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Chao TC, Chiang SL, Lai CY, Huang CY, Lee MS, Lin CH, Chang CC, Lin CH. Association Between Physical Activity Amount and Cardiorespiratory Fitness, Sleep Quality, and Health-Related Quality of Life in Patients With Long COVID: A Cross-sectional Study. Arch Phys Med Rehabil 2024; 105:1673-1681. [PMID: 38697594 DOI: 10.1016/j.apmr.2024.04.010] [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: 09/19/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE To investigate the association between physical activity (PA) amount and gender differences on cardiorespiratory fitness (CRF), sleep quality, and health-related quality of life (HRQoL) in individuals with long COVID. DESIGN Cross-sectional study. SETTING An integrated outpatient clinic for post-COVID-19 at a medical center. PARTICIPANTS Convenience sample of patients (N=264) diagnosed with long COVID. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES PA amounts, sleep quality, and HRQoL were measured by the International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, and the World Health Organization Questionnaire on Quality of Life: Short Form, respectively. CRF was evaluated through graded exercise testing. RESULTS The participants had a mean age of 42.5±13.5 years and a mean duration of post-COVID-19 symptoms of 12.7±6.8 weeks. More than half (n=149, 56.5%) were female patients. Female participants had significantly lower CRF than male participants (P<.05). Older age and higher body mass index were associated with worse CRF and HRQoL (P<.05). Less sitting behavior and greater amounts of vigorous-intensity PA (VPA) or total PA were associated with better CRF (P<.05). In addition, greater total PA and moderate-intensity PA (MPA) were associated with better sleep quality and HRQoL (P<.05), respectively. CONCLUSIONS Gender differences were found in CRF among patients with long COVID. Greater self-reported VPA or total PA was associated with better CRF, whereas greater total PA and MPA were associated with better sleep quality and HRQoL, respectively, in patients with long COVID. Further research is needed to explore these associations in longitudinal studies.
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Affiliation(s)
- Ta-Chung Chao
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei
| | - Shang-Lin Chiang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei
| | - Chia-Ying Lai
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei
| | - Chien-Yao Huang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei
| | - Chueh-Ho Lin
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Taiwan
| | - Cheng-Chiang Chang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei
| | - Chia-Huei Lin
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.
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Zerón-Rugerio MF, Zaragozá MC, Domingo JC, Sanmartín-Sentañes R, Alegre-Martin J, Castro-Marrero J, Cambras T. Sleep and circadian rhythm alterations in myalgic encephalomyelitis/chronic fatigue syndrome and post-COVID fatigue syndrome and its association with cardiovascular risk factors: A prospective cohort study. Chronobiol Int 2024; 41:1104-1115. [PMID: 39037125 DOI: 10.1080/07420528.2024.2380020] [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: 03/13/2024] [Revised: 07/01/2024] [Accepted: 07/09/2024] [Indexed: 07/23/2024]
Abstract
This study aimed to investigate circadian rhythm manifestations in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) patients (including a subpopulation of long-COVID patients) and matched healthy controls while also exploring their association with cardiovascular health variables. Thirty-one ME/CFS patients (75% females), 23 individuals diagnosed with post-COVID ME/CFS (56% females) and 31 matched healthy controls (68% females) were enrolled in this study. Demographic and clinical characteristics were assessed using validated self-reported outcome measures. Actigraphy data, collected over one week, were used to analyze the 24-h profiles of wrist temperature, motor activity, and sleep circadian variables in the study participants. Associations between lipid profile with endothelial dysfunction biomarkers (such as endothelin-1, ICAM-1 and VCAM-1) and with sleep and circadian variables were also studied. No differences were found in these variables between the two group of patients. Patients showed lower activity and worse sleep quality than matched healthy controls, together with a worse lipid profile than controls, that was associated with disturbances in the circadian temperature rhythm. ICAM-1 levels were associated with plasma lipids in healthy controls, but not in patients, who showed higher levels of endothelin-1 and VCAM-1. These findings suggest that lipid profiles in ME/CFS are linked to disrupted circadian rhythms and sleep patterns, likely due to endothelial dysfunction. Furthermore, they highlight the intricate relationship between sleep, circadian rhythms, and cardiovascular health in this condition.
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Affiliation(s)
- María Fernanda Zerón-Rugerio
- Department of Clinical and Fundamental Nursing, Faculty of Nursing, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute (INSA-UB), University of Barcelona, Barcelona, Spain
| | | | - Joan Carles Domingo
- Department of Biochemistry and Molecular Biomedicine, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Ramon Sanmartín-Sentañes
- Division of Rheumatology, ME/CFS Clinical Unit, Vall d'Hebron University Hospital, Barcelona, Spain
- Division of Rheumatology, Research Unit in ME/CFS and Long COVID, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jose Alegre-Martin
- Division of Rheumatology, ME/CFS Clinical Unit, Vall d'Hebron University Hospital, Barcelona, Spain
- Division of Rheumatology, Research Unit in ME/CFS and Long COVID, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Castro-Marrero
- Division of Rheumatology, Research Unit in ME/CFS and Long COVID, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Trinitat Cambras
- Nutrition and Food Safety Research Institute (INSA-UB), University of Barcelona, Barcelona, Spain
- Department of Biochemistry and Physiology, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
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3
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Wright TJ, Sheffield‐Moore M, Pyles RB, Randolph KM, McGovern KA, Danesi CP, Lindsay SE, Zaidan MF, Masel BE, Urban RJ. Growth hormone treatment for neurologic symptoms of post-acute sequelae of COVID-19. Clin Transl Sci 2024; 17:e13826. [PMID: 38894576 PMCID: PMC11187940 DOI: 10.1111/cts.13826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/17/2024] [Accepted: 05/04/2024] [Indexed: 06/21/2024] Open
Abstract
Following SARS-CoV-2 infection, some patients develop lingering neurologic symptoms of post-acute sequelae of COVID-19 (PASC) that commonly include fatigue and "brain fog." PASC symptoms are also linked with reduced growth hormone (GH) secretion, but GH treatment has not been tested to relieve symptoms. We enrolled 13 adults with neurologic PASC symptoms and peak stimulated GH secretion less than 10 ng/mL (glucagon stimulation) in a pilot study to receive 9 months of daily GH injections and an additional 3 months of off-treatment assessment. We compared peak stimulated GH secretion at baseline and 12 months and assessed measures of cognition, metabolism, body composition, and physical performance over the first 6 months of treatment. Patient-reported outcomes of fatigue, quality of life, sleep, and mood were recorded at baseline and compared with timepoints at 6, 9, and 12 months. GH treatment was associated with significantly improved scores for Brief Fatigue Inventory, Multidimensional Fatigue Symptom Inventory, Quality of Life Assessment of Growth Hormone Deficiency in Adults, Profile of Mood States, and Beck Depression Inventory-II, with no significant change in Pittsburgh Sleep Quality Index. Six months of adjunct GH treatment was not associated with significant changes in cognition, body composition, resting energy expenditure, or physical performance. Peak stimulated GH secretion was not altered at 12 months following 9 months of GH treatment. GH treatment significantly improved neurologic symptoms in PASC patients but cognition, sleep, and physical performance were not significantly altered.
