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Björkdahl A, Gustafsson M, Öhlén H, Jarl S, Santos Tavares Silva I. Exploring the impact of cognitive dysfunction, fatigue, and shortness of breath on activities of daily life after COVID-19 infection, until 1-year follow-up. J Rehabil Med 2024; 56:jrm35403. [PMID: 38915292 PMCID: PMC11218676 DOI: 10.2340/jrm.v56.35403] [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] [Accepted: 05/06/2024] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVE Despite expanding knowledge on COVID-19, the long-term effects on daily-life activities remain unclear. The prevalence and changes in fatigue, cognitive dysfunction, and activity limitations in the first year after COVID-19 infection in hospitalized and non-hospitalized patients were explored. SUBJECTS A total of 122 patients were recruited from hospital care and 90 from primary care. METHOD Baseline data comprised the Montreal Cognitive Assessment and Trail Making Test. Participants were followed up at 3 and 12 months using these tests and a semi-structured interview to identify symptoms and how they affected participation in daily-life activities. Both within- and between-group analyses were performed to explore changes over time and compare groups. RESULT High levels of fatigue and cognitive dysfunction were found in both groups, which persisted for 12 months. A significant impact on daily-life activities was also observed, with marginal change at the 12-month follow-up. The hospital care group performed worse than the primary care group in the cognitive tests, although the primary care group perceived a higher level of fatigue and cognitive dysfunction. Activity limitations were higher in the primary care group than in the hospital care group. CONCLUSION These findings highlight the need for long-term follow-up and further investigation of the impact of persistent deficits on rehabilitation.
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Affiliation(s)
- Ann Björkdahl
- Sahlgrenska University Hospital, Occupational Therapy and Physiotherapy, Gothenburg, Sweden; University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden.
| | - Marie Gustafsson
- Sahlgrenska University Hospital, Occupational Therapy and Physiotherapy, Gothenburg, Sweden
| | - Hilda Öhlén
- Sahlgrenska University Hospital, Occupational Therapy and Physiotherapy, Gothenburg, Sweden
| | - Sara Jarl
- Primary care rehabilitation, Region of Västra Götaland, Gothenburg, Sweden
| | - Iolanda Santos Tavares Silva
- Sahlgrenska University Hospital, Occupational Therapy and Physiotherapy, Gothenburg, Sweden; University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Gothenburg, Sweden
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Badinlou F, Abzhandadze T, Rahimian F, Jansson-Fröjmark M, Hedman-Lagerlöf M, Lundgren T. Investigating the trajectory of post-COVID impairments: a longitudinal study in Sweden. Front Psychol 2024; 15:1402750. [PMID: 38915427 PMCID: PMC11195806 DOI: 10.3389/fpsyg.2024.1402750] [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: 03/18/2024] [Accepted: 05/23/2024] [Indexed: 06/26/2024] Open
Abstract
Introduction Individuals recovering from COVID-19 often experience a range of post-recovery symptoms. However, the literature on post-COVID-19 symptoms reveals conflicting results, necessitating a heightened focus on longitudinal studies to comprehend the trajectory of impairments over time. Our study aimed to investigate changes in long-term impairments among individuals infected with COVID-19 and explore potential predictors influencing these changes. Methods We conducted a web-survey targeting individuals that had been infected with COVID-19 at four time-points: T0 (baseline), T1 (three months), T2 (six months), and T3 (twelve months). The survey included contextual factors, factors related to body functions and structures, and post-COVID impairments. The longitudinal sample included 213 individuals (with a mean age of 48.92 years). Linear mixed models were employed to analyze changes in post-COVID impairments over time and identify impacting factors. Results Findings revealed a general decline in post-COVID impairments over time, with each symptom exhibiting a dynamic pattern of fluctuations. Factors such as initial infection severity, education level, and work status were significantly associated with the levels of impairments. Discussion The study emphasizes that post-COVID impairments are not static but exhibit variations over time. Personalized care, especially for vulnerable populations, is crucial. The results underscore the need for long-term monitoring and multidisciplinary treatment approaches. Targeted support and interventions are highlighted for individuals with severe initial infections and those in socioeconomically disadvantaged groups.
