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Skiba EM, Drewitz KP, Panchyrz I, Deckert S, Apfelbacher C, Piontek K. [Follow-up outpatient clinics for patients with post COVID: a survey to assess and characterize aspects of care]. Dtsch Med Wochenschr 2024; 149:e48-e57. [PMID: 38621680 PMCID: PMC11018383 DOI: 10.1055/a-2255-9252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
After acute infection with the SARS-CoV-2 virus, up to 10 % of affected individuals suffer from long-term health impairments, also referred to as "Post-COVID". In Germany, specialized outpatient clinics have been established to care for patients with Post-COVID. A structured survey of the care situation is not yet available, but essential for a demand-oriented care. The present study aimed to systematically assess and describe structural and process-related aspects of care, and to perform an inventory and needs analysis of Post-COVID outpatient clinics in Germany.An online survey was developed assessing the structure and organization of the outpatient clinics, service offerings and networking of care from the perspective of the outpatient clinic directors. A total of 95 outpatient clinics were identified, and an invitation to participate in the online survey was sent via e-mail to the directors of the outpatient clinics. Data were collected between February and May 2022. Descriptive data analysis was performed.A total of 28 outpatient clinic managers (29 %) took part in the survey. Participants were between 32 and 66 years old, and 61 % (n = 17) were male. The outpatient clinics were most frequently affiliated with the specialties of pneumology (n = 10; 36 %), internal medicine, psychiatric and psychosomatic medicine, and neurology (n = 8; 29 %, respectively). Among the outpatient clinic directors, 64 % (n = 18) stated that the time spent waiting for an appointment was more than one month. Utilization (n = 25; 89 %), appointment demand (n = 26; 93 %), and the need for more Post-COVID outpatient clinics (n = 20; 71 %) were rated as high by the outpatient clinic directors. Nearly all directors reported networking with in-clinic facilities (n = 27; 96 %), with primary care physicians and with specialists in private practice (n = 21; 75 %, respectively).The main focus of care is pneumology. Internal medicine, psychiatry/psychosomatics and neurology are also equally represented. Our data further suggest a high demand for Post-COVID outpatient clinics and the need to expand this care offer.
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Affiliation(s)
- Eva-Maria Skiba
- Institut für Sozialmedizin und Gesundheitssystemforschung, Universitätsmedizin Magdeburg
| | - Karl Philipp Drewitz
- Institut für Sozialmedizin und Gesundheitssystemforschung, Universitätsmedizin Magdeburg
| | - Ivonne Panchyrz
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Stefanie Deckert
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der Technischen Universität Dresden
| | - Christian Apfelbacher
- Institut für Sozialmedizin und Gesundheitssystemforschung, Universitätsmedizin Magdeburg
| | - Katharina Piontek
- Institut für Sozialmedizin und Gesundheitssystemforschung, Universitätsmedizin Magdeburg
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Patro M, Gothi D, Anand S, Priyadarshini DPDK, Ojha UC, Pal RS, Malhotra N, Kumar R, Jain A, Kumar S, Agarwal P. Follow-up study of COVID-19 sequelae (FOSCO study). Lung India 2024; 41:103-109. [PMID: 38700403 PMCID: PMC10959308 DOI: 10.4103/lungindia.lungindia_400_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/10/2023] [Accepted: 11/06/2023] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION We undertook the first study from India to evaluate the long-term health effects of coronavirus disease 2019 (COVID-19). METHODS The patients enrolled in our post-COVID-19 clinic were followed up for assessment at 1, 3, 6 and 12 months after recovery from acute disease prospectively. RESULTS 200 patients with mean age of 50.72 years and 57.5% males were analysed. 42.5% had severe and 17% had moderate disease at the time of diagnosis. The persistence of symptoms beyond 1 month of diagnosis was seen in 72.5% (145/200) patients. 8% (16/200) of the patients had post-COVID-19 complications that required rehospitalisation after discharge or recovery from acute COVID-19. The complications included respiratory failure (2%), lung cavities (3.5%), fungal infection, pericardial effusion, pneumothorax and death. The symptoms were persistent beyond 3 months in 51% (102/200) and beyond 6 months in 17.5% (35/200) of cases. The patients with persistent symptoms beyond 3 months and 6 months had significantly higher intensive care unit (ICU) admission during acute COVID-19, severe disease during acute COVID-19, and higher prevalence of comorbidities compared to the recovered patients. The clinical recovery was attained in 95.5% (91/200) patients, and the radiological recovery was attained in 97.92% patients at 1 year. The mean duration to clinical recovery was 174.2 days. CONCLUSIONS COVID-19 recovery takes longer time. However, clinico-radiological recovery is attained in >95% cases by one year.
