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Voss JG, Pinto MD, Burton CW. How do the Social Determinants of Health Impact the Post-Acute Sequelae of COVID-19: A Critical Review. Nurs Clin North Am 2023; 58:541-568. [PMID: 37832998 DOI: 10.1016/j.cnur.2023.07.004] [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] [Indexed: 10/15/2023]
Abstract
The review critically analyzes the social determinants of health (SDOH) variables in the current literature of patients with post-acute sequelae (PASC) of COVID-19 in the United States. Race, gender, and age were discussed as well as health outcomes, severity of illness, and phenotypes of long-COVID. Most research was retrospectively with samples that had access to health insurance, which did not capture populations with poor or no access to health care. More research is needed that directly addresses the impact on SDOH on PASC. The current literature is sparse and provides little actionable information.
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Affiliation(s)
- Joachim G Voss
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Health Education Campus, 9500 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Melissa D Pinto
- University of California, Irvine, Sue and Bill Gross School of Nursing, 854 Health Sciences, Irvine, CA 92697, USA
| | - Candace W Burton
- University of Nevada Las Vegas School of Nursing, 4505 South Maryland Parkway, Box 453018, Las Vegas, NV 89154-3018, USA
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Formiga MF, Dosbaba F, Hartman M, Batalik L, Senkyr V, Radkovcova I, Richter S, Brat K, Cahalin LP. Role of the Inspiratory Muscles on Functional Performance From Critical Care to Hospital Discharge and Beyond in Patients With COVID-19. Phys Ther 2023; 103:pzad051. [PMID: 37247250 DOI: 10.1093/ptj/pzad051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 01/04/2023] [Accepted: 02/19/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The role of inspiratory muscle performance in functional performance in patients with coronavirus disease 2019 (COVID-19) is poorly understood. The purpose of this study was to perform a longitudinal examination of inspiratory and functional performance from intensive care unit (ICU) discharge (ICUD) to hospital discharge (HD) and symptoms at HD and 1 month after HD in patients with COVID-19. METHODS Thirty patients (19 men, 11 women) with COVID-19 were included. Examination of inspiratory muscle performance at ICUD and HD was performed with an electronic manometer, which provided the maximal inspiratory pressure (MIP) and several other inspiratory measures. Examination of dyspnea and functional performance was performed at ICUD and HD with the Modified Borg Dyspnea Scale and the 1-minute sit-to-stand test (1MSST), respectively. RESULTS The mean age was 71 (SD = 11) years, the mean length of ICU stay was 9 (SD = 6) days, and the mean length of hospital stay was 26 (SD = 16) days. Most of the patients were diagnosed with severe COVID-19 (76.7%) and had a mean Charlson Comorbidity Index of 4.4 (SD = 1.9), reflecting high comorbidity. The mean MIP of the entire cohort increased minimally from ICUD to HD (from 36 [SD = 21] to 40 [SD = 20] cm H2O), reflecting predicted values for men and women at ICUD and HD of 46 (25%) to 51 (23%) and 37 (24%) to 37 (20%), respectively. The 1MSTS score increased significantly from ICUD to HD (9.9 [SD = 7.1] vs 17.7 [SD = 11.1]) for the entire cohort but remained far below population-based reference values (2.5th percentile) for the majority of patients at ICUD and HD. At ICUD, MIP was found to be a significant predictor of a favorable change in 1MSTS performance (β = 0.308; odds ratio = 1.36) at HD. CONCLUSION A significant reduction in inspiratory and functional performance exists in patients with COVID-19 at both ICUD and HD, with a greater MIP at ICUD being a significant predictor of a greater 1MSTS score at HD. IMPACT This study shows that inspiratory muscle training may be an important adjunct after COVID-19.
