1
|
Hapfelmeier A, Donhauser J, Teusen C, Eck S, Schneider A. Frequency, persistence and relation of disease symptoms, psychosomatic comorbidity and daily life impairment after COVID-19: a cohort study in general practice. BMC PRIMARY CARE 2024; 25:295. [PMID: 39127653 DOI: 10.1186/s12875-024-02551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Long-lasting symptoms with a possible relation to psychosomatic comorbidity have been described following COVID-19. However, data is sparse in general practice. The trial's objective was to investigate the time-dependent frequency of disease symptoms and relation to psychosomatic comorbidity and daily life impairment (DLI). METHODS Comparative cohort study of patients reporting a previous SARS-CoV-2 infection and uninfected controls in general practice. Participants were recruited in 14 general practices in the greater Munich area. Data collection was questionnaire based with a 12 months follow-up. Descriptive statistics, multivariable regression and bivariate correlations were used for analysis. RESULTS A total of n = 204 cases infected up to 42 months ago (n = 141 Omicron, n = 63 earlier variants), and n = 119 controls were included. Disease symptoms were substantially more prevalent in cases (55-79% vs. 43% within one year of infection). This difference also appeared in the multivariable analysis adjusting for socio-demographics and psychosomatic comorbidity with odds ratios (OR) of 4.15 (p < 0.001) and 3.51 (p = 0.054) for the cohorts with Omicron or earlier variants infection (vs. controls), respectively. It was persistent with earlier variants (OR 1.00 per month, p = 0.903), while a decreasing trend was observed for Omicron (OR 0.89 per month, p < 0.001). DLI was especially correlated with fatigue (r = 0.628). CONCLUSION DLI, psychosomatic comorbidity and independently increased disease symptoms require holistic treatment of the patient in general practice according to the bio-psycho-social model. A key role in restoring the daily life capability may be attributed to the symptom fatigue.
Collapse
Affiliation(s)
- Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
| | - Jan Donhauser
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Clara Teusen
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stefanie Eck
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Antonius Schneider
- Institute of General Practice and Health Services Research, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| |
Collapse
|
2
|
Sathyamoorthy M, Sevak RJ, Cabrera J, Lopez M, Fox J, Shah SA, Verduzco-Gutierrez M. Enhanced External Counterpulsation Improves Cognitive Function of Persons With Long COVID. Am J Phys Med Rehabil 2024; 103:734-739. [PMID: 38206585 DOI: 10.1097/phm.0000000000002433] [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: 01/12/2024]
Abstract
OBJECTIVE The aim of this study is to determine the effects of enhanced external counterpulsation (EECP) in patients with long COVID and objectively assessed cognitive impairment. DESIGN A retrospective evaluation of long COVID patients referred for EECP, with cognitive sequela, and having completed an objective digital assessment before and after therapy. Patients had either cognitive impairment or no cognitive impairment at baseline. We assessed changes in composite score using multifactor analysis of variance. Multiple linear and logistic regression analyses were conducted to evaluate several independent variables. RESULTS Eighty long COVID patients (38 cognitive impairment vs. 42 no cognitive impairment) were included for analyses. All baseline characteristics were well matched. There was significant improvement in composite score post EECP in those with objective cognitive impairment at baseline. There were no notable documented safety concerns. CONCLUSIONS This is the first study showing that EECP led to significant improvement in cognitive functioning of long COVID patients with objectively defined cognitive impairment. Although a lack of a negative control group is a limitation of this study, EECP seems to be highly safe and effective with the potential for widespread application.
Collapse
Affiliation(s)
- Mohanakrishnan Sathyamoorthy
- From the Department of Internal Medicine, Burnett School of Medicine at Texas Christian University, Fort Worth, Texas (MS); Consultants in Cardiovascular Medicine and Science-Fort Worth, Fort Worth, Texas (MS); Department of Pharmacy Practice, Thomas J Long School of Pharmacy, University of the Pacific, Stockton, California (RJS, SAS); Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas (JC, ML); Flow Therapy, Fort Worth, Texas (JF, SAS); and Department of Physical Medicine and Rehabilitation, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, Texas (MV-G)
| | | | | | | | | | | | | |
Collapse
|
3
|
Kennedy AB, Mitcham A, Parris K, Albertson F, Sanchez Ferrer L, O'Boyle C, Patel MK, Gartner T, Broomer AM, Katzman E, Coffin J, Grier JT, Natafgi N. Wonderings to research questions: Engaging patients in long COVID research prioritization within a learning health system. Learn Health Syst 2024; 8:e10410. [PMID: 38883877 PMCID: PMC11176583 DOI: 10.1002/lrh2.10410] [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: 09/28/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 06/18/2024] Open
Abstract
Background An integral component of research within a learning health system is patient engagement at all stages of the research process. While there are well-defined best practices for engaging with patients on predetermined research questions, there is little specific methodology for engaging patients at the stage of research question formation and prioritization. Further, with an emerging disease such as Long COVID, population-specific strategies for meaningful engagement have not been characterized. Methods The COVID-19 Focused Virtual Patient Engagement Studio (CoVIP studio) was a virtual panel created to facilitate patient-centered studies surrounding the effects of long-term COVID ("Long COVID") also known as post-acute SARS-CoV-2 syndrome (PASC). A diverse group of panelists was recruited and trained in several different areas of knowledge, competencies, and abilities regarding research and Long COVID. A three-step approach was developed that consisted of recording panelists' broad wonderings to generate patient-specific research questions. Results The "wonderings" discussed in panelists' training sessions were analyzed to identify specific populations, interventions, comparators, outcomes, and timeframes (PICOT) elements, which were then used to create a survey to identify the elements of greatest importance to the panel. Based on the findings, 10 research questions were formulated using the PICOT format. The panelists then ranked the questions on perceived order of importance and distributed one million fictional grant dollars between the five chosen questions in the second survey. Through this stepwise prioritization process, the project team successfully translated panelists' research wonderings into investigable research questions. Conclusion This methodology has implications for the advancement of patient-engaged prioritization both within the scope of Long COVID research and in research on other rare or emerging diseases.
Collapse
Affiliation(s)
- Ann Blair Kennedy
- Biomedical Sciences University of South Carolina School of Medicine Greenville South Carolina USA
- Family Medicine Prisma Health Greenville South Carolina USA
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Ariana Mitcham
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
- Health Services Policy and Management, University of South Carolina Arnold School of Public Health Columbia South Carolina USA
| | - Katherine Parris
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Faith Albertson
- Health Services Policy and Management, University of South Carolina Arnold School of Public Health Columbia South Carolina USA
- Neurodevelopmental Disorders Lab University of South Carolina College of Art and Sciences Columbia South Carolina USA
- University of South Carolina Honors College Columbia South Carolina USA
| | - Luis Sanchez Ferrer
- Biomedical Sciences University of South Carolina School of Medicine Greenville South Carolina USA
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Conor O'Boyle
- Biomedical Sciences University of South Carolina School of Medicine Greenville South Carolina USA
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Maushmi K Patel
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
- Health Services Policy and Management, University of South Carolina Arnold School of Public Health Columbia South Carolina USA
| | - Tracey Gartner
- Biomedical Sciences University of South Carolina School of Medicine Greenville South Carolina USA
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Amy M Broomer
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Evan Katzman
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Jeanette Coffin
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
| | - Jennifer T Grier
- Biomedical Sciences University of South Carolina School of Medicine Greenville South Carolina USA
| | - Nabil Natafgi
- Patient Engagement Studio, University of South Carolina Greenville South Carolina USA
- Health Services Policy and Management, University of South Carolina Arnold School of Public Health Columbia South Carolina USA
| |
Collapse
|
4
|
Sunkersing D, Ramasawmy M, Alwan NA, Clutterbuck D, Mu Y, Horstmanshof K, Banerjee A, Heightman M. What is current care for people with Long COVID in England? A qualitative interview study. BMJ Open 2024; 14:e080967. [PMID: 38760030 PMCID: PMC11107429 DOI: 10.1136/bmjopen-2023-080967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/01/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE To investigate current care for people with Long COVID in England. DESIGN In-depth, semistructured interviews with people living with Long COVID and Long COVID healthcare professionals; data analysed using thematic analysis. SETTING National Health Service England post-COVID-19 services in six clinics from November 2022 to July 2023. PARTICIPANTS 15 healthcare professionals and 21 people living with Long COVID currently attending or discharged (18 female; 3 male). RESULTS Health professionals and people with lived experience highlighted the multifaceted nature of Long COVID, including its varied symptoms, its impact on people's lives and the complexity involved in managing this condition. These impacts encompass physical, social, mental and environmental dimensions. People with Long COVID reported barriers in accessing primary care, as well as negative general practitioner consultations where they felt unheard or invalidated, though some positive interactions were also noted. Peer support or support systems proved highly valuable and beneficial for individuals, aiding their recovery and well-being. Post-COVID-19 services were viewed as spaces where overlooked voices found validation, offering more than medical expertise. Despite initial challenges, healthcare providers' increasing expertise in diagnosing and treating Long COVID has helped refine care approaches for this condition. CONCLUSION Long COVID care in England is not uniform across all locations. Effective communication, specialised expertise and comprehensive support systems are crucial. A patient-centred approach considering the unique complexities of Long COVID, including physical, mental health, social and environmental aspects is needed. Sustained access to post-COVID-19 services is imperative, with success dependent on offering continuous rehabilitation beyond rapid recovery, acknowledging the condition's enduring impacts and complexities.
Collapse
Affiliation(s)
- David Sunkersing
- Institute of Health Informatics, University College London, London, UK
| | - Mel Ramasawmy
- Institute of Health Informatics, University College London, London, UK
| | - Nisreen A Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Donna Clutterbuck
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yi Mu
- Institute of Health Informatics, University College London, London, UK
| | | | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
| | - Melissa Heightman
- University College London Hospitals NHS Foundation Trust, London, UK
| |
Collapse
|
5
|
Al-Jabr H, Windle K, Clifton A, Thompson DR, Castle DJ, Ski CF. Patient experiences of the Long COVID-Optimal Health Programme: a qualitative interview study in community settings. BJGP Open 2024; 8:BJGPO.2023.0137. [PMID: 37907337 PMCID: PMC11169993 DOI: 10.3399/bjgpo.2023.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Long COVID (LC) symptoms persist 12 weeks or more beyond the acute infection. To date, no standardised diagnostic or treatment pathways exist. However, a holistic approach has been recommended. This study explored participants' experiences of a Long COVID-Optimal Health Programme (LC-OHP); a psychoeducational self-efficacy programme. AIM To explore perceptions and experiences of people with LC regarding the LC-OHP and identify suggestions to further improve the programme. DESIGN & SETTING Qualitative study with patients with LC recruited through community settings. METHOD This study is part of a wider randomised controlled trial. Eligible participants were aged ≥18 years, have LC, and attended a minimum of five LC-OHP sessions plus a booster session. We interviewed those randomised to the intervention group. Interviews were conducted by an independent researcher and thematically analysed to identify common, emerging themes. RESULTS Eleven participants were interviewed, mostly women from a White British ethnic group (n = 10). Four main themes were identified, reflecting programme benefits and suggestions for improvement. The programme demonstrated potential for assisting patients in managing their LC, including physical health and mental wellbeing. Participants found the programme to be flexible and provided suggestions to adapting it for future users. CONCLUSION Findings support the acceptability of the LC-OHP to people living with LC. The programme has shown several benefits in supporting physical health and mental wellbeing. Suggestions made to further adapt the programme and improve its delivery will be considered for future trials.