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Affiliation(s)
- Traver J. Wright
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
| | | | - Richard B. Pyles
- Department of PediatricsThe University of Texas Medical BranchGalvestonTexasUSA
| | - Kathleen M. Randolph
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
| | - Kristen A. McGovern
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
| | - Christopher P. Danesi
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
| | - Sarah E. Lindsay
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
| | - Mohammed F. Zaidan
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
| | - Brent E. Masel
- Department of NeurologyThe University of Texas Medical BranchGalvestonTexasUSA
- Centre for Neuro SkillsBakersfieldCaliforniaUSA
| | - Randall J. Urban
- Department of Internal MedicineThe University of Texas Medical BranchGalvestonTexasUSA
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4
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Tan Y, Xie Y, Dong G, Yin M, Shang Z, Zhou K, Bao D, Zhou J. The Effect of 14-Day Consumption of Hydrogen-Rich Water Alleviates Fatigue but Does Not Ameliorate Dyspnea in Long-COVID Patients: A Pilot, Single-Blind, and Randomized, Controlled Trial. Nutrients 2024; 16:1529. [PMID: 38794767 PMCID: PMC11123997 DOI: 10.3390/nu16101529] [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: 03/29/2024] [Revised: 05/02/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: Hydrogen (H2) may be a potential therapeutic agent for managing Long COVID symptoms due to its antioxidant and anti-inflammatory properties. However, more scientific literature is needed to describe the effects of H2 administration on treating symptoms. A study aimed to investigate the impact of hydrogen-rich water (HRW) administration on the fatigue and dyspnea of Long-COVID patients for 14 consecutive days. (2) Methods: In this randomized, single-blind, placebo-controlled study, 55 participants were recruited, and 23 of them were excluded. A total of 32 eligible participants were randomized into a hydrogen-rich water (HRW) group (n = 16) and a placebo water (PW) group (n = 16) in which they were instructed to consume hydrogen-rich water or placebo water for 14 days, respectively. The participants completed the Fatigue Severity Scale (FSS), Six-Minute Walk Test (6MWT), 30 s Chair Stand Test (30s-CST), Modified Medical Research Council Dyspnea Rating Scale (mMRC), Pittsburgh Sleep Quality Index (PSQI), and depression anxiety stress scale (DASS-21) before and after the intervention. A linear mixed-effects model was used to analyze the effects of HRW. Cohen's d values were used to assess the effect size when significance was observed. The mean change with 95% confidence intervals (95% CI) was also reported. (3) Results: The effects of HRW on lowering FSS scores (p = 0.046, [95% CI = -20.607, -0.198, d = 0.696] and improving total distance in the 6WMT (p < 0.001, [95% CI = 41.972, 61.891], d = 1.010), total time for the 30s-CST (p = 0.002, [95% CI = 1.570, 6.314], d = 1.190), and PSQI scores (p = 0.012, [95% CI = -5.169, 0.742], d = 1.274) compared to PW were of a significantly moderate effect size, while there was no significant difference in mMRC score (p = 0.556) or DASS-21 score (p > 0.143). (4) Conclusions: This study demonstrates that HRW might be an effective strategy for alleviating fatigue and improving cardiorespiratory endurance, musculoskeletal function, and sleep quality. Still, it does not ameliorate dyspnea among Long-COVID patients.
