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Girma AZ, Brathwaite R, Karamagi Y, Nakabuye F, Nakasujja N, Byansi W, Nabunya P, Bahar OS, Ssewamala FM. The impact of COVID-19 changes and disruptions on generalized anxiety disorder among young adults living with HIV (YLHIV) in Uganda. J Health Psychol 2024; 29:633-649. [PMID: 38321709 PMCID: PMC11138144 DOI: 10.1177/13591053241228205] [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] [Indexed: 02/08/2024] Open
Abstract
In the context of the COVID-19 pandemic, we investigated associations between specific COVID-19-related changes and its impact on generalized anxiety disorder (GAD) levels among vulnerable young adults living with HIV (YALHIV) in a low-resource setting in Southern Uganda. This research utilized data from 500 YALHIV aged 19 to 25 from the Suubi+Adherence-R2 COVID-19 Supplement study. Disruptions were assessed using an 8-item modified Coronavirus Impact Scale, while anxiety was measured with the GAD-7 questionnaire. Hierarchical logistic regression analysis and multivariate linear regression were employed, guided by the Social Determinants of Health framework. Key findings highlighted changes in routines, family income, stress from the pandemic, changes in family stress and discord, and reduced access to mental health services heightened levels of probable GAD for YALHIV during the pandemic. Additionally, female young adults showed greater levels than males. These results underscore the urgency to develop tailored support mechanisms for YALHIV, especially during challenging and unprecedented times.
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Cipolli GC, Alonso V, Yasuda CL, Assumpção DD, Cachioni M, Melo RCD, Hinsliff-Smith K, Yassuda MS. Cognitive impairment in post-acute COVID-19 syndrome: a scoping review. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1053-1069. [PMID: 38157873 PMCID: PMC10756850 DOI: 10.1055/s-0043-1777115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/22/2023] [Indexed: 01/03/2024]
Abstract
Emerging studies indicate the persistence of symptoms beyond the acute phase of COVID-19. Cognitive impairment has been observed in certain individuals for months following infection. Currently, there is limited knowledge about the specific cognitive domains that undergo alterations during the post-acute COVID-19 syndrome and the potential impact of disease severity on cognition. The aim of this review is to examine studies that have reported cognitive impairment in post-acute COVID-19, categorizing them into subacute and chronic phases. The methodology proposed by JBI was followed in this study. The included studies were published between December 2019 and December 2022. The search was conducted in PubMed, PubMed PMC, BVS - BIREME, Embase, SCOPUS, Cochrane, Web of Science, Proquest, PsycInfo, and EBSCOHost. Data extraction included specific details about the population, concepts, context, and key findings or recommendations relevant to the review objectives. A total of 7,540 records were identified and examined, and 47 articles were included. The cognitive domains most frequently reported as altered 4 to 12 weeks after acute COVID-19 were language, episodic memory, and executive function, and after 12 weeks, the domains most affected were attention, episodic memory, and executive function. The results of this scoping review highlight that adults with post-acute COVID-19 syndrome may have impairment in specific cognitive domains.
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Affiliation(s)
- Gabriela Cabett Cipolli
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-graduação em Gerontologia, Campinas SP, Brazil.
| | - Vanessa Alonso
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-graduação em Gerontologia, Campinas SP, Brazil.
| | - Clarissa Lin Yasuda
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Neurologia, Campinas SP, Brazil.
| | - Daniela de Assumpção
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-graduação em Gerontologia, Campinas SP, Brazil.
| | - Meire Cachioni
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-graduação em Gerontologia, Campinas SP, Brazil.
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Programa de Pós-graduação em Gerontologia, São Paulo SP, Brazil.
| | - Ruth Caldeira de Melo
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-graduação em Gerontologia, Campinas SP, Brazil.
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Programa de Pós-graduação em Gerontologia, São Paulo SP, Brazil.
| | - Kathryn Hinsliff-Smith
- De Montfort University, Faculty of Health and Life Sciences, Leicester School of Nursing & Midwifery, United Kingdom.
| | - Mônica Sanches Yassuda
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Programa de Pós-graduação em Gerontologia, Campinas SP, Brazil.
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Programa de Pós-graduação em Gerontologia, São Paulo SP, Brazil.