Collapse
Affiliation(s)
- Hiyam Al-Jabr
- Primary Community and Social Care, University of Keele, Keele, UK
- Midlands Partnership University NHS Foundation Trust, St Georges Hospital, Stafford, UK
| | - Karen Windle
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Andrew Clifton
- School of Health and Sports Sciences, University of Suffolk, Ipswich, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Department of Psychiatry, University of Tasmania, Tasmania, Australia
- Centre for Mental Health Service Innovation, Tasmania, Australia
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
6
|
Roder S, Mohacsi LM, Schmachtenberg T. [Experiences of people with Long COVID in their medical accompaniment and in the social environment]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 185:27-34. [PMID: 38199938 DOI: 10.1016/j.zefq.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 09/26/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Permanent health impairments after a COVID-19 infection can lead to a lack of social participation and pronounced emotional stress. The aim of this study was to find out how Long COVID affects the social activities of those affected and understand the role that medical support and the immediate social environment play in this. METHODS Between January and May 2022, 25 participants with long COVID were interviewed about their health situation, their perception of health care in Germany, and their social and professional context. The interviews, which were mainly conducted online, were analyzed for content, and the results were assessed using lifeworld-theoretical approaches. RESULTS The participants reported a variety of health symptoms such as fatigue, shortness of breath, and cognitive impairments. The majority of respondents had a pessimistic attitude toward a timely recovery. Most participants perceived the medical support for long COVID as inadequate. Long waiting times for specialist appointments and the lack of acceptance of the health impairment by some doctors lead to an increase in existing uncertainties. Long COVID also had a major impact on respondents' social life. Many participants referred to a burdensome decline in the number of meetings with family and friends. Many respondents avoided physical contact with friends and family members due to a high level of fear of infection. Some participants explained that they separated themselves from people in their environment because they did not take their precarious situation seriously. However, an important resource was the close circle of family and friends from whom the majority of the interviewees received support. DISCUSSION While other research studies particularly emphasize the comprehensive psychological and emotional consequences of long COVID, such as identity conflicts, existential angst, or depression, the present study shows that a lack of understanding from medical professionals as well as heavily delayed treatment leave the interviewees in a state of emotional void. CONCLUSIONS The findings show a considerable need for support among people with health impairments after a COVID-19 infection. Empathic and empirically based counseling and support by general practitioners as well as improvement of access to rehabilitative services can provide substantial support for people with long COVID.
Collapse
Affiliation(s)
- Sascha Roder
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland; Hochschule Bielefeld - University of Applied Sciences and Arts, Fachbereich Sozialwesen, Bielefeld, Deutschland
| | - Laura Milena Mohacsi
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Tim Schmachtenberg
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland; Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
| |
Collapse
|
7
|
Wheibe E, Dalkin BH, Meltzer HC, Russ-Sellers R, Grier JT. The Multisystem effects of Long COVID Syndrome and Potential Benefits of Massage Therapy in Long COVID Care. Int J Ther Massage Bodywork 2024; 17:19-42. [PMID: 38486840 PMCID: PMC10911825 DOI: 10.3822/ijtmb.v17i1.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background A major complication of infection with Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, is the potential for Long COVID Syndrome. While the pathophysiology of Long COVID Syndrome has yet to be described, the disease presentation is characterized by long-term symptoms with debilitating effects on human health. A better understanding of Long COVID symptomology may open up new avenues for patient treatment such as massage therapy. Methods From the PubMed database, cohort studies that examined post-infection COVID sequelae published between January 1st, 2021 and April 30th, 2021 were selected to investigate patient demographics and symptoms. A review of massage therapy literature since 2000 in conjunction with identified Long COVID symptoms was performed. Results This systematic review identified 17 cohort studies across the world that investigated the symptomatology of patients suffering from post-COVID sequelae in multiple organ systems. We identified the pulmonary and nervous systems to be the organ systems most affected with post-COVID sequelae, with PTSD, fatigue, dyspnea, cough, sleep disturbances, loss of smell, abdominal pain, and decreased appetite as the most common symptoms reported by >20% of Long COVID patients. Massage therapy was historically found to provide benefits to patients experiencing similar symptoms to those identified in Long COVID. Conclusions Recognizing the need for new approaches to treatment for Long COVID Syndrome, we identify massage therapy as a potential therapeutic treatment to positively impact the organ systems affected by Long COVID, especially the high-incident symptoms, and improve patient quality of life.
Collapse
Affiliation(s)
- Elias Wheibe
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Benjamin H. Dalkin
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Haley C. Meltzer
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | | | - Jennifer T. Grier
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| |
Collapse
|
8
|
Schröder D, Heinemann S, Heesen G, Hummers E, Schmachtenberg T, Dopfer-Jablonka A, Vahldiek K, Klawonn F, Klawitter S, Steffens S, Mikuteit M, Niewolik J, Müller F. Association of long COVID with health-related Quality of Life and Social Participation in Germany: Finding from an online-based cross-sectional survey. Heliyon 2024; 10:e26130. [PMID: 38380019 PMCID: PMC10877341 DOI: 10.1016/j.heliyon.2024.e26130] [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: 05/07/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
Purpose This study aims to examine the health-related Quality of Life (hrQoL) and social participation in participants with Long COVID compared to participants without symptoms after COVID-19 and participants with no prior SARS-CoV-2 infection. Methods A cross-sectional online survey was conducted in Germany. The non-random sample consists of participants 18 years or older. Participants were divided in three groups: Lg COVID with a prior SARS-CoV-2 infection and new or persistent symptoms 28 days after infection, ExCOVID with a prior SARS-CoV-2 infection and without new or persistent symptoms after 28 days, and NoCOVID when participants had no prior SARS-CoV-2 infection. EQ-5D-3L was used as hrQoL measure and the Index for the Assessment of Health Impairments (IMET) to reflect social participation. Descriptive and inferential statistics were performed. Results A total of 3188 participants were included in the analysis (1421 Lg COVID, 260 ExCOVID, 1507 NoCOVID). Lg COVID was associated with the lowest EQ-5D-3L index values (p < 0.001), Visual Analogue Scale (VAS) scores (p < 0.001), and IMET (p < 0.001) scores followed by NoCOVID and ExCOVID. After adjusting for sociodemographic and medical conditions in a multivariable model Long COVID was still associated with lower hrQoL compared to NoCOVID (p < 0.001). About 10% of Lg COVID participants showed no health impairments in all EQ-5D dimensions while 51.1% of NoCOVID and 60% of ExCOVID participants showed no health impairments. Conclusion This study highlights the impairments of persons with Long COVID on hrQoL and social participation compared to individuals without Long COVID in Germany. Trial registration German Clinical Trial Registry, DRKS00026007.
Collapse
Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Geriatrics, University Medical Center, Göttingen, Germany
| | - Gloria Heesen
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany
| | - Kai Vahldiek
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Sandra Klawitter
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- Deans' Office, Curricular Development, Hannover Medical School, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Germany
- Deans' Office, Curricular Development, Hannover Medical School, Germany
| | | | - Frank Müller
- Department of General Practice, University Medical Center, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
| |
Collapse
|
9
|
Rybkina J, Jacob N, Colella B, Gold D, Stewart DE, Ruttan LA, Meusel LAC, McAndrews MP, Abbey S, Green R. Self-managing symptoms of Long COVID: an education and strategies research protocol. Front Public Health 2024; 12:1106578. [PMID: 38384879 PMCID: PMC10879441 DOI: 10.3389/fpubh.2024.1106578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/04/2024] [Indexed: 02/23/2024] Open
Abstract
Post-acute sequelae of SARS-COV-2 (PASC) is growing in prevalence, and involves symptoms originating from the central neurological, cardiovascular, respiratory, gastrointestinal, autonomic nervous, or immune systems. There are non-specific symptoms such as fatigue, headaches, and brain fog, which cannot be ascribed to a single system. PASC places a notable strain on our healthcare system, which is already laden with a large number of acute-COVID-19 patients. Furthermore, it impedes social, academic and vocational functioning, and impacts family life, relationships, and work/financial life. The treatment for PASC needs to target this non-specific etiology and wide-ranging sequelae. In conditions similar to PASC, such as "chemo brain," and prolonged symptoms of concussion, the non-specific symptoms have shown to be effectively managed through education and strategies for self-management and Mindfulness interventions. However, such interventions have yet to be empirically evaluated in PASC to our knowledge. In response to this gap, we have developed a virtual education intervention synthesized by psychiatrists and clinical psychologists for the current study. We will undertake a two-phase randomized controlled trial to determine the feasibility (Phase 1; N = 90) and efficacy (Phase 2; sample sized based on phase 1 results) of the novel 8 week Education and Self-Management Strategies group compared to a mindfulness skills program, both delivered virtually. Main outcomes include confidence/ability to self-manage symptoms, quality of life, and healthcare utilization. This study stands to mitigate the deleterious intrusiveness of symptoms on everyday life in patients with PASC, and may also help to reduce the impact of PASC on the healthcare system. Clinical trial registration:https://classic.clinicaltrials.gov/ct2/show/NCT05268523; identifier NCT05268523.
Collapse
Affiliation(s)
- Julia Rybkina
- KITE Research Institute, Toronto Rehabilitation Institute—University Health Network, Toronto, ON, Canada
| | - Nithin Jacob
- KITE Research Institute, Toronto Rehabilitation Institute—University Health Network, Toronto, ON, Canada
| | - Brenda Colella
- Telerehab Centre for Acquired Brain Injury, Toronto Rehabilitation Institute—University Centre, University Health Network, Toronto, ON, Canada
| | - David Gold
- Krembil Brain Institute, University of Toronto, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Donna E. Stewart
- University of Toronto, Centre for Mental Health and Senior Scientist, University Health Network, Toronto, ON, Canada
| | - Lesley A. Ruttan
- University of Toronto Scarborough, Neuro-Rehab Program, Toronto Rehabilitation Institute—University Centre, University Health Network, Toronto, ON, Canada
| | - Liesel-Ann C. Meusel
- Telerehab Centre for Acquired Brain Injury, Toronto Rehabilitation Institute—University Centre, University Health Network, Toronto, ON, Canada
| | - Mary P. McAndrews
- Krembil Research Institute, University of Toronto, University Health Network, Toronto, ON, Canada
| | - Susan Abbey
- Medical Psychiatry and Psychiatry and Psychosocial Oncology, University Health Network, Toronto, ON, Canada
| | - Robin Green
- KITE Research Institute, Toronto Rehabilitation Institute—University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
10
|
Wiederhold BK. The Path Forward: Self-Management Strategies for Long COVID. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024; 27:97-99. [PMID: 38153845 DOI: 10.1089/cyber.2023.29305.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
|
11
|
Zaman R, Ravichandran V, Tan CK. Role of dietary supplements in the continuous battle against COVID-19. Phytother Res 2024; 38:1071-1088. [PMID: 38168043 DOI: 10.1002/ptr.8096] [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: 09/09/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
A sudden outbreak of the COVID-19 pandemic was a big blow to the world community on every level. Created by a novel coronavirus, SARS-CoV-2, which was previously unknown to the human immune system. The expert opinion almost immediately united on the fact that the most effective way of fighting the pandemic would be by building immunity artificially via a mass immunization program. However, it took about a year for the approval of the first vaccine against COVID-19. In the meantime, a big part of the general population started adapting nutritious diet plans and dietary supplements to boost natural immunity as a potential prophylactic strategy against SARS-CoV-2 infection. Whether they originate from mainstream medicine, such as synthetic supplements, or traditional herbal remedies in the form of single or poly-herbs, these supplements may comprise various components that exhibit immunomodulatory, anti-inflammatory, antioxidant, and antimicrobial characteristics. There is a substantial body of predictions and expert opinions suggesting that enhancing one's diet with dietary supplements containing additional nutrients and bioactive compounds like vitamins, minerals, amino acids, fatty acids, phytochemicals, and probiotics can enhance the immune system's ability to develop resistance against COVID-19, although none of them have any conclusive evidence nor officially recommended by World Health Organization (WHO). The current review critically acclaims the gap between public perception-based preference and real evidence-based study to weigh the actual benefit of dietary supplements in relation to COVID-19 prevention and management.
