapfelmeier A, Donhauser J, Teusen C, Eck S, Schneider A. Frequency, persistence and relation of disease symptoms, psychosomatic comorbidity and daily life impairment after COVID-19: a cohort study in general practice. BMC PRIMARY CARE 2024; 25:295. [PMID: 39127653 DOI: 10.1186/s12875-024-02551-w] [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: 05/17/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Long-lasting symptoms with a possible relation to psychosomatic comorbidity have been described following COVID-19. However, data is sparse in general practice. The trial's objective was to investigate the time-dependent frequency of disease symptoms and relation to psychosomatic comorbidity and daily life impairment (DLI). METHODS Comparative cohort study of patients reporting a previous SARS-CoV-2 infection and uninfected controls in general practice. Participants were recruited in 14 general practices in the greater Munich area. Data collection was questionnaire based with a 12 months follow-up. Descriptive statistics, multivariable regression and bivariate correlations were used for analysis. RESULTS A total of n = 204 cases infected up to 42 months ago (n = 141 Omicron, n = 63 earlier variants), and n = 119 controls were included. Disease symptoms were substantially more prevalent in cases (55-79% vs. 43% within one year of infection). This difference also appeared in the multivariable analysis adjusting for socio-demographics and psychosomatic comorbidity with odds ratios (OR) of 4.15 (p < 0.001) and 3.51 (p = 0.054) for the cohorts with Omicron or earlier variants infection (vs. controls), respectively. It was persistent with earlier variants (OR 1.00 per month, p = 0.903), while a decreasing trend was observed for Omicron (OR 0.89 per month, p < 0.001). DLI was especially correlated with fatigue (r = 0.628). CONCLUSION DLI, psychosomatic comorbidity and independently increased disease symptoms require holistic treatment of the patient in general practice according to the bio-psycho-social model. A key role in restoring the daily life capability may be attributed to the symptom fatigue.
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Affiliation(s)
- Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
| | - Jan Donhauser
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Clara Teusen
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stefanie Eck
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Antonius Schneider
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
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Baldi F, De Rose C, Mariani F, Morello R, Raffaelli F, Valentini P, Buonsenso D. Cardiopulmonary Exercise Testing in Children With Long COVID: A Case-controlled Study. Pediatr Infect Dis J 2024; 43:795-802. [PMID: 38713816 PMCID: PMC11250093 DOI: 10.1097/inf.0000000000004371] [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] [Accepted: 03/09/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Cardiopulmonary exercise testing (CPET) is a noninvasive and nonexpensive diagnostic tool, that provides a comprehensive evaluation of the pulmonary, cardiovascular, and skeletal muscle systems' integrated reactions to exercise. CPET has been extensively used in adults with Long COVID (LC), while the evidence about its role in children with this condition is scarce. METHODS Prospective, case-controlled observational study. Children with LC and a control group of healthy children underwent CPET. CPET findings were compared within the 2 groups, and within the LC groups according to main clusters of persisting symptoms. RESULTS Sixty-one children with LC and 29 healthy controls were included. Overall, 90.2% of LC patients (55 of 61) had a pathologic test vs 10.3% (3/29) of the healthy control. Children with LC presented a statistically significant higher probability of having abnormal values of peak VO2 ( P = 0.001), AT% pred ( P <0.001), VO2/HR % ( P = 0.03), VO2 work slope ( P = 0.002), VE/VCO2 slope ( P = 0.01). The mean VO2 peak was 30.17 (±6.85) in LC and 34.37 (±6.55) in healthy patients ( P = 0.007). CONCLUSIONS Compared with healthy controls, children with LC have objective impaired functional capacity (expressed by a low VO2 peak), signs of deconditioning and cardiogenic inefficiency when assessed with CPET. As such, CPET should be routinely used in clinical practice to objectify and phenotype the functional limitations of children with LC, and to follow-up them.
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Affiliation(s)
- Fabiana Baldi
- From the Pulmonary Medicine Unit, Department of Medical and Surgical Sciences
| | | | | | - Rosa Morello
- Department of Woman and Child Health and Public Health
| | - Francesca Raffaelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS
| | | | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy
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10
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Baig AM, Rosko S, Jaeger B, Gerlach J, Rausch H. Unraveling the enigma of long COVID: novel aspects in pathogenesis, diagnosis, and treatment protocols. Inflammopharmacology 2024; 32:2075-2090. [PMID: 38771409 DOI: 10.1007/s10787-024-01483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024]
Abstract
Long COVID, now unmistakably identified as a syndromic entity encompassing a complex spectrum of symptoms, demands immediate resolution of its elusive pathogenic underpinnings. The intricate interplay of diverse factors presents a complex puzzle, difficult to resolve, and thus poses a substantial challenge. As instances of long COVID manifest by repeated infections of SARS-CoV-2 and genetic predisposition, a detailed understanding in this regard is needed. This endeavor is a comprehensive exploration and analysis of the cascading pathogenetic events driven by viral persistence and replication. Beyond its morbidity, long COVID, more disabling than fatal, exacts one of the most substantial tolls on public health in contemporary times, with the potential to cripple national economies. The paper introduces a unified theory of long COVID, detailing a novel pathophysiological framework that interlinks persistent SARS-CoV-2 infection, autoimmunity, and systemic vascular pathology. We posit a model where viral reservoirs, immune dysregulation, and genetic predispositions converge to perpetuate disease. It challenges prevailing hypotheses with new evidence, suggesting innovative diagnostic and therapeutic approaches. The paper aims to shift the paradigm in long COVID research by providing an integrative perspective that encapsulates the multifaceted nature of the condition. We explain the immunological mechanisms, hypercoagulability states, and viral reservoirs in the skull that feed NeuroCOVID in patients with long COVID. Also, this study hints toward a patient approach and how to prioritize treatment sequences in long COVID patients in hospitals and clinics.
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Affiliation(s)
| | - Sandy Rosko
- Clinicum St. George, Rosenheimer Str. 6-8, Bad Aibling, Germany
| | - Beate Jaeger
- Clinicum St. George, Rosenheimer Str. 6-8, Bad Aibling, Germany
| | - Joachim Gerlach
- Clinicum St. George, Rosenheimer Str. 6-8, Bad Aibling, Germany
| | - Hans Rausch
- Clinicum St. George, Rosenheimer Str. 6-8, Bad Aibling, Germany
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Rafieian M, Skokauskas N, Cheslack-Postava K, Hoven CW. The association between intolerance of uncertainty and depressive symptoms during COVID-19 in New York, USA. J Affect Disord 2024; 356:628-638. [PMID: 38608765 DOI: 10.1016/j.jad.2024.04.037] [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: 11/29/2023] [Revised: 03/19/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19), a highly contagious respiratory illnesses, has globally impacted mental health. This study aims to investigate the association between intolerance of uncertainty and depressive symptoms during the pandemic in New York, USA, considering COVID-19-related worries as modifiers and mediators. METHOD 1227 participants from three ongoing cohort studies, originally centered on trauma-exposed children and adolescents, provided data via questionnaires and telephone interviews across three waves. We used multivariable logistic and linear regression models to investigate the intolerance of uncertainty-depressive symptoms relationship, while adjusting for potential confounders and assessing the modification and mediation effects of Covid-19 related worries. RESULTS Depressive symptoms prevalence was 18 %, 12 %, and 9 % at waves 0, 1, and 2 respectively. Strong positive associations were observed between intolerance of uncertainty above the median and depressive symptoms which remained significant after adjusting for potential confounders. Odds ratios were 2.14 (95 % CI: 1.54-2.99) and 4.50 (95 % CI: 2.67-7.93) for intolerance of uncertainty-depressive symptoms association at wave 0 and 1 respectively, and 3.22 (95 % CI: 1.68-6.63) for intolerance of uncertainty at wave 1 and depressive symptoms at wave 2. There was evidence of partial mediation by worries (12-37 %), but no evidence of a moderating effect. LIMITATION It includes study's methodology, including self-report measures, remote data collection, and uncontrolled variables like anxiety and COVID-19 perspectives. CONCLUSION The findings emphasize the importance of evidence-based strategies for tackling intolerance of uncertainty during pandemics, particularly in managing long COVID. Collaborative efforts between policymakers and clinicians are essential in this endeavor.