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Affiliation(s)
- Mahismita Patro
- Department of Pulmonary and Critical Care Medicine, AIIMS Bhubaneswar, Odisha, India
| | - Dipti Gothi
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, New Delhi, India
| | - Shweta Anand
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | | | - Umesh C. Ojha
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, New Delhi, India
| | - Ramesh S. Pal
- Department of Pulmonary and Critical Care Medicine, ESI-PGIMSR, New Delhi, India
| | - Nipun Malhotra
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - Rahul Kumar
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - Anshul Jain
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - Sunil Kumar
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - Pranzal Agarwal
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
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Boehmeke T. Reduced Fatigue Symptoms in the Post-COVID Syndrome With Amifampridine: A Collective Casuistry With Double-Blind Discontinuation Trials. Cureus 2024; 16:e52935. [PMID: 38406122 PMCID: PMC10893954 DOI: 10.7759/cureus.52935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
After a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, approximately 10-20% of patients are affected by the post-COVID syndrome (PCS). This condition leads to a variety of functional complaints, including symptoms of fatigue. To date, there is still no adequate treatment option. Five patients are presented, including the self-observation of one of the authors, in whom the administration of amifampridine as an "off-label use" led to a normalization of the unphysiologically increased need for sleep with a simultaneous increase in the Bell score. This effect was confirmed in a double-blind discontinuation trial (the medication was discontinued on a trial basis) in two of the patients. The five patients, who were previously unable to lead a normal life due to their fatigue symptoms, were able to return to everyday life after treatment with amifampridine. This offers hope to millions of affected patients.
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Yamoldinov NR, Dudarev MV, Sarksyan DS, Maleev VV. [Сardiac arrhythmias in people who have had a coronavirus infection COVID-19: A review]. TERAPEVT ARKH 2023; 95:991-995. [PMID: 38158958 DOI: 10.26442/00403660.2023.11.202480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
Heart rhythm disorders are one of the most common complications of coronavirus infection. Heart rhythm disorders can develop in 6-17% of hospitalized patients, and in convalescents, COVID-19 can manifest itself up to 12 months after the completion of the acute phase of the disease. Among the mechanisms for the development of cardiac arrhythmias, there are a direct cytopathic effect of SARS-CoV-2 on the myocardium, systemic inflammatory response syndrome, electrolyte imbalance, hypoxia, the use of antibacterial, antimalarial and antiviral drugs, exudative pericarditis, autonomic dysfunction. The main COVID-19-mediated heart rhythm disorders are sinus tachycardia and bradycardia, atrial fibrillation, ventricular tachycardia, long QT syndrome. Despite a significant amount of research, the literature data on the prevalence of certain types of cardiac arrhythmias (especially in COVID-19 convalescents), as well as methods for their correction, are somewhat contradictory and need to be clarified. Taking into account the impact of arrhythmia on the quality of life and mortality, active monitoring of convalescents of coronavirus infection, identification and development of approaches to the treatment of heart rhythm disorders in patients who have had COVID-19, seem to be relevant and promising areas in modern cardiology.
