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Elmer N, Reißhauer A, Brehm K, Drebinger D, Schaller SJ, Schwedtke C, Liebl ME. Functional outcome after interdisciplinary, acute rehabilitation in COVID-19 patients: a retrospective study. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01862-4. [PMID: 39012495 DOI: 10.1007/s00406-024-01862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Survivors of severe COVID-19 often exhibit a variety of sequelae including loss of mobility and ADL (activities of daily living) capacity. Acute rehabilitation (AR) is an interdisciplinary rehabilitation intervention applied early while still in a hospital setting. The goal of AR is to improve functional limitations and to increase functional independence at discharge. It is established in the treatment of patients with other severe diseases such as sepsis, polytrauma, or stroke. Data concerning AR in COVID-19 are sparse. AIM To evaluate the changes in physical function during AR in patients after severe COVID-19. METHODS This monocentric, retrospective observational study examined the functional outcomes of a sample of COVID-19-patients who received interdisciplinary AR at a university hospital. Inclusion criteria were a positive SARS-CoV-2 test in 05/2020-01/2022 and transfer to AR after intensive care treatment. 87 patients were elegible for evaluation, 3 of whom were excluded because of death during AR. Data were extracted from the hospital information system. In a pre-post analysis, mobility (Charité Mobility Index), ADL (Barthel Index), and oxygen demand were assessed. In addition, discharge location after AR, factors associated with AR unit length of stay, and functional improvements were analyzed. RESULTS Data of 84 patients were analyzed. Mobility increased significantly from a median of 4 [1.25-6] CHARMI points at admission to a median of 9 [8.25-9] at discharge (p < 0.001). ADL increased significantly from a median of 52.5 [35.0-68.75] Barthel Index points at admission to a median of 92.5 [85-95] at discharge (p < 0.001). Oxygen demand decreased from 80.7 to 30.5% of patients. The majority (55.9%) of patients were discharged home, while 36.9% received direct follow-up rehabilitation. Older age correlated significantly with lower scores on the discharge assessment for mobility (Spearman's ϱ = -0.285, p = 0.009) and ADL (Spearman's ϱ = -0.297, p = 0.006). CONCLUSION Acute rehabilitation is a viable option for COVID-19 patients with severe functional deficits after ICU treatment to achieve functional progress in mobility and ADL, reduce oxygen requirements and enable follow-up rehabilitation. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION FOR PROSPECTIVELY REGISTERED TRIALS: Trial registration number: DRKS00025239. Date of registration: 08 Sep 2021.
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Affiliation(s)
- Nancy Elmer
- Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Anett Reißhauer
- Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Katharina Brehm
- Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Drebinger
- Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Stefan J Schaller
- Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- School of Medicine, Department of Anesthesiology and Intensive Care, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Christine Schwedtke
- Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Max E Liebl
- Department of Physical Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Huang J, Qiao X, Song K, Liu R, Huang S, He J, Zhu S, Reinhardt JD, He C. Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis. Clin Rehabil 2024; 38:857-883. [PMID: 38629433 DOI: 10.1177/02692155241239881] [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: 05/24/2024]
Abstract
OBJECTIVE Assessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases. DATA SOURCES Systematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023. REVIEW METHODS Evaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies. RESULTS The most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, -1.85; 95% CI, -3.00 to -0.70, low certainty), the mMRC Dyspnea Scale (MD, -0.45; 95% CI, -0.72 to -0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, -4.64; 95% CI, -6.54 to -2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33-51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07-5.01, low certainty). CONCLUSION Rehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.
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Affiliation(s)
- Jinming Huang
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xu Qiao
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Kangping Song
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rong Liu
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shuangshuang Huang
- Rehabilitation Medicine Department, The Fifth People's Hospital of Sichuan Province, Chengdu, China
| | - Jing He
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Siyi Zhu
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jan D Reinhardt
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Center for Rehabilitation Research, Jiangsu Province Hospital, First Affiliated Hospital of Nanjing Medical University, Jiangsu, China
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Chengqi He
- Rehabilitation Medicine Key Laboratory of Sichuan Province, Rehabilitation Medical Center, West China Hospital, and Institute for Disaster Management and Reconstruction, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Gao Y, Lin K, Wang B, Ji W, Liu J, Du M, Wang W, Li Y, Du X, Wang Y, Jiang T. Decision-making ability limitations and brain neural activity changes in healthcare workers after mild COVID-19. Neurosci Res 2024; 204:14-21. [PMID: 38355017 DOI: 10.1016/j.neures.2024.02.001] [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: 08/16/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
Studies have demonstrated that the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) extensively affects brain function. Although cognitive dysfunction is considered a common manifestation in COVID-19 patients during the recovery period, the potential changes in decision-making ability, are not yet clear. Decision-making functions are essential to the work of healthcare workers. However, there is a lack of a multidimensional assessment of its functioning in COVID-19 cases. Here, we used tests combined with the resting-state functional magnetic resonance imaging (rs-fMRI) stabilization feature amplitude of low-frequency fluctuations (ALFF) to explore decision-making behavior and brain neural activity changes in healthcare workers after mild COVID-19. Participants were divided into the SARS-CoV-2 infected group (SI, n = 41) and healthy controls (HC, n = 42). All participants underwent a series of neuropsychological tests. They performed the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT), followed by fMRI (n = 20) to assess their decision-making ability under ambiguous and risky conditions and changes in brain neural activity. The SI group performed worse in verbal memory than the HC group. Furthermore, the SI group performed worse in the IGT, whereas no significant difference was observed in the GDT. In addition, rs-fMRI showed enhanced spontaneous neural activity in the postcentral gyrus and inferior parietal lobe in the SI group compared to the HC group.
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Affiliation(s)
- Yaotian Gao
- Department of Neurosurgery, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Anhui Public Health Clinical Center, Hefei, China
| | - Keyi Lin
- Department of Neurosurgery, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Anhui Public Health Clinical Center, Hefei, China
| | - Bangyue Wang
- Department of Neurosurgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Ji
- Department of Neurosurgery, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Anhui Public Health Clinical Center, Hefei, China; Department of Neurosurgery, Huaan Brain Hospital, Hefei, China
| | - Jia Liu
- Anhui Public Health Clinical Center, Hefei, China; Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mengcheng Du
- Department of Neurosurgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Wang
- Department of Neurosurgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yan Li
- Anhui Public Health Clinical Center, Hefei, China; Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaowen Du
- Anhui Public Health Clinical Center, Hefei, China; Department of Radiology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuyang Wang
- Department of Neurosurgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Tao Jiang
- Department of Neurosurgery, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Anhui Public Health Clinical Center, Hefei, China; Anhui Provincial Institute of Translational Medicine, Hefei, China.
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Almeria M, Cejudo JC, Deus J, Krupinski J. Neurocognitive and Neuropsychiatric Sequelae in Long COVID-19 Infection. Brain Sci 2024; 14:604. [PMID: 38928604 PMCID: PMC11202095 DOI: 10.3390/brainsci14060604] [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: 05/16/2024] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Objective: To characterize the cognitive profile of long COVID-19 subjects and its possible association with clinical symptoms, emotional disturbance, biomarkers, and disease severity. Methods: We performed a single-center cross-sectional cohort study. Subjects between 20 and 60 years old with confirmed COVID-19 infection were included. The assessment was performed 6 months following hospital or ambulatory discharge. Excluded were those with prior neurocognitive impairment and severe neurological/neuropsychiatric disorders. Demographic and laboratory data were extracted from medical records. Results: Altogether, 108 participants were included, 64 were male (59.25%), and the mean age was 49.10 years. The patients were classified into four groups: non-hospitalized (NH, n = 10), hospitalized without Intensive Care Unit (ICU) or oxygen therapy (HOSPI, n = 21), hospitalized without ICU but with oxygen therapy (OXY, n = 56), and ICU (ICU, n = 21) patients. In total, 38 (35.18%) reported Subjective Cognitive Complaints (SCC). No differences were found considering illness severity between groups. Females had more persistent clinical symptoms and SCC than males. Persistent dyspnea and headache were associated with higher scores in anxiety and depression. Persistent fatigue, anxiety, and depression were associated with worse overall cognition. Conclusions: No cognitive impairment was found regarding the severity of post-COVID-19 infection. SCC was not associated with a worse cognitive performance, but with higher anxiety and depression. Persistent clinical symptoms were frequent independent of illness severity. Fatigue, anxiety, and depression were linked to poorer cognitive function. Tests for attention, processing speed, and executive function were the most sensitive in detecting cognitive changes in these patients.
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Affiliation(s)
- Marta Almeria
- Department of Neurology, Hospital Universitari MútuaTerrassa, 08221 Terrassa, Spain;
| | - Juan Carlos Cejudo
- Cognitive Impairment and Dementia Unit, Hospital Sagrat Cor, Hermanas Hospitalarias, 08760 Martorell, Spain
| | - Joan Deus
- Clinical and Health Department, Psychology Faculty, Autonomous University of Barcelona, 08193 Bellaterra, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003 Barcelona, Spain
| | - Jerzy Krupinski
- Department of Neurology, Hospital Universitari MútuaTerrassa, 08221 Terrassa, Spain;
- Faculty of Science and Engineering, Department of Life Sciences John Dalton Building, Manchester Metropolitan University, Manchester M15 6BH, UK
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D'Hondt S, Gisle L, De Pauw R, Van Cauteren D, Demarest S, Drieskens S, Cornelissen L, De Ridder K, Charafeddine R, Smith P. Anxiety and depression in people with post-COVID condition: a Belgian population-based cohort study three months after SARS-CoV-2 infection. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02655-9. [PMID: 38819519 DOI: 10.1007/s00127-024-02655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/07/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Since the onset of the COVID-19 pandemic, most research has focused on the management of the acute symptoms of the disease. Yet some people tend to experience symptoms beyond the acute phase, defined as Post-COVID-19 Condition (PCC). This study aims to assess the impact of COVID-19 and PCC on anxiety and depression. METHODS This is a prospective longitudinal cohort study among the Belgian adult population with recent SARS-CoV-2 infection for which contact tracing was initiated. A total of 3127 people were followed-up just after their infection and three months later (from April 2021 to January 2022). Anxiety and depression were assessed at the two stages using the GAD-7 (Generalized Anxiety Disorder) and the PHQ-9 (Patient Health Questionnaire). RESULTS Three months after infection, participants with PCC (50%) had an increased probability of having both anxiety and depressive symptoms (p < 0.001). The proportion with anxiety and depressive symptoms at three months were significantly higher in people with PCC (11% and 19%) compared to people without persistent COVID symptoms (3.8% and 4.2%) and to a matched sub-sample not infected with SARS-CoV-2 (6.5% and 4.3%). Having at least one acute COVID-19 symptom (p < 0.001), experiencing financial loss following the infection (p < 0.001), and different PCC symptoms were associated with anxiety and depressive symptoms worsening over time. CONCLUSIONS This study showed that three months after a SARS-CoV-2 infection, one in two people suffer from PCC with significant consequences for their mental health. Follow-up on mental health must therefore have an important place in people suffering from PCC.
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Affiliation(s)
- Stéphanie D'Hondt
- Faculty of Public Health, Université catholique de Louvain, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Lydia Gisle
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Robby De Pauw
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Stefaan Demarest
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Sabine Drieskens
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Laura Cornelissen
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Karin De Ridder
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Pierre Smith
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium.
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.
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AL-Mhanna SB, Batrakoulis A, Hofmeister M, Drenowatz C, Ghazali WSW, Badicu G, Afolabi HA, Gülü M, Wada Y, Aldhahi MI, Nikolaidis PT. Psychophysiological Adaptations to Exercise Training in COVID-19 Patients: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2024; 2024:3325321. [PMID: 38726292 PMCID: PMC11081749 DOI: 10.1155/2024/3325321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024]
Abstract
Introduction Many COVID-19 patients display adverse symptoms, such as reduced physical ability, poor quality of life, and impaired pulmonary function. Therefore, this systematic review is aimed at evaluating the effectiveness of physical exercise on various psychophysiological indicators among COVID-19 patients who may be at any stage of their illness (i.e., critically ill, hospitalized, postdischarge, and recovering). Methods A systematic search was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar from 2019 to 2021. Twenty-seven studies, which assessed a total of 1525 patients, were included and analysed. Results Overall, data revealed significant improvements in the following parameters: physical function, dyspnoea, pulmonary function, quality of life (QOL), lower limb endurance and strength, anxiety, depression, physical activity level, muscle strength, oxygen saturation, fatigue, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-α), lymphocyte, leukocytes, and a fibrin degradation product (D-dimer). Conclusions Physical training turns out to be an effective therapy that minimises the severity of COVID-19 in the intervention group compared to the standard treatment. Therefore, physical training could be incorporated into conventional treatment of COVID-19 patients. More randomized controlled studies with follow-up evaluations are required to evaluate the long-term advantages of physical training. Future research is essential to establish the optimal exercise intensity level and assess the musculoskeletal fitness of recovered COVID-19 patients. This trial is registered with CRD42021283087.
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Affiliation(s)
- Sameer Badri AL-Mhanna
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Karies, Trikala, Greece
| | - Martin Hofmeister
- Department Food and Nutrition, Consumer Centre of the German Federal State of Bavaria, Munich, Germany
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, Brasov, Romania
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Türkiye
| | - Yusuf Wada
- Department of Zoology, Ahmadu Bello University, Zaria, Nigeria
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Llana T, Zorzo C, Mendez-Lopez M, Mendez M. Memory alterations after COVID-19 infection: a systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:292-305. [PMID: 36108666 DOI: 10.1080/23279095.2022.2123739] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
SARS-CoV-2 infection has a wide range of both acute and long-term symptoms. Memory alterations have been frequently reported in studies that explore cognition. The main objective of the systematic review is to update and further analyze the existing evidence of objective memory impairments in long-COVID-19 considering sample and study design characteristics, as well as to explore associations between memory performance and their epidemiological, clinical, and pathological features. A total of 13 studies were identified by searching in PubMed, Web of Science, and PsycInfo databases up to May 6, 2022. Most studies evaluated verbal component of memory in the short-term and long-term recall up to 30 min and mainly performed a single assessment completed at 4-6 months after the infection. The samples mainly consisted of middle-aged adults that required hospitalization. Samples were not stratified by sex, age, and severity. Poor verbal learning was reported in most cases (6-58%), followed by deficits in long-term (4-58%) and short-term (4-37%) verbal memory. Visuospatial component of memory was studied less than verbal component, showing impairment of long-term retention of visual items (10-49%). COVID-19 severity in the acute stage was not systematically associated with poor memory performance. Verbal memory deficits were associated with anxiety and depression. The existing literature on objective memory assessment in long-COVID suggests further research is warranted to confirm memory dysfunction in association with epidemiological, pathological, and clinical factors, using both verbal and visuospatial tests, and exploring in deep long-term memory deficits.
