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Gutiérrez-Canales LG, Muñoz-Corona C, Barrera-Chávez I, Viloria-Álvarez C, Macías AE, Martínez-Navarro LJ, Alvarez JA, Scavo-Montes DA, Guaní-Guerra E. Persistence of COVID-19 Symptoms and Quality of Life at Three and Twelve Months after Hospital Discharge. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:944. [PMID: 38929561 PMCID: PMC11205838 DOI: 10.3390/medicina60060944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Medical and public recognition of "long-COVID or post-COVID syndrome", as well as its impact on the quality of life (QoL), is required to better address the disease burden. Objectives: We aimed to describe the persistence of COVID-19 symptoms and QoL among patients at three and twelve months after their discharge from the hospital. Materials and Methods: We conducted an observational, prospective, and longitudinal analytic study from September 2021 to April 2022. To measure QoL, we used a validated version of the 36-item Short-Form Health Survey (SF-36). Results: We included 68 patients in the study. A total of 54 (79.4%) patients reported at least one persistent symptom at three months vs. 52 (76.4%) at twelve months (p = 0.804). Some persistent symptoms (myalgia, alopecia, and cough) decreased significantly at twelve months (50% vs. 30.9%, 29.4% vs. 13.2%, and 23.5% vs. 7.4%; respectively, p = 0.007); in contrast, other persistent symptoms (sleep-wake and memory disorders) were more frequent (5.9% vs. 32.4% and 4.4% vs. 20.6%; respectively, p = ≤0.001). Regarding QoL, a statistically significant improvement was observed in some scores over time, p = ≤0.037. At twelve months, dyspnea, myalgia, and depression were risk factors associated with a poor physical component summary (PCS), p = ≤0.027, whereas anxiety, depression, and fatigue were associated with a poor mental component summary (MCS), p = ≤0.015. Conclusion: As the proportion of persistent symptoms at twelve months is high, we suggest that patients must continue under long-term follow up to reclassify, diagnose, and treat new onset symptoms/diseases.
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Affiliation(s)
- Lizeth Guadalupe Gutiérrez-Canales
- General Directorate of Quality and Health Education, Ministry of Health, Ciudad de Mexico 11410, Mexico;
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
| | - Carolina Muñoz-Corona
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
| | - Isaac Barrera-Chávez
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
| | - Carlos Viloria-Álvarez
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
| | - Alejandro E. Macías
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
| | - Liz Jovanna Martínez-Navarro
- Servicios de Salud del Instituto Mexicano del Seguro Social Para el Bienestar (IMSS-BIENESTAR), Hospital Regional de Alta Especialidad del Bajío, León 37544, Guanajuato, Mexico;
| | - Jose A. Alvarez
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
- Servicios de Salud del Instituto Mexicano del Seguro Social Para el Bienestar (IMSS-BIENESTAR), Hospital Regional de Alta Especialidad del Bajío, León 37544, Guanajuato, Mexico;
| | | | - Eduardo Guaní-Guerra
- Department of Medicine, University of Guanajuato, León 37670, Guanajuato, Mexico; (C.M.-C.); (I.B.-C.); (C.V.-Á.); (A.E.M.); (J.A.A.)
- Servicios de Salud del Instituto Mexicano del Seguro Social Para el Bienestar (IMSS-BIENESTAR), Hospital Regional de Alta Especialidad del Bajío, León 37544, Guanajuato, Mexico;
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Srivastava A, Nalroad Sundararaj S, Bhatia J, Singh Arya D. Understanding long COVID myocarditis: A comprehensive review. Cytokine 2024; 178:156584. [PMID: 38508059 DOI: 10.1016/j.cyto.2024.156584] [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: 12/29/2023] [Revised: 02/21/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
Infectious diseases are a cause of major concern in this twenty-first century. There have been reports of various outbreaks like severe acute respiratory syndrome (SARS) in 2003, swine flu in 2009, Zika virus disease in 2015, and Middle East Respiratory Syndrome (MERS) in 2012, since the start of this millennium. In addition to these outbreaks, the latest infectious disease to result in an outbreak is the SARS-CoV-2 infection. A viral infection recognized as a respiratory illness at the time of emergence, SARS-CoV-2 has wreaked havoc worldwide because of its long-lasting implications like heart failure, sepsis, organ failure, etc., and its significant impact on the global economy. Besides the acute illness, it also leads to symptoms months later which is called long COVID or post-COVID-19 condition. Due to its ever-increasing prevalence, it has been a significant challenge to treat the affected individuals and manage the complications as well. Myocarditis, a long-term complication of coronavirus disease 2019 (COVID-19) is an inflammatory condition involving the myocardium of the heart, which could even be fatal in the long term in cases of progression to ventricular dysfunction and heart failure. Thus, it is imperative to diagnose early and treat this condition in the affected individuals. At present, there are numerous studies which are in progress, investigating patients with COVID-19-related myocarditis and the treatment strategies. This review focuses primarily on myocarditis, a life-threatening complication of COVID-19 illness, and endeavors to elucidate the pathogenesis, biomarkers, and management of long COVID myocarditis along with pipeline drugs in detail.
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Affiliation(s)
- Arti Srivastava
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | | | - Jagriti Bhatia
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Dharamvir Singh Arya
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India.
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van der Feltz-Cornelis C, Turk F, Sweetman J, Khunti K, Gabbay M, Shepherd J, Montgomery H, Strain WD, Lip GYH, Wootton D, Watkins CL, Cuthbertson DJ, Williams N, Banerjee A. Prevalence of mental health conditions and brain fog in people with long COVID: A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 88:10-22. [PMID: 38447388 DOI: 10.1016/j.genhosppsych.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Long COVID can include impaired cognition ('brain fog'; a term encompassing multiple symptoms) and mental health conditions. We performed a systematic review and meta-analysis to estimate their prevalence and to explore relevant factors associated with the incidence of impaired cognition and mental health conditions. METHODS Searches were conducted in Medline and PsycINFO to cover the start of the pandemic until August 2023. Included studies reported prevalence of mental health conditions and brain fog in adults with long COVID after clinically-diagnosed or PCR-confirmed SARS-CoV-2 infection. FINDINGS 17 studies were included, reporting 41,249 long COVID patients. Across all timepoints (3-24 months), the combined prevalence of mental health conditions and brain fog was 20·4% (95% CI 11·1%-34·4%), being lower among those previously hospitalised than in community-managed patients(19·5 vs 29·7% respectively; p = 0·047). The odds of mental health conditions and brain fog increased over time and when validated instruments were used. Odds of brain fog significantly decreased with increasing vaccination rates (p = ·000). CONCLUSIONS Given the increasing prevalence of mental health conditions and brain fog over time, preventive interventions and treatments are needed. Research is needed to explore underlying mechanisms that could inform further research in development of effective treatments. The reduced risk of brain fog associated with vaccination emphasizes the need for ongoing vaccination programs.