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Affiliation(s)
| | | | | | - V V Maleev
- Central Research Institute of Epidemiology
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Almazini P, Soesanto AM. Global Longitudinal Strain and Myocardial Work Index in Post-COVID-19 Syndrome with Mild Symptoms: A Case Series. Acta Med Indones 2023; 55:327-331. [PMID: 37915152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
The involvement of the cardiovascular system in COVID-19 is prevalent. The effect of SARS-COV-2 infection in both acute and recovery phases is called a post-COVID-19 syndrome. Considering the high prevalence of cardiac abnormalities after COVID-19, clinicians should continue to monitor cardiac function in COVID-19 patients after hospital discharge. Echocardiography is an accurate and accessible tool to assess cardiac function after COVID-19. Left-ventricle (LV) and right ventricle (RV) longitudinal strains are more sensitive to detecting subtle abnormalities than standard parameters, such as left-ventricle ejection fraction and tricuspid annular plane systolic excursion (TAPSE). Myocardial work index is a novel parameter including afterload to evaluate cardiac function. These parameters can give further information on cardiac function in COVID-19 patients. We presented two cases of COVID-19 with serial cardiac assessment using echocardiography.
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Affiliation(s)
- Prima Almazini
- Department of Cardiology and Vascular Medicine, Universitas Indonesia Hospital, Jakarta, Indonesia.
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Kotova OV, Medvedev VE, Poluektov MG, Belyaev AA, Akarachkova ES. Sleep Disorders in Post-COVID Syndrome: A Psychiatric or Neurological Problem? Neurosci Behav Physiol 2023; 53:16-20. [PMID: 36969358 PMCID: PMC10006556 DOI: 10.1007/s11055-023-01385-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 03/24/2023]
Abstract
The coronavirus pandemic that began in 2019 continues. COVID-19 adversely affects human health not only in the acute, but also in the long-term period of the disease: in a large percentage of cases, health is not fully restored after long periods, requires medical intervention, and is often difficult to correct. Researchers noted during the first wave of the pandemic in 2020 that about 10–20% of patients did not fully recover by three weeks from disease onset and the possible duration of the recovery period remains insufficiently clear, as do the reasons for differences in course during this period. Prolonged recovery after viral infection is not a feature exclusive to COVID-19, which does not facilitate the management of patients with post-COVID syndrome (PCS). The mental health impact of COVID-19 is significant, with at least 30% of recovered patients likely to have symptoms of anxiety and/or depression after the acute phase has passed. Since the onset of COVID-19, there has been an increase in sleep disorders by 42%, with every third COVID-19 survivor reporting sleep complaints. In PCS, this condition is referred to as coronasomnia. The success of therapy for this condition depends on identifying and correcting patients’ mental disorders, as anxiety and depression are often accompanied by sleep disorders this results in a bidirectional interaction between mental disorders and sleep quality. This article presents data on the anti-anxiety drugs Noofen and Adaptol, which help to correct the manifestations of PCS with sleep disorders.
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Affiliation(s)
- O. V. Kotova
- Peoples’ Friendship University of Russia, Moscow, Russia
- International Association “Stress Under Control,”, Moscow, Russia
| | - V. E. Medvedev
- Peoples’ Friendship University of Russia, Moscow, Russia
| | - M. G. Poluektov
- Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health, Moscow, Russia
| | - A. A. Belyaev
- Sklifosovsky Research Institute of Emergency Medicine, Moscow Health Department, Moscow, Russia
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Thor DC, Suarez S. Corona With Lyme: A Long COVID Case Study. Cureus 2023; 15:e36624. [PMID: 37155451 PMCID: PMC10122830 DOI: 10.7759/cureus.36624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 05/10/2023] Open
Abstract
The longevity of the coronavirus disease 2019 (COVID-19) pandemic has necessitated continued discussion about the long-term impacts of SARS-CoV-2 infection. Many who develop an acute COVID-19 infection will later face a constellation of enduring symptoms of varying severity, otherwise known as long COVID. As the pandemic reaches its inevitable endemicity, the long COVID patient population will undoubtedly grow and require improved recognition and management. The case presented describes the three-year arc of a previously healthy 26-year-old female medical student from initial infection and induction of long COVID symptomology to near-total remission of the disease. In doing so, the course of this unique post-viral illness and the trials and errors of myriad treatment options will be chronologized, thereby contributing to the continued demand for understanding this mystifying disease.