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Affiliation(s)
- Tania Llana
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
| | - Candela Zorzo
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
- Faculty of Psychology, Neuroscience Institute of Principado de Asturias (INEUROPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario, Oviedo, Spain
| | - Magdalena Mendez-Lopez
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- IIS Aragón, Zaragoza, Spain
| | - Marta Mendez
- Department of Psychology, Faculty of Psychology, University of Oviedo, Oviedo, Spain
- Faculty of Psychology, Neuroscience Institute of Principado de Asturias (INEUROPA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario, Oviedo, Spain
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Rehman K, Sohail M, Saleem M, Akhtar A. Addressing the research deficiencies in selective brain cooling methods in prehospital care for stroke patients. Brain Circ 2024; 10:188-189. [PMID: 39036295 PMCID: PMC11259328 DOI: 10.4103/bc.bc_90_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 07/23/2024] Open
Affiliation(s)
- Komal Rehman
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
- Department of Research, Darul Qalb, Knoxville, TN, United States
| | - Myra Sohail
- Department of Research, Darul Qalb, Knoxville, TN, United States
- Department of Medicine, Ziauddin University, Karachi, Pakistan
| | - Muskaan Saleem
- Department of Research, Darul Qalb, Knoxville, TN, United States
- Department of Medicine, Bahria University of Health Sciences, Karachi, Pakistan
| | - Ahmad Akhtar
- Department of Research, Darul Qalb, Knoxville, TN, United States
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Pollini E, Lazzarini SG, Cordani C, Del Furia MJ, Kiekens C, Negrini S, Arienti C. Effectiveness of Rehabilitation Interventions on Adults With COVID-19 and Post-COVID-19 Condition. A Systematic Review With Meta-analysis. Arch Phys Med Rehabil 2024; 105:138-149. [PMID: 37802177 DOI: 10.1016/j.apmr.2023.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of rehabilitation interventions for adults with COVID-19 and post COVID-19 condition (PCC) in all settings. DATA SOURCES PubMed, EMBASE, CINAHL, Scopus, Web of Science, and Physiotherapy Evidence Database were searched from inception to December 31st, 2021. PROSPERO registration number: CRD42021258553. STUDY SELECTION We included randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSI) according to the University of Alberta Evidence-based Practice Center. DATA EXTRACTION One author extracted data using a predetermined Excel form. DATA SYNTHESIS The meta-analysis indicates uncertain evidence about the effect of pulmonary rehabilitation and self-activities on exercise capacity (MD 65.06, 95% CI 42.87 to 87.25), respiratory function (forced expiratory volume in the first second [FEV1]: MD 0.16, 95% CI 0.05 to 0.28; FEV1/forced vital capacity [FVC]: MD 0.05, 95% CI 0.01 to 0.09; FVC: MD 0.19, 95% CI -0.03 to 0.42) and anxiety (MD -12.03, 95% CI -21.16 to -2.90) in mild COVID-19 and PCC patients. According to the narrative synthesis, including RCTs and NRSI, prone positioning seems to show improvements in vital parameters in severe COVID-19 post intensive care unit (ICU) discharge, pulmonary rehabilitation in activities of daily living, and qigong exercise and acupressure rehabilitation program, and "twist and raise" walking technique in reducing dyspnea and weakness in any degree of severity of COVID-19 and PCC. Functional electrical stimulation-cycling or early rehabilitation programs seem to support a faster recovery in patients with moderate COVID-19 after ICU discharge. Yoga and naturopathy, Mandala coloring, and respiratory exercise seem to reduce anxiety and depression in patients with moderate and mild COVID-19. Cognitive motor training seems to improve cognitive function in PCC patients. CONCLUSIONS There is very uncertain evidence about the effect of pulmonary rehabilitation on exercise capacity and respiratory function in patients with mild COVID-19 and PCC. Further high-quality research is required to improve the certainty of evidence available to support rehabilitation's crucial role in managing COVID-19.
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Affiliation(s)
| | | | - Claudio Cordani
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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del Valle MF, Valenzuela J, Bascour-Sandoval C, Marzuca-Nassr GN, del Sol M, Díaz Canales C, Escobar-Cabello M, Lizama-Pérez R, Valenzuela-Aedo F, Muñoz-Cofré R. Effects of a pulmonary rehabilitation program on pulmonary function, exercise performance, and quality of life in patients with severe COVID-19. Ther Adv Respir Dis 2024; 18:17534666231212431. [PMID: 38660953 PMCID: PMC11047239 DOI: 10.1177/17534666231212431] [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: 04/20/2023] [Accepted: 10/19/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Severe coronavirus 2019 disease (COVID-19) causes acute hypoxemic respiratory failure requiring invasive mechanical ventilation (IMV). Once these symptoms are resolved, patients can present systemic deterioration. OBJECTIVE The two objectives of this study were as follows: to describe the results of a pulmonary rehabilitation program (PRP), which is divided into three groups with different numbers of sessions (12, 24, and 36), and to associate the variables of pulmonary function, exercise performance, and functionality with the number of sessions and functional improvement. DESIGN Prospective, observational study. METHODS PRP consisted of aerobic + strength + flexibility exercises under the supervision and individualized into 12, 24, or 36 sessions (12s, 24s, and 36s), depending on the evolution of each patient. At the beginning of the study and immediately after the intervention, forced vital capacity (FVC), maximal inspiratory pressure, 6-minute walk test (6MWT), sit-to-stand test (STS), maximal handgrip strength (HGS), Fatigue Assessment Scale, Post-COVID-19 Functional Status (PCFS), and health-related quality of life (HRQoL) were measured. RESULTS The proposed PRP demonstrated a positive effect on pulmonary function, exercise performance, and HRQoL, regardless of the number of sessions. A higher score on the PCFS and more days on IMV were associated with the increased likelihood of needing more sessions, whereas more meters on the 6MWT in the initial evaluation was associated with a reduced likelihood of needing more sessions. Finally, more repetitions on the STS and less distance covered on the initial 6MWT were associated with a greater improvement in exercise performance evaluated with the 6MWT. CONCLUSION Supervised and individualized PRP for patients with severe post-COVID-19 improves pulmonary function, exercise performance, functionality, and quality of life. Functionality, distance covered on the 6MWT, and the days on IMV are central to the scheduling of the number of sessions for these patients.
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Affiliation(s)
| | - Jorge Valenzuela
- Servicio de Medicina Física y Rehabilitación, Hospital el Carmen, Maipú, Chile
| | - Claudio Bascour-Sandoval
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Gabriel Nasri Marzuca-Nassr
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Mariano del Sol
- Centro de Excelencia en Estudios Morfológicos y Quirúrgicos, Universidad de La Frontera. Temuco, Chile
- Doctorado en Ciencias Morfológicas, Universidad de La Frontera. Temuco, Chile
| | | | - Máximo Escobar-Cabello
- Laboratorio de Función Disfunción Ventilatoria, Departamento de Kinesiología, Universidad Católica del Maule, Talca, Chile
| | - Rodrigo Lizama-Pérez
- Department of Physical Education and Sport, Faculty of Sport Science, University of Granada, Granada, Spain
| | - Fernando Valenzuela-Aedo
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
- Doctorado en Ciencias Morfológicas, Universidad de La Frontera. Temuco, Chile
| | - Rodrigo Muñoz-Cofré
- Posdoctorado en Ciencias Morfológicas, Universidad de La Frontera, Av. Francisco Salazar 01145, Temuco 4811230, Chile
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Ghram A, Latiri I, Methnani J, Souissi A, Benzarti W, Toulgui E, Ben Saad H. Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies. Expert Rev Respir Med 2023; 17:1095-1124. [PMID: 38063359 DOI: 10.1080/17476348.2023.2293226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].
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Affiliation(s)
- Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Imed Latiri
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jabeur Methnani
- LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie: de l'Intégré au Moléculaire 10 « Biologie, Médecine et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Amine Souissi
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Physiology and Functional Exploration, Farhat HACHED Hospital, Sousse, Tunisia
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12
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Ceravolo MG, Anwar F, Andrenelli E, Udensi C, Qureshi J, Sivan M, Kiekens C, Zampolini M. Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2023; 59:789-799. [PMID: 38214046 DOI: 10.23736/s1973-9087.23.08315-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, rehabilitation plays a key role for this patient population. This study aimed to improve Physical and Rehabilitation Medicine (PRM) physician's professional practice for persons with COVID-19-related functioning limitations, to promote functional recovery and reduce activity limitations and/or participation restrictions. A systematic review of the scientific literature was performed from December 2019 to August 2022, followed by production of recommendations through 5 Delphi rounds, by consensus among the delegates of all European countries represented in the Union of European Medical Specialists PRM Section. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The PRM physician's role for persons with COVID-19-related limitations of functioning is to develop, foster, and monitor the implementation of an individual rehabilitation project tailored to the patient's age, previous medical and functional status, current comorbidities and complications, activity limitations and participation restrictions and personal and environmental factors. This is done by applying the concept of a multi-specialty integrated service model with multi-professional/interdisciplinary teams, providing care at all stages of COVID-19 illness. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section.
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Affiliation(s)
- Maria G Ceravolo
- Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Italy
| | - Fahim Anwar
- Department of Rehabilitation Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Italy -
| | - Cynthia Udensi
- Department of Rehabilitation Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Jawaria Qureshi
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds General Infirmary, University of Leeds, Leeds, UK
| | | | - Mauro Zampolini
- Department of Rehabilitation, Hospital of Foligno, USL Umbria2, Perugia, Italy
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13
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Tavares-Júnior JWL, Oliveira DN, da Silva JBS, Queiroz Feitosa WL, Sousa AVM, Marinho SC, Cunha LCV, Gaspar SDB, Gomes CMP, de Oliveira LLB, Moreira-Nunes CA, Sobreira EST, de Moraes MEA, Sobreira-Neto MA, Montenegro RC, Braga-Neto P. Post-COVID-19 Cognitive Decline and Apoe Polymorphism: Towards a Possible Link? Brain Sci 2023; 13:1611. [PMID: 38137059 PMCID: PMC10742128 DOI: 10.3390/brainsci13121611] [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: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/24/2023] Open
Abstract
APOE ε4 polymorphism has been recently described as a possible association with cognitive deficits in COVID-19 patients. This research aimed to establish the correlation between COVID-19 and cognitive impairment, and the APOE gene polymorphism among outpatients. We performed a cross-sectional study with confirmed COVID-19 patients and neurological symptoms that persisted for more than three months from onset. APOE genotypes were determined. The final number of patients included in this study was 219, of which 186 blood samples were collected for APOE genotyping, evaluated 4.5 months after COVID-19. Among the participants, 143 patients (65.3%) reported memory impairment symptoms as their primary concern. However, this complaint was objectively verified through screening tests (Addenbrooke Cognitive Examination-Revised and Mini-Mental State Examination) in only 36 patients (16.4%). The group experiencing cognitive decline exhibited a higher prevalence of the APOE ε4 allele than the normal group (30.8% vs. 16.4%, respectively, p = 0.038). Furthermore, the APOE ε4 allele and anxiety symptoms remained significant after multivariate analysis. This study assessed an outpatient population where cognitive changes were the primary complaint, even in mild cases. Moreover, the ε4 allele, sleep disorders, and anxiety symptoms were more frequent in the cognitive decline group.
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Affiliation(s)
- José Wagner Leonel Tavares-Júnior
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
| | - Danilo Nunes Oliveira
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
| | - Jean Breno Silveira da Silva
- Medicine Research and Development Center (NPDM), Pharmacogenetics Laboratory, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.B.S.d.S.); (L.L.B.d.O.); (C.A.M.-N.); (M.E.A.d.M.); (R.C.M.)
| | - Werbety Lucas Queiroz Feitosa
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
| | - Artur Victor Menezes Sousa
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
| | - Samuel Cavalcante Marinho
- Health Sciences Center, State University of Ceará (UECE), Fortaleza 60714-903, CE, Brazil; (S.C.M.); (S.d.B.G.); (C.M.P.G.)
| | - Letícia Chaves Vieira Cunha
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
| | - Safira de Brito Gaspar
- Health Sciences Center, State University of Ceará (UECE), Fortaleza 60714-903, CE, Brazil; (S.C.M.); (S.d.B.G.); (C.M.P.G.)
| | - Carmem Meyve Pereira Gomes
- Health Sciences Center, State University of Ceará (UECE), Fortaleza 60714-903, CE, Brazil; (S.C.M.); (S.d.B.G.); (C.M.P.G.)
| | - Laís Lacerda Brasil de Oliveira
- Medicine Research and Development Center (NPDM), Pharmacogenetics Laboratory, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.B.S.d.S.); (L.L.B.d.O.); (C.A.M.-N.); (M.E.A.d.M.); (R.C.M.)
| | - Caroline Aquino Moreira-Nunes
- Medicine Research and Development Center (NPDM), Pharmacogenetics Laboratory, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.B.S.d.S.); (L.L.B.d.O.); (C.A.M.-N.); (M.E.A.d.M.); (R.C.M.)
| | - Emmanuelle Silva Tavares Sobreira
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
| | - Maria Elisabete Amaral de Moraes
- Medicine Research and Development Center (NPDM), Pharmacogenetics Laboratory, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.B.S.d.S.); (L.L.B.d.O.); (C.A.M.-N.); (M.E.A.d.M.); (R.C.M.)
| | - Manoel Alves Sobreira-Neto
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
| | - Raquel Carvalho Montenegro
- Medicine Research and Development Center (NPDM), Pharmacogenetics Laboratory, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.B.S.d.S.); (L.L.B.d.O.); (C.A.M.-N.); (M.E.A.d.M.); (R.C.M.)
| | - Pedro Braga-Neto
- Neurology Division, Clinical Medicine Department, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil; (J.W.L.T.-J.); (D.N.O.); (W.L.Q.F.); (A.V.M.S.); (L.C.V.C.); (E.S.T.S.); (M.A.S.-N.)
- Clinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará (UFC), Fortaleza 60020-181, CE, Brazil
- Health Sciences Center, State University of Ceará (UECE), Fortaleza 60714-903, CE, Brazil; (S.C.M.); (S.d.B.G.); (C.M.P.G.)
