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Torreiter S, So P. An adaptive approach to developing a Long COVID rehabilitation program. Healthc Manage Forum 2024; 37:276-282. [PMID: 38557284 DOI: 10.1177/08404704241239867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
As more people became infected with the SARS-CoV-2 virus, it was anticipated that 10-20% of these individuals would develop a post-viral illness that would affect their ability to work and participate in daily activities and reduce quality of life. To support these patients, Unity Health Toronto opened the Outpatient Post-COVID Condition Rehabilitation Program in June 2021, with the aim of teaching patients how to manage their ongoing symptoms, and to maximize their independence and function. The program incorporated a multidisciplinary, patient-centred approach that leveraged group education and a virtual platform to allow patients from across Ontario to learn from one another and share experiences. Over the two years of the program, the multidisciplinary team continuously adapted to the new research on Long COVID and evolving needs of patients. This article will outline the development and evolution of the program.
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Affiliation(s)
| | - Peggy So
- Unity Health Toronto, Toronto, Ontario, Canada
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2
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Arron HE, Marsh BD, Kell DB, Khan MA, Jaeger BR, Pretorius E. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: the biology of a neglected disease. Front Immunol 2024; 15:1386607. [PMID: 38887284 PMCID: PMC11180809 DOI: 10.3389/fimmu.2024.1386607] [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: 02/15/2024] [Accepted: 04/11/2024] [Indexed: 06/20/2024] Open
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic, debilitating disease characterised by a wide range of symptoms that severely impact all aspects of life. Despite its significant prevalence, ME/CFS remains one of the most understudied and misunderstood conditions in modern medicine. ME/CFS lacks standardised diagnostic criteria owing to variations in both inclusion and exclusion criteria across different diagnostic guidelines, and furthermore, there are currently no effective treatments available. Moving beyond the traditional fragmented perspectives that have limited our understanding and management of the disease, our analysis of current information on ME/CFS represents a significant paradigm shift by synthesising the disease's multifactorial origins into a cohesive model. We discuss how ME/CFS emerges from an intricate web of genetic vulnerabilities and environmental triggers, notably viral infections, leading to a complex series of pathological responses including immune dysregulation, chronic inflammation, gut dysbiosis, and metabolic disturbances. This comprehensive model not only advances our understanding of ME/CFS's pathophysiology but also opens new avenues for research and potential therapeutic strategies. By integrating these disparate elements, our work emphasises the necessity of a holistic approach to diagnosing, researching, and treating ME/CFS, urging the scientific community to reconsider the disease's complexity and the multifaceted approach required for its study and management.
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Affiliation(s)
- Hayley E. Arron
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
| | - Benjamin D. Marsh
- MRCPCH Consultant Paediatric Neurodisability, Exeter, Devon, United Kingdom
| | - Douglas B. Kell
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
- The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Lyngby, Denmark
| | - M. Asad Khan
- Directorate of Respiratory Medicine, Manchester University Hospitals, Wythenshawe Hospital, Manchester, United Kingdom
| | - Beate R. Jaeger
- Long COVID department, Clinic St Georg, Bad Aibling, Germany
| | - Etheresia Pretorius
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
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Kaplan K, Mendenhall E. Framing Long Covid through Patient activism in the United States: Patient, Provider, Academic, and Policymaker Views. Soc Sci Med 2024; 350:116901. [PMID: 38688088 DOI: 10.1016/j.socscimed.2024.116901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
In 2020, when COVID-19 patients first recognized their complex and progressive symptoms, patient activists defined "Long Covid" on social media. While patient support groups are by no means new, the predominance of online support groups and those leveraging the power of social media has become a defining characteristic of Long Covid. In this article, we argue that naming Long Covid served as a powerful conduit of legitimacy for patient activists in media, medicine, and policy. We conducted 57 in-depth qualitative interviews with patients (n = 22), clinicians (n = 20), and policy and academic experts (n = 15). We found naming was not a primary area of contention. In contrast, patients found pride and a sense of identity within the terms. Many clinicians struggled with diagnostics because Long Covid lacks clear biological tests, while patients were consistently disappointed by the lack of positive tests and clarity around their symptomatology. The heterogeneity of the Long Covid experience, as well as the diversity of symptoms, further provides opportunities for contestation and disbelief among clinicians and policymakers not only in diagnostics but also in disability rights. Thus, the power of patient activism has transformed how the condition is perceived among and between patients, clinicians, policymakers, and the media in unprecedented ways that will likely have longstanding impacts on how IACCs are viewed in medicine and the public alike.
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Affiliation(s)
- Kenton Kaplan
- Walsh School of Foreign Service, Georgetown University, Washington D.C, USA
| | - Emily Mendenhall
- Walsh School of Foreign Service, Georgetown University, Washington D.C, USA.
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Naik H, Cooke E, Boulter T, Dyer R, Bone JN, Tsai M, Cristobal J, McKay RJ, Song X, Nacul L. Low-dose naltrexone for post-COVID fatigue syndrome: a study protocol for a double-blind, randomised trial in British Columbia. BMJ Open 2024; 14:e085272. [PMID: 38740499 PMCID: PMC11097836 DOI: 10.1136/bmjopen-2024-085272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION A significant proportion of individuals suffering from post COVID-19 condition (PCC, also known as long COVID) can present with persistent, disabling fatigue similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-viral fatigue syndromes. There remains no clear pharmacological therapy for patients with this subtype of PCC, which can be referred to as post-COVID fatigue syndrome (PCFS). A low dose of the opioid antagonist naltrexone (ie, low-dose naltrexone (LDN)) has emerged as an off-label treatment for treating fatigue and other symptoms in PCC. However, only small, non-controlled studies have assessed LDN in PCC, so randomised trials are urgently required. METHODS AND ANALYSIS A prospective, randomised, double-blind, parallel arm, placebo-controlled phase II trial will be performed to assess the efficacy of LDN for improving fatigue in PCFS. The trial will be decentralised and open to eligible individuals throughout the Canadian province of British Columbia (BC). Participants will be recruited through the province-wide Post-COVID-19 Interdisciplinary Clinical Care Network (PC-ICCN) and research volunteer platform (REACH BC). Eligible participants will be 19-69 years old, have had a confirmed or physician-suspected SARS-CoV-2 infection at least 3 months prior and meet clinical criteria for PCFS adapted from the Institute of Medicine ME/CFS criteria. Individuals who are taking opioid medications, have a history of ME/CFS prior to COVID-19 or history of significant liver disease will be excluded. Participants will be randomised to an LDN intervention arm (n=80) or placebo arm (n=80). Participants in each arm will be prescribed identical capsules starting at 1 mg daily and follow a prespecified schedule for up-titration to 4.5 mg daily or the maximum tolerated dose. The trial will be conducted over 16 weeks, with assessments at baseline, 6, 12 and 16 weeks. The primary outcome will be fatigue severity at 16 weeks evaluated by the Fatigue Severity Scale. Secondary outcomes will include pain Visual Analogue Scale score, overall symptom severity as measured by the Patient Phenotyping Questionnaire Short Form, 7-day step count and health-related quality of life measured by the EuroQol 5-Dimension questionnaire. ETHICS AND DISSEMINATION The trial has been authorised by Health Canada and approved by The University of British Columbia/Children's and Women's Health Centre of British Columbia Research Ethics Board. On completion, findings will be disseminated to patients, caregivers and clinicians through engagement activities within existing PCC and ME/CFS networks. Results will be published in academic journals and presented at conferences. TRIAL REGISTRATION NUMBER NCT05430152.
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Affiliation(s)
- Hiten Naik
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post-COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
| | - Erin Cooke
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Travis Boulter
- Women's Health Research Institute, Vancouver, British Columbia, Canada
- Complex Chronic Diseases Program, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Roger Dyer
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Jeffrey N Bone
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Melody Tsai
- Women's Health Research Institute, Vancouver, British Columbia, Canada
- Complex Chronic Diseases Program, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Jaymie Cristobal
- Women's Health Research Institute, Vancouver, British Columbia, Canada
- Complex Chronic Diseases Program, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - R Jane McKay
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Xiaowei Song
- Fraser Health Authority, Surrey, British Columbia, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Luis Nacul
- Women's Health Research Institute, Vancouver, British Columbia, Canada
- Complex Chronic Diseases Program, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
- London School of Hygiene and Tropical Medicine, London, UK
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Carpallo-Porcar B, Calvo S, Alamillo-Salas J, Herrero P, Gómez-Barrera M, Jiménez-Sánchez C. An Opportunity for Management of Fatigue, Physical Condition, and Quality of Life Through Asynchronous Telerehabilitation in Patients After Acute Coronavirus Disease 2019: A Randomized Controlled Pilot Study. Arch Phys Med Rehabil 2024:S0003-9993(24)00986-9. [PMID: 38710426 DOI: 10.1016/j.apmr.2024.04.014] [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: 09/02/2023] [Revised: 03/05/2024] [Accepted: 04/30/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE To compare the preliminary efficacy of asynchronous telerehabilitation in patients after acute coronavirus disease 2019 (COVID-19) on fatigue, physical condition, quality of life, and feasibility of this pilot study with that of a booklet format. DESIGN Randomized pilot study with 2 intervention arms: asynchronous telerehabilitation group and booklet-based rehabilitation group, with 2 follow-ups at 3 and 6 months. SETTING Hospital. PARTICIPANTS Patients discharged after COVID-19 were recruited and evaluated (N=35). INTERVENTIONS The intervention consisted of a 12-week multimodal rehabilitation program via telerehabilitation or by a booklet. MAIN OUTCOME MEASURES Fatigue as the main outcome and functional status, quality of life, and feasibility as secondary outcomes were evaluated. RESULTS After the intervention, there was no significant difference between groups in fatigue, but there were significant differences in favor of the asynchronous telerehabilitation group for the 6-Minute Walk Test (p=.008), the 30-Second Sit-to-Stand Test (p=.019), and physical quality of life (p=.035). These improvements were maintained throughout the 6-month follow-up. Telerehabilitation was shown to be a viable option, without incidents and with a higher adhesion (p=.028) than the booklet format. CONCLUSIONS A multimodal rehabilitation program by means of asynchronous telerehabilitation appears as a more effective option than traditional formats in improving post-acute COVID-19 sequelae.
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Affiliation(s)
- Beatriz Carpallo-Porcar
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain; IIS Aragon, Zaragoza, Spain
| | - Sandra Calvo
- IIS Aragon, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
| | | | - Pablo Herrero
- IIS Aragon, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Manuel Gómez-Barrera
- Departament of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain; Pharmacoeconomics & Outcomes Iberia, Madrid, Spain
| | - Carolina Jiménez-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain; IIS Aragon, Zaragoza, Spain
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Heald AH, Williams R, Jenkins DA, Stewart S, Bakerly ND, Mccay K, Ollier W. The prevalence of long COVID in people with diabetes mellitus-evidence from a UK cohort. EClinicalMedicine 2024; 71:102607. [PMID: 38813442 PMCID: PMC11133790 DOI: 10.1016/j.eclinm.2024.102607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 05/31/2024] Open
Abstract
Background It was apparent from the early phase of the SARS-CoV-2 virus (COVID-19) pandemic that a multi-system syndrome can develop in the weeks following a COVID-19 infection, now referred to as Long COVID. Given that people living with diabetes are at increased risk of hospital admission/poor outcomes following COVID-19 infection we hypothesised that they may also be more susceptible to developing Long COVID. We describe here the prevalence of Long COVID in people living with diabetes when compared to matched controls in a Northwest UK population. Methods This was a retrospective cohort study of people who had a recorded diagnosis of type 1 diabetes (T1D) or type 2 diabetes (T2D) who were alive on 1st January 2020 and who had a proven COVID-19 infection. We used electronic health record data from the Greater Manchester Care Record collected from 1st January 2020 to 16th September 2023, we determined the prevalence of Long COVID in people with T1D and T2D vs matched individuals without diabetes (non-DM). Findings There were 3087 T1D individuals with 14,077 non-diabetes controls and 3087 T2D individuals with 14,077 non-diabetes controls and 29,700 T2D individuals vs 119,951 controls. For T1D, there was a lower proportion of Long COVID diagnosis and/or referral to a Long COVID service at 0.33% vs 0.48% for matched controls. The prevalence of Long COVID In T2D individuals was 0.53% vs 1:3 matched controls 0.54%. For T2D, there were differences by sex in the prevalence of Long COVID in comparison with 1:3 matched controls. For Long COVID between males with T2D and their matched controls, the prevalence was lower in matched controls at 0.46%.vs 0.54% (0.008). When considering the prevalence of LC between females with T2D and their matched controls, the prevalence was higher in matched controls at 0.61% vs 0.53% (0.007). The prevalence of Long COVID in males with T2D vs females was not different. T2D patients at older vs younger age were at reduced risk of developing Long COVID (OR 0.994 [95% CI) [0.989, 0.999]). For females there was a minor increase of risk (OR 1.179, 95% CI [1.002, 1.387]). Presence of a higher body mass index (BMI) was also associated an increased risk of developing Long COVID (OR 1.013, 95% CI [1.001, 1.026]). The estimated general population prevalence of Long COVID based on general practice coding (not self-reported) of this diagnosis was 0.5% of people with a prior acute COVID-19 diagnosis. Interpretation Recorded Long COVID was more prevalent in men with T2D than in matched non-T2D controls with the opposite seen for T2D women, with recorded Long COVID rates being similar for T2D men and women. Younger age, female sex and higher BMI were all associated with a greater likelihood of developing Long COVID when taken as individual variables. There remains an imperative for continuing awareness of Long COVID as a differential diagnosis for multi-system symptomatic presentation in the context of a previous acute COVID-19 infection. Funding The time of co-author RW was supported by the NIHR Applied Research Collaboration Greater Manchester (NIHR200174) and the NIHR Manchester Biomedical Research Centre (NIHR203308).