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Affiliation(s)
- Yineng Tan
- School of Strength and Conditioning Training, Beijing Sport University, Beijing 100084, China;
| | - Yixun Xie
- College of Swimming, Beijing Sport University, Beijing 100084, China;
| | - Gengxin Dong
- School of Sport Medicine and Physical Therapy, Beijing Sport University, Beijing 100084, China;
| | - Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China;
| | - Zhangyuting Shang
- College of Physical Education and Health Management, Chongqing University of Education, Chongqing 400065, China;
| | - Kaixiang Zhou
- College of Physical Education and Health Science, Chongqing Normal University, Chongqing 401331, China
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Junhong Zhou
- Hebrew Senior Life Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA 02115, USA;
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5
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Ruzicka M, Sachenbacher S, Heimkes F, Uebleis AO, Karch S, Grosse-Wentrup F, Ibarra Fonseca GJ, Wunderlich N, Bogner J, Mayerle J, von Bergwelt-Baildon M, Falkai P, Subklewe M, Ruzicka T, Benesch C, Valdinoci E, Pernpruner A, Thomas A, Heindl B, Stubbe HC, Adorjan K. Characterization of cognitive symptoms in post COVID-19 patients. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01821-z. [PMID: 38739263 DOI: 10.1007/s00406-024-01821-z] [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: 06/16/2023] [Accepted: 04/19/2024] [Indexed: 05/14/2024]
Abstract
Cognitive symptoms (CS) belong to the most common manifestations of the Post COVID-19 (PC) condition. We sought to objectify CS in PC patients using routine diagnostic assessments: neurocognitive testing (NCT) and brain imaging (BI). Further, we investigated possible associations of CS with patient reported outcomes (PROs), and risk factors for developing CS. Clinical data and PROs of 315 PC patients were assessed at a mean of 6 months after SARS-CoV-2 infection. 231 (73.3%) patients reported any sort of CS. Among them, 78 underwent NCT and 55 received BI. In NCT, the cognitive domains most affected were the working memory, attention, and concentration. Nonetheless, pathological thresholds were exceeded only in few cases. Neurocognitive performance did not differ significantly between patients complaining of severe (n = 26) versus non-severe (n = 52) CS. BI findings were abnormal in 8 (14.5%) cases with CS but were most likely not related to PC. Patients reporting high severity of CS scored worse in the PHQ-9, FSS, WHOQOL-BREF, were more likely to report impaired sleep, and had a higher prevalence of psychiatric diagnoses. Overall, NCT could confirm mild impairment in some but not all PC patients with CS, while BI studies were abnormal in only few cases. CS severity did not affect NCT results, but severe CS were associated with symptoms of depression (PHQ-9), fatigue (FSS), reduced quality of life (WHOQOL-BREF) and higher prevalence of psychiatric illnesses. These findings support the importance of NCT, BI, and neuro-psychological assessment in the work-up of PC patients reporting CS. TRIAL REGISTRATION: Trial registration number and date of registration: DRKS00030974, 22 Dec 2022, retrospectively registered.
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Affiliation(s)
- Michael Ruzicka
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Munich, Germany.
| | - Simone Sachenbacher
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fides Heimkes
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Aline Olivia Uebleis
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fabienne Grosse-Wentrup
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Nora Wunderlich
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Bogner
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Mayerle
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Marion Subklewe
- Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Munich, Germany
| | - Thomas Ruzicka
- Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Christopher Benesch
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
| | - Elisabeth Valdinoci
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anna Pernpruner
- Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany
| | - Anabel Thomas
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Bernhard Heindl
- Stabstelle Strategische Unternehmenssteuerung, LMU Munich, Munich, Germany
| | | | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
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6
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Müllenmeister C, Stoelting A, Schröder D, Schmachtenberg T, Ritter S, El-Sayed I, Steffens S, Klawonn F, Klawitter S, Homann S, Mikuteit M, Berg C, Behrens G, Hummers E, Cook A, Müller F, Dopfer-Jablonka A, Happle C. Evaluating the Feasibility, Acceptance, and Beneficial Effects of Online Occupational Therapy for Post-COVID-19 Condition: Protocol for a Randomized Controlled Trial (ErgoLoCo Study). JMIR Res Protoc 2024; 13:e50230. [PMID: 38739435 PMCID: PMC11130769 DOI: 10.2196/50230] [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: 06/26/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Post-COVID-19 syndrome (PCS; also known as "long COVID") is a relatively novel disease comprising physical, psychological, and cognitive complaints persisting several weeks to months after acute infection with SARS-CoV-2. Approximately 10% of patients with COVID-19 are affected by long-term symptoms. However, effective treatment strategies are lacking. The ErgoLoCo (Occupational Therapy [Ergotherapie] for Long COVID) study was designed to develop and evaluate a novel occupational therapy (OT) concept of online delivery of therapy for long COVID. OBJECTIVE The primary study objective is to assess the feasibility of the online OT intervention in PCS. Secondary aims include the evaluation of online OT concerning cognitive problems, occupational performance, and social participation. METHODS This randomized controlled interventional pilot study involves parallel mixed methods process analyses and a realist evaluation approach. A total of 80 clients with PCS aged at least 16 years will be recruited into two interventional groups. The control cohort (watch and wait) comprises 80 clients with long COVID. Treatment is provided through teletherapy (n=40) or delivery of prerecorded videos (n=40) using the same standardized OT concept twice weekly over 12 weeks. Analyses of quantitative questionnaires and qualitative interviews based on the theoretical framework of acceptability will be performed to assess feasibility. Focus group meetings will be used to assess how acceptable and helpful the intervention was to the participating occupational therapists. Standardized tests will be used to assess the initial efficacy of the intervention on neurocognitive performance; limitations in mobility, self-care, and everyday activities; pain; disabilities; quality of life (QoL); social participation; and anxiety and depression in PCS, and the possible effects of online OT on these complaints. RESULTS The German Ministry of Education and Research provided funding for this research in March 2022. Data collection took place from October 2022 to August 31, 2023. Data analysis will be completed by the end of April 2024. We anticipate publishing the results in the fall of 2024. CONCLUSIONS Despite the enormous clinical need, effective and scalable treatment options for OT clients who have PCS remain scarce. The ErgoLoCo study will assess whether online-delivered OT is a feasible treatment approach in PCS. Furthermore, this study will assess the effect of the intervention on cognitive symptoms, QoL, and occupational performance and participation in everyday life. Particular emphasis will be placed on the experiences of clients and occupational therapists with digitally delivered OT. This study will pave the way for novel and effective treatment strategies in PCS. TRIAL REGISTRATION German Clinical Trial Registry DRKS00029990; https://drks.de/search/de/trial/DRKS00029990. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50230.