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14
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Notarstefano C, Bertolucci F, Miccoli M, Posteraro F. Recovery of activities of daily living in COVID-19 patients requiring intensive care unit or medical care unit: an observational study on the role of rehabilitation in the subacute phase. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1256999. [PMID: 38028154 PMCID: PMC10667478 DOI: 10.3389/fresc.2023.1256999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Purpose This study aims to describe the functional status of a cohort of subacute COVID-19 patients treated in a dedicated rehabilitation unit and to compare functional outcomes between patients previously hospitalized in the intensive care unit (ICU group) and patients assisted in the medical care unit (MCU group). Materials and methods Clinical and functional evaluations were performed at admission and discharge. The functional status was assessed using Barthel index (BI), functional ambulation categories (FAC), trunk control test (TCT), and dysphagia outcome and severity score (DOSS). All patients received multidisciplinary tailored rehabilitation. Results We evaluated 171 patients (with a mean age of 67.7 ± 11.9 years, 117 were males), 110 coming from the ICU (with a mean age of 63.24 ± 10.9 years), and 61 coming from the MCU (with a mean age of 75.75 ± 9.09 years). The ICU group showed a worse functional status at admission compared with the MCU group [BI 2.5 (0-20) vs. 20 (10-60), FAC 0 (0-0) vs. 0 (0-2), TCT 61 (42-100) vs. 100 (61-100), DOSS 5 (1-7) vs. 7 (7-7)] and had significantly longer hospital stay. At discharge, all functional scales were improved with no statistically significant differences between the two groups. Conclusion Early rehabilitation of COVID-19 survivors improves functional recovery closing the initial gap between the ICU and MCU groups. In addition, it is effective to improve the functional outcome reducing the costs for longer-term assistance of COVID-19 patients.
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Affiliation(s)
- Chiara Notarstefano
- Department of Translational Research and New Technologies in Medicine and Surgery, DS Neurorehabilitation, University of Pisa, Pisa, Italy
| | - Federica Bertolucci
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Posteraro
- Department of Rehabilitation, Versilia Hospital, AUSL Toscana Nord Ovest, Lucca, Italy
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15
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Almeida MP, Machado Vaz I, Winck JC, Marques A. Inpatient rehabilitation of a person with Guillain-Barré syndrome associated with COVID-19 infection: An expert interdisciplinary approach to a case study. Physiother Theory Pract 2023; 39:2479-2489. [PMID: 35521973 DOI: 10.1080/09593985.2022.2072252] [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: 11/08/2021] [Revised: 04/10/2022] [Accepted: 04/26/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Several cases of Guillain-Barré Syndrome (GBS) associated with a COVID-19 infection have been recently reported. Rehabilitation might be a key player in the recovery of these highly complex patients however, results are yet unknown. This case report aimed to describe the effects of an inpatient rehabilitation program, with an interdisciplinary team approach, in a patient with GBS in the context of a COVID-19 infection. CASE DESCRIPTION A 58-year-old man with GBS after COVID-19 started an inpatient rehabilitation program focused on reducing dyspnea and fatigue symptoms; improving muscle strength, balance, aerobic and functional training; practicing activities of daily living and energy conservation techniques; swallowing training; emotional support and patient and family education about daily routines. An expert interdisciplinary team delivered the intervention, approximately 5 h/day, 5 days/week for 6 weeks. OUTCOMES Improvements were observed in dyspnea, fatigue, nocturnal ventilation, muscle strength, balance, walking capacity, functional status, and swallowing function. CONCLUSION This clinical case report illustrates the impact of a tailored and interdisciplinary rehabilitation program, on promoting recovery in multiple health domains of a patient with GBS associated with COVID-19 infection. Our experience might be useful to guide other inpatient rehabilitation programs to successfully manage these highly complex patients.
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Affiliation(s)
- Miguel P Almeida
- Centro de Reabilitação do Norte, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Respiratory Research and Rehabilitation Laboratory (Lab3r), School of Health Sciences (ESSUA) and Institute of Biomedicine (IBiMED), University of Aveiro, Aveiro, Portugal
| | - Inês Machado Vaz
- Serviço de Medicina Física e de Reabilitação - Centro Hospitalar de Trás-Os-Montes e Alto Douro, Vila Real, Portugal
| | - João Carlos Winck
- Centro de Reabilitação do Norte, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3r), School of Health Sciences (ESSUA) and Institute of Biomedicine (IBiMED), University of Aveiro, Aveiro, Portugal
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16
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Nayani S, Castanares-Zapatero D, De Pauw R, Van Cauteren D, Demarest S, Drieskens S, Cornelissen L, Devleesschauwer B, De Ridder K, Charafeddine R, Smith P. Classification of post COVID-19 condition symptoms: a longitudinal study in the Belgian population. BMJ Open 2023; 13:e072726. [PMID: 37802617 PMCID: PMC10565235 DOI: 10.1136/bmjopen-2023-072726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES Since the onset of the COVID-19 pandemic, most research has focused on its acute pathophysiology, yet some people tend to experience persisting symptoms beyond the acute phase of infection, referred to as post COVID-19 condition (PCC). However, evidence on PCC is still scarce. This study aimed to assess the distribution, classification of symptoms and associated factors of PCC in adults. DESIGN Longitudinal online cohort study. SETTING National study in Belgium. PARTICIPANTS Participants were Belgian adults with a recent SARS-CoV-2 infection and were recruited when called up for contact tracing. A total of 3039 participants were included and completed an online questionnaire at the time of their infection and again 3 months later. OUTCOME MEASURES The baseline questionnaire assessed the initial health status of the participants and their status during the acute phase of the infection. The follow-up questionnaire assessed their PCC status 3 months after infection. A latent class analysis (LCA) was performed to assess whether there are different classes of individuals with a similar set of self-reported PCC symptoms. RESULTS Half of the participants reported PCC 3 months after infection (47%). The most frequent symptoms were fatigue (21%), headache (11%) and memory problems (10%). The LCA highlighted three different classes of PCC symptoms with different risk factors: (1) a combination of loss of smell and taste, (2) a combination of neurological symptoms and (3) other heterogeneous symptoms. CONCLUSIONS With the increasing number of people who underwent COVID-19, PCC has become an important but complex public health problem due to the heterogeneity of its symptoms. The classification of symptoms performed in this study can help give insight into different aetiologies of PCC and better plan care according to the symptoms and needs of those affected.
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Affiliation(s)
- Sarah Nayani
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Robby De Pauw
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | | | | | | | - Brecht Devleesschauwer
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Ghent, Belgium
| | - Karin De Ridder
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Pierre Smith
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
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17
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Declercq PL, Fournel I, Demeyere M, Berraies A, Ksiazek E, Nyunga M, Daubin C, Ampere A, Sauneuf B, Badie J, Delbove A, Nseir S, Artaud-Macari E, Bironneau V, Ramakers M, Maizel J, Miailhe AF, Lacombe B, Delberghe N, Oulehri W, Georges H, Tchenio X, Clarot C, Redureau E, Bourdin G, Federici L, Adda M, Schnell D, Bousta M, Salmon-Gandonnière C, Vanderlinden T, Plantefeve G, Delacour D, Delpierre C, Le Bouar G, Sedillot N, Beduneau G, Rivière A, Meunier-Beillard N, Gélinotte S, Rigaud JP, Labruyère M, Georges M, Binquet C, Quenot JP. Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study. Intensive Care Med 2023; 49:1168-1180. [PMID: 37620561 PMCID: PMC10556111 DOI: 10.1007/s00134-023-07180-y] [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: 03/05/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Survivors after acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) are at high risk of developing respiratory sequelae and functional impairment. The healthcare crisis caused by the pandemic hit socially disadvantaged populations. We aimed to evaluate the influence of socio-economic status on respiratory sequelae after COVID-19 ARDS. METHODS We carried out a prospective multicenter study in 30 French intensive care units (ICUs), where ARDS survivors were pre-enrolled if they fulfilled the Berlin ARDS criteria. For patients receiving high flow oxygen therapy, a flow ≥ 50 l/min and an FiO2 ≥ 50% were required for enrollment. Socio-economic deprivation was defined by an EPICES (Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé - Evaluation of Deprivation and Inequalities in Health Examination Centres) score ≥ 30.17 and patients were included if they performed the 6-month evaluation. The primary outcome was respiratory sequelae 6 months after ICU discharge, defined by at least one of the following criteria: forced vital capacity < 80% of theoretical value, diffusing capacity of the lung for carbon monoxide < 80% of theoretical value, oxygen desaturation during a 6-min walk test and fibrotic-like findings on chest computed tomography. RESULTS Among 401 analyzable patients, 160 (40%) were socio-economically deprived and 241 (60%) non-deprived; 319 (80%) patients had respiratory sequelae 6 months after ICU discharge (81% vs 78%, deprived vs non-deprived, respectively). No significant effect of socio-economic status was identified on lung sequelae (odds ratio (OR), 1.19 [95% confidence interval (CI), 0.72-1.97]), even after adjustment for age, sex, most invasive respiratory support, obesity, most severe P/F ratio (adjusted OR, 1.02 [95% CI 0.57-1.83]). CONCLUSIONS In COVID-19 ARDS survivors, socio-economic status had no significant influence on respiratory sequelae 6 months after ICU discharge.
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Affiliation(s)
| | - Isabelle Fournel
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | | | - Eléa Ksiazek
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Martine Nyunga
- Service de Médecine Intensive Réanimation, CH de Roubaix, Roubaix, France
| | - Cédric Daubin
- Department of Medical Intensive Care, CHU de Caen Normandie, Caen, France
| | | | - Bertrand Sauneuf
- Service de Médecine Intensive Réanimation, CH Public du Cotentin, Cherbourg-en-Cotentin, France
| | - Julio Badie
- Service de Médecine Intensive Réanimation, Hopital Nord Franche-Comte, Trevenans, France
| | - Agathe Delbove
- Service de Réanimation Polyvalente, CHBA Vannes, Vannes, France
| | - Saad Nseir
- Service de Médecine Intensive Réanimation, CHRU Roger Salengro, Lille, France
- Inserm U1285, Univ. Lille, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Elise Artaud-Macari
- University of Normandie, UNIROUEN, EA3830, CHU Rouen, Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care Unit, Rouen, France
| | - Vanessa Bironneau
- Service de Pneumologie, CHU Poitiers, Poitiers, France
- INSERM CIC 1402, ALIVES Research Group, Université de Poitiers, Poitiers, France
| | - Michel Ramakers
- Service de Médecine Intensive Réanimation, Centre Hospitalier Mémorial de Saint-Lô, Saint-Lô, France
| | - Julien Maizel
- Service de Médecine Intensive Réanimation, CHU d’Amiens, Amiens, France
| | | | - Béatrice Lacombe
- Service de Réanimation Polyvalente, Groupe Hospitalier Bretagne Sud, Lorient, France
| | | | - Walid Oulehri
- Service de Réanimation Chirurgicale, CHRU Strasbourg, Strasbourg, France
| | - Hugues Georges
- Service de Médecine Intensive Réanimation, CH de Tourcoing, Tourcoing, France
| | - Xavier Tchenio
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | | | - Elise Redureau
- Service de Pneumologie, CHD Vendée, La Roche-sur-Yon, France
| | - Gaël Bourdin
- Service de Réanimation Polyvalente, CH Saint Joseph Saint Luc, Lyon, France
| | - Laura Federici
- Service de Médecine Intensive Réanimation, AP-HP, Hôpital Louis Mourier, Colombes, France
| | - Mélanie Adda
- Service de Médecine Intensive Réanimation, Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - David Schnell
- Service de Réanimation Polyvalente et USC, CH d’Angoulême, Angoulême, France
| | - Mehdi Bousta
- Service de Réanimation Médico-Chirugicale, Groupe Hospitalier du Havre, Le Havre, France
| | | | - Thierry Vanderlinden
- Intensive Care Unit, St Philibert hospital, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Gaëtan Plantefeve
- Service de Médecine Intensive Réanimation, CH d’Argenteuil, Argenteuil, France
| | - David Delacour
- Service de radiologie, Clinique du Cèdre, Bois-Guillaume, France
| | | | - Gurvan Le Bouar
- Service de Médecine Intensive Réanimation, CHES Evreux, Evreux, France
| | - Nicholas Sedillot
- Service de Réanimation Polyvalente, Centre Hospitalier Fleyriat, Bourg en Bresse, France
| | - Gaëtan Beduneau
- Normandie Univ, UNIROUEN, UR3830, CHU Rouen, Department of Medical Intensive Care, 76000 Rouen, France
| | - Antoine Rivière
- Service de Réanimation Polyvalente, CH d’Abbeville, Abbeville, France
| | - Nicolas Meunier-Beillard
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | | | - Jean-Philippe Rigaud
- Service de Médecine Intensive Réanimation, CH de Dieppe, Dieppe, France
- Espace de Réflexion Ethique de Normandie, CHU Caen, Caen, France
| | - Marie Labruyère
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079 Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - Marjolaine Georges
- Department of Pulmonary Medicine and Intensive Care Unit, University Hospital, Dijon, France
| | - Christine Binquet
- Centre d’Investigation Clinique, CHU Dijon, Dijon, France
- INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Burgundy University Hospital, 14 rue Paul Gaffarel, B.P 77908, 21079 Dijon Cedex, France
- Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France
- INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
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18
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Meléndez-Oliva E, Martínez-Pozas O, Cuenca-Zaldívar JN, Villafañe JH, Jiménez-Ortega L, Sánchez-Romero EA. Efficacy of Pulmonary Rehabilitation in Post-COVID-19: A Systematic Review and Meta-Analysis. Biomedicines 2023; 11:2213. [PMID: 37626710 PMCID: PMC10452542 DOI: 10.3390/biomedicines11082213] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis examines how pulmonary rehabilitation impacts in patients suffering from subacute and long COVID-19 infections, gauging enhancements in of dyspnea, physical function, quality of life, psychological state (anxiety and depression), and fatigue. METHODS Three electronic databases (PubMed, Web of Science, Cochrane Library) were systematically searched for full-text articles published from inception to January 2023. Randomized, quasi-experimental, and observational studies were included, with adults diagnosed with subacute or long COVID-19 who received pulmonary rehabilitation as intervention. Outcomes related to dyspnea, physical function, quality of life, fatigue, and psychological status were included. Risk of bias was assessed with Cochrane Risk of Bias Tool for Randomized Controlled Trials and Risk of bias in non-randomized studies of intervention. The review was registered before starting in PROSPERO (CRD: 42022373075). RESULTS Thirty-four studies were included, involving 1970 patients with subacute and long COVID-19. The meta-analysis demonstrated moderate to large effects on dyspnea, physical function, quality of life, and depressive symptoms compared to usual care intervention. No significant differences were found in fatigue compared to usual care, nor in anxiety levels after pulmonary rehabilitation intervention. CONCLUSIONS Pulmonary rehabilitation has the potential to improve health outcomes in patients with subacute and long COVID-19. However, due to the high risk of bias of included studies, conclusions should be taken with caution.