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Affiliation(s)
- Adrian H. Heald
- The School of Medicine and Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
- Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK
| | - Richard Williams
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - David A. Jenkins
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Applied Research Collaboration Greater Manchester, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stuart Stewart
- Centre for Primary Care & Health Services Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Donal O’Donoghue Renal Research Centre, Northern Care Alliance Research & Innovation, Salford Royal NHS Foundation Trust, Salford, UK
| | - Nawar Diar Bakerly
- Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Department of Respiratory Medicine, Salford Royal Hospital, Salford, UK
- School of Biological Sciences, Manchester Metropolitan University, Manchester, UK
| | - Kevin Mccay
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - William Ollier
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
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Korapatti C, Vera L, Miller K. Biosound Therapy as a treatment for long COVID patients: A pre-post pilot study. Explore (NY) 2024:S1550-8307(24)00063-6. [PMID: 38697866 DOI: 10.1016/j.explore.2024.04.004] [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: 09/21/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND 43 % of people who are diagnosed with COVID-19 will experience persistent symptoms, also known as "long COVID," which lasts past the recovery of the acute infection. Long COVID symptoms overlap with symptoms that the Biosound Therapy System (BTS) has been shown to improve. The BTS is a multimodal treatment that includes biofeedback, vibroacoustic therapy synchronized with music that plays binaural beats, and video content. This study aimed to determine feasibility for a future full-scale Randomized Controlled Trial (RCT) and explore the impact of the BTS on long COVID symptoms. METHODS This pre-post pilot study was conducted in an outpatient mental health clinic. Adults aged 20-65 years old with persistent COVID-19 symptoms were screened and randomly assigned to the intervention or control group. The intervention group was given 8 Biosound Therapy sessions during a period of 4 weeks. All participants were assessed at baseline and at post-intervention using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), Cambridge Brain Sciences (CBS) tasks, and the COVID-19 Persistent Symptom Questionnaire. The feasibility outcomes were recruitment rates, retention rates, and open-ended questions about participants' experiences. RESULTS 15 participants enrolled in the study and 13 completed the study (9 intervention, 4 control). Trial recruitment ended prematurely due to the emergence of the Omicron variant of COVID-19. Participants responded to open-ended questions with only positive remarks and made no comments on the study not being feasible. A Wilcoxon signed-rank test indicated that compared to baseline, participants in the intervention group had significant improvement in their GAD-7 score, PHQ9 score, 2 Cambridge Brain Science tasks ("Odd" and "Double Trouble"), fatigue, and difficulties in concentrating or remembering (p < 0.05; 95 % CI). CONCLUSION The intervention group showed promising improvement without reported side effects. A full-scale RCT is feasible as long as the recruitment setting is changed to a location that allows access to more patients with long COVID. Results were limited due to the small sample size; therefore, a full-scale trial is needed.
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Affiliation(s)
| | | | - Keith Miller
- Department of Social Work, University of Indianapolis, Indianapolis, Indiana, USA
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Staub K, Ballouz T, Puhan M. An Unwanted but Long-Known Company: Post-Viral Symptoms in the Context of Past Pandemics in Switzerland (and Beyond). Public Health Rev 2024; 45:1606966. [PMID: 38651133 PMCID: PMC11033310 DOI: 10.3389/phrs.2024.1606966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Objectives: Some people do not fully recover from an acute viral infection and experience persistent symptoms or incomplete recovery for months or even years. This is not unique to the SARS-CoV-2 virus and history shows that post-viral conditions like post COVID-19 condition, also referred to as Long Covid, are not new. In particular, during and after pandemics caused by respiratory viruses in which large parts of the population were infected or exposed, professional and public attention was increased, not least because of the large number of people affected. Methods: Given the current relevance of the topic, this article aims to narratively review and summarize the literature on post-viral symptoms during past pandemics and to supplement and illustrate it with Swiss examples from the pandemics of 1890, 1918-1920 and later. Results: Post-viral diseases were an increasingly emphasised health topic during and after past pandemics triggered by respiratory infections over the last 150 years. Conclusion: In the next pandemic, it should not be surprising that post-viral conditions will again play a role, and pandemic plans should reflect this.
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Affiliation(s)
- Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health, Zurich, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo Puhan
- Swiss School of Public Health, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Zayeri ZD, Torabizadeh M, Kargar M, Kazemi H. The molecular fingerprint of neuroinflammation in COVID-19: A comprehensive discussion on molecular mechanisms of neuroinflammation due to SARS-COV2 antigens. Behav Brain Res 2024; 462:114868. [PMID: 38246395 DOI: 10.1016/j.bbr.2024.114868] [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: 08/27/2023] [Revised: 01/13/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Severe acute respiratory syndrome coronavirus 2 attacks the neural system directly and indirectly via various systems, such as the nasal cavity, olfactory system, and facial nerves. Considering the high energy requirement, lack of antioxidant defenses, and high amounts of metal ions in the brain, oxidative damage is very harmful to the brain. Various neuropathic pain conditions, neurological disorders, and neuropsychiatric complications were reported in Coronavirus disease 2019, prolonged Coronavirus disease 2019, and after Coronavirus disease 2019 immunization. This manuscript offers a distinctive outlook on the interconnectedness between neurology and neuropsychiatry through its meticulous analysis of complications. DISCUSSION After recovering from Coronavirus disease 2019, approximately half of the patients reported developing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Long Coronavirus disease 2019 imaging reports illustrated the hypometabolism in various parts of the brain, such as olfactory bulbs, limbic/paralimbic domains, the brainstem, and the cerebellum. Ninety imaging and neuropathological studies of Coronavirus disease 2019 have shown evidence of white matter, brainstem, frontotemporal, and oculofrontal lesions. Emotional functions, such as pleasant, long/short-term memory, movement, cognition and cognition in decision-making are controlled by these regions. The neuroinflammation and the mechanisms of defense are well presented in the discussion. The role of microglia activation, Inducible NO synthase, Cyclooxygenases ½, Reactive oxygen species, neurotoxic toxins and pro-inflammatory cytokines, such as Interleukin-1 beta, Interleukin-6 and Tumor Necrosis Factor-alpha are highlighted in neuronal dysfunction and death. Nuclear factor kappa-light-chain-enhancer of activated B cells, Mitogen-activated protein kinase, Activator Protein 1, and Interferon regulatory factors are the main pathways involved in microglia activation in Coronavirus disease 2019 neuroinflammation. CONCLUSION The neurological aspect of Coronavirus disease 2019 should be highlighted. Neurological, psychological, and behavioral aspects of Coronavirus disease 2019, prolonged Coronavirus disease 2019, and Coronavirus disease 2019 vaccines can be the upcoming issues. We need a global awareness where this aspect of the disease should be more considered in health research.
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Affiliation(s)
- Zeinab Deris Zayeri
- Golestan Hospital Clinical Research Development Unit, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mehdi Torabizadeh
- Golestan Hospital Clinical Research Development Unit, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoud Kargar
- Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hashem Kazemi
- Department of Biology, Dezful Branch, Islamic Azad University, Dezful, Iran
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Finch F, Parker P, Nollett C, Burns S. The novel application of the Lightning Process to treat Long COVID in primary care - Case report. Explore (NY) 2024; 20:248-252. [PMID: 38176975 DOI: 10.1016/j.explore.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 01/06/2024]
Abstract
As a result of the COVID-19 pandemic, Long COVID (LC) is now prevalent in many countries. Little evidence exists regarding how this chronic condition should be treated, but guidelines suggest for most people it can be managed symptomatically in primary care. The Lightning Process is a trademarked positive psychology focused self-management programme which has shown to be effective in reducing fatigue and accompanying symptoms in other chronic conditions including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Here we outline its novel application to two patients with LC who both reported improvements in fatigue and a range of physical and emotional symptoms post-treatment and at 3 months follow-up.
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Affiliation(s)
| | - P Parker
- London Metropolitan University, UK
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11
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Krishna BA, Lim EY, Metaxaki M, Jackson S, Mactavous L, Lyons PA, Doffinger R, Bradley JR, Smith KGC, Sinclair J, Matheson NJ, Lehner PJ, Sithole N, Wills MR. Spontaneous, persistent, T cell-dependent IFN-γ release in patients who progress to Long Covid. SCIENCE ADVANCES 2024; 10:eadi9379. [PMID: 38381822 PMCID: PMC10881041 DOI: 10.1126/sciadv.adi9379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024]
Abstract
After acute infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a proportion of patients experience persistent symptoms beyond 12 weeks, termed Long Covid. Understanding the mechanisms that cause this debilitating disease and identifying biomarkers for diagnostic, therapeutic, and monitoring purposes are urgently required. We detected persistently high levels of interferon-γ (IFN-γ) from peripheral blood mononuclear cells of patients with Long Covid using highly sensitive FluoroSpot assays. This IFN-γ release was seen in the absence of ex vivo peptide stimulation and remains persistently elevated in patients with Long Covid, unlike the resolution seen in patients recovering from acute SARS-CoV-2 infection. The IFN-γ release was CD8+ T cell-mediated and dependent on antigen presentation by CD14+ cells. Longitudinal follow-up of our study cohort showed that symptom improvement and resolution correlated with a decrease in IFN-γ production to baseline levels. Our study highlights a potential mechanism underlying Long Covid, enabling the search for biomarkers and therapeutics in patients with Long Covid.
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Affiliation(s)
- Benjamin A. Krishna
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Eleanor Y. Lim
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Marina Metaxaki
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
| | - Sarah Jackson
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Lenette Mactavous
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - NIHR BioResource
- NIHR BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Paul A. Lyons
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Rainer Doffinger
- Department of Clinical Biochemistry and Immunology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - John R. Bradley
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- NIHR BioResource, Cambridge University Hospitals, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
- National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre, Cambridge CB2 0QQ, UK
- Department of Renal Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Kenneth G. C. Smith
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - John Sinclair
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Nicholas J. Matheson
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- NHS Blood and Transplant, Cambridge CB2 0PT, UK
| | - Paul J. Lehner
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Nyaradzai Sithole
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Mark R. Wills
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Department of Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
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12
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Cornelissen MEB, Bloemsma LD, Vaes AW, Baalbaki N, Deng Q, Beijers RJHCG, Noij LCE, Houweling L, Bazdar S, Spruit MA, Maitland-van der Zee AH. Fatigue and symptom-based clusters in post COVID-19 patients: a multicentre, prospective, observational cohort study. J Transl Med 2024; 22:191. [PMID: 38383493 PMCID: PMC10880228 DOI: 10.1186/s12967-024-04979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/11/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND In the Netherlands, the prevalence of post COVID-19 condition is estimated at 12.7% at 90-150 days after SARS-CoV-2 infection. This study aimed to determine the occurrence of fatigue and other symptoms, to assess how many patients meet the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) criteria, to identify symptom-based clusters within the P4O2 COVID-19 cohort and to compare these clusters with clusters in a ME/CFS cohort. METHODS In this multicentre, prospective, observational cohort in the Netherlands, 95 post COVID-19 patients aged 40-65 years were included. Data collection at 3-6 months after infection included demographics, medical history, questionnaires, and a medical examination. Follow-up assessments occurred 9-12 months later, where the same data were collected. Fatigue was determined with the Fatigue Severity Scale (FSS), a score of ≥ 4 means moderate to high fatigue. The frequency and severity of other symptoms and the percentage of patients that meet the ME/CFS criteria were assessed using the DePaul Symptom Questionnaire-2 (DSQ-2). A self-organizing map was used to visualize the clustering of patients based on severity and frequency of 79 symptoms. In a previous study, 337 Dutch ME/CFS patients were clustered based on their symptom scores. The symptom scores of post COVID-19 patients were applied to these clusters to examine whether the same or different clusters were found. RESULTS According to the FSS, fatigue was reported by 75.9% of the patients at 3-6 months after infection and by 57.1% of the patients 9-12 months later. Post-exertional malaise, sleep disturbances, pain, and neurocognitive symptoms were also frequently reported, according to the DSQ-2. Over half of the patients (52.7%) met the Fukuda criteria for ME/CFS, while fewer patients met other ME/CFS definitions. Clustering revealed specific symptom patterns and showed that post COVID-19 patients occurred in 11 of the clusters that have been observed in the ME/CFS cohort, where 2 clusters had > 10 patients. CONCLUSIONS This study shows persistent fatigue and diverse symptomatology in post COVID-19 patients, up to 12-18 months after SARS-CoV-2 infection. Clustering showed that post COVID-19 patients occurred in 11 of the clusters that have been observed in the ME/CFS cohort.
