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Smith A, Greenwood D, Horton M, Osborne T, Goodwin M, Lawrence RR, Winch D, Williams P, Milne R, Sivan M. Psychometric analysis of the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) in a prospective multicentre study. BMJ Open Respir Res 2024; 11:e002271. [PMID: 38724221 PMCID: PMC11086182 DOI: 10.1136/bmjresp-2023-002271] [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: 12/22/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Long COVID (LC) is a novel multisystem clinical syndrome affecting millions of individuals worldwide. The modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) is a condition-specific patient-reported outcome measure designed for assessment and monitoring of people with LC. OBJECTIVES To evaluate the psychometric properties of the C19-YRSm in a prospective sample of people with LC. METHODS 1314 patients attending 10 UK specialist LC clinics completed C19-YRSm and EuroQol 5D-5L (EQ-5D-5L) longitudinally. Scale characteristics were derived for C19-YRSm subscales (Symptom Severity (SS), Functional Disability (FD) and Overall Health (OH)) and internal consistency (Cronbach's alpha). Convergent validity was assessed using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale. Known groups validity was assessed for the Other Symptoms subscale as tertiles, as well as by hospitalisation and intensive care admission. Responsiveness and test-retest reliability was evaluated for C19-YRSm subscales and EQ-5D-5L. The minimal important difference (MID) and minimal clinically important difference (MCID) were estimated. Confirmatory factor analysis was applied to determine the instrument's two-factor structure. RESULTS C19-YRSm demonstrated good scale characteristic properties. Item-total correlations were between 0.37 and 0.65 (for SS and FD), with good internal reliability (Cronbach's alphas>0.8). Item correlations between subscales ranged between 0.46 and 0.72. Convergent validity with FACIT was good (-0.46 to -0.62). The three subscales discriminated between different levels of symptom burden (p<0.001) and between patients admitted to hospital and intensive care. There was moderate responsiveness for the three subscales ranging from 0.22 (OH) to 0.50 (SS) which was greater than for the EQ-5D-5L. Test-retest reliability was good for both SS 0.86 and FD 0.78. MID was 2 for SS, 2 for FD and 1 for OH; MCID was 4 for both the SS and FD. The factor analysis supported the two-factor SS and FD structure. CONCLUSIONS The C19-YRSm is a condition-specific, reliable, valid and responsive patient-reported outcome measure for LC.
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Affiliation(s)
- Adam Smith
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Darren Greenwood
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Mike Horton
- Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK
| | - Thomas Osborne
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Madeline Goodwin
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | | | - Darren Winch
- Kent & Medway ICB Patient Reference Group, Kent, UK
| | - Paul Williams
- Hertfordshire Community NHS Trust, Welwyn Garden City, UK
| | | | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- COVID Rehabilitation Service, Leeds Community Healthcare NHS Trust, Leeds, UK
- National Demonstration Centre of Rehabilitation Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Sivan M, Smith AB, Osborne T, Goodwin M, Lawrence RR, Baley S, Williams P, Lee C, Davies H, Balasundaram K, Greenwood DC. Long COVID Clinical Severity Types Based on Symptoms and Functional Disability: A Longitudinal Evaluation. J Clin Med 2024; 13:1908. [PMID: 38610673 PMCID: PMC11012375 DOI: 10.3390/jcm13071908] [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: 02/26/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Long COVID (LC) is a multisystem clinical syndrome with functional disability and compromised overall health. Information on LC clinical severity types is emerging in cross-sectional studies. This study explored the pattern and consistency of long COVID (LC) clinical severity types over time in a prospective sample. Methods: Participants with LC completed the condition-specific outcome measure C19-YRSm (Yorkshire Rehabilitation Scale modified version) at two assessment time points. A cluster analysis for clinical severity types was undertaken at both time points using the k-means partition method. Results: The study included cross-sectional data for 759 patients with a mean age of 46.8 years (SD = 12.7), 69.4% females, and a duration of symptoms of 360 days (IQR 217 to 703 days). The cluster analysis at first assessment revealed three distinct clinical severity type clusters: mild (n = 96), moderate (n = 422), and severe (n = 241). Longitudinal data on 356 patients revealed that the pattern of three clinical severity types remained consistent over time between the two assessments, with 51% of patients switching clinical severity types between the assessments. Conclusions: This study is the first of its kind to demonstrate that the pattern of three clinical severity types is consistent over time, with patients also switching between severity types, indicating the fluctuating nature of LC.