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Affiliation(s)
- Mojdeh Rafieian
- Department of Community Medicine, The Arctic University of Norway, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, IPH, NTNU, Trondheim, Norway.
| | - Keely Cheslack-Postava
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, USA
| | - Christina W Hoven
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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12
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Knowles LM, Grewal M, Drever SA, Hoffman JM, Friedly JL, Herring TE. A pilot randomized controlled trial of a telemedicine psychosocial intervention to improve symptom management in adults with long COVID: the COPE study protocol. Pilot Feasibility Stud 2024; 10:93. [PMID: 38886814 PMCID: PMC11181592 DOI: 10.1186/s40814-024-01515-2] [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: 11/29/2023] [Accepted: 06/06/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Long COVID is a serious public health concern due to its high prevalence and potentially debilitating symptoms. Symptoms may include fatigue, dyspnea, cognitive problems, insomnia, anxiety, and depression. There is currently no cure for long COVID, and the average length of recovery and proportion of patients who fully recover are still unknown. Subsequently, there is a critical need to improve function. Research in other chronic conditions suggests that psychosocial self-management interventions reduce symptom severity and interference with functioning. We describe the design of our study to examine the feasibility, acceptability, appropriateness, and preliminary efficacy of an intervention designed to improve symptom management and coping in adults with long COVID. METHODS This pilot trial (N = 50) uses a pragmatic, randomized two-group parallel design set within the University of Washington Post-COVID Rehabilitation and Recovery Clinic. The self-management intervention is a 6-week, group-based telemedicine intervention that teaches evidence-based strategies to manage common symptoms and improve stress management as well as communication and self-advocacy. The comparator is a wait-list control. Participants complete self-report measures of the primary and secondary outcomes at baseline and post-treatment/wait-list. Primary outcomes include intervention feasibility, acceptability, and appropriateness. Secondary outcomes include Patient-Reported Outcomes Measurement Information System measures of fatigue, sleep disturbance, cognitive difficulties, self-efficacy, pain interference, depression and anxiety symptoms, and a measure of long COVID symptoms and impression of change. At post-intervention, intervention participants also complete a qualitative interview to inform intervention refinement. Quantitative data will be examined using descriptive and statistical analysis including t-tests and chi-square tests to compare the intervention and wait-list groups on secondary outcomes. Qualitative data will be analyzed using the rigorous and accelerated data reduction technique (RADaR). DISCUSSION Results of this pilot randomized controlled trial will characterize the feasibility, acceptability, and appropriateness of the self-management intervention and inform intervention refinement necessary prior to further testing. Long COVID is a public health concern, and rehabilitation approaches that equip patients to manage symptoms may improve patient function and quality of life and reduce burden on the health care system. TRIAL REGISTRATION NCT05658536. December 16, 2022.
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Affiliation(s)
- Lindsey M Knowles
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, 98104, USA.
| | | | - Sydney A Drever
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, 98104, USA
| | - Jeanne M Hoffman
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, 98104, USA
| | - Janna L Friedly
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, 98104, USA
| | - Tracy E Herring
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, 98104, USA
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13
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Liira H, Garner P, Malmivaara A, Kanerva M, Kvarnström K, Sainio M, Varonen M, Venäläinen M, Vuokko A, Arokoski J. Prognosis of patients with post-Covid-19 condition: Prospective cohort cluster analysis at one year. J Psychosom Res 2024; 182:111808. [PMID: 38781803 DOI: 10.1016/j.jpsychores.2024.111808] [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: 10/24/2023] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE We aimed to identify clinically relevant clusters among patients with post-Covid-19 condition (PCC) and assess prognosis overall and within clusters. METHODS Prospective cohort study of patients with PCC attending a rehabilitation clinic. We monitored patient reported outcome measures (PROMs): EuroHIS quality of life and symptoms. Unsupervised hierarchical cluster analyses were performed to identify clusters of patients with different quantity of symptoms, and symptoms presenting together. Preliminary findings on symptom prevalence and quality of life at 12 months are reported. RESULTS Among 409 patients, 70.4% were women, with an average baseline of 20.3 (SD 6.8) symptoms. Three clusters emerged based on symptom quantity, labelled by the average number of symptoms at baseline: Cluster-11 (17% of all patients), Cluster-17 (35%), and Cluster-25 (48%). Multinomial logistic regression showed female sex, multiple comorbidities predicting more symptoms. Four symptom-based clusters were defined: fatigue and cognitive complaints; pain, trouble sleeping, palpitations and other symptoms; gastrointestinal symptoms; and emotion-related symptoms. Linear regression models showed that female sex, multiple comorbidities, anxiety, use of antidepressants, BMI and smoking were among the determinants of symptom clusters. In 12-month follow-up, symptom count decreased, and quality of life improved across all clusters, with 9% having good quality of life at baseline and 33% at 12 months. CONCLUSION Four patient clusters based on symptoms were identified in the PCC cohort. Prognosis was favorable across all clusters, with symptom reduction and improved quality of life observed. Female sex, comorbidities, BMI, and mental-health related variables predicted higher symptom burden, suggesting multifactorial origins of PCC.
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Affiliation(s)
- Helena Liira
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland.
| | - Paul Garner
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Antti Malmivaara
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Mari Kanerva
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Kvarnström
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Markku Sainio
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Mikko Varonen
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Mikko Venäläinen
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Aki Vuokko
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Jari Arokoski
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
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14
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Gaudreau-Majeau F, Gagnon C, Djedaa SC, Bérubé B, Malo J, Iglesies-Grau J, Gayda M, Bherer L, Besnier F. Cardiopulmonary rehabilitation's influence on cognitive functions, psychological state, and sleep quality in long COVID-19 patients: A randomized controlled trial. Neuropsychol Rehabil 2024:1-17. [PMID: 38607276 DOI: 10.1080/09602011.2024.2338613] [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: 10/02/2023] [Accepted: 03/02/2024] [Indexed: 04/13/2024]
Abstract
CLINICALTRIALS.GOV NCT05035628.Trial registration: ClinicalTrials.gov identifier: NCT05035628..
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Affiliation(s)
- Flavie Gaudreau-Majeau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Christine Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
| | - Sarah Clavet Djedaa
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Béatrice Bérubé
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Jacques Malo
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
| | - Josep Iglesies-Grau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
| | - Mathieu Gayda
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
| | - Louis Bherer
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Florent Besnier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
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15
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Huth D, Bräscher AK, Tholl S, Fiess J, Birke G, Herrmann C, Jöbges M, Mier D, Witthöft M. Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial. Psychol Med 2024; 54:1122-1132. [PMID: 37842765 DOI: 10.1017/s0033291723002921] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND The post-COVID-19 condition describes the persistence or onset of somatic symptoms (e.g. fatigue) after acute COVID-19. Based on an existing cognitive-behavioral treatment protocol, we developed a specialized group intervention for individuals with post-COVID-19 condition. The present study examines the feasibility, acceptance, and effectiveness of the program for inpatients in a neurological rehabilitation setting. METHODS The treatment program comprises eight sessions and includes psychoeducational and experience-based interventions on common psychophysiological mechanisms of persistent somatic symptoms. A feasibility trial was conducted using a one-group design in a naturalistic setting. N = 64 inpatients with a history of mild COVID-19 that fulfilled WHO criteria for post-COVID-19 condition were enrolled. After each session, evaluation forms were completed and psychometric questionnaires on somatic and psychopathological symptom burden were collected pre- and post-intervention. RESULTS The treatment program was well received by participants and therapists. Each session was rated as comprehensible and overall satisfaction with the sessions was high. Pre-post effect sizes (of standard rehabilitation incl. new treatment program; intention-to-treat) showed significantly reduced subjective fatigue (p < 0.05, dav = 0.33) and improved disease coping (ps < 0.05, dav = 0.33-0.49). CONCLUSIONS Our results support the feasibility and acceptance of the newly developed cognitive-behavioral group intervention for individuals with post-COVID-19 condition. Yet, findings have to be interpreted cautiously due to the lack of a control group and follow-up measurement, the small sample size, and a relatively high drop-out rate.