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Affiliation(s)
- Christina van der Feltz-Cornelis
- Department of Health Sciences, University of York, York, United Kingdom; Hull York Medical School, (HYMS), University of York, York, United Kingdom; Institute of Health Informatics, University College London, London, United Kingdom.
| | - Fidan Turk
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jennifer Sweetman
- Department of Health Sciences, University of York, York, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Mark Gabbay
- Department of Primary Care and Mental Health University of Liverpool, Liverpool, United Kingdom
| | - Jessie Shepherd
- Department of Health Sciences, University of York, York, United Kingdom
| | - Hugh Montgomery
- Department of Medicine, University College London, London, United Kingdom
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Clinical and Biomedical Science and College of Medicine and Health, University of Exeter, Exeter, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dan Wootton
- Institute of Infection Veterinary and Ecological Sciences and NIHR HPRU in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Caroline Leigh Watkins
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, United Kingdom; School of Nursing and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Daniel J Cuthbertson
- Institute of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Nefyn Williams
- Department of Primary Care and Mental Health University of Liverpool, Liverpool, United Kingdom
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom; Department of Cardiology, University College London Hospitals NHS Trust, London, United Kingdom; Department of Cardiology, Barts Health NHS Trust, London, United Kingdom
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S NM, G R, Sampath A, Gadwala R, V CG, Pakhare AP, Joshi R, Singhai A, Mishra VN, Khadanga S. The Post-COVID-19 Haul on Pulmonary Function: A Prospective Cross-Sectional Study. Cureus 2024; 16:e61101. [PMID: 38813071 PMCID: PMC11134480 DOI: 10.7759/cureus.61101] [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] [Accepted: 05/24/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Long COVID syndrome, characterized by symptoms like dyspnea, fatigue, and cough, persisting for weeks to months after the initial SARS-CoV-2 infection, poses significant challenges globally. Studies suggest a potential higher risk among females aged 40-50, with symptoms affecting individuals regardless of initial COVID-19 severity, underscoring the need for comprehensive understanding and management. METHODS A prospective longitudinal study was conducted at a teaching tertiary care institute in Central India, involving COVID-19 patients from May 2020 to September 2021. Participants, aged 18 or older, diagnosed with COVID-19 and surviving until the last follow-up, were monitored telephonically and during outpatient visits for treatment details and outcomes. Data analysis was done using R software 4.2.1. RESULTS The baseline characteristics of the study participants showed a majority of moderate COVID-19 severity (47.5%), with a higher proportion of males (64.8%) affected. Common comorbidities included diabetes (27.1%) and hypertension (22.9%). Long COVID-19 symptoms, notably breathlessness, were prevalent, with females exhibiting a significantly higher association. Pulmonary function abnormalities were associated with both long COVID-19 symptoms and higher COVID-19 severity categories, indicating lasting respiratory impact post-infection. CONCLUSION Long after the pandemic, COVID-19 continues to raise concerns due to persistent sequelae, with a majority experiencing long COVID symptoms, particularly those with severe initial illness, including breathlessness and abnormal lung function, highlighting prevalent restrictive lung pattern changes.
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Affiliation(s)
- Nitish M S
- Internal Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Revadi G
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Ananyan Sampath
- Medical School, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Ramesh Gadwala
- Internal Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Charan G V
- Nephrology, Osmania Medical College, Hyderabad, IND
| | - Abhijit P Pakhare
- Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Rajnish Joshi
- Internal Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Abhishek Singhai
- General Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - V N Mishra
- General Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
| | - Sagar Khadanga
- General Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND
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5
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Sitbon A, Hauw-Berlemont C, Mebarki M, Heming N, Mayaux J, Diehl JL, Demoule A, Annane D, Marois C, Demeret S, Weiss E, Voiriot G, Fartoukh M, Constantin JM, Mégarbane B, Plantefève G, Boucher-Pillet H, Churlaud G, Cras A, Maheux C, Pezzana C, Diallo MH, Lebbah S, Ropers J, Salem JE, Straus C, Menasché P, Larghero J, Monsel A. Treatment of COVID-19-associated ARDS with umbilical cord-derived mesenchymal stromal cells in the STROMA-CoV-2 multicenter randomized double-blind trial: long-term safety, respiratory function, and quality of life. Stem Cell Res Ther 2024; 15:109. [PMID: 38637891 PMCID: PMC11027516 DOI: 10.1186/s13287-024-03729-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/10/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The STROMA-CoV-2 study was a French phase 2b, multicenter, double-blind, randomized, placebo-controlled clinical trial that did not identify a significant efficacy of umbilical cord-derived mesenchymal stromal cells in patients with SARS-CoV-2-induced acute respiratory distress syndrome. Safety on day 28 was found to be good. The aim of our extended study was to assess the 6- and 12-month safety of UC-MSCs administration in the STROMA-CoV-2 cohort. METHODS A detailed multi-domain assessment was conducted at 6 and 12 months following hospital discharge focusing on adverse events, lung computed tomography-scan, pulmonary and muscular functional status, and quality of life in the STROMA-CoV-2 cohort including SARS-CoV-2-related early (< 96 h) mild-to-severe acute respiratory distress syndrome. RESULTS Between April 2020 and October 2020, 47 patients were enrolled, of whom 19 completed a 1-year follow-up. There were no significant differences in any endpoints or adverse effects between the UC-MSCs and placebo groups at the 6- and 12-month assessments. Ground-glass opacities persisted at 1 year in 5 patients (26.3%). Furthermore, diffusing capacity for carbon monoxide remained altered over 1 year, although no patient required oxygen or non-invasive ventilatory support. Quality of life revealed declines in mental, emotional and physical health throughout the follow-up period, and the six-minute walking distance remained slightly impaired at the 1-year patient assessment. CONCLUSIONS This study suggests a favorable safety profile for the use of intravenous UC-MSCs in the context of the first French wave of SARS-CoV-2-related moderate-to-severe acute respiratory distress syndrome, with no adverse effects observed at 1 year.