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Affiliation(s)
- Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
- COVID Rehabilitation Service, Leeds Community Healthcare NHS Trust, Leeds LS11 0DL, UK
- National Demonstration Centre of Rehabilitation Medicine, Leeds Teaching Hospitals NHS Trust, Leeds LS7 4SA, UK
| | - Adam B. Smith
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.B.S.); (D.C.G.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
| | - Thomas Osborne
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
| | - Madeline Goodwin
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
| | - Román Rocha Lawrence
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
- ELAROS 24/7 Digital Company, Sheffield S1 2BJ, UK
| | - Sareeta Baley
- Birmingham Community Healthcare NHS Trust, Birmingham B7 4BN, UK;
| | - Paul Williams
- Hertfordshire Community NHS Trust, Welwyn AL6 9PW, UK;
| | - Cassie Lee
- Imperial College Healthcare NHS Trust, London W2 1NY, UK;
| | - Helen Davies
- Cardiff and Vale University Hospitals NHS Trust, Cardiff CF14 4XW, UK;
| | - Kumaran Balasundaram
- NIHR Leicester Biomedical Research Centre—Respiratory & Infection Theme, Glenfield Hospital, Leicester LE3 9QP, UK;
| | - Darren C. Greenwood
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.B.S.); (D.C.G.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
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Kustura L, Bobek D, Poljičanin A, Pavelin S, Buljubašić Šoda M, Šoda J, Aksentijević J, Duka Glavor K, Narančić Knez N, Viali V, Cukrov A, Todorić Laidlaw I, Ipavec N, Vukorepa D, Stipica I, Bakrač K, Bošković B, Mastelić A, Režić Mužinić N, Markotić A, Đogaš Z, Dolić K, Rogić Vidaković M. Psychometric properties and observational data for COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) for post-COVID-19 syndrome. QJM 2024; 117:38-47. [PMID: 37788123 DOI: 10.1093/qjmed/hcad224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/14/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The recently developed modified COVID-19 (coronavirus of 2019) Yorkshire Rehabilitation Scale (C19-YRSm) captures comprehensive biopsychosocial components of WHO's International Classification of Functioning, Disability, and Health related to the Long Covid or post-COVID syndrome. The scale response categories on C19-YRSm were done post hoc on data collected from the original version of C19-YRS. AIM To evaluate the C19-YRSm scale using reliability and validity measures. DESIGN Prospective, observational study. METHODS The study includes 369 patients (clinical group) and 426 subjects of the general population (control group) and captures their post-COVID-19 symptoms. In addition, the reliability of C19-YRSm was estimated by Cronbach's alpha coefficients of internal consistency and inter-item correlations for subscales ('Symptom severity, Functional disability, and Other symptoms'). Convergent validity was established using correlations between C19-YRSm and Fatigue Severity Scale (FSS). The incremental validity of C19-YRSm was measured by introducing a hierarchical regression model using the C19-YRSm 'Overall health' subscale and FSS as criterion variables. RESULTS C19-YRSm subscales have excellent internal consistencies (Cronbach's α value 0.81-0.96) and acceptable inter-item correlations (r value 0.23-0.79). Hereafter, the convergent validity of the C19-YRSm is good due to significant correlations between C19-YRSm subscales and FSS and C19-YRSm subscales. Finally, the hierarchical regression analysis supported consistent evidence for the incremental validity of the C19-YRSm subscales. CONCLUSION C19-YRSm is a reliable and valid self-assessment scale for the assessment of post-COVID-19 syndrome.