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Affiliation(s)
- Daniel Huth
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sarah Tholl
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Johanna Fiess
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Gunnar Birke
- Kliniken Schmieder Gailingen, Gailingen, Germany
| | | | | | - Daniela Mier
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
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16
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Pignon B, Matta J, Wiernik E, Toussaint A, Loewe B, Robineau O, Carrat F, Severi G, Touvier M, Gouraud C, Ouazana Vedrines C, Pitron V, Ranque B, Hoertel N, Kab S, Goldberg M, Zins M, Lemogne C. Psychological burden associated with incident persistent symptoms and their evolution during the COVID-19 pandemic: a prospective population-based study. BMJ MENTAL HEALTH 2024; 27:e300907. [PMID: 38490690 PMCID: PMC11021747 DOI: 10.1136/bmjment-2023-300907] [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: 10/16/2023] [Accepted: 02/01/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Identifying factors that predict the course of persistent symptoms that occurred during the COVID-19 pandemic is a public health issue. Modifiable factors could be targeted in therapeutic interventions. OBJECTIVE This prospective study based on the population-based CONSTANCES cohort examined whether the psychological burden associated with incident persistent symptoms (ie, that first occurred from March 2020) would predict having ≥1 persistent symptom 6-10 months later. METHODS A total of 8424 participants (mean age=54.6 years (SD=12.6), 57.2% women) having ≥1 incident persistent symptom at baseline (ie, between December 2020 and February 2021) were included. The psychological burden associated with these persistent symptoms was assessed with the Somatic Symptom Disorder-B Criteria Scale (SSD-12). The outcome was having ≥1 persistent symptom at follow-up. Adjusted binary logistic regression models examined the association between the SSD-12 score and the outcome. FINDINGS At follow-up, 1124 participants (13.3%) still had ≥1 persistent symptom. The SSD-12 score at baseline was associated with persistent symptoms at follow-up in both participants with (OR (95% CI) for one IQR increase: 1.42 (1.09 to 1.84)) and without SARS-CoV-2 infection prior to baseline (1.39 (1.25 to 1.55)). Female gender, older age, poorer self-rated health and infection prior to baseline were also associated with persistent symptoms at follow-up. CONCLUSIONS The psychological burden associated with persistent symptoms at baseline predicted the presence of ≥1 persistent symptom at follow-up regardless of infection prior to baseline. CLINICAL IMPLICATIONS Intervention studies should test whether reducing the psychological burden associated with persistent symptoms could improve the course of these symptoms.
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Affiliation(s)
- Baptiste Pignon
- Population-based Cohorts Unit, Paris Saclay University, Paris, France
| | - Joane Matta
- Population-based Cohorts Unit, Paris Saclay University, Paris, France
| | - Emmanuel Wiernik
- Population-based Cohorts Unit, Paris Saclay University, Paris, France
| | - Anne Toussaint
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Loewe
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Olivier Robineau
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
- EA2694, Univ Lille, Centre Hospitalier de Tourcoing, Tourcoing, Paris
| | - Fabrice Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
- Département de santé publique, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, INSERM, CESP U1018, Gustave Roussy, Villejuif, France
- Department of Statistics, University of Florence, Florence, Italy
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics (CRESS) - Université Paris Cité (CRESS), Bobigny, France
| | - Clement Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm; INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France
- Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, Paris, France
| | - Brigitte Ranque
- Université Paris Cité, Service de Médecine interne, AP-HP, Hôpital européen Georges-Pompidou, Paris, France
| | - Nicolas Hoertel
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, Paris, France
- Service de Psychiatrie et Addictologie, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Issy-les-Moulineaux, France
| | - Sofiane Kab
- Population-based Cohorts Unit, Paris Saclay University, Paris, France
| | - Marcel Goldberg
- Population-based Cohorts Unit, Paris Saclay University, Paris, France
| | - Marie Zins
- Population-based Cohorts Unit, Paris Saclay University, Paris, France
| | - Cédric Lemogne
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm; INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
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17
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Allwang C, Frank T, Bruckmann P, Dinkel A, Binneboese M, Wallis H, Elgner M, Giel KE, Schurr M, Gündel H, Wedekind L, Kuhn J, Lahmann C, Müller AM, Beckmann P, Massag J, Mikolajczyk R, Junne F. Addressing psychosocial needs in patients with Long-COVID (PsyLoCo-Study): study protocol of a pilot-study of a specialized modular intervention. Front Psychiatry 2024; 15:1305691. [PMID: 38510801 PMCID: PMC10951091 DOI: 10.3389/fpsyt.2024.1305691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/14/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction After an acute infection with the corona virus 10-20% of those affected suffer from ongoing or new symptoms. A causal therapy for the phenomenon known as Long/Post-COVID is still lacking and specific therapies addressing psychosocial needs of these patients are imperatively needed. The aim of the PsyLoCo-study is developing and piloting a psychotherapeutic manual, which addresses Long/Post-COVID-related psychosocial needs and supports in coping with persistent bodily symptoms as well as depressive or anxiety symptoms. Methods and analysis This pilot trial implements a multi-centre, 2-arm (N=120; allocation ratio: 1:1), parallel group, randomised controlled design. The pilot trial is designed to test the feasibility and estimate the effect of 1) a 12-session psychotherapeutic intervention compared to 2) a wait-list control condition on psychosocial needs as well as bodily and affective symptoms in patients suffering from Long/Post-COVID. The intervention uses an integrative, manualized, psychotherapeutic approach. The primary study outcome is health-related quality of life. Outcome variables will be assessed at three timepoints, pre-intervention (t1), post-intervention (t2) and three months after completed intervention (t3). To determine the primary outcome, changes from t1 to t2 are examined. The analysis will be used for the planning of the RCT to test the efficacy of the developed intervention. Discussion The pilot study will evaluate a 12-session treatment manual for Long/Post-COVID sufferers and the therapy components it contains. The analysis will provide insights into the extent to which psychotherapeutic treatment approaches improve the symptoms of Long/Post-COVID sufferers. The treatment manual is designed to be carried out by psychotherapists as well as people with basic training in psychotherapeutic techniques. This approach was chosen to enable a larger number of practitioners to provide therapeutic support for Long/Post-COVID patients. After completion of the pilot study, it is planned to follow up with a randomized controlled study and to develop a treatment guideline for general practitioners and interested specialists. Trial registration The pilot trial has been registered with the German Clinical Trials Register (Deutsches Register Klinischer Studien; Trial-ID: DRKS00030866; URL: https://drks.de/search/de/trial/DRKS00030866) on March 7, 2023.
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Affiliation(s)
- Christine Allwang
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Tamara Frank
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Paul Bruckmann
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Marius Binneboese
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Hannah Wallis
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Melanie Elgner
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Katrin E. Giel
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Marisa Schurr
- Department of Psychosomatic Medicine and Psychotherapy, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Lisa Wedekind
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Julia Kuhn
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Anne-Maria Müller
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Pauline Beckmann
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Janka Massag
- Medical Faculty, Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Medical Faculty, Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Mental Health (DZPG), partner site Halle-Jena-Magdeburg, Halle, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- German Center for Mental Health (DZPG), partner Site Halle-Jena-Magdeburg, Magdeburg, Germany
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18
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Gheorghita R, Soldanescu I, Lobiuc A, Caliman Sturdza OA, Filip R, Constantinescu – Bercu A, Dimian M, Mangul S, Covasa M. The knowns and unknowns of long COVID-19: from mechanisms to therapeutical approaches. Front Immunol 2024; 15:1344086. [PMID: 38500880 PMCID: PMC10944866 DOI: 10.3389/fimmu.2024.1344086] [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: 11/24/2023] [Accepted: 02/14/2024] [Indexed: 03/20/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been defined as the greatest global health and socioeconomic crisis of modern times. While most people recover after being infected with the virus, a significant proportion of them continue to experience health issues weeks, months and even years after acute infection with SARS-CoV-2. This persistence of clinical symptoms in infected individuals for at least three months after the onset of the disease or the emergence of new symptoms lasting more than two months, without any other explanation and alternative diagnosis have been named long COVID, long-haul COVID, post-COVID-19 conditions, chronic COVID, or post-acute sequelae of SARS-CoV-2 (PASC). Long COVID has been characterized as a constellation of symptoms and disorders that vary widely in their manifestations. Further, the mechanisms underlying long COVID are not fully understood, which hamper efficient treatment options. This review describes predictors and the most common symptoms related to long COVID's effects on the central and peripheral nervous system and other organs and tissues. Furthermore, the transcriptional markers, molecular signaling pathways and risk factors for long COVID, such as sex, age, pre-existing condition, hospitalization during acute phase of COVID-19, vaccination, and lifestyle are presented. Finally, recommendations for patient rehabilitation and disease management, as well as alternative therapeutical approaches to long COVID sequelae are discussed. Understanding the complexity of this disease, its symptoms across multiple organ systems and overlapping pathologies and its possible mechanisms are paramount in developing diagnostic tools and treatments.
