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Banihashemi ZS, Azizi-Fini I, Rajabi M, Maghami M, Yadollahi S. Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract. BMJ Support Palliat Care 2024:spcare-2023-004595. [PMID: 38834234 DOI: 10.1136/spcare-2023-004595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 05/21/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE This study aimed to evaluate the effect of Astragalus root extract on nurses suffering from post-COVID-19 chronic fatigue syndrome. MATERIALS AND METHODS The study was designed as a triple-blind, randomised, controlled trial in Iran in 2023. 64 chronic fatigue syndrome nurses were randomly assigned to one of two groups: an intervention group (n=32) that received Astragalus root extract (500 mg two times per day) or a control group (n=32) that received a placebo. Changes in chronic fatigue syndrome scores were measured before to, at the end of and 1 month after the intervention. Data were analysed using descriptive and analytical statistics (T-tests, χ2, analysis of variances, Cochran's Q tests, McNemar and generalised estimating equations). RESULTS In comparison to before, chronic fatigue prevalence decreased statistically significantly at the end of the intervention group (13.8%) and 1 month later (17.2%). Further, the frequency differed between before and after (p=0.0001) and 1 month later (p=0.0001). In the control group, chronic fatigue was statistically significantly different before and after the intervention (72.2%; p=0.003). Having an underlying disease (B=0.84, OR=2.33; p=0.04) and being in the control group (B=2.15, OR=12.36; p=0.01) increased the risk of chronic fatigue, whereas increasing the length of time decreased it (B=-0.67, OR=0.50; p=0.0001). CONCLUSION Astragalus root extract has been shown to reduce chronic fatigue in nurses. Therefore, this herbal extract can be used to reduce the incidence and treatment of chronic fatigue in nurses.
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Affiliation(s)
- Zahra-Sadat Banihashemi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Isfahan, Iran
| | - Ismail Azizi-Fini
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Isfahan, Iran
| | - Mahdi Rajabi
- Department of Anesthesiology, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahboobeh Maghami
- Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Safoura Yadollahi
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Isfahan, Iran
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Annesley SJ, Missailidis D, Heng B, Josev EK, Armstrong CW. Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies. Trends Mol Med 2024; 30:443-458. [PMID: 38443223 DOI: 10.1016/j.molmed.2024.02.003] [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: 11/20/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic illness often triggered by an initiating acute event, mainly viral infections. The transition from acute to chronic disease remains unknown, but interest in this phenomenon has escalated since the COVID-19 pandemic and the post-COVID-19 illness, termed 'long COVID' (LC). Both ME/CFS and LC share many clinical similarities. Here, we present recent findings in ME/CFS research focussing on proposed disease pathologies shared with LC. Understanding these disease pathologies and how they influence each other is key to developing effective therapeutics and diagnostic tests. Given that ME/CFS typically has a longer disease duration compared with LC, with symptoms and pathologies evolving over time, ME/CFS may provide insights into the future progression of LC.
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Affiliation(s)
- Sarah J Annesley
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, VIC, Australia.