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Affiliation(s)
| | - Andrea Stoelting
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Dominik Schröder
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
| | - Tim Schmachtenberg
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Simon Ritter
- Department of Pediatric Pulmology, Allergology and Neoantology, Hannover Medical School, Hannover, Germany
- RESIST Cluster of Excellence, Hannover, Germany
| | - Iman El-Sayed
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
- Biostatistics Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Sandra Klawitter
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbuettel, Germany
| | - Stefanie Homann
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- Department of Dermatology, Hannover Medical School, Hannover, Germany
| | - Christoph Berg
- FOM University of Applied Sciences for Economics and Management, Hannover, Germany
| | - Georg Behrens
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research, partner site Hannover-Brunswick, Hannover, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
| | - Aisha Cook
- Timmcook Occupational Therapy Center, Hannover, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Goettingen, Goettingen, Germany
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Alexandra Dopfer-Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- RESIST Cluster of Excellence, Hannover, Germany
| | - Christine Happle
- Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- RESIST Cluster of Excellence, Hannover, Germany
- Biomedical Research in End-stage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany
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7
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Kim C, Moon JY, Kim SH, Kim SH, Chang Y, Cho WH, Kim WY, Kwon SJ, Kim HC, Yoo KH, Lee YS. Prevalences and Interrelationships of Post COVID-19 Fatigue, Sleep Disturbances, and Depression in Healthy Young and Middle-Aged Adults. J Clin Med 2024; 13:2801. [PMID: 38792343 PMCID: PMC11122371 DOI: 10.3390/jcm13102801] [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: 03/09/2024] [Revised: 04/21/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
Background: An evaluation of the persistence of symptoms following COVID-19 in economically active young and middle-aged adults is crucial due to its significant socioeconomic impact resulting from compromised work performance. Methods: A prospective, multicenter study at 12 South Korean hospitals from January to December 2022 involved telephone interviews along with validated questionnaires. Results: Among 696 participants with a median age of 32 and no prior diagnoses, 30% of participants experienced persistent fatigue, while 21.4% suffered from sleep disturbance at 6 months following infection. Additionally, approximately 25% of the participants exhibited depression that endured for up to 6 months. Symptomatic individuals at 3 months exhibited a significantly higher prevalence of persistent fatigue, sleep disturbances, and depression at 6 months compared to those who remained asymptomatic. Notably, sleep disturbance and persistent fatigue at 3 months emerged as significant independent predictors of the presence of depression at 6 months. Conclusions: Even among young and middle-aged healthy adults, prolonged fatigue, sleep disturbance, and depression exhibit a significant prevalence and persisted for up to 6 months. Therefore, implementing a workplace management protocol for these symptoms is essential to mitigate the socioeconomic burden caused by the impairment of work efficiency.
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Affiliation(s)
- Changhwan Kim
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si 18450, Republic of Korea;
| | - Jae Young Moon
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea;
| | - Sung Hyun Kim
- Division of Pulmonary, Allergy, and Critical Care, Department of Internal Medicine, Inje University Busan Paik Hospital, College of Medicine, Busan 47392, Republic of Korea;
| | - Sun-Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea;
| | - Youjin Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea;
| | - Woo Hyun Cho
- Division of Allergy, Pulmonary and Critical Care Medicine, Transplant Research Center, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea;
- Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan 46241, Republic of Korea
| | - Won-Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul 06974, Republic of Korea;
| | - Sun Jung Kwon
- Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Konyang University College of Medicine, Daejeon 35365, Republic of Korea;
| | - Ho Cheol Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon 51472, Republic of Korea;
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of Korea;
| | - Young Seok Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
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8
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Kim HC. Impact of COVID-19 on the development of major mental disorders in patients visiting a university hospital: a retrospective observational study. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2024; 41:86-95. [PMID: 38317275 DOI: 10.12701/jyms.2023.01256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on the development of major mental disorders in patients visiting a university hospital. METHODS The study participants were patients with COVID-19 (n=5,006) and those without COVID-19 (n=367,162) registered in the database of Keimyung University Dongsan Hospital and standardized with the Observational Medical Outcomes Partnership Common Data Model. Data on major mental disorders that developed in both groups over the 5-year follow-up period were extracted using the FeederNet computer program. A multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of major mental disorders. RESULTS The incidences of dementia and sleep, anxiety, and depressive disorders were significantly higher in the COVID-19 group than in the control group. The incidence rates per 1,000 patient-years in the COVID-19 group vs. the control group were 12.71 vs. 3.76 for dementia, 17.42 vs. 7.91 for sleep disorders, 6.15 vs. 3.41 for anxiety disorders, and 8.30 vs. 5.78 for depressive disorders. There was no significant difference in the incidence of schizophrenia or bipolar disorder between the two groups. COVID-19 infection increased the risk of mental disorders in the following order: dementia (HR, 3.49; 95% CI, 2.45-4.98), sleep disorders (HR, 2.27; 95% CI, 1.76-2.91), anxiety disorders (HR, 1.90; 95% CI, 1.25-2.84), and depressive disorders (HR, 1.54; 95% CI, 1.09-2.15). CONCLUSION This study showed that the major mental disorders associated with COVID-19 were dementia and sleep, anxiety, and depressive disorders.
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Affiliation(s)
- Hee-Cheol Kim
- Department of Psychiatry and Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea
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9
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Kowal M, Morgiel E, Winiarski S, Dymarek R, Bajer W, Madej M, Sebastian A, Madziarski M, Wedel N, Proc K, Madziarska K, Wiland P, Paprocka-Borowicz M. Ebbing Strength, Fading Power: Unveiling the Impact of Persistent Fatigue on Muscle Performance in COVID-19 Survivors. SENSORS (BASEL, SWITZERLAND) 2024; 24:1250. [PMID: 38400407 PMCID: PMC10892381 DOI: 10.3390/s24041250] [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: 12/19/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
The total number of confirmed cases of COVID-19 caused by SARS-CoV-2 virus infection is over 621 million. Post-COVID-19 syndrome, also known as long COVID or long-haul COVID, refers to a persistent condition where individuals experience symptoms and health issues after the acute phase of COVID-19. The aim of this study was to assess the strength and fatigue of skeletal muscles in people recovered from COVID-19. A total of 94 individuals took part in this cross-sectional study, with 45 participants (referred to as the Post-COVID Cohort, PCC) and 49 healthy age-matched volunteers (Healthy Control Cohort, HCC). This research article uses the direct dynamometry method to provide a detailed analysis of post-COVID survivors' strength and power characteristics. The Biodex System 4 Pro was utilized to evaluate muscle strength characteristics during the fatigue test. The fatigue work in extensors and flexors was significantly higher in the PCC. The PCC also showed significantly less power in both extensors and flexors compared to the HCC. In conclusion, this study provides compelling evidence of the impact of post-COVID-19 fatigue on muscle performance, highlighting the importance of considering these effects in the rehabilitation and care of individuals recovering from the virus. PCC achieved lower muscle strength values than HCC.