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Affiliation(s)
- Roxana Gheorghita
- Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, Suceava, Romania
| | - Iuliana Soldanescu
- Integrated Center for Research, Development and Innovation for Advanced Materials, Nanotechnologies, Manufacturing and Control Distributed Systems (MANSiD), University of Suceava, Suceava, Romania
| | - Andrei Lobiuc
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, Suceava, Romania
| | - Olga Adriana Caliman Sturdza
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, Suceava, Romania
- Suceava Emergency Clinical County Hospital, Suceava, Romania
| | - Roxana Filip
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, Suceava, Romania
- Suceava Emergency Clinical County Hospital, Suceava, Romania
| | - Adela Constantinescu – Bercu
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, Suceava, Romania
- Institute of Cardiovascular Science, Hemostasis Research Unit, University College London (UCL), London, United Kingdom
| | - Mihai Dimian
- Integrated Center for Research, Development and Innovation for Advanced Materials, Nanotechnologies, Manufacturing and Control Distributed Systems (MANSiD), University of Suceava, Suceava, Romania
- Department of Computer, Electronics and Automation, University of Suceava, Suceava, Romania
| | - Serghei Mangul
- Department of Clinical Pharmacy, USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, United States
- Department of Quantitative and Computational Biology, USC Dornsife College of Letters, Arts and Sciences, University of Southern California (USC), Los Angeles, CA, United States
| | - Mihai Covasa
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, Suceava, Romania
- Department of Basic Medical Sciences, Western University of Health Sciences, College of Osteopathic Medicine, Pomona, CA, United States
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19
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Sun Z, Jin Z, Zhao K, Wen X, Lu H, Hu N, Zhu Q, Zhang Y, Ye M, Huang Y, Song W, Wang DB, Wu Y. The moderated-mediation role of risk perception and intolerance of uncertainty in the association between residual symptoms and psychological distress: a cross-sectional study after COVID-19 policy lifted in China. BMC Psychiatry 2024; 24:136. [PMID: 38365620 PMCID: PMC10874086 DOI: 10.1186/s12888-024-05591-9] [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: 08/29/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A considerable number of individuals infected with COVID-19 experience residual symptoms after the acute phase. However, the correlation between residual symptoms and psychological distress and underlying mechanisms are scarcely studied. We aim to explore the association between residual symptoms of COVID-19 and psychological distress, specifically depression, anxiety, and fear of COVID-19, and examine the role of risk perception and intolerance of uncertainty in the association. METHODS A cross-sectional survey was conducted by online questionnaire-based approach in mid-January 2023. Self-reported demographic characteristics, COVID-19-related information, and residual symptoms were collected. Depression, anxiety, fear, risk perception and intolerance of uncertainty were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Fear of COVID-19 Scale (FCV-19S), COVID-19 Risk Perception Scale and Intolerance of Uncertainty Scale-12 (IUS-12), respectively. Linear regression analyses were conducted to explore the associations. A moderated mediation model was then constructed to examine the role of risk perception of COVID-19 and intolerance of uncertainty in the association between residual symptoms and psychological distress. RESULTS 1735 participants effectively completed the survey. 34.9% of the patients experienced residual symptoms after acute phase of COVID-19. Psychological distress was markedly increased by COVID-19 infection, while residual symptoms had a significant impact on psychological distress (Ps < 0.001), including depression (β = 0.23), anxiety (β = 0.21), and fear of COVID-19 (β = 0.14). Risk perception served as a mediator between residual symptoms and all forms of psychological distress, while intolerance of uncertainty moderated the effect of risk perception on depression and anxiety. CONCLUSION A considerable proportion of patients experience residual symptoms after acute phase of COVID-19, which have a significant impact on psychological distress. Risk perception and intolerance of uncertainty play a moderated-mediation role in the association between residual symptoms and depression/anxiety. It highly suggests that effective treatment for residual symptoms, maintaining appropriate risk perception and improving intolerance of uncertainty are critical strategies to alleviate COVID-19 infection-associated psychological distress.
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Affiliation(s)
- Zhiyu Sun
- Department of Psychiatry, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Zhou Jin
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Kejie Zhao
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Xin Wen
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Hui Lu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Nuonuo Hu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Qinxin Zhu
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Yi Zhang
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Minjie Ye
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China
| | - Yili Huang
- Lyons Insights Consulting, 69534, Lyons, IL, USA
| | - Weihong Song
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China.
| | - Deborah Baofeng Wang
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China.
| | - Yili Wu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Institute of Aging, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou Medical University, 325000, Wenzhou, Zhejiang, China.
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20
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Freda MF, Scandurra C, Auriemma E, Guarino A, Lemmo D, Martino ML, Nunziata F, Maldonato NM, Continisio GI. Long-COVID in children: An exploratory case-control study from a bio-psycho-social perspective. J Psychosom Res 2024; 176:111564. [PMID: 38100898 DOI: 10.1016/j.jpsychores.2023.111564] [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: 06/01/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE This study aimed to determine psychosocial differences between children with Long-COVID Syndrome (LCS) and two control groups (i.e., children who did not have COVID-19 and children who had previously had COVID-19 but did not develop LCS) from a bio-psycho-social and psychosomatic perspective. To classify children in these three groups, we examined the percentage of children meeting criteria for LCS, the type, frequency, perceived severity of symptoms, and their prevalence compared with children who never had SARS-CoV-2 infection. METHODS Data were collected from 198 Italian mothers of children aged 4 to 13 years using a cross-sectional web-based case-control survey. Of these, 105 were mothers of children who had contracted SARS-CoV-2 and 94 were mothers of children who had previously had COVID-19. Information was collected on the type and frequency of symptoms commonly referred to as "Long-COVID symptoms" and psychosocial dimensions (i.e., maternal and child health anxiety, COVID-19 anxiety, adjustment, and child deprivation). Descriptive analyses, chi-square tests, Student's T-Test, and analyses of variance were performed. RESULTS 29 children (15% of the total sample) developed LCS, mostly in the neurological/neuropsychiatric domain (59%), and of mild intensity. Regarding psychosocial and psychological dimensions, maternal health anxiety, child deprivation, and fear of SARS-CoV-2 infection differed between groups, with the first two dimensions higher in children with LCS than in controls and the latter lower in children with LCS than in controls. CONCLUSION This study sheds light on the need of integrating a psychosocial approach into the medical care of children with LCS and their caregivers.
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Affiliation(s)
- Maria Francesca Freda
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Cristiano Scandurra
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Ersilia Auriemma
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy.
| | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Maria Luisa Martino
- Department of Humanistic Studies, University of Naples Federico II - Via Porta di Massa 1, Napoli 80133, Italy.
| | - Francesco Nunziata
- Department of Translational Medical Sciences, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy.
| | - Grazia Isabella Continisio
- Department of Translational Medical Sciences, University of Naples Federico II - Via Sergio Pansini 5, Napoli 80131, Italy.
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21
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Pignon B, Wiernik E, Kab S, Matta J, Toussaint A, Löewe B, Horn M, Amad A, Fovet T, Gouraud C, Ouazana-Vedrines C, Pitron V, Goldberg M, Zins M, Lemogne C. Somatic Symptom Disorder-B criteria scale (SSD-12): Psychometric properties of the French version and associations with health outcomes in a population-based cross-sectional study. J Psychosom Res 2024; 176:111556. [PMID: 38056109 DOI: 10.1016/j.jpsychores.2023.111556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/13/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The 12-item Somatic Symptom Disorder-B Criteria Scale (SSD-12) is a self-reported questionnaire designed to assess the B criteria of the DSM-5 somatic symptom disorder. In this cross-sectional study, we aimed to examine the psychometric properties of the SSD-12 French version and associated health outcomes. METHODS Participants were volunteers from the population-based CONSTANCES cohort who reported at least one new symptom that occurred between March 2020 and January 2021. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS A total of 18,796 participants completed the SSD-12. The scree plot was consistent with a 1-factor structure, while goodness-of-fit indices of the confirmatory factorial analyses and clinical interpretability were consistent with a 3-factor structure (excluding the item 7): 'Perceived severity', 'Perceived impairment', 'Negative expectations'. The Cronbach's α coefficients of the total and factors scores were 0.90, 0.88, 0.84 and 0.877, respectively. The total score was associated with depressive symptoms (Spearmann's rho: 0.32), self-rated health (-0.46), the number of persistent symptoms (0.32), and seeking medical consultation (odds ratio [95% confidence interval] for one interquartile range increase: 1.51 [1.48-1.54]). Among participants seeking medical consultation, those with higher SSD-12 scores were more likely to have their symptoms attributed to "stress/anxiety/depression" (1.32 [1.22-1.43]) and "psychosomatic origin" (1.25 [1.20-1.29]), and less to "COVID-19" (0.89 [0.85-0.93]). CONCLUSION While the SSD-12 French version can be used as a unidimensional tool, it also has a 3-factor structure, somewhat different from the DSM-5 theoretical structure, with high internal consistency and clinically meaningful associations with other health outcomes.