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Affiliation(s)
- Erika Meléndez-Oliva
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Valencia, Pg. de l’Albereda, 7, 46010 Valencia, Spain;
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
| | - Oliver Martínez-Pozas
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933 Alcorcón, Spain
| | - Juan Nicolás Cuenca-Zaldívar
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
- Physical Therapy Unit, Primary Health Care Center “El Abajón”, 28231 Madrid, Spain
| | | | - Laura Jiménez-Ortega
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain;
- Center of Human Evolution and Behavior, Carlos III Health Institute, Complutense University of Madrid, 28040 Madrid, Spain
| | - Eleuterio A. Sánchez-Romero
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
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19
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Kelly AA, Lewis CA, Escalon MX. Inpatient Rehabilitation Issues Related to COVID-19. Phys Med Rehabil Clin N Am 2023; 34:513-522. [PMID: 37419528 DOI: 10.1016/j.pmr.2023.04.001] [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: 07/09/2023]
Abstract
Patients who are hospitalized due to COVID-19 are predisposed to requiring acute inpatient rehabilitation. Multiple factors have posed challenges to inpatient rehabilitation during the COVID-19 pandemic, such as staff shortages, restrictions with therapy, and barriers to discharge. Despite these challenges, data have shown that inpatient rehabilitation plays a key role in functional gains for this patient population. There remains a need for more data on the current challenges that are faced in the inpatient rehabilitation setting, as well as better understanding of long-term functional outcomes following COVID-19.
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Affiliation(s)
- Amanda A Kelly
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai (Mount Sinai), One Gustave L Levy Place, Box 1240B, New York, NY 10029, USA.
| | - Caroline A Lewis
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai (Mount Sinai), One Gustave L Levy Place, Box 1240B, New York, NY 10029, USA
| | - Miguel X Escalon
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai (Mount Sinai), One Gustave L Levy Place, Box 1240B, New York, NY 10029, USA
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20
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Smith P, De Pauw R, Van Cauteren D, Demarest S, Drieskens S, Cornelissen L, Devleesschauwer B, De Ridder K, Charafeddine R. Post COVID-19 condition and health-related quality of life: a longitudinal cohort study in the Belgian adult population. BMC Public Health 2023; 23:1433. [PMID: 37495947 PMCID: PMC10373376 DOI: 10.1186/s12889-023-16336-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/18/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Since the onset of the COVID-19 pandemic, most research has focused on the acute phase of COVID-19, yet some people experience symptoms beyond, referred to as post COVID-19 conditions (PCC). However, evidence on PCC and its impacts on health-related quality of life (HRQoL) is still scarce. This study aimed to assess the impact of COVID-19 and PCC on HRQoL. METHODS This is a longitudinal cohort study of the Belgian adult population with recent SARS-CoV-2 infection. In total, 5,727 people were followed up between the time of their infection and three months later. HRQoL was measured with the EQ-5D-5L questionnaire before and during the infection and three months later. Linear mixed regression models were built to assess the longitudinal association between participants' characteristics and the evolution of their HRQoL. RESULTS This study found a significant decline in HRQoL during the SARS-CoV-2 infection in comparison to the situation before (β=-9.91, 95%CI=-10.13;-9.85), but no clinically important difference three months after the infection compared to the situation before, except among people reporting PCC (β=-11.15, 95%CI=-11.72;-10.51). The main symptoms of PCC with a significant negative impact on the different dimensions of HRQoL were fatigue/exhaustion (21%), headache (11%), memory problems (10%), shortness of breath (9%), and joint (7%) or muscle pain (6%). The dimension of HRQoL most negatively affected by several PCC symptoms was pain/discomfort. CONCLUSIONS With the growing number of people infected with SARS-CoV-2, PCC and its impact on HRQoL are becoming important public health issues. To allow people with PCC to recover and to limit its detrimental impact on HRQoL, it is essential to manage its various heterogeneous symptoms using a multidisciplinary approach.
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Affiliation(s)
- Pierre Smith
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium.
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Dieter Van Cauteren
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Stefaan Demarest
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Sabine Drieskens
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Laura Cornelissen
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Ghent, Belgium
| | - Karin De Ridder
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
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21
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Pescaru CC, Crisan AF, Marc M, Trusculescu AA, Maritescu A, Pescaru A, Sumenkova A, Bratosin F, Oancea C, Vastag E. A Systematic Review of Telemedicine-Driven Pulmonary Rehabilitation after the Acute Phase of COVID-19. J Clin Med 2023; 12:4854. [PMID: 37510969 PMCID: PMC10381369 DOI: 10.3390/jcm12144854] [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: 06/15/2023] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The acute phase of COVID-19 often leaves patients with persistent pulmonary deficits. Pulmonary Rehabilitation (PR) has been recommended as an essential part of post-acute COVID-19 management. In light of the global pandemic, telerehabilitation has been increasingly employed to deliver PR. This systematic review aimed to evaluate the effectiveness of telemedicine-driven PR in patients recovering from the acute phase of COVID-19, assessing variations in telerehabilitation practices and identifying the degree of change in mental health, physical health, quality of life, and lung function. A systematic search was conducted across PubMed, Web of Science, Cochrane, and Scopus up until April 2023. Studies focusing on telerehabilitation in PR for post-acute COVID-19 patients with outcomes including pulmonary function, exercise capacity, and quality of life were included after careful assessment of this study's protocol. The selection process involved careful scrutiny of abstracts and full texts, and the quality assessment was performed using the National Heart, Lung, and Blood Institute (NHLBI) tool. Seven studies, published between 2021 and 2022, involving a total of 412 patients, were included. The evaluated telerehabilitation programs stretched between 4 and 10 weeks, involving a mobile app or video connection with the patient, integrating a mix of aerobic and resistance training, breathing exercises, functional activities, and muscle strengthening. Findings revealed that telemedicine-driven PR significantly improved physical health, measured by the step test score (73 vs. 71), 6MWD (30.2 vs. 17.1) and BPAQ, mental health evaluated by SF-12 (6.15 vs. 4.17) and PHQ-4, quality of life measured by the SF-12 (7.81 vs. 3.84), SGRQ (31.5 vs. 16.9), and CAT scores, and some parameters of pulmonary function in post-acute COVID-19 patients (mMRC, STST, and MVV). This review substantiates the potential of telemedicine-driven PR to improve various health outcomes in post-acute COVID-19 patients. The findings underscore the importance of integrating telerehabilitation into the management of post-acute COVID-19 and call for further exploration of its long-term effects, cost-effectiveness, and best practices.
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Affiliation(s)
- Camelia Corina Pescaru
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Alexandru Florian Crisan
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
- Research Center for the Assessment of Human Motion, Functionality and Disability (CEMFD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Monica Marc
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Ana Adriana Trusculescu
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Adelina Maritescu
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Andrei Pescaru
- Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Anastasiia Sumenkova
- Penza State University, Faculty of Medicine, Ulitsa Krasnaya 40, 440026 Penza, Russia
| | - Felix Bratosin
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy "Victor Babes" Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
| | - Emanuela Vastag
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Pulmonology Clinic, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania
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22
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Samper-Pardo M, Formento-Marín N, Oliván-Blázquez B, León-Herrera S, Benedé-Azagra B. Use of community resources as health assets for rehabilitation of people with Long COVID in northeastern Spain two years after the outbreak of the COVID-19 pandemic: qualitative study. Arch Public Health 2023; 81:125. [PMID: 37415256 DOI: 10.1186/s13690-023-01139-7] [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: 09/28/2022] [Accepted: 06/22/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION The epidemiology of Post COVID Condition is not yet known. There are different treatment options, but they are not recommended or suitable for all those affected. For this reason and due to the lack of health treatment, many of these patients have tried to carry out their own rehabilitation through the use of community resources. OBJECTIVE The objective of this study is to deepen into the understanding about the use of community resources as assets for health and rehabilitation by people with Long COVID and their utility. METHODOLOGY A qualitative design was carried out with the participation of 35 Long COVID patients, of which 17 subjects were interviewed individually and 18 of them were part of two focus groups. The participating patients were recruited in November and December 2021 from the Primary Health Care centers and through the Association of Long COVID patients of Aragon. The research topics were the use of community resources, before and after their infection by COVID-19, rehabilitation through their use, as well as barriers and strengths for their employment. All analyses were performed iteratively using NVivo software. RESULTS Long COVID patients who have used community resources for rehabilitation have seen an improvement in their physical and mental health. Most of them, specifically those affected, have used green spaces, public facilities, physical or cultural activities and associations. The main barriers identified have been the symptoms themselves and the fear of reinfection, with the main advantage of these activities being the perceived health benefits. CONCLUSION The use of community resources seems to be beneficial in the recovery process of Long COVID patients, so it is necessary to continue delving into this topic and promote the formal use of the Recommendation of Health Assets from Primary healthcare.
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Affiliation(s)
- Mario Samper-Pardo
- Institute for Health Research Aragón (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain
| | - Natalia Formento-Marín
- Institute for Health Research Aragón (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain.
- Department of Psychology and Sociology, University of Zaragoza, Calle de Violante de Hungría, 23, Zaragoza, 50009, Spain.
- Research Network on Chronicity, Primary Care and Health Promotion (RD21/0016/0005), Carlos III Health Institute, Avda. de Monforte de Lemos, 5, Madrid, 28029, Spain.
| | - Sandra León-Herrera
- Institute for Health Research Aragón (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain
| | - Belén Benedé-Azagra
- Institute for Health Research Aragón (IIS Aragón), C. de San Juan Bosco, 13, Zaragoza, 50009, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RD21/0016/0005), Carlos III Health Institute, Avda. de Monforte de Lemos, 5, Madrid, 28029, Spain
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23
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Rabady S, Hoffmann K, Aigner M, Altenberger J, Brose M, Costa U, Denk-Linnert DM, Gruber S, Götzinger F, Helbok R, Hüfner K, Koczulla R, Kurz K, Lamprecht B, Leis S, Löffler J, Müller CA, Rittmannsberger H, Rommer PS, Sator P, Strenger V, Struhal W, Untersmayr E, Vonbank K, Wancata J, Weber T, Wendler M, Zwick RH. [S1 guidelines for the management of postviral conditions using the example of post-COVID-19]. Wien Klin Wochenschr 2023; 135:525-598. [PMID: 37555900 PMCID: PMC10504206 DOI: 10.1007/s00508-023-02242-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 08/10/2023]
Abstract
These S1 guidelines are an updated and expanded version of the S1 guidelines on long COVID differential diagnostic and management strategies. They summarize the state of knowledge on postviral conditions like long/post COVID at the time of writing. Due to the dynamic nature of knowledge development, they are intended to be "living guidelines". The focus is on practical applicability at the level of primary care, which is understood to be the appropriate place for initial access and for primary care and treatment. The guidelines provide recommendations on the course of treatment, differential diagnostics of the most common symptoms that can result from infections like with SARS-CoV-2, treatment options, patient management and care, reintegration and rehabilitation. The guidelines have been developed through an interdisciplinary and interprofessional process and provide recommendations on interfaces and possibilities for collaboration.
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Affiliation(s)
- Susanne Rabady
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich.
| | - Kathryn Hoffmann
- Leiterin der Abteilung Primary Care Medicine, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Martin Aigner
- Abteilung für Psychiatrie und psychotherapeutische Medizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich
| | - Johann Altenberger
- Pensionsversicherungsanstalt, Rehabilitationszentrum Großgmain, Salzburger Str. 520, 5084, Großgmain, Österreich
| | - Markus Brose
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich
| | - Ursula Costa
- Ergotherapie und Handlungswissenschaft, fhg - Zentrum für Gesundheitsberufe Tirol GmbH/fh, Innrain 98, 6020, Innsbruck, Österreich
| | - Doris-Maria Denk-Linnert
- Klinische Abteilung für Allgemeine Hals‑, Nasen- und Ohrenkrankheiten, Klin. Abteilung Phoniatrie-Logopädie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Samuel Gruber
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Str. 30, 3500, Krems, Österreich
| | - Florian Götzinger
- Abteilung für Kinderheilkunde, Klinik Ottakring, Montleartstr. 37, 1160, Wien, Österreich
| | - Raimund Helbok
- Universitätsklinik für Neurologie, Johannes Kepler Universität Linz, Standort Neuromed Campus & Med Campus Kepler Universitätsklinikum GmbH, 4020, Linz, Österreich
| | - Katharina Hüfner
- Dep. für Psychiatrie, Psychotherapie, Psychosomatik und Medizinische Psychologie, Universitätsklinik für Psychiatrie II, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Rembert Koczulla
- Fachbereich Medizin, Klinik für Pneumologie Marburg, Baldingerstr., 35035, Marburg, Deutschland
| | - Katharina Kurz
- Innere Medizin II, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Bernd Lamprecht
- Universitätsklinik für Innere Medizin mit Schwerpunkt Pneumologie, Kepler Universitätsklinikum, 4020, Linz, Österreich
| | - Stefan Leis
- Universitätsklinik für Neurologie der PMU, MME Universitätsklinikum Salzburg Christian-Doppler-Klinik, Ignaz-Harrer-Str. 79, 5020, Salzburg, Österreich
| | - Judith Löffler
- Innere Medizin II, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Christian A Müller
- Klinische Abteilung für Allgemeine Hals‑, Nasen- und Ohrenkrankheiten, Klin. Abteilung für Allgemeine HNO, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | | | - Paulus S Rommer
- Universitätsklinik für Neurologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Paul Sator
- Dermatologische Abteilung, Klinik Hietzing, Wolkersbergenstr. 1, 1130, Wien, Österreich
| | - Volker Strenger
- Klinische Abteilung für Allgemeinpädiatrie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, 8036, Graz, Österreich
| | - Walter Struhal
- Klinische Abteilung für Neurologie, Universitätsklinikum Tulln, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Alter Ziegelweg 10, 3430, Tulln an der Donau, Österreich
| | - Eva Untersmayr
- Institut für Pathophysiologie und Allergieforschung Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Karin Vonbank
- Klinische Abteilung für Pulmologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Johannes Wancata
- Klinische Abteilung für Sozialpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Thomas Weber
- Kardiologische Abteilung Klinikum Wels-Grieskirchen, Grieskirchnerstr. 42, 4600, Wels, Österreich
| | | | - Ralf-Harun Zwick
- Ludwig Boltzmann Institute for Rehabilitation Research, Kurbadstr. 14, 1100, Wien, Österreich
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24
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McCarthy A, Galvin R, Dockery F, McLoughlin K, O'Connor M, Corey G, Whiston A, Carey L, Steed F, Tierney A, Robinson K. Multidisciplinary inpatient rehabilitation for older adults with COVID-19: a systematic review and meta-analysis of clinical and process outcomes. BMC Geriatr 2023; 23:391. [PMID: 37365515 DOI: 10.1186/s12877-023-04098-4] [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: 01/25/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Older adults are at increased risk for disease severity and poorer prognosis following COVID-19 infection. The aim of this systematic review and meta-analysis is to explore the impact of multidisciplinary rehabilitation in the acute or post-acute hospital setting for older adults with COVID-19. METHODS The Cochrane library, EMBASE, Cinahl and Medline (via EBSCO), PubMed, and Web of Science were systematically searched in June 2022 and a repeat search was completed in March 2023. Screening, data extraction and quality appraisal were conducted independently by two reviewers. Studies reporting outcomes for older adults following multidisciplinary rehabilitation (provided by two or more Health and Social Care Professionals) were included. Both observational and experimental study designs were included. The primary outcome was functional ability. Secondary outcomes included discharge disposition, acute hospital and rehabilitation unit length of stay, mortality, primary and secondary healthcare utilisation, and long-term effects of COVID-19. RESULTS Twelve studies met the inclusion criteria, comprising a total of 570 older adults. Where reported, older adults stayed in the acute hospital for a mean of 18 days (95%CI, 13.35- 23.13 days) and in rehabilitation units for 19 days (95%CI, 15.88-21.79 days). There was a significant improvement in functional ability among older adults with COVID-19 who received multidisciplinary rehabilitation (REM, SMD = 1.46, 95% CI 0.94 to 1.98). The proportion of older adults who were discharged directly home following rehabilitation ranged from 62 to 97%. Two studies reported a 2% inpatient mortality rate of older persons during rehabilitative care. No study followed up patients after the point of discharge and no study reported on long term effects of COVID-19. CONCLUSIONS Multidisciplinary rehabilitation may result in improved functional outcomes on discharge from rehabilitation units/centres for older adults with COVID-19. Findings also highlight the need for further research into the long-term effect of rehabilitation for older adults following COVID-19. Future research should comprehensively describe multidisciplinary rehabilitation in terms of disciplines involved and the intervention provided.