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Martínez E, Aguilera C, Márquez D, Ziegler G, Plumet J, Tschopp L, Cominotti C, Sturzenegger V, Cimino C, Escobar H, Pereyra C, Hidalgo E, Adanza SP, Morelli DM, Masevicius FD. Post intensive care syndrome in survivors of COVID-19 who required mechanical ventilation during the third wave of the pandemic: A prospective study. Heart Lung 2023; 62:72-80. [PMID: 37348211 PMCID: PMC10277848 DOI: 10.1016/j.hrtlng.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/29/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Post intensive care syndrome is defined as the presence of any impairment affecting the physical, psychiatric, or cognitive domains as a result of critical illnesses. OBJECTIVES To explore functional, cognitive and psychological outcomes at 30 days post hospital discharge among survivors of COVID-19-associated acute respiratory distress syndrome, who required mechanical ventilation. METHODS Prospective cohort study. We included adult patients with COVID-19-associated acute respiratory distress syndrome, invasively ventilated in two ICUs in Buenos Aires. We measured functional, cognitive and psychological impairments with Barthel index, Montreal Cognitive Assessment test, Patient Health Questionnaire-9 and General Anxiety Disorder-7. Primary outcome was post-intensive care syndrome. Secondary outcome was mortality at 60 days. RESULTS We admitted 40 patients, median age was 69 (60-75) and mostly male (75%). Mortality at 60 days was 37%. Cox regression analysis identified diabetes and Apache II as independent predictors of mortality. Out of 22 patients studied, 14 (64%) developed PICS after discharge. With a physical, cognitive and psychological impairment in 64%, 41% and 32% of patients, respectively. Obesity, days of mechanical ventilation, Apache II, vasopressors use, delirium duration and cumulative midazolam dose were associated with functional dependence. CONCLUSIONS We identified a high prevalence of functional, cognitive and mental impairment at 30 days after hospital discharge in COVID-19-associated acute respiratory distress syndrome survivors, invasively ventilated. The physical domain was the most frequently affected. These findings suggest the need for long-term follow-up of this population.
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Affiliation(s)
- Ezequiel Martínez
- Hospital Juan A Fernández, Buenos Aires, Argentina; Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina.
| | | | | | - Gabriela Ziegler
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Javier Plumet
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Lorena Tschopp
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Claudia Cominotti
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Viviana Sturzenegger
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Carlos Cimino
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Hernán Escobar
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | - Cecilia Pereyra
- Sanatorio de la Trinidad Ramos Mejía, Ramos Mejía, (CP: 1704) Ramos Mejía, Buenos Aires 13264, Argentina
| | | | | | - Daniela Moraes Morelli
- Institute for Clinical Effectiveness and Health Politicy (IECS), Buenos Aires, Argentina
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Sonneville R, Dangayach NS, Newcombe V. Neurological complications of critically ill COVID-19 patients. Curr Opin Crit Care 2023; 29:61-67. [PMID: 36880556 DOI: 10.1097/mcc.0000000000001029] [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: 03/08/2023]
Abstract
PURPOSE OF REVIEW COVID-19 and systemic critical illness are both associated with neurological complications. We provide an update on the diagnosis and critical care management of adult patients with neurological complications of COVID-19. RECENT FINDINGS Large prospective multicentre studies conducted in the adult population over the last 18 months improved current knowledge on severe neurological complications of COVID-19. In COVID-19 patients presenting with neurological symptoms, a multimodal diagnostic workup (including CSF analysis, brain MRI, and EEG) may identify different syndromes associated with distinct trajectories and outcomes. Acute encephalopathy, which represents the most common neurological presentation of COVID-19, is associated with hypoxemia, toxic/metabolic derangements, and systemic inflammation. Other less frequent complications include cerebrovascular events, acute inflammatory syndromes, and seizures, which may be linked to more complex pathophysiological processes. Neuroimaging findings include infarction, haemorrhagic stroke, encephalitis, microhaemorrhages and leukoencephalopathy. In the absence of structural brain injury, prolonged unconsciousness is usually fully reversible, warranting a cautious approach for prognostication. Advanced quantitative MRI may provide useful insights into the extent and pathophysiology of the consequences of COVID-19 infection including atrophy and functional imaging changes in the chronic phase. SUMMARY Our review highlights the importance of a multimodal approach for the accurate diagnosis and management of complications of COVID-19, both at the acute phase and in the long-term.