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Affiliation(s)
- Farzaneh Badinlou
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Medical Unit Allied Health Professionals, Women’s Health and Allied Health Professionals Theme, Karolinska University Hospital, Solna, Sweden
| | - Tamar Abzhandadze
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Fatemeh Rahimian
- Research Institutes of Sweden, Department of Computer Science, Stockholm, Sweden
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Maria Hedman-Lagerlöf
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tobias Lundgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Guillén N, Pérez-Millan A, Falgàs N, Lledó-Ibáñez GM, Rami L, Sarto J, Botí MA, Arnaldos-Pérez C, Ruiz-García R, Naranjo L, Segura B, Balasa M, Sala-Llonch R, Lladó A, Gray SM, Johannesen JK, Pantoni MM, Rutledge GA, Sawant R, Wang Y, Watson LS, Dalmau J, Sanchez-Valle R. Cognitive profile, neuroimaging and fluid biomarkers in post-acute COVID-19 syndrome. Sci Rep 2024; 14:12927. [PMID: 38839833 PMCID: PMC11153491 DOI: 10.1038/s41598-024-63071-2] [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: 11/16/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
We aimed to characterize the cognitive profile of post-acute COVID-19 syndrome (PACS) patients with cognitive complaints, exploring the influence of biological and psychological factors. Participants with confirmed SARS-CoV-2 infection and cognitive complaints ≥ 8 weeks post-acute phase were included. A comprehensive neuropsychological battery (NPS) and health questionnaires were administered at inclusion and at 1, 3 and 6 months. Blood samples were collected at each visit, MRI scan at baseline and at 6 months, and, optionally, cerebrospinal fluid. Cognitive features were analyzed in relation to clinical, neuroimaging, and biochemical markers at inclusion and follow-up. Forty-nine participants, with a mean time from symptom onset of 10.4 months, showed attention-executive function (69%) and verbal memory (39%) impairment. Apathy (64%), moderate-severe anxiety (57%), and severe fatigue (35%) were prevalent. Visual memory (8%) correlated with total gray matter (GM) and subcortical GM volume. Neuronal damage and inflammation markers were within normal limits. Over time, cognitive test scores, depression, apathy, anxiety scores, MRI indexes, and fluid biomarkers remained stable, although fewer participants (50% vs. 75.5%; p = 0.012) exhibited abnormal cognitive evaluations at follow-up. Altered attention/executive and verbal memory, common in PACS, persisted in most subjects without association with structural abnormalities, elevated cytokines, or neuronal damage markers.
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Affiliation(s)
- Núria Guillén
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Institut de Neurociències, Faculty of Medicine and Medical Sciences, University of Barcelona, Barcelona, Spain
- Department of Biomedicine, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | | | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Jordi Sarto
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Maria A Botí
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Cristina Arnaldos-Pérez
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Ruiz-García
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laura Naranjo
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Bàrbara Segura
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Institut de Neurociències, Faculty of Medicine and Medical Sciences, University of Barcelona, Barcelona, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
| | - Roser Sala-Llonch
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Institut de Neurociències, Faculty of Medicine and Medical Sciences, University of Barcelona, Barcelona, Spain
- Department of Biomedicine, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Institut de Neurociències, Faculty of Medicine and Medical Sciences, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Yi Wang
- Sage Therapeutics, Cambridge, USA
| | | | - Josep Dalmau
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain
- Institut de Neurociències, Faculty of Medicine and Medical Sciences, University of Barcelona, Barcelona, Spain
- Department of Neurology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Enfermedades Raras, Centro de Investigación Biomédica en Red, Madrid, Spain
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Catalan Institute for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Service of Neurology, Hospital Clínic de Barcelona, Barcelona, Spain.
- Fundació Recerca Clínic Barcelona-IDIBAPS, Barcelona, Spain.
- Institut de Neurociències, Faculty of Medicine and Medical Sciences, University of Barcelona, Barcelona, Spain.
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Song X, Song W, Cui L, Duong TQ, Pandy R, Liu H, Zhou Q, Sun J, Liu Y, Li T. A Comprehensive Review of the Global Epidemiology, Clinical Management, Socio-Economic Impacts, and National Responses to Long COVID with Future Research Directions. Diagnostics (Basel) 2024; 14:1168. [PMID: 38893693 PMCID: PMC11171614 DOI: 10.3390/diagnostics14111168] [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: 04/24/2024] [Revised: 05/14/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID's epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management; Conclusions: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Addressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.
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Affiliation(s)
- Xiufang Song
- National Science Library, Chinese Academy of Sciences, Beijing 100190, China;
- Department of Information Resources Management, School of Economics and Management, University of Chinese Academy of Sciences, Beijing 100190, China
| | - Weiwei Song
- Jiangsu Taizhou People’s Hospital, Taizhou 225306, China;
- School of Integrative Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
| | - Lizhen Cui
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China;
| | - Tim Q. Duong
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA;
| | - Rajiv Pandy
- Indian Council of Forestry Research & Education, Dehradun 248006, India;
| | - Hongdou Liu
- Centre for Planetary Health and Food Security, School of Environment and Science, Griffith University, Nathan, Brisbane, QLD 4111, Australia;
| | - Qun Zhou
- Department of Library, China Agricultural University (East Campus), 17 Qinghua East Road, Haidian District, Beijing 100193, China; (Q.Z.); (J.S.)
| | - Jiayao Sun
- Department of Library, China Agricultural University (East Campus), 17 Qinghua East Road, Haidian District, Beijing 100193, China; (Q.Z.); (J.S.)