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Affiliation(s)
- Merel E B Cornelissen
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Lizan D Bloemsma
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anouk W Vaes
- Department of Research and Development, Ciro, Horn, The Netherlands
| | - Nadia Baalbaki
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Qichen Deng
- Department of Research and Development, Ciro, Horn, The Netherlands
- Department of Respiratory Medicine, Nutrim Institute of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Rosanne J H C G Beijers
- Department of Respiratory Medicine, Nutrim Institute of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Lieke C E Noij
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Laura Houweling
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Somayeh Bazdar
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, The Netherlands
- Department of Respiratory Medicine, Nutrim Institute of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Anke H Maitland-van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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13
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Leonel JW, Ciurleo GCV, Formiga AM, Vasconcelos TDMF, de Andrade MH, Feitosa WLQ, Sobreira-Neto AA, Portugal CG, Morais LM, Marinho SC, Gomes EDABM, Feitosa EDAAF, Sobreira EST, Oriá RB, Sobreira-Neto MA, Braga-Neto P. Long COVID: neurological manifestations - an updated narrative review. Dement Neuropsychol 2024; 18:e20230076. [PMID: 38425701 PMCID: PMC10901563 DOI: 10.1590/1980-5764-dn-2023-0076] [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: 09/06/2023] [Revised: 10/21/2023] [Indexed: 03/02/2024] Open
Abstract
Infection with the SARS-CoV-2 virus can lead to neurological symptoms in the acute phase and in the Long COVID phase. These symptoms usually involve cognition, sleep, smell disorders, psychiatric manifestations, headache and others. This condition is more commonly described in young adults and women. This symptomatology can follow severe or mild cases of the disease. The importance of this issue resides in the high prevalence of neurological symptoms in the Long COVID phase, which entails significant morbidity in this population. In addition, such a condition is associated with high health care costs, with some estimates hovering around 3.7 trillion US dollars. In this review, we will sequentially describe the current knowledge about the most prevalent neurological symptoms in Long COVID, as well as their pathophysiology and possible biomarkers.
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14
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Harandi AA, Pakdaman H, Medghalchi A, Kimia N, Kazemian A, Siavoshi F, Barough SS, Esfandani A, Hosseini MH, Sobhanian SA. A randomized open-label clinical trial on the effect of Amantadine on post Covid 19 fatigue. Sci Rep 2024; 14:1343. [PMID: 38228731 DOI: 10.1038/s41598-024-51904-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
Many COVID-19 survivors experience lingering post-COVID-19 symptoms, notably chronic fatigue persisting for months after the acute phase. Despite its prevalence, limited research has explored effective treatments for post-COVID-19 fatigue. This randomized controlled clinical trial assessed the impact of Amantadine on patients with post-COVID-19 fatigue. The intervention group received Amantadine for two weeks, while the control group received no treatment. Fatigue levels were assessed using the Visual Analog Fatigue Scale (VAFS) and Fatigue Severity Scale (FSS) questionnaires before and after the trial. At the study's onset, VAFS mean scores were 7.90 ± 0.60 in the intervention group and 7.34 ± 0.58 in the control group (P-value = 0.087). After two weeks, intervention group scores dropped to 3.37 ± 0.44, significantly lower than the control group's 5.97 ± 0.29 (P-value < 0.001). Similarly, FSS mean scores at the trial's commencement were 53.10 ± 5.96 in the intervention group and 50.38 ± 4.88 in the control group (P-value = 0.053). At the trial's end, intervention group scores decreased to 28.40 ± 2.42, markedly lower than the control group's 42.59 ± 1.50 (P-value < 0.001). In this study, we report the safety, tolerability, and substantial fatigue-relieving effects of Amantadine in post-COVID-19 fatigue. The intervention demonstrates a statistically significant reduction in fatigue levels, suggesting Amantadine's potential as an effective treatment for this persistent condition.
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Affiliation(s)
- Ali Amini Harandi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hossein Pakdaman
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aida Medghalchi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin Kimia
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Kazemian
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Siavoshi
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Akram Esfandani
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Seyed Ali Sobhanian
- Pharmacy Department, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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15
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Tackey C, Slepian PM, Clarke H, Mittal N. Post-Viral Pain, Fatigue, and Sleep Disturbance Syndromes: Current Knowledge and Future Directions. Can J Pain 2024; 7:2272999. [PMID: 38239826 PMCID: PMC10795785 DOI: 10.1080/24740527.2023.2272999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/16/2023] [Indexed: 01/22/2024]
Abstract
Background Post-viral pain syndrome, also known as post-viral syndrome, is a complex condition characterized by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, neurocognitive difficulties, and sleep disturbances that can occur after an individual has recovered from a viral infection. Aims This narrative review provides a summary of the sequelae of post-viral syndromes, viral agents that cause it, and the pathophysiology, treatment, and future considerations for research and targeted therapies. Methods Medline, PubMed, and Embase databases were used to search for studies on viruses associated with post-viral syndrome. Conclusion Much remains unknown regarding the pathophysiology of post-viral syndromes, and few studies have provided a comprehensive summary of the condition, agents that cause it, and successful treatment modalities. With the COVID-19 pandemic continuing to affect millions of people worldwide, the need for an understanding of the etiology of post-viral illness and how to help individuals cope with the sequalae is paramount.
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Affiliation(s)
- Caleb Tackey
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - P. Maxwell Slepian
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Hance Clarke
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Nimish Mittal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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16
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Sathu S, Kumar R, Maley DK, Eppakayala S, Kashyap A, NynaSindhu A, Madhu Latha K, Lakkireddy M. Increased Frequency of Low Back Pain in Recent Times: Does the Answer Lie in COVID-19? Cureus 2023; 15:e50021. [PMID: 38186417 PMCID: PMC10767474 DOI: 10.7759/cureus.50021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/09/2024] Open
Abstract
Background The COVID-19 pandemic has impacted many people's activities of daily living and health. It has also created economic burdens and caused mental turmoil across the world. Musculoskeletal symptoms, especially low back pain, have been observed in subjects of post-COVID-19 infection and post-vaccination. Aim In this study, we aimed to investigate the relationship between low back pain and COVID-19 infection and vaccination, as well as associated factors and characteristics. Methods We conducted a questionnaire-based cross-sectional observational study at All India Institute of Medical Science (AIIMS) Bibinagar between September 2021 and March 2022. We collected data from individuals through physical and Google Forms (Google, Mountain View, California). Results We included a total of 535 individuals in the study: 274 (51.2%) were previously positive for COVID-19 infection (group A), and 261 (48.8%) were vaccinated against COVID-19 without a history of COVID-19 infection (group B). Each group was divided into two categories based on whether they had low back pain before COVID-19 infection or vaccination. In group A, 90.1% of individuals experienced an aggravation of low back pain after COVID-19 infection, which was found to be significant (p<0.001). In group B, there was an insignificant increase in low back pain following COVID-19 vaccination (p=0.275). The study also revealed a significant association between comorbidities and low back pain in both groups (p<0.001). Additionally, several differences were observed between the two groups, including duration (p<0.001), severity (p=0.012), and intensity (p<0.001) of low back pain, usage of a back support or brace (p=0.043), and intake of vitamin D (p=0.002). Conclusion Low back pain is an ignored feature of one of the musculoskeletal symptoms of COVID-19 and was aggravated by COVID-19 infection in our patients compared to those who received the vaccination. The findings of this study have implications for raising awareness, improving management and rehabilitation, and guiding future research in this area.
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Affiliation(s)
- Sreedhar Sathu
- Department of Orthopedics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Ravi Kumar
- Department of Orthopedics, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Deepak K Maley
- Department of Orthopedics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Srikanth Eppakayala
- Department of Orthopedics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Adinarayana Kashyap
- Department of Orthopedics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Akula NynaSindhu
- Department of General Surgery, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Karra Madhu Latha
- Department of Biochemistry, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
| | - Maheshwar Lakkireddy
- Department of Orthopedics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND
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17
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Hwang JH, Lee JS, Oh HM, Lee EJ, Lim EJ, Son CG. Evaluation of viral infection as an etiology of ME/CFS: a systematic review and meta-analysis. J Transl Med 2023; 21:763. [PMID: 37898798 PMCID: PMC10612276 DOI: 10.1186/s12967-023-04635-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Myalgic encephalitis/chronic fatigue syndrome (ME/CFS) is a long-term disabling illness without a medically explained cause. Recently during COVID-19 pandemic, many studies have confirmed the symptoms similar to ME/CFS in the recovered individuals. To investigate the virus-related etiopathogenesis of ME/CFS, we conducted a systematic assessment of viral infection frequency in ME/CFS patients. METHODS We conducted a comprehensive search of PubMed and the Cochrane Library from their inception through December 31, 2022, using selection criteria of viral infection prevalence in ME/CFS patients and controls. Subsequently, we performed a meta-analysis to assess the extent of viral infections' contribution to ME/CFS by comparing the odds ratio between ME/CFS patients and controls (healthy and/or diseased). RESULTS Finally, 64 studies met our eligibility criteria regarding 18 species of viruses, including a total of 4971 ME/CFS patients and 9221 control subjects. The participants included healthy subjects and individuals with one of 10 diseases, such as multiple sclerosis or fibromyalgia. Two DNA viruses (human herpes virus (HHV)-7 and parvovirus B19, including their co-infection) and 3 RNA viruses (borna disease virus (BDV), enterovirus and coxsackie B virus) showed odds ratios greater than 2.0 compared with healthy and/or diseased subjects. Specifically, BDV exceeded the cutoff with an odds ratio of ≥ 3.47 (indicating a "moderate association" by Cohen's d test) compared to both healthy and diseased controls. CONCLUSION This study comprehensively evaluated the risk of viral infections associated with ME/CFS, and identified BDV. These results provide valuable reference data for future studies investigating the role of viruses in the causation of ME/CFS.
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Affiliation(s)
- Jae-Hyun Hwang
- Korean Medical College of Daejeon University, 62, Daehak-Ro, Dong-Gu, Daejeon, Republic of Korea, 34520
| | - Jin-Seok Lee
- Institute of Bioscience and Integrative Medicine, Daejeon University, 62 Daehak-Ro, Dong-Gu, Daejeon, Republic of Korea, 34520
| | - Hyeon-Muk Oh
- Institute of Bioscience and Integrative Medicine, Daejeon University, 62 Daehak-Ro, Dong-Gu, Daejeon, Republic of Korea, 34520
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, 176 Daedeok-Daero, Seo-Gu, Daejeon, Republic of Korea, 35235
| | - Eun-Jin Lim
- Department of Integrative Medicine, Graduate School of Integrative Medicine, CHA University, 335 Pangyo-Ro, Bundang-Gu, Seongnam-city, 13488, Gyeonggi-Do, Korea
| | - Chang-Gue Son
- Institute of Bioscience and Integrative Medicine, Daejeon University, 62 Daehak-Ro, Dong-Gu, Daejeon, Republic of Korea, 34520.
- Research Center for CFS/ME, Daejeon Oriental Hospital of Daejeon University, 176 Daedeok-Daero, Seo-Gu, Daejeon, Republic of Korea, 35235.
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18
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Sanal-Hayes NEM, Mclaughlin M, Hayes LD, Mair JL, Ormerod J, Carless D, Hilliard N, Meach R, Ingram J, Sculthorpe NF. A scoping review of 'Pacing' for management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): lessons learned for the long COVID pandemic. J Transl Med 2023; 21:720. [PMID: 37838675 PMCID: PMC10576275 DOI: 10.1186/s12967-023-04587-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Controversy over treatment for people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a barrier to appropriate treatment. Energy management or pacing is a prominent coping strategy for people with ME/CFS. Whilst a definitive definition of pacing is not unanimous within the literature or healthcare providers, it typically comprises regulating activity to avoid post exertional malaise (PEM), the worsening of symptoms after an activity. Until now, characteristics of pacing, and the effects on patients' symptoms had not been systematically reviewed. This is problematic as the most common approach to pacing, pacing prescription, and the pooled efficacy of pacing was unknown. Collating evidence may help advise those suffering with similar symptoms, including long COVID, as practitioners would be better informed on methodological approaches to adopt, pacing implementation, and expected outcomes. OBJECTIVES In this scoping review of the literature, we aggregated type of, and outcomes of, pacing in people with ME/CFS. ELIGIBILITY CRITERIA Original investigations concerning pacing were considered in participants with ME/CFS. SOURCES OF EVIDENCE Six electronic databases (PubMed, Scholar, ScienceDirect, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched; and websites MEPedia, Action for ME, and ME Action were also searched for grey literature, to fully capture patient surveys not published in academic journals. METHODS A scoping review was conducted. Review selection and characterisation was performed by two independent reviewers using pretested forms. RESULTS Authors reviewed 177 titles and abstracts, resulting in 17 included studies: three randomised control trials (RCTs); one uncontrolled trial; one interventional case series; one retrospective observational study; two prospective observational studies; four cross-sectional observational studies; and five cross-sectional analytical studies. Studies included variable designs, durations, and outcome measures. In terms of pacing administration, studies used educational sessions and diaries for activity monitoring. Eleven studies reported benefits of pacing, four studies reported no effect, and two studies reported a detrimental effect in comparison to the control group. CONCLUSIONS Highly variable study designs and outcome measures, allied to poor to fair methodological quality resulted in heterogenous findings and highlights the requirement for more research examining pacing. Looking to the long COVID pandemic, our results suggest future studies should be RCTs utilising objectively quantified digitised pacing, over a longer duration of examination (i.e. longitudinal studies), using the core outcome set for patient reported outcome measures. Until these are completed, the literature base is insufficient to inform treatment practises for people with ME/CFS and long COVID.