Collapse
Affiliation(s)
- Rahela Zaman
- School of Healthy Aging, Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Vignesh Ravichandran
- School of Healthy Aging, Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Chung Keat Tan
- School of Healthy Aging, Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| |
Collapse
|
12
|
León-Herrera S, Oliván-Blázquez B, Samper-Pardo M, Aguilar-Latorre A, Sánchez Arizcuren R. Motivational Interviewing as a Tool to Increase Motivation and Adherence to a Long COVID Telerehabilitation Intervention: Secondary Data Analysis from a Randomized Clinical Trial. Psychol Res Behav Manag 2024; 17:157-169. [PMID: 38234406 PMCID: PMC10793119 DOI: 10.2147/prbm.s433950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/26/2023] [Indexed: 01/19/2024] Open
Abstract
Background Although motivational interviewing was originally developed to address abuse disorders, scientific evidence confirms that it is an increasingly used and effective approach in a wide range of therapeutic interventions. To date, however, no studies have analyzed the use of this tool in patients with persistent symptoms following coronavirus disease 2019, a condition known as Long COVID. Purpose To analyze the effectiveness of motivational interviewing with regard to the adherence to telerehabilitation for Long COVID using a mobile application. As a secondary objective, factors related to greater motivation before and after the motivational interviewing techniques were analyzed. Patients and Methods This longitudinal design substudy used a sample of 52 adult patients with Long COVID participating in the intervention group of a randomized clinical trial. This trial examined the effectiveness of a telerehabilitation program for this population using a mobile application. This program included three motivational interviews to achieve maximum treatment adherence. In this study, the main variables were motivation and adherence to application use. Sociodemographic and clinical data, personal constructs, and affective state were also collected. Subsequently, a descriptive, correlational, and regression statistical analysis was performed using the SPSS Statistics program. Results The median motivation prior to the first motivational interview was 8 (IQR 2), the median at the end of the last motivational interview was 8.5 (IQR 2.75), and the change in motivation levels after the three motivational interviews was 0.5 (IQR 1). Affective state and final motivation scores were predictors of greater adherence to telerehabilitation treatment. Conclusion A high level of motivation after participating in motivational interviewing appears to be related to higher levels of adherence to telerehabilitation in patients with Long COVID. This suggests that motivational interviewing may be an effective tool in the treatment of this disease.
Collapse
Affiliation(s)
- Sandra León-Herrera
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | | |
Collapse
|
13
|
Schmachtenberg T, Königs G, Dragaqina A, Roder S, Müller F, Müllenmeister C, Schröder D, Dopfer-Jablonka A, Vieth K, El-Sayed I. "There is no one who helps you with it": experiences of people with long COVID regarding medical care, therapeutic measures, and barriers in the German healthcare system: results of a qualitative study with four focus groups. BMC Health Serv Res 2023; 23:1160. [PMID: 37884993 PMCID: PMC10601213 DOI: 10.1186/s12913-023-10170-x] [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: 05/22/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Many people experience long-term symptoms such as fatigue, cognitive problems, or shortness of breath after an acute infection with COVID-19. This emerging syndrome, known as long COVID, is new and complex in many aspects. This study aims to collect the experiences of people with long COVID with ambulatory healthcare structures. METHODS Four focus groups were conducted with a total of 23 adults with long COVID in June and July 2022. These discussions were audio-recorded, subsequently transcribed, and analyzed using the qualitative content analysis of Mayring and Kuckartz. RESULTS Fourteen out of 19 participants who had a primary care encounter regarding their long COVID symptoms did not perceive it as helpful. Many respondents reported that their general practitioners did not take their long COVID symptoms seriously and did not refer them to specialists or made therapeutic recommendations. However, some participants reported that they were prescribed non-pharmaceutical therapies (e.g., group meetings supported by psychotherapists, occupational therapy, etc.) that improved their condition. 14 of 23 respondents perceived care barriers such as providers' lack of awareness of long COVID, poor access to specialists, a lack of specialized care (e.g., long COVID clinics), or high bureaucratic hurdles for specific healthcare services. To improve medical care, participants suggested campaigns to raise awareness of long COVID among healthcare providers and the general population, increase research and government investments regarding the development of treatment structures for long COVID, expanding existing therapeutic services, and establishing one-stop shops for integrated specialist healthcare for people with long COVID. CONCLUSIONS Several implications for healthcare professionals and policymakers can be derived from this study: (1) general practitioners should take the symptoms of long COVID seriously, assume a care coordinating role, make referrals, and establish contact with long COVID clinics; (2) care planners should focus on developing interprofessional evidence-based care and treatment approaches for long COVID; (3) existing care structures such as long COVID outpatient clinics should be expanded. The overarching goal must be to develop consistent guidelines for long COVID diagnosis, care, and treatment. TRIAL REGISTRATION The study is registered in the German register for clinical trials (DRKS00026007, first registration on 09/09/2021).
Collapse
Affiliation(s)
- Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Anita Dragaqina
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, 15 Michigan St NE, Grand Rapids, MI, 49503, USA
| | - Christina Müllenmeister
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- German Center for Infection Research, Partner Site Hannover-Braunschweig, Feodor-Lynen- Str. 26, 30625, Hannover, Germany
| | - Katharina Vieth
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| |
Collapse
|
14
|
Derksen C, Rinn R, Gao L, Dahmen A, Cordes C, Kolb C, Becker P, Lippke S. Longitudinal Evaluation of an Integrated Post-COVID-19/Long COVID Management Program Consisting of Digital Interventions and Personal Support: Randomized Controlled Trial. J Med Internet Res 2023; 25:e49342. [PMID: 37792437 PMCID: PMC10563866 DOI: 10.2196/49342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/31/2023] [Accepted: 09/06/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The postacute COVID-19 syndrome (PACS) can be addressed with multidisciplinary approaches, including professional support and digital interventions. OBJECTIVE This research aimed to test whether patients who received a health care facilitation program including medical internet support from human personal pilots and digital interventions (intervention group [IG] and active control group [ACG]) would experience fewer symptoms and have higher work ability and social participation than an untreated comparison group (CompG). The second objective was to compare the impact of a diagnostic assessment and digital interventions tailored to patients' personal capacity (IG) with that of only personal support and digital interventions targeting the main symptoms (ACG). METHODS In total, 1020 patients with PACS were recruited. Using a randomized controlled trial design between the IG and the ACG, as well as propensity score matching to include the CompG, analyses were run with logistic regression and hierarchical-linear models. RESULTS Symptoms decreased significantly in all groups over time (βT1-T2=0.13, t549=5.67, P<.001; βT2-T4=0.06, t549=2.83, P=.01), with a main effect of the group (β=-.15, t549=-2.65, P=.01) and a more pronounced effect in the IG and ACG compared to the CompG (between groups: βT1-T2=0.14, t549=4.31, P<.001; βT2-T4=0.14, t549=4.57, P<.001). Work ability and social participation were lower in the CompG, but there was no significant interaction effect. There were no group differences between the IG and the ACG. CONCLUSIONS Empowerment through personal pilots and digital interventions reduces symptoms but does not increase work ability and social participation. More longitudinal research is needed to evaluate the effects of a diagnostic assessment. Social support and digital interventions should be incorporated to facilitate health care interventions for PACS. TRIAL REGISTRATION ClinicalTrials.gov NCT05238415; https://classic.clinicaltrials.gov/ct2/show/NCT05238415. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12879-022-07584-z.
Collapse
Affiliation(s)
- Christina Derksen
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Robin Rinn
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Lingling Gao
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Alina Dahmen
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| | - Cay Cordes
- Dr. Becker Kiliani-Klinik, Dr. Becker Klinikgruppe, Bad Windsheim, Germany
| | | | | | - Sonia Lippke
- Health Psychology and Behavioural Medicine, Constructor University Bremen, Bremen, Germany
| |
Collapse
|
15
|
Meng QT, Song WQ, Churilov LP, Zhang FM, Wang YF. Psychophysical therapy and underlying neuroendocrine mechanisms for the rehabilitation of long COVID-19. Front Endocrinol (Lausanne) 2023; 14:1120475. [PMID: 37842301 PMCID: PMC10570751 DOI: 10.3389/fendo.2023.1120475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
With the global epidemic and prevention of the COVID-19, long COVID-19 sequelae and its comprehensive prevention have attracted widespread attention. Long COVID-19 sequelae refer to that three months after acute COVID-19, the test of SARS-CoV-2 is negative, but some symptoms still exist, such as cough, prolonged dyspnea and fatigue, shortness of breath, palpitations and insomnia. Its pathological mechanism is related to direct viral damage, immunopathological response, endocrine and metabolism disorders. Although there are more effective methods for treating COVID-19, the treatment options available for patients with long COVID-19 remain quite limited. Psychophysical therapies, such as exercise, oxygen therapy, photobiomodulation, and meditation, have been attempted as treatment modalities for long COVID-19, which have the potential to promote recovery through immune regulation, antioxidant effects, and neuroendocrine regulation. Neuroendocrine regulation plays a significant role in repairing damage after viral infection, regulating immune homeostasis, and improving metabolic activity in patients with long COVID-19. This review uses oxytocin as an example to examine the neuroendocrine mechanisms involved in the psychophysical therapies of long COVID-19 syndrome and proposes a psychophysical strategy for the treatment of long COVID-19.
Collapse
Affiliation(s)
- Qing-Tai Meng
- WU Lien-Teh Institute, Department of Microbiology, Harbin Medical University, Harbin, China
| | - Wu-Qi Song
- WU Lien-Teh Institute, Department of Microbiology, Harbin Medical University, Harbin, China
| | - Leonid P. Churilov
- Department of Experimental Tuberculosis, St. Petersburg State Research Institute of Phthisiopulmonology, Saint-Petersburg, Russia
| | - Feng-Min Zhang
- WU Lien-Teh Institute, Department of Microbiology, Harbin Medical University, Harbin, China
| | - Yu-Feng Wang
- Department of Physiology, Harbin Medical University, Harbin, China
- International Translational Neuroscience Research Institute, Zhejiang Chinese Medical University, Hangzhou, China
| |
Collapse
|
16
|
León-Herrera S, Magallón-Botaya R, Oliván-Blázquez B, Sagarra-Romero L, Jaurrieta CM, Méndez-López F. Online multimodal rehabilitation programme to improve symptoms and quality of life for adults diagnosed with long COVID-19: a Randomised Clinical Trial protocol. Front Public Health 2023; 11:1222888. [PMID: 37744502 PMCID: PMC10513419 DOI: 10.3389/fpubh.2023.1222888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Background Long COVID is a multisystemic condition which affects quality of life and implies a multidisciplinary treatment approach. There is still limited evidence on management techniques for this syndrome. "Telerehabilitation" could be an important tool when addressing the symptoms of this patients with the aim of increasing their quality of life. The purpose of this trial is to analyse the effectiveness of an online multimodal rehabilitation programme to improve the symptomatology of people with long COVID and their quality of life. Methods A pragmatic randomised controlled trial will be performed with two parallel groups: (1) usual treatment by the primary care practitioner (Treatment as usual, TAU; control group) and (2) TAU plus the use of an online multimodal rehabilitation programme, including videoconferences and content published on a Moodle platform (intervention group). The data will be collected before and after the intervention. A follow-up will take place 3 months later. Discussion There is still a lack of knowledge regarding the management of the symptoms of long COVID. This creates the need to add scientific evidence about the care of this disease, considering that multidisciplinary social and health teams can offer the necessary care so that these patients can recover their previous quality of life.Clinical trial registration: The protocol for this study was registered with the ISRCTN Registry [registration number: ISRCTN15414370] on 28 December 2022.