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Affiliation(s)
- Baptiste Pignon
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Emmanuel Wiernik
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Sofiane Kab
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Joane Matta
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Anne Toussaint
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löewe
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Mathilde Horn
- Univ Lille, Inserm, CHU de Lille, U1172, Lille Neuroscience & Cognition, 59000 Lille, France
| | - Ali Amad
- Univ Lille, Inserm, CHU de Lille, U1172, Lille Neuroscience & Cognition, 59000 Lille, France
| | - Thomas Fovet
- Univ Lille, Inserm, CHU de Lille, U1172, Lille Neuroscience & Cognition, 59000 Lille, France
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - Charles Ouazana-Vedrines
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France; Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Marie Zins
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France
| | - Cédric Lemogne
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
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22
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Tebeka S, Carcaillon-Bentata L, Decio V, Alleaume C, Beltzer N, Gallay A, Lemogne C, Pignon B, Makovski TT, Coste J. Complex association between post-COVID-19 condition and anxiety and depression symptoms. Eur Psychiatry 2023; 67:e1. [PMID: 38088068 DOI: 10.1192/j.eurpsy.2023.2473] [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] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND To assess the associations between anxiety and depressive symptoms and post-COVID-19 condition (PCC) by exploring the direction of these associations and their relevance in the definition of PCC. METHODS Nationwide survey among French adults, recruited between March and April, 2022, using a quota method to capture a representative sample of the general population with regard to sex, age, socioeconomic status, size of the place of residence, and region. We included all participants who met the World Health Organization (WHO) definition of PCC in addition to a random sample of participants infected with SARS-COV-2 for at least 3 months but without PCC. Self-reported anxiety and depressive symptoms, chronic anxiety and depression (for more than 3 years), and anxiety and depression were measured using the GAD-2 and PHQ-2 questionnaires, respectively. RESULTS In a sample of 1,095 participants with PCC and 1,021 participants infected with SARS-COV-2 without PCC, 21% had self-reported anxiety and 18% self-reported depression, whereas 33% and 20% had current measured symptoms of anxiety and depression, respectively. The high prevalence of these symptoms cannot only be explained by the characterization of PCC, as only 13.4% of anxiety symptoms and 7.6% of depressive symptoms met the WHO criteria for PCC. Only one participant met the WHO criteria based on self-reported anxiety or depressive symptoms alone, as these were always combined with other symptoms in patients with PCC. Chronic symptoms were associated with PCC (aOR 1.27; 95% CI: 1.00-1.61). In addition, measured anxiety was associated with PCC (aOR = 1.29; 95% CI: 1.02-1.62). CONCLUSIONS Pre-COVID-19 chronic anxiety and depression may play a role in the development of PCC or share vulnerability factors with it. Our results challenge the inclusion of anxiety and depression in the definition of PCC.
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Affiliation(s)
- Sarah Tebeka
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
- Institute of Psychiatry and Neurosciences, Team 1, Université Paris Cité, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Laure Carcaillon-Bentata
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Valentina Decio
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Caroline Alleaume
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Nathalie Beltzer
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Cédric Lemogne
- Center for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Paris, France
- Service de Psychiatrie de l'Adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Baptiste Pignon
- DMU IMPACT, INSERM U955, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Université Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires "H. Mondor", Creteil, France
| | - Tatjana T Makovski
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Joël Coste
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
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23
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Kupferschmitt A, Jöbges M, Randerath J, Hinterberger T, Loew TH, Köllner V. Attention deficits and depressive symptoms improve differentially after rehabilitation of post-COVID condition - A prospective cohort study. J Psychosom Res 2023; 175:111540. [PMID: 37918327 DOI: 10.1016/j.jpsychores.2023.111540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Depressive and cognitive symptoms like fatigue, loss of energy or sleep disorders characterise the post-COVID condition. Post-COVID psychosomatic rehabilitation should focus on both symptom groups. The current prospective cohort study addresses the change in these symptoms in the context of a psychosomatic rehabilitation. METHOD N = 80 patients with post-COVID symptoms underwent psychological testing on admission and discharge: PHQ-9 questionnaire for depression, TAP - test battery for the attention test with the sub-tests working memory, sustained attention, divided attention and alertness. Sample characteristics, including health-related and work-related parameters, the general symptom load and the course of symptoms during the five weeks of rehabilitation were evaluated. RESULTS On admission, the PHQ-9 indicated the presence of depressive symptoms in post-COVID patients (PHQ-9 = 15.15 ± 5.11). Over the course of rehabilitation, the depressive symptoms decreased to a sub-clinical level (PHQ-9 = 8.80 ± 4.61), suggesting a strong effect of post-COVID inpatient rehabilitation (Cohen's d = 1.57). At the same time, post-COVID patients showed clinically relevant impairments in attention and working memory that persisted throughout the rehabilitation period despite multimodal post-COVID treatment. CONCLUSION Over the course of post-COVID rehabilitation, depressive symptoms appear to be significantly reduced. With regard to cognitive impairment, a comparable effect within the short period of 5 weeks is not evident. Our results suggest the need for specific treatment of persistent neuropsychological deficits following post-COVID rehabilitation.
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Affiliation(s)
- Alexa Kupferschmitt
- Department of Psychosomatic Medicine, University Hospital Regensburg, Rilkestraße 39, 93049 Regensburg, Germany; Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, 10098 Berlin, Germany; Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Lichterfelder Allee 55, 14513 Teltow, Germany.
| | - Michael Jöbges
- Schmieder Clinics Constance, Eichhornstraße 68, 78464 Konstanz, Germany; Lurija Institute for Rehabilitation Science and Health Research, Kliniken Schmieder, Allensbach, Germany
| | - Jennifer Randerath
- Lurija Institute for Rehabilitation Science and Health Research, Kliniken Schmieder, Allensbach, Germany; Department of Psychology, University of Constance, Germany; Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Austria
| | - Thilo Hinterberger
- Department of Psychosomatic Medicine, University Hospital Regensburg, Rilkestraße 39, 93049 Regensburg, Germany
| | - Thomas H Loew
- Department of Psychosomatic Medicine, University Hospital Regensburg, Rilkestraße 39, 93049 Regensburg, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, 10098 Berlin, Germany; Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Lichterfelder Allee 55, 14513 Teltow, Germany
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24
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Schauenburg H. Post-COVID and ME/CFS - DoWe Need New Disease Theories? ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2023; 69:304-315. [PMID: 37830884 DOI: 10.13109/zptm.2023.69.oa7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Background and Research Question: The SARS-CoV-2 pandemic often resulted in prolonged illness courses. A particular challenge today lies in the clinical presentation resembling that of Myalgic Encephalitis/Chronic Fatigue Syndrome (ME/CFS). Method: We review selected literature concerning the psychosocial factors influencing chronic courses characterized primarily by fatigue. Additionally, we explore the neurobiologically grounded theory of "Predictive Coding" as a possible explanatory framework for complex somato- psychic interactions. Results: Physical findings only partially account for the dynamics and progression of chronic fatigue syndromes, necessitating more intricate disease models that incorporate aspects of bodily perception. Conclusions: Incorporating these newer theories of perception and behavior could provide a more helpful perspective on phenomena such as fatigue, leading to improved therapeutic support measures, all without contributing to premature attributions of "psychological" causes and the associated risk of stigmatization.
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Affiliation(s)
- Henning Schauenburg
- Heidelberg Institute for Psychotherapy at the Department of General Internal Medicine and Psychosomatics University of Heidelberg Vossstr. 9 69115 Heidelberg Deutschland
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25
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Gouraud C, Thoreux P, Ouazana-Vedrines C, Pitron V, Betouche S, Bolloch K, Caumes E, Guemouni S, Xiang K, Lemogne C, Ranque B. Patients with persistent symptoms after COVID-19 attending a multidisciplinary evaluation: Characteristics, medical conclusions, and satisfaction. J Psychosom Res 2023; 174:111475. [PMID: 37741114 DOI: 10.1016/j.jpsychores.2023.111475] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE Among patients attending a multidisciplinary day-hospital program for persistent symptoms after COVID-19, we aimed i) to describe their characteristics ii) to present the medical conclusions (diagnoses and recommendations) and iii) to assess the patients' satisfaction and its correlates. METHODS For this retrospective chart review study, frequent symptoms were systematically assessed. Standardized questionnaires explored fatigue (Pichot scale), physical activity (Ricci & Gagnon scale), health-related quality of life (Short-Form Health Survey), anxiety and depressive symptoms (Hospital Anxiety and Depression scale) and associated psychological burden (Somatic-Symptom-Disorder B criteria Scale). Medical record conclusions were collected and a satisfaction survey was performed at 3-months follow-up. RESULTS Among 286 consecutive patients (median age: 44 years; 70% women), the most frequent symptoms were fatigue (86%), breathlessness (65%), joint/muscular pain (61%) and cognitive dysfunction (58%), with a median duration of 429 days (Inter-quartile range (IqR): 216-624). Questionnaires revealed low levels of physical activity and quality of life, and high levels of fatigue, anxiety, depression, and psychological burden, with 32% and 23% meeting the diagnostic criteria for a depressive or anxiety disorder, respectively. Positive arguments for a functional somatic disorder were found in 76% of patients, including 96% with no abnormal clinical or test findings that may explain the symptoms. Physical activity rehabilitation was recommended for 91% of patients. Patients' median satisfaction was 8/10 (IqR: 6-9). CONCLUSION Most patients attending this program presented with long-lasting symptoms and severe quality of life impairment, received a diagnosis of functional somatic disorder, and reported high levels of satisfaction regarding the program.