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Affiliation(s)
- Nilihan E M Sanal-Hayes
- Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
- School of Health and Society, University of Salford, Salford, UK
| | - Marie Mclaughlin
- Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
- School of Sport, Exercise & Rehabilitation Sciences, University of Hull, Hull, UK
| | - Lawrence D Hayes
- Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Jacqueline L Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Jane Ormerod
- Long COVID Scotland, 12 Kemnay Place, Aberdeen, UK
| | - David Carless
- Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | | | - Rachel Meach
- Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Joanne Ingram
- School of Education and Social Sciences, University of the West of Scotland, Glasgow, UK
| | - Nicholas F Sculthorpe
- Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
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19
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Gosser R, Anderson S, Blaszczyk A, Jen C, Bhatt S. In It for the Long Haul: Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2. J Pharm Pract 2023; 36:1048-1051. [PMID: 35356830 PMCID: PMC8971963 DOI: 10.1177/08971900221088799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has caused immeasurable clinical, economic, and societal challenges for the world since early 2020. Intense focus has been placed on determining evidence-based acute management of patients infected with the SARS-CoV-2 virus, as well as accelerating vaccination efforts for those eligible to receive it. As patients recover from infection, many are left with long-term symptoms, known as "Long COVID" or "Post-Acute Sequelae of COVID19," that challenges the ability to fully recover, return to baseline health status, and regain quality of life. As the most accessible healthcare professional, pharmacists can assist with the management of long COVID as a member of the multidisciplinary team. Pharmacists' medication acumen is beneficial to the management of long COVID symptomatology as more research comes to the forefront of this deadly disease.
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Affiliation(s)
- Rena Gosser
- Department of Pharmacy, University of Washington Medicine - Harborview Medical Center, Seattle, WA, USA
| | | | - Amie Blaszczyk
- Department of Pharmacy Practice, Texas Tech University School of Pharmacy, Dallas, TX, USA
| | - Christi Jen
- Department of Pharmacy, Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Snehal Bhatt
- Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
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20
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Schnekenberg L, Sedghi A, Schoene D, Pallesen LP, Barlinn J, Woitek F, Linke A, Puetz V, Barlinn K, Mangner N, Siepmann T. Assessment and Therapeutic Modulation of Heart Rate Variability: Potential Implications in Patients with COVID-19. J Cardiovasc Dev Dis 2023; 10:297. [PMID: 37504553 PMCID: PMC10380874 DOI: 10.3390/jcdd10070297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/02/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Cardiac damage has been attributed to SARS-CoV-2-related pathology contributing to increased risk of vascular events. Heart rate variability (HRV) is a parameter of functional neurocardiac integrity with low HRV constituting an independent predictor of cardiovascular mortality. Whether structural cardiac damage translates into neurocardiac dysfunction in patients infected with SARS-CoV-2 remains poorly understood. Hypothesized mechanisms of possible neurocardiac dysfunction in COVID-19 comprise direct systemic neuroinvasion of autonomic control centers, ascending virus propagation along cranial nerves and cardiac autonomic neuropathy. While the relationship between the autonomic nervous system and the cytokine cascade in general has been studied extensively, the interplay between the inflammatory response caused by SARS-CoV-2 and autonomic cardiovascular regulation remains largely unclear. We reviewed the current literature on the potential diagnostic and prognostic value of autonomic neurocardiac function assessment via analysis of HRV including time domain and spectral analysis techniques in patients with COVID-19. Furthermore, we discuss potential therapeutic targets of modulating neurocardiac function in this high-risk population including HRV biofeedback and the impact of long COVID on HRV as well as the approaches of clinical management. These topics might be of particular interest with respect to multimodal pandemic preparedness concepts.
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Affiliation(s)
- Luiz Schnekenberg
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Annahita Sedghi
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Daniela Schoene
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Lars-Peder Pallesen
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jessica Barlinn
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Felix Woitek
- Dresden Heart Center, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Axel Linke
- Dresden Heart Center, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Volker Puetz
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Kristian Barlinn
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Norman Mangner
- Dresden Heart Center, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Timo Siepmann
- Department of Neurology, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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21
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Schulder T, Rudenstine S, Ettman CK, Galea S. Correlates of long-COVID-19: the role of demographics, chronic illness, and psychiatric diagnosis in an urban sample. PSYCHOL HEALTH MED 2023; 28:1831-1843. [PMID: 36752386 DOI: 10.1080/13548506.2023.2177684] [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: 03/29/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
Long-COVID-19 symptoms are an emerging public health issue. This study sought to investigate demographics, chronic illness, and probable psychiatric diagnoses as correlates for long-COVID-19 in an urban adult sample. Self-report Qualtrics surveys were sent to students across City University of New York (CUNY) campuses in New York City in Winter 2021-2022. Binary logistic regressions were used to assess the relation of a range of factors with endorsement of long-COVID-19. Results demonstrated that Latinx participants endorsed higher odds of long-COVID-19, as compared to non-Latinx white participants. Participants who endorsed having a prior chronic illness and those who met the cut-off for probable psychiatric diagnoses all endorsed higher odds of long-COVID-19. Long-COVID-19 may be more likely among specific subpopulations and among persons with other ongoing physical and mental illness.
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Affiliation(s)
- Talia Schulder
- Department of Psychology, City College of New York, New York, NY, USA
| | - Sasha Rudenstine
- Department of Psychology, City College of New York, New York, NY, USA
| | | | - Sandro Galea
- Department of Psychology, City College of New York, New York, NY, USA
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22
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Mueller MR, Ganesh R, Hurt RT, Beckman TJ. Post-COVID Conditions. Mayo Clin Proc 2023; 98:1071-1078. [PMID: 37419575 DOI: 10.1016/j.mayocp.2023.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 07/09/2023]
Abstract
Postinfectious syndromes have been described since the Spanish influenza pandemic of 1918. A similar syndrome-post-COVID condition (PCC)-is common; it occurs months after COVID-19 infection and involves fatigue, postexertional malaise, dyspnea, memory loss, diffuse pain, and orthostasis. The medical, psychosocial, and economic impact of PCC is immense. In the United States, PCC has caused widespread unemployment and billions in lost wages. Risk factors for development of PCC are female sex and severity of acute COVID-19 infection. Proposed pathophysiologic mechanisms include central nervous system inflammation, viral reservoirs, persistent spike protein, cell receptor dysregulation, and autoimmunity. Because presenting symptoms are often vague, the approach to evaluation should be comprehensive with consideration of other diseases that could masquerade as PCC. Treatments of PCC are little researched, are largely expert based, and are likely to evolve as more evidence emerges. Current therapies, which are symptom targeted, include medications and nonpharmacologic therapies such as optimizing fluid intake, compression garments, progressive activity, meditation, biofeedback, cognitive rehabilitation, and addressing concomitant mood disorders. Many patients will enjoy significant improvements in their quality of life with multimodal treatments and longitudinal care.
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Affiliation(s)
| | | | - Ryan T Hurt
- Department of Medicine, Mayo Clinic, Rochester, MN
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23
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Najafi MB, Javanmard SH. Post-COVID-19 Syndrome Mechanisms, Prevention and Management. Int J Prev Med 2023; 14:59. [PMID: 37351054 PMCID: PMC10284243 DOI: 10.4103/ijpvm.ijpvm_508_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/24/2021] [Indexed: 06/24/2023] Open
Abstract
As the population of patients recovering from COVID-19 grows, post COVID-19 challenges are recognizing by ongoing evidences at once. Long COVID is defined as a syndrome with a range of persistent symptoms that remain long after (beyond 12 weeks) the acute SARS-CoV-2 infection. Studies have shown that long COVID can cause multi-organ damages with a wide spectrum of manifestations. Many systems, but not limited to, including respiratory, cardiovascular, nervous, gastrointestinal, and musculoskeletal systems, are involved in long COVID. Fatigue and dyspnea are the most common symptoms of long COVID. Long COVID-19 may be driven by tissue damage caused by virus-specific pathophysiologic changes or secondary to pathological long-lasting inflammatory response because of viral persistence, immune dysregulation, and autoimmune reactions. Some risk factors like sex and age, more than five early symptoms, and specific biomarkers have been revealed as a probable long COVID predicator discussed in this review. It seems that vaccination is the only way for prevention of long COVID and it can also help patients who had already long COVID. Managing long COVID survivors recommended being in a multidisciplinary approach, and a framework for identifying those at high risk for post-acute COVID-19 must be proposed. Possible therapeutic options and useful investigation tools for follow-up are suggested in this review. In sum, as evidence and researches are regularly updated, we provide the current understanding of the epidemiology, clinical manifestation, suspected pathophysiology, associated risk factors, and treatment options of long COVID in this review.
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Affiliation(s)
- Majed B. Najafi
- Applied Physiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh H. Javanmard
- Applied Physiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Šipetić T, Rajković D, Bogavac Stanojević N, Marinković V, Meštrović A, Rouse MJ. SMART Pharmacists Serving the New Needs of the Post-COVID Patients, Leaving No-One Behind. PHARMACY 2023; 11:pharmacy11020061. [PMID: 36961039 PMCID: PMC10037608 DOI: 10.3390/pharmacy11020061] [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: 01/15/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
This study aims to demonstrate the improvements in clinical symptoms in patients with post-COVID syndrome after a community pharmacy-based intervention in Serbia. The Pharmaceutical Chamber of Serbia ("Chamber") invited pharmacists to deliver post-COVID patient care counselling, supported by the SMART Pharmacist Program, offering education and guidance. Present symptoms, duration and patient self-reported severity of symptoms on a scale of 1-5 on the first visit were recorded. After the counselling and proposed self-medication treatment, the time of the follow-up visit and the severity of the recorded symptoms were also recorded. The prospective data collection lasted from December 2021 to September 2022. In total, 871 patients with post-COVID symptoms were included in the study, served by 53 pharmacists. The most frequently reported post-COVID symptoms coincided with the literature, mostly related to the respiratory system (51.2%), immunity status (32.2%), fatigue and exhaustion (30.7%), skin, hair and nails (27.4%) and cognitive functions (27.9%). A total of 26.5% of patients were referred to their family physician (general practitioner), and 69.5% returned to the pharmacist for a follow-up visit. On the first visit, the median severity of patients' symptoms was three, while on the second visit it dropped to one. The pharmacists' intervention led to a significant improvement in the post-COVID patients' condition.
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Affiliation(s)
- Tatjana Šipetić
- AU Lilly Drogerie, Patrijarha Dimitrija 14, 11090 Belgrade, Serbia
- The Pharmaceutical Chamber of Serbia, Mutapova 25, 11000 Belgrade, Serbia
- Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11000 Belgrade, Serbia
| | - Dragana Rajković
- The Pharmaceutical Chamber of Serbia, Mutapova 25, 11000 Belgrade, Serbia
| | | | - Valentina Marinković
- Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, 11000 Belgrade, Serbia
| | - Arijana Meštrović
- Pharma Expert Consultancy and Education, Deščevec 56, 10040 Zagreb, Croatia
| | - Michael J Rouse
- International Services Program, Accreditation Council for Pharmacy Education (ACPE), Chicago, IL 60603, USA
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25
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Milà López M, Jiménez Heffernan A, Sánchez de Mora E, Fierro Alanis MP. [Nuclear Cardiology in the COVID-19 pandemic]. Rev Esp Med Nucl Imagen Mol 2023; 42:106-112. [PMID: 36683949 PMCID: PMC9841071 DOI: 10.1016/j.remn.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
SARS-CoV-2 infection has a very important relationship with cardiovascular disease. Since the beginning of the pandemic, a close relationship has been observed between cardiovascular comorbidity and a worse prognosis in COVID-19 patients. The study of the pathophysiology of SARS-CoV-2 infection and cardiovascular disease suggests several concomitant hypotheses: direct myocardial damage by the virus, hypoxemia secondary to respiratory failure, inflammatory response to infection and/or thromboembolic phenomena. Cardiovascular damage can manifest in the acute phase of infection with acute myocardial infarction, myocarditis, arrhythmias..., during this phase Nuclear Cardiology procedures have not played a determining role in the diagnosis and management of these patients. On the other hand, in the subacute phase of the infection and in the post-acute COVID syndrome, Nuclear Cardiology seems to shed light on what happens in the cardiovascular system in this phase of the disease.The COVID-19 pandemic has represented a great challenge for health systems, with a significant reduction in non-urgent diagnostic procedures with the aim of reducing the risk of transmission to patients and health personnel. Nuclear Cardiology has not been an exception. In addition to the prioritization of urgent/non-deferrable procedures and general screening, hygiene and distance measures, the main organizations and scientific societies of Nuclear Medicine and Nuclear Cardiology released recommendations and guidelines for safe practice, introducing significant changes in myocardial perfusion SPECT protocols.
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Affiliation(s)
- M Milà López
- Servicio de Medicina Nuclear IDI, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España
| | - A Jiménez Heffernan
- Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, España
| | - E Sánchez de Mora
- Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, España
| | - M P Fierro Alanis
- Servicio de Medicina Nuclear IDI, Hospital Universitario de Tarragona Joan XXIII, Tarragona, España
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26
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Milà López M, Jiménez Heffernan A, Sánchez de Mora E, Fierro Alanis MP. Nuclear Cardiology in the COVID-19 pandemic. Rev Esp Med Nucl Imagen Mol 2023; 42:106-112. [PMID: 36681148 PMCID: PMC9847316 DOI: 10.1016/j.remnie.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/08/2023] [Indexed: 01/19/2023]
Abstract
SARS-CoV-2 infection has a very important relationship with cardiovascular disease. Since the beginning of the pandemic, a close relationship has been observed between cardiovascular comorbidity and a worse prognosis in COVID-19 patients. The study of the pathophysiology of SARS-CoV-2 infection and cardiovascular disease suggests several concomitant hypotheses: direct myocardial damage by the virus, hypoxemia secondary to respiratory failure, inflammatory response to infection and/or thromboembolic phenomena. Cardiovascular damage can manifest in the acute phase of infection with acute myocardial infarction, myocarditis, arrhythmias…, during this phase Nuclear Cardiology procedures have not played a determining role in the diagnosis and management of these patients. On the other hand, in the subacute phase of the infection and in the post-acute COVID syndrome, Nuclear Cardiology seems to shed light on what happens in the cardiovascular system in this phase of the disease. The COVID-19 pandemic has represented a great challenge for health systems, with a significant reduction in non-urgent diagnostic procedures with the aim of reducing the risk of transmission to patients and health personnel. Nuclear Cardiology has not been an exception. In addition to the prioritization of urgent/non-deferrable procedures and general screening, hygiene and distance measures, the main organizations and scientific societies of Nuclear Medicine and Nuclear Cardiology released recommendations and guidelines for safe practice, introducing significant changes in myocardial perfusion SPECT protocols.