| | - Yanli Liu
- National Science Library, Chinese Academy of Sciences, Beijing 100190, China;
- Department of Information Resources Management, School of Economics and Management, University of Chinese Academy of Sciences, Beijing 100190, China
| | - Tong Li
- School of Agriculture and Food Sustainability, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia
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Geny M, Andres E, Talha S, Geny B. Liability of Health Professionals Using Sensors, Telemedicine and Artificial Intelligence for Remote Healthcare. SENSORS (BASEL, SWITZERLAND) 2024; 24:3491. [PMID: 38894282 PMCID: PMC11174849 DOI: 10.3390/s24113491] [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: 03/28/2024] [Revised: 05/17/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
In the last few decades, there has been an ongoing transformation of our healthcare system with larger use of sensors for remote care and artificial intelligence (AI) tools. In particular, sensors improved by new algorithms with learning capabilities have proven their value for better patient care. Sensors and AI systems are no longer only non-autonomous devices such as the ones used in radiology or surgical robots; there are novel tools with a certain degree of autonomy aiming to largely modulate the medical decision. Thus, there will be situations in which the doctor is the one making the decision and has the final say and other cases in which the doctor might only apply the decision presented by the autonomous device. As those are two hugely different situations, they should not be treated the same way, and different liability rules should apply. Despite a real interest in the promise of sensors and AI in medicine, doctors and patients are reluctant to use it. One important reason is a lack clear definition of liability. Nobody wants to be at fault, or even prosecuted, because they followed the advice from an AI system, notably when it has not been perfectly adapted to a specific patient. Fears are present even with simple sensors and AI use, such as during telemedicine visits based on very useful, clinically pertinent sensors; with the risk of missing an important parameter; and, of course, when AI appears "intelligent", potentially replacing the doctors' judgment. This paper aims to provide an overview of the liability of the health professional in the context of the use of sensors and AI tools in remote healthcare, analyzing four regimes: the contract-based approach, the approach based on breach of duty to inform, the fault-based approach, and the approach related to the good itself. We will also discuss future challenges and opportunities in the promising domain of sensors and AI use in medicine.
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Affiliation(s)
- Marie Geny
- Joint Research Unit-UMR 7354, Law, Religion, Business and Society, University of Strasbourg, 67000 Strasbourg, France;
| | - Emmanuel Andres
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (E.A.); (S.T.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France
- Department of Internal Medicine, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Samy Talha
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (E.A.); (S.T.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France
- Department of Physiology and Functional Explorations, University Hospital of Strasbourg, 67091 Strasbourg, France
| | - Bernard Geny
- Biomedicine Research Center of Strasbourg (CRBS), UR 3072, “Mitochondria, Oxidative Stress and Muscle Plasticity”, University of Strasbourg, 67000 Strasbourg, France; (E.A.); (S.T.)
- Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France
- Department of Physiology and Functional Explorations, University Hospital of Strasbourg, 67091 Strasbourg, France
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Riou M, Coste F, Meyer A, Enache I, Talha S, Charloux A, Reboul C, Geny B. Mechanisms of Pulmonary Vasculopathy in Acute and Long-Term COVID-19: A Review. Int J Mol Sci 2024; 25:4941. [PMID: 38732160 PMCID: PMC11084496 DOI: 10.3390/ijms25094941] [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: 03/27/2024] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Despite the end of the pandemic, coronavirus disease 2019 (COVID-19) remains a major public health concern. The first waves of the virus led to a better understanding of its pathogenesis, highlighting the fact that there is a specific pulmonary vascular disorder. Indeed, COVID-19 may predispose patients to thrombotic disease in both venous and arterial circulation, and many cases of severe acute pulmonary embolism have been reported. The demonstrated presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the endothelial cells suggests that direct viral effects, in addition to indirect effects of perivascular inflammation and coagulopathy, may contribute to pulmonary vasculopathy in COVID-19. In this review, we discuss the pathological mechanisms leading to pulmonary vascular damage during acute infection, which appear to be mainly related to thromboembolic events, an impaired coagulation cascade, micro- and macrovascular thrombosis, endotheliitis and hypoxic pulmonary vasoconstriction. As many patients develop post-COVID symptoms, including dyspnea, we also discuss the hypothesis of pulmonary vascular damage and pulmonary hypertension as a sequela of the infection, which may be involved in the pathophysiology of long COVID.
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Affiliation(s)
- Marianne Riou
- Translational Medicine Federation of Strasbourg (FMTS), University of Strasbourg, CRBS, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 1 rue Eugène Boeckel, CS 60026, 67084 Strasbourg, France; (M.R.); (A.M.); (I.E.); (S.T.); (A.C.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 1 Place de l’hôpital, 67091 Strasbourg, France
| | - Florence Coste
- EA4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, UFR Sciences Technologies Santé, Pôle Sport et Recherche, 74 rue Louis Pasteur, 84000 Avignon, France; (F.C.); (C.R.)