| | - Daniel Missailidis
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, VIC, Australia
| | - Benjamin Heng
- Macquarie Medical School, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Elisha K Josev
- Neurodisability & Rehabilitation, Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia; Mercy Hospital for Women, Heidelberg, VIC, Australia
| | - Christopher W Armstrong
- Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, VIC, Australia
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Sarmento A, Adodo R, Hodges G, Webber SC, Sanchez-Ramirez DC. Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study. BMC Pulm Med 2024; 24:139. [PMID: 38500051 PMCID: PMC10949685 DOI: 10.1186/s12890-024-02965-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The characteristics of optimal virtual pulmonary rehabilitation (PR) for individuals with post-COVID syndrome (PCS) have not been identified. This study aimed to assess the feasibility, safety, and satisfaction associated with a virtual PR program with the exercise component delivered through group or self-directed sessions. METHODS Adults with PCS-respiratory symptoms were randomly assigned to the video conference (PRVC) or self-directed (PRSD) group and completed an exercise program (aerobic, strengthening, and breathing exercises) three times/week for eight weeks. PRVC sessions were led by a physiotherapist via Zoom, whereas the PRSD group exercised individually following a pre-recorded video. Both groups received personalized exercise recommendations, education related to the condition, and a weekly follow up call. Satisfaction was assessed through a patient survey. Lung function, dyspnea, fatigue, sit-to-stand capacity, health-related quality of life, and participation were assessed pre- and post-PR. RESULTS Fourteen PCS individuals (49 ± 9 years, 86% females) completed 83% of the sessions. All participants were satisfied with information provided by the therapist and frequency of data submission, whereas most were satisfied with the frequency and duration of exercise sessions (88% in PRVC and 83% in PRSD). A higher proportion of participants in the PRVC (88%) were satisfied with the level of difficulty of exercises compared with the PRSD (67%), and 84% of the sample reported a positive impact of the program on their health. No adverse events were reported. Significant changes in sit-to-stand capacity (p = 0.012, Cohen's r = 0.67) and questions related to fatigue (p = 0.027, Cohen's r = 0.58), neurocognitive (p = 0.045, Cohen's r = 0.53), and autonomic (p = 0.024, Cohen's r = 0.60) domains of the DePaul Symptom Questionnaire short-form were also found between groups. CONCLUSION Virtual PR with exercises delivered via video conference or pre-recorded video were feasible, safe, and well-received by individuals with PCS. TRIAL REGISTRATION NCT05003271 (first posted: 12/08/2021).
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Affiliation(s)
- Antonio Sarmento
- Department of Respiratory Therapy, University of Manitoba, Room 334 - 771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada
| | - Rachel Adodo
- Department of Respiratory Therapy, University of Manitoba, Room 334 - 771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada
| | - Greg Hodges
- Health Sciences Centre. Winnipeg, Winnipeg, MB, Canada
| | - Sandra C Webber
- Department of Physical Therapy, University of Manitoba, Winnipeg, MB, Canada
| | - Diana C Sanchez-Ramirez
- Department of Respiratory Therapy, University of Manitoba, Room 334 - 771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada.
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McGarrigle WJ, Furst J, Jason LA. Psychometric evaluation of the DePaul Symptom Questionnaire-Short Form (DSQ-SF) among adults with Long COVID, ME/CFS, and healthy controls: A machine learning approach. J Health Psychol 2024:13591053231223882. [PMID: 38282368 DOI: 10.1177/13591053231223882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Long COVID shares a number of clinical features with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), including post-exertional malaise, severe fatigue, and neurocognitive deficits. Utilizing validated assessment tools that accurately and efficiently screen for these conditions can facilitate diagnostic and treatment efforts, thereby improving patient outcomes. In this study, we generated a series of random forest machine learning algorithms to evaluate the psychometric properties of the DePaul Symptom Questionnaire-Short Form (DSQ-SF) in classifying large groups of adults with Long COVID, ME/CFS (without Long COVID), and healthy controls. We demonstrated that the DSQ-SF can accurately classify these populations with high degrees of sensitivity and specificity. In turn, we identified the particular DSQ-SF symptom items that best distinguish Long COVID from ME/CFS, as well as those that differentiate these illness groups from healthy controls.