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Affiliation(s)
- Marta Milà López
- Servicio de Medicina Nuclear IDI, Hospital Universitario de Tarragona Joan XXIII, Tarragona, Spain.
| | | | - Elena Sánchez de Mora
- Servicio de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
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27
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Chathoth AT, Anaswara N, Meethal AC, Vasudevan J, Gopal PV. Persisting and New Onset Symptomatology and Determinants of Functional Limitation of Post Acute COVID-19 Syndrome Cases- A Study from a Northern District of Kerala. Indian J Community Med 2023; 48:250-257. [PMID: 37323742 PMCID: PMC10263041 DOI: 10.4103/ijcm.ijcm_170_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023] Open
Abstract
Background COVID-19 disease has a wide range of persisting and new onset clinical manifestations even long after the acute phase. This study was conducted to identify the persisting and new onset symptomatology of post-COVID-19 syndrome patients from clinics in urban and peri-urban Kozhikode, South India, as well as to grade their functional limitation; assess the determinants and predictors. Material and Methods A cross-sectional study was conducted among 938 subjects attending the post-COVID clinics. Symptom profile, functional assessment, and limitation grading were done using the Post-COVID-19 Functional Status (PCFS) scale. Statistical analyses were done using the SPSS ver.20. Results Mean age was 41.50 ± 16.90 years. Fever, anosmia, dysgeusia, headache, and myalgia were the common acute COVID-19 symptoms (505,54%; 433,46.3%; 420,44.9%; 323,34.4%; 252,26.9%, respectively). Post-COVID-19, common persisting symptoms were myalgia (167,17.8%), fatigue (149,15.9%), dyspnea (113,12%), and headache (85,9.1%); the common new onset symptoms were shortness of breath and fatigue (228,24.3% and 220,23.4%, respectively). A total of 91 cases (9.7%) had post-COVID sleep disturbances; 16 (1.7%) had symptoms of anxiety and depressive thoughts. PCFS grading showed that 552 (63.8%) had negligible limitations (Grade I). Only one person had Grade IV limitation. Significant association (p < 0.05) was found between functional impairment grading by PCFS and age, gender, locality, type of family, duration of hospitalization, duration of unemployment following illness, source of infection, diabetes mellitus, and hypertension. Male gender, married status, CAD, and smoking had significant higher risks; urban locality and hospitalization decreased the risk. Conclusions SARS-CoV-2 cases have persistent and new onset symptoms and some degree of functional impairment post-COVID. Significant association was identified for various sociodemographic and clinical variables with the PCFS functional impairment grading.
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Affiliation(s)
- Anuradha Thalian Chathoth
- Department of Health Services, Government of Kerala, District Medical Office (Health), Kozhikode, Kerala, India
| | - Naveen Anaswara
- Department of Health Services, Government of Kerala, District Medical Office (Health), Kozhikode, Kerala, India
| | - Arjun Chathoth Meethal
- Department of Health Services, Government of Kerala, District Medical Office (Health), Kozhikode, Kerala, India
| | - Jayasree Vasudevan
- Department of Health Services, Government of Kerala, District Medical Office (Health), Kozhikode, Kerala, India
| | - Parvathi V. Gopal
- Department of Health Services, Government of Kerala, District Medical Office (Health), Kozhikode, Kerala, India
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28
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Non-Invasive Assessment of Vascular Circulation Based on Flow Mediated Skin Fluorescence (FMSF). BIOLOGY 2023; 12:biology12030385. [PMID: 36979077 PMCID: PMC10044925 DOI: 10.3390/biology12030385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
Flow Mediated Skin Fluorescence (FMSF) is a new non-invasive method for assessing vascular circulation and/or metabolic regulation. It enables assessment of both vasoconstriction and vasodilation. The method measures stimulation of the circulation in response to post-occlusive reactive hyperemia (PORH). It analyzes the dynamical changes in the emission of NADH fluorescence from skin tissue, providing the information on mitochondrial metabolic status and intracellular oxygen delivery through the circulatory system. Assessment of the vascular state using the FMSF technique is based on three parameters: reactive hyperemia response (RHR), hypoxia sensitivity (HS), and normoxia oscillatory index (NOI). The RHR and HS parameters determine the risk of vascular circulatory disorders and are the main diagnostic parameters. The NOI parameter is an auxiliary parameter for evaluating the state of microcirculation under stress of various origins (e.g., emotional stress, physical exhaustion, or post-infection stress). The clinical data show that the risk of vascular complications is limited among people whose RHR, log(HS), and NOI parameters are not significantly below the mean values determined by the FMSF technique, especially if they simultaneously meet the conditions RHR > 30% and log(HS) > 1.5 (HS > 30), and NOI > 60%.
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29
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de Andrade EC, Pinheiro LICC, Pinheiro PR, Nunes LC, Pinheiro MCD, Pereira MLD, de Abreu WC, Filho RH, Simão Filho M, Pinheiro PGCD, Nunes REC. Hybrid model for early identification post-Covid-19 sequelae. JOURNAL OF AMBIENT INTELLIGENCE AND HUMANIZED COMPUTING 2023; 14:1-14. [PMID: 36779007 PMCID: PMC9902243 DOI: 10.1007/s12652-023-04555-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Artificial Intelligence techniques based on Machine Learning algorithms, Neural Networks and Naïve Bayes can optimise the diagnostic process of the SARS-CoV-2 or Covid-19. The most significant help of these techniques is analysing data recorded by health professionals when treating patients with this disease. Health professionals' more specific focus is due to the reduction in the number of observable signs and symptoms, ranging from an acute respiratory condition to severe pneumonia, showing an efficient form of attribute engineering. It is important to note that the clinical diagnosis can vary from asymptomatic to extremely harsh conditions. About 80% of patients with Covid-19 may be asymptomatic or have few symptoms. Approximately 20% of the detected cases require hospital care because they have difficulty breathing, of which about 5% may require ventilatory support in the Intensive Care Unit. Also, the present study proposes a hybrid approach model, structured in the composition of Artificial Intelligence techniques, using Machine Learning algorithms, associated with multicriteria methods of decision support based on the Verbal Decision Analysis methodology, aiming at the discovery of knowledge, as well as exploring the predictive power of specific data in this study, to optimise the diagnostic models of Covid-19. Thus, the model will provide greater accuracy to the diagnosis sought through clinical observation.
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Affiliation(s)
- Evandro Carvalho de Andrade
- Graduate Program in Applied Informatics, University of Fortaleza, Fortaleza, Ceará Brazil
- Ceara State University, Fortaleza, Ceara Brazil
| | | | - Plácido Rogério Pinheiro
- Graduate Program in Applied Informatics, University of Fortaleza, Fortaleza, Ceará Brazil
- Ceara State University, Fortaleza, Ceara Brazil
| | - Luciano Comin Nunes
- Graduate Program in Applied Informatics, University of Fortaleza, Fortaleza, Ceará Brazil
- University Center September 7, Fortaleza, Ceara Brazil
| | | | | | | | | | - Marum Simão Filho
- Graduate Program in Applied Informatics, University of Fortaleza, Fortaleza, Ceará Brazil
- University Center September 7, Fortaleza, Ceara Brazil
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30
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Francis G, Thunell E. COVID-19 infection does not seem to affect cognition in college students. Conscious Cogn 2023; 108:103464. [PMID: 36680925 PMCID: PMC9829608 DOI: 10.1016/j.concog.2023.103464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/25/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
Emerging evidence indicates that COVID-19 damages the central nervous system and thereby might engender long-term cognitive impairment. Self-reports and some measures of cognitive ability suggest that long COVID can lead to substantial and frightening detriments in cognition. To further explore this issue, we used data from university courses on cognitive psychology where students participated in classic experiments that measure various aspects of cognition. Across 24 experiments we compared cognitive performance of students who had contracted COVID-19 against those who were uninfected. Using Bayes Factor analyses, we assessed both differences and invariances in performance as a function of infection status. Our findings suggest that COVID-19 infection has hardly any impact on cognition for university students.
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Affiliation(s)
- Gregory Francis
- Department of Psychological Sciences, Purdue University, West Lafayette, USA.
| | - Evelina Thunell
- Department of Psychological Sciences, Purdue University, West Lafayette, USA,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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31
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Abuhammad S, Alzoubi KH, Khabour OF, Hamaideh S, Khasawneh B. Sleep quality and sleep patterns among recovered individuals during post-COVID-19 among Jordanian: A cross-sectional national study. Medicine (Baltimore) 2023; 102:e32737. [PMID: 36701736 PMCID: PMC9857545 DOI: 10.1097/md.0000000000032737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This study aims to investigate sleep patterns and quality in patients who had SARS-CoV-2 (COVID-19) infection and to determine the sleep quality and pattern among patients. A cross-sectional design was used to assess sleeping patterns during the post-COVID-19 era for recovered individuals from April 1st, 2022, to June 1st, 2022. The participants had to meet the following requirements: both genders, ages 18 to 70, and previously infected with COVID-19. The prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was 834 (40.6%), and the prevalence of disturbance in sleep quality was 1308 (63.6%). Lower economic status and younger ages in twenties and thirties experienced more disturbances in sleep patterns than other older ages. Many predictors were determined the quality of sleep. These predictors were age (B = .105, P = .00), income (B = .05, P = .035) and educational level (B = .20, P = .006). To sum up, our study found that the prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was moderate, and the prevalence of disturbance in sleep quality was high. The predictors of quality of sleep were age, income, and educational level. Practitioners should be trained to evaluate and manage sleep disturbances, as this comprehensive approach has the potential to reduce mental distress and prevent the consequences of sleep disturbances.
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Affiliation(s)
- Sawsan Abuhammad
- Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, Jordan
- * Correspondence: Sawsan Abuhammad, Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid 22110, Jordan (e-mail: )
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Khabour
- Dept. of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Shaher Hamaideh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Basheer Khasawneh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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32
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Andreeva IG, Gvozdeva A, Pimenova V, Ryabkova V, Lukashenko M, Kamaeva E, Shapkina V, Soprun L, Gavrilova N, Fedotkina TV, Churilov LP, Shoenfeld Y. Assessment of Hearing and Vestibular Functions in a Post-COVID-19 Patient: A Clinical Case Study. Diagnostics (Basel) 2022; 13:diagnostics13010122. [PMID: 36611414 PMCID: PMC9819003 DOI: 10.3390/diagnostics13010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
SARS-CoV-2 infection may cause such complications as post-COVID-19 syndrome, which includes chronic fatigue, myalgia, arthralgia, as well as a variety of neurological manifestations, e.g., neuropathy of small fibers, hearing and vestibular dysfunction, and cognitive impairment. This clinical case describes a 41-year-old patient suffering from post-COVID-19 syndrome and chronic fatigue syndrome. A detailed examination was performed, including an in-depth study of peripheral and central hearing and vestibular functions, as well as small nerve fibers length and density in the skin and cornea of the eye. Contrary to expectations, no peripheral nervous system dysfunction was detected, despite the presence of dizziness and gait instability in the patient. Hearing tests (gap detection test and dichotic test) showed central auditory processing disorders. The evaluated lesion in the processing of temporal and verbal auditory information can be a significant factor contributing to additional overload of the neural activity and leading to chronic fatigue when performing daily activities in patients with CFS and post-COVID-19 complications.