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Affiliation(s)
- Mateusz Kowal
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Ewa Morgiel
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Sławomir Winiarski
- Biomechanics Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland;
| | - Robert Dymarek
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Weronika Bajer
- Department of Physiotherapy, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.K.); (W.B.); (M.P.-B.)
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Agata Sebastian
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
| | - Marcin Madziarski
- Department of Rheumatology and Internal Medicine, University Teaching Hospital, 50-556 Wroclaw, Poland; (M.M.); (K.P.)
| | - Nicole Wedel
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Krzysztof Proc
- Department of Rheumatology and Internal Medicine, University Teaching Hospital, 50-556 Wroclaw, Poland; (M.M.); (K.P.)
| | - Katarzyna Madziarska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland; (E.M.); (M.M.); (A.S.); (P.W.)
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10
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Gaber MM, Hosny H, Hussein M, Ashmawy MA, Magdy R. Cognitive function and quantitative electroencephalogram analysis in subjects recovered from COVID-19 infection. BMC Neurol 2024; 24:60. [PMID: 38336659 PMCID: PMC10858500 DOI: 10.1186/s12883-023-03518-7] [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: 09/08/2023] [Accepted: 12/19/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND & OBJECTIVES Objective assessment of post-COVID-19 cognitive dysfunction is highly warranted. This study aimed to evaluate the cognitive dysfunction of COVID-19 survivors with cognitive complaints, both clinically and neurophysiologically, using Quantitative Electroencephalogram (QEEG). METHODS This case-control study was conducted on 50 recovered subjects from COVID-19 infection with cognitive complaints and 50 age, sex, and educational-matched healthy controls. Both groups were subjected to the following neurocognitive tests: Paired associate learning Test (PALT) and Paced Auditory Serial Addition Test (PASAT). The neurophysiological assessment was also done for both groups using QEEG. RESULTS COVID-19 survivors had significantly lower PALT scores than controls (P < 0.001). QEEG analysis found significantly higher levels of Theta / Beta ratio in both central and parietal areas in patients than in the controls (P < 0.001 for each). The interhemispheric coherence for the frontal, central, and parietal regions was also significantly lower in patients than in the control group regarding alpha and beta bands. There were statistically significant lower scores of PALT and PASAT among cases with severe COVID-19 infection (P = 0.011, 0.005, respectively) and those who needed oxygen support (P = 0.04, 0.01, respectively). On the other hand, a statistically significantly lower mean of frontal alpha inter-hemispheric coherence among patients with severe COVID-19 infection (P = 0.01) and those needing mechanical ventilation support (P = 0.04). CONCLUSION Episodic memory deficit is evident in COVID-19 survivors with subjective cognitive complaints accompanied by lower inter-hemispheric coherence in frontal regions. These clinical and neurophysiological changes are associated with hypoxia and COVID-19 severity.
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Affiliation(s)
- Manal M Gaber
- Clinical Neurophysiology Department, Neuro Diagnostic Research Center (NDRC), Beni-Suef University, Beni-Suef, Egypt
| | - Hanan Hosny
- Clinical Neurophysiology Department, Neuro Diagnostic Research Center (NDRC), Beni-Suef University, Beni-Suef, Egypt
| | - Mona Hussein
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Mona A Ashmawy
- Clinical Neurophysiology Department, Neuro Diagnostic Research Center (NDRC), Beni-Suef University, Beni-Suef, Egypt
| | - Rehab Magdy
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt.
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11
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Tański W, Tomasiewicz A, Jankowska-Polańska B. Sleep Disturbances as a Consequence of Long COVID-19: Insights from Actigraphy and Clinimetric Examinations-An Uncontrolled Prospective Observational Pilot Study. J Clin Med 2024; 13:839. [PMID: 38337533 PMCID: PMC10856322 DOI: 10.3390/jcm13030839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
The COVID-19 pandemic represents a global health and social challenge. However, the impact of a SARS-CoV-2 infection itself on mental health and sleep quality remains poorly understood. The purpose of the present uncontrolled prospective observational pilot study was to evaluate the impact of past COVID-19 disease on the incidence of quantitative and qualitative sleep disturbances. A group of 61 subjects (37 female, 24 male) reported sleep disturbances that had lasted for at least one month and had started after recovery from COVID-19. The study used self-reported instruments: the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI), as well as an objective method-actigraphy-for quantitative analysis of sleep architecture. It was shown that sleep disturbances most commonly started after recovery (68.3%, n = 41) and lasted for more than one month (83.6%, n = 51). ESS scores of 7.8 ± 5.0 points indicate moderate daytime sleepiness, and ISI scores of 16.3 ± 5.8 points denote moderate insomnia. ESS scores were negatively correlated with total time in bed (r = -0.3780, p = 0.003), total sleep time (r = -0.2969, p = 0.020), and wakefulness after sleep onset (r = -0.2654, p = 0.039). In addition, ESS scores were correlated negatively with the respondents' age (B = -0.17, p = 0.000) and time from COVID-19 onset. A positive correlation was found between wakefulness after sleep onset and ESS scores (B = -0.05, p = 0.039). ISI scores were positively correlated with time in bed (r = 0.3275, p = 0.010). Female gender was found to be a significant predictor of insomnia's severity (B = 2.159, t = 3.04, p = 0.004). In conclusion, patients with a history of COVID-19 report long-lasting sleep disturbances that do not subside spontaneously. In the patient group studied, moderate levels of daytime sleepiness and insomnia were found. The most frequently reported problems included irregular sleep, frequent awakenings, and difficulty maintaining sleep, while normal sleep duration was preserved. These findings underscore the need for continued attention to the long-term consequences of COVID-19 on sleep health and emphasize the importance of targeted interventions to address these enduring sleep disturbances in affected individuals.