| | - Alain Meyer
- Translational Medicine Federation of Strasbourg (FMTS), University of Strasbourg, CRBS, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 1 rue Eugène Boeckel, CS 60026, 67084 Strasbourg, France; (M.R.); (A.M.); (I.E.); (S.T.); (A.C.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 1 Place de l’hôpital, 67091 Strasbourg, France
| | - Irina Enache
- Translational Medicine Federation of Strasbourg (FMTS), University of Strasbourg, CRBS, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 1 rue Eugène Boeckel, CS 60026, 67084 Strasbourg, France; (M.R.); (A.M.); (I.E.); (S.T.); (A.C.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 1 Place de l’hôpital, 67091 Strasbourg, France
| | - Samy Talha
- Translational Medicine Federation of Strasbourg (FMTS), University of Strasbourg, CRBS, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 1 rue Eugène Boeckel, CS 60026, 67084 Strasbourg, France; (M.R.); (A.M.); (I.E.); (S.T.); (A.C.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 1 Place de l’hôpital, 67091 Strasbourg, France
| | - Anne Charloux
- Translational Medicine Federation of Strasbourg (FMTS), University of Strasbourg, CRBS, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 1 rue Eugène Boeckel, CS 60026, 67084 Strasbourg, France; (M.R.); (A.M.); (I.E.); (S.T.); (A.C.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 1 Place de l’hôpital, 67091 Strasbourg, France
| | - Cyril Reboul
- EA4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, UFR Sciences Technologies Santé, Pôle Sport et Recherche, 74 rue Louis Pasteur, 84000 Avignon, France; (F.C.); (C.R.)
| | - Bernard Geny
- Translational Medicine Federation of Strasbourg (FMTS), University of Strasbourg, CRBS, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 1 rue Eugène Boeckel, CS 60026, 67084 Strasbourg, France; (M.R.); (A.M.); (I.E.); (S.T.); (A.C.)
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 1 Place de l’hôpital, 67091 Strasbourg, France
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Emerson ND, Lavretsky H, Pittman WQ, Viswanathan N, Siddarth P. An open trial of biofeedback for long COVID. J Psychosom Res 2024; 179:111625. [PMID: 38458016 DOI: 10.1016/j.jpsychores.2024.111625] [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: 04/24/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE Biofeedback is a therapeutic treatment model that teaches self-regulation of autonomic functions to alleviate stress-related symptoms. "Long COVID" refers to chronic physical and cognitive sequelae post-SARS-CoV-2 infection. This study examined the efficacy of a six-week intervention, consisting of weekly one-hour sessions combining heart rate variability and temperature biofeedback, for alleviating mood symptoms, somatic symptoms and sleep disturbance of patients diagnosed with long COVID. METHODS Data were collected from 20 adult participants aged 22-63 (Mage = 44.1, SDage = 12.2) with varying long COVID symptoms. Within this single arm design, 16 of the 20 participants completed all six sessions of biofeedback; 14 completed an assessment at the three-month post-treatment time point. RESULTS Participants self-reported significant improvements in somatic, anxiety, and depressive symptoms, sleep quality, quality of life, and number of "bad days" immediately after the intervention and three months later (Cohen's d effect size (ES) = 1.09-0.46). Reduced number of medical doctor visits (ES = 0.85) and prescription drug use over the last month (odds ratio = 0.33), as well as improved emotional wellbeing (ES = 0.97) were observed at the three-month time point only. CONCLUSION Results suggest that this short, readily scalable intervention can be potentially efficacious in alleviating symptoms of long COVID. Despite notable improvements, the major limitation of this study is its lack of control group. While a randomized trial merits study, biofeedback appears to be a brief, effective, non-invasive, and low-cost treatment option for patients with chronic somatic symptoms secondary to SARS-CoV-2 infection. CLINICALTRIALS govID: NCT05120648.
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Affiliation(s)
- Natacha D Emerson
- UCLA Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, United States.
| | - Helen Lavretsky
- UCLA Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - William Q Pittman
- UCLA Department of Medicine, David Geffen School of Medicine, United States
| | - Nisha Viswanathan
- UCLA Department of Medicine, David Geffen School of Medicine, United States
| | - Prabha Siddarth
- UCLA Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, United States
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Ceklarz J. Symptom intensity of post-COVID and long COVID syndromes in patients entering rehabilitation treatment. Reumatologia 2024; 62:18-25. [PMID: 38558899 PMCID: PMC10979377 DOI: 10.5114/reum/183912] [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: 10/22/2023] [Accepted: 02/09/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction The problem of post-COVID symptoms is still being analysed. Many of them may be related to other conditions, but the new appearance and greater intensity of some of them, e.g. fatigue, musculoskeletal pain, and neuropathic pain, seem to be related to a previous viral infection. Efforts are being made to determine in more detail the most characteristic symptoms of post-COVID syndrome. The conditions of rehabilitation after COVID-19 provide an opportunity for such observations. In rehabilitation centres and sanatoriums, it is possible to compare patients with post-COVID syndrome and other patients referred for rehabilitation, who constitute a natural control group. Such a comparison is the aim of the present work. Material and methods The study included 59 post-COVID-19 patients and 57 sanatorium patients without COVID (non-COVID group) as a control group. The 31-element questionnaire ("Post-COVID syndrome symptoms assessment card") was part of the routine management of post-COVID patients referred for rehabilitation after symptomatic SARS-CoV-2 infection in Polish conditions. In the control group, the questionnaire was introduced as a part of a physical examination and an interview regarding the symptoms reported by the patient before standard rehabilitation. The questions were scored in the scale from 0 to a maximum of 10 points. Each patient gave informed consent to the use of the questionnaire for research purposes. Results Symptoms of the highest intensity in the COVID-19 group were: feeling unwell after physical effort (avg. 6.25 points), chronic fatigue (avg. 5.97 points), dyspnoea on exertion (avg. 5.83 points), concentration disturbances (avg. 4.93), muscle pain (avg. 4.92), joint pain (avg. 4.86), memory disorders (avg. 4.81 points), sleep disorders (avg. 4.05 points), numbness of the limbs (avg. 3.73 points), tingling in the limbs (avg. 3.68 points).Symptoms of highest intensity in patients in the non-COVID-19 group: joint pain (avg. 4.61 points), tingling in the limbs (avg. 2.84 points), numbness of the limbs (avg. 2.79 points), muscle pain (avg. 2.11 points).There was no statistically significant difference between the group under examination and the control group in the following symptoms: fever, diarrhoea, abdominal pain, resting dyspnoea, olfactory disorders, joint pain, tingling in the limbs and numbness of the limbs. Conclusions The results of this study show symptoms of the highest intensity with post-COVID syndromes. However, also symptoms that are a problem both in post-COVID and non-COVID patients, i.e. joint pain, tingling in and numbness of the limbs were identified. This confirms that the control non-COVID group consisted of patients referred for rehabilitation treatment mainly due to musculoskeletal problems and chronic pain.