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Affiliation(s)
- Alexandre Sitbon
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology-Critical Care and Perioperative Medicine, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (APHP) Sorbonne University, 47-83, boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Caroline Hauw-Berlemont
- Intensive Care Unit, APHP-CUP, Hôpital Européen Georges-Pompidou, Université Paris Cité, 75015, Paris, France
| | - Miryam Mebarki
- APHP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Centre d'Investigation Clinique en Biothérapies CBT501, INSERM, Université Paris Cité, Paris, France
| | - Nicholas Heming
- FHU SEPSIS, Department of Intensive Care, Hôpital Raymond-Poincaré (APHP), Laboratory of Infection & Inflammation-INSERM U1173, Simone Veil School of Medicine, University Versailles Saint Quentin-University Paris Saclay, 92380, Garches, France
| | - Julien Mayaux
- APHP, Groupe Hospitalier Universitaire-Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive et Réanimation (Département R3S), INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France
| | - Jean-Luc Diehl
- Intensive Care Unit, APHP-CUP, Hôpital Européen Georges-Pompidou, Université Paris Cité, 75015, Paris, France
- Innovative Therapies in Hemostasis, INSERM, Université Paris Cité, 75006, Paris, France
- Biosurgical Research Laboratory (Carpentier Foundation), APHP-CUP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Alexandre Demoule
- APHP, Groupe Hospitalier Universitaire-Sorbonne Université, site Pitié-Salpêtrière, Service de Médecine Intensive et Réanimation (Département R3S), INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France
| | - Djillali Annane
- FHU SEPSIS, Department of Intensive Care, Hôpital Raymond-Poincaré (APHP), Laboratory of Infection & Inflammation-INSERM U1173, Simone Veil School of Medicine, University Versailles Saint Quentin-University Paris Saclay, 92380, Garches, France
| | - Clémence Marois
- Neurological Intensive Care Unit, Department of Neurology, La Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
- Groupe de Recherche Clinique en REanimation et Soins Intensifs du Patient en Insuffisance Respiratoire aiguE (GRC-RESPIRE), Sorbonne Université, Paris, France
| | - Sophie Demeret
- Neurological Intensive Care Unit, Department of Neurology, La Pitié-Salpêtrière Hospital, APHP, Sorbonne University, Paris, France
- Groupe de Recherche Clinique en REanimation et Soins Intensifs du Patient en Insuffisance Respiratoire aiguE (GRC-RESPIRE), Sorbonne Université, Paris, France
| | - Emmanuel Weiss
- Department of Anesthesiology and Critical Care, Beaujon Hospital, DMU PARABOL, APHP Nord, Paris, France
- Center for Research on Inflammation, INSERM, Université Paris Cité, Paris, France
| | - Guillaume Voiriot
- Centre de Recherche Saint-Antoine UMRS_938 INSERM, Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Muriel Fartoukh
- Centre de Recherche Saint-Antoine UMRS_938 INSERM, Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Jean-Michel Constantin
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology-Critical Care and Perioperative Medicine, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (APHP) Sorbonne University, 47-83, boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, INSERM UMRS1144, University of Paris, Paris, France
| | - Gaëtan Plantefève
- Service de Réanimation Polyvalente, Centre Hospitalier Victor Dupouy, 69, Rue du Lieutenant-Colonel Prud'hon, 95100, Argenteuil, France
| | - Hélène Boucher-Pillet
- Centre MEARY de Thérapie Cellulaire et Génique, APHP, Hôpital Saint-Louis, Paris, France
| | - Guillaume Churlaud
- Centre MEARY de Thérapie Cellulaire et Génique, APHP, Hôpital Saint-Louis, Paris, France
| | - Audrey Cras
- APHP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Centre d'Investigation Clinique en Biothérapies CBT501, INSERM, Université Paris Cité, Paris, France
- INSERM UMR1140, Université Paris Cité, 75006, Paris, France
| | - Camille Maheux
- Centre MEARY de Thérapie Cellulaire et Génique, APHP, Hôpital Saint-Louis, Paris, France
| | - Chloé Pezzana
- INSERM, UMR S 970, Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Paris, France
| | | | - Said Lebbah
- Clinical Research Unit, Pitié-Salpêtrière University Hospital, APHP, Paris, France
| | - Jacques Ropers
- Clinical Research Unit, Pitié-Salpêtrière University Hospital, APHP, Paris, France
| | - Joe-Elie Salem
- Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Paris (AP-HP), Clinical Investigation Center (CIC-1901), Regional Pharmacovigilance Centre, Department of Pharmacology, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Christian Straus
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département R3S (Respiration, Réanimation, Réadaptation Respiratoire, Sommeil), Service d'Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, Sorbonne Université, 75013, Paris, France
| | - Philippe Menasché
- INSERM UMR1140, Université Paris Cité, 75006, Paris, France
- Department of Cardiovascular Surgery, Hôpital Européen Georges-Pompidou, Paris, France
| | - Jérôme Larghero
- APHP, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Centre d'Investigation Clinique en Biothérapies CBT501, INSERM, Université Paris Cité, Paris, France
- Centre MEARY de Thérapie Cellulaire et Génique, APHP, Hôpital Saint-Louis, Paris, France
| | - Antoine Monsel
- Multidisciplinary Intensive Care Unit, Department of Anesthesiology-Critical Care and Perioperative Medicine, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (APHP) Sorbonne University, 47-83, boulevard de l'Hôpital, 75651, Paris Cedex 13, France.
- INSERM UMRS_959, Immunology-Immunopathology-Immunotherapy (I3), Sorbonne Université, 75013, Paris, France.
- Biotherapy (CIC-BTi), Hôpital Pitié-Salpêtrière, APHP, 75651, Paris, France.
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Barilaite E, Watson H, Hocaoglu MB. Understanding Patient-Reported Outcome Measures Used in Adult Survivors Experiencing Long-Term Effects After COVID-19 Infection: A Rapid Review. J Patient Cent Res Rev 2024; 11:36-50. [PMID: 38596351 PMCID: PMC11000699 DOI: 10.17294/2330-0698.2041] [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: 04/11/2024] Open
Abstract
Purpose Patient-reported outcome measures (PROMs) are used in individuals experiencing long-term effects from COVID-19 infection, or Long COVID, to evaluate the quality of life and functional status of these individuals. However, little is known about which PROMs are being utilised and the psychometric properties of these PROMs. Our purpose was thus to explore which PROMs are used in Long COVID patients and to discuss the psychometric properties of the PROMs. Methods For this rapid review, a systematic literature search was performed in the PubMed, Embase, and CINAHL databases. The found studies were screened using the PRISMA flowchart. We then performed study quality appraisal and assessed the psychometric properties of the found PROMs. Results Per the systematic literature search and after removal of duplicates, 157 publications were identified for individual screening. After screening and eligibility assessment, 74 articles were selected for our review. In total, 74 PROMs were used and primarily comprised quality of life, fatigue, breathlessness, mental health, and smell/taste issues in COVID "long haulers." Five studies used newly developed, COVID-19-specific PROMs. We assessed the psychometric properties of the 10 most-used PROMs. The majority were found to be reliable and valid instruments. EQ-5D-5L was the most popular and highly rated PROM. Conclusions We assessed PROMs used in Long COVID patients and evaluated their psychometric properties. EQ-5D-5L was the most favourably rated PROM. PROMs addressing mental health issues are crucial in managing anxiety and depression in Long COVID patients. New COVID-specific PROMs assess functional status and smell/taste perception and show great utilisation potential in olfactory training at COVID smell clinics. However, many reviewed PROMs currently lack sufficient analysis of their psychometric properties. Therefore, future research needs to examine these measures.