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Affiliation(s)
- L Kustura
- Department of Psychiatry, University Hospital of Split, Split, Croatia
| | - D Bobek
- Department of Physical and Rehabilitation Medicine with Rheumatology, Dubrava University Hospital, Zagreb, Croatia
| | - A Poljičanin
- Department of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, Split, Croatia
- Department of Health Studies, University of Split, Split, Croatia
| | - S Pavelin
- Department of Neurology, University Hospital of Split, Split, Croatia
| | - M Buljubašić Šoda
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - J Šoda
- Department of Marine Electrical Engineering and Information Technologies, Signal Processing, Analysis, and Advanced Diagnostics Research and Education Laboratory (SPAADREL), Faculty of Maritime Studies, University of Split, Split, Croatia
| | - J Aksentijević
- Department of Physical and Rehabilitation Medicine with Rheumatology, Dubrava University Hospital, Zagreb, Croatia
| | - K Duka Glavor
- Department of Neurology, General Hospital Zadar, Zadar, Croatia
- Department of Health Studies, University of Zadar, Zadar, Croatia
| | - N Narančić Knez
- Department of Neurology, General Hospital Zadar, Zadar, Croatia
| | - V Viali
- Family Medicine Vanja Viali, Split, Split-Dalmatia County, Croatia
| | - A Cukrov
- Primary/Family Care Office, Slunj Community Health Centre, Slunj, Croatia
| | - I Todorić Laidlaw
- Department for Forensic Psychiatry, University Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - N Ipavec
- Department for Transfusion Medicine, University Hospital of Split, Split, Croatia
| | - D Vukorepa
- Department of Psychiatry, University Hospital of Split, Split, Croatia
| | - I Stipica
- Department of Family Medicine, University of Split School of Medicine, Split, Croatia
| | - K Bakrač
- Institute of Emergency Medicine, Split-Dalmatia County, Split, Croatia
| | - B Bošković
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital of Split, Split, Croatia
| | - A Mastelić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - N Režić Mužinić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - A Markotić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - Z Đogaš
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), School of Medicine, University of Split, Split, Croatia
- Sleep Medicine Centre, University Hospital of Split, Split, Croatia
| | - K Dolić
- Department of Interventional and Diagnostic Radiology, University Hospital of Split, Split, Croatia
- Department of Radiology, University of Split School of Medicine, Split, Croatia
| | - M Rogić Vidaković
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), School of Medicine, University of Split, Split, Croatia
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Goździewicz Ł, Tobis S, Chojnicki M, Wieczorowska-Tobis K, Neumann-Podczaska A. The Value of the COVID-19 Yorkshire Rehabilitation Scale in the Assessment of Post-COVID among Residents of Long-Term Care Facilities. Healthcare (Basel) 2024; 12:333. [PMID: 38338218 PMCID: PMC10855238 DOI: 10.3390/healthcare12030333] [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: 12/30/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a patient-reported outcome measure designed to assess the long-term effects of COVID-19. The scale was validated and is commonly used in the general population. In this study, we assess the utility of the C19-YRS in evaluating the post-COVID burden among residents of long-term care facilities with a mean age of 79. C19-YRS and Barthel index evaluations were performed among 144 residents of long-term care facilities reporting new or worsened symptoms or functioning three months after convalescence from COVID-19. The C19-YRS-based screening showed that 70.9% of COVID-19 convalescents had ≥1 complaint three months after recovery. The highest C19-YRS-scored symptoms (indicating a higher burden) were breathlessness, fatigue, and cognitive and continence problems; however, symptomatology was very heterogeneous, revealing a high complexity of the disease in older persons. The mean total C19-YRS score was higher in hospitalized patients (n = 78) than in the outpatient group (n = 66) (p = 0.02). The functioning subscale of the C19-YRS strongly correlated with the Barthel index, with r = -0.8001 (p < 0.0001). A moderately strong correlation existed between retrospectively reported C19-YRS-based functioning and the Barthel index score reported before illness (r = 0.7783, p < 0.0001). The C19-YRS is instrumental in evaluating the consequences of COVID-19 among long-term-care residents. The assessment allows for a broad understanding of rehabilitation needs.