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Affiliation(s)
- Aoife McCarthy
- School of Allied Health, Faculty of Education and Health Sciences, Post Graduate Member HRI, University of Limerick, Limerick, Ireland.
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Frances Dockery
- Department of Geriatric and Stroke Medicine, and Integrated Care Team for Older People North Dublin, Beaumont Hospital, Dublin, Ireland
| | - Kara McLoughlin
- Department of Occupational Therapy, Beaumont Hospital, Dublin, Ireland
| | - Margaret O'Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
- School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Gillian Corey
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - Aoife Whiston
- Post Doctoral Researcher, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Leonora Carey
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Fiona Steed
- UL Hospitals Group, University Hospital Limerick, Limerick, Ireland
| | - Audrey Tierney
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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25
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de Oliveira Almeida K, Nogueira Alves IG, de Queiroz RS, de Castro MR, Gomes VA, Santos Fontoura FC, Brites C, Neto MG. A systematic review on physical function, activities of daily living and health-related quality of life in COVID-19 survivors. Chronic Illn 2023; 19:279-303. [PMID: 35404175 PMCID: PMC9006095 DOI: 10.1177/17423953221089309] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To analyze the published studies that investigated the physical function, activities of daily living and health-related quality of life in COVID-19 survivors. DESIGN Systematic review. METHODS We searched MEDLINE/PubMed, Scopus, SciELO, and Cochrane Library for studies that evaluated the physical function, activities of daily living and health-related quality of life after COVID-19 from the earliest date available to July 2021. Two independent reviewers screened and selected the studies. The Newcastle Ottawa Scale was used to evaluate methodological quality. RESULTS We included 35 studies in this systematic review. Of the 35 studies included, 28 were cohort, and 7 cross-sectional studies The studies demonstrated that COVID-19 survivors had reduced levels of physical function, activities of daily living, and health-related quality of life. Furthermore, incomplete recovery of physical function, and performance in activities of daily living were observed 1 to 6 months post-infection. DISCUSSION Physical disability and reduction in health-related quality of life is a common condition in post-COVID-19 and impairments may persist up to 1 to 6 months. Researchers and clinicians can use these findings to understand the potential disabilities and rehabilitation needs of people recovering from the COVID-19.
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Affiliation(s)
- Katna de Oliveira Almeida
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Iura Gonzalez Nogueira Alves
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Department of Medicine, Bahiana School of Medicine and Public Health (BSMPH), Salvador, Bahia, Brazil
| | - Rodrigo Santos de Queiroz
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Marcela Rodrigues de Castro
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Educação Física, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Vinicius Afonso Gomes
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Hospital Especializado Octávio Mangabeira, Salvador, Bahia, Brazil
| | - Fabiane Costa Santos Fontoura
- Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Hospital Especializado Octávio Mangabeira, Salvador, Bahia, Brazil
| | - Carlos Brites
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Mansueto Gomes Neto
- 28111Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, 28111Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
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26
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Hajibashi A, Sarrafzadeh J, Amiri A, Salehi R, Vasaghi-Gharamaleki B. Effect of progressive muscle relaxation as an add-on to pulmonary telerehabilitation in discharged patients with COVID-19: A randomised controlled trial. Complement Ther Clin Pract 2023; 51:101730. [PMID: 36731284 PMCID: PMC9877153 DOI: 10.1016/j.ctcp.2023.101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND and purpose: Most patients with coronavirus disease 2019 (COVID-19) experience persistent physical and psychological symptoms. This study aimed to investigate the effects of pulmonary telerehabilitation (PTR) combined with progressive muscle relaxation (PMR) on the physical and psychological outcomes of discharged patients with COVID-19. MATERIALS AND METHODS This randomised, assessor-blinded, parallel-group study was conducted in hospitals affiliated with Qom University of Medical Sciences between May and October 2021. Discharged COVID-19 patients aged 18-65 years were randomly assigned to two groups of 26 patients each. The experimental group underwent PTR and PMR for six weeks, while the comparison group received PTR alone. Primary (functional capacity) and secondary (dyspnoea, anxiety, depression, fatigue, sleep quality, and quality of life) outcomes were evaluated at baseline and after six weeks. RESULTS The experimental group showed significantly higher sleep quality (P = 0.001, 95% confidence interval [CI]: 1.20-4.09) and significantly lower fatigue (P = 0.041, 95% CI: 4.79-5.25) and anxiety (P = 0.001, 95% CI: 1.21-4.47) than the comparison group. No between-group differences were observed in terms of other outcomes (P > 0.05). CONCLUSION PTR coupled with PMR was more effective for promoting sleep quality and alleviating anxiety and fatigue than PTR alone.
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Affiliation(s)
- Arghavan Hajibashi
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Sarrafzadeh
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Ali Amiri
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Geriatric Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behnoosh Vasaghi-Gharamaleki
- Rehabilitation Research Center, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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27
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Teodoro T, Chen J, Gelauff J, Edwards MJ. Functional neurological disorder in people with long COVID: A systematic review. Eur J Neurol 2023; 30:1505-1514. [PMID: 36719069 DOI: 10.1111/ene.15721] [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: 12/21/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Acute health events, including infections, can trigger the onset of functional neurological disorder (FND). It was hypothesized that a proportion of people with long COVID might be experiencing functional symptoms. METHODS A systematic review of studies containing original data on long COVID was performed. The frequency and characteristics of neurological symptoms were reviewed, looking for positive evidence suggesting an underlying functional disorder and the hypothesized causes of long COVID. RESULTS In all, 102 studies were included in our narrative synthesis. The most consistently reported neurological symptoms were cognitive difficulties, headaches, pain, dizziness, fatigue, sleep-related symptoms and ageusia/anosmia. Overall, no evidence was found that any authors had systematically looked for positive features of FND. An exception was three studies describing temporal inconsistency. In general, the neurological symptoms were insufficiently characterized to support or refute a diagnosis of FND. Moreover, only 13 studies specifically focused on long COVID after mild infection, where the impact of confounders from the general effects of severe illness would be mitigated. Only one study hypothesized that some people with long COVID might have a functional disorder, and another eight studies a chronic-fatigue-syndrome-like response. DISCUSSION Neurological symptoms are prevalent in long COVID, but poorly characterized. The similarities between some manifestations of long COVID and functional disorders triggered by acute illnesses are striking. Unfortunately, the current literature is plagued by confounders, including the mixing of patients with initial mild infection with those with severe acute medical complications. The hypothesis that long COVID might in part correspond to a functional disorder remains untested.
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Affiliation(s)
- Tiago Teodoro
- Neurosciences Research Centre, Institute of Molecular and Clinical Sciences, St George's, University of London, London, UK
| | - Jiaying Chen
- Neurosciences Research Centre, Institute of Molecular and Clinical Sciences, St George's, University of London, London, UK
| | - Jeannette Gelauff
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mark J Edwards
- Neurosciences Research Centre, Institute of Molecular and Clinical Sciences, St George's, University of London, London, UK
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28
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Tamburlani M, Cuscito R, Servadio A, Galeoto G. Effectiveness of Respiratory Rehabilitation in COVID-19's Post-Acute Phase: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11081071. [PMID: 37107905 PMCID: PMC10137696 DOI: 10.3390/healthcare11081071] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by the new grave and acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), generated an unprecedented danger to public health. This condition may impact survivors' quality of life and includes extensive pulmonary and respiratory outcomes. Respiratory rehabilitation is known for its effects in improving dyspnea, alleviating anxiety and depression, reducing complications, preventing and ameliorating dysfunctions, reducing morbidity, preserving functions and improving subjects' quality of life. For this reason, respiratory rehabilitation may be recommended for this category of patients. OBJECTIVE Our objective was to evaluate the effectiveness and benefits produced by the adoption of pulmonary rehabilitation (PR) programs in COVID-19's post-acute phase. MATERIAL AND METHODS A search of relevant publications was conducted using the following electronic databases: PubMed, Scopus, PEDro, and Cochrane Library. A single reviser selected pertinent articles that studied the effects of pulmonary rehabilitation during COVID-19's post-acute phase in improving the respiratory function, physical performance, autonomy and quality of life (QoL). RESULTS After an initial selection, 18 studies were included in this systematic review, of which 14 concern respiratory rehabilitation delivered in conventional form and 4 concern respiratory rehabilitation provided in telehealth. CONCLUSIONS Pulmonary rehabilitation combining different types of training-breathing, aerobic, fitness and strength-and not bypassing the neuropsychological aspects revealed itself to be capable of improving pulmonary and muscular functions, general health and quality of life in post-acute COVID-19 patients, besides increasing workout capacity and muscle strength, improving fatigue states and reducing anxiety and depression.
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Affiliation(s)
| | - Rossana Cuscito
- Master's Degree Course in Rehabilitation Sciences of the Health Professions, University of Rome Tor Vergata, 00133 Roma, Italy
| | | | - Giovanni Galeoto
- Departement of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Neuromed, IRCCS, 86077 Pozzilli, Italy
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29
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Bae S, Malcolm MP, Nam S, Hong I. Association Between COVID-19 and Activities of Daily Living in Older Adults. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:202-210. [PMID: 36377234 PMCID: PMC9666414 DOI: 10.1177/15394492221134911] [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: 11/16/2022]
Abstract
Older adults gradually decrease their independence with activities of daily living (ADL) due to aging. The coronavirus disease-19 (COVID-19), the recent pandemic, can accelerate the decline in functions, such as ADL. This study aimed to examine whether there is an association between positive COVID-19 results and decreased independence with ADL in older adults. Data for a total of 3,118 older adults were extracted from the 2020 National Health and Aging Trends Study-COVID-19. A total of 71 (2.29%) participants presented with positive COVID-19 tests. There was a significant association between a positive COVID-19 result and decreased independence with ADL (relative risk [RR] = 1.47, 95% confidence interval [CI] = [1.11, 1.96], p = .0079). The study findings revealed that COVID-19 survivors had a high risk of decreased independence with ADL. These findings indicate that COVID-19 survivors have residual functional deficits and would need comprehensive health care services.
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Affiliation(s)
- Suyeong Bae
- Graduate School, Yonsei University, Wonju-si, Republic of Korea
| | - Matt P Malcolm
- Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Sanghun Nam
- Graduate School, Yonsei University, Wonju-si, Republic of Korea
| | - Ickpyo Hong
- College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Republic of Korea
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30
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Rutkowski S, Bogacz K, Rutkowska A, Szczegielniak J, Casaburi R. Inpatient post-COVID-19 rehabilitation program featuring virtual reality-Preliminary results of randomized controlled trial. Front Public Health 2023; 11:1121554. [PMID: 36815161 PMCID: PMC9939639 DOI: 10.3389/fpubh.2023.1121554] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023] Open
Abstract
Background Numerous recommendations from pulmonary scientific societies indicate the need to implement rehabilitation programs for patients after COVID-19. The aim of this study was to propose an innovative comprehensive intervention based on a hospital-based pulmonary rehabilitation program for individuals with post-acute sequelae of COVID-19. Methods It was decided to evaluate two forms of hospital rehabilitation: traditional and one provided through virtual reality. Preliminary results are based on a group of 32 patients (20 female and 12 male), of average age 57.8 (4.92) years in the period of 3-6 months after the initial infection. Primary outcomes included analysis of lung function, exercise performance and stress level. A 3-week, high-intensity, five-times per week pulmonary rehabilitation program was designed to compare the effectiveness of a traditional form with a VR-led, novel form of therapy. Results The analysis of the results showed a statistically significant improvement in both groups with regard to exercise performance expressed as 6MWT distance. Moreover, a statistically significant decrease in dyspnoea levels following the 6MWT was also noted in intergroup comparison, but the between-group comparison revealed non-statistically significant changes with low effect size. Regarding lung function, the analysis showed essentially normal lung function at baseline and a non-statistically significant improvement after the completion of the rehabilitation program. The analysis of the stress level showed a statistically significant improvement in both groups within the inter-group comparison, yet the between-group comparison of deltas values showed a non-significant difference with low effect size. Conclusion A 3-weeks inpatients pulmonary rehabilitation program led to improvement of the exercise performance of people with post-acute sequelae of COVID-19, but not lung function. Furthermore, the program was shown to reduce patients' stress levels. A comparison of the traditional form of rehabilitation to the novel form using VR, shows similar effectiveness in terms of exercise performance and stress levels.