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Affiliation(s)
- Irina Germanovna Andreeva
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences (IEPhB RAS), Laboratory of Comparative Sensory Physiology, 194223 St. Petersburg, Russia
| | - Alisa Gvozdeva
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences (IEPhB RAS), Laboratory of Comparative Sensory Physiology, 194223 St. Petersburg, Russia
| | - Vera Pimenova
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences (IEPhB RAS), Laboratory of Comparative Sensory Physiology, 194223 St. Petersburg, Russia
| | - Varvara Ryabkova
- Department of Therapy, Pavlov First St. Petersburg State Medical University, 197022 St. Petersburg, Russia
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 St. Petersburg, Russia
| | - Maria Lukashenko
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 St. Petersburg, Russia
| | - Evelina Kamaeva
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 St. Petersburg, Russia
| | - Valeria Shapkina
- Department of Hospital Surgery, Saint-Petersburg State University, 199034 St. Petersburg, Russia
| | - Lidia Soprun
- Department of Healthcare and Medical law, Saint-Petersburg State University, 199034 St. Petersburg, Russia
- Outpatient Clinic No. 1, Saint-Petersburg State University Clinic, 190103 St. Petersburg, Russia
| | - Natalia Gavrilova
- Outpatient Clinic No. 1, Saint-Petersburg State University Clinic, 190103 St. Petersburg, Russia
- Department of Faculty Therapy, Saint-Petersburg State University, 199034 St. Petersburg, Russia
- St. Petersburg Research Institute of Phthisiopulmonology of the Ministry of Health of the Russian Federation, 191036 St. Petersburg, Russia
- Correspondence:
| | - Tamara Viktorovna Fedotkina
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences (IEPhB RAS), Laboratory of Comparative Sensory Physiology, 194223 St. Petersburg, Russia
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 St. Petersburg, Russia
| | - Leonid Pavlovich Churilov
- St. Petersburg Research Institute of Phthisiopulmonology of the Ministry of Health of the Russian Federation, 191036 St. Petersburg, Russia
- Department of Pathology, Saint-Petersburg State University, 199034 St. Petersburg, Russia
| | - Yehuda Shoenfeld
- Laboratory of the Mosaic of Autoimmunity, Saint-Petersburg State University, 199034 St. Petersburg, Russia
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel HaShomer 5265601, Israel
- Sackler Faculty of Medicine, Ariel University, Ariel 40700, Israel
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Bautista-Rodriguez E, Cortés-Álvarez NY, Vuelvas-Olmos CR, Reyes-Meza V, González-López T, Flores-delosÁngeles C, Pérez-Silva NB, Aguirre-Alarcón HA, Cortez-Sanchez JL, Rocha-Rocha VM, Escobedo-Straffon J, Contreras-Mioni L, Reyes-Vergara ML. Stress, anxiety, depression and long COVID symptoms. FATIGUE: BIOMEDICINE, HEALTH & BEHAVIOR 2022. [DOI: 10.1080/21641846.2022.2154500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Elizabeth Bautista-Rodriguez
- Laboratory of Medical & Pharmaceutical Biotechnology, Faculty of Biotechnology, Universidad Popular Autónoma del Estado de Puebla (UPAEP), Puebla, Mexico
| | - Nadia Yanet Cortés-Álvarez
- Department of Nursing and Obstetrics, Division of Natural and Exact Sciences, Universidad de Guanajuato, Guanajuato, Mexico
| | | | - Verónica Reyes-Meza
- Centro Tlaxcala de Biología de la Conducta, Universidad Autonóma de Tlaxcala, Tlaxcala, Mexico
| | - Thelma González-López
- Center for Psychological, Educational, and Family Development, Comprehensive Health Clinic, UPAEP, Puebla, Mexico
| | | | | | - Héctor Alberto Aguirre-Alarcón
- Laboratory of Medical & Pharmaceutical Biotechnology, Faculty of Biotechnology, Universidad Popular Autónoma del Estado de Puebla (UPAEP), Puebla, Mexico
| | - Jose Luis Cortez-Sanchez
- Laboratory of Medical & Pharmaceutical Biotechnology, Faculty of Biotechnology, Universidad Popular Autónoma del Estado de Puebla (UPAEP), Puebla, Mexico
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Sasso EM, Muraki K, Eaton-Fitch N, Smith P, Lesslar OL, Deed G, Marshall-Gradisnik S. Transient receptor potential melastatin 3 dysfunction in post COVID-19 condition and myalgic encephalomyelitis/chronic fatigue syndrome patients. Mol Med 2022; 28:98. [PMID: 35986236 PMCID: PMC9388968 DOI: 10.1186/s10020-022-00528-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/24/2022] [Indexed: 10/30/2023] Open
Abstract
Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe multisystemic condition associated with post-infectious onset, impaired natural killer (NK) cell cytotoxicity and impaired ion channel function, namely Transient Receptor Potential Melastatin 3 (TRPM3). Long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has resulted in neurocognitive, immunological, gastrointestinal, and cardiovascular manifestations recently recognised as post coronavirus disease 2019 (COVID-19) condition. The symptomatology of ME/CFS overlaps significantly with post COVID-19; therefore, this research aimed to investigate TRPM3 ion channel function in post COVID-19 condition patients. Methods Whole-cell patch-clamp technique was used to measure TRPM3 ion channel activity in isolated NK cells of N = 5 ME/CFS patients, N = 5 post COVID-19 patients, and N = 5 healthy controls (HC). The TRPM3 agonist, pregnenolone sulfate (PregS) was used to activate TRPM3 function, while ononetin was used as a TRPM3 antagonist. Results As reported in previous research, PregS-induced TRPM3 currents were significantly reduced in ME/CFS patients compared with HC (p = 0.0048). PregS-induced TRPM3 amplitude was significantly reduced in post COVID-19 condition compared with HC (p = 0.0039). Importantly, no significant difference was reported in ME/CFS patients compared with post COVID-19 condition as PregS-induced TRPM3 currents of post COVID-19 condition patients were similar of ME/CFS patients currents (p > 0.9999). Isolated NK cells from post COVID-19 condition and ME/CFS patients were resistant to ononetin and differed significantly with HC (p < 0.0001). Conclusion The results of this investigation suggest that post COVID-19 condition patients may have impaired TRPM3 ion channel function and provide further evidence regarding the similarities between post COVID-19 condition and ME/CFS. Impaired TRPM3 channel activity in post COVID-19 condition patients suggest impaired ion mobilisation which may consequently impede cell function resulting in chronic post-infectious symptoms. Further investigation into TRPM3 function may elucidate the pathomechanism, provide a diagnostic and therapeutic target for post COVID-19 condition patients and commonalities with ME/CFS patients. Supplementary Information The online version contains supplementary material available at 10.1186/s10020-022-00528-y.
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Oliveira AMDSS, Carvalho MA, Nacul L, Cabar FR, Fabri AW, Peres SV, Zaccara TA, O’Boyle S, Alexander N, Takiuti NH, Mayaud P, Brizot MDL, Francisco RPV. Post-Viral Fatigue Following SARS-CoV-2 Infection during Pregnancy: A Longitudinal Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15735. [PMID: 36497810 PMCID: PMC9737157 DOI: 10.3390/ijerph192315735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Studies reported post-COVID-19 fatigue in the general population, but not among pregnant women. Our objectives were to determine prevalence, duration, and risk factors of post-viral fatigue among pregnant women with SARS-CoV-2. This study involved 588 pregnant women with SARS-CoV-2 during pregnancy or delivery in Brazil. Three groups were investigated: G1 (n = 259, symptomatic infection during pregnancy); G2 (n = 131, positive serology at delivery); G3 (n = 198, negative serology at delivery). We applied questionnaires investigating fatigue at determined timepoints after infection for G1, and after delivery for all groups; fatigue prevalence was then determined. Cox regression was used to estimate hazard ratio (HR) and 95% CI of the risk of remaining with fatigue in G1. Overall fatigue prevalence in G1 at six weeks, three months and six months were 40.6%, 33.6%, and 27.8%, respectively. Cumulative risk of remaining with fatigue increased over time, with HR of 1.69 (95% CI: 0.89-3.20) and 2.43 (95% CI: 1.49-3.95) for women with moderate and severe symptoms, respectively. Multivariate analysis showed cough and myalgia as independent risk factors in G1. Fatigue prevalence was significantly higher in G1 compared to G2 and G3. Post-viral fatigue prevalence is higher in women infected during pregnancy; fatigue's risk and duration increased with the severity of infection.
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Affiliation(s)
- Ana Maria da Silva Sousa Oliveira
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Mariana Azevedo Carvalho
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Luis Nacul
- Complex Chronic Diseases Program—BC Women’s Hospital and Health Centre, Vancouver, BC V6H 3N1, Canada
- Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Fábio Roberto Cabar
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Amanda Wictky Fabri
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Stela Verzinhasse Peres
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Tatiana Assuncao Zaccara
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | | | - Neal Alexander
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Nilton Hideto Takiuti
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Maria de Lourdes Brizot
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
| | - Rossana Pulcineli Vieira Francisco
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-000, Brazil
- Divisão de Obstetrícia e Ginecología, Hospital Universitário da Universidade de São Paulo, São Paulo 05508-000, Brazil
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36
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Cardiac function in relation to functional status and fatigue in patients with post-COVID syndrome. Sci Rep 2022; 12:19575. [PMID: 36380000 PMCID: PMC9664421 DOI: 10.1038/s41598-022-24038-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Patients with Post-COVID syndrome (PCS) are frequently referred for cardiologic evaluation. We assessed cardiac function and biomarkers in relation to functional status and fatigue in patients with PCS. This prospective single-center cohort study included 227 patients with persisting symptoms after COVID-19 infection. Most frequent complaints were fatigue (70%), dyspnea (56%), neurocognitive symptoms (34%) and chest pain (28%). Standardized questionnaires were used to assess Post-COVID-Functional-Scale (PCFS) and fatigue (MFI-20). The fatigue severity was inversely related to age and did not correlate with cardiovascular diseases, echocardiographic findings, or biomarkers. Similarly, mild to moderate functional impairment (PCFS 1-3) did not correlate with cardiovascular alterations. However, the subgroup of patients with significant functional impairment (PCFS = 4) had more frequent cardiovascular comorbidities, biomarkers and impaired global longitudinal strain (GLS). Patients with elevated troponin T showed abnormal GLS, reduced left ventricular ejection fraction and impaired tricuspid annular plane systolic excursion. The majority of patients with PCS shows a normal cardiac function. Only the small subgroup of patients with severe functional impairment and patients with elevated troponin T is at risk for impaired cardiac function and likely to benefit from specialized care by a cardiologist.
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37
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Campos MC, Nery T, Starke AC, de Bem Alves AC, Speck AE, S Aguiar A. Post-viral fatigue in COVID-19: A review of symptom assessment methods, mental, cognitive, and physical impairment. Neurosci Biobehav Rev 2022; 142:104902. [PMID: 36202253 PMCID: PMC9528075 DOI: 10.1016/j.neubiorev.2022.104902] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 12/14/2022]
Abstract
Coronavirus 2 is responsible for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), and the main sequela is persistent fatigue. Post-viral fatigue is common and affects patients with mild, asymptomatic coronavirus disease-2019 (COVID-19). However, the exact mechanisms involved in developing post-COVID-19 fatigue remain unclear. Furthermore, physical and cognitive impairments in these individuals have been widely described. Therefore, this review aims to summarize and propose tools from a multifaceted perspective to assess COVID-19 infection. Herein, we point out the instruments that can be used to assess fatigue in long-term COVID-19: fatigue in a subjective manner or fatigability in an objective manner. For physical and mental fatigue, structured questionnaires were used to assess perceived symptoms, and physical and cognitive performance assessment tests were used to measure fatigability using reduced performance.
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Affiliation(s)
| | | | | | | | | | - Aderbal S Aguiar
- Correspondence to: Labioex, Federal University of Santa Catarina, Pedro João Pereira, nº 150, Mato Alto, Araranguá, Santa Catarina, Brazil
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38
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Rudenstine S, Schulder T, Bhatt KJ, McNeal K, Ettman CK, Galea S. Long-COVID and comorbid depression and anxiety two years into the COVID-19 pandemic. Psychiatry Res 2022; 317:114924. [PMID: 37732865 PMCID: PMC9597528 DOI: 10.1016/j.psychres.2022.114924] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/16/2022] [Accepted: 10/22/2022] [Indexed: 11/24/2022]
Abstract
Long-COVID, or the persistence of COVID-19 symptoms for months after initial infection, has been shown to impact the lives of those affected. The current study sought to investigate the relationships between long-COVID, COVID-19 related stress, depression, anxiety, and comorbid depression and anxiety outcomes. Data were collected in Winter 2021-2022 from a population of adults enrolled in at least one course across multiple City University of New York (CUNY) campuses. Frequencies and chi-square tests were computed to assess for demographics and relationships to probable diagnoses of depression and anxiety, and binary logistic regressions were computed to assess for the odds of probable comorbid depression and anxiety based on demographics, stressors, and long-COVID. Women participants reported higher odds of probable depression outcomes, and stressor levels were significant correlates of probable anxiety outcomes. Women participants, 3.2 [1.5-6.9], as compared to men, lower-SES participants, 2.16 [1.1-4.2], as compared to higher-SES participants, participants with higher COVID-19 related stress levels, 4.8 [2.0-12.0], as compared to those with low levels, and participants with long-COVID, 3.7 [1.9-7.0], as compared to those without, all had higher odds of probable comorbid depression and anxiety. Findings highlight the importance of social location, stress, and long-COVID, in tandem, as correlates of psychological health during the shifting pandemic.
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Affiliation(s)
- Sasha Rudenstine
- Department of Psychology, City College of New York, 160 Convent Avenue NAC 8/122B, New York, NY 10031, United States.
| | - Talia Schulder
- Department of Psychology, City College of New York, 160 Convent Avenue NAC 8/122B, New York, NY 10031, United States.
| | - Krish J Bhatt
- Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States
| | - Kat McNeal
- Department of Psychology, City College of New York, 160 Convent Avenue NAC 8/122B, New York, NY 10031, United States
| | - Catherine K Ettman
- School of Public Health, Boston University, 715 Albany St, Boston, MA 02118, United States
| | - Sandro Galea
- School of Public Health, Boston University, 715 Albany St, Boston, MA 02118, United States
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Retornaz F, Rebaudet S, Stavris C, Jammes Y. Long-term neuromuscular consequences of SARS-Cov-2 and their similarities with myalgic encephalomyelitis/chronic fatigue syndrome: results of the retrospective CoLGEM study. Lab Invest 2022; 20:429. [PMID: 36153556 PMCID: PMC9509619 DOI: 10.1186/s12967-022-03638-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Patients with long-COVID often complain of continuous fatigue, myalgia, sleep problems, cognitive dysfunction, and post-exertional malaise. No data are available on EMG recording of evoked myopotentials (M-waves) or exercise-induced alterations in long-COVID patients, providing evidence of muscle membrane fatigue. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) develops in more than half of patients after an infectious disease, particularly viral diseases. A large proportion (around 70%) of these patients have neuromuscular disorders with M-wave alterations during and after exercise. Our hypothesis was that M-wave alterations would be also found in long-COVID patients, in association with neuromuscular symptoms, similar to ME/CFS.