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Affiliation(s)
- Łukasz Goździewicz
- Geriatric Unit, Department of Palliative Medicine, Poznań University of Medical Sciences, 61-245 Poznań, Poland
| | - Sławomir Tobis
- Department of Occupational Therapy, Poznań University of Medical Sciences, 60-781 Poznań, Poland
| | - Michał Chojnicki
- Department of Immunobiology, Poznań University of Medical Sciences, 60-806 Poznań, Poland
- Department of Infectious Diseases, Józef Struś Hospital, 61-285 Poznań, Poland
| | - Katarzyna Wieczorowska-Tobis
- Geriatric Unit, Department of Palliative Medicine, Poznań University of Medical Sciences, 61-245 Poznań, Poland
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, 60-624 Poznań, Poland
| | - Agnieszka Neumann-Podczaska
- Geriatric Unit, Department of Palliative Medicine, Poznań University of Medical Sciences, 61-245 Poznań, Poland
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Jiang Y, Cheng Y, Xiao J, Wang Y, Chen G, Zhang Y. Analysis of the correlation between heart rate variability and palpitation symptoms in female patients with long COVID. Front Cardiovasc Med 2023; 10:1273156. [PMID: 38045913 PMCID: PMC10690811 DOI: 10.3389/fcvm.2023.1273156] [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: 08/07/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives To analyze the correlation between heart rate variability (HRV) and palpitation symptoms in female patients with long COVID. Methods A total of 272 female healthcare workers who were infected with SARS-CoV-2 for the first time in December 2022 at Fuzhou First Hospital affiliated with Fujian Medical University, were selected as study subjects. These subjects were divided into three groups based on their symptoms: a group with palpitations (70 cases), a group without palpitations but with other symptoms (124 cases), and a group consisting of asymptomatic cases (78 cases). The study compared the general information, COMPASS-31 scores, quality of life scores, and HRV parameters among the three groups. Furthermore, it analyzed the factors influencing palpitation symptoms in female patients with long COVID. Results Compared to the other two groups, the HRV parameters SDNN, HRVIndex, LF, and TP were significantly reduced in the group with palpitations (p < 0.05). Multivariate analysis revealed that HRVIndex (p = 0.016; OR: 0.966, 95% CI: 0.940∼0.994) had a significant impact on palpitation symptoms in female patients with long COVID. Conclusions The symptoms of palpitations in female patients with long COVID were found to be related to HRV parameters. Autonomic dysfunction may be connected to the occurrence of palpitation symptoms in long COVID.
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Affiliation(s)
- Yu Jiang
- Department of Cardiovascular Medicine, Fuzhou First Hospital Affiliated with Fujian Medical University, Fuzhou, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Cardiovascular Disease Research Institute of Fuzhou City, Fuzhou, China
| | - Yan Cheng
- Department of Cardiovascular Medicine, Fuzhou First Hospital Affiliated with Fujian Medical University, Fuzhou, China
- Cardiovascular Disease Research Institute of Fuzhou City, Fuzhou, China
| | - Jingwen Xiao
- Department of Cardiovascular Medicine, Fuzhou First Hospital Affiliated with Fujian Medical University, Fuzhou, China
- Cardiovascular Disease Research Institute of Fuzhou City, Fuzhou, China
| | - Yicheng Wang
- Department of Cardiovascular Medicine, Fuzhou First Hospital Affiliated with Fujian Medical University, Fuzhou, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Cardiovascular Disease Research Institute of Fuzhou City, Fuzhou, China
| | - Geng Chen
- Department of Nursing, Fuzhou First Hospital Affiliated with Fujian Medical University, Fuzhou, China
| | - Yan Zhang
- Department of Cardiovascular Medicine, Fuzhou First Hospital Affiliated with Fujian Medical University, Fuzhou, China
- Cardiovascular Disease Research Institute of Fuzhou City, Fuzhou, China
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Bergersen KV, Pham K, Li J, Ulrich MT, Merrill P, He Y, Alaama S, Qiu X, Harahap-Carrillo IS, Ichii K, Frost S, Kaul M, Godzik A, Heinrich EC, Nair MG. Health disparities in COVID-19: immune and vascular changes are linked to disease severity and persist in a high-risk population in Riverside County, California. BMC Public Health 2023; 23:1584. [PMID: 37598150 PMCID: PMC10439554 DOI: 10.1186/s12889-023-16462-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/05/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Health disparities in underserved communities, such as inadequate healthcare access, impact COVID-19 disease outcomes. These disparities are evident in Hispanic populations nationwide, with disproportionately high infection and mortality rates. Furthermore, infected individuals can develop long COVID with sustained impacts on quality of life. The goal of this study was to identify immune and endothelial factors that are associated with COVID-19 outcomes in Riverside County, a high-risk and predominantly Hispanic community, and investigate the long-term impacts of COVID-19 infection. METHODS 112 participants in Riverside County, California, were recruited according to the following criteria: healthy control (n = 23), outpatients with moderate infection (outpatient, n = 33), ICU patients with severe infection (hospitalized, n = 33), and individuals recovered from moderate infection (n = 23). Differences in outcomes between Hispanic and non-Hispanic individuals and presence/absence of co-morbidities were evaluated. Circulating immune and vascular biomarkers were measured by ELISA, multiplex analyte assays, and flow cytometry. Follow-up assessments for long COVID, lung health, and immune and vascular changes were conducted after recovery (n = 23) including paired analyses of the same participants. RESULTS Compared to uninfected controls, the severe infection group had a higher proportion of Hispanic individuals (n = 23, p = 0.012) than moderate infection (n = 8, p = 0.550). Disease severity was associated with changes in innate monocytes and neutrophils, lymphopenia, disrupted cytokine production (increased IL-8 and IP-10/CXCL10 but reduced IFNλ2/3 and IFNγ), and increased endothelial injury (myoglobin, VCAM-1). In the severe infection group, a machine learning model identified LCN2/NGAL, IL-6, and monocyte activation as parameters associated with fatality while anti-coagulant therapy was associated with survival. Recovery from moderate COVID infection resulted in long-term immune changes including increased monocytes/lymphocytes and decreased neutrophils and endothelial markers. This group had a lower proportion of co-morbidities (n = 8, p = 1.0) but still reported symptoms associated with long COVID despite recovered pulmonary function. CONCLUSION This study indicates increased severity of COVID-19 infection in Hispanic individuals of Riverside County, California. Infection resulted in immunological and vascular changes and long COVID symptoms that were sustained for up to 11 months, however, lung volume and airflow resistance was recovered. Given the immune and behavioral impacts of long COVID, the potential for increased susceptibility to infections and decreased quality of life in high-risk populations warrants further investigation.