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Affiliation(s)
- Magno F Formiga
- Programa Pós-Graduação em Fisioterapia e Funcionalidade, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Martin Hartman
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
- Department of Public Health, Faculty of Medicine, Masaryk University Brno, Brno, South Moravia, Czech Republic
| | - Vojtech Senkyr
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Ivana Radkovcova
- Department of Rehabilitation, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Svatopluk Richter
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, South Moravia, Czech Republic
| | - Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno South Moravia, Czech Republic
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
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Abuhammad S, Khabour OF, Alzoubi KH, Hamaideh S, Khassawneh BY, Mehrass AAKO, Alsmadi BF, Ababneh AM. Health-Related Quality of Life for Jordanian-Recovered Individuals During Post-COVID-19 Era: A Cross-Sectional Study. Patient Prefer Adherence 2023; 17:1303-1310. [PMID: 37250297 PMCID: PMC10216861 DOI: 10.2147/ppa.s415336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/13/2023] [Indexed: 05/31/2023] Open
Abstract
Aim This study aims to determine health-related quality of life (HRQoL) that includes the physical and mental health of recovered patients of COVID-19 and examines the significant impact of variables such as period of infection, sample demographics characteristics, hospitalization past, and chronic disease past and the other variables on HRQoL of COVID-19-recovered patients. Methods An exploratory, community-based, cross-sectional research layout was adopted, using an electronic self-reporting survey disseminated online to recovered COVID-19 patients in Jordan. Targeted COVID-19 patients were individuals who were 18 years old or above. They had a documented background of COVID-19 illness, as stated in the following inclusion requirements: Those who had not been formally proven to have been afflicted by COVID-19 were excluded. Results The mean of the physical well-being of study participants during COVID-19 was M=68.00 (SD=6.95), representing medium physical well-being status. The mean of psychological well-being of study participants during COVID-19 was M=60.20 (SD=8.85), representing medium physical health. Multiple regression showed that female recovered patients who are not working, with a low level of income, married women, and who getting COVID-19 more than once are having lower health-related quality of life compared to other recovered patients. Conclusion The HRQoL of COVID-19 patients was significantly impacted, independent of the period since hospitalization or rehabilitation. Policymakers and health workers should research strong ways to enhance the HRQoL of COVID-19 patients as soon as possible. Elderly patients and those who have been infected more than one time and being hospitalized have a greater probability of decreased HRQoL after infection.
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Affiliation(s)
- Sawsan Abuhammad
- Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shaher Hamaideh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, 13133, Jordan
| | | | | | - Baha F Alsmadi
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Frontera JA, Sabadia S, Yang D, de Havenon A, Yaghi S, Lewis A, Lord AS, Melmed K, Thawani S, Balcer LJ, Wisniewski T, Galetta SL. Life stressors significantly impact long-term outcomes and post-acute symptoms 12-months after COVID-19 hospitalization. J Neurol Sci 2022; 443:120487. [PMID: 36379135 PMCID: PMC9637014 DOI: 10.1016/j.jns.2022.120487] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Limited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19. METHODS We conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19. Predictors of these outcomes, including demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics, and life stressors, were evaluated using multivariable logistic regression. RESULTS Of 790 COVID-19 patients who survived hospitalization, 451(57%) completed 6-month (N = 383) and/or 12-month (N = 242) follow-up, and 77/451 (17%) died between discharge and 12-month follow-up. Significant life stressors were reported in 121/239 (51%) at 12-months. In multivariable analyses, life stressors including financial insecurity, food insecurity, death of a close contact and new disability were the strongest independent predictors of worse mRS, Barthel Index, depression, fatigue, and sleep scores, and prolonged symptoms, with adjusted odds ratios ranging from 2.5 to 20.8. Other predictors of poor outcome included older age (associated with worse mRS, Barthel, t-MoCA, depression scores), baseline disability (associated with worse mRS, fatigue, Barthel scores), female sex (associated with worse Barthel, anxiety scores) and index COVID-19 severity (associated with worse Barthel index, prolonged symptoms). CONCLUSIONS Life stressors contribute substantially to worse functional, cognitive and neuropsychiatric outcomes 12-months after COVID-19 hospitalization. Other predictors of poor outcome include older age, female sex, baseline disability and severity of index COVID-19.