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Affiliation(s)
- Egle Barilaite
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
| | - Harry Watson
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
| | - Mevhibe B Hocaoglu
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom
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Roder S, Mohacsi LM, Schmachtenberg T. [Experiences of people with Long COVID in their medical accompaniment and in the social environment]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 185:27-34. [PMID: 38199938 DOI: 10.1016/j.zefq.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 09/26/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Permanent health impairments after a COVID-19 infection can lead to a lack of social participation and pronounced emotional stress. The aim of this study was to find out how Long COVID affects the social activities of those affected and understand the role that medical support and the immediate social environment play in this. METHODS Between January and May 2022, 25 participants with long COVID were interviewed about their health situation, their perception of health care in Germany, and their social and professional context. The interviews, which were mainly conducted online, were analyzed for content, and the results were assessed using lifeworld-theoretical approaches. RESULTS The participants reported a variety of health symptoms such as fatigue, shortness of breath, and cognitive impairments. The majority of respondents had a pessimistic attitude toward a timely recovery. Most participants perceived the medical support for long COVID as inadequate. Long waiting times for specialist appointments and the lack of acceptance of the health impairment by some doctors lead to an increase in existing uncertainties. Long COVID also had a major impact on respondents' social life. Many participants referred to a burdensome decline in the number of meetings with family and friends. Many respondents avoided physical contact with friends and family members due to a high level of fear of infection. Some participants explained that they separated themselves from people in their environment because they did not take their precarious situation seriously. However, an important resource was the close circle of family and friends from whom the majority of the interviewees received support. DISCUSSION While other research studies particularly emphasize the comprehensive psychological and emotional consequences of long COVID, such as identity conflicts, existential angst, or depression, the present study shows that a lack of understanding from medical professionals as well as heavily delayed treatment leave the interviewees in a state of emotional void. CONCLUSIONS The findings show a considerable need for support among people with health impairments after a COVID-19 infection. Empathic and empirically based counseling and support by general practitioners as well as improvement of access to rehabilitative services can provide substantial support for people with long COVID.
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Affiliation(s)
- Sascha Roder
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland; Hochschule Bielefeld - University of Applied Sciences and Arts, Fachbereich Sozialwesen, Bielefeld, Deutschland
| | - Laura Milena Mohacsi
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Tim Schmachtenberg
- Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland; Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
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Seo JW, Kim SE, Kim Y, Kim EJ, Kim T, Kim T, Lee SH, Lee E, Lee J, Seo YB, Jeong YH, Jung YH, Choi YJ, Song JY. Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID. Infect Chemother 2024; 56:122-157. [PMID: 38527781 PMCID: PMC10990882 DOI: 10.3947/ic.2024.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/27/2024] Open
Abstract
"Long COVID" is a term used to describe a condition when the symptoms and signs associated with coronavirus disease 2019 (COVID-19) persist for more than three months among patients infected with COVID-19; this condition has been reported globally and poses a serious public health issue. Long COVID can manifest in various forms, highlighting the need for appropriate evaluation and management by experts from various fields. However, due to the lack of clear clinical definitions, knowledge of pathophysiology, diagnostic methods, and treatment protocols, it is necessary to develop the best standard clinical guidelines based on the scientific evidence reported to date. We developed this clinical guideline for diagnosing and treating long COVID by analyzing the latest research data collected from the start of the COVID-19 pandemic until June 2023, along with the consensus of expert opinions. This guideline provides recommendations for diagnosis and treatment that can be applied in clinical practice, based on a total of 32 key questions related to patients with long COVID. The evaluation of patients with long COVID should be comprehensive, including medical history, physical examination, blood tests, imaging studies, and functional tests. To reduce the risk of developing long COVID, vaccination and antiviral treatment during the acute phase are recommended. This guideline will be revised when there is a reasonable need for updates based on the availability of new knowledge on the diagnosis and treatment of long COVID.
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Affiliation(s)
- Jun-Won Seo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Seong Eun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Eun Jung Kim
- Health, Welfare, Family and Gender Equality Team, National Assembly Research Service, Seoul, Korea
| | - Tark Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Taehwa Kim
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Young-Hoon Jeong
- CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, and Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Yu Jung Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
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Shang Q, Xu K, Ji H, Dai Q, Ju H, Huang H, Hu J, Bao C. Changes in prevalence of anxiety and depression among COVID-19 patients during a two-year recovery period: A systematic review and meta-analysis. J Psychosom Res 2024; 178:111602. [PMID: 38359637 DOI: 10.1016/j.jpsychores.2024.111602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To analyze the temporal trend of anxiety and depression prevalences up to 2 years of follow-up for COVID-19 patients during the recovery period and to compare regional differences. METHODS We performed a systematic review from PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP using keywords such as "COVID-19", "anxiety", "depression", and "cohort study". Meta-analysis was performed to estimate the pooled prevalence of anxiety and depression at five follow-up time intervals. Subgroup analyses were conducted by different regions. RESULTS 34 cohort studies were included in the meta-analyses. The pooled anxiety prevalence rates at 0-1 month, 1-3 months, 3-6 months, 6-12 months and 12-24 months were 18% (95% CI: 11% to 28%), 18% (95% CI: 12% to 28%), 22% (95% CI: 16% to 29%), 15% (95% CI: 11% to 21%), and 10% (95% CI: 0.05% to 20%), respectively, and the pooled depression prevalence rates were 22% (95%CI: 15% to 33%), 19% (95% CI: 13% to 29%), 21% (95% CI: 15% to 28%), 15% (95% CI: 11% to 20%), and 9% (95% CI: 0.4% to 21%) respectively. The prevalence of depression in Asian and non-Asian countries was statistically different at 0-1 month (χ2 = 15.248, P < 0.001) and 1-3 months (χ2 = 28.298, P < 0.001), and prevalence of anxiety was statistically different at 3-6 months (χ2 = 9.986, P = 0.002) and 6-12 months (χ2 = 7.378, P = 0.007). CONCLUSION The prevalence of anxiety and depression in COVID-19 patients generally tends to decrease after 2 years of recovery, but may temporarily increase at 3-6 months. There are regional differences in the changes in prevalence of anxiety and depression.
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Affiliation(s)
- Qingxiang Shang
- School of Public Health, Nanjing Medical University, Nanjing, PR China
| | - Ke Xu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Hong Ji
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Qigang Dai
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Hao Ju
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Haodi Huang
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Jianli Hu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Changjun Bao
- School of Public Health, Nanjing Medical University, Nanjing, PR China; Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China.
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10
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Kim Y, Bae S, Chang HH, Kim SW. Characteristics of long COVID and the impact of COVID-19 vaccination on long COVID 2 years following COVID-19 infection: prospective cohort study. Sci Rep 2024; 14:854. [PMID: 38191556 PMCID: PMC10774352 DOI: 10.1038/s41598-023-50024-4] [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: 07/11/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
This prospective cohort study aimed to identify characteristics of long COVID and any potential mitigating effects of COVID-19 vaccinations in patients 24 months following COVID-19 infection. Adult patients diagnosed with COVID-19 between February 17, 2020, and March 24, 2020, were scheduled to visit the study hospital four times (6, 12, 18, and 24 months after infection) to assess their symptoms, quality of life, and mental health. Among the 235 patients, 121 (51.5%) completed the study visits. Of these, 59.5% were female, with a median age of 52 years. Mild to moderate disease severity were identified in 101 (83.4%) patients. A total of 75 participants (62.0%) were still experiencing long COVID symptoms 24 months after acute infection. Fatigue, amnesia, difficulty concentrating, and insomnia were the most common symptoms. The frequency of neuropsychiatric symptoms did not differ based on vaccination status or the number of doses received. Quality of life improved over time for the participants, but 32.2% of respondents still reported anxiety/depression at the end of the study. Overall, our cohort demonstrates that long COVID can persist up to 24 months after COVID-19 infection, affecting mental health and quality of life.