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Affiliation(s)
- Danielle C Thor
- Internal Medicine, Touro College of Osteopathic Medicine, New York, USA
| | - Sergio Suarez
- Osteopathic Medicine, Touro College of Osteopathic Medicine, New York, USA
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Haider S, Janowski AJ, Lesnak JB, Hayashi K, Dailey DL, Chimenti R, Frey-Law LA, Sluka KA, Berardi G. A comparison of pain, fatigue, and function between post-COVID-19 condition, fibromyalgia, and chronic fatigue syndrome: a survey study. Pain 2023; 164:385-401. [PMID: 36006296 PMCID: PMC9797623 DOI: 10.1097/j.pain.0000000000002711] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/02/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACT A growing number of individuals report prolonged symptoms following acute Coronavirus-19 (COVID-19) infection, known as post-COVID-19 condition (post-COVID-19). While studies have emerged investigating the symptom sequelae of post-COVID-19, there has been limited investigation into the characterization of pain, fatigue, and function in these individuals, despite initial reports of a clinical phenotype similar to fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME). This study aimed to characterize multiple symptom domains in individuals reporting post-COVID-19 and compare its clinical phenotype with those with FMS and CFS. A total of 707 individuals with a single or comorbid diagnosis of post-COVID-19, FMS, and/or CFS completed multiple surveys assessing self-reported pain, fatigue, physical and cognitive function, catastrophizing, kinesiophobia, anxiety, depression, dyspnea, and sleep quality. In all 3 diagnoses, elevated pain, fatigue, anxiety, depression, catastrophizing, and kinesiophobia were reported. Physical and cognitive function were similarly impacted among individuals with post-COVID-19, FMS, and CFS; however, individuals with post-COVID-19 reported lower pain and fatigue than FMS and CFS. The comorbid diagnosis of post-COVID-19 with FMS and/or CFS further exacerbated pain, fatigue, and psychological domains when compared with post-COVID-19 alone. In summary, individuals with post-COVID-19 report a symptom phenotype similar to FMS and CFS, negatively impacting cognitive and physical function, but with less severe pain and fatigue overall. These findings may help direct future investigations of the benefit of a biopsychosocial approach to the clinical management of post-COVID-19.
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Affiliation(s)
- Saman Haider
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Adam J. Janowski
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Joseph B. Lesnak
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Kazuhiro Hayashi
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Dana L. Dailey
- Department of Physical Therapy, St. Ambrose University, Davenport, IA 52803
| | - Ruth Chimenti
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Laura A. Frey-Law
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
| | - Giovanni Berardi
- Department of Physical Therapy & Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52242
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Quigley C, Butler T, Byrne L, Moore D, Doyle A. Post-Coronavirus Disease 2019 (COVID-19) Syndrome Associated with Central Retinal Vein Occlusion: A Case Report. Ocul Immunol Inflamm 2023; 31:185-187. [PMID: 34637677 DOI: 10.1080/09273948.2021.1977830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE Coronavirus Disease 2019 (COVID-19) pneumonia may predispose to thromboembolic disease, including after the acute phase. We report on a unique case of central retinal vein occlusion (CRVO) occurring eight months after diagnosis of Coronavirus Disease 2019 (COVID-19) pneumonia in a likely case of post-COVID-19 syndrome. CASE REPORT A 42-year-old man developed blurred vision in his right eye eight months after symptoms of pneumonia. He had no underlying medical conditions, but experienced exertional chest pain since diagnosis of COVID-19 was confirmed by detection of SARS-CoV-2 on nasopharyngeal swab and was also seeing cardiology for management of myocarditis. His best-corrected visual acuity on snellen chart testing was reduced to 6/18 in the affected right eye, and dilated fundal examination revealed a non-ischaemic CRVO. CONCLUSION The thromboembolic complications of COVID-19 may extend to CRVO, which in this case presented months after onset of symptoms of pneumonia, in association with myocarditis.