Collapse
Affiliation(s)
- Sandra León-Herrera
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Lucía Sagarra-Romero
- GAIAS Research Group, Department of Health Sciences, Faculty of Health Sciences, Zaragoza, Spain
| | | | | |
Collapse
|
17
|
Das S, Kumar S. Exploring the mechanisms of long COVID: Insights from computational analysis of SARS-CoV-2 gene expression and symptom associations. J Med Virol 2023; 95:e29077. [PMID: 37675861 DOI: 10.1002/jmv.29077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/02/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
Long coronavirus disease (COVID) has emerged as a global health issue, affecting a substantial number of people worldwide. However, the underlying mechanisms that contribute to the persistence of symptoms in long COVID remain obscure, impeding the development of effective diagnostic and therapeutic interventions. In this study, we utilized computational methods to examine the gene expression profiles of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their associations with the wide range of symptoms observed in long COVID patients. Using a comprehensive data set comprising over 255 symptoms affecting multiple organ systems, we identified differentially expressed genes and investigated their functional similarity, leading to the identification of key genes with the potential to serve as biomarkers for long COVID. We identified the participation of hub genes associated with G-protein-coupled receptors (GPCRs), which are essential regulators of T-cell immunity and viral infection responses. Among the identified common genes were CTLA4, PTPN22, KIT, KRAS, NF1, RET, and CTNNB1, which play a crucial role in modulating T-cell immunity via GPCR and contribute to a variety of symptoms, including autoimmunity, cardiovascular disorders, dermatological manifestations, gastrointestinal complications, pulmonary impairments, reproductive and genitourinary dysfunctions, and endocrine abnormalities. GPCRs and associated genes are pivotal in immune regulation and cellular functions, and their dysregulation may contribute to the persistent immune responses, chronic inflammation, and tissue abnormalities observed in long COVID. Targeting GPCRs and their associated pathways could offer promising therapeutic strategies to manage symptoms and improve outcomes for those experiencing long COVID. However, the complex mechanisms underlying the condition require continued study to develop effective treatments. Our study has significant implications for understanding the molecular mechanisms underlying long COVID and for identifying potential therapeutic targets. In addition, we have developed a comprehensive website (https://longcovid.omicstutorials.com/) that provides a curated list of biomarker-identified genes and treatment recommendations for each specific disease, thereby facilitating informed clinical decision-making and improved patient management. Our study contributes to the understanding of this debilitating disease, paving the way for improved diagnostic precision, and individualized therapeutic interventions.
Collapse
Affiliation(s)
- Sanisha Das
- Department of Diagnostic & Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, Shah Alam, Selangor, Malaysia
| | - Suresh Kumar
- Department of Diagnostic & Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, Shah Alam, Selangor, Malaysia
| |
Collapse
|
18
|
Owen R, Ashton RE, Ferraro FV, Skipper L, Bewick T, Leighton P, Phillips BE, Faghy MA. Forming a consensus opinion to inform long COVID support mechanisms and interventions: a modified Delphi approach. EClinicalMedicine 2023; 62:102145. [PMID: 37599906 PMCID: PMC10432807 DOI: 10.1016/j.eclinm.2023.102145] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
Background Current approaches to support patients living with post-COVID condition, also known as Long COVID, are highly disparate with limited success in managing or resolving a well-documented and long-standing symptom burden. With approximately 2.1 million people living with the condition in the UK alone and millions more worldwide, there is a desperate need to devise support strategies and interventions for patients. Methods A three-round Delphi consensus methodology was distributed internationally using an online survey and was completed by healthcare professionals (including clinicians, physiotherapists, and general practitioners), people with long COVID, and long COVID academic researchers (round 1 n = 273, round 2 n = 186, round 3 n = 138). Across the three rounds, respondents were located predominantly in the United Kingdom (UK), with 17.3-15.2% (round 1, n = 47; round 2 n = 32, round 2 n = 21) of respondents located elsewhere (United States of America (USA), Austria, Malta, United Arab Emirates (UAE), Finland, Norway, Malta, Netherlands, Iceland, Canada, Tunisie, Brazil, Hungary, Greece, France, Austrailia, South Africa, Serbia, and India). Respondents were given ∼5 weeks to complete the survey following enrolment, with round one taking place from 02/15/2022 to 03/28/22, round two; 05/09/2022 to 06/26/2022, and round 3; 07/14/2022 to 08/09/2022. A 5-point Likert scale of agreement was used and the opportunity to include free text responses was provided in the first round. Findings Fifty-five statements reached consensus (defined as >80% agree and strongly agree), across the domains of i) long COVID as a condition, ii) current support and care available for long COVID, iii) clinical assessments for long COVID, and iv) support mechanisms and rehabilitation interventions for long COVID, further sub-categorised by consideration, inclusion, and focus. Consensus reached proposes that long COVID requires specialised, comprehensive support mechanisms and that interventions should form a personalised care plan guided by the needs of the patients. Supportive approaches should focus on individual symptoms, including but not limited to fatigue, cognitive dysfunction, and dyspnoea, utilising pacing, fatigue management, and support returning to daily activities. The mental impact of living with long COVID, tolerance to physical activity, emotional distress and well-being, and research of pre-existing conditions with similar symptoms, such as myalgic encephalomyelitis, should also be considered when supporting people with long COVID. Interpretation We provide an outline that achieved consensus with stakeholders that could be used to inform the design and implementation of bespoke long COVID support mechanisms. Funding None.
Collapse
Affiliation(s)
- Rebecca Owen
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Ruth E.M. Ashton
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection Network (HL-Pivot), USA
| | - Francesco V. Ferraro
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Lindsay Skipper
- Patient and Public Involvement and Engagement Representative, UK
| | - Tom Bewick
- Department of Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Uttoxeter Road, Derby DE22 3NE, UK
| | - Paul Leighton
- School of Medicine, University of Nottingham, Nottingham and Derby, UK
| | | | - Mark A. Faghy
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection Network (HL-Pivot), USA
| |
Collapse
|
19
|
Teraž K, Šimunič B, Peskar M, Marusic U, Pišot S, Šlosar L, Gasparini M, Pišot R. Functional characteristics and subjective disease perception in patients with COVID-19 two months after hospital discharge. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1209900. [PMID: 37546579 PMCID: PMC10401436 DOI: 10.3389/fresc.2023.1209900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023]
Abstract
Introduction Although early inpatient and post-hospital rehabilitation is recognized as necessary, not all COVID-19 patients have access to rehabilitation. There are no published reports in the literature that investigate the outcomes of patients who do not receive rehabilitation after COVID-19. Our aim was to evaluate possible improvements in determinate functional and psychological parameters in COVID-19 patients two months after their hospital discharge. Methods On both time points various motor, cognitive, and clinical measurements such as body composition, tensiomyography, blood pressure, spirometry, grip strength test, Timed Up and Go test, gait speed, 30-second chair-stand test, and Montreal Cognitive Assessment, were performed. Additionally, questionnaires such as the SARC-CalF test, Edmonton frail scale, International Physical Activity questionnaire andThe Mediterranean Lifestyle index were conducted to assess lifestyle characteristics. Results A total of 39 patients (87.2% male; mean age of 59.1 ± 10.3 years), who were hospitalized due to COVID-19 at the Izola General Hospital (IGH), Slovenia between December 2020 and April 2021, were included. Patients were assessed at two time points (T1 and T2): T1 was taken after receiving a negative COVID-19 test and T2 was taken two months after T1. After two months of self-rehabilitation, we have detected a BMI increase (p < .001), fat free mass increase (p < .001), better Edmonton frail scale (p < .001), SARC-CalF score (p = .014) and MoCA score (p = .014). There were no detected changes in lifestyle habits nor in physical performance tests. Discussion It is already known that COVID-19 has long-term negative consequences regardless of the stage of the disease. Our findings support the notion that patients cannot fully regain all their functions within a two-month period without receiving structured or supervised rehabilitation. Therefore, it is crucial to offer patients comprehensive and structured rehabilitation that incorporates clinical, cognitive, and motor exercises.
Collapse
Affiliation(s)
- Kaja Teraž
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Manca Peskar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
| | - Saša Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
| | - Malden Gasparini
- Department of General Surgery, General Hospital Izola, Izola, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| |
Collapse
|
20
|
Al-Jabr H, Hawke LD, Thompson DR, Clifton A, Shenton M, Castle DJ, Ski CF. Interventions to support mental health in people with long COVID: a scoping review. BMC Public Health 2023; 23:1186. [PMID: 37340400 DOI: 10.1186/s12889-023-16079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION Long COVID (LC) is a multisystem disease with symptoms lasting weeks or months beyond the acute COVID-19 infection. Several manifestations are reported by people with LC, including effects on mental health, with varying degrees of psychological distress and disturbances to daily activities. Research conducted to identify effective interventions to support mental health among people with LC has been limited by the breadth and scope of studies. AIM This review aims to identify interventions being tested to support mental health of people with LC. METHODS A scoping review was conducted by searching five databases for articles published between January 2020 and early October 2022 to identify research evaluating interventions focused on improving mental health symptoms associated with LC. Results from all sources were checked for eligibility by two reviewers, and agreements were resolved by discussion. Gray literature and reference list of included studies and relevant reviews were scrutinised to identify any additional studies. Data extraction was conducted by one reviewer and checked by another reviewer for accuracy. RESULTS Of the 940 studies identified, 17 were included, the design of which varied but included mainly case studies (n = 6) and clinical trials (n = 5). Several interventions were described, ranging from single interventions (e.g., pharmacologic) to more holistic, comprehensive suites of services (pharmacologic and non-pharmacologic). Several mental health outcomes were measured, mostly anxiety and depression. All included studies were reported to be associated with improvements in participants' mental health outcomes. CONCLUSION This scoping review identified studies reporting on a variety of interventions to support mental health among people with LC. Although positive changes were reported by all studies, some were case studies and thus their findings must be interpreted with caution. There is a need for more research to be conducted to identify the impact of interventions on mental health of people with LC.
Collapse
Affiliation(s)
- Hiyam Al-Jabr
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Canada
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Andrew Clifton
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Mark Shenton
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David J Castle
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
21
|
Bogale KA, Zeru T, Tarkegn M, Balew M, Worku M, Asrat A, Adamu A, Mulu Y, Getachew A, Ambaw F. Awareness and care seeking for long COVID symptoms among Coronavirus disease survivors in Bahir Dar City, Northwest Ethiopia: phenomenological study. BMC Public Health 2023; 23:941. [PMID: 37226170 DOI: 10.1186/s12889-023-15889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Corona Virus Disease (COVID-19) has long-term sequels that persisted for months to years and manifested with a spectrum of signs and symptoms. Presentations of long COVID-19 symptoms are heterogeneous, vary from person to person, and can reach up to over 200 symptoms. Limited studies are conducted on the awareness of long COVID-19. So, this study aimed to explore the awareness about and care seeking for long COVID-19 symptoms among COVID survivors in Bahir Dar City in 2022. METHODS A qualitative study with a phenomenological design was used. Participants of the study were individuals who survived five months or longer after they tested positive for COVID-19 in Bahir Dar city. Individuals were selected purposively. An in-depth interview guide was prepared and used to collect the data. Open Cod 4.03 software was used for coding and synthesizing. Thematic analysis was used to analyze the transcripts. RESULTS The themes emerged from the data were awareness, experience of symptoms and their effects, and care practices of long COVID-19. Although only one participant mentioned the common symptoms of long COVID-19 the survivors experienced general, respiratory, cardiac, digestive, neurological, and other symptoms. These symptoms include rash, fatigue fever, cough, palpitations, shortness of breath, chest pain, and abdominal pain, loss of concentration, loss of smell, sleep disorder, depression, joint and muscle pain. These symptoms brought various physical and psychosocial effects. The majority of the respondents described that long COVID-19 symptoms will go off by themselves. To alleviate the problems some of the participants had taken different measures including medical care, homemade remedies, spiritual solutions, and lifestyle modification. CONCLUSIONS The result of this study revealed that participants have a significant deficit of awareness about the common symptoms, risk groups, and communicability of Long COVID. However, they experienced the majority of the common symptoms of Long COVID. To alleviate the problems, they had taken different measures including medical care, homemade remedies, spiritual solutions, and lifestyle modification.