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Affiliation(s)
- Jan Ceklarz
- Department of Systemic Rehabilitation, Rabka Sanatorium, Poland
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9
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Manta A, Michelakis I, Dafni M, Spanoudaki A, Krontira S, Tsoutsouras T, Flessa K, Papadopoulos C, Mantzos D, Tzavara V. Long-term outcomes, residual symptoms and quality of life in COVID-19 hospitalized patients: A 12-month longitudinal study. J Investig Med 2024; 72:193-201. [PMID: 37916444 DOI: 10.1177/10815589231212899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
The long-term impact of the coronavirus disease 2019 (COVID-19) pandemic is a critical public health concern. The presence of residual symptoms in COVID-19 survivors has been investigated with various results; however, there is limited data documenting outcomes longer than 6 months post-hospitalization. We aimed to investigate the 12-month lasting effects of COVID-19 in hospitalized patients. From October 2020 through March 2021, 92 patients were enrolled. At admission and 1, 3, 6, and 12 months post-hospitalization, demographic, clinical, laboratory and imaging data, and echocardiography and spirometry test results were recorded. Possible cognitive and functional impairment, as well as the quality of life (QoL), were also assessed. In our cohort (median age: 61 years), 31.5% had severe disease at admission, which correlated with worse laboratory findings and a longer hospital stay (p < 0.001). Inflammatory markers were associated with severity initially, but reverted to normal after 3 months. In total, 55%, 37%, 19%, and 15.5% of patients reported at least one persistent symptom in months 1, 3, 6, and 12, respectively, while "brain fog" persisted up to 12 months in 10% of patients. Spirometry and echocardiography tests returned to normal in most patients during the evaluation, and no one had substantial residual disease. Our study provides insight into the long-term effects of COVID-19 on patients' physical and mental health. Despite the lack of significant residual disease or major complications after a year of thorough follow-up, COVID-19 survivors experienced lasting symptoms and a negative impact on their QoL.
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Affiliation(s)
- Aspasia Manta
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | - Ioannis Michelakis
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | - Maria Dafni
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | - Anastasia Spanoudaki
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | - Sofia Krontira
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | | | - Konstantina Flessa
- First Department of Cardiology, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | | | - Dionysios Mantzos
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
| | - Vasiliki Tzavara
- First Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece
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Fernandez-de-Las-Peñas C, Notarte KI, Macasaet R, Velasco JV, Catahay JA, Ver AT, Chung W, Valera-Calero JA, Navarro-Santana M. Persistence of post-COVID symptoms in the general population two years after SARS-CoV-2 infection: A systematic review and meta-analysis. J Infect 2024; 88:77-88. [PMID: 38101521 DOI: 10.1016/j.jinf.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE This meta-analysis investigated the prevalence of post-COVID symptoms two-years after SARS-CoV-2 infection. METHODS Electronic literature searches on PubMed, MEDLINE, CINAHL, EMBASE, Web of Science databases, and on medRxiv/bioRxiv preprint servers were conducted up to October 1, 2023. Studies reporting data on post-COVID symptoms at two-years after infection were included. Methodological quality was assessed using the Newcastle-Ottawa Scale. Random-effects models were used for meta-analytical pooled prevalence of each symptom. RESULTS From 742 studies identified, twelve met inclusion criteria. The sample included 7912 COVID-19 survivors (50.7% female; age: 59.5, SD: 16.3). Post-COVID symptoms were assessed at a follow-up of 722.9 (SD: 51.5) days after. The overall methodological quality of studies was moderate (mean: 6/10, SD: 1.2 points). The most prevalent post-COVID symptoms two-years after SARS-CoV-2 infection were fatigue (28.0%, 95%CI 12.0-47.0), cognitive impairments (27.6%, 95%CI 12.6-45.8), and pain (8.4%, 95%CI 4.9-12.8). Psychological disturbances such as anxiety (13.4%, 95%CI 6.3-22.5) and depressive (18.0%, 95%CI 4.8-36.7) levels as well as sleep problems (20.9%, 95%CI 5.25-43.25) were also prevalent. Pooled data showed high heterogeneity (I2 ≥ 75%). CONCLUSION This meta-analysis shows the presence of post-COVID symptoms in 30% of patients two-years after COVID-19. Fatigue, cognitive disorders, and pain were the most prevalent post-COVID symptoms. Psychological disturbances as well as sleep problems were still present two-years after COVID-19.