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Affiliation(s)
- Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Sohyun Bae
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Hyun-Ha Chang
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Shin-Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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11
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Schröder D, Schmachtenberg T, Heinemann S, Müllenmeister C, Roder S, El-Sayed I, Heesen G, Königs G, Dopfer-Jablonka A, Hummers E, Mikuteit M, Dopfer C, Grewendorf S, Niewolik J, Steffens S, Doze V, Klawonn F, Müller F. Parenting and Gender as Impact Factors for Social Participation, Quality of Life, and Mental Health in Long COVID. J Prim Care Community Health 2024; 15:21501319241255592. [PMID: 38805375 PMCID: PMC11135092 DOI: 10.1177/21501319241255592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVES This study aims to investigate the impact of gender and parental tasks on social participation, health-related quality of life (hrQoL), and mental health in persons with long COVID. METHODS A mixed-methods approach was followed including a cross-sectional web-based survey and semi-structured interviews. Multivariable linear regressions were used to quantify the effect of gender and parenting tasks on social participation, hrQoL, and mental health. Qualitative data from interviews with participants experiencing long COVID symptoms was analyzed using content analysis. RESULTS Data from 920 participants in the quantitative study and 25 participants in the qualitative study was analyzed. Parenting tasks were associated with increased impairments in family and domestic responsibilities in persons with long COVID compared to lower impairments in persons without long COVID (P = .02). The qualitative data indicate that coping with long COVID and pursuing parenting tasks limit participants' ability to perform leisure activities and attend social gatherings. In long COVID, men had higher anxiety symptoms than women, and in those without long COVID, the opposite was observed (P < .001). In the qualitative study, participants expressed feelings of dejection and pessimism about their future private, occupational, and health situations. No differences between the genders could be observed. CONCLUSIONS Long COVID is associated with impairments in family and domestic responsibilities in individuals who have parenting tasks. Among participants with long COVID, anxiety symptoms are higher in men than women.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Stephanie Heinemann
- Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | | | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Social Work, University of Applied Sciences and Arts, Bielefeld, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Heesen
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover-Braunschweig, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Marie Mikuteit
- Department of Dermatology and Allergology, Hannover Medical School, Hannover, Germany
| | - Christian Dopfer
- Department of Pediatric Pneumology, Allergology, and Neonatology, Hannover, Hannover Medical School, Germany
| | - Simon Grewendorf
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Jacqueline Niewolik
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Valerie Doze
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
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Sun C, Liu Z, Li S, Wang Y, Liu G. Impact of Long COVID on Health-Related Quality of Life Among Patients After Acute COVID-19 Infection: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241246461. [PMID: 38646896 PMCID: PMC11036910 DOI: 10.1177/00469580241246461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/01/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024]
Abstract
Concerns have been raised globally regarding the long-term effects of the novel coronavirus disease 2019 (COVID-19). This study aimed to investigate the impact of long COVID on the health of patients recovering from acute COVID-19 in China. We conducted a cross-sectional questionnaire survey from 1 February to 9 March 2023. Propensity score matching (PSM) was used to understand the differences in health utility values between individuals with and without long COVID. Factors associated with health-related quality of life (HRQoL) were determined using a multiple linear regression model. A chi-square test was used to compare differences between the 2 groups for each dimension of the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale. In total, 307 participants were included in the analysis, of which 40.39% exhibited at least 1 persistent symptom. The common symptoms of long COVID were fatigue/weakness, coughing, memory decline, poor concentration, and phlegm in the throat. Most patients with long COVID reported mild effects from their symptoms. After propensity score matching, the long-COVID group had lower health utility scores than the non-long-COVID group (0.94 vs 0.97). In the multivariable linear regression analysis, persistent symptoms and low annual household income were associated with lower health utility values (P < .05). Anxiety/depression and pain/discomfort were the major problems experienced by the participants with long COVID. Long-COVID symptoms following acute COVID-19 infection have a serious impact on health-related quality of life. Therefore, it is necessary to implement interventions to improve patient health after the recovery from acute COVID-19.
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Affiliation(s)
- Chengyao Sun
- Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Ziwei Liu
- Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Sixuan Li
- Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yuqi Wang
- Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Guoxiang Liu
- Harbin Medical University, Harbin, Heilongjiang Province, China
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13
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Schmachtenberg T, Königs G, Dragaqina A, Roder S, Müller F, Müllenmeister C, Schröder D, Dopfer-Jablonka A, Vieth K, El-Sayed I. "There is no one who helps you with it": experiences of people with long COVID regarding medical care, therapeutic measures, and barriers in the German healthcare system: results of a qualitative study with four focus groups. BMC Health Serv Res 2023; 23:1160. [PMID: 37884993 PMCID: PMC10601213 DOI: 10.1186/s12913-023-10170-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Many people experience long-term symptoms such as fatigue, cognitive problems, or shortness of breath after an acute infection with COVID-19. This emerging syndrome, known as long COVID, is new and complex in many aspects. This study aims to collect the experiences of people with long COVID with ambulatory healthcare structures. METHODS Four focus groups were conducted with a total of 23 adults with long COVID in June and July 2022. These discussions were audio-recorded, subsequently transcribed, and analyzed using the qualitative content analysis of Mayring and Kuckartz. RESULTS Fourteen out of 19 participants who had a primary care encounter regarding their long COVID symptoms did not perceive it as helpful. Many respondents reported that their general practitioners did not take their long COVID symptoms seriously and did not refer them to specialists or made therapeutic recommendations. However, some participants reported that they were prescribed non-pharmaceutical therapies (e.g., group meetings supported by psychotherapists, occupational therapy, etc.) that improved their condition. 14 of 23 respondents perceived care barriers such as providers' lack of awareness of long COVID, poor access to specialists, a lack of specialized care (e.g., long COVID clinics), or high bureaucratic hurdles for specific healthcare services. To improve medical care, participants suggested campaigns to raise awareness of long COVID among healthcare providers and the general population, increase research and government investments regarding the development of treatment structures for long COVID, expanding existing therapeutic services, and establishing one-stop shops for integrated specialist healthcare for people with long COVID. CONCLUSIONS Several implications for healthcare professionals and policymakers can be derived from this study: (1) general practitioners should take the symptoms of long COVID seriously, assume a care coordinating role, make referrals, and establish contact with long COVID clinics; (2) care planners should focus on developing interprofessional evidence-based care and treatment approaches for long COVID; (3) existing care structures such as long COVID outpatient clinics should be expanded. The overarching goal must be to develop consistent guidelines for long COVID diagnosis, care, and treatment. TRIAL REGISTRATION The study is registered in the German register for clinical trials (DRKS00026007, first registration on 09/09/2021).