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Affiliation(s)
- Clare Quigley
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Triona Butler
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Luke Byrne
- Department of Cardiology, Tallaght University Hospital, Dublin, Ireland
| | - David Moore
- Department of Cardiology, Tallaght University Hospital, Dublin, Ireland
| | - Aoife Doyle
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
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Adorjan K, Ruzicka M, Ibarra G, Stubbe HC. [Treatment of severe post-COVID syndrome]. MMW Fortschr Med 2023; 165:52-57. [PMID: 36648675 PMCID: PMC9844173 DOI: 10.1007/s15006-022-2187-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kristina Adorjan
- Klinik f. Psychiatrie u. Psychotherapie/Tagesklinik, Klinikum Innenstadt der LMU München, Nussbaumstraße 7, 80336 München, Deutschland
| | - Michael Ruzicka
- Medizinische Klinik und Poliklinik III, LMU Klinikum, München, Deutschland
| | - Gerardo Ibarra
- Med. Klinik und Poliklinik IV, Campus Innenstadt d. LMU München/Sektion Klin. Infektiologie, München, Deutschland
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Muacevic A, Adler JR, Alsulami RA, Alghamdi AF, Almalawi AM, Alghamdi MS, Hazazi HA. Post-COVID-19 Syndrome: Incidence, Risk Factor, and the Most Common Persisting Symptoms. Cureus 2022; 14:e32058. [PMID: 36600841 PMCID: PMC9802640 DOI: 10.7759/cureus.32058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The pandemic of the coronavirus disease 2019 (COVID-19) has caused a significant burden worldwide. The most common presentation of coronavirus disease is acute, and most patients recover completely. However, now a substantial proportion of patients experience long-term health effects. Post-COVID-19 syndrome (PCS) is defined as "signs and symptoms that develop after an infection consistent with COVID-19 that persist for more than 12 weeks and have not been explained yet by an alternative diagnosis." We faced a lack of studies regarding PCS in the Gulf area. Therefore, this study aimed to assess the incidence, risk factors, and most common persisting symptoms of PCS in confirmed COVID-19 patients who presented to King Abdulaziz University Hospital (KAUH) in Jeddah between June 1, 2020 and December 31, 2020. METHODS This retrospective cohort study was conducted via telephone survey, which took place in June 2022 at KAUH. PCS was defined as the presence of one or more symptoms beyond 12 weeks from the onset of the illness. The inclusion criteria were patients aged 18 or above with laboratory-confirmed SARS-CoV-2 infection through positive RT-PCR in KAUH from June 1, 2020 to December 31, 2020, and both genders were included. The exclusion criteria were inability to provide informed consent, death, currently active COVID-19 infection (PCR +ve), and if they did not complete the interview. Medical records were obtained from patients diagnosed with COVID-19 through positive RT-PCR tests from June 1, 2020 to December 31, 2020. RESULTS Data of 504 patients were analyzed. The incidence of PCS was 45.0% (95%CI, 40.7% to 49.5%). PCS was associated with female gender (OR = 1.71, 95%CI, 1.13 to 2.59, p = 0.011), having three or more co-morbid conditions (OR = 2.37, 95%CI, 1.19 to 4.75, p = 0.014), receiving steroids (OR = 2.13, 95%CI, 1.16 to 3.98, p = 0.016), also patients who experienced congestion (OR = 1.68, 95%CI, 1.05 to 2.71, p = 0.032) and depression (OR = 1.80, 95%CI, 1.03 to 3.18, p = 0.039) during acute COVID-19 infection. The most commonly reported symptoms beyond 12 weeks included fatigue (19.6%), joint pain (14.1%), and decreased exercise tolerance (12.7%). CONCLUSION In conclusion, the main risk factors to develop PCS are being female, having three or more co-morbidities, receiving steroids, or patients presenting with nasal congestion and/or depression.
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Lapteva ES, Ariev AL, Arieva GT, Tsutsunawa MR, Diachkova-Gerceva DC. On the Role of Geriatric Services in the Diagnosis and Monitoring of Outcomes of Post-Covid Syndrome (Review). Adv Gerontol 2022; 12. [PMCID: PMC9774082 DOI: 10.1134/s2079057022040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In addition to the rapid spread of the pandemic in waves across the globe today, there is a growing problem called “long-COVID-19,” a term that describes the long-term effects of the novel coronavirus infection COVID-19. How the disease proceeds after “recovery,” including long-term physical and psychological health consequences, and the future of COVID-19 survivors remains largely unclear. This is especially true for older age groups. This article summarizes the experience of foreign studies aimed at determining the duration and clarifying the nature of multi-organ complications after suffering from COVID-19, as well as ways of the long-term rehabilitation of patients in older age groups with post-COVID syndrome.