Collapse
Affiliation(s)
- Kassawmar Angaw Bogale
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Taye Zeru
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Molalign Tarkegn
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Melashu Balew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Masetewal Worku
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Anemaw Asrat
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Ayinengida Adamu
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yared Mulu
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Rennes University, Rennes, France
| | - Atalay Getachew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Fentie Ambaw
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
22
|
Thomas C, Faghy MA, Owen R, Yates J, Ferraro F, Bewick T, Haggan K, Ashton REM. Lived experience of patients with Long COVID: a qualitative study in the UK. BMJ Open 2023; 13:e068481. [PMID: 37185640 PMCID: PMC10151237 DOI: 10.1136/bmjopen-2022-068481] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Long COVID is a rapidly evolving global health crisis requiring interdisciplinary support strategies that incorporate the lived experience of patients. Currently, there is a paucity of research documenting the day-to-day experiences of patients living with Long COVID. OBJECTIVE To explore the lived experience of Long COVID patients. STUDY DESIGN Longitudinal, observation study. SETTING An inductive, data-driven, qualitative approach was used to evaluate hand-written diaries obtained from individuals who had been referred to a Derbyshire Long COVID clinic. PARTICIPANTS 12 participants (11 females, age 49±10 years, 11 Caucasians) were recruited. Participants were included if they had a previous confirmed or suspected COVID-19 infection with ongoing recovery, >18 years old, understood the study requirements and provided informed consent. METHOD Participants were directed to complete self-report diaries over 16 weeks. Responses were transcribed verbatim and analysed using thematic analysis. RESULTS Three key themes were highlighted: (1) understanding who helps patients manage symptoms, (2) daily activities and the impact on quality of life and health status and (3) the effect of turbulent and episodic symptom profiles on personal identity and recovery. CONCLUSIONS The novel challenges presented by Long COVID are complex with varying inter-related factors that are broadly impacting functional status and quality of life. Support mechanisms must incorporate the lived experiences and foster true collaborations between health professionals, patients and researchers to improve patient outcomes. TRIAL REGISTRATION NUMBER NCT04649957.
Collapse
Affiliation(s)
- Callum Thomas
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Mark A Faghy
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Rebecca Owen
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - James Yates
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Francesco Ferraro
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Tom Bewick
- Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Kate Haggan
- Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Ruth E M Ashton
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| |
Collapse
|
23
|
Rinn R, Gao L, Schoeneich S, Dahmen A, Anand Kumar V, Becker P, Lippke S. Digital Interventions for Treating Post-COVID or Long-COVID Symptoms: Scoping Review. J Med Internet Res 2023; 25:e45711. [PMID: 36943909 PMCID: PMC10131666 DOI: 10.2196/45711] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Patients with post-COVID/long-COVID symptoms need support, and health care professionals need to be able to provide evidence-based patient care. Digital interventions can meet these requirements, especially if personal contact is limited. OBJECTIVE We reviewed evidence-based digital interventions that are currently available to help manage physical and mental health in patients with post-COVID/long-COVID symptoms. METHODS A scoping review was carried out summarizing novel digital health interventions for treating post-COVID/long-COVID patients. Using the PICO (population, intervention, comparison, outcome) scheme, original studies were summarized, in which patients with post-COVID/long-COVID symptoms used digital interventions to help aid recovery. RESULTS From all scanned articles, 8 original studies matched the inclusion criteria. Of the 8 studies, 3 were "pretest" studies, 3 described the implementation of a telerehabilitation program, 1 was a post-COVID/long-COVID program, and 1 described the results of qualitative interviews with patients who used an online peer-support group. Following the PICO scheme, we summarized previous studies. Studies varied in terms of participants (P), ranging from adults in different countries, such as former hospitalized patients with COVID-19, to individuals in disadvantaged communities in the United Kingdom, as well as health care workers. In addition, the studies included patients who had previously been infected with COVID-19 and who had ongoing symptoms. Some studies focused on individuals with specific symptoms, including those with either post-COVID-19 or long-term symptoms, while other studies included patients based on participation in online peer-support groups. The interventions (I) also varied. Most interventions used a combination of psychological and physical exercises, but they varied in duration, frequency, and social dimensions. The reviewed studies investigated the physical and mental health conditions of patients with post-COVID/long-COVID symptoms. Most studies had no control (C) group, and most studies reported outcomes (O) or improvements in physiological health perception, some physical conditions, fatigue, and some psychological aspects such as depression. However, some studies found no improvements in bowel or bladder problems, concentration, short-term memory, unpleasant dreams, physical ailments, perceived bodily pain, emotional ailments, and perceived mental health. CONCLUSIONS More systematic research with larger sample sizes is required to overcome sampling bias and include health care professionals' perspectives, as well as help patients mobilize support from health care professionals and social network partners. The evidence so far suggests that patients should be provided with digital interventions to manage symptoms and reintegrate into everyday life, including work.
Collapse
Affiliation(s)
- Robin Rinn
- Constructor University, Bremen, Germany
- Julius-Maximilians-Universität, Würzburg, Germany
| | | | | | - Alina Dahmen
- Constructor University, Bremen, Germany
- Klinikum Wolfsburg, Wolfsburg, Germany
- Dr Becker Klinikgruppe, Cologne, Germany
| | | | | | | |
Collapse
|
24
|
Veliz PT, Zhou W, Smith S, Larson JL. Substance Use and the Self-Management of Persistent Symptoms of COVID-19. Subst Use Misuse 2023; 58:835-840. [PMID: 36942996 DOI: 10.1080/10826084.2023.2184208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background: Understanding the self-management practices of persistent symptoms of SARS-Cov-2 (COVID-19) is critical given the misinformation that has been presented about this disease in the U.S. The purpose of this descriptive study is to assess the self-management of persistent symptoms of COVID-19 with commonly used and misused substances (i.e., alcohol, marijuana and commonly prescribed medications) among adults in the U.S. Methods: The data for this study comes from a cross-sectional survey of U.S. adults that was designed to broadly assess symptom burden, persistent symptom patterns, self-efficacy for symptom management and self-management strategies among people who experienced persistent/Long COVID. Multiple logistic regression analyses were used to assess how symptom length of COVID-19 was associated with the use of several substances to manage these persistent symptoms. Results: The analysis found that adults who had COVID-19 symptoms that persisted for 13 weeks or longer had higher rates of using alcohol (27.3%), marijuana (30.9%) and prescription tranquilizers (21.4%) to manage these symptoms when compared to their adult peers who had COVID-19 symptoms persist for only 4 weeks or less. For instance, the odds of indicating the use of marijuana (AOR = 4.21 95% CI = 1.68,10.5) to manage COVID-19 related symptoms was roughly four times higher for respondents who had COVID-19 symptoms persist for 13 weeks or longer when compared to respondents whose COVID-19 symptoms persisted for only 4 weeks or less. Conclusion: The findings suggest that screening of substance use disorders should be considered among healthcare providers who are treating adults who have persistent symptoms of COVID-19.
Collapse
Affiliation(s)
- Philip T Veliz
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Weijiao Zhou
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sheree Smith
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Janet L Larson
- School of Nursing, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
25
|
Schmachtenberg T, Müller F, Kranz J, Dragaqina A, Wegener G, Königs G, Roder S. How do long COVID patients perceive their current life situation and occupational perspective? Results of a qualitative interview study in Germany. Front Public Health 2023; 11:1155193. [PMID: 36969629 PMCID: PMC10034079 DOI: 10.3389/fpubh.2023.1155193] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023] Open
Abstract
IntroductionMany people experience persistent or new-onset symptoms such as fatigue or cognitive problems after an acute infection with COVID-19. This phenomenon, known as long COVID, impacts physical and mental wellbeing, and may affect perceived quality of life and occupational perspectives likewise. The aim of this study is to gain a deeper understanding of how people with long COVID experience health-related restrictions in their daily life and their occupational situation, and to identify key challenges they face.MethodsGuided qualitative interviews were conducted with 25 people with long COVID. The interviews were transcribed according to Dresing/Pehl and Kuckartz and analyzed using qualitative content analysis. Afterward, a systematic comparison of the data and a reflection under consideration of lifeworld-theoretical approaches (Berger and Luckmann) were carried out.ResultsThe interviews revealed that many participants have severe symptoms which strongly impair them in perform daily and work-related activities, and in their personal interests. Many interviewees already reach their stress limit during routine household activities or childcare. Of the 25 participants, 19 experienced limitations in pursuing leisure activities, and 10 of the 23 interviewees with jobs reported being on sick leave for several months. Several respondents who had vocational reintegration are still affected by ongoing symptoms that affect their work performance considerably. This leads to uncertainty, role conflicts, a decline in social contacts, and decreased incomes, which contribute to an impairment in their quality of life.ConclusionsThis study shows the huge need for specific support for people with long COVID in different areas of life. To prevent people with long COVID from finding themselves in social and economic precarity, decision-makers should develop strategies to systematically support them in their sustainable reintegration into the workforce. The focus should be on creating long COVID-sensitive workplaces, compensating for decreased incomes, and improving access to relief services such as vocational reintegration. We argue, that a shift of perspectives is necessary and that long COVID should be considered rather as a “social disease” with considerably impairments in the social life of those affected.Trial registrationThe study is registered in the German register for clinical trials (DRKS00026007).
Collapse
Affiliation(s)
- Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- *Correspondence: Tim Schmachtenberg
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Jennifer Kranz
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Anita Dragaqina
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Greta Wegener
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| |
Collapse
|
26
|
An observational multi-centric COVID-19 sequelae study among health care workers. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 10:100129. [PMID: 36531928 PMCID: PMC9744681 DOI: 10.1016/j.lansea.2022.100129] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
Background India has seen more than 43 million confirmed cases of COVID-19 as of April 2022, with a recovery rate of 98.8%, resulting in a large section of the population including the healthcare workers (HCWs), susceptible to develop post COVID sequelae. This study was carried out to assess the nature and prevalence of medical sequelae following COVID-19 infection, and risk factors, if any. Methods This was an observational, multicenter cross-sectional study conducted at eight tertiary care centers. The consenting participants were HCWs between 12 and 52 weeks post discharge after COVID-19 infection. Data on demographics, medical history, clinical features of COVID-19 and various symptoms of COVID sequelae was collected through specific questionnaire. Finding Mean age of the 679 eligible participants was 31.49 ± 9.54 years. The overall prevalence of COVID sequelae was 30.34%, with fatigue (11.5%) being the most common followed by insomnia (8.5%), difficulty in breathing during activity (6%) and pain in joints (5%). The odds of having any sequelae were significantly higher among participants who had moderate to severe COVID-19 (OR 6.51; 95% CI 3.46-12.23) and lower among males (OR 0.55; 95% CI 0.39-0.76). Besides these, other predictors for having sequelae were age (≥45 years), presence of any comorbidity (especially hypertension and asthma), category of HCW (non-doctors vs doctors) and hospitalisation due to COVID-19. Interpretation Approximately one-third of the participants experienced COVID sequelae. Severity of COVID illness, female gender, advanced age, co-morbidity were significant risk factors for COVID sequelae. Funding This work is a part of Indian Council for Medical Research (ICMR)- Rational Use of Medicines network. No additional financial support was received from ICMR to carry out the work, for study materials, medical writing, and APC.