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Affiliation(s)
- Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,*Correspondence: Sebastian Rutkowski ✉
| | - Katarzyna Bogacz
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,Specialist Hospital of the Ministry of the Interior and Administration in Głuchołazy, Głuchołazy, Poland
| | - Anna Rutkowska
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Jan Szczegielniak
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland,Specialist Hospital of the Ministry of the Interior and Administration in Głuchołazy, Głuchołazy, Poland
| | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States
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31
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Rahmati M, Molanouri Shamsi M, Woo W, Koyanagi A, Won Lee S, Keon Yon D, Shin JI, Smith L. Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:149-158. [PMID: 36717302 PMCID: PMC9851951 DOI: 10.1016/j.joim.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hospitalized patients recovering from coronavirus disease 2019 (COVID-19) may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge. However, to date, no attempt has been made to collate and synthesize literature in this area. OBJECTIVE This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital. SEARCH STRATEGY A systematic search of MEDLINE/PubMed, CINAHL, Scopus and medRxiv was conducted to identify articles published up to March 2022. INCLUSION CRITERIA This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity, exercise, or breathing training to enhance or restore functional capacity, pulmonary function, quality of life, and mental health or function. DATA EXTRACTION AND ANALYSIS Selection of included articles, data extraction, and methodological quality assessments were conducted by two review authors respectively, and consensus was reached through discussion and consultation with a third reviewer. Finally, we review the outcomes of studies based on four categories including: (1) functional capacity, (2) pulmonary function, (3) quality of life, and (4) mental health status. RESULTS A total of 7534 titles and abstracts were screened; 10 cohort studies, 4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review. Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity, pulmonary function, quality of life and mental health status. CONCLUSION Physical rehabilitation interventions may be safe, feasible and effective in COVID-19 patients discharged from the hospital, and can improve a variety of clinically relevant outcomes. Further studies are warranted to determine the underlying mechanisms. Please cite this article as: Rahmati M, Shamsi MM, Woo W, Koyanagi A, Lee SW, Yon DK, Shin JI, Smith L. Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital: A systematic review. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, 6816785468 Khoramabad, Iran.
| | - Mahdieh Molanouri Shamsi
- Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, 1411713116 Tehran, Iran.
| | - Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Gangnam-gu, Seoul 06273, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona 08010, Spain
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Dong Keon Yon
- Medical Science Research Institute, Kyung Hee University, Seoul 02447, Republic of Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea.
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Postolache PA, Nechifor A, Buculei I, Soare I, Mocanu H, Petrariu FD. Clinical Features and Paraclinical Findings in Patients with SARS CoV-2 Pneumonia and the Impact of Pulmonary Rehabilitation on the Instrumental Activities of Daily Living in POST-COVID-19 Patients. J Pers Med 2023; 13:jpm13020182. [PMID: 36836416 PMCID: PMC9964772 DOI: 10.3390/jpm13020182] [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: 12/06/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
The functional sequelae grouped under the name "long COVID" most often bring the patient in front of a team of specialists in pulmonary rehabilitation. The aim of this study was to evaluate clinical features and paraclinical findings in patients with SARS CoV-2 (Severe Acute Respiratory Syndrome-Corona Virus-2) pneumonia and to also evaluate the impact of rehabilitation in this category of patients. This study included 106 patients diagnosed with SARS CoV-2. The division of the patients into two groups was performed based on the presence of SAR-CoV-2 pneumonia. Clinical symptoms, biochemical parameters, and pulmonary functional and radiological examinations were recorded and analyzed. The Lawton Instrumental Activities of Daily Living (IADL) scale was applied to all patients. Patients in group I were included in the pulmonary rehabilitation program. Among demographic characteristics, age over 50 years (50.9%; p = 0.027) and the female sex (66%; p = 0.042) were risk factors for pneumonia in patients with SARS CoV-2. Over 90% of the 26 patients included in the rehabilitation program were less able to feed, bathe, dress, and walk. After 2 weeks, approximately 50% of patients were able to eat, wash, and dress. It is important to provide longer rehabilitation programs in cases of moderate, severe, and very severe COVID-19 patients, in order to significantly improve patients' participation in daily activities and their quality of life.
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Affiliation(s)
- Paraschiva A. Postolache
- Internal Medicine Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800008 Galati, Romania
- Correspondence: (A.N.); (I.B.)
| | - Ioana Buculei
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, “Grigore T. Popa” University of Medicine and Pharmacy, 700454 Iasi, Romania
- Doctoral School of the Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Correspondence: (A.N.); (I.B.)
| | - Ioana Soare
- Insurance Medicine Department, Faculty of Medicine, “Titu Maiorescu” University, 040441 Bucharest, Romania
| | - Horia Mocanu
- Department of Ear, Nose and Throat and Head and Neck, Faculty of Medicine, “Titu Maiorescu” University, 040441 Bucharest, Romania
| | - Florin Dumitru Petrariu
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Rodrigues M, Costa AJ, Santos R, Diogo P, Gonçalves E, Barroso D, Almeida MP, Vaz IM, Lima A. Inpatient rehabilitation can improve functional outcomes of post-intensive care unit COVID-19 patients-a prospective study. Disabil Rehabil 2023; 45:266-276. [PMID: 35133225 DOI: 10.1080/09638288.2022.2032408] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the impact of an inpatient multimodal and intensive rehabilitation program on neuromuscular, respiratory, and functional impairments of post-ICU COVID-19 patients. MATERIALS AND METHODS Prospective study including post-ICU COVID-19 survivors consecutively admitted to a rehabilitation centre. Rehabilitation was conducted by an interdisciplinary team. Medical Research Council (MRC) score, maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), peak cough flow (PCF), Functional Oral Intake Scale (FOIS), Brief Balance Evaluation Systems Test (Brief-BESTest), Timed Up and Go (TUG) test, 1 min Sit to Stand Test (1' STST), 6 min Walking Test (6MWT), Fatigue Assessment Scale (FAS), Functional Independence Measure (FIM) were assessed at admission (T0) and discharge (T1). RESULTS A total of 42 patients were included. After 32.00;26.00 days of inpatient rehabilitation, there was a significant improvement in limb and respiratory muscle strength, cough effectiveness, fatigue, balance, exercise capacity, and in the ability to perform activities of daily living. Advanced age, longer acute care hospitalization, depressive symptoms, and cognitive deficits were associated with poorer functional outcomes. CONCLUSION Post-ICU COVID-19 patients present multiple sequelae with detrimental functional impact. An adapted interdisciplinary rehabilitation program is essential for a thorough evaluation of these patients and results in significant functional gains.IMPLICATIONS FOR REHABILITATIONPost-ICU COVID-19 survivors present multiple sequelae and disabilities.An intensive and interdisciplinary inpatient rehabilitation results in significant improvement in limb and respiratory muscle strength, cough effectiveness, fatigue, balance, exercise capacity, and ability to perform activities of daily living.Timely referral from the acute care setting to rehabilitation services is crucial to minimize the functional impact of severe multisystemic disease and prolonged hospitalization.
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Affiliation(s)
| | - Ana João Costa
- Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal
| | - Rui Santos
- Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal
| | - Pedro Diogo
- Hospital Central do Funchal, Funchal, Portugal
| | | | - Denise Barroso
- Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal
| | - Miguel P Almeida
- Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal
- Escola Superior de Saúde, Universidade de Aveiro, Aveiro, Portugal
| | - Inês Machado Vaz
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Ana Lima
- Centro de Reabilitação do Norte, Vila Nova de Gaia, Portugal
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Samper-Pardo M, León-Herrera S, Oliván-Blázquez B, Benedé-Azagra B, Magallón-Botaya R, Gómez-Soria I, Calatayud E, Aguilar-Latorre A, Méndez-López F, Pérez-Palomares S, Cobos-Rincón A, Valero-Errazu D, Sagarra-Romero L, Sánchez-Recio R. Development and Validation of a Mobile Application as an Adjuvant Treatment for People Diagnosed with Long COVID-19: Protocol for a Co-Creation Study of a Health Asset and an Analysis of Its Effectiveness and Cost-Effectiveness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010462. [PMID: 36612782 PMCID: PMC9819090 DOI: 10.3390/ijerph20010462] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To analyse the overall effectiveness and cost-efficiency of a mobile application (APP) as a community health asset (HA) with recommendations and recovery exercises created bearing in mind the main symptoms presented by patients in order to improve their quality of life, as well as other secondary variables, such as the number and severity of ongoing symptoms, physical and cognitive functions, affective state, and sleep quality. METHODS The first step was to design and develop the technologic community resource, the APP, following the steps involved in the process of recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st) usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI), as an interventional group. An evaluation will be carried out at baseline with further assessments three and six months following the end of the intervention. DISCUSSION Although research and care for these patients are still in their initial stages, it is necessary to equip patients and health care practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved through telerehabilitation (TR).
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Affiliation(s)
| | | | - Bárbara Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Belén Benedé-Azagra
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Department of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Isabel Gómez-Soria
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Estela Calatayud
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Fátima Méndez-López
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Sara Pérez-Palomares
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, University of La Rioja, 26004 Logroño, Spain
| | - Diana Valero-Errazu
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Lucia Sagarra-Romero
- GAIAS Research Group, Faculty of Health Sciences, University San Jorge, 50830 Zaragoza, Spain
| | - Raquel Sánchez-Recio
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain
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Perrottelli A, Sansone N, Giordano GM, Caporusso E, Giuliani L, Melillo A, Pezzella P, Bucci P, Mucci A, Galderisi S. Cognitive Impairment after Post-Acute COVID-19 Infection: A Systematic Review of the Literature. J Pers Med 2022; 12:jpm12122070. [PMID: 36556290 PMCID: PMC9781311 DOI: 10.3390/jpm12122070] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The present study aims to provide a critical overview of the literature on the relationships between post-acute COVID-19 infection and cognitive impairment, highlighting the limitations and confounding factors. A systematic search of articles published from 1 January 2020 to 1 July 2022 was performed in PubMed/Medline. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies using validated instruments for the assessment of cognitive impairment were included. Out of 5515 screened records, 72 studies met the inclusion criteria. The available evidence revealed the presence of impairment in executive functions, speed of processing, attention and memory in subjects recovered from COVID-19. However, several limitations of the literature reviewed should be highlighted: most studies were performed on small samples, not stratified by severity of disease and age, used as a cross-sectional or a short-term longitudinal design and provided a limited assessment of the different cognitive domains. Few studies investigated the neurobiological correlates of cognitive deficits in individuals recovered from COVID-19. Further studies with an adequate methodological design are needed for an in-depth characterization of cognitive impairment in individuals recovered from COVID-19.
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Abstract
PURPOSE OF REVIEW To describe the burden of post-COVID respiratory sequelae in posthospital and nonhospitalized COVID-19 survivors and to describe the priorities of clinical management. RECENT FINDINGS Due to varying definitions of 'Long COVID' or 'Post-COVID', the prevalence of post-COVID sequelae or persisting symptoms is challenging to estimate but ranges from 2.3 to 51%. Risk factors for persistent post-COVID symptoms include age, female sex, deprivation, presence of comorbidities; and in posthospital COVID-19 survivors, the severity of acute infection. Common post-COVID respiratory symptoms include breathlessness, cough and chest pain and many individuals also experience exercise intolerance. The most common pulmonary function test abnormality is impaired diffusing capacity for carbon monoxide. In posthospital COVID-19 survivors, the prevalence of interstitial lung damage is 5-11%. Disordered breathing is common in all post-COVID patients and respiratory physiotherapy is helpful. SUMMARY The vast numbers of COVID-19 infections globally implies that a large number of people will be affected by post-COVID sequelae even with conservative estimates. A significant number of people are affected for several months and up to years following acute infection. Post-COVID sequelae have a detrimental impact on quality of life and ability to work.
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Barbieri V, Scarabel L, Bertella L, Scarpina F, Schiavone N, Perucca L, Rossi P. Evaluation of the predictive factors of the short-term effects of a multidisciplinary rehabilitation in COVID-19 survivors. J Int Med Res 2022; 50:3000605221138843. [PMID: 36448484 PMCID: PMC9716619 DOI: 10.1177/03000605221138843] [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: 12/05/2022] Open
Abstract
OBJECTIVE Functional impairments after coronavirus disease 2019 (COVID-19) constitute a major concern in rehabilitative settings; however, evidence assessing the efficacy of rehabilitation programs is lacking. The aim of this study was to verify the clinical characteristics that may represent useful predictors of the short-term effectiveness of multidisciplinary rehabilitation. METHODS In this real-practice retrospective pre-post intervention cohort study, the short-term effectiveness of a multidisciplinary patient-tailored rehabilitation program was assessed through normalized variations in the Functional Independence Measure in post-acute care patients who had overcome severe COVID-19. Biochemical markers, motor and nutritional characteristics, and the level of comorbidity were evaluated as predictors of functional outcome. Length of stay in the rehabilitation ward was also considered. RESULTS Following rehabilitation, all participants (n = 53) reported a significant decrease in the level of disability in both motor and cognitive functioning. However, neither motor and nutritional characteristics nor comorbidities played a significant role in predicting the overall positive change registered after rehabilitation. CONCLUSIONS The results support the existing sparse evidence addressing the importance of an early rehabilitation program for patients who received intensive care and post-acute care due to severe COVID-19.