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Affiliation(s)
- E. S. Lapteva
- Mechnikov North-Western State Medical University, 193015 St. Petersburg, Russia
| | - A. L. Ariev
- Mechnikov North-Western State Medical University, 193015 St. Petersburg, Russia
| | - G. T. Arieva
- Mechnikov North-Western State Medical University, 193015 St. Petersburg, Russia
| | - M. R. Tsutsunawa
- Mechnikov North-Western State Medical University, 193015 St. Petersburg, Russia
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Ermilov VV, Smirnov AV, Dorofeev NA, Grigor'eva NV, Tarasova NV, Kushniruk PI, Karadzhe M, Barkanov VB, Chernetsky OA, Poplavsky AE, Nesterova AA, Lozovik VV, Somova VV. [COVID-19-associated mucormycosis in ophthalmological practice in the Volgograd region]. Arkh Patol 2022; 84:43-49. [PMID: 36178222 DOI: 10.17116/patol20228405143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The problem of fungal infections in the era of COVID-19 has acquired special significance. This infection, directly or indirectly, through the use of glucocorticoids and antibiotics in its treatment, as well as poorer self-management of chronic diseases, has led to a wide spread of risk factors for fungal diseases among people who have had a novel coronavirus infection. The article presents two cases of COVID-19-associated mycosis, more related to mucormycosis, which were diagnosed by ophthalmologists in the Volgograd region. In the first case, the severe course of rhino-orbito-cerebral form of mucormycosis required a number of surgical interventions and prolonged treatment in the intensive care unit. In the second case, the patient asked for help without signs of aggravation of the general condition, but with irreversible local manifestations. In both cases, the eyeball was removed. Morphological examination revealed aseptal ribbon hyphae of different diameters, branching mainly at right angles, more typical for fungi of the Mucorales family. Due to the severe consequences of the disease, clinicians, including ophthalmologists, need to be especially alertness in patients with the described symptoms and risk factors in the post-COVID period.
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Affiliation(s)
- V V Ermilov
- Volgograd State Medical University, Volgograd, Russia
| | - A V Smirnov
- Volgograd State Medical University, Volgograd, Russia
- Volgograd Medical Research Center, Volgograd, Russia
| | - N A Dorofeev
- Volgograd State Medical University, Volgograd, Russia
- Volgograd Medical Research Center, Volgograd, Russia
| | | | - N V Tarasova
- Volgograd State Medical University, Volgograd, Russia
| | - P I Kushniruk
- Volgograd State Medical University, Volgograd, Russia
| | - M Karadzhe
- Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| | - V B Barkanov
- Volgograd State Medical University, Volgograd, Russia
| | - O A Chernetsky
- Volgograd Regional Pathological Bureau, Volgograd, Russia
| | - A E Poplavsky
- Volgograd Regional Pathological Bureau, Volgograd, Russia
| | - A A Nesterova
- Volgograd State Medical University, Volgograd, Russia
| | - V V Lozovik
- Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| | - V V Somova
- Volgograd State Medical University, Volgograd, Russia
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14
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Håkansson A, Cronhjort M, Lidin-Darlington P, Lilja G, Nilsson A, Schandl A, Friberg H. Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (CBT-ACT) vs. Standard Care After Critical Illness Due to COVID-19: Protocol for a Pilot Randomized Controlled Trial. Front Psychiatry 2022; 13:907215. [PMID: 35911237 PMCID: PMC9334556 DOI: 10.3389/fpsyt.2022.907215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/20/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Post-covid syndrome is an emerging condition involving a wide range of symptoms, including high rates of poor mental health. The diagnostic relevance and clinical severity of these symptoms are largely unknown, and evidence for treatment of post-covid mental health symptoms is lacking. This protocol describes a pilot randomized clinical trial, primarily aiming to assess feasibility, participant adherence