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Affiliation(s)
- Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Anita Dragaqina
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
- Department of Family Medicine, College of Human Medicine, Michigan State University, 15 Michigan St NE, Grand Rapids, MI, 49503, USA
| | - Christina Müllenmeister
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- German Center for Infection Research, Partner Site Hannover-Braunschweig, Feodor-Lynen- Str. 26, 30625, Hannover, Germany
| | - Katharina Vieth
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany
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14
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Kim Y, Bae S, Chang HH, Kim SW. Long COVID prevalence and impact on quality of life 2 years after acute COVID-19. Sci Rep 2023; 13:11207. [PMID: 37433819 PMCID: PMC10336045 DOI: 10.1038/s41598-023-36995-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
There has been an increasing interest in the long-term impact of long COVID. However, only a few studies have investigated the clinical manifestations of long COVID after 24 months of acute infection. In this study, prospective online surveys were conducted in adults previously diagnosed with coronavirus disease 2019 (COVID-19) in South Korea between February 13 and March 13, 2020, at 6, 12, and 24 months after COVID-19. We investigated self-reported symptoms and the EuroQol-5-dimension index. Among 900 individuals enrolled initially, 150 completed all 3 surveys. After excluding the cases of COVID-19 reinfection, 132 individuals were included in the final analysis. Among the 132 participants, 94 (71.2%) experienced symptoms of long COVID. The most frequently reported symptoms were fatigue (34.8%), amnesia (30.3%), concentration difficulties (24.2%), insomnia (20.5%), and depression (19.7%). Notably, no significant differences were noted in the incidence of long COVID at 24 months in terms of the number of vaccinations received. Although the neuropsychiatric quality of life improved over time, it continued to affect 32.7% of participants. Symptoms of long COVID, particularly neuropsychiatric symptoms, tend to persist over time, and COVID-19 vaccination or the number of vaccinations received may not significantly affect the incidence of long COVID.
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Affiliation(s)
- Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Sohyun Bae
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Hyun-Ha Chang
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Shin-Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University Hospital, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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15
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Babicki M, Kapusta J, Pieniawska-Śmiech K, Kałuzińska-Kołat Ż, Kołat D, Mastalerz-Migas A, Jankowski P, Chudzik M. Do COVID-19 Vaccinations Affect the Most Common Post-COVID Symptoms? Initial Data from the STOP-COVID Register-12-Month Follow-Up. Viruses 2023; 15:1370. [PMID: 37376668 DOI: 10.3390/v15061370] [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: 05/29/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Around the world, various vaccines have been developed to prevent the SARS-CoV-2 virus infection and consequently the COVID-19 disease. However, many patients continue to report persistent symptoms after the acute phase. Since gathering scientific information on long COVID and post-COVID syndrome has become an urgent issue, we decided to investigate them in relation to the vaccination status of patients from the STOP-COVID registry. In this retrospective study, we analyzed data from the medical visit after contraction of COVID-19 and follow-up visits in the 3rd and 12th month after the disease. In total, 801 patients were included in the analysis. The most frequent complaints after 12 months included deterioration of exercise tolerance (37.5%), fatigue (36.3%), and memory/concentration difficulties (36.3%). In total, 119 patients declared that they had been diagnosed with at least one new chronic disease since the end of isolation, and 10.6% required hospitalization. The analysis of individual symptoms revealed that headache (p = 0.001), arthralgia (p = 0.032), and dysregulation of hypertension (p = 0.030) were more common in unvaccinated patients. Considering headache and muscle pain, people vaccinated after the disease manifested these symptoms less frequently. Subsequent research is needed to consider vaccines as a preventive factor for post-COVID syndrome.
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Affiliation(s)
- Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland
| | - Joanna Kapusta
- Department of Internal Diseases, Rehabilitation and Physical Medicine, Medical University of Lodz, 90-647 Lodz, Poland
| | - Karolina Pieniawska-Śmiech
- Department of Immunology and Pediatrics, The J. Gromkowski Provincial Specialist Hospital, 51-149 Wroclaw, Poland
- Department of Clinical Immunology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Żaneta Kałuzińska-Kołat
- Department of Experimental Surgery, Medical University of Lodz, 90-136 Lodz, Poland
- Boruta Medical Center, 95-100 Zgierz, Poland
| | - Damian Kołat
- Department of Experimental Surgery, Medical University of Lodz, 90-136 Lodz, Poland
- Boruta Medical Center, 95-100 Zgierz, Poland
| | | | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01-813 Warsaw, Poland
| | - Michał Chudzik
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01-813 Warsaw, Poland
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland
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16
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Ciaffi J, Vanni E, Mancarella L, Brusi V, Lisi L, Pignatti F, Naldi S, Assirelli E, Neri S, Reta M, Faldini C, Ursini F. Post-Acute COVID-19 Joint Pain and New Onset of Rheumatic Musculoskeletal Diseases: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13111850. [PMID: 37296705 DOI: 10.3390/diagnostics13111850] [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: 04/25/2023] [Revised: 05/20/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
As the number of reports of post-acute COVID-19 musculoskeletal manifestations is rapidly rising, it is important to summarize the current available literature in order to shed light on this new and not fully understood phenomenon. Therefore, we conducted a systematic review to provide an updated picture of post-acute COVID-19 musculoskeletal manifestations of potential rheumatological interest, with a particular focus on joint pain, new onset of rheumatic musculoskeletal diseases and presence of autoantibodies related to inflammatory arthritis such as rheumatoid factor and anti-citrullinated protein antibodies. We included 54 original papers in our systematic review. The prevalence of arthralgia was found to range from 2% to 65% within a time frame varying from 4 weeks to 12 months after acute SARS-CoV-2 infection. Inflammatory arthritis was also reported with various clinical phenotypes such as symmetrical polyarthritis with RA-like pattern similar to other prototypical viral arthritis, polymyalgia-like symptoms, or acute monoarthritis and oligoarthritis of large joints resembling reactive arthritis. Moreover, high figures of post-COVID-19 patients fulfilling the classification criteria for fibromyalgia were found, ranging from 31% to 40%. Finally, the available literature about prevalence of rheumatoid factor and anti-citrullinated protein antibodies was largely inconsistent. In conclusion, manifestations of rheumatological interest such as joint pain, new-onset inflammatory arthritis and fibromyalgia are frequently reported after COVID-19, highlighting the potential role of SARS-CoV-2 as a trigger for the development of autoimmune conditions and rheumatic musculoskeletal diseases.
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Affiliation(s)
- Jacopo Ciaffi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Elena Vanni
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Luana Mancarella
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Veronica Brusi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Lucia Lisi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Federica Pignatti
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Susanna Naldi
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Elisa Assirelli
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Simona Neri
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Massimo Reta
- UO Interaziendale Medicina Interna ad Indirizzo Reumatologico (SC) AUSL BO-IRCCS AOU BO, 40133 Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
- 1st Orthopedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
| | - Francesco Ursini
- Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli (IOR), 40136 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
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17
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Alshammary AF, AlQarni HM, Farzan R, Ali Khan I, Vennu V. The risk of venous thromboembolism and blood hyperlactatemia is associated with increased mortality among critically ill patients with Covid-19. THE CLINICAL RESPIRATORY JOURNAL 2023. [PMID: 37144596 DOI: 10.1111/crj.13628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (Covid-19) following venous thromboembolism (VTE) and blood hyperlactatemia are associated with higher mortality. However, reliable biomarkers for this association remain to be elucidated. This study investigated the associations of VTE risk and blood hyperlactatemia with mortality among critically ill Covid-19 patients admitted to the intensive care unit (ICU). METHODS In this single-centre retrospective study, we included 171 patients aged ≥18 years with confirmed Covid-19 admitted to the ICU at a tertiary healthcare clinic in the Eastern region of Saudi Arabia between 1 March 2020 and 31 January 2021. Patients were divided into two groups: survivor and non-survivor. The survivors have been identified as the patients discharged from the ICU alive. The VTE risk was defined using a Padua prediction score (PPS) >4. The blood lactate concentration (BLC) cut-off value >2 mmol/L was used to determine the blood hyperlactatemia. RESULTS Multi-factor Cox analysis showed that PPS >4 and BLC >2 mmol/L were more likely to be significantly associated with higher odds of ICU mortality in critically ill Covid-19 patients (hazard ratio [HR] = 2.80, 95% confidence interval [CI] = 1.00-8.08, p = 0.050; HR = 3.87, 95% CI = 1.12-13.45, p = 0.033, respectively). The Area under the Curve for VTE and blood hyperlactatemia were 0.62 and 0.85, respectively. CONCLUSION VTE risk and blood hyperlactatemia have been associated with a higher mortality risk in critically ill Covid-19 patients who are hospitalized in the ICU in Saudi Arabia. According to our findings, these people needed more effective VTE prevention strategies based on a personalized assessment of their risk of bleeding. Moreover, persons without diabetes and other groups with a high risk of dying from COVID-19 may be recognized by measuring glucose as having elevated glucose and lactate jointly.