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Orji NC, Cox IA, Jason LA, Chen G, Zhao T, Rogerson MJ, Kelly RM, Wills K, Hensher M, Palmer AJ, de Graaff B, Campbell JA. Assessing health state utilities for people with myalgic encephalomyelitis/chronic fatigue syndrome in Australia using the EQ-5D-5L, AQoL-8D and EQ-5D-5L-psychosocial instruments. Qual Life Res 2024; 33:45-57. [PMID: 37561337 PMCID: PMC10784392 DOI: 10.1007/s11136-023-03498-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic condition with a constellation of symptoms presenting as severe and profound fatigue of ≥ 6 months not relieved by rest. ME/CFS affects health-related quality of life (HRQoL), which can be measured using multi-attribute health state utility (HSU) instruments. The aims of this study were to quantify HSUs for people living with ME/CFS, and to identify an instrument that is preferentially sensitive for ME/CFS. METHODS Cross-sectional national survey of people with ME/CFS using the AQoL-8D and EQ-5D-5L. Additional questions from the AQoL-8D were used as 'bolt-ons' to the EQ-5D-5L (i.e., EQ-5D-5L-Psychosocial). Disability and fatigue severity were assessed using the De Paul Symptom Questionnaire-Short Form (DSQ-SF). HSUs were generated using Australian tariffs. Mean HSUs were stratified for sociodemographic and clinical factors. Bland-Altman plots were used to compare the three HSU instruments. RESULTS For the 198 participants, mean HSUs (95% confidence intervals) were EQ-5D-5L: 0.46 (0.42-0.50); AQoL-8D: 0.43 (0.41-0.45); EQ-5D-5L-Psychosocial: 0.44 (0.42-0.46). HSUs were substantially lower than population norms: EQ-5D-5L: 0.89; AQoL-8D: 0.77. As disability and fatigue severity increased, HSUs decreased in all three instruments. Bland-Altman plots revealed interchangeability between the AQoL-8D and EQ-5D-5LPsychosocial. Floor and ceiling effects of 13.5% and 2.5% respectively were observed for the EQ-5D-5L instrument only. CONCLUSIONS ME/CFS has a profound impact on HRQoL. The AQoL-8D and EQ-5D-5L-Psychosocial can be used interchangeably: the latter represents a reduced participant burden.
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Affiliation(s)
- Nneka C Orji
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ingrid A Cox
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Leonard A Jason
- DePaul University Center for Community Research, Chicago, IL, USA
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, VIC, Australia
| | - Ting Zhao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Melissa J Rogerson
- School of Computing & Information Systems, University of Melbourne, Melbourne, VIC, Australia
| | - Ryan M Kelly
- School of Computing & Information Systems, University of Melbourne, Melbourne, VIC, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Martin Hensher
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
| | - Julie A Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Worrall S, Harris EJ, Silverio SA, Fallon V. The identification and measurement of postpartum anxiety in England: A Delphi survey. J Psychiatr Res 2023; 168:381-391. [PMID: 37976556 DOI: 10.1016/j.jpsychires.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 08/14/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
Postpartum anxiety has negative consequences for both mother and infant, so effective identification and measurement is vital to enable intervention. Despite NICE recommendations to prioritise the measurement of postpartum anxiety in mothers, current clinical measurement in England remains both fragmented and flawed. The Postpartum Specific Anxiety Scale [PSAS] offers an alternative, as it measures maternal-focused anxieties which can enable specifically targeted interventions. However, it is only currently used as a research tool and may require modification for clinical use. To inform modification of the PSAS, nineteen stakeholders from a variety of organisations participated in a two-round Delphi consensus survey to measure its clinical relevance and potential for effective identification of clinical anxiety. Descriptive analyses revealed all subscales of the PSAS scored highly across all domains, excluding Practical Infant Care Anxieties. Analyses also indicated good consensus between stakeholders across specific items, suggesting that the some items on the PSAS are relevant and effective at identifying clinical postpartum anxiety. Participants also expressed a need for a shorter version of the PSAS for clinical use, and that additional items may need including. Future research must now adapt the existing PSAS based on the results of this study and pilot the adapted measure in a clinical population.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Elizabeth J Harris
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, UK.