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Affiliation(s)
- C Gouraud
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), F-75004 Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France.
| | - P Thoreux
- Université Paris Cité, Faculté de Santé, UFR de Médecine, F- 75006 Paris, France; CIMS (Centre d'Investigations en Médecine du Sport), APHP, Hôpital Hôtel Dieu, F-75004 Paris, France
| | - C Ouazana-Vedrines
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), F-75004 Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
| | - V Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), F-75004 Paris, France; Centre du Sommeil et de la Vigilance-Pathologie Professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - S Betouche
- Unité CASPer, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - K Bolloch
- CIMS (Centre d'Investigations en Médecine du Sport), APHP, Hôpital Hôtel Dieu, F-75004 Paris, France
| | - E Caumes
- Service de Prise en Charge Ambulatoire des Maladies Infectieuses, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - S Guemouni
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), F-75004 Paris, France
| | - K Xiang
- Unité CASPer, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - C Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and Statistics (CRESS), F-75004 Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
| | - B Ranque
- Unité CASPer, AP-HP, Hôpital Hôtel-Dieu, Paris, France; Service de Prise en Charge Ambulatoire des Maladies Infectieuses, APHP, Hôtel-Dieu, F-75004 Paris, France; Service de Médecine interne, AP-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France
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Li J, Zhou Y, Ma J, Zhang Q, Shao J, Liang S, Yu Y, Li W, Wang C. The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID. Signal Transduct Target Ther 2023; 8:416. [PMID: 37907497 PMCID: PMC10618229 DOI: 10.1038/s41392-023-01640-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 11/02/2023] Open
Abstract
There have been hundreds of millions of cases of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With the growing population of recovered patients, it is crucial to understand the long-term consequences of the disease and management strategies. Although COVID-19 was initially considered an acute respiratory illness, recent evidence suggests that manifestations including but not limited to those of the cardiovascular, respiratory, neuropsychiatric, gastrointestinal, reproductive, and musculoskeletal systems may persist long after the acute phase. These persistent manifestations, also referred to as long COVID, could impact all patients with COVID-19 across the full spectrum of illness severity. Herein, we comprehensively review the current literature on long COVID, highlighting its epidemiological understanding, the impact of vaccinations, organ-specific sequelae, pathophysiological mechanisms, and multidisciplinary management strategies. In addition, the impact of psychological and psychosomatic factors is also underscored. Despite these crucial findings on long COVID, the current diagnostic and therapeutic strategies based on previous experience and pilot studies remain inadequate, and well-designed clinical trials should be prioritized to validate existing hypotheses. Thus, we propose the primary challenges concerning biological knowledge gaps and efficient remedies as well as discuss the corresponding recommendations.
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Affiliation(s)
- Jingwei Li
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Zhou
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jiechao Ma
- AI Lab, Deepwise Healthcare, Beijing, China
| | - Qin Zhang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Postgraduate Student, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jun Shao
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Shufan Liang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yizhou Yu
- Department of Computer Science, The University of Hong Kong, Hong Kong, China.
| | - Weimin Li
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
| | - Chengdi Wang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Med-X Center for Manufacturing, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
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27
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Richter D, Theodoridou A. [A virus and its consequences: COVID-19 and Long Covid - A hybrid disease model]. PSYCHIATRISCHE PRAXIS 2023; 50:341-343. [PMID: 37820685 DOI: 10.1055/a-2168-4553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Affiliation(s)
- Dirk Richter
- Departement Gesundheit, Berner Fachhochschule, Zentrum Psychiatrische Rehabilitation, Universitäre Psychiatrische Dienste Bern, Schweiz
| | - Anastasia Theodoridou
- Psychiatrie Baselland, Liestal, Schweiz, Psychiatrische Universitätsklinik Zürich, Schweiz
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28
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Matta J, Robineau O, Wiernik E, Carrat F, Severi G, Touvier M, Gouraud C, Ouazana Vedrines C, Pitron V, Ranque B, Pignon B, Hoertel N, Kab S, Goldberg M, Zins M, Lemogne C. Depression and anxiety before and at the beginning of the COVID-19 pandemic and incident persistent symptoms: a prospective population-based cohort study. Mol Psychiatry 2023; 28:4261-4271. [PMID: 37464077 DOI: 10.1038/s41380-023-02179-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/09/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
Many patients affected by COVID-19 suffer from debilitating persistent symptoms whose risk factors remained poorly understood. This prospective study examined the association of depression and anxiety symptoms measured before and at the beginning of the COVID-19 pandemic with the incidence of persistent symptoms. Among 25,114 participants [mean (SD) age, 48.72 years (12.82); 51.1% women] from the SAPRIS and SAPRIS-Sérologie surveys nested in the French CONSTANCES population-based cohort, depression and anxiety symptoms were measured with the Center for Epidemiologic Studies-Depression scale and the 12-item General Health Questionnaire before the pandemic, and with the 9-item Patient Health Questionnaire and the 7-Item Generalized Anxiety Disorder scale at the beginning of the pandemic (i.e., between April 6, 2020 and May 4, 2020). Incident persistent symptoms were self-reported between December 2020 and January 2021. The following variables were also considered: gender, age, educational level, household income, smoking status, BMI, hypertension, diabetes, self-rated health, and SARS-CoV-2 infection according to serology/PCR test results. After a follow-up of seven to ten months, 2329 participants (9.3%) had been infected with SARS-CoV-2 and 4262 (17.0%) reported at least one incident persistent symptom that emerged from March 2020, regardless of SARS-CoV-2 infection. In multi-adjusted logistic regression models, participants in the highest (versus the lowest) quartile of depressive or anxiety symptom levels before or at the beginning of the pandemic were more likely to have at least one incident persistent symptom (versus none) at follow-up [OR (95%CI) ranging from 2.10 (1.89-2.32) to 3.01 (2.68-3.37)], with dose-response relationships (p for linear trend <0.001). Overall, these associations were significantly stronger in non-infected versus infected participants, except for depressive symptoms at the beginning of the pandemic. Depressive symptoms at the beginning of the pandemic were the strongest predictor of incident persistent symptoms in both infected and non-infected participants [OR (95%CI): 2.88 (2.01-4.14) and 3.03 (2.69-3.42), respectively]. In exploratory analyses, similar associations were found for each symptom taken separately in different models. Depression and anxiety symptoms should be tested as a potential target for preventive interventions against persistent symptoms after an infection with SARS-CoV-2.
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Affiliation(s)
- Joane Matta
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Olivier Robineau
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
- EA2694, Univ Lille, Centre Hospitalier de, Tourcoing, France
| | - Emmanuel Wiernik
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
- Département de santé publique, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, INSERM, CESP U1018, Gustave Roussy, Villejuif, France
- Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Florence, Italy
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and StatisticS (CRESS) - Université Paris Cité, Bobigny, France
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
- Université Paris Cité, and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Charles Ouazana Vedrines
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
- Université Paris Cité, and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France
- Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, Paris, France
| | - Brigitte Ranque
- Université de Paris, Service de Médecine interne, AP-HP, Hôpital européen Georges-Pompidou, Paris, France
| | - Baptiste Pignon
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Nicolas Hoertel
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, Paris, France
- Service de Psychiatrie et Addictologie de l'adulte et du sujet âgé, AP-HP, Hôpital Corentin-Celton, Issy-les-Moulineaux, France
| | - Sofiane Kab
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Marie Zins
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Cédric Lemogne
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France.
- Université Paris Cité, and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France.
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Ludwig B, Deckert M, Krajnc N, Keritam O, Macher S, Bsteh G, Zulehner G, Thurnher M, Berger T, Seidel S, Willinger U, Rommer P. Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 infection: A systematic diagnostic approach. Eur J Neurol 2023; 30:2713-2725. [PMID: 37306533 DOI: 10.1111/ene.15923] [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: 05/30/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE Following increasing demands of patients with suspected neurological symptoms after infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the Department of Neurology at the Medical University of Vienna established a new outpatient clinic to systematically assess, diagnose, and document neurological complaints potentially associated with a prior SARS-CoV-2 infection. METHODS The data presented here include prospectively collected 156 outpatients from May 2021 to April 2022. Patients underwent semistandardized interviewing about symptoms with reported onset after SARS-CoV-2 infection, neurological examination, and comprehensive diagnostic workup. RESULTS Reported new onset symptoms after infection included fatigue (77.6%), subjective cognitive impairment (72.4%), headache (47.7%), loss of smell and/or taste (43.2%), and sleep disturbances (42.2%). Most patients had a mild coronavirus disease (COVID-19) disease course (84%) and reported comorbidities (71%), of which the most frequent were psychiatric disorders (34%). Frequency of symptoms was not associated with age, sex, or severity of COVID-19 course. A comprehensive diagnostic workup revealed no neurological abnormalities in the clinical examination, or electrophysiological or imaging assessments in the majority of patients (n = 143, 91.7%). Neuropsychological assessment of a subgroup of patients (n = 28, 17.9%) showed that cognitive impairments in executive functions and attention, anxiety, depression, and somatization symptoms were highly common. CONCLUSIONS In this systematic registry, we identified fatigue, cognitive impairment, and headache as the most frequently reported persisting complaints after SARS-CoV-2 infection. Structural neurological findings were rare. We also suspect a link between the growing burden of the COVID-19 pandemic on personal lives and the increase in reported neurological and psychiatric complaints.