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Affiliation(s)
- Cesar Fernandez-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Madrid, Spain.
| | - Kin Israel Notarte
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Raymart Macasaet
- Department of Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA
| | | | - Jesus Alfonso Catahay
- Department of Medicine, Saint Peter's University Hospital, New Brunswick, NJ 08901, USA
| | - Abbygail Therese Ver
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila 1008, Philippines
| | - William Chung
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Juan A Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Marcos Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid (UCM), Madrid, Spain
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Kwon J, Milne R, Rayner C, Rocha Lawrence R, Mullard J, Mir G, Delaney B, Sivan M, Petrou S. Impact of Long COVID on productivity and informal caregiving. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023:10.1007/s10198-023-01653-z. [PMID: 38146040 DOI: 10.1007/s10198-023-01653-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/21/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Around 2 million people in the UK suffer from Long COVID (LC). Of concern is the disease impact on productivity and informal care burden. This study aimed to quantify and value productivity losses and informal care receipt in a sample of LC patients in the UK. METHODS The target population comprised LC patients referred to LC specialist clinics. The questionnaires included a health economics questionnaire (HEQ) measuring productivity impacts, informal care receipt and service utilisation, EQ-5D-5L, C19-YRS LC condition-specific measure, and sociodemographic and COVID-19 history variables. Outcomes were changes from the incident infection resulting in LC to the month preceding the survey in paid work status/h, work income, work performance and informal care receipt. The human capital approach valued productivity losses; the proxy goods method valued caregiving hours. The values were extrapolated nationally using published prevalence data. Multilevel regressions, nested by region, estimated associations between the outcomes and patient characteristics. RESULTS 366 patients responded to HEQ (mean LC duration 449.9 days). 51.7% reduced paid work hours relative to the pre-infection period. Mean monthly work income declined by 24.5%. The average aggregate value of productivity loss since incident infection was £10,929 (95% bootstrap confidence interval £8,844-£13,014) and £5.7 billion (£3.8-£7.6 billion) extrapolated nationally. The corresponding values for informal caregiving were £8,726 (£6,247-£11,204) and £4.8 billion (£2.6-£7.0 billion). Multivariate analyses found significant associations between each outcome and health utility and C19-YRS subscale scores. CONCLUSION LC significantly impacts productivity losses and provision of informal care, exacerbated by high national prevalence of LC.
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Affiliation(s)
- Joseph Kwon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England.
| | - Ruairidh Milne
- Public Health, Wessex Institute, University of Southampton, Southampton, England
| | - Clare Rayner
- Locomotion Patient Advisory Group (Co-Lead), University of Leeds, Leeds, England
| | | | - Jordan Mullard
- School of Medicine, University of Leeds, Leeds, England
- Department of Sociology, University of Durham, Durham, England
| | - Ghazala Mir
- School of Medicine, University of Leeds, Leeds, England
| | - Brendan Delaney
- Department of Surgery and Cancer, Imperial College London, London, England
| | - Manoj Sivan
- Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, England
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England
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Kromydas T, Demou E, Edge R, Gittins M, Katikireddi SV, Pearce N, van Tongeren M, Wilkinson J, Rhodes S. Occupational differences in the prevalence and severity of long-COVID: analysis of the Coronavirus (COVID-19) Infection Survey. Occup Environ Med 2023; 80:545-552. [PMID: 37770179 PMCID: PMC7615205 DOI: 10.1136/oemed-2023-108930] [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: 03/27/2023] [Accepted: 08/08/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To establish whether prevalence and severity of long-COVID symptoms vary by industry and occupation. METHODS We used Office for National Statistics COVID-19 Infection Survey (CIS) data (February 2021-April 2022) of working-age participants (16-65 years). Exposures were industry, occupation and major Standard Occupational Classification (SOC) group. Outcomes were self-reported: (1) long-COVID symptoms and (2) reduced function due to long-COVID. Binary (outcome 1) and ordered (outcome 2) logistic regression were used to estimate odds ratios (OR)and prevalence (marginal means). RESULTS Public facing industries, including teaching and education, social care, healthcare, civil service, retail and transport industries and occupations, had the highest likelihood of long-COVID. By major SOC group, those in caring, leisure and other services (OR 1.44, 95% CIs 1.38 to 1.52) had substantially elevated odds than average. For almost all exposures, the pattern of ORs for long-COVID symptoms followed SARS-CoV-2 infections, except for professional occupations (eg, some healthcare, education, scientific occupations) (infection: OR<1 ; long-COVID: OR>1). The probability of reporting long-COVID for industry ranged from 7.7% (financial services) to 11.6% (teaching and education); whereas the prevalence of reduced function by 'a lot' ranged from 17.1% (arts, entertainment and recreation) to 22%-23% (teaching and education and armed forces) and to 27% (not working). CONCLUSIONS The risk and prevalence of long-COVID differs across industries and occupations. Generally, it appears that likelihood of developing long-COVID symptoms follows likelihood of SARS-CoV-2 infection, except for professional occupations. These findings highlight sectors and occupations where further research is needed to understand the occupational factors resulting in long-COVID.