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
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Oliveira CR, Jason LA, Unutmaz D, Bateman L, Vernon SD. Improvement of Long COVID symptoms over one year. Front Med (Lausanne) 2023; 9:1065620. [PMID: 36698810 PMCID: PMC9868805 DOI: 10.3389/fmed.2022.1065620] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Importance Early and accurate diagnosis and treatment of Long COVID, clinically known as post-acute sequelae of COVID-19 (PASC), may mitigate progression to chronic diseases such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Our objective was to determine the utility of the DePaul Symptom Questionnaire (DSQ) to assess the frequency and severity of common symptoms of ME/CFS, to diagnose and monitor symptoms in patients with PASC. Methods This prospective, observational cohort study enrolled 185 people that included 34 patients with PASC that had positive COVID-19 test and persistent symptoms of >3 months and 151 patients diagnosed with ME/CFS. PASC patients were followed over 1 year and responded to the DSQ at baseline and 12 months. ME/CFS patients responded to the DSQ at baseline and 1 year later. Changes in symptoms over time were analyzed using a fixed-effects model to compute difference-in-differences estimates between baseline and 1-year follow-up assessments. Participants Patients were defined as having PASC if they had a previous positive COVID-19 test, were experiencing symptoms of fatigue, post-exertional malaise, or other unwellness for at least 3 months, were not hospitalized for COVID-19, had no documented major medical or psychiatric diseases prior to COVID-19, and had no other active and untreated disease processes that could explain their symptoms. PASC patients were recruited in 2021. ME/CFS patients were recruited in 2017. Results At baseline, patients with PASC had similar symptom severity and frequency as patients with ME/CFS and satisfied ME/CFS diagnostic criteria. ME/CFS patients experienced significantly more severe unrefreshing sleep and flu-like symptoms. Five symptoms improved significantly over the course of 1 year for PASC patients including fatigue, post-exertional malaise, brain fog, irritable bowel symptoms and feeling unsteady. In contrast, there were no significant symptom improvements for ME/CFS patients. Conclusion and relevance There were considerable similarities between patients with PASC and ME/CFS at baseline. However, symptoms improved for PASC patients over the course of a year but not for ME/CFS patients. PASC patients with significant symptom improvement no longer met ME/CFS clinical diagnostic criteria. These findings indicate that the DSQ can be used to reliably assess and monitor PASC symptoms.
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Affiliation(s)
- Carlos R. Oliveira
- Section of Infectious Diseases and Global Health, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States
- Section of Health Informatics, Department of Biostatistics, Yale University School of Public Health, New Haven, CT, United States
| | - Leonard A. Jason
- Center for Community Research, DePaul University, Chicago, IL, United States
| | - Derya Unutmaz
- The Jackson Laboratory for Genomic Medicine, University of Connecticut School of Medicine, Farmington, CT, United States
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Jason LA, Dorri JA. ME/CFS and Post-Exertional Malaise among Patients with Long COVID. Neurol Int 2022; 15:1-11. [PMID: 36648965 PMCID: PMC9844405 DOI: 10.3390/neurolint15010001] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 11/28/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
This study sought to ascertain the prevalence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) among a sample of 465 patients with Long COVID. The participants completed three questionnaires: (1) a new questionnaire measuring both the frequency and severity of 38 common symptoms of COVID and Long COVID, (2) a validated short form questionnaire assessing ME/CFS, and (3) a validated questionnaire measuring post-exertional malaise. The population was predominantly white, female, and living in North America. The mean duration since the onset of COVID-19 symptoms was 70.5 weeks. Among the 465 participants, 58% met a ME/CFS case definition. Of respondents who reported that they had ME/CFS only 71% met criteria for ME/CFS and of those who did not report they had ME/CFS, 40% nevertheless did meet criteria for the disease: both over-diagnosis and under-diagnosis were evident on self-report. This study supports prior findings that ME/CFS occurs with high prevalence among those who have persistent COVID-19 symptoms.
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Shaheen N, Shaheen A. Long-term sequelae of COVID-19 (myalgic encephalomyelitis): An international cross-sectional study. Medicine (Baltimore) 2022; 101:e31819. [PMID: 36397426 PMCID: PMC9665887 DOI: 10.1097/md.0000000000031819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As a result of prolonged effects on multiple organs, recovery from COVID-19 caused by SARS-CoV-2 cannot be verified. This study seeks to understand chronic and acute long-term symptoms of COVID-19 lasting from a few weeks after diagnosis. The study also aims to gain insight into prevalence of chronic fatigue syndrome/myalgic encephalomyelitis, a potentially comorbid condition for several months after the infection, in addition to taking a broad perspective on rare symptoms that may have developed during or after the infection. STUDY DESIGN Cross-sectional questionnaire\descriptive study. METHODS The questionnaire was developed to assess the long-term effects of the global pandemic of COVID-19 using DePaul Symptom Questionnaire-2. The DePaul Symptom Questionnaire, Patient Health Questionnaire, and other symptoms that have been introduced by literature review. DISCUSSION A large cohort of people from all over the world will be examined to understand the differential effects of people who have experienced COVID-19, as well as the potential occurrence of ME. In total, 20,000 COVID patients are expected to be included in the study by Sep 1, 2022. Patients who have experienced COVID-19 will be asked about their persistent symptoms from 1 week up to more than 6 months after catching or recovery from the infection.