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Affiliation(s)
- Kristina V Bergersen
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Kathy Pham
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Jiang Li
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Michael T Ulrich
- Riverside University Health System Medical Center, Riverside, CA, U.S
| | - Patrick Merrill
- Kaiser Permanente Riverside Medical Center, Riverside, CA, U.S
| | - Yuxin He
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Sumaya Alaama
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Xinru Qiu
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Indira S Harahap-Carrillo
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Keita Ichii
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Shyleen Frost
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Marcus Kaul
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Adam Godzik
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S
| | - Erica C Heinrich
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S..
| | - Meera G Nair
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA, U.S..
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López-López L, Calvache-Mateo A, Ortiz-Rubio A, Granados-Santiago M, Heredia-Ciuró A, Martín-Núñez J, Valenza MC. Differences of Disabling Symptoms between Previously Hospitalized or Non-Hospitalized Currently Working Long-COVID Survivors One Year after Infection: A Descriptive Study. Healthcare (Basel) 2023; 11:2306. [PMID: 37628505 PMCID: PMC10454028 DOI: 10.3390/healthcare11162306] [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: 07/21/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to describe the presence of disabling symptoms in currently working Long-COVID survivors by comparing the hospitalized and non-hospitalized one year after infection. Patients with Long-COVID syndrome (LCS) that have been infected by COVID-19 a year ago and were actually working were included. Participants that had been hospitalized due to COVID-19 were included in the LCS hospitalized group, and participants that had not been hospitalized were included in the LCS non-hospitalized group. The eligible patients were prompted to complete the latest self-report version of the COVID-19 Yorkshire Rehabilitation Screening Tool (C19-YRS). A total of 465 subjects were included in the study. Participants in the LCS hospitalized group were significantly older, had a significantly higher BMI, and had a significantly higher prevalence of women compared to the LCS non-hospitalized group. Additionally, participants in the LCS hospitalized group had obtained significantly worse results in symptom severity, functional disability, and global health perceived subscales of C19-YRS compared to the participants included in the LCS non-hospitalized group. We concluded that disabling symptoms are presented in patients with LCS at working age one year after infection and are higher in LCS hospitalized patients compared to LCS non-hospitalized patients.
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Affiliation(s)
- Laura López-López
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.L.-L.); (A.C.-M.); (A.O.-R.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Andrés Calvache-Mateo
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.L.-L.); (A.C.-M.); (A.O.-R.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Araceli Ortiz-Rubio
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.L.-L.); (A.C.-M.); (A.O.-R.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | | | - Alejandro Heredia-Ciuró
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.L.-L.); (A.C.-M.); (A.O.-R.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Javier Martín-Núñez
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.L.-L.); (A.C.-M.); (A.O.-R.); (A.H.-C.); (J.M.-N.); (M.C.V.)
| | - Marie Carmen Valenza
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.L.-L.); (A.C.-M.); (A.O.-R.); (A.H.-C.); (J.M.-N.); (M.C.V.)