and satisfaction in a novel phycho-therapeutic intervention on post-covid anxiety and depression symptoms ≥1 year after critically ill COVID-19. Whether the intervention may generate improvements in post-covid depression, anxiety, post-traumatic stress and health-related quality of life (HRQoL) will be addressed in a following larger trial. METHODS A multicenter, investigator-initiated randomized controlled trial (Clinical Trial Identifier number NCT05119608) including Intensive Care Unit (ICU)-treated COVID-19 survivors, who display symptoms of anxiety and/or depression at follow-up 12 months after hospitalization (Hospital Anxiety and Depression Scale ≥8 for depression or anxiety). Eligible individuals are referred to a psychiatrist for structured diagnostic assessment and inclusion in the trial. Participants will be randomized to either a 10-week cognitive behavioral therapy intervention with added acceptance and commitment therapy (CBT-ACT) or standard care (primary care referral). Primary study outcome measure is feasibility and patient adherence, defined as the proportion of participants who consent to randomization and remain in the study including follow-up. Secondary outcome measures include reduced symptoms in the HADS depression/anxiety subscales, post-traumatic symptoms, HRQoL and user satisfaction at 3 months after the intervention. DISCUSSION This protocol describes a pilot trial to assess feasibility and preliminary effects of a structured psycho-therapeutic intervention to ameliorate mental health in a population severely affected by COVID-19, where evidence for structured psycho-therapy is lacking.
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Affiliation(s)
- Anders Håkansson
- Faculty of Medicine, Lund University, Lund, Sweden.,Clinical Research Unit, Department of Psychiatry, Malmø, Sweden
| | - Maria Cronhjort
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.,Södersjukhuset AB Hospital, Stockholm, Sweden
| | - Pernilla Lidin-Darlington
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.,Södersjukhuset AB Hospital, Stockholm, Sweden
| | - Gisela Lilja
- Faculty of Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Malmö, Sweden
| | - Anna Nilsson
- Faculty of Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Malmö, Sweden
| | - Anna Schandl
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.,Södersjukhuset AB Hospital, Stockholm, Sweden
| | - Hans Friberg
- Faculty of Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Malmö, Sweden
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15
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Kostenko AA, Koneva ES, Malyutin DS, Tsvetkova AV, Bisheva DR, Vasilieva ES, Bazarov DV, Shestakov AV, Kotenko KV. [Hypoxic training in rehabilitation of patients at the early stages of recovery after SARS-CoV-2 pneumonia]. Vopr Kurortol Fizioter Lech Fiz Kult 2022; 99:11-16. [PMID: 36083812 DOI: 10.17116/kurort20229904211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate efficacy and safety of hypoxic-hyperoxic therapy in rehabilitation after SARS-CoV-2 pneumonia. MATERIAL AND METHODS There were 44 patients aged 49-75 years in early recovery period after previous SARS-CoV-2 pneumonia (ICD-10 U07.1 and U07.2). Patients were divided into 2 groups depending on treatment strategy: group 1 (n=23) - rehabilitation treatment with therapeutic exercises, massage and physiotherapy; group 2 (n=21) - basic procedures with hypoxic-hyperoxic therapy. RESULTS At initial evaluation, we found positive tendencies of rehabilitation in both groups. There were no side effects associated with hypoxic-hyperoxic therapy in the second group. Patients positively perceived this method of rehabilitation. There were significant between-group differences in exercise tolerance (p<0.05). These data indicate more favorable physical recovery in the second group and similar improvement of psycho-emotional status in both groups. CONCLUSION Hypoxic-hyperoxic therapy is effective and safe approach in rehabilitation of patients with previous SARS-CoV-2 pneumonia. It is necessary to continue searching for effective methods of rehabilitation and develop accurate rehabilitation methods for various groups of patients.