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Affiliation(s)
- Wojciech Tański
- Department of Internal Medicine, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland;
- Faculty of Medicine, Wrocław University of Science and Technology, 50-376 Wroclaw, Poland
| | - Anna Tomasiewicz
- Student Research Club of Surgical Specialties, Wroclaw Medical University, 50-532 Wroclaw, Poland
| | - Beata Jankowska-Polańska
- Faculty of Medicine, Wrocław University of Science and Technology, 50-376 Wroclaw, Poland
- Center for Research and Innovation, 4th Military Clinical Hospital, 50-981 Wroclaw, Poland
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12
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Helbing DL, Dommaschk EM, Danyeli LV, Liepinsh E, Refisch A, Sen ZD, Zvejniece L, Rocktäschel T, Stabenow LK, Schiöth HB, Walter M, Dambrova M, Besteher B. Conceptual foundations of acetylcarnitine supplementation in neuropsychiatric long COVID syndrome: a narrative review. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-023-01734-3. [PMID: 38172332 DOI: 10.1007/s00406-023-01734-3] [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: 05/31/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024]
Abstract
Post-acute sequelae of COVID-19 can present as multi-organ pathology, with neuropsychiatric symptoms being the most common symptom complex, characterizing long COVID as a syndrome with a significant disease burden for affected individuals. Several typical symptoms of long COVID, such as fatigue, depressive symptoms and cognitive impairment, are also key features of other psychiatric disorders such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and major depressive disorder (MDD). However, clinically successful treatment strategies are still lacking and are often inspired by treatment options for diseases with similar clinical presentations, such as ME/CFS. Acetylcarnitine, the shortest metabolite of a class of fatty acid metabolites called acylcarnitines and one of the most abundant blood metabolites in humans can be used as a dietary/nutritional supplement with proven clinical efficacy in the treatment of MDD, ME/CFS and other neuropsychiatric disorders. Basic research in recent decades has established acylcarnitines in general, and acetylcarnitine in particular, as important regulators and indicators of mitochondrial function and other physiological processes such as neuroinflammation and energy production pathways. In this review, we will compare the clinical basis of neuropsychiatric long COVID with other fatigue-associated diseases. We will also review common molecular disease mechanisms associated with altered acetylcarnitine metabolism and the potential of acetylcarnitine to interfere with these as a therapeutic agent. Finally, we will review the current evidence for acetylcarnitine as a supplement in the treatment of fatigue-associated diseases and propose future research strategies to investigate the potential of acetylcarnitine as a treatment option for long COVID.
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Affiliation(s)
- Dario Lucas Helbing
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany
- Leibniz Institute on Aging, Fritz Lipmann Institute, Jena, Germany
- Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745, Jena, Germany
| | - Eva-Maria Dommaschk
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
| | - Lena Vera Danyeli
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Edgars Liepinsh
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia
- Faculty of Pharmacy, Riga Stradins University, Riga, Latvia
| | - Alexander Refisch
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
| | - Zümrüt Duygu Sen
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
| | - Liga Zvejniece
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia
| | - Tonia Rocktäschel
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany
| | - Leonie Karoline Stabenow
- Institute of Molecular Cell Biology, Jena University Hospital, Friedrich Schiller University Jena, 07745, Jena, Germany
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Helgi B Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, 751 24, Uppsala, Sweden
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Maija Dambrova
- Laboratory of Pharmaceutical Pharmacology, Latvian Institute of Organic Synthesis, Riga, Latvia
- Faculty of Pharmacy, Riga Stradins University, Riga, Latvia
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Philosophenweg 3, 07743, Jena, Germany.
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits, Underlying Mental Health (C-I-R-C), Jena, Magdeburg, Halle, Germany.
- German Center for Mental Health (DZPG), Site Halle, Jena, Magdeburg, Germany.
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13
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Straßburger C, Hieber D, Karthan M, Jüster M, Schobel J. Return to work after Post-COVID: describing affected employees' perceptions of personal resources, organizational offerings and care pathways. Front Public Health 2023; 11:1282507. [PMID: 38089028 PMCID: PMC10715408 DOI: 10.3389/fpubh.2023.1282507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023] Open
Abstract
Background Most individuals recover from the acute phase of infection with the SARS-CoV-2 virus, however, some encounter prolonged effects, referred to as the Post-COVID syndrome. Evidence exists that such persistent symptoms can significantly impact patients' ability to return to work. This paper gives a comprehensive overview of different care pathways and resources, both personal and external, that aim to support Post-COVID patients during their work-life reintegration process. By describing the current situation of Post-COVID patients pertaining their transition back to the workplace, this paper provides valuable insights into their needs. Methods A quantitative research design was applied using an online questionnaire as an instrument. Participants were recruited via Post-COVID outpatients, rehab facilities, general practitioners, support groups, and other healthcare facilities. Results The analyses of 184 data sets of Post-COVID affected produced three key findings: (1) The evaluation of different types of personal resources that may lead to a successful return to work found that particularly the individuals' ability to cope with their situation (measured with the FERUS questionnaire), produced significant differences between participants that had returned to work and those that had not been able to return so far (F = 4.913, p = 0.001). (2) In terms of organizational provisions to facilitate successful reintegration into work-life, predominantly structural changes (i.e., modification of the workplace, working hours, and task) were rated as helpful or very helpful on average (meanworkplace 2.55/SD = 0.83, meanworking hours 2.44/SD = 0.80; meantasks 2.55/SD = 0.83), while the remaining offerings (i.e., job coaching or health courses) were rated as less helpful or not helpful at all. (3) No significant correlation was found between different care pathways and a successful return to work. Conclusion The results of the in-depth descriptive analysis allows to suggests that the level of ability to cope with the Post-COVID syndrome and its associated complaints, as well as the structural adaptation of the workplace to meet the needs and demands of patients better, might be important determinants of a successful return. While the latter might be addressed by employers directly, it might be helpful to integrate training on coping behavior early in care pathways and treatment plans for Post-COVID patients to strengthen their coping abilities aiming to support their successful return to work at an early stage.