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Affiliation(s)
- Jennifer A Frontera
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA.
| | - Sakinah Sabadia
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Dixon Yang
- Department of Neurology, New York Presbyterian, Columbia Medical Center, New York, NY, USA
| | - Adam de Havenon
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Shadi Yaghi
- Department of Neurology, Brown University School of Medicine, Providence, RI, USA
| | - Ariane Lewis
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Aaron S Lord
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Kara Melmed
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sujata Thawani
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Laura J Balcer
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Population Health, New York University Grossman School of Medicine, New York, NY, USA; Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA
| | - Thomas Wisniewski
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Pathology, New York University Grossman School of Medicine, New York, NY, USA; Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Steven L Galetta
- Departments of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA
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Lobanov AA, Irina A Grishechkina, Andronov SV, Gleb N Barashkov, Andrey I Popov, Anatoliy D Fesyun, Elena P Ivanova, Maccarone MC, Stefano Masiero. Can aquatic exercises contribute to the improvement of the gait stereotype function in patients with Long COVID outcomes? Eur J Transl Myol 2022; 32. [PMID: 35833897 PMCID: PMC9580543 DOI: 10.4081/ejtm.2022.10698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/11/2022] Open
Abstract
A variety of rehabilitation programmes can be offered to Long COVID patients, specifically physical training. Indeed 90% of these patients reports impairments of verticalization, stability and spatial orientation, making difficult exercise in the gym. The aim of our study was to assess the effectiveness and safety of aquatic exercise techniques as part of a comprehensive rehabilitation program for patients with Long COVID. The first of a two-stage program involved development of aquatic exercises technique, which was evaluated in 12 patients with impaired upright posture control before and after exercising by "Habilect" video gait analysis system. During the second phase, effectiveness and safety of aqua exercises were tested in water pool as part of a comprehensive rehabilitation programme conducted in 23 patients with Long COVID outcomes. Physical examination, 6-minute step test, Euro-QL-5D questionnaire, Borg scale, laser Doppler flowmetry, cardiointervalography, and spirometry were performed before and after the aquatic exercises program. After the training with aquatic exercises, indices of deviations of the main body axes of the head and the body mass centre ameliorated, as well as direction of body movement vector decreased (p<0.05). This study demonstrated a statistically significant improvement in exercise tolerance in both groups, as measured by the 6-minute step test after rehabilitation. The comparison group averaged 236.7 metres [126; 380] (T=8, p=0.047) after the rehabilitation course and the intervention group averaged 233.71 metres [150; 320] (T=8.0, p=0.047). When tested with the Euro-QL-5D questionnaire, a post-treatment improvement was noted in the comparison group on the anxiety/depression subscale (3 [3;3] (T=0, p=0.043)). In the intervention group, laser Doppler flowmetry revealed a statistically significant increase in microcirculation (6.36 standard units after rehabilitation) [5.54; 8.17] (T=7.0, p=0.004), and a decrease of oxidative metabolism index of 6.89 standard units. [4.76; 6.96] (T=4.0, p=0.03). No serious adverse events were reported. In conclusion, the developed aquatic exercises technique seems to contribute to recovery of impaired upright posture and motor function, normalizing the walking pattern.
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Affiliation(s)
- Andrey A Lobanov
- National Medical Research Center, National Research Medical Center, Moscow.
| | | | - Sergei V Andronov
- National Medical Research Center, National Research Medical Center, Moscow.
| | | | - Andrey I Popov
- National Medical Research Center, National Research Medical Center, Moscow.
| | - Anatoliy D Fesyun
- National Medical Research Center, National Research Medical Center, Moscow.
| | - Elena P Ivanova
- National Medical Research Center, National Research Medical Center, Moscow.
| | | | - Stefano Masiero
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy; Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua.
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