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Affiliation(s)
- Nour Shaheen
- Department of Medicine, Alexandria University, Alexandria, Egypt
- * Correspondence: Nour Shaheen, Department of Medicine, Alexandria University, Alexandria, Egypt (e-mail: )
| | - Ahmed Shaheen
- Department of Medicine, Alexandria University, Alexandria, Egypt
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Jimeno-Almazán A, Martínez-Cava A, Buendía-Romero Á, Franco-López F, Sánchez-Agar JA, Sánchez-Alcaraz BJ, Tufano JJ, Pallarés JG, Courel-Ibáñez J. Relationship between the severity of persistent symptoms, physical fitness, and cardiopulmonary function in post-COVID-19 condition. A population-based analysis. Intern Emerg Med 2022; 17:2199-2208. [PMID: 35904700 PMCID: PMC9335466 DOI: 10.1007/s11739-022-03039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/19/2022] [Indexed: 11/25/2022]
Abstract
The aim of this study was to determine the relationship between physical fitness, cardiopulmonary function and patient-reported severity of symptoms in people with post-COVID-19 condition. We examined ambulatory patients (n = 72) with post-COVID-19 condition who had a chronic symptomatic phase lasting > 12 weeks from the onset of symptoms, but had not been hospitalized for acute COVID-19. A comprehensive medical screening was conducted, including clinical history, symptomatology, comorbidities, body composition and physical activity levels. We then identified the relationship between physical fitness (cardiorespiratory fitness and muscular strength), cardiopulmonary function (echocardiographic and spirometry parameters) and patient-reported severity of symptoms (fatigue, dyspnea, health-related quality of life, anxiety, and depression). Age, body mass index, sex, number of comorbidities and duration of symptoms were included as potential confounders. Results showed that greater physical fitness and cardiopulmonary function were associated with lower severity of symptoms in people with post-COVID-19 condition. Cardiorespiratory fitness, lower-limb muscle strength, maximal voluntary ventilation and left ventricular ejection fraction account for reducing fatigue and dyspnea. Greater physical activity levels were associated with fewer symptoms and less-severe fatigue and dyspnea. In conclusion, preserving better cardiopulmonary health and physical condition during the course of the disease-even in mild cases-was related to a lower intensity of symptoms in non-hospitalized people with post-COVID-19 condition. It is probable that exercise and physical conditioning are valuable pre- and post-COVID-19 countermeasures that could help decrease the severity, not only of acute infection, but of post-COVID-19 persistent symptoms and prognosis.
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Affiliation(s)
- Amaya Jimeno-Almazán
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30730, San Javier, Murcia, Spain
- Department of Infectious Diseases, Hospital Universitario Santa Lucía, 30202, Cartagena, Murcia, Spain
| | - Alejandro Martínez-Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30730, San Javier, Murcia, Spain
| | - Ángel Buendía-Romero
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30730, San Javier, Murcia, Spain
| | - Francisco Franco-López
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30730, San Javier, Murcia, Spain
| | - José Antonio Sánchez-Agar
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30730, San Javier, Murcia, Spain
- Family Medicine Residency, Hospital Universitario Virgen de La Arrixaca, 30120, Murcia, Spain
| | | | - James J Tufano
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, 16252, Prague, Czech Republic
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30730, San Javier, Murcia, Spain
| | - Javier Courel-Ibáñez
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University, 16252, Prague, Czech Republic.