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Affiliation(s)
- Valentina Barbieri
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland,IRCCS Istituto Auxologico Italiano, U.O. di Riabilitazione Neuromotoria Auxologico ‘Capitanio’, Milan, Italy,Valentina Barbieri, Clinica Hildebrand, Centro di Riabilitazione Brissago, Via Crodolo 18, 6614 Brissago, Switzerland.
| | - Luca Scarabel
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland,Cliniche di Riabilitazione Ente Ospedaliero Cantonale (CREOC), Novaggio and Faido, Switzerland
| | - Laura Bertella
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland
| | - Federica Scarpina
- ‘Rita Levi Montalcini’ Department of Neurosciences, University of Turin, , Turin, Italy,IRCCS Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Piancavallo (VCO), Italy
| | - Nicola Schiavone
- Cliniche di Riabilitazione Ente Ospedaliero Cantonale (CREOC), Novaggio and Faido, Switzerland
| | - Laura Perucca
- IRCCS Istituto Auxologico Italiano, U.O. di Riabilitazione Neuromotoria Auxologico ‘Capitanio’, Milan, Italy,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Paolo Rossi
- Clinica Hildebrand, Centro di Riabilitazione Brissago, Brissago, Switzerland
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Muacevic A, Adler JR, Papavdi M, Manousopoulou G, Karamani T, Avgoustou H, Kotsi E, Niakas D, Vassilopoulos D. Long-Term Effect on Health-Related Quality of Life in Patients With COVID-19 Requiring Hospitalization Compared to Non-hospitalized COVID-19 Patients and Healthy Controls. Cureus 2022; 14:e31342. [PMID: 36514618 PMCID: PMC9741546 DOI: 10.7759/cureus.31342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/12/2022] Open
Abstract
Background In this study, we aimed to evaluate the health-related quality of life (HRQL) in patients with severe coronavirus disease 2019 (COVID-19) six months after their hospitalization and compare it to that of non-hospitalized patients with mild COVID-19 and healthy controls. Methodology Participants were enrolled between September 2021 and April 2022 and included hospitalized COVID-19 patients at General Hospital of Athens "Hippocration" who had been discharged at least six months prior to enrollment, non-hospitalized patients with COVID-19, and healthy controls. Collected data included demographics, disease severity, medication history, and comorbidities. Participants completed a EuroQol 5 Dimensions 5Levels (EQ5D5L), a Short Form 36 version 2 (SF36v2), a Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and a Post-COVID-19 Functional Status Scale (PCFSS) regarding HRQL before and six months after infection with severe acute respiratory syndrome coronavirus 2. In the case of healthy controls, two sets of questionnaires were completed at least six months apart. Statistical analysis was performed using the SPSS version 25 software (IBM Corp., Armonk, NY, USA). Results A total of 151 participants were enrolled. Hospitalized patients with COVID-19 demonstrated a statistically significant deterioration in most parameters of SF36v2 as well as both parameters of the EQ5D5L and FACIT-F questionnaires. Hospitalized patients exhibited worse results in SF36v2 and EQ5D5L when compared to both healthy controls as well as those with mild COVID-19 (p < 0.05). Hospitalized women, in particular, were shown to fare worse than other women in parameters associated with both mental/psychological and physical health (p < 0.05). Hospitalized patients between 41 and 60 years old demonstrated a statistically significant drop in the scores of all three main questionnaires compared to their previous health status (p < 0.05). Hospitalized patients between 61 and 80 years old exhibited a similar trend, but statistical significance was achieved in fewer parameters. HRQL decline was greater in both age groups compared to that of healthy and milder disease counterparts. There was a significant correlation between the results from the three main questionnaires. Similarly, PCFS scale values were shown to correlate with disease severity (hospitalization or not) and age. Conclusions HRQL remained noticeably impacted six months after hospitalization due to COVID-19. The physical and mental/psychological stress of severe COVID-19 translated into lasting health deterioration, especially for women and those aged 41-60 years old. The use of questionnaires, such as those implemented in this study, might help in the early detection of patients who could benefit from rehabilitation programs. Psychological, as well as physical and social, support is crucial to alleviate the burden of post-COVID-19 symptomatology and expedite the recovery of this group of patients.
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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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BENZARTI W, TOULGUI E, GHRAM A, RAHMANI C, AISSA S, GHANNOUCHI I, GARGOURI I, SAYHI A, KNAZ A, OUANES W, JEMNI S, BEN SAAD H. Impact of a pulmonary rehabilitation program on social disadvantage and physical activity data of postCOVID19 patients: A North-African pilot study. F1000Res 2022; 11:1226. [PMID: 37547787 PMCID: PMC10403745 DOI: 10.12688/f1000research.126301.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 08/08/2023] Open
Abstract
Background In addition to the cardiorespiratory, muscular, and neurological manifestations, coronavirus disease 2019 (COVID-19) alters patients' health-related quality of life (HRQoL), induces a large variety of psychiatric manifestations, and reduces mobility and motor activity. Several studies have raised the impact of a pulmonary rehabilitation program (PRP) on social disadvantage ( e.g., HRQoL, anxiety, depression) and physical activity of COVID-19 patients, but very few have been performed in low-income countries. This study aimed to investigate the impact of a PRP on post-COVID-19 HRQoL, hospital anxiety and depression (HAD), and physical activity in Tunisian post-COVID19-patients. Methods This was a cross-sectional study in an outpatient care setting. Patients with post-COVID-19 were included. They completed an interview (including three questionnaires) before and after a PRP (three sessions/week for four weeks, each session was 70 minutes in duration, PRP items: aerobic cycle endurance, strength training, and education). The VQ11 questionnaire assessed functional dimension, psychological dimension, relational dimension, and total score; HAD appraised depression and anxiety; and Voorrips physical activity assessed daily activity, physical activity, leisure activity, and total scores. Data were expressed as mean±standard deviation in PRP change (PRP change=after-PRP values - before-PRP values). Results In total, 14 moderate to severe post-COVID-19 patients (61±4 years) were included. The PRP significantly improved the i) functional, psychological, and relational dimensions, and the VQ11 total score by 1.79±1.58 (p=0.0033), 2.00±2.15 (p=0.0108), 1.57±1.50 (p=0.0077), and 5.36±3.97 (p=0.0015), respectively; ii) HAD anxiety and depression scores by 2.07±2.40 (p=0.0076), and 2.57±3.08 (p=0.0058); and iii) physical activity and total scores by 1.75±2.44 (p=0.0251), and 1.78±2.65 (p=0.0341), respectively. Conclusion The PRP improved HRQoL, HAD, and physical activity of Tunisian post-COVID-19 patients.
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Affiliation(s)
- Wafa BENZARTI
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna TOULGUI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Amine GHRAM
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
| | - Chiraz RAHMANI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Sana AISSA
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines GHANNOUCHI
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Imene GARGOURI
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani SAYHI
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma KNAZ
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Walid OUANES
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Sonia JEMNI
- Department of Physical Medicine and Rehabilitation,, Sahloul Hospital,, Sousse, Tunisia
| | - Helmi BEN SAAD
- Research laboratory “Heart failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
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Toulgui E, Benzarti W, Rahmani C, Aissa S, Ghannouchi I, Knaz A, Sayhi A, Sellami S, Mahmoudi K, Jemni S, Gargouri I, Hayouni A, Ouanes W, Ammar A, Ben saad H. Impact of cardiorespiratory rehabilitation program on submaximal exercise capacity of Tunisian male patients with post-COVID19: A pilot study. Front Physiol 2022; 13:1029766. [PMID: 36246110 PMCID: PMC9555273 DOI: 10.3389/fphys.2022.1029766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/12/2022] [Indexed: 12/12/2022] Open
Abstract
Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work.
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Affiliation(s)
- Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Chiraz Rahmani
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Sana Aissa
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines Ghannouchi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma Knaz
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani Sayhi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sana Sellami
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Khaoula Mahmoudi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sonia Jemni
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Imene Gargouri
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | | | - Walid Ouanes
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, Paris Nanterre University, UFR STAPS, Nanterre, France
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- *Correspondence: Achraf Ammar,
| | - Helmi Ben saad
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
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Spiegl C, Schiefermeier-Mach N, Schifferegger E, Wiederin C, Scheiber B. Physiotherapeutic evaluation of patients with post COVID-19 condition: current use of measuring instruments by physiotherapists working in Austria and South Tyrol. Arch Physiother 2022; 12:21. [PMID: 36104802 PMCID: PMC9473730 DOI: 10.1186/s40945-022-00147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background The implementation of standardized assessments in physiotherapeutic practice strongly supports diagnostic and treatment plans. Previous studies reported insufficient usage of standardized assessments due to lack of time, lack of knowledge, lack of resources and other barriers. Physiotherapy in outpatient settings became essential for the rehabilitation of patients with post COVID-19 condition but it remains unknown to what extent assessments are implemented into the evaluation of these patients. In this study, we explored the current use and barriers regarding the implementation of physiotherapeutic assessments to evaluate patients with post COVID-19 condition. Methods A cross-sectional online survey was carried out among 180 physiotherapists working in outpatient settings in Austria and South Tyrol. Results The majority of physiotherapists (88%) indicated that standardized assessments are useful, though less than a fifth of participants actually implement assessments in practice. Among implementation barriers, “insufficient experience” (41.8%) and “lack of knowledge” (36.6%) were mentioned most often. Concerning specific post COVID-19 assessments, the evaluation of “physical and respiratory function”, “quality of life” and “activities of daily living” were stated to be of particular relevance. Conclusions Our study revealed a low implementation rate and identified the main barriers regarding the non-usage of standardized assessments for post COVID-19 patients. Trial registration The Private University for Health Sciences and Health Technology (UMIT TIROL), and the Research Committee for Scientific Ethical Questions granted approval for the survey (RCSEQ, Hall in Tirol, Austria, Number 2834). Supplementary Information The online version contains supplementary material available at 10.1186/s40945-022-00147-0.
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Toulgui E, Benzarti W, Saad HB. Comments about the “Systematic Review: Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae”. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
I read with great interest the systematic review of Prabawa et al. “Physical Rehabilitation Therapy for Long COVID-19 Patient with Respiratory Sequelae: A Systematic Review”. The rational of this systematic review is very interesting, since it discusses the rehabilitation therapy for long coronavirus disease 2019 (COVID-19) syndrome with respiratory sequelae. In COVID-19, physical rehabilitation is a new management axis, and studies related to its impacts on COVID-19 patients’ data are scarce. In their paper, Prabawa et al. have included one Tunisian study (Benzarti W, et al. General practitioners should provide the cardiorespiratory rehabilitation’ ‘minimum advice’ for long COVID-19 patients. Lib J Med. 2022;17(1):2009101) published by the authors of this correspondence. However, three remarks related to the following points were noted: i) Citation of a wrong country of Benzarti et al., ii) Publishing a figure belonging to Benzarti et al. without obtaining the authors’ permission, and iii) Omission to develop a chapter for nutrition rehabilitation. The present Letter to Editor is an appeal for a more rigor when reporting data from previous publications (eg; avoid mistakes related to the country of the first author), and is a remain that permission is needed if some authors want to use a figure created by somebody else.
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Woo H, Lee S, Lee HS, Chae HJ, Jung J, Song MJ, Lim SY, Lee YJ, Cho YJ, Kim ES, Kim HB, Lim JY, Song KH, Beom J. Comprehensive Rehabilitation in Severely Ill Inpatients With COVID-19: A Cohort Study in a Tertiary Hospital. J Korean Med Sci 2022; 37:e262. [PMID: 36038958 PMCID: PMC9424699 DOI: 10.3346/jkms.2022.37.e262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/19/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study aimed to investigate the effects of comprehensive rehabilitation management on functional recovery and examine the correlation between clinical parameters and improvements in functional outcomes in severe-to-critical inpatients with coronavirus disease 2019 (COVID-19) in a tertiary hospital. METHODS Post-acute COVID-19 patients who had a World Health Organization (WHO) ordinal scale of 5-7, underwent intensive care, and received comprehensive rehabilitation management, including exercise programs, nutritional support, dysphagia evaluation, and psychological care were included. The appendicular skeletal muscle mass index (SMI), Medical Research Council sum score, handgrip strength, number of repetitions in the 1-minute sit-to-stand test, gait speed, Berg Balance Scale (BBS), and Functional Ambulation Classification (FAC) were evaluated at hospital stay, discharge, and 1-month follow-up. The correlation between the rehabilitation dose and improvement in each outcome measure was analyzed. RESULTS Overall, 37 patients were enrolled, of whom 59.5% and 32.4% had a score of 6 and 7 on the WHO ordinal scale, respectively. Lengths of stay in the intensive care unit and hospital were 33.6 ± 23.9 and 63.8 ± 36.5 days. Outcome measures revealed significant improvements at discharge and 1-month follow-up. The SMI was significantly increased at the 1-month follow-up (6.13 [5.24-7.76]) compared with that during the hospital stay (5.80 [5.39-7.05]). We identified dose-response associations between the rehabilitation dose and FAC (ρ = 0.46) and BBS (ρ = 0.50) scores. Patients with older age, longer hospitalization, longer stay at the intensive care unit, longer duration of mechanical ventilation, tracheostomy, a more depressive mood, and poorer nutritional status revealed poorer improvement in gait speed at the 1-month follow-up. CONCLUSION Comprehensive rehabilitation management effectively improved muscle mass, muscle strength, and physical performance in severe-to-critical COVID-19 patients. Dose-response relationship of rehabilitation and functional improvement emphasizes the importance of intensive post-acute inpatient rehabilitation in COVID-19 survivors. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05104411.
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Affiliation(s)
- Hyeonseong Woo
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sanghee Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Sung Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyun Jun Chae
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jongtak Jung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Myung Jin Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Yoon Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeon Joo Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Jae Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Jaewon Beom
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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Compagno S, Palermi S, Pescatore V, Brugin E, Sarto M, Marin R, Calzavara V, Nizzetto M, Scevola M, Aloi A, Biffi A, Zanella C, Carretta G, Gallo S, Giada F. Physical and psychological reconditioning in long COVID syndrome: Results of an out-of-hospital exercise and psychological - based rehabilitation program. IJC HEART & VASCULATURE 2022; 41:101080. [PMID: 35854691 PMCID: PMC9286763 DOI: 10.1016/j.ijcha.2022.101080] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
Background Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatment of this syndrome are still poorly understood, even if evidences suggest the potential role of physical rehabilitation in improving symptoms in these patients. Aim of the study The aim of the present study was to evaluate effectiveness, safety and feasibility of an out-of-hospital multidisciplinary rehabilitation (MDR) program, based both on physical and psychological reconditioning, in reducing symptoms and improving physical fitness and psychological parameters in patients with LCS. Methods Thirty consecutive patients with LCS (18 males, mean age 58 years) underwent an accurate medical screening process including anthropometric and muscular strength evaluation, cardiopulmonary exercise test, quality of life (QoL) and psychological appraisal before and after a MDR program. Results At baseline, all LCS patients were strongly symptomatic and showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during the exercise training sessions. After the MDR program, COVID-19 residual symptoms significantly decreased, and significant improvements in upper and lower limb muscular strength, cardiopulmonary parameters, perceived physical and mental health, depression and anxiety were observed. Conclusions The present study confirms the severe physical and psychological impairment of patients with LCS and suggests that a MDR program is effective, safe and feasible in these patients and could promote their physical and psychological recovery.