Methods
This retrospective observational ColGEM (Covid LonG Encéphalomyelite Myalgique) study compared 59 patients with long-COVID and 55 ME/CFS patients with a history of severe infection who presented before the COVID pandemic. All of these patients underwent the same protocol consisting of a questionnaire focusing on neural and neuromuscular disorders and M-wave recording in the rectus femoris muscle before, during, and 10 min after a progressive cycling exercise. Maximal handgrip strength (MHGS) and maximal exercise power were also measured. The frequency of symptoms and magnitude of M-wave changes in the two groups were compared using non-parametric and parametric tests.
Results
The frequency of fatigue, myalgia, sleep problems, cognitive dysfunction, and post-exertional malaise as well as the magnitude of exercise-induced M-wave alterations were the same in the two groups. By contrast, digestive problems were less present in long-COVID. M-wave alterations were greater in ME/CFS patients as in those with long-COVID when the highest muscle strength and highest exercise performance were measured.
Conclusions
These high clinical and biological similarities between long-COVID and ME/CFS support the hypothesis that SARS-Cov-2 infection can cause ME/CFS symptoms.
Trial registration Registered retrospectively.
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40
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Kimmig LM, Rako ZA, Ziegler S, Richter MJ, G S AT, Roller F, Grimminger F, Vadász I, Seeger W, Herold S, Tello K, Matt U. Long-term comprehensive cardiopulmonary phenotyping of COVID-19. Respir Res 2022; 23:263. [PMID: 36131349 PMCID: PMC9491263 DOI: 10.1186/s12931-022-02173-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Persistent symptoms after initial COVID-19 infection are common and are frequently referred to by the umbrella terms “post-COVID syndrome” and “long COVID”. The sheer number of affected patients pose an increasing challenge to healthcare systems worldwide. To date, our understanding of the pathophysiology of the post-COVID syndrome remains poor and the extent to which persistent cardiopulmonary abnormalities contribute to the symptom complex is unclear. We sought to determine the presence and impact of cardiopulmonary sequelae after COVID-19 in longitudinal assessment. Methods We report on 71 patients who underwent comprehensive, longitudinal testing in regular intervals for up to 12 months after their initial COVID-19 diagnosis. Testing included pulmonary function testing, cardiopulmonary exercise testing, dedicated left and right heart echocardiography, lung ultrasonography, and cardiac MRI. Results Our results demonstrate that subjective quality of life after COVID-19 (EQ-5D visual acuity scale, VAS, 67.4 for patients treated as outpatient, 79.2 for patients admitted to the general floor, 71.8 for patients treated in an ICU) is not related to the severity of the initial infection. Maximal exercise capacity is also reduced (VO2max 79% predicted, SD ± 19%); however, this is driven in large parts by patients who had initially required ICU-level of care. The degree of objective reduction in exertion did not correlate with quality of life scores. Pulmonary function testing revealed mild and persistent reduction in DLCO over the first 12 months without significant restrictive or obstructive lung disease. Left and right heart function was intact with good RV function and intact RV/PA coupling, imaging findings suggestive of myocarditis were uncommon (7% of patients). Conclusion A reduction in exercise capacity after COVID-19 is common, but is most prominent in patients previously treated in the ICU and more likely related to deconditioning or fatigue than to cardiopulmonary impairment. Subjective quality of life scores are independent of the severity of initial infection and do not correlate with objective measures of cardiopulmonary function. In our cohort, persistent cardiopulmonary impairment after COVID-19 was uncommon. The post-COVID syndrome is unlikely to be the result of cardiopulmonary sequalae and may reflect a post-ICU syndrome in some. Trial registration Registered on clinicaltrials.gov (NCT04442789), Date: June 23, 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02173-9.
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Affiliation(s)
- Lucas M Kimmig
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany. .,Section of Pulmonary and Critical Care, Department of Medicine, The University of Chicago, Chicago, IL, USA.
| | - Zvonimir A Rako
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Stefanie Ziegler
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Manuel J Richter
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Ashkan Tolou G S
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Fritz Roller
- Department of Radiology, University Hospital Giessen, Giessen, Germany
| | - Friedrich Grimminger
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany.,Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany.,Excellence Cluster Cardio-Pulmonary Institute (CPI), Giessen, Germany
| | - István Vadász
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany.,Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany.,Excellence Cluster Cardio-Pulmonary Institute (CPI), Giessen, Germany
| | - Werner Seeger
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany.,Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany.,Excellence Cluster Cardio-Pulmonary Institute (CPI), Giessen, Germany.,Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Susanne Herold
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany.,Institute for Lung Health (ILH), Justus Liebig University Giessen, Giessen, Germany.,Excellence Cluster Cardio-Pulmonary Institute (CPI), Giessen, Germany
| | - Khodr Tello
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Ulrich Matt
- Department of Internal Medicine II, Universities of Giessen and Marburg Lung Center, Justus Liebig University, Member of the German Center for Lung Research (DZL), Giessen, Germany
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41
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Chudzik M, Cender A, Mordaka R, Zielinski J, Katarzynska J, Marcinek A, Gebicki J. Chronic Fatigue Associated with Post-COVID Syndrome versus Transient Fatigue Caused by High-Intensity Exercise: Are They Comparable in Terms of Vascular Effects? Vasc Health Risk Manag 2022; 18:711-719. [PMID: 36097586 PMCID: PMC9464031 DOI: 10.2147/vhrm.s371468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The pathophysiology of chronic fatigue associated with post-COVID syndrome is not well recognized. It is assumed that this condition is partly due to vascular dysfunction developed during an acute phase of infection. There is great demand for a diagnostic tool that is able to clinically assess post-COVID syndrome and monitor the rehabilitation process. Patients and Methods The Flow Mediated Skin Fluorescence (FMSF) technique appears uniquely suitable for the analysis of basal microcirculatory oscillations and reactive hyperemia induced by transient ischemia. The FMSF was used to measure vascular circulation in 45 patients with post-COVID syndrome. The results were compared with those for a group of 26 amateur runners before and after high-intensity exercise as well as for a control group of 32 healthy age-matched individuals. Results Based on the observed changes in the NOI (Normoxia Oscillatory Index) and RHR (Reactive Hyperemia Response) parameters measured with the FMSF technique, it was found that chronic fatigue associated with post-COVID syndrome is comparable with transient fatigue caused by high-intensity exercise in terms of vascular effects, which are associated with vascular stress in the macrocirculation and microcirculation. Acute and chronic fatigue symptomatology shared similarly altered changes in the NOI and RHR parameters and both can be linked to calcium homeostasis modification. Conclusion The NOI and RHR parameters measured with the FMSF technique can be used for non-invasive clinical assessment of post-COVID syndrome as well as for monitoring the rehabilitation process.
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Affiliation(s)
- Michal Chudzik
- Medical Center, Saint Family Hospital, Lodz, Poland.,Department of Internal Medicine and Geronto-Cardiology, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - Anna Cender
- Medical Center, Saint Family Hospital, Lodz, Poland
| | | | - Jacek Zielinski
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | | | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland.,Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland.,Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
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42
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Busatto GF, de Araujo AL, Castaldelli-Maia JM, Damiano RF, Imamura M, Guedes BF, de Rezende Pinna F, Sawamura MVY, Mancini MC, da Silva KR, Garcia ML, Sumita N, Brunoni AR, da Silva Duarte AJ, Burdmann EA, Kallas EG, Cerri GG, Nitrini R, Bento RF, Rocha VG, de Souza HP, Miguel EC, de Carvalho CRR, Forlenza OV, Batistella LR. Post-acute sequelae of SARS-CoV-2 infection: relationship of central nervous system manifestations with physical disability and systemic inflammation. Psychol Med 2022; 52:2387-2398. [PMID: 35521752 PMCID: PMC9151630 DOI: 10.1017/s0033291722001374] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Despite the multitude of clinical manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC), studies applying statistical methods to directly investigate patterns of symptom co-occurrence and their biological correlates are scarce. METHODS We assessed 30 symptoms pertaining to different organ systems in 749 adults (age = 55 ± 14 years; 47% female) during in-person visits conducted at 6-11 months after hospitalization due to coronavirus disease 2019 (COVID-19), including six psychiatric and cognitive manifestations. Symptom co-occurrence was initially investigated using exploratory factor analysis (EFA), and latent variable modeling was then conducted using Item Response Theory (IRT). We investigated associations of latent variable severity with objective indices of persistent physical disability, pulmonary and kidney dysfunction, and C-reactive protein and D-dimer blood levels, measured at the same follow-up assessment. RESULTS The EFA extracted one factor, explaining 64.8% of variance; loadings were positive for all symptoms, and above 0.35 for 16 of them. The latent trait generated using IRT placed fatigue, psychiatric, and cognitive manifestations as the most discriminative symptoms (coefficients > 1.5, p < 0.001). Latent trait severity was associated with decreased body weight and poorer physical performance (coefficients > 0.240; p ⩽ 0.003), and elevated blood levels of C-reactive protein (coefficient = 0.378; 95% CI 0.215-0.541; p < 0.001) and D-dimer (coefficient = 0.412; 95% CI 0.123-0.702; p = 0.005). Results were similar after excluding subjects with pro-inflammatory comorbidities. CONCLUSIONS Different symptoms that persist for several months after moderate or severe COVID-19 may unite within one latent trait of PASC. This trait is dominated by fatigue and psychiatric symptoms, and is associated with objective signs of physical disability and persistent systemic inflammation.
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Affiliation(s)
- Geraldo F. Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
- Diretoria Executiva dos LIMs, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Adriana Ladeira de Araujo
- Diretoria Executiva dos LIMs, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - João Mauricio Castaldelli-Maia
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
- Departamento de Neurociências, Centro Universitário da Faculdade de Medicina do ABC, São Paulo, SP, Brasil
| | - Rodolfo Furlan Damiano
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Marta Imamura
- Departamento de Medicina Legal, Etica Medica e Medicina Social e do Trabalho, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Bruno F. Guedes
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Fabio de Rezende Pinna
- Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Marcio Valente Yamada Sawamura
- Departamento de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Márcio C. Mancini
- Unidade de Obesidade e Síndrome Metabólica, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Katia R. da Silva
- Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Michelle L. Garcia
- Divisão de Pneumologia, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Nairo Sumita
- Departamento de Patologia Clínica, LIM/03 – Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Andre Russowsky Brunoni
- Departamento de Clínica Médica, LIM/27 – Laboratório de Neurociências, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Alberto J. da Silva Duarte
- Departamento de Dermatologia, Laboratório de Dermatologia e Imunodeficiências, LIM-56, Faculdade de Medicina e Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brasil
| | - Emmanuel A. Burdmann
- Departamento de Clínica Médica, LIM/12 – Laboratório de Pesquisa Básica em Doenças Renais, Disciplina de Nefrologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Esper G. Kallas
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Giovanni G. Cerri
- Departamento de Radiologia, Faculdade de Medicina, LIM/44, Laboratório de Ressonância Magnética em Neurorradiologia Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Ricardo Nitrini
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Ricardo F. Bento
- Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
- Divisão de Otorrinolaringologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Vanderson Geraldo Rocha
- Serviço de Hematologia, Hemoterapia e Terapia Celular, Divisão de Clínica Médica I do ICHC, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Heraldo Possolo de Souza
- Departamento de Clínica Médica, Disciplina de Emergências Clínicas, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Euripedes C. Miguel
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Carlos R. R. de Carvalho
- Divisão de Pneumologia, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Orestes V. Forlenza
- Departamento e Instituto de Psiquiatria, Laboratório de Neurociências – LIM-27, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
| | - Linamara Rizzo Batistella
- Departamento de Medicina Legal, Etica Medica e Medicina Social e do Trabalho, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brasil
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Sukocheva OA, Maksoud R, Beeraka NM, Madhunapantula SV, Sinelnikov M, Nikolenko VN, Neganova ME, Klochkov SG, Amjad Kamal M, Staines DR, Marshall-Gradisnik S. Analysis of post COVID-19 condition and its overlap with myalgic encephalomyelitis/chronic fatigue syndrome. J Adv Res 2022; 40:179-196. [PMID: 36100326 PMCID: PMC8619886 DOI: 10.1016/j.jare.2021.11.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19) triggers the development of numerous pathologies and infection-linked complications and exacerbates existing pathologies in nearly all body systems. Aside from the primarily targeted respiratory organs, adverse SARS-CoV-2 effects were observed in nervous, cardiovascular, gastrointestinal/metabolic, immune, and other systems in COVID-19 survivors. Long-term effects of this viral infection have been recently observed and represent distressing sequelae recognised by the World Health Organisation (WHO) as a distinct clinical entity defined as post-COVID-19 condition. Considering the pandemic is still ongoing, more time is required to confirm post COVID-19 condition diagnosis in the COVID-19 infected cohorts, although many reported post COVID-19 symptoms overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). AIMS OF REVIEW In this study, COVID-19 clinical presentation and associated post-infection sequelae (post-COVID-19 condition) were reviewed and compared with ME/CFS symptomatology. KEY SCIENTIFIC CONCEPTS OF REVIEW The onset, progression, and symptom profile of post COVID-19 condition patients have considerable overlap with ME/CFS. Considering the large scope and range of pro-inflammatory effects of this virus, it is reasonable to expect development of post COVID-19 clinical complications in a proportion of the affected population. There are reports of a later debilitating syndrome onset three months post COVID-19 infection (often described as long-COVID-19), marked by the presence of fatigue, headache, cognitive dysfunction, post-exertional malaise, orthostatic intolerance, and dyspnoea. Acute inflammation, oxidative stress, and increased levels of interleukin-6 (IL-6) and tumor necrosis factor α (TNFα), have been reported in SARS-CoV-2 infected patients. Longitudinal monitoring of post COVID-19 patients is warranted to understand the long-term effects of SARS-CoV-2 infection and the pathomechanism of post COVID-19 condition.