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Activity monitoring and patient-reported outcome measures in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome patients. PLoS One 2022; 17:e0274472. [PMID: 36121803 PMCID: PMC9484698 DOI: 10.1371/journal.pone.0274472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/26/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease with no validated specific and sensitive biomarker, and no standard approved treatment. In this observational study with no intervention, participants used a Fitbit activity tracker. The aims were to explore natural symptom variation, feasibility of continuous activity monitoring, and to compare activity data with patient reported outcome measures (PROMs). Materials and methods In this pilot study, 27 patients with mild to severe ME/CFS, of mean age 42.3 years, used the Fitbit Charge 3 continuously for six months. Patients wore a SenseWear activity bracelet for 7 days at baseline, at 3 and 6 months. At baseline and follow-up they completed the Short Form 36 Health Survey (SF-36) and the DePaul Symptom Questionnaire–Short Form (DSQ-SF). Results The mean number of steps per day decreased with increasing ME/CFS severity; mild 5566, moderate 4991 and severe 1998. The day-by-day variation was mean 47% (range 25%–79%). Mean steps per day increased from the first to the second three-month period, 4341 vs 4781 steps, p = 0.022. The maximum differences in outcome measures between 4-week periods (highest vs lowest), were more evident in a group of eight patients with milder disease (baseline SF-36 PF > 50 or DSQ-SF < 55) as compared to 19 patients with higher symptom burden (SF-36 PF < 50 and DSQ-SF > 55), for SF-36 PF raw scores: 16.9 vs 3.4 points, and for steps per day: 958 versus 479 steps. The correlations between steps per day and self-reported SF-36 Physical function, SF-36 Social function, and DSQ-SF were significant. Fitbit recorded significantly higher number of steps than SenseWear. Resting heart rates were stable during six months. Conclusion Continuous activity registration with Fitbit Charge 3 trackers is feasible and useful in studies with ME/CFS patients to monitor steps and resting heart rate, in addition to self-reported outcome measures. Clinical trial registration Clinicaltrials.gov: NCT04195815.
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12
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Jimeno‐Almazán A, Franco‐López F, Buendía‐Romero Á, Martínez‐Cava A, Sánchez‐Agar JA, Martínez BJS, Courel‐Ibáñez J, Pallarés JG. Rehabilitation for
post‐COVID
‐19 condition through a supervised exercise intervention: a randomized controlled trial. Scand J Med Sci Sports 2022; 32:1791-1801. [PMID: 36111386 PMCID: PMC9538729 DOI: 10.1111/sms.14240] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/28/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Amaya Jimeno‐Almazán
- Department of Infectious Diseases, Hospital Universitario Santa Lucía, Cartagena Murcia Spain
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences University of Murcia Murcia Spain
| | - Francisco Franco‐López
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences University of Murcia Murcia Spain
| | - Ángel Buendía‐Romero
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences University of Murcia Murcia Spain
| | - Alejandro Martínez‐Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences University of Murcia Murcia Spain
| | - José Antonio Sánchez‐Agar
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences University of Murcia Murcia Spain
| | | | | | - Jesús G. Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences University of Murcia Murcia Spain
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Ramiller A, Mudie K, Seibert E, Whittaker S. The Facilitation of Clinical and Therapeutic Discoveries in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome and Related Diseases: A Protocol for the You + ME Registry Research Platform (Preprint). JMIR Res Protoc 2022; 11:e36798. [PMID: 35816681 PMCID: PMC9369615 DOI: 10.2196/36798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 11/26/2022] Open
Abstract
Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, complex, heterogeneous disease that affects millions and lacks both diagnostics and treatments. Big data, or the collection of vast quantities of data that can be mined for information, have transformed the understanding of many complex illnesses, such as cancer and multiple sclerosis, by dissecting heterogeneity, identifying subtypes, and enabling the development of personalized treatments. It is possible that big data can reveal the same for ME/CFS. Objective This study aims to describe the protocol for the You + ME Registry, present preliminary results related to participant enrollment and satisfaction, and discuss the limitations of the registry as well as next steps. Methods We developed and launched the You + ME Registry to collect longitudinal health data from people with ME/CFS, people with long COVID (LC), and control volunteers using rigorous protocols designed to harmonize with other groups collecting data from similar groups of people. Results As of September 30, 2021, the You + ME Registry had over 4200 geographically diverse participants (3033/4339, 69.9%, people with ME/CFS; 833/4339, 19.2%, post–COVID-19 people; and 473/4339, 10.9%, control volunteers), with an average of 72 new people registered every week. It has qualified as “great” using a net promotor score, indicating registrants are likely to recommend the registry to a friend. Analyses of collected data are currently underway, and preliminary findings are expected in the near future. Conclusions The You + ME Registry is an invaluable resource because it integrates with a symptom-tracking app, as well as a biorepository, to provide a robust and rich data set that is available to qualified researchers. Accordingly, it facilitates collaboration that may ultimately uncover causes and help accelerate the development of therapies. Trial Registration ClinicalTrials.gov NCT04806620; https://clinicaltrials.gov/ct2/show/NCT04806620 International Registered Report Identifier (IRRID) DERR1-10.2196/36798
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Affiliation(s)
| | | | - Elle Seibert
- Solve ME/CFS Initiative, Glendale, CA, United States
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Froehlich L, Hattesohl DB, Cotler J, Jason LA, Scheibenbogen C, Behrends U. Causal attributions and perceived stigma for myalgic encephalomyelitis/chronic fatigue syndrome. J Health Psychol 2021; 27:2291-2304. [PMID: 34240650 PMCID: PMC9434257 DOI: 10.1177/13591053211027631] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic disease with the hallmark symptom of post-exertional malaise. Evidence for physiological causes is converging, however, currently no diagnostic test or biomarker is available. People with ME/CFS experience stigmatization, including the perception that the disease is psychosomatic. In a sample of 499 participants with self-diagnosed ME/CFS, we investigated perceived stigma as a pathway through which perceived others' causal attributions relate to lower satisfaction with social roles and activities and functional status. Higher perceived attributions by others to controllable and unstable causes predicted lower health-related and social outcomes via higher perceived stigma.
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Medical Care Situation of People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Germany. ACTA ACUST UNITED AC 2021; 57:medicina57070646. [PMID: 34201825 PMCID: PMC8306083 DOI: 10.3390/medicina57070646] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022]
Abstract
Background and Objective: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a severe illness with the hallmark symptom of Post-Exertional Malaise (PEM). Currently, no biomarkers or established diagnostic tests for ME/CFS exist. In Germany, it is estimated that over 300,000 people are affected by ME/CFS. Research from the United States and the UK shows that patients with ME/CFS are medically underserved, as they face barriers to medical care access and are dissatisfied with medical care. The first aim of the current research was to investigate whether patients with ME/CFS are medically underserved in Germany in terms of access to and satisfaction with medical care. Second, we aimed at providing a German-language version of the DePaul Symptom Questionnaire Short Form (DSQ-SF) as a tool for ME/CFS diagnostics and research in German-speaking countries. Materials and Methods: The current research conducted an online questionnaire study in Germany investigating the medical care situation of patients with ME/CFS. The questionnaire was completed by 499 participants who fulfilled the Canadian Consensus Criteria and reported PEM of 14 h or longer. Results: Participants frequently reported geographic and financial reasons for not using the available medical services. Furthermore, they reported low satisfaction with medical care by the physician they most frequently visited due to ME/CFS. The German version of the DSQ-SF showed good reliability, a one-factorial structure and construct validity, demonstrated by correlations with the SF-36 as a measure of functional status. Conclusions: Findings provide evidence that patients with ME/CFS in Germany are medically underserved. The German-language translation of the DSQ-SF provides a brief, reliable and valid instrument to assess ME/CFS symptoms to be used for research and clinical practice in German-speaking countries. Pathways to improve the medical care of patients with ME/CFS are discussed.
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