Collapse
Key Words
- ACE2, Angiotensin-converting enzyme 2
- AE, Adverse events
- BMI, Body mass index
- CAD, Coronary artery disease
- CI, Confidence interval
- COVID sequelae
- COVID-19
- COVID-19, Corona virus disease 2019
- CTRI, Clinical Trials Registry- India
- DASS-21, Depression, Anxiety, and Stress Scale-21
- ENT, Ear, nose, and throat
- GERD, Gastroesophageal reflux disease
- HCQ, Hydroxychloroquine
- HCW, Health care worker
- ICMR, Indian council of medical research
- ICMR-RUMC
- Long COVID
- MOHFW, Ministry of Health and Family Welfare, Govt. of India
- NICE, National Institute for Health and Clinical Excellence
- OR, Odds ratio
- PCOS, Polycystic Ovarian Disease
- PLOG, Polymerase gamma-related disorders
- RHD, Rheumatic heart disease
- RUMC, Rational use of medicine center
- SARS-CoV-2
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- WHO, World Health Organization
- p-value, Probability value
Collapse
|
27
|
Maneze D, Salamonson Y, Grollman M, Montayre J, Ramjan L. Mandatory COVID-19 vaccination for healthcare workers: A discussion paper. Int J Nurs Stud 2023; 138:104389. [PMID: 36462385 PMCID: PMC9709452 DOI: 10.1016/j.ijnurstu.2022.104389] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The devastating effects of COVID-19 sparked debates among professionals in the fields of health, law, and bioethics regarding policies on mandatory vaccination for healthcare workers. Suboptimal vaccine uptake among healthcare workers had been implicated in the increased risk of nosocomial spread of COVID infection and absenteeism among healthcare workers, impacting the quality of patient care. However, mandatory vaccine policies were also seen to encroach on the autonomy of healthcare workers. AIMS AND OBJECTIVES To synthesise the arguments for and against mandatory vaccination for healthcare workers (HCWs) and its long-term impact on the healthcare workforce, through an analysis of texts and opinions of professionals from different fields of study. METHODS This is a systematic review of opinions published in peer-reviewed journals. After initial search in Cochrane and JBI systematic review databases to ensure no previous review had been done, five databases were searched (PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Scopus). Inclusion criteria were: 1) focused on COVID-19; 2) healthcare workers specific; 3) specific to mandatory vaccination; 4) opinion piece with an identified author; and 5) in English. EXCLUSION 1) focus on other vaccine preventable diseases, not COVID-19 and 2) discussion on mandatory vaccination not-specific to healthcare workers. The Joanna Briggs Critical Appraisal tool for Text and Opinions was used to assess quality. Data were synthesised in the summary table. RESULTS The review included 28 opinion and viewpoint articles. Of these, 12 (43 %) adopted a pro-mandatory vaccination stance, 13 (46 %) were neutral or had presented arguments from both sides of the debate and only three (11 %) were against. The overall arguments among those who were pro-, neutral and anti-mandatory COVID-19 vaccination were underpinned by ethical, moral and legal principles of such a mandate on a vulnerable healthcare workforce. This review highlighted the polarised opinions concerning choices, human rights, professional responsibilities and personal risks (i.e. health risks, losing a job) with the introduction of vaccination mandate. However, the articles found in this review discussed mandatory vaccination of healthcare workers in the USA, Europe and Australia only. CONCLUSION The review underscores the need to balance the rights of the public to safe and quality care with the rights and moral obligations of healthcare workers during a public health emergency. This can be achieved when policies and mandates are guided by reliable scientific evidence which are flexible in considering legal and ethical dilemmas. TWEETABLE ABSTRACT To mandate or not to mandate COVID-19 vaccination for healthcare workers: A synthesis of published opinions in health, law, and bioethics.
Collapse
Affiliation(s)
- Della Maneze
- University of Wollongong, School of Nursing, Wollongong, NSW, Australia; Western Sydney University, School of Nursing and Midwifery, Australia; South Western Sydney Local Health District, Multicultural Health Service, Australia; Australian Centre for Integration of Oral Health (ACIOH), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Yenna Salamonson
- University of Wollongong, School of Nursing, Wollongong, NSW, Australia; Western Sydney University, School of Nursing and Midwifery, Australia; Australian Centre for Integration of Oral Health (ACIOH), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Maxwell Grollman
- University of California, Los Angeles, Institute for Society and Genetics, Los Angeles, CA, USA.
| | - Jed Montayre
- Western Sydney University, School of Nursing and Midwifery, Australia; Australian Centre for Integration of Oral Health (ACIOH), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Lucie Ramjan
- Western Sydney University, School of Nursing and Midwifery, Australia; Australian Centre for Integration of Oral Health (ACIOH), Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| |
Collapse
|
28
|
Kjellberg A, Hassler A, Boström E, El Gharbi S, Al-Ezerjawi S, Kowalski J, Rodriguez-Wallberg KA, Bruchfeld J, Ståhlberg M, Nygren-Bonnier M, Runold M, Lindholm P. Hyperbaric oxygen therapy for long COVID (HOT-LoCO), an interim safety report from a randomised controlled trial. BMC Infect Dis 2023; 23:33. [PMID: 36670365 PMCID: PMC9854077 DOI: 10.1186/s12879-023-08002-8] [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: 07/12/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With ~ 50 million individuals suffering from post-COVID condition (PCC), low health related quality of life (HRQoL) is a vast problem. Common symptoms of PCC, that persists 3 months from the onset of COVID-19 are fatigue, shortness of breath and cognitive dysfunction. No effective treatment options have been widely adopted in clinical practice. Hyperbaric oxygen (HBO2) is a candidate drug. METHODS The objective of this interim analysis is to describe our cohort and evaluate the safety of HBO2 for post covid condition. In an ongoing randomised, placebo-controlled, double blind, clinical trial, 20 previously healthy subjects with PCC were assigned to HBO2 or placebo. Primary endpoints are physical domains in RAND-36; Physical functioning (PF) and Role Physical (RP) at 13 weeks. Secondary endpoints include objective physical tests. Safety endpoints are occurrence, frequency, and seriousness of Adverse Events (AEs). An independent data safety monitoring board (DSMB) reviewed unblinded data. The trial complies with Good Clinical Practice. Safety endpoints are evaluated descriptively. Comparisons against norm data was done using t-test. RESULTS Twenty subjects were randomised, they had very low HRQoL compared to norm data. Mean (SD) PF 31.75 (19.55) (95% Confidence interval; 22.60-40.90) vs 83.5 (23.9) p < 0.001 in Rand-36 PF and mean 0.00 (0.00) in RP. Very low physical performance compared to norm data. 6MWT 442 (180) (95% CI 358-525) vs 662 (18) meters p < 0.001. 31 AEs occurred in 60% of subjects. In 20 AEs, there were at least a possible relationship with the study drug, most commonly cough and chest pain/discomfort. CONCLUSIONS An (unexpectedly) high frequency of AEs was observed but the DSMB assessed HBO2 to have a favourable safety profile. Our data may help other researchers in designing trials. Trial Registration ClinicalTrials.gov: NCT04842448. Registered 13 April 2021, https://clinicaltrials.gov/ct2/show/NCT04842448 . EudraCT: 2021-000764-30. Registered 21 May 2021, https://www.clinicaltrialsregister.eu/ctr-search/trial/2021-000764-30/SE.
Collapse
Affiliation(s)
- Anders Kjellberg
- grid.4714.60000 0004 1937 0626Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Perioperative Medicine and Intensive Care, Medical Unit Intensive Care and Thoracic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Adrian Hassler
- grid.4714.60000 0004 1937 0626Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Medical Unit Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Emil Boström
- grid.4714.60000 0004 1937 0626Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Medical Unit Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sara El Gharbi
- grid.4714.60000 0004 1937 0626Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Medical Unit Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sarah Al-Ezerjawi
- grid.4714.60000 0004 1937 0626Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Medical Unit Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | - Kenny A. Rodriguez-Wallberg
- grid.4714.60000 0004 1937 0626Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Division of Gynaecology and Reproduction, Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Judith Bruchfeld
- grid.4714.60000 0004 1937 0626Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Marcus Ståhlberg
- grid.4714.60000 0004 1937 0626Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Medical Unit Cardiology, Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Nygren-Bonnier
- grid.4714.60000 0004 1937 0626Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Women’s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Runold
- grid.4714.60000 0004 1937 0626Department of Medicine Solna, Respiratory Medicine Unit, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Lindholm
- grid.4714.60000 0004 1937 0626Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden ,grid.266100.30000 0001 2107 4242Division of Hyperbaric Medicine, Department of Emergency Medicine, University of California San Diego, La Jolla, CA 92093 USA
| |
Collapse
|
29
|
Santana K, França E, Sato J, Silva A, Queiroz M, de Farias J, Rodrigues D, Souza I, Ribeiro V, Caparelli-Dáquer E, Teixeira AL, Charvet L, Datta A, Bikson M, Andrade S. Non-invasive brain stimulation for fatigue in post-acute sequelae of SARS-CoV-2 (PASC). Brain Stimul 2023; 16:100-107. [PMID: 36693536 PMCID: PMC9867562 DOI: 10.1016/j.brs.2023.01.1672] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/10/2023] [Accepted: 01/19/2023] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND and purpose: Fatigue is among the most common persistent symptoms following post-acute sequelae of Sars-COV-2 infection (PASC). The current study investigated the potential therapeutic effects of High-Definition transcranial Direct Current Stimulation (HD-tDCS) associated with rehabilitation program for the management of PASC-related fatigue. METHODS Seventy patients with PASC-related fatigue were randomized to receive 3 mA or sham HD-tDCS targeting the left primary motor cortex (M1) for 30 min paired with a rehabilitation program. Each patient underwent 10 sessions (2 sessions/week) over five weeks. Fatigue was measured as the primary outcome before and after the intervention using the Modified Fatigue Impact Scale (MFIS). Pain level, anxiety severity and quality of life were secondary outcomes assessed, respectively, through the McGill Questionnaire, Hamilton Anxiety Rating Scale (HAM-A) and WHOQOL. RESULTS Active HD-tDCS resulted in significantly greater reduction in fatigue compared to sham HD-tDCS (mean group MFIS reduction of 22.11 points vs 10.34 points). Distinct effects of HD-tDCS were observed in fatigue domains with greater effect on cognitive (mean group difference 8.29 points; effect size 1.1; 95% CI 3.56-13.01; P < .0001) and psychosocial domains (mean group difference 2.37 points; effect size 1.2; 95% CI 1.34-3.40; P < .0001), with no significant difference between the groups in the physical subscale (mean group difference 0.71 points; effect size 0.1; 95% CI 4.47-5.90; P = .09). Compared to sham, the active HD-tDCS group also had a significant reduction in anxiety (mean group difference 4.88; effect size 0.9; 95% CI 1.93-7.84; P < .0001) and improvement in quality of life (mean group difference 14.80; effect size 0.7; 95% CI 7.87-21.73; P < .0001). There was no significant difference in pain (mean group difference -0.74; no effect size; 95% CI 3.66-5.14; P = .09). CONCLUSION An intervention with M1 targeted HD-tDCS paired with a rehabilitation program was effective in reducing fatigue and anxiety, while improving quality of life in people with PASC.