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Affiliation(s)
- Claudia Straßburger
- Department of Tourism Management, Kempten University of Applied Sciences, Kempten, Germany
| | - Daniel Hieber
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Department of Pathology, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Maximilian Karthan
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Markus Jüster
- Department of Tourism Management, Kempten University of Applied Sciences, Kempten, Germany
| | - Johannes Schobel
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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14
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Chen TB, Chang CM, Yang CC, Tsai IJ, Wei CY, Yang HW, Yang CP. Neuroimmunological Effect of Vitamin D on Neuropsychiatric Long COVID Syndrome: A Review. Nutrients 2023; 15:3802. [PMID: 37686834 PMCID: PMC10490318 DOI: 10.3390/nu15173802] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/26/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19). COVID-19 is now recognized as a multiorgan disease with a broad spectrum of manifestations. A substantial proportion of individuals who have recovered from COVID-19 are experiencing persistent, prolonged, and often incapacitating sequelae, collectively referred to as long COVID. To date, definitive diagnostic criteria for long COVID diagnosis remain elusive. An emerging public health threat is neuropsychiatric long COVID, encompassing a broad range of manifestations, such as sleep disturbance, anxiety, depression, brain fog, and fatigue. Although the precise mechanisms underlying the neuropsychiatric complications of long COVID are presently not fully elucidated, neural cytolytic effects, neuroinflammation, cerebral microvascular compromise, breakdown of the blood-brain barrier (BBB), thrombosis, hypoxia, neurotransmitter dysregulation, and provoked neurodegeneration are pathophysiologically linked to long-term neuropsychiatric consequences, in addition to systemic hyperinflammation and maladaptation of the renin-angiotensin-aldosterone system. Vitamin D, a fat-soluble secosteroid, is a potent immunomodulatory hormone with potential beneficial effects on anti-inflammatory responses, neuroprotection, monoamine neurotransmission, BBB integrity, vasculometabolic functions, gut microbiota, and telomere stability in different phases of SARS-CoV-2 infection, acting through both genomic and nongenomic pathways. Here, we provide an up-to-date review of the potential mechanisms and pathophysiology of neuropsychiatric long COVID syndrome and the plausible neurological contributions of vitamin D in mitigating the effects of long COVID.
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Affiliation(s)
- Ting-Bin Chen
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Faculty of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
| | - I-Ju Tsai
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan;
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 11114, Taiwan
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua 50544, Taiwan
| | - Hao-Wen Yang
- Department of Family Medicine, Kuang Tien General Hospital, Taichung 433, Taiwan
| | - Chun-Pai Yang
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan;
- Department of Neurology, Kuang Tien General Hospital, Taichung 433, Taiwan
- Department of Nutrition, HungKuang University, Taichung 433, Taiwan
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan
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15
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Li Z, Zhang Z, Zhang Z, Wang Z, Li H. Cognitive impairment after long COVID-19: current evidence and perspectives. Front Neurol 2023; 14:1239182. [PMID: 37583958 PMCID: PMC10423939 DOI: 10.3389/fneur.2023.1239182] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
COVID-19, caused by the SARS-CoV-2 virus, is a respiratory infectious disease. While most patients recover after treatment, there is growing evidence that COVID-19 may result in cognitive impairment. Recent studies reveal that some individuals experience cognitive deficits, such as diminished memory and attention, as well as sleep disturbances, suggesting that COVID-19 could have long-term effects on cognitive function. Research indicates that COVID-19 may contribute to cognitive decline by damaging crucial brain regions, including the hippocampus and anterior cingulate cortex. Additionally, studies have identified active neuroinflammation, mitochondrial dysfunction, and microglial activation in COVID-19 patients, implying that these factors may be potential mechanisms leading to cognitive impairment. Given these findings, the possibility of cognitive impairment following COVID-19 treatment warrants careful consideration. Large-scale follow-up studies are needed to investigate the impact of COVID-19 on cognitive function and offer evidence to support clinical treatment and rehabilitation practices. In-depth neuropathological and biological studies can elucidate precise mechanisms and provide a theoretical basis for prevention, treatment, and intervention research. Considering the risks of the long-term effects of COVID-19 and the possibility of reinfection, it is imperative to integrate basic and clinical research data to optimize the preservation of patients' cognitive function and quality of life. This integration will also offer valuable insights for responding to similar public health events in the future. This perspective article synthesizes clinical and basic evidence of cognitive impairment following COVID-19, discussing potential mechanisms and outlining future research directions.
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Affiliation(s)
- Zhitao Li
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhen Zhang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhuoya Zhang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiyong Wang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Hao Li
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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16
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Munteanu I, Marc M, Gheorghevici C, Diaconu GA, Feraru N, Sion D, Nemes RM, Mahler B. Sleep Quality Aspects in Post-COVID-19 Patients. J Pers Med 2023; 13:1125. [PMID: 37511738 PMCID: PMC10381792 DOI: 10.3390/jpm13071125] [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: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
In this observational cohort study, sleep quality in post-COVID-19 patients was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. This study aimed to examine aspects of sleep quality in patients who have undergone SARS-CoV-2 infection and if there is a pattern of progression or regression over time (6 months). We also observed and analyzed the results in order to identify any possible links between the severity of COVID-19 and sleep quality as measured by the PSQI questionnaire. The study group consisted of 65 adult patients with confirmed SARS-CoV-2 infection who were referred to a pulmonologist for evaluation. Sleep quality was impacted at a high rate in post-COVID-19 patients, quantified by a PSQI score ≥5. Out of 65 patients, 51% of them had scores greater than or equal to 5. Sleep was subjectively reported as unsatisfactory predominantly in mild and moderate COVID-19 patients. According to the PSQI score and a 6-month follow-up, many patients presented persistency in poor sleep quality. Investigation and individualized treatment of sleep disorders in post-COVID-19 patients should be part of the routine pneumological control, as improvement in sleep quality has an impact not only on the health but also on the psychological state of patients. Educating patients about the importance of sleep and sleep quality impairment should be a primary concern.