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Affiliation(s)
- Amal F Alshammary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Hassan M AlQarni
- Clinical Pharmacy Resident, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Raed Farzan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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18
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Schmachtenberg T, Müller F, Kranz J, Dragaqina A, Wegener G, Königs G, Roder S. How do long COVID patients perceive their current life situation and occupational perspective? Results of a qualitative interview study in Germany. Front Public Health 2023; 11:1155193. [PMID: 36969629 PMCID: PMC10034079 DOI: 10.3389/fpubh.2023.1155193] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023] Open
Abstract
IntroductionMany people experience persistent or new-onset symptoms such as fatigue or cognitive problems after an acute infection with COVID-19. This phenomenon, known as long COVID, impacts physical and mental wellbeing, and may affect perceived quality of life and occupational perspectives likewise. The aim of this study is to gain a deeper understanding of how people with long COVID experience health-related restrictions in their daily life and their occupational situation, and to identify key challenges they face.MethodsGuided qualitative interviews were conducted with 25 people with long COVID. The interviews were transcribed according to Dresing/Pehl and Kuckartz and analyzed using qualitative content analysis. Afterward, a systematic comparison of the data and a reflection under consideration of lifeworld-theoretical approaches (Berger and Luckmann) were carried out.ResultsThe interviews revealed that many participants have severe symptoms which strongly impair them in perform daily and work-related activities, and in their personal interests. Many interviewees already reach their stress limit during routine household activities or childcare. Of the 25 participants, 19 experienced limitations in pursuing leisure activities, and 10 of the 23 interviewees with jobs reported being on sick leave for several months. Several respondents who had vocational reintegration are still affected by ongoing symptoms that affect their work performance considerably. This leads to uncertainty, role conflicts, a decline in social contacts, and decreased incomes, which contribute to an impairment in their quality of life.ConclusionsThis study shows the huge need for specific support for people with long COVID in different areas of life. To prevent people with long COVID from finding themselves in social and economic precarity, decision-makers should develop strategies to systematically support them in their sustainable reintegration into the workforce. The focus should be on creating long COVID-sensitive workplaces, compensating for decreased incomes, and improving access to relief services such as vocational reintegration. We argue, that a shift of perspectives is necessary and that long COVID should be considered rather as a “social disease” with considerably impairments in the social life of those affected.Trial registrationThe study is registered in the German register for clinical trials (DRKS00026007).
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Affiliation(s)
- Tim Schmachtenberg
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- *Correspondence: Tim Schmachtenberg
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Jennifer Kranz
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Anita Dragaqina
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Greta Wegener
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Gloria Königs
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Sascha Roder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
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19
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Takao M, Ohira M. Neurological post-acute sequelae of SARS-CoV-2 infection. Psychiatry Clin Neurosci 2023; 77:72-83. [PMID: 36148558 PMCID: PMC9538807 DOI: 10.1111/pcn.13481] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
Abstract
The novel coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can have two phases: acute (generally 4 weeks after onset) and chronic (>4 weeks after onset). Both phases include a wide variety of signs and symptoms including neurological and psychiatric symptoms. The signs and symptoms that are considered sequelae of COVID-19 are termed post-COVID condition, long COVID-19, and post-acute sequelae of SARS-CoV-2 infection (PASC). PASC symptoms include fatigue, dyspnea, palpitation, dysosmia, subfever, hypertension, alopecia, sleep problems, loss of concentration, amnesia, numbness, pain, gastrointestinal symptoms, depression, and anxiety. Because the specific pathophysiology of PASC has not yet been clarified, there are no definite criteria of the condition, hence the World Health Organization's definition is quite broad. Consequently, it is difficult to correctly diagnose PASC. Approximately 50% of patients may show at least one PASC symptom up to 12 months after COVID-19 infection; however, the exact prevalence of PASC has not been determined. Despite extensive research in progress worldwide, there are currently no clear diagnostic methodologies or treatments for PASC. In this review, we discuss the currently available information on PASC and highlight the neurological sequelae of COVID-19 infection. Furthermore, we provide clinical suggestions for diagnosing and caring for patients with PASC based on our outpatient clinic experience.
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Affiliation(s)
- Masaki Takao
- Department of Clinical Laboratory and Internal Medicine, National Center of Neurology and Psychiatry (NCNP), National Center Hospital, Tokyo, Japan
| | - Masayuki Ohira
- Department of Clinical Laboratory and Internal Medicine, National Center of Neurology and Psychiatry (NCNP), National Center Hospital, Tokyo, Japan
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Kim SW. COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons? J Korean Med Sci 2022; 37:e356. [PMID: 36573388 PMCID: PMC9792262 DOI: 10.3346/jkms.2022.37.e356] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
The first coronavirus disease 2019 (COVID-19) outbreak in Daegu city was overcome by efforts, including; 1) prompt isolation and quarantine action by local government with cooperative help from expert groups and the central government, 2) high-intensity social distancing and active cooperation of citizens, 3) admission of asymptomatic and mild patients in 'residential treatment centers', and 4) use of a telephone scoring system for the allocation of patients, with a mortality rate of 2.5%. A continuous suppression policy with test, tracing, and treatment (3 Ts) was implemented as an active response to the initial outbreaks in Korea. With the introduction of vaccines and therapeutic agents, the COVID-19 crisis had improved. Recently, the omicron variant was responsible for most domestic outbreaks, albeit with a low mortality rate (0.1%). Since the omicron outbreak, a damage mitigation policy has been implemented, focusing on protecting vulnerable groups. In the future, preparation including below are needed; 1) improving the national public health emergency response system, 2) strengthening the crisis response capacity of local governments, 3) cooperation between public healthcare and private healthcare, and 4) establishing a resilient medical response system.