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Affiliation(s)
- Olga A Sukocheva
- College of Nursing and Health Sciences, Flinders University of South Australia, Bedford Park 5042, SA, Australia; The National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
| | - Rebekah Maksoud
- The National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Consortium Health International for Myalgic Encephalomyelitis, National Centre for Neuroimmunology and Emerging Diseases, Griffith University, Gold Coast, QLD, Australia
| | - Narasimha M Beeraka
- Department of Biochemistry, Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), JSS Academy of Higher Education & Research (JSS AHER), Mysore, India
| | - SabbaRao V Madhunapantula
- Department of Biochemistry, Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), JSS Academy of Higher Education & Research (JSS AHER), Mysore, India; Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore, India
| | - Mikhail Sinelnikov
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mohovaya 11c10, Moscow, Russia
| | - Vladimir N Nikolenko
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Mohovaya 11c10, Moscow, Russia
| | - Margarita E Neganova
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka 142432, Russia
| | - Sergey G Klochkov
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka 142432, Russia
| | - Mohammad Amjad Kamal
- King Fahd Medical Research Center, King Abdulaziz University, P. O. Box 80216, Jeddah 21589, Saudi Arabia; Enzymoics, 7 Peterlee Place, Novel Global Community Educational Foundation, Hebersham, NSW 2770, Australia
| | - Donald R Staines
- The National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Consortium Health International for Myalgic Encephalomyelitis, National Centre for Neuroimmunology and Emerging Diseases, Griffith University, Gold Coast, QLD, Australia
| | - Sonya Marshall-Gradisnik
- The National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Consortium Health International for Myalgic Encephalomyelitis, National Centre for Neuroimmunology and Emerging Diseases, Griffith University, Gold Coast, QLD, Australia
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Zasadzka E, Tobis S, Trzmiel T, Marchewka R, Kozak D, Roksela A, Pieczyńska A, Hojan K. Application of an EMG-Rehabilitation Robot in Patients with Post-Coronavirus Fatigue Syndrome (COVID-19)-A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10398. [PMID: 36012033 PMCID: PMC9407702 DOI: 10.3390/ijerph191610398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/07/2022] [Accepted: 08/17/2022] [Indexed: 05/27/2023]
Abstract
This pilot study aimed to assess the safety and feasibility of an EMG-driven rehabilitation robot in patients with Post-Viral Fatigue (PVF) syndrome after COVID-19. The participants were randomly assigned to two groups (IG-intervention group and CG-control group) in an inpatient neurological rehabilitation unit. Both groups were assessed on admission and after six weeks of rehabilitation. Rehabilitation was carried out six days a week for six weeks. The patients in the IG performed additional training using an EMG rehabilitation robot. Muscle fatigue was assessed using an EMG rehabilitation robot; secondary outcomes were changes in hand grip strength, Fatigue Assessment Scale, and functional assessment scales (Functional Independence Measure, Barthel Index). Both groups improved in terms of the majority of measured parameters comparing pre- and post-intervention results, except muscle fatigue. Muscle fatigue scores presented non-significant improvement in the IG and non-significant deterioration in the CG. Using an EMG rehabilitation robot in patients with PVF can be feasible and safe. To ascertain the effectiveness of such interventions, more studies are needed, particularly involving a larger sample and also assessing the participants' cognitive performance.
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Affiliation(s)
- Ewa Zasadzka
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Sławomir Tobis
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Tomasz Trzmiel
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Renata Marchewka
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland
| | - Dominika Kozak
- Department of Physiotherapy, University of Health Science, 85-067 Bydgoszcz, Poland
- Egzotech sp. z o.o., 44-100 Gliwice, Poland
| | - Anna Roksela
- Egzotech sp. z o.o., 44-100 Gliwice, Poland
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Anna Pieczyńska
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Katarzyna Hojan
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-781 Poznan, Poland
- Neurorehabilitation Ward, Greater Poland Provincial Hospital, 60-480 Poznan, Poland
- Department of Rehabilitation, Greater Poland Cancer Centre, 61-866 Poznan, Poland
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45
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Xu B. The impact of COVID-19 on the doctor-patient relationship in China. Front Public Health 2022; 10:907009. [PMID: 35979467 PMCID: PMC9376673 DOI: 10.3389/fpubh.2022.907009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
A strong doctor-patient relationship (DPR) is crucial to the effectiveness of treatment. It is imperative to maintain a good DPR during treatment. During 2019, Coronavirus Disease 2019 (COVID-19) brought new challenges to already difficult doctor-patient relationships. This paper summarized the current state of the DPR, compared the changes between China and other countries after the outbreak of COVID-19, and listed the solutions proposed by various countries. Finally, the author suggested some solutions in order to improve the DPR according to China's own circumstances.
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Affiliation(s)
- Bo Xu
- Medical Humanity and Information Management College, Hunan University of Medicine, Huaihua, China
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46
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Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is an unprecedented challenge for the global community. The pathogenesis of COVID-19, its complications and long term sequelae (so called Long/Post-COVID) include, in addition to the direct virus-induced tissues injury, multiple secondary processes, such as autoimmune response, impairment of microcirculation, and hyperinflammation. Similar pathological processes, but in the settings of neurological, cardiovascular, rheumatological, nephrological, and dermatological diseases can be successfully treated by powerful methods of Therapeutic Apheresis (TA). We describe here the rationale and the initial attempts of TA treatment in severe cases of acute COVID-19. We next review the evidence for the role of autoimmunity, microcirculatory changes and inflammation in pathogenesis of Long/Post COVID and the rationale for targeting those pathogenic processes by different methods of TA. Finally, we discuss the impact of COVID-19 pandemic on patients, who undergo regular TA treatments due to their underlying chronic conditions, with the specific focus on the patients with inherited lipid diseases being treated at the Dresden University Apheresis Center.
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Affiliation(s)
- Sergey Tselmin
- University Hospital Carl Gustav Carus, Lipidology and Center for Extracorporeal Therapy, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Ulrich Julius
- University Hospital Carl Gustav Carus, Lipidology and Center for Extracorporeal Therapy, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Natalia Jarzebska
- University Hospital Carl Gustav Carus, University Center for Vascular Medicine, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - Roman N Rodionov
- University Hospital Carl Gustav Carus, Lipidology and Center for Extracorporeal Therapy, University Center for Vascular Medicine, Department of Medicine III, Technische Universität Dresden, Dresden, Germany
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Khaswal A, Kumar V, Kumar S. Long-Term Health Consequences of SARS-CoV-2: Assumptions Based on SARS-CoV-1 and MERS-CoV Infections. Diagnostics (Basel) 2022; 12:diagnostics12081852. [PMID: 36010203 PMCID: PMC9406530 DOI: 10.3390/diagnostics12081852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus Disease-2019 (COVID-19) is one of the worst pandemics in the history of the world. It is the third coronavirus disease that has afflicted humans in a short span of time. The world appears to be recovering from the grasp of this deadly pandemic; still, its post-disease health effects are not clearly understood. It is evident that the vast majority of COVID-19 patients usually recovered over time; however, disease manifestation is reported to still exist in some patients even after complete recovery. The disease is known to have left irreversible damage(s) among some patients and these damages are expected to cause mild or severe degrees of health effects. Apart from the apparent damage to the lungs caused by SARS-CoV-1, MERS-CoV, and SARS-CoV-2 infection, COVID-19-surviving patients display a wide spectrum of dysfunctions in different organ systems that is similar to what occurs with SARS-CoV-1 and MERS diseases. The major long COVID-19 manifestations include the following aspects: (1) central nervous system, (2) cardiovascular, (3) pulmonary, (4) gastrointestinal, (5) hematologic, (6) renal and (7) psycho-social systems. COVID-19 has a disease display manifestation in these organs and its related systems amongst a large number of recovered cases. Our study highlights the expected bodily consequences of the pandemic caused by SARS-CoV-2 infection based on the understanding of the long-term effects of SARS-CoV-1 and MERS-CoV.
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Affiliation(s)
- Ashutosh Khaswal
- Department of Biotechnology, IMS Engineering College, NH-24, Ghaziabad 201009, Uttar Pradesh, India; (A.K.); (V.K.)
| | - Vivek Kumar
- Department of Biotechnology, IMS Engineering College, NH-24, Ghaziabad 201009, Uttar Pradesh, India; (A.K.); (V.K.)
| | - Subodh Kumar
- Center of Emphasis in Neuroscience, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Drive, El Paso, TX 79905, USA
- Correspondence:
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48
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Barbagelata L, Masson W, Iglesias D, Lillo E, Migone JF, Orazi ML, Maritano Furcada J. Cardiopulmonary Exercise Testing in Patients with Post-COVID-19 Syndrome. MEDICINA CLINICA (ENGLISH ED.) 2022; 159:6-11. [PMID: 35814791 PMCID: PMC9254647 DOI: 10.1016/j.medcle.2021.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/20/2021] [Indexed: 01/31/2023]
Abstract
Background and aim Several reports have shown the persistence of long term symptoms after the initial COVID-19 infection (post-COVID-19 syndrome). The objective of this study was to analyze the characteristics of cardiopulmonary exercise testing (CPET) performed in patients with a history of COVID-19, comparing subjects according to the presence of post-COVID-19 syndrome. Methods A cross-sectional study was performed. Consecutive patients >18 years with history of SARS-CoV-2 infection confirmed by polymerase chain reaction test and a CPET performed between 45 and 120 days after the viral episode were included. The association between variables related to CPET and post-COVID-19 syndrome was assessed using univariate and multivariate analysis. Results A total of 200 patients (mean age 48.8 ± 14.3 years, 51% men) were included. Patients with post-COVID-19 syndrome showed significantly lower main peak VO2 (25.8 ± 8.1 mL/min/kg vs. 28.8 ± 9.6 mL/min/kg, p = 0.017) as compared to asymptomatic subjects. Moreover, patients with post-COVID-19 syndrome developed symptoms more frequently during CPET (52.7% vs. 13.7%, p < 0.001) and were less likely to reach the anaerobic threshold (50.9% vs. 72.7%, p = 0.002) when compared to asymptomatic subjects. These findings were not modified when adjusting for confounders. Conclusion Our data suggest that post-COVID-19 syndrome was associated with less peak VO2, a lower probability of achieving the anaerobic threshold and a higher probability of presenting symptoms during the CPET. Future studies are needed to determine if these abnormalities during CPET would have prognostic value.
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Affiliation(s)
- Leandro Barbagelata
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina,Corresponding author
| | - Walter Masson
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Diego Iglesias
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Ezequiel Lillo
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Juan Francisco Migone
- Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Maria Laura Orazi
- Pulmonology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
| | - Joaquin Maritano Furcada
- Pulmonology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina
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Merz EL, Gholizadeh S. Mental and Physical Health Concerns in the Context of COVID-19: Opportunities and Applications for Behavioral Medicine. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:292-300. [PMID: 37205014 PMCID: PMC10172526 DOI: 10.1176/appi.focus.20220044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Numerous physical and mental health concerns have been documented in the context of COVID-19, and it is likely that patients, survivors, frontline health care workers, and other affected individuals will present to psychiatry for treatment. Behavioral medicine, an interdisciplinary field that is defined by a behavioral and biomedical conceptualization of clinical care, offers an opportunity for collaboration with psychiatry and other health care providers to meet the myriad needs resulting from the pandemic. This review summarizes a conceptual framework of behavioral medicine and clinical health psychology, COVID-19-related quality of life concerns that may be applicable to behavioral medicine referrals, clinical assessment directions, and intervention opportunities. The review combines both findings specific to COVID-19 and general behavioral medicine principles with an overall goal of providing a basic introduction to behavioral medicine practice, applications, and opportunities for management of medical and psychological symptoms.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, College of Natural and Behavioral Sciences, California State University, Dominguez Hills, Carson (Merz); TheKey Research Group™, San Diego (Gholizadeh)
| | - Shadi Gholizadeh
- Department of Psychology, College of Natural and Behavioral Sciences, California State University, Dominguez Hills, Carson (Merz); TheKey Research Group™, San Diego (Gholizadeh)
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Shivani FNU, Kumari N, Bai P, Rakesh FNU, Haseeb M, Kumar S, Jamil A, Zaidi M, Shaukat F, Rizwan A. Long-Term Symptoms of COVID-19: One-Year Follow-Up Study. Cureus 2022; 14:e25937. [PMID: 35844318 PMCID: PMC9282616 DOI: 10.7759/cureus.25937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/05/2022] Open
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