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Affiliation(s)
- Birgit Ludwig
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Matthias Deckert
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Nik Krajnc
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Omar Keritam
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Stefan Macher
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Gabriel Bsteh
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Gudrun Zulehner
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Majda Thurnher
- Section of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Stefan Seidel
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
- Rehabilitation Clinic Pirawarth, Bad Pirawarth, Austria
| | - Ulrike Willinger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Paulus Rommer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
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30
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Guillen-Burgos HF, Galvez-Florez JF, Moreno-Lopez S, Gonzalez I, Guillen M, Anaya JM. Factors associated with mental health outcomes after COVID-19: A 24-month follow-up longitudinal study. Gen Hosp Psychiatry 2023; 84:241-249. [PMID: 37690207 DOI: 10.1016/j.genhosppsych.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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Investigate the proportion of mental health outcomes (MHOs) and associated factors in COVID-19 survivors during a 24-month follow-up period. METHOD An observational, prospective study was performed in a teaching hospital in Barranquilla, Colombia, from April 1, 2020, to August 30, 2022. A cohort of 1565 COVID-19 survivors was recruited after discharge from the emergency room (ER), inpatient floor (IF), and intensive care unit (ICU) services and followed for 24 -months. The clinical assessment included screening scales for symptoms of anxiety, depressive, post-traumatic stress disorder (PTSD), and insomnia. Sociodemographic and clinical factors were also collected to identify possible associated factors. Descriptive, bivariate and mixed random-effect linear models were performed. RESULTS A total of 1565 patients were included, of whom 785 (50.35%) were men. A large proportion of patients with mental symptoms were identified. After 24-months, the proportions of anxiety, depression, PTSD, and insomnia symptoms remained high at 16.55%, 21.79%, 35.27%, and 23.86%, respectively. Social factors, location of hospital stays, physical comorbidities, and the severity of COVID-19 were significantly associated with anxiety, depression, PTSD, and insomnia symptoms. CONCLUSIONS COVID-19's 2-year deleterious impacts on mental health, as well as the variables influencing these findings, have been documented. These results should aid in the development of public health initiatives to reduce morbidity rates in post-COVID-19 patients.
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Affiliation(s)
- Hernan F Guillen-Burgos
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; Center for Clinical and Translational Research, School of Medicine, Universidad El Bosque, Bogotá, Colombia; Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
| | - Juan Francisco Galvez-Florez
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; Latin-American Society of Consultation - Liaison Psychiatry, Bogotá, Colombia
| | | | - Isabella Gonzalez
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; School of Medicine, Universidad del Rosario, Bogotá, Colombia
| | - Manuela Guillen
- Center for Clinical and Translational Research, Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia; School of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juan-Manuel Anaya
- Health Research and Innovation Center - Coosalud EPS, Cartagena, Colombia.
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31
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Lemogne C, Pitron V. Shedding light on the work burden of long COVID. THE LANCET REGIONAL HEALTH. EUROPE 2023; 31:100678. [PMID: 37547275 PMCID: PMC10398582 DOI: 10.1016/j.lanepe.2023.100678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris F-75004, France
- Service de Psychiatrie de l’Adulte, AP-HP, Hôpital Hôtel-Dieu, Paris F-75004, France
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris F-75004, France
- Centre du Sommeil et de la Vigilance-Pathologie Professionnelle, AP-HP, Hôpital Hôtel-Dieu, Paris F-75004, France
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32
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Fox T, Hunt BJ, Ariens RA, Towers GJ, Lever R, Garner P, Kuehn R. Plasmapheresis to remove amyloid fibrin(ogen) particles for treating the post-COVID-19 condition. Cochrane Database Syst Rev 2023; 7:CD015775. [PMID: 37491597 PMCID: PMC10368521 DOI: 10.1002/14651858.cd015775] [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] [Indexed: 07/27/2023]
Abstract
BACKGROUND The post-COVID-19 condition (PCC) consists of a wide array of symptoms including fatigue and impaired daily living. People seek a wide variety of approaches to help them recover. A new belief, arising from a few laboratory studies, is that 'microclots' cause the symptoms of PCC. This belief has been extended outside these studies, suggesting that to recover people need plasmapheresis (an expensive process where blood is filtered outside the body). We appraised the laboratory studies, and it was clear that the term 'microclots' is incorrect to describe the phenomenon being described. The particles are amyloid and include fibrin(ogen); amyloid is not a part of a thrombus which is a mix of fibrin mesh and platelets. Initial acute COVID-19 infection is associated with clotting abnormalities; this review concerns amyloid fibrin(ogen) particles in PCC only. We have reported here our appraisal of laboratory studies investigating the presence of amyloid fibrin(ogen) particles in PCC, and of evidence that plasmapheresis may be an effective therapy to remove amyloid fibrin(ogen) particles for treating PCC. OBJECTIVES Laboratory studies review To summarize and appraise the research reports on amyloid fibrin(ogen) particles related to PCC. Randomized controlled trials review To assess the evidence of the safety and efficacy of plasmapheresis to remove amyloid fibrin(ogen) particles in individuals with PCC from randomized controlled trials. SEARCH METHODS Laboratory studies review We searched for all relevant laboratory studies up to 27 October 2022 using a comprehensive search strategy which included the search terms 'COVID', 'amyloid', 'fibrin', 'fibrinogen'. Randomized controlled trials review We searched the following databases on 21 October 2022: Cochrane COVID-19 Study Register; MEDLINE (Ovid); Embase (Ovid); and BIOSIS Previews (Web of Science). We also searched the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for trials in progress. SELECTION CRITERIA Laboratory studies review Laboratory studies that investigate the presence of amyloid fibrin(ogen) particles in plasma samples from patients with PCC were eligible. This included studies with or without controls. Randomized controlled trials review Studies were eligible if they were of randomized controlled design and investigated the effectiveness or safety of plasmapheresis for removing amyloid fibrin(ogen) particles for treating PCC. DATA COLLECTION AND ANALYSIS Two review authors applied study inclusion criteria to identify eligible studies and extracted data. Laboratory studies review We assessed the risk of bias of included studies using pre-developed methods for laboratory studies. We planned to perform synthesis without meta-analysis (SWiM) as described in our protocol. Randomized controlled trials review We planned that if we identified any eligible studies, we would assess risk of bias and report results with 95% confidence intervals. The primary outcome was recovery, measured using the Post-COVID-19 Functional Status Scale (absence of symptoms related to the illness, ability to do usual daily activities, and a return to a previous state of health and mind). MAIN RESULTS Laboratory studies review We identified five laboratory studies. Amyloid fibrin(ogen) particles were identified in participants across all studies, including those with PCC, healthy individuals, and those with diabetes. The results of three studies were based on visual images of amyloid fibrin(ogen) particles, which did not quantify the amount or size of the particles identified. Formal risk of bias assessment showed concerns in how the studies were conducted and reported. This means the results were insufficient to support the belief that amyloid fibrin(ogen) particles are associated with PCC, or to determine whether there is a difference in the amount or size of amyloid fibrin(ogen) particles in the plasma of people with PCC compared to healthy controls. Randomized controlled trials review We identified no trials meeting our inclusion criteria. AUTHORS' CONCLUSIONS In the absence of reliable research showing that amyloid fibrin(ogen) particles contribute to the pathophysiology of PCC, there is no rationale for plasmapheresis to remove amyloid fibrin(ogen) particles in PCC. Plasmapheresis for this indication should not be used outside the context of a well-conducted randomized controlled trial.