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Affiliation(s)
- Ioana Munteanu
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Monica Marc
- Department of Pneumology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | | | - Nicolae Feraru
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Dragos Sion
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Roxana Maria Nemes
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Beatrice Mahler
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
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Maslova O, Vladimirova T, Videnin A, Gochhait S, Pyatin V. Comparative study of quality of life 9 months post-COVID-19 infection with SARS-CoV-2 of varying degrees of severity: impact of hospitalization vs. outpatient treatment. FRONTIERS IN SOCIOLOGY 2023; 8:1143561. [PMID: 37260721 PMCID: PMC10229053 DOI: 10.3389/fsoc.2023.1143561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/17/2023] [Indexed: 06/02/2023]
Abstract
Purpose This experimental study was conducted during the post-COVID-19 period to investigate the relationship between the quality of life 9 months after and the severity of the SARS-CoV-2 infection in two scenarios: hospitalization (with/without medical oxygen) and outpatient treatment. Methods We employed the EQ-5D-5L Quality of Life tests and the PSQI as a survey to evaluate respondents' quality of life 9 months after a previous SARS-CoV-2 infection of varying severity. Results We identified a clear difference in the quality of life of respondents, as measured on the 100-point scale of the EQ-5D-5L test, which was significantly lower 9 months after a previous SARS-CoV-2 infection for Group 1 (n = 14), respondents who had received medical attention for SARS-CoV-2 infection in a hospital with oxygen treatment, compared to those with the SARS-CoV-2 infection who were treated without oxygen treatment (Group 2) (n = 12) and those who were treated on an outpatient basis (Group 3) (n = 13) (H = 7.08 p = 0.029). There were no intergroup differences in quality of life indicators between hospitalized patients (Group 2) and groups 1 and 3. PSQI survey results showed that "mobility," "self-care," "daily activities," "pain/discomfort," and "anxiety/ depression" did not differ significantly between the groups, indicating that these factors were not associated with the severity of the SARS-CoV-2 infection. On the contrary, the respondents demonstrated significant inter-group differences (H = 7.51 p = 0.023) and the interdependence of respiratory difficulties with the severity of clinically diagnosed SARS-CoV-2 infection. This study also demonstrated significant differences in the values of sleep duration, sleep disorders, and daytime sleepiness indicators between the three groups of respondents, which indicate the influence of the severity of the infection. The PSQI test results revealed significant differences in "bedtime" (H = 6.00 p = 0.050) and "wake-up time" (H = 11.17 p = 0.004) between Groups 1 and 3 of respondents. At 9 months after COVID-19, respondents in Group 1 went to bed at a later time (pp = 0.02727) and woke up later (p = 0.003) than the respondents in Group 3. Conclusion This study is the first of its kind in the current literature to report on the quality of life of respondents 9 months after being diagnosed with COVID-19 and to draw comparisons between cohorts of hospitalized patients who were treated with medical oxygen vs. the cohorts of outpatient patients. The study's findings regarding post-COVID-19 quality of life indicators and their correlation with the severity of the SARS-CoV-2 infection can be used to categorize patients for targeted post-COVID-19 rehabilitation programs.
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Affiliation(s)
- Olga Maslova
- Neurosociology Laboratory, Neurosciences Research Institute, Samara State Medical University, Samara, Russia
| | - Tatiana Vladimirova
- Department of Otorhinolaryngology, Samara State Medical University, Samara, Russia
| | - Arseny Videnin
- Institute of Clinical Medicine, Samara State Medical University, Samara, Russia
| | - Saikat Gochhait
- Neurosociology Laboratory, Neurosciences Research Institute, Samara State Medical University, Samara, Russia
- Symbiosis International (Deemed University), Pune, India
| | - Vasily Pyatin
- Neurosociology Laboratory, Neurosciences Research Institute, Samara State Medical University, Samara, Russia
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Shaik L, Boike S, Ramar K, Subramanian S, Surani S. COVID-19 and Sleep Disturbances: A Literature Review of Clinical Evidence. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050818. [PMID: 37241050 DOI: 10.3390/medicina59050818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 05/28/2023]
Abstract
The need for adequate good quality sleep to optimally function is well known. Over years, various physical, psychological, biological, and social factors have been investigated to understand their impact on sleep. However, understanding the etiological processes that are involved in causing sleep disturbances (SD) as impacted by stressful phases such as pandemics has not been well studied. Many such etiological and management strategies have surfaced during the latest "coronavirus disease of 2019 (COVID-19) pandemic. The occurrence of these SD in the infected and uninfected individuals poses a need to investigate factors linked to such occurrence during this phase. Some of such factors include stressful practices such as social distancing, masking, vaccines, and medications availability, changes in routines, and lifestyles. As the status of infection improved, a collective term for all the prolonged effects of COVID-19 after the resolution of the primary infection called the post-COVID-19 syndrome (PCS) surfaced. Apart from impacting sleep during the infectious phase, the aftereffects of this virus left an even greater impact during the PCS. Various mechanisms have been hypothesized to be linked to such SD during the PCS, but the available data are inconclusive. Further, the varied patterns of incidence of these SDs differed by many factors, such as age, gender, and geographical location, making clinical management even more challenging. This review elucidates the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease on sleep health during the various phases of the COVID-19 pandemic. We also investigate different causal relationships, management strategies, and knowledge gaps related to SD during the COVID-19 pandemic.
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Affiliation(s)
- Likhita Shaik
- Department of Family Medicine, Hennepin Healthcare, Minneapolis, MN 55415, USA
| | - Sydney Boike
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | | | | | - Salim Surani
- Department of Pulmonary, Critical Care and Sleep Medicine, Texas A&M University, College Station, TX 77843, USA
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