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Partiprajak S, Krongthaeo S, Piaseu N, Wongsathikun J, Kongsuwan A. The Thai version of the COVID-19 Yorkshire Rehabilitation Scale: a valid instrument for the psychometric assessment of the community members in Bangkok, Thailand. BMC Public Health 2023; 23:663. [PMID: 37041552 PMCID: PMC10088103 DOI: 10.1186/s12889-023-15566-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/30/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) can develop into a long-term COVID in some cases, which can have a major impact on various health systems requiring appropriate treatment involving multi-disciplinary healthcare. The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a standardized tool widely used for screening the symptoms and severity of long-term COVID. Translation of the English version of the C19-YRS into the Thai language and testing it is essential for the psychometric evaluation of the severity of the long-term COVID syndrome prior to providing rehabilitation care for community members. METHODS Forward-and back-translations including cross-cultural aspects were conducted in order to develop a preliminary Thai version of that tool. Five experts evaluated the content validity of the tool and produced a highly valid index. A cross-sectional study was then conducted on a sample of 337 Thai community members recovering from COVID-19. Assessment of internal consistency and individual item analyses were also performed. RESULTS The content validity resulted in valid indices. The analyses showed that 14 items had acceptable internal consistency, based on the corrected item correlations. However, five symptom severity items and two functional ability items were deleted. The Cronbach's alpha coefficient of the final C19-YRS was 0.723, indicating acceptable internal consistency and reliability of the survey instrument. CONCLUSIONS This study indicated that the Thai C19-YRS tool had acceptable validity and reliability for the evaluation and testing of the psychometric variables in a Thai community population. The survey instrument also had acceptable validity and reliability for screening the symptoms and severity of long-term COVID. Further studies are warranted in order to standardize the various applications of this tool.
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Affiliation(s)
- Suphamas Partiprajak
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Rachathewi, Bangkok, 10400, Thailand
| | - Suphanna Krongthaeo
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Rachathewi, Bangkok, 10400, Thailand.
| | - Noppawan Piaseu
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Rachathewi, Bangkok, 10400, Thailand
| | - Jatuporn Wongsathikun
- Cardiovascular Pulmonary Physical Therapy Unit, Chaopraya Hospital, Borommaratchachonnani Road, Arun Amarin, Bangkoknoi, Bangkok, 10700, Thailand
| | - Anon Kongsuwan
- Center for Health Promotion and Well-being, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Rachathewi, Bangkok, 10400, Thailand
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Ho FF, Xu S, Kwong TMH, Li ASC, Ha EH, Hua H, Liong C, Leung KC, Leung TH, Lin Z, Wong SYS, Pan F, Chung VCH. Prevalence, Patterns, and Clinical Severity of Long COVID among Chinese Medicine Telemedicine Service Users: Preliminary Results from a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1827. [PMID: 36767195 PMCID: PMC9914360 DOI: 10.3390/ijerph20031827] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The emergence and persistence of symptoms after acute COVID-19 is expected to become a major burden on healthcare systems. We assessed the features of the post-COVID-19 Syndrome (Long COVID) burden in a cohort of COVID-19 patients during the fifth major wave in Hong Kong. METHODS A cross-sectional study of 135 patients with confirmed COVID-19 from Feb to Apr 2022 who utilized traditional Chinese medicine telemedicine services was conducted. The COVID-19 Yorkshire Rehabilitation Scale was administered using an online survey 12 weeks after the COVID-19 infection. Prevalence of symptom severity and functional impairments were assessed to identify burdens and patterns. The correlation between symptom severity, functional impairments, patient characteristics, and overall health was evaluated. RESULTS The mean age was 46.8 years, with 46 (34.1%) males. Symptoms, functional impairments, and overall health worsened significantly when compared to the status prior to the infection. More than 50% reported the following sequelae 12 weeks after the acute infection: breathlessness, laryngeal or airway complications, fatigue, weakness, sleep, cognition, and anxiety. The presence of a single symptom or functional impairment significantly correlated with at least seven other problems positively, except for pain. Severity tended to be higher among vulnerable groups, including those who were chronic disease patients, older, less well educated, female, or had incomplete COVID-19 vaccinations. CONCLUSIONS Long COVID is a significant healthcare burden among telemedicine users in Hong Kong, with complex needs for symptom and functional impairment management. Designing relevant health and rehabilitation services tailored to the needs of these patients is warranted.
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Affiliation(s)
- Fai Fai Ho
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Shanshan Xu
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Talos Ming Hong Kwong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Angus Siu-cheong Li
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Eun Hae Ha
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Heyu Hua
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Ching Liong
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Kwan Chi Leung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Ting Hung Leung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Zhixiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Faming Pan
- Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Vincent Chi Ho Chung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
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