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Affiliation(s)
- Romain Sonneville
- Université Paris Cité, IAME, INSERM UMR1137
- AP-HP, Hôpital Bichat - Claude Bernard, Department of Intensive Care Medicine, F-75018 Paris, France
| | - Neha S Dangayach
- Neurocritical Care Division, Departments of Neurosurgery and Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Virginia Newcombe
- University Division of Anaesthesia, Department of Medicine, University of Cambridge, United Kingdom
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Pelle J, Nedelec T, Marois C. Neuro-Psychological Outcome of ICU-Admitted COVID-19 Patients Presenting With CNS Complications. Crit Care Med 2023; 51:e101-e103. [PMID: 36928023 DOI: 10.1097/ccm.0000000000005738] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Juliette Pelle
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Département de Neurologie, médecine intensive et réanimation à orientation neurologique, Paris, France
| | - Thomas Nedelec
- Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Clémence Marois
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Département de Neurologie, médecine intensive et réanimation à orientation neurologique, Paris, France
- Sorbonne Université, Assistance Publique-Groupe de Recherche Clinique en REanimation et Soins intensifs du Patient en Insuffisance Respiratoire aiguE (GRC-RESPIRE), Paris, France
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Jaquet P, Legouy C, Sonneville R. The authors reply. Crit Care Med 2023; 51:e103-e104. [PMID: 36928024 DOI: 10.1097/ccm.0000000000005794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Affiliation(s)
- Pierre Jaquet
- Médecine intensive-réanimation, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France
| | - Camille Legouy
- Médecine intensive-réanimation, CH Saint Anne, Paris, France
| | - Romain Sonneville
- Médecine intensive-réanimation, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France
- Université de Paris, INSERM UMR1148, team 6, Paris, France
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Wimmer C, Egger M, Bergmann J, Huge V, Müller F, Jahn K. Critical COVID-19 disease: Clinical course and rehabilitation of neurological deficits. Front Neurol 2022; 13:1012685. [PMID: 36388208 PMCID: PMC9649895 DOI: 10.3389/fneur.2022.1012685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The COVID-19 disease frequently causes neurological symptoms. Critically ill patients often require neurorehabilitation for manifestations like intensive care unit (ICU) acquired weakness or encephalopathy. The outcome of these patients, however, is largely unknown. Here we report the clinical course of critical affected COVID-19 patients from hospital admission to discharge from inpatient neurorehabilitation. METHODS Prospective cohort study. COVID-19 patients admitted to neurorehabilitation were included based on a laboratory-confirmed SARS-CoV-2 infection. Assessments [modified Rankin Scale (mRS), Barthel-Index, Fatigue-Severity-Scale-7 and health-related quality of life (EQ-5D-5L)] were conducted at admission and before discharge from inpatient care. Data were compared to the preclinical health status. RESULTS Sixty-one patients (62 ± 13 years, 16 female) were included in the analysis. Most patients had been treated on ICU (n = 58; 57 ± 23 days) and had received invasive ventilation (n = 57; 46 ± 21 days). After discharge from ICU, patients spent on average 57 ± 26 days in neurorehabilitation. The most frequent neurological diagnoses were ICU-acquired weakness (n = 56) and encephalopathy (n = 23). During rehabilitation overall disability improved [mRS median (IQR) 4.0 (1.0) at inclusion and 2.0 (1.0) at discharge]. However, the preclinical health state [mRS 0.0 (0.0)] was not regained (p < 0.001). This was also reflected by the Barthel-Index [preclinical 100.0 (0.0), at inclusion 42.5 (35.0), at discharge 65.0 (7.5); p < 0.001]. Patients had only minor fatigue during inpatient care. Quality of life generally improved but was still low at discharge from hospital. CONCLUSION Patients with neurological sequelae after critical COVID-19 disease showed substantial deficits at discharge from inpatient care up to 4 months after the initial infection. They were restricted in activities of daily living and had reduced health-related quality of life. All patients needed continued medical support and physical treatment.
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Affiliation(s)
- Corinna Wimmer
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Marion Egger
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- Pettenkofer School of Public Health, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Jeannine Bergmann
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Volker Huge
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Friedemann Müller
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Klaus Jahn
- Department of Neurology and Intensive Care Medicine, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University (LMU), Munich, Germany
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de Sire A, Andrenelli E, Negrini F, Lazzarini SG, Cordani C, Ceravolo MG. Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of February 28th, 2022. Eur J Phys Rehabil Med 2022; 58:498-501. [PMID: 35612401 PMCID: PMC9980520 DOI: 10.23736/s1973-9087.22.07593-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Francesco Negrini
- Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy - .,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
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