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Affiliation(s)
- Theocharis Kromydas
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rhiannon Edge
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Matthew Gittins
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | - Srinivasa Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Neil Pearce
- Faculty of Public Health, London School of Hygiene & Tropical Medicine, London, UK
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
- Thomas Ashton Institute for Risk and Regulatory Research, The University of Manchester, Manchester, UK
| | - Jack Wilkinson
- Centre for Biostatistics, The University of Manchester, Manchester, UK
| | - Sarah Rhodes
- Centre for Biostatistics, The University of Manchester, Manchester, UK
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13
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Talha S, Lamrous S, Kassegne L, Lefebvre N, Zulfiqar AA, Tran Ba Loc P, Geny M, Meyer N, Hajjam M, Andrès E, Geny B. Early Hospital Discharge Using Remote Monitoring for Patients Hospitalized for COVID-19, Regardless of Need for Home Oxygen Therapy: A Descriptive Study. J Clin Med 2023; 12:5100. [PMID: 37568502 PMCID: PMC10419442 DOI: 10.3390/jcm12155100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
AIM Since beds are unavailable, we prospectively investigated whether early hospital discharge will be safe and useful in patients hospitalized for COVID-19, regardless of their need for home oxygen therapy. POPULATION AND METHODS Extending the initial inclusion criteria, 62 patients were included and 51 benefited from home telemonitoring, mainly assessing clinical parameters (blood pressure, heart rate, respiratory rate, dyspnea, temperature) and peripheral saturation (SpO2) at follow-up. RESULTS 47% of the patients were older than 65 years; 63% needed home oxygen therapy and/or presented with more than one comorbidity. At home, the mean time to dyspnea and tachypnea resolutions ranged from 21 to 24 days. The mean oxygen-weaning duration was 13.3 ± 10.4 days, and the mean SpO2 was 95.7 ± 1.6%. The nurses and/or doctors managed 1238 alerts. Two re-hospitalizations were required, related to transient chest pain or pulmonary embolism, but no death occurred. Patient satisfaction was good, and 743 potential days of hospitalization were saved for other patients. CONCLUSION The remote monitoring of vital parameters and symptoms is safe, allowing for early hospital discharge in patients hospitalized for COVID-19, whether or not home oxygen therapy was required. Oxygen tapering outside the hospital allowed for a greater reduction in hospital stay. Randomized controlled trials are necessary to confirm this beneficial effect.
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Affiliation(s)
- Samy Talha
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67000 Strasbourg, France;
- Research Team 3072 “Mitochondria, Oxidative Stress and Muscle”, University of Strasbourg, 90032 Strasbourg, France;
| | - Sid Lamrous
- UTBM, CNRS, FEMTO-ST Institute, 90000 Belfort, France;
| | - Loic Kassegne
- Pneumology Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Nicolas Lefebvre
- Infectious Disease Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Abrar-Ahmad Zulfiqar
- Internal Medicine Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Pierre Tran Ba Loc
- Public Health Department, University Hospital Strasbourg, 67000 Strasbourg, France; (P.T.B.L.); (N.M.)
| | - Marie Geny
- Association for Assistance to Victims, Place Alfred de Musset, BP 3314, CEDEX, 27033 Evreux, France;
| | - Nicolas Meyer
- Public Health Department, University Hospital Strasbourg, 67000 Strasbourg, France; (P.T.B.L.); (N.M.)