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Affiliation(s)
- Tilly Fox
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Robert As Ariens
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Greg J Towers
- Division of Infection and Immunity, University College London, London, UK
| | | | - Paul Garner
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Extraordinary Professor in Epidemiology and Biostatistics, Stellenbosch University, Stellenbosch, South Africa
| | - Rebecca Kuehn
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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33
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Lemogne C, Ranque B. [Role of psychological factors in post-COVID-19 condition]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2023:S0001-4079(23)00185-1. [PMID: 37363156 PMCID: PMC10282978 DOI: 10.1016/j.banm.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023]
Abstract
Even after a mild episode of coronavirus disease 2019 (COVID-19), many patients suffer from persistent symptoms that can impair their quality of life for months. The potential role of psychological mechanisms in this post-COVID-19 condition, often referred to as long COVID, has been discussed early in the pandemic. Evidence supporting this hypothesis is now accumulating. First, a history of anxiety or depression is now an established risk factor for post-COVID-19 condition with a dose-response relationship and effect size similar to those of other known risk factors. This association extends to other forms of psychological distress, including perceived stress and loneliness. Second, specific beliefs about COVID-19 have been associated with the risk of subsequent similar symptoms, occurring weeks to several months later. Other studies, which have yet to be replicated, suggest an influence of the context of the initial infection (first versus second wave of the pandemic, before the emergence of significant variants and vaccination) and the trust in various sources of information about COVID-19 on the risk of subsequent symptoms. Bayesian models of perception can account for these results particularly well within a theoretical framework similar to that advanced for functional somatic disorders, integrating increased symptom expectations with decreased perception of the body internal state (interoception) and intolerance of uncertainty in the context of symptoms initially triggered by an infectious episode. These psychological mechanisms should obviously not be considered as exclusive. However, since they are modifiable, they could be targeted in clinical trials, within an integrative and multidisciplinary approach.
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Affiliation(s)
- Cédric Lemogne
- Université Paris Cité and université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 1 place du Parvis Notre-Dame, 75004 Paris, France
- Service de psychiatrie de l'adulte, AP-HP, hôpital Hôtel-Dieu, 75004 Paris, France
| | - Brigitte Ranque
- Service de médecine interne, AP-HP, hôpital européen Georges-Pompidou, 75015 Paris, France
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Schneider A, Huber L, Lohse J, Linde K, Greissel A, Sattel H, Henningsen P, Hapfelmeier A. Association between somatic symptom disorder and symptoms with daily life impairment after SARS-CoV-2 infection - results from a population-based cross-sectional study. J Psychosom Res 2023; 168:111230. [PMID: 36933364 PMCID: PMC10010058 DOI: 10.1016/j.jpsychores.2023.111230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND Post-COVID syndrome (PCS) is defined by symptom persistence accompanied by daily life impairment (DLI). The association of somatic symptom disorder (SSD) and symptoms with DLI after SARS-CoV-2 infection in the general population is unclear to date. The main objective of the study was to investigate the association of possible SSD, depression, anxiety, and participant-reported symptoms with DLI in a local population sample. METHODS Anonymised cross-sectional study. A symptom questionnaire, including the scales Patient Health Questionnaire PHQ-15 (somatisation module), SSD-12 (psychological distress in SSD), PHQ-2 (depression), GAD-2 (anxiety), and FAS (fatigue assessment scale) was sent in 02/2022 to all adult residents of the district Bad Tölz-Wolfratshausen, Germany, who were registered for SARS-CoV-2-infection between 03/2020 and 11/2021 (8925 delivered). Associations between DLI, symptoms and scales were estimated using binary logistic regression models and network analysis. RESULTS 2828 questionnaires (31.7%) were complete. 1486 (52.5%) reported persistent symptoms, and 509 (18.0%) perceived DLI. DLI was strongest associated with self-reported fatigue (OR 7.86; 95%CI 5.63-10.97), dyspnea (3.93; 2.73-5.67), impaired concentration (3.05; 2.17-4.30), SSD-12 (4.36; 2.57-7.41), and PHQ-2 (2.48; 1.57-3.92). Self-reported fatigue showed the strongest correlation (rp = 0.248) and closest proximity to DLI in network analysis. CONCLUSION PCS appears as a complex clinical picture in which SSD might play an important role when DLI is present. The pychological burden might partly be explained by the persistent symptoms, which are difficult to treat up to now. Screening for SSD could help in differential diagnostic decision-making to ensure that patients receive appropriate psychosocial interventions for disease coping.
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Affiliation(s)
- Antonius Schneider
- Institute of General Practice and Health Services Research, School of Medicine, Technical University Munich, Germany.
| | - Laura Huber
- Institute of General Practice and Health Services Research, School of Medicine, Technical University Munich, Germany
| | | | - Klaus Linde
- Institute of General Practice and Health Services Research, School of Medicine, Technical University Munich, Germany
| | - Anna Greissel
- Institute of General Practice and Health Services Research, School of Medicine, Technical University Munich, Germany
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University Munich, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University Munich, Germany
| | - Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, School of Medicine, Technical University Munich, Germany; Institute of AI and Informatics in Medicine School of Medicine, Technical University Munich, Germany
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Matta J, Wiernik E, Robineau O, Severi G, Touvier M, Gouraud C, Ouazana-Vedrines C, Pitron V, Ranque B, Hoertel N, Van den Bergh O, Witthöft M, Kab S, Goldberg M, Zins M, Lemogne C. Trust in sources of information on COVID-19 at the beginning of the pandemic's first wave and incident persistent symptoms in the population-based CONSTANCES cohort: A prospective study. J Psychosom Res 2023; 169:111326. [PMID: 37037155 PMCID: PMC10072983 DOI: 10.1016/j.jpsychores.2023.111326] [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: 01/27/2023] [Revised: 03/20/2023] [Accepted: 04/02/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To examine the association between trust in different sources of information on COVID-19 at the beginning of the pandemic and the burden of incident persistent symptoms. METHODS This prospective study used data from the SAPRIS and SAPRIS-Sérologie surveys nested in the French CONSTANCES population-based cohort. Trust in different information sources was measured between April 6 and May 4, 2020. Persistent symptoms that emerged afterwards were self-reported between December 2020 and January 2021. The associated psychological burden was measured with the somatic symptom disorder B criteria scale (SSD-12). The analyses were adjusted for gender, age, education, income, self-rated health, SARS-CoV-2 serology tests, and self-reported COVID-19. RESULTS Among 20,985 participants [mean age (SD), 49.0 years (12.7); 50.2% women], those with higher trust in government/journalists at baseline had fewer incident persistent symptoms at follow-up (estimate (SE) for one IQR increase: -0.21 (0.03), p < 0.001). Participants with higher trust in government/journalists and medical doctors/scientists were less likely to have ≥1 symptom (odds ratio (95% confidence interval) for one IQR increase: 0.87 (0.82-0.91) and 0.91 (0.85-0.98), respectively). Among 3372 participants (16.1%) who reported ≥1 symptom, higher trust in government/journalists and medical doctors/scientists predicted lower SSD-12 scores (-0.39 (0.17), p = 0.02 and - 0.85 (0.24), p < 0.001, respectively), whereas higher trust in social media predicted higher scores in those with lower trust in government/journalists (0.90 (0.34), p = 0.008). These associations did not depend upon surrogate markers of infection with SARS-CoV-2. CONCLUSIONS Trust in information sources on COVID-19 may be associated with incident persistent symptoms and associated psychological burden, regardless of infection with SARS-CoV-2.
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Affiliation(s)
- Joane Matta
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Emmanuel Wiernik
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Olivier Robineau
- Sorbonne Université, Inserm, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France; EA2694, Univ Lille, Centre Hospitalier de Tourcoing, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, INSERM, CESP U1018, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, Florence, Italy
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - Université Paris Cité (CRESS), Bobigny, France
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
| | - Charles Ouazana-Vedrines
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France; Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France; Centre du Sommeil et de la Vigilance-Pathologie professionnelle, APHP, Hôtel-Dieu, F-75004 Paris, France
| | - Brigitte Ranque
- Université Paris Cité, Service de Médecine interne, AP-HP, Hôpital européen Georges-Pompidou, Paris, France
| | - Nicolas Hoertel
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France; Service de Psychiatrie et Addictologie, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, F-92130 Issy-les-Moulineaux, France
| | - Omer Van den Bergh
- Health Psychology, Faculty of Psychology & Educational Sciences, University of Leuven, 3000 Leuven, Belgium
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University, 55122 Mainz, Germany
| | - Sofiane Kab
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Marie Zins
- Université Paris Cité, « Population-based Cohorts Unit », INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
| | - Cédric Lemogne
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France; Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France.
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Kleinschnitz C. Postvirale Erkrankungen – die Neurologie sollte Farbe bekennen. DGNEUROLOGIE 2023. [PMCID: PMC10031698 DOI: 10.1007/s42451-023-00561-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- C. Kleinschnitz
- grid.477805.90000 0004 7470 9004Klinik für Neurologie, Universitätsmedizin Essen, Essen, Deutschland
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