Collapse
Affiliation(s)
| | | | - João Sato
- Center of Mathematics, Computing and Cognition, Federal University of ABC, Santo André, Brazil
| | - Ana Silva
- Federal University of Paraíba, João Pessoa, Brazil
| | | | | | | | - Iara Souza
- Federal University of Paraíba, João Pessoa, Brazil
| | - Vanessa Ribeiro
- Department of Health, Government of Paraíba, João Pessoa, Brazil
| | - Egas Caparelli-Dáquer
- Nervous System Electric Stimulation Lab, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Antonio L. Teixeira
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, United States,Faculdade Santa Casa BH, Belo Horizonte, Brazil
| | - Leigh Charvet
- Department of Neurology, New York University Langone Health, New York, United States
| | - Abhishek Datta
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, United States,Research & Development, Soterix Medical, Inc., New York, United States
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, United States
| | | |
Collapse
|
30
|
Klocke C, Valentini J, Stolz R, Gaßner L, Joos S, Förster C. Patients' Experiences With Therapeutic Approaches for Post-COVID Syndrome: Results of a Crowdsourced Research Survey. Ann Fam Med 2023; 21:73-75. [PMID: 36690496 PMCID: PMC9870628 DOI: 10.1370/afm.2898] [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: 04/25/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 01/24/2023] Open
Abstract
Some patients develop multiple protracted sequelae after infection with SARS-CoV-2, collectively known as post-COVID syndrome or long COVID. To date, there is no evidence showing benefit of specific therapies for this condition, and patients likely resort to self-initiated therapies. We aimed to obtain information about therapies used by and needs of this population via inductive crowdsourcing research. Patients completed an online questionnaire about their symptoms and experiences with therapeutic approaches. Responses of 499 participants suggested few approaches (eg, mind-body medicine, respiratory therapy) had positive effects and showed a great need for patient-centered communication (eg, more recognition of this syndrome). Our findings can help design clinical studies and underscore the importance of the holistic approach to care provided by family medicine.
Collapse
Affiliation(s)
- Carina Klocke
- Institute for General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Jan Valentini
- Institute for General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Regina Stolz
- Institute for General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Lena Gaßner
- Institute for General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
- Center for Public Health and Health Services Research, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Christian Förster
- Institute for General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| |
Collapse
|
31
|
Cao X, Feng M, Ge R, Wen Y, Yang J, Li X. Relationship between self-management of patients with anxiety disorders and their anxiety level and quality of life: A cross-sectional study. PLoS One 2023; 18:e0284121. [PMID: 37172052 PMCID: PMC10180596 DOI: 10.1371/journal.pone.0284121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/23/2023] [Indexed: 05/14/2023] Open
Abstract
PURPOSE To explore the correlation between self-management and anxiety and quality of life in patients with anxiety disorders and to understand whether self-management can influence the relationship between anxiety and quality of life and provide a basis for improving their anxiety and quality of life. METHODS A cross-sectional survey of 245 patients with anxiety disorders in West China Hospital of Sichuan University was conducted using the Self-Management of Anxiety Disorders Scale, Self-rating anxiety scale (SAS), and World Health Organization Quality of Life-BBREF. The data were then analyzed using descriptive tests and Pearson correlation in SPSS 25. Bootstrap mediated effects tests were used to test the effect relationship between anxiety, quality of life and self-management scores in patients with anxiety disorders and Amos was used to establish the structural equation model. RESULTS The results of the correlation analysis showed that the total self-management score was positively correlated with the total quality of life score (r = 0.695, P <0.001), physical domain score (r = 0.552, P <0.001), psychological domain score (r = 0.661, P <0.001), social relations domain score (r = 0.542, P <0.001), and environmental domain score (r = 0.614, P <0.001). Additionally, it was negatively correlated with SAS score (r = -0.470, P <0.001). Self-management partially mediates the relationship between anxiety and quality of life, and the direct effect value of anxiety on quality of life was -0.44. The indirect effect value of self-management was -0.27, accounting for 38% of the total effect value. CONCLUSION Self-management of patients with anxiety disorders was negatively correlated with anxiety and positively correlated with quality of life. It played a partially mediating effect between anxiety and quality of life. We recommend that healthcare providers pay attention to self-management interventions for patients with anxiety disorders to further improve their quality of life.
Collapse
Affiliation(s)
- Xinyu Cao
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Mei Feng
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Ruyu Ge
- West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Yan Wen
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Pulmonary and Critical Care Medicine, West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolin Li
- West China Hospital / West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
32
|
Pharmacological Mechanism of NRICM101 for COVID-19 Treatments by Combined Network Pharmacology and Pharmacodynamics. Int J Mol Sci 2022; 23:ijms232315385. [PMID: 36499711 PMCID: PMC9740625 DOI: 10.3390/ijms232315385] [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: 11/07/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Symptom treatments for Coronavirus disease 2019 (COVID-19) infection and Long COVID are one of the most critical issues of the pandemic era. In light of the lack of standardized medications for treating COVID-19 symptoms, traditional Chinese medicine (TCM) has emerged as a potentially viable strategy based on numerous studies and clinical manifestations. Taiwan Chingguan Yihau (NRICM101), a TCM designed based on a medicinal formula with a long history of almost 500 years, has demonstrated its antiviral properties through clinical studies, yet the pharmacogenomic knowledge for this formula remains unclear. The molecular mechanism of NRICM101 was systematically analyzed by using exploratory bioinformatics and pharmacodynamics (PD) approaches. Results showed that there were 434 common interactions found between NRICM101 and COVID-19 related genes/proteins. For the network pharmacology of the NRICM101, the 434 common interacting genes/proteins had the highest associations with the interleukin (IL)-17 signaling pathway in the Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Moreover, the tumor necrosis factor (TNF) was found to have the highest association with the 30 most frequently curated NRICM101 chemicals. Disease analyses also revealed that the most relevant diseases with COVID-19 infections were pathology, followed by cancer, digestive system disease, and cardiovascular disease. The 30 most frequently curated human genes and 2 microRNAs identified in this study could also be used as molecular biomarkers or therapeutic options for COVID-19 treatments. In addition, dose-response profiles of NRICM101 doses and IL-6 or TNF-α expressions in cell cultures of murine alveolar macrophages were constructed to provide pharmacodynamic (PD) information of NRICM101. The prevalent use of NRICM101 for standardized treatments to attenuate common residual syndromes or chronic sequelae of COVID-19 were also revealed for post-pandemic future.
Collapse
|
33
|
Debski M, Tsampasian V, Haney S, Blakely K, Weston S, Ntatsaki E, Lim M, Madden S, Perperoglou A, Vassiliou VS. Post-COVID-19 syndrome risk factors and further use of health services in East England. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001188. [PMID: 36962824 PMCID: PMC10022108 DOI: 10.1371/journal.pgph.0001188] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/24/2022] [Indexed: 12/05/2022]
Abstract
Post-COVID syndrome, defined as symptoms persisting for more than twelve weeks after the diagnosis of COVID-19, has been recognised as a new clinical entity in the context of SARS-CoV-2 infection. This study was conducted to characterise the burden and predictors for post-COVID-19 syndrome in the local population. It was a community-based web-survey study conducted in Norfolk, East England, UK. We sent the survey to patients with confirmed COVID-19 infection by real-time polymerase chain reaction by December 6th, 2020. Questions related to the pre-COVID and post-COVID level of symptoms and further healthcare use. Baseline characteristics were collected from the primary care records. Logistic regression analysis was conducted to establish predictors for post-COVID-19 syndrome and further healthcare utilisation. Of 6,318 patients, survey responses were obtained from 1,487 participants (23.5%). Post-COVID-19 syndrome symptoms were experienced by 774 (52.1%) respondents. Male sex compared to female sex was a factor protective of post-COVID symptoms; relative risk (RR) 0.748, 95% confidence interval (CI), 0.605-0.924. Body mass index was associated with a greater risk of developing post-COVID-19 symptoms (RR 1.031, 95% CI, 1.016-1.047, for 1 kg/m2). A total of 378 (25.4%) people used further health services after their index COVID-19 infection, of whom 277 (73.2%) had post-COVID symptoms. Male sex was negatively associated with the use of further health services (RR 0.618, 95% CI, 0.464-0.818) whereas BMI was positively associated (RR 1.027, 95% CI, 1.009-1.046). Overall, post-COVID-19 symptoms increased the probability of using health services with RR 3.280, 95% CI, 2.540-4.262. This survey of a large number of people previously diagnosed with COVID-19 across East England shows a high prevalence of self-reported post-COVID-19 syndrome. Female sex and BMI were associated with an increased risk of post-COVID-19 syndrome and further utilisation of healthcare.
Collapse
Affiliation(s)
- Maciej Debski
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Vasiliki Tsampasian
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Shawn Haney
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Katy Blakely
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Samantha Weston
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Eleana Ntatsaki
- Rheumatology Department, East Suffolk and North Essex Foundation NHS Trust, Ipswich Hospital, Ipswich, United Kingdom
- Centre for Rheumatology, University College London, London, United Kingdom
| | - Mark Lim
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Susan Madden
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Aris Perperoglou
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Vassilios S. Vassiliou
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
- Institute of Continuing Education, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
34
|
Correa EM, Vallespín GT. COVID persistente. Elementos básicos para el médico de atención primaria. FMC : FORMACION MEDICA CONTINUADA EN ATENCION PRIMARIA 2022; 29:481-489. [PMID: 36338437 PMCID: PMC9619169 DOI: 10.1016/j.fmc.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
•La COVID persistente es una presentación clínica prevalente entre las personas contagiadas por SARS-CoV-2 que provoca multitud de síntomas que pueden afectar a prácticamente todos los sistemas del cuerpo y que impactan en la funcionalidad de las personas afectadas. •La dificultad inicial en su reconocimiento y diagnóstico han provocado un infradiagnóstico y un déficit en la atención sanitaria a las personas afectadas. •Hasta el momento no se han aclarado cuáles son las causas que producen la persistencia de síntomas invalidantes en personas infectadas por SARS-CoV-2 transcurridos 3 meses de la infección aguda. •No existe ningún tratamiento que haya demostrado ser efectivo en la curación de la COVID persistente. •El abordaje de las personas afectadas por COVID persistente debe recaer en la atención primaria priorizando la atención integral, el acompañamiento y la investigación.
Collapse
|
35
|
Chen Y, Wang G, Li J, Xia L, Zhu L, Li W, Luo Q, Liao Y, Lin Y, Bi L, Chen H, Chu J, Li Y, Su J, Ye L, Jiang JJ, Liang H, Li W, An S. CASA: a comprehensive database resource for the COVID-19 Alternative Splicing Atlas. J Transl Med 2022; 20:473. [PMID: 36266726 PMCID: PMC9583055 DOI: 10.1186/s12967-022-03699-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/09/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND As a key process in transcriptional regulatory mechanisms, alternative splicing (AS) plays a crucial role in maintaining the diversity of RNA and protein expression, and mediates the immune response in infectious diseases, especially for the COVID-19. Therefore, urgent data gathering and more research of AS profiles in microbe-infected human cells are needed to improve understanding of COVID-19 and related infectious diseases. Herein, we have created CASA, the COVID-19 Alternative Splicing Atlas to provide a convenient computing platform for studies of AS in COVID-19 and COVID-19-related infectious diseases. METHODS In CASA, we reanalyzed thousands of RNA-seq datasets generated from 65 different tissues, organoids and cell lines to systematically obtain quantitative data on AS events under different conditions. A total of 262,994 AS events from various infectious diseases with differing severity were detected and visualized in this database. In order to explore the potential function of dynamics AS events, we performed analysis of functional annotations and drug-target interactions affected by AS in each dataset. RNA-binding proteins (RBPs), which may regulate these dynamic AS events are also provided for users in this database. RESULTS CASA displays microbe-induced alterations of the host cell splicing landscape across different virus families and helps users identify condition-specific splicing patterns, as well as their potential regulators. CASA may greatly facilitate the exploration of AS profiles and novel mechanisms of host cell splicing by viral manipulation. CASA is freely available at http://www.splicedb.net/casa/ .