| | | | - Emmanuel Andrès
- Research Team 3072 “Mitochondria, Oxidative Stress and Muscle”, University of Strasbourg, 90032 Strasbourg, France;
- Internal Medicine Department, University Hospital Strasbourg, 67000 Strasbourg, France;
| | - Bernard Geny
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, 67000 Strasbourg, France;
- Research Team 3072 “Mitochondria, Oxidative Stress and Muscle”, University of Strasbourg, 90032 Strasbourg, France;
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14
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Kerksieck P, Ballouz T, Haile SR, Schumacher C, Lacy J, Domenghino A, Fehr JS, Bauer GF, Dressel H, Puhan MA, Menges D. Post COVID-19 condition, work ability and occupational changes in a population-based cohort. THE LANCET REGIONAL HEALTH. EUROPE 2023:100671. [PMID: 37366496 PMCID: PMC10287546 DOI: 10.1016/j.lanepe.2023.100671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
Background Evidence on the impact of post COVID-19 condition (PCC) on work ability is limited but critical due to its high prevalence among working-age individuals. This study aimed to evaluate the association between PCC, work ability, and occupational changes in a population-based cohort. Methods We used data from working-age adults included in a prospective, longitudinal cohort of a random sample of all individuals infected with SARS-CoV-2 between August 2020 and January 2021 in the Canton of Zurich, Switzerland. We evaluated current work ability, work ability related to physical and mental demands, and estimated future work ability in 2 years (assessed using Work Ability Index), and PCC-related occupational changes one year after infection. Findings Of 672 individuals included in this study, 120 (17.9%) were categorised as having PCC (defined as presence of self-reported COVID-19 related symptoms) at 12 months. There was very strong evidence that current work ability scores were mean 0.62 (95% CI 0.30-0.95) points lower among those with PCC compared to those without in adjusted regression analyses. Similarly, there was very strong evidence for lower odds of reporting higher work ability with respect to physical (adjusted odds ratio (aOR) 0.30, 95% CI 0.20-0.46) and mental (aOR 0.40, 0.27-0.62) demands in individuals with PCC. Higher age and history of psychiatric diagnosis were associated with more substantial reductions in current work ability. 5.8% of those with PCC reported direct effects of PCC on their occupational situation, with 1.6% of those with PCC completely dropping out of the workforce. Interpretation These findings highlight the need for providing support and interdisciplinary interventions to individuals affected by PCC to help them maintain or regain their work ability and productivity. Funding Federal Office of Public Health, Department of Health of the Canton of Zurich, University of Zurich Foundation, Switzerland; Horizon Europe.
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Affiliation(s)
- Philipp Kerksieck
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Tala Ballouz
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Celine Schumacher
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Joanne Lacy
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Anja Domenghino
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
- Department of Visceral and Transplantation Surgery, University Hospital Zurich (USZ), Rämistrasse 100, Zurich 8091, Switzerland
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Georg F Bauer
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Holger Dressel
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
| | - Dominik Menges
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Hirschengraben 84, Zurich 8001, Switzerland
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15
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Ts P, Kk A, Bhavanam S, Mathew B. Post-COVID Quality of Life and Sleep Among Younger Healthcare Workers of Designated COVID Care Centers: A Cross-Sectional Study. Cureus 2023; 15:e38190. [PMID: 37252472 PMCID: PMC10222835 DOI: 10.7759/cureus.38190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Frontline healthcare workers (FLHCWs) have been persuaded to work this coronavirus disease (COVID) pandemic way in and out but the pandemic has not subsided. The persistence of symptoms after COVID infection, especially chest symptoms like early fatigue with breathlessness, has been documented very well. However, FLHCWs have repeatedly caught the COVID infection and have been working in traumatic and helpless situations since the pandemic started. Post-COVID infection, quality of life (QOL) and sleep are greatly affected, regardless of the time elapsed since discharge or recovery. The continuous assessment of COVID-infected persons for post-COVID sequelae is an important and effective step to reduce complications. Materials and methods This was a cross-sectional study conducted for a period of one year at R.L. Jalappa Hospital and Research Center, Kolar, and SNR District Hospital, Kolar, which were designated COVID care centers. FLHCWs working in these centers who had contracted COVID infection at least once, who were more than 18 years and less than 30 years, and who had experience of less than five years irrespective of their vaccination status were included in the study. FLHCWs with COVID-related health illnesses, which needed ICU admission and prolonged hospital admission, were excluded. To assess QOL, the WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaire was used. To assess sleepiness, the Epworth daytime sleepiness scale was used. The study was started after the institutional ethical committee's clearance was obtained. Results A total of 201 healthcare workers (HCWs) completed the survey. Of the participants, 119 (59.2%) were male, 107 (53.2%) were junior residents, 134 (66.7%) were unmarried, and 171 (85.1%) said they followed regular shifts. Male HCWs had higher scores in the psychological, social relationship, and environmental domains of QoL. Consultants had higher scores in all domains of QoL. Married HCWs had higher scores in the physical, psychological, and social relationship domains of QoL. Out of 201 FLHCWs, 67 (33.3%) had moderate excessive daytime sleep, and 25 (12.4%) had severe excessive daytime sleep. Few factors like gender, occupation, duration of work in the hospital, and regular shifts were statistically significant factors associated with daytime sleepiness. Conclusion The present study has shown that even after the COVID vaccination doses received by the HCWs, sleep and Qol have still been impaired among infected younger healthcare staff. Acceptable and righteous efforts must be made by the institutions for proper policymaking to manage such infectious outbreaks in the future.
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Affiliation(s)
- Pradeep Ts
- Community Medicine, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
| | - Athish Kk
- Dermatology, Venereology, and Leprosy, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
| | - Sravani Bhavanam
- Internal Medicine, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
| | - Bejoi Mathew
- Preventive Medicine, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
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