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Affiliation(s)
- Shin-Woo Kim
- Division of Infectious Disease, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
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21
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Notarte KI, de Oliveira MHS, Peligro PJ, Velasco JV, Macaranas I, Ver AT, Pangilinan FC, Pastrana A, Goldrich N, Kavteladze D, Gellaco MML, Liu J, Lippi G, Henry BM, Fernández-de-las-Peñas C. Age, Sex and Previous Comorbidities as Risk Factors Not Associated with SARS-CoV-2 Infection for Long COVID-19: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11247314. [PMID: 36555931 PMCID: PMC9787827 DOI: 10.3390/jcm11247314] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/21/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Identification of predictors of long COVID-19 is essential for managing healthcare plans of patients. This systematic literature review and meta-analysis aimed to identify risk factors not associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, but rather potentially predictive of the development of long COVID-19. MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers were screened through 15 September 2022. Peer-reviewed studies or preprints evaluating potential pre-SARS-CoV-2 infection risk factors for the development of long-lasting symptoms were included. The methodological quality was assessed using the Quality in Prognosis Studies (QUIPSs) tool. Random-effects meta-analyses with calculation of odds ratio (OR) were performed in those risk factors where a homogenous long COVID-19 definition was used. From 1978 studies identified, 37 peer-reviewed studies and one preprint were included. Eighteen articles evaluated age, sixteen articles evaluated sex, and twelve evaluated medical comorbidities as risk factors of long COVID-19. Overall, single studies reported that old age seems to be associated with long COVID-19 symptoms (n = 18); however, the meta-analysis did not reveal an association between old age and long COVID-19 (n = 3; OR 0.86, 95% CI 0.73 to 1.03, p = 0.17). Similarly, single studies revealed that female sex was associated with long COVID-19 symptoms (n = 16); which was confirmed in the meta-analysis (n = 7; OR 1.48, 95% CI 1.17 to 1.86, p = 0.01). Finally, medical comorbidities such as pulmonary disease (n = 4), diabetes (n = 1), obesity (n = 6), and organ transplantation (n = 1) were also identified as potential risk factors for long COVID-19. The risk of bias of most studies (71%, n = 27/38) was moderate or high. In conclusion, pooled evidence did not support an association between advancing age and long COVID-19 but supported that female sex is a risk factor for long COVID-19. Long COVID-19 was also associated with some previous medical comorbidities.
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Affiliation(s)
- Kin Israel Notarte
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | | | | | | | - Imee Macaranas
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila 1008, Philippines
| | - Abbygail Therese Ver
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila 1008, Philippines
| | | | - Adriel Pastrana
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila 1008, Philippines
| | | | - David Kavteladze
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | | | - Jin Liu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, 37129 Verona, Italy
| | - Brandon Michael Henry
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28933 Madrid, Spain
- Correspondence: ; Tel.: +34-91-488-88-84
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22
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Quality of Life and Persistence of Symptoms in Outpatients after Recovery from COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121795. [PMID: 36556998 PMCID: PMC9781541 DOI: 10.3390/medicina58121795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
Background and Objectives: Patients infected with SARS-CoV-2 can have persistent symptoms after acute illness, which affects their quality of life (QoL). Research and data about this topic in Latin American ambulatory patients are scarce. Materials and Methods: We conducted an observational, prospective, transversal, and analytical study. To measure QoL, we used a validated Spanish version of the MOS/RAND 36-Item Short Form Health Survey (SF-36). Results: We included 206 outpatients in the study. A total of 73.3% patients had persistence of one or more symptoms. The most frequent persistent symptoms were fatigue (36.9%), anxiety (26.2%), and headache (24.8%). No statistically significant difference in the SF-36 QoL scores and the frequency of persistent COVID-19 symptoms was found when comparing the ≤5 and >5 months groups, except for myalgia, which was less frequently observed in the >5 months group after COVID-19 (26.2% vs. 14.1%, p < 0.038). Female gender was associated with an increased risk of persistence of symptoms (OR = 2.95, 95% CI 1.56−5.57). Having comorbidities/sequelae attributed to COVID-19 and persistence of COVID-19 symptoms were associated risk factors for poor physical component summary (PCS); on the other hand, female gender, anxiety, and depression were associated with poor mental component summary (MCS). Conclusion: Most outpatients had persistent COVID-19 symptoms after infection. Persistence of symptoms was associated with poor MCS and PCS. It is important to follow-up not only patients discharged from the hospital after SARS-CoV-2 infection, but also those under ambulatory management to provide them with rehabilitation and psychological therapy to improve their QoL.
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23
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Kim Y, Kim SE, Kim T, Yun KW, Lee SH, Lee E, Seo JW, Jung YH, Chong YP. Preliminary Guidelines for the Clinical Evaluation and Management of Long COVID. Infect Chemother 2022; 54:566-597. [PMID: 36196612 PMCID: PMC9533168 DOI: 10.3947/ic.2022.0141] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
Long-lasting coronavirus disease 2019 (COVID-19) symptoms beyond 12 weeks, the so-called ‘long COVID’ have been increasingly reported worldwide. Long COVID can be manifested in various forms, and there is an increasing demand for proper assessment and management. However, it is challenging when trying to determine the best-practice standards of care based on the current evidence because there is no internationally agreed clinical definition or clear treatment pathway. Therefore, the present guidelines have been drafted to provide advice on diagnosis and management based on the latest updated available evidence and the consensus of expert opinion. So far, no standard test and drug treatment can be strongly recommended for patients with long COVID because of a lack of evidence. The present guidelines provide advice based on 12 key questions, including appropriate interventions for long COVID that can be used in clinical practice. Continuous careful observation and studies related to long COVID are needed for the long-term impact of COVID-19 and proper management for long COVID to be determined.
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Affiliation(s)
- Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Seong Eun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Tark Kim
- Divison of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ki Wook Yun
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
| | - Eunjung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jun-Won Seo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Health-related quality of life in survivors of severe COVID-19 infection. Pharmacol Rep 2022; 74:1286-1295. [PMID: 36376776 PMCID: PMC9662770 DOI: 10.1007/s43440-022-00433-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Long-term effects of Coronavirus Disease 2019 (COVID-19) are increasingly recognized as having a significant impact on Health-Related Quality of Life (HRQoL). Understanding HRQoL status for each patient affected by long COVID-19 and its determinants may have a key role to prevent and treat this condition. METHODS In this prospective observational study conducted in a large academic COVID-19 hospital in Rome, participants were contacted 2 years after hospital admission for severe COVID-19. To assess HRQoL, EQ-5D-5L and Visual analog scale (EQ VAS) standard questionnaires were administered by interview. Logistic regression model was used to the five health dimensions as dependent variables (0 = no problem, 1 = some/extreme problem). KEY RESULTS In 137 enrolled patients, the mean pre-COVID and post-COVID EQ-5D-5L index and EQ-VAS score were 0.97 (SD 0.06), 0.79 (SD 0.26) and 72.38 (SD 15.18), respectively. After subdivision of the participants for clinical and social variables, the EQ-5D-5L index resulted significantly lower than in the pre-COVID-19 period. Female gender, unemployed status, and chronic comorbidities were the most common predictors for having any problems in each EQ-5D-5L domain, while also older age and higher Body Mass Index (BMI) showed to be related to a lower EQ-VAS score. CONCLUSION HRQoL showed to be still low in patients 2 years after acute severe COVID-19. Given the significant impact of SARS-CoV-2 on long-term chronic symptoms, predictors of poor outcomes must be considered during the acute phase of illness to plan a tailored follow-up path for each patient.
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