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Affiliation(s)
- Silvia Compagno
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
| | - Stefano Palermi
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy.,Federico II University Hospital, Naples, Italy
| | - Valentina Pescatore
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
| | - Erica Brugin
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
| | | | - Ruggero Marin
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
| | - Valli Calzavara
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
| | - Manuele Nizzetto
- Sub-Intensive Care COVID Unit, Pneumology Service, Dolo - Venice, Italy
| | - Moreno Scevola
- Non-critical COVID Area, Internal Medicine Service, Dolo - Venice, Italy
| | - Accurso Aloi
- Sub-Intensive Care COVID Unit, Pneumology Service, Dolo - Venice, Italy
| | - Alessandro Biffi
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Carlo Zanella
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
| | | | - Silvia Gallo
- Medical Direction, Azienda ULLS 3 Serenissima, Venice, Italy
| | - Franco Giada
- Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
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Torres-Castro R, Neculhueque-Zapata X, Hrzic-Miranda K, Gutiérrez-Arias R, Valenzuela-Suazo R, Castro-Acuña C, Ríos-Quevedo M, Águila-Villanueva C, Seron P. How a Developing Country Faces COVID-19 Rehabilitation: The Chilean Experience. Front Public Health 2022; 10:924068. [PMID: 35875023 PMCID: PMC9298948 DOI: 10.3389/fpubh.2022.924068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/10/2022] [Indexed: 01/24/2023] Open
Abstract
The coronavirus 19 (COVID-19) pandemic has been one of the most significant challenges to public health in recent decades. The heterogeneity of government responses and the varying preparedness of health systems has determined that the pandemic's impact differs from country to country. Chile is no stranger to the challenges posed by rehabilitation in a developing country. We aimed to describe the approach to rehabilitation during the pandemic in Chile in the public health system since rehabilitation is considered a relevant health strategy from the prevention to management of complications, mitigation of sequelae, or new complications associated with COVID-19. For this, a descriptive study was conducted on the rehabilitation strategies implemented by Chile to respond to the COVID-19 pandemic. The analysis includes the context of the Chilean health system and the matrix of access to rehabilitation services in COVID-19. The Health Ministry (MINSAL) rehabilitation strategy includes five central axes: approaches, specific lines, transversal lines, intervention, and funding. Additionally, the policies were based and supported by the WHO recommendations. Intensive care unit beds were increased approximately 68%, and the primary care response was the reconversion of function depending on the epidemiological context. During the 2021-2022 period, the estimated number of people diagnosed with a post-COVID-19 condition was 80,528. With this, we can conclude that a developing country has managed to coordinate a rehabilitation policy for people with COVID-19 by generating a structure of the different health system levels. However, the effectiveness of this policy will need to be evaluated in the future.
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Affiliation(s)
| | - Ximena Neculhueque-Zapata
- Department of Rehabilitation and Disability, Subsecretary of Public Health, Ministry of Health, Santiago, Chile
| | - Katherina Hrzic-Miranda
- Department of Rehabilitation and Disability, Subsecretary of Public Health, Ministry of Health, Santiago, Chile
| | - Ruvistay Gutiérrez-Arias
- Servicio de Medicina Física y Rehabilitación, Instituto Nacional del Tórax, Santiago, Chile.,Exercise and Rehabilitation Sciences Laboratory, Faculty of Rehabilitation Sciences, School of Physical Therapy, Universidad Andres Bello, Santiago, Chile
| | - Raúl Valenzuela-Suazo
- Department of Rehabilitation and Disability, Subsecretary of Public Health, Ministry of Health, Santiago, Chile
| | - Cristobal Castro-Acuña
- Department of Rehabilitation and Disability, Subsecretary of Public Health, Ministry of Health, Santiago, Chile
| | - Marianela Ríos-Quevedo
- Department of Rehabilitation and Disability, Subsecretary of Public Health, Ministry of Health, Santiago, Chile
| | - Camilo Águila-Villanueva
- Department of Rehabilitation and Disability, Subsecretary of Public Health, Ministry of Health, Santiago, Chile
| | - Pamela Seron
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
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Bailly M, Pélissier L, Coudeyre E, Evrard B, Bingula R, Rochette C, Mériade L, Blavignac C, Fournier AC, Bignon YJ, Rannou F, Dutheil F, Thivel D, Duclos M. Systematic Review of COVID-19-Related Physical Activity-Based Rehabilitations: Benefits to Be Confirmed by More Robust Methodological Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159025. [PMID: 35897400 PMCID: PMC9331032 DOI: 10.3390/ijerph19159025] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
The first emergency was to receive and treat COVID-19 patients in their acute phase; today, there is a clear need to propose appropriate post-acute rehabilitation programs. The aim of this research was to systematically review the effects of physical activity programs in the recovery of post-COVID-19 patients. The literature search followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, was registered in the PROSPERO database (CRD42022289219), and was conducted between August and December 2021. A total of 35 studies out of the 1528 initially identified were finally included in the analysis. The systematic review clearly showed the health benefits of rehabilitation including physical activity in post-COVID-19 recovery, regardless of exercise modalities. These positive results were even observed using minor muscle re-mobilization for severe cases (i.e., postural changes, few steps—2 times/day) or using low volumes of exercise for mild-to-moderate cases (i.e., 120 min/week). A total of 97% of the 29 studies that performed statistical analyses demonstrated a significant increase in at least one parameter of functional capacity, and 96% of the 26 studies that statistically investigated the effects on the quality of life, mental health, and general state reported improvements. Yet, most of the studies were retrospective, uncontrolled, and enrolled aged people with comorbidities presented in severe forms of COVID-19. Physical activity programs, in addition to their high heterogeneity, remained poorly described in 83% of the studies and were part of a multidisciplinary program for 89% of the studies. Despite promising results, there is today a real need for prospective well-designed studies specifically assessing the effects of physical activity. In addition, it might appear relevant to propose standardized programs further considering the main characteristics of patients such as age, comorbidities, or the severity of COVID-19.
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Affiliation(s)
- Mélina Bailly
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Léna Pélissier
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
- Correspondence:
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Bertrand Evrard
- Service d’Immunologie, Centre Hospitalier Universitaire (CHU) Gabriel-Montpied, 63000 Clermont-Ferrand, France;
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Rea Bingula
- Micro-Environnement CellulaiRE, Immunomodulation et Nutrition (ECREIN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité Mixte de Recherche (UMR) 1019 Unité de Nutrition Humaine (UNH), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Corinne Rochette
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Laurent Mériade
- Health and Territory Chair, Université Clermont Auvergne, CleRMa, 63000 Clermont-Ferrand, France; (C.R.); (L.M.)
| | - Christelle Blavignac
- Centre Imagerie Cellulaire Santé, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Anne-Cécile Fournier
- Cluster Auvergne-Rhône-Alpes Innovation Innovatherm, 63000 Clermont-Ferrand, France;
| | - Yves-Jean Bignon
- U1240 Imagerie Moléculaire et Stratégies Théranostiques, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Clermont Auvergne, 63000 Clermont Ferrand, France;
- Département d’Oncogénétique, Centre Jean Perrin, 63011 Clermont-Ferrand, France
| | - Fabrice Rannou
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, LaPSCo, Physiological and Psychosocial Stress, Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Witty Fit, Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - David Thivel
- Centre de Recherche en Nutrition Humaine (CRNH), Laboratoire des Adaptations Métaboliques à l’Exercice en Conditions Physiologiques et Pathologiques (AME2P), Unité de Formation et de Recherche (UFR) des Sciences et Techniques des Activités Physiques et Sportives (STAPS), Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (M.B.); (D.T.)
| | - Martine Duclos
- Service de Médecine du Sport et des Explorations Fonctionnelles, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Nutrition Humaine (UNH), Centre de Recherche en Nutrition Humaine (CRNH) Auvergne, Université Clermont Auvergne, 63000 Clermont-Ferrand, France; (F.R.); (M.D.)
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48
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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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49
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Rausch L, Puchner B, Fuchshuber J, Seebacher B, Löffler-Ragg J, Pramsohler S, Netzer N, Faulhaber M. The Effects of Exercise Therapy Moderated by Sex in Rehabilitation of COVID-19. Int J Sports Med 2022; 43:1043-1051. [PMID: 35649438 PMCID: PMC9622303 DOI: 10.1055/a-1866-6092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Standardized exercise therapy programs in pulmonary rehabilitation have been
shown to improve physical performance and lung function parameters in post-acute
COVID-19 patients. However, it has not been investigated if these positive
effects are equally beneficial for both sexes. The purpose of this study was to
analyze outcomes of a pulmonary rehabilitation program with respect to sex
differences, in order to identify sex-specific pulmonary rehabilitation
requirements. Data of 233 post-acute COVID-19 patients (40.4% females)
were analyzed before and after a three-week standardized pulmonary
rehabilitation program. Lung function parameters were assessed using
body-plethysmography and functional exercise capacity was measured by the
Six-Minute Walk Test. At post-rehabilitation, females showed a significantly
smaller improvement in maximal inspiration capacity and forced expiratory volume
(F=5.86, ω
2=
.02; p<0.05) than males.
Exercise capacity improvements between men and women did not differ
statistically. Females made greater progress towards reference values of
exercise capacity (T(231)=−3.04; p<0.01) and forced
expiratory volume in the first second (T(231)=2.83; p<0.01) than
males. Sex differences in the improvement of lung function parameters seem to
exist and should be considered when personalizing standardized exercise
therapies in pulmonary rehabilitation.
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Affiliation(s)
- Linda Rausch
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Bernhard Puchner
- Department of Rehabilitation Research, Rehab Center Muenster, Muenster, Austria
| | - Jürgen Fuchshuber
- Grüner Kreis Society, Center for Integrative Addiction Research (CIAR), Vienna, Austria.,University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Seebacher
- Department of Rehabilitation Research, Rehab Center Muenster, Muenster, Austria
| | - Judith Löffler-Ragg
- Department of Internal Medicine II, Medical University Innsbruck, Innsbruck, Austria
| | - Stephan Pramsohler
- associated to University of Innsbruck, Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Lenggries, Germany
| | - Nikolaus Netzer
- associated to University Innsbruck, Hermann Buhl Institute for Hypoxia and Sleep Medicine Research, Lenggries, Germany.,Department Medicine, Division Sports Medicine, University Hospital Ulm, Ulm, Germany.,Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Martin Faulhaber
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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50
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Dacosta-Aguayo R, Lamonja-Vicente N, Chacón C, Carrasco-Ribelles LA, Montero-Alia P, Costa-Garrido A, García-Sierra R, López-Lifante VM, Moreno-Gabriel E, Massanella M, Puig J, Muñoz-Moreno JA, Mateu L, Prats A, Rodríguez C, Mataró M, Prado JG, Martínez-Cáceres E, Violán C, Torán-Monserrat P. Neurocognitive Profile of the Post-COVID Condition in Adults in Catalonia-A Mixed Method Prospective Cohort and Nested Case-Control Study: Study Protocol. Vaccines (Basel) 2022; 10:849. [PMID: 35746457 PMCID: PMC9230542 DOI: 10.3390/vaccines10060849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
The diagnosis of the post-COVID condition is usually achieved by excluding other diseases; however, cognitive changes are often found in the post-COVID disorder. Therefore, monitoring and treating the recovery from the post-COVID condition is necessary to establish biomarkers to guide the diagnosis of symptoms, including cognitive impairment. Our study employs a prospected cohort and nested case-control design with mixed methods, including statistical analyses, interviews, and focus groups. Our main aim is to identify biomarkers (functional and structural neural changes, inflammatory and immune status, vascular and vestibular signs and symptoms) easily applied in primary care to detect cognitive changes in post-COVID cases. The results will open up a new line of research to inform diagnostic and therapeutic decisions with special considerations for cognitive impairment in the post-COVID condition.
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Affiliation(s)
- Rosalia Dacosta-Aguayo
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Comparative Medicine and Bioimaging Center (CMCiB), Germans Trias i Pujol Research Institute, 08916 Badalona, Spain;
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035 Barcelona, Spain;
| | - Noemí Lamonja-Vicente
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
| | - Carla Chacón
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
| | - Lucia Amalía Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
| | - Pilar Montero-Alia
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Centre d’Atenció Primària La Riera (Mataró 1), Institut Català de la Salut, 08302 Barcelona, Spain
| | - Anna Costa-Garrido
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
| | - Rosa García-Sierra
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Victor M. López-Lifante
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
- Palau-Solità Healthcare Centre, Palau-Solità Plegamans Institut Català de la Salut, 08124 Barcelona, Spain
| | - Eduard Moreno-Gabriel
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Department of Social Psychology, Universitat Autònoma de Barcelona, Cerdanyola de Vallès, 08193 Bellaterra, Spain
| | - Marta Massanella
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), Can Ruti Campus, 08916 Badalona, Spain; (M.M.); (L.M.); (J.G.P.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Josep Puig
- Comparative Medicine and Bioimaging Center (CMCiB), Germans Trias i Pujol Research Institute, 08916 Badalona, Spain;
| | - Jose A. Muñoz-Moreno
- Infectious Diseases Department, Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Can Ruti Campus, 08916 Badalona, Spain; (J.A.M.-M.); (A.P.)
- Facultat de Psicologia i Ciències de l’Educació, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain
| | - Lourdes Mateu
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), Can Ruti Campus, 08916 Badalona, Spain; (M.M.); (L.M.); (J.G.P.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
- Infectious Diseases Department, Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Can Ruti Campus, 08916 Badalona, Spain; (J.A.M.-M.); (A.P.)
- Germans Trias i Pujol Hospital, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Anna Prats
- Infectious Diseases Department, Fight against AIDS Foundation (FLS), Germans Trias i Pujol Hospital, Can Ruti Campus, 08916 Badalona, Spain; (J.A.M.-M.); (A.P.)
| | - Carmina Rodríguez
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Sant Fost de Campcentelles Healthcare Centre, Sant Fost de Campcentelles, Institut Català de la Salut, 08105 Barcelona, Spain
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035 Barcelona, Spain;
| | - Julia G. Prado
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (IGTP), Can Ruti Campus, 08916 Badalona, Spain; (M.M.); (L.M.); (J.G.P.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Germans Trias i Pujol Research Institute, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Eva Martínez-Cáceres
- Immunology Department, FOCIS Center of Excellence—Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain;
- Immunology Division, Laboratori Clinic Metropolitana Nord (LCMN), Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
- Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
- Germans Trias i Pujol Research Institute, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain; (R.D.-A.); (N.L.-V.); (C.C.); (L.A.C.-R.); (P.M.-A.); (A.C.-G.); (R.G.-S.); (V.M.L.-L.); (E.M.-G.); (C.R.); (P.T.-M.)
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08916 Mataró, Spain
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Germans Trias i Pujol Research Institute, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Girona, 17003 Girona, Spain
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