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Affiliation(s)
- A A Kostenko
- Group of companies «MEDSI», Otradnoe, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - E S Koneva
- Group of companies «MEDSI», Otradnoe, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - D S Malyutin
- Group of companies «MEDSI», Otradnoe, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A V Tsvetkova
- Group of companies «MEDSI», Otradnoe, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - D R Bisheva
- Group of companies «MEDSI», Otradnoe, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - E S Vasilieva
- FGBNU "Russian Scientific Center for Surgery named after acad. B.V. Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - D V Bazarov
- FGBNU "Russian Scientific Center for Surgery named after acad. B.V. Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - A V Shestakov
- FGBNU "Russian Scientific Center for Surgery named after acad. B.V. Petrovsky Russian Research Center for Surgery, Moscow, Russia
| | - K V Kotenko
- FGBNU "Russian Scientific Center for Surgery named after acad. B.V. Petrovsky Russian Research Center for Surgery, Moscow, Russia
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16
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Bierle DM, Aakre CA, Grach SL, Salonen BR, Croghan IT, Hurt RT, Ganesh R. Central Sensitization Phenotypes in Post Acute Sequelae of SARS-CoV-2 Infection (PASC): Defining the Post COVID Syndrome. J Prim Care Community Health 2021; 12:21501327211030826. [PMID: 34231404 PMCID: PMC8267019 DOI: 10.1177/21501327211030826] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To develop and implement criteria for description of post COVID syndrome based on analysis of patients presenting for evaluation at Mayo Clinic Rochester between November 2019 and August 2020. METHODS A total of 465 patients with a history of testing positive for COVID-19 were identified and their medical records reviewed. After a thorough review, utilizing the DELPHI methods by an expert panel, 42 (9%) cases were identified with persistent central sensitization (CS) symptoms persisting after the resolution of acute COVID-19, herein referred to as Post COVID syndrome (PoCoS). In this report we describe the baseline characteristics of these PoCoS patients. RESULTS Among these 42 PoCoS patients, the mean age was 46.2 years (median age was 46.5 years). Pain (90%), fatigue (74%), dyspnea (43%), and orthostatic intolerance (38%) were the most common symptoms. The characteristics of an initial 14 patients were utilized for the development of clinical criteria via a modified Delphi Method by a panel of experts in central sensitization disorders. These criteria were subsequently applied in the identification of 28 additional cases of suspected PoCoS. A 2-reviewer system was used to analyze agreement with using the criteria, with all 28 cases determined to be either probable or possible cases by the reviewers. Inter-reviewer agreement using these proposed defining criteria was high with a Cohen's alpha of .88. CONCLUSIONS Here we present what we believe to be the first definitional criteria for Post COVID syndrome. These may be useful in clinical phenotyping of these patients for targeted treatment and future research.
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17
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Reshetova TV, Lapteva ES, Lukashkova VV, Reshetov AV. [The problems of older people and directions of medical, social and psychological support during the COVID-19 pandemic.]. Adv Gerontol 2021; 34:679-693. [PMID: 34998005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The review article examines the medical, psychological and social problems that older people face due to the pandemic. The article contains the analysis of the mortality rate in the older age group in different countries. It also demonstrates the negative impact of the pandemic stress on the formation of psychopathological disorders (anxiety, asthenia, panic, cognitive dysfunction). The authors carried out an analysis of psychological support methods for various psychopathological disorders among the elderly, based on both the results of their own clinical experience in the treatment and psychological correction of the disorders of older people experiencing the pandemic, and similar results of other researches in other countries. The results of the presented research during the pandemic suggest that the frequency of asthenia and psychosomatic disorders in patients was increased. The paper presents algorithms for the differential diagnosis and treatment of asthenia as part of the post-covid syndrome. The article contains an objective scientific and practical assessment of the experience of self-isolation for the elderly, as well as the analysis of the reasons for mental maladjustment and the formation of addictions. The algorithm and the results of psychological support, provided to older people by a psychosocial support organization, are demonstrated.
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Affiliation(s)
- T V Reshetova
- I.I.Mechnikov North Western State Medical University, 41 Kirochnaya str., St. Petersburg 191015, Russian Federation, e-mail:
| | - E S Lapteva
- I.I.Mechnikov North Western State Medical University, 41 Kirochnaya str., St. Petersburg 191015, Russian Federation, e-mail:
| | - V V Lukashkova
- I.I.Mechnikov North Western State Medical University, 41 Kirochnaya str., St. Petersburg 191015, Russian Federation, e-mail:
| | - A V Reshetov
- National Library of Russia, 18 Sadovaya str., St. Petersburg 191011, Russian Federation
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