Collapse
Affiliation(s)
- Yaxin Chen
- Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Research Center, West China Hospital, Department of Respiratory and Critical Care Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Gang Wang
- Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Research Center, West China Hospital, Department of Respiratory and Critical Care Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jingyi Li
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lei Xia
- Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Lin Zhu
- Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Research Center, West China Hospital, Department of Respiratory and Critical Care Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Wenxing Li
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Qiang Luo
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Yinlu Liao
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Yao Lin
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Liyun Bi
- Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Research Center, West China Hospital, Department of Respiratory and Critical Care Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Hubin Chen
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jiemei Chu
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Yueqi Li
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jinming Su
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Li Ye
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jun-Jun Jiang
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Hao Liang
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Weimin Li
- Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Research Center, West China Hospital, Department of Respiratory and Critical Care Medicine, Sichuan University, Chengdu, Sichuan, China.
| | - Sanqi An
- Biosafety Level-3 Laboratory, Life Sciences Institute & Guangxi Collaborative Innovation Center for Biomedicine, Guangxi Medical University, Nanning, 530021, Guangxi, China.
| |
Collapse
|
36
|
Banerjee I, Robinson J, Sathian B. Treatment of Long COVID or Post COVID syndrome: A Pharmacological approach. Nepal J Epidemiol 2022; 12:1220-1223. [PMID: 36407052 PMCID: PMC9659683 DOI: 10.3126/nje.v12i3.48532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 09/26/2023] Open
Abstract
The novel virus SARS-CoV-2 has plagued our earth for more than a quarter of a decade and is still currently a limiting factor in our daily lives. Of late a new dilemma is beginning to incapacitate a large populous who have been infected by the virus, this condition being termed as post COVID syndrome or Long COVID.Long COVID is becoming more prolific and common amongst those infected with COVID-19 and its development in patients does not delineate between those who have suffered from a symptomatic or an asymptomatic preliminary infection. The effect of this post COVID syndrome can be multisystemic in nature and can affect the daily cognitive abilities of the individual. It is therefore pertinent and of the upmost importance that therapeutic options against Long COVID are explored as the incidence of this condition is rising and will continue to do so in future.
Currently no definitive treatment against Long COVID has been approved and the mainstay treatment is divided into Symptomatic, Supportive and Rehabilitative treatment with self-monitoring. The crux of the current treatment trends for Long COVID is that of a multidisciplinary approach with a great portion of the treatment implicating the patient to take an active role in their recovery, self-monitoring and treatment of the syndrome. Hyperbaric oxygen therapy as well as the use of adaptogens has shown promising results and is advisable to be added to the treatment regimen of patients to aid in decreasing fatigue in patients suffering from post-COVID syndrome. The use of melatonin in patients suffering from insomnia and poor sleep hygiene is also advisable.
Collapse
Affiliation(s)
| | - Jared Robinson
- Sir Seewoosagur Ramgoolam Medical College, Belle Rive, Mauritius
| | - Brijesh Sathian
- Geriatrics and long term care Department, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
37
|
Dahmen A, Keller FM, Derksen C, Rinn R, Becker P, Lippke S. Screening and assessment for post-acute COVID-19 syndrome (PACS), guidance by personal pilots and support with individual digital trainings within intersectoral care: a study protocol of a randomized controlled trial. BMC Infect Dis 2022; 22:693. [PMID: 35971066 PMCID: PMC9377288 DOI: 10.1186/s12879-022-07584-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/30/2022] [Indexed: 11/14/2022] Open
Abstract
Background Because the clinical patterns and symptoms that persist after a COVID-19 infection are diverse, a diagnosis of post-acute COVID-19 syndrome (PACS) is difficult to implement. The current research project therefore aims to evaluate the feasibility and the practicability of a comprehensive, interdisciplinary, and cross-sectoral treatment program consisting of a low-threshold online screening and holistic assessment for PACS. Furthermore, it aims to evaluate digital interventions and the use of so-called personal guides that may help to facilitate the recovery of PACS. Methods This German study consists of a low-threshold online screening for PACS where positively screened participants will be supported throughout by personal pilots. The personal pilots are aimed at empowering patients and helping them to navigate through the study and different treatment options. Patients will then be randomly assigned either to an intervention group (IG) or an active control group (ACG). The IG will receive a comprehensive assessment of physiological and psychological functioning to inform future treatment. The ACG does not receive the assessment but both groups will receive a treatment consisting of an individual digital treatment program (digital intervention platform and an intervention via a chatbot). This digital intervention is based on the needs identified during the assessment for participants in the IG. Compared to that, the ACG will receive a more common digital treatment program aiming to reduce PACS symptoms. Importantly, a third comparison group (CompG) will be recruited that does not receive any treatment. A propensity score matching will take place, ensuring comparability between the participants. Primary endpoints of the study are symptom reduction and return to work. Secondary outcomes comprise, for example, social participation and activities in daily life. Furthermore, the feasibility and applicability of the online screening tool, the holistic assessment, digital trainings, and personal pilots will be evaluated. Discussion This is one of the first large-scale studies to improve the diagnosis and the care of patients with PACS by means of empowerment. It is to be evaluated whether the methods utilized can be used for the German and international population. Trial registration ClinicalTrials.gov Identifier: NCT05238415; date of registration: February 14, 2022 Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07584-z.
Collapse
Affiliation(s)
- Alina Dahmen
- Klinikum Wolfsburg, Sauerbruchstraße 7, 38440, Wolfsburg, Germany.,Jacobs University Bremen gGmbH, Campus Ring 1, 28759, Bremen, Germany.,Dr. Becker Klinikgruppe, 50968, Cologne, Germany
| | | | - Christina Derksen
- Jacobs University Bremen gGmbH, Campus Ring 1, 28759, Bremen, Germany
| | - Robin Rinn
- Jacobs University Bremen gGmbH, Campus Ring 1, 28759, Bremen, Germany.,Julius-Maximilians-Universität, Röntgenring 10, 97070, Würzburg, Germany
| | - Petra Becker
- Dr. Becker Klinikgruppe, 50968, Cologne, Germany
| | - Sonia Lippke
- Jacobs University Bremen gGmbH, Campus Ring 1, 28759, Bremen, Germany.
| |
Collapse
|
38
|
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.
Collapse
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:
| |
Collapse
|
39
|
Sabino JS, Amorim MR, de Souza WM, Marega LF, Mofatto LS, Toledo-Teixeira DA, Forato J, Stabeli RG, Costa ML, Spilki FR, Sabino EC, Faria NR, Benites BD, Addas-Carvalho M, Stucchi RSB, Vasconcelos DM, Weaver SC, Granja F, Proenca-Modena JL, Vilela MMDS. Clearance of Persistent SARS-CoV-2 RNA Detection in a NFκB-Deficient Patient in Association with the Ingestion of Human Breast Milk: A Case Report. Viruses 2022; 14:1042. [PMID: 35632784 PMCID: PMC9143223 DOI: 10.3390/v14051042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023] Open
Abstract
Currently, there are no evidence-based treatment options for long COVID-19, and it is known that SARS-CoV-2 can persist in part of the infected patients, especially those with immunosuppression. Since there is a robust secretion of SARS-CoV-2-specific highly-neutralizing IgA antibodies in breast milk, and because this immunoglobulin plays an essential role against respiratory virus infection in mucosa cells, being, in addition, more potent in neutralizing SARS-CoV-2 than IgG, here we report the clinical course of an NFκB-deficient patient chronically infected with the SARS-CoV-2 Gamma variant, who, after a non-full effective treatment with plasma infusion, received breast milk from a vaccinated mother by oral route as treatment for COVID-19. After such treatment, the symptoms improved, and the patient was systematically tested negative for SARS-CoV-2. Thus, we hypothesize that IgA and IgG secreted antibodies present in breast milk could be useful to treat persistent SARS-CoV-2 infection in immunodeficient patients.
Collapse
Affiliation(s)
- Janine S. Sabino
- Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil; (J.S.S.); (L.F.M.)
| | - Mariene R. Amorim
- Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil; (M.R.A.); (L.S.M.); (D.A.T.-T.); (J.F.); (F.G.)
| | - William M. de Souza
- World Reference Center for Emerging Viruses, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA; (W.M.d.S.); (S.C.W.)
| | - Lia F. Marega
- Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil; (J.S.S.); (L.F.M.)
| | - Luciana S. Mofatto
- Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil; (M.R.A.); (L.S.M.); (D.A.T.-T.); (J.F.); (F.G.)
| | - Daniel A. Toledo-Teixeira
- Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil; (M.R.A.); (L.S.M.); (D.A.T.-T.); (J.F.); (F.G.)
| | - Julia Forato
- Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil; (M.R.A.); (L.S.M.); (D.A.T.-T.); (J.F.); (F.G.)
| | - Rodrigo G. Stabeli
- Oswaldo Cruz Foundation (Fiocruz-SP), Ribeirão Preto 14049-900, Brazil;
- Department of Public Health Emergency, Preparedness and Disaster, PAHO/WHO, Brasilia 70312-970, Brazil
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil;
| | - Fernando R. Spilki
- One Health Laboratory, Feevale University, Novo Hamburgo 93510-235, Brazil;
| | - Ester C. Sabino
- Tropical Medicine Institute, Medical School, University of São Paulo, São Paulo 5403-907, Brazil;
- Department of Infectious and Parasitic Disease, Medical School, University of São Paulo, São Paulo 05403-000, Brazil;
| | - Nuno R. Faria
- Department of Infectious and Parasitic Disease, Medical School, University of São Paulo, São Paulo 05403-000, Brazil;
- Department of Zoology, University of Oxford, Oxford OX1 2JD, UK
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London SW7 2AZ, UK
| | - Bruno D. Benites
- Hematology and Transfusion Medicine Center, University of Campinas, Campinas 13083-878, Brazil; (B.D.B.); (M.A.-C.)
| | - Marcelo Addas-Carvalho
- Hematology and Transfusion Medicine Center, University of Campinas, Campinas 13083-878, Brazil; (B.D.B.); (M.A.-C.)
| | - Raquel S. B. Stucchi
- Division of Infectious Diseases, University of Campinas, Campinas 13083-887, Brazil;
| | - Dewton M. Vasconcelos
- Laboratory of Investigation in Dermatology and Immunodeficiencies, Department of Dermatology, Medical School, University of São Paulo, São Paulo 05403-000, Brazil;
| | - Scott C. Weaver
- World Reference Center for Emerging Viruses, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA; (W.M.d.S.); (S.C.W.)
- Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Fabiana Granja
- Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil; (M.R.A.); (L.S.M.); (D.A.T.-T.); (J.F.); (F.G.)
- Biodiversity Research Centre, Federal University of Roraima, Boa Vista 72000-000, Brazil
| | - José Luiz Proenca-Modena
- Laboratory of Emerging Viruses, Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas 13083-862, Brazil; (M.R.A.); (L.S.M.); (D.A.T.-T.); (J.F.); (F.G.)
- Experimental Medicine Research Cluster (EMRC), University of Campinas, Campinas 13083-862, Brazil
- Hub of Global Health (HGH), University of Campinas, Campinas 13083-862, Brazil
| | - Maria Marluce dos S. Vilela
- Laboratory of Pediatric Immunology, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas 13083-887, Brazil; (J.S.S.); (L.F.M.)
| |
Collapse
|