An assessment of post-COVID-19 infection pulmonary functions in healthcare professionals

Assessing post-COVID-19 functional recovery in healthcare workers: Insights from the 6-minute walking test and DLCO analysis

INTRODUCTION

The COVID-19 pandemic has impacted healthcare workers (HCWs) worldwide, necessitating an understanding of its effects on their health and functional capacity. This study utilized the 6-Minute Walk Test (6MWT) and pulmonary function test (PFT) to evaluate post-infection recovery of HCWs, and analyzed the results in relation to comorbidities, symptoms, and healthcare admission.

METHODS

HCWs who previously tested positive for SARS-CoV-2 were recruited, and the 6MWT and PFT were conducted. Clinical data, including comorbidities, symptoms, hospitalization history, intensive care unit (ICU) admission, and mechanical ventilation, were collected. Binary logistic regression analysis and Fisher's exact test were employed to examine the associations between these factors and diffusing capacity of the lungs for carbon monoxide (DLCO) and the 6MWT.

RESULTS

The study comprised 80 HCWs, with various comorbidities and various presenting symptoms. On average, 167.24 days (± 63.83 days) post-SARS-CoV-2 infection, 34 (42.5 %) had a DLCO% < 80 % of the predicted value, while 46 (57.5 %) had a DLCO% of ≥ 80 %. The mean six-minute-walk distance (6MWD) was 400.6 ± 54.1 m. No significant associations were found between DLCO% and most of the factors examined, except for Forced Expiratory Flow 25-75 % (FEF25-75 %), although this was not statistically significant (P=0.069).

CONCLUSION

The study provides significant data regarding the functional recovery of HCWs who have recovered from COVID-19 using the 6MWT. Importantly, the findings demonstrated that SARS-CoV-2 infection did not substantially impair the pulmonary functional capacity of HCWs.

Functional Recovery of Adults Following Acute COVID-19: A Systematic Review and Meta-Analysis

OBJECTIVE

This systematic review and meta-analysis aimed to investigate the objective, functional recovery of patients more than 3 months after acute coronavirus disease 2019 (COVID-19) infection.

METHODS

Comprehensive database searches of EMBASE, PubMed/MEDLINE, Cochrane COVID-19 Study Register, CINAHL, and Google Scholar in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement were carried out until October 19, 2022. Data were extracted and agreed in duplicate. Data were narratively synthesized, and a series of meta-analyses were performed using the random-effects inverse variance method.

RESULTS

One-hundred six papers covering 20,063 patients, who were either hospitalized or not hospitalized with acute COVID-19 and were followed-up between 3 and 24 months, were included. Percentage predicted 6-minute walk distance at 3 months to <5 months was 84.3% (95% CI = 79.2-89.3; n = 21; I2 = 98.3%) and 92.5% (95% CI = 89.8-95.3; n = 9; I2 = 94.5%) at ≥11 months. Cardiopulmonary exercise testing revealed the percentage predicted peak oxygen consumption rate ($peak\dot{\mathsf{V}}{\mathsf{o}}_{\mathsf{2}}$) at 3 months to <5 months was 77.3% (95% CI = 71.0-83.7; n = 6; I2 = 92.3%) and 95.4% (95% CI = 87.1-103.6; n = 2; I2 = 77.3%) at ≥11 months. Mean handgrip strength was greatest at ≥11 months at 31.16 kg (95% CI = 19.89-42.43; n = 2; I2 = 98.3%) of all time points. All analyses showed marked heterogeneity.

CONCLUSION

Patients have reduced physical function more than 3 months after COVID-19 infection. Better physical function in multiple physical domains is found after a longer recovery time.

IMPACT

Physical function as measured by the 6-minute walk test, hand grip strength, and cardiopulmonary exercise testing is reduced at 3 months after COVID-19 infection and can remain over 11 months of follow-up. This protracted recovery following acute COVID-19 infection supports the need to assess physical function at any clinical follow-up, and further research into rehabilitation programs and intervention for patients who have not recovered.

Tracking cognitive trajectories in older survivors of COVID-19 up to 2.5 years post-infection

Emerging evidence suggests that neurological and other post-acute sequelae of COVID-19 can persist beyond or develop following SARS-CoV-2 infection. However, the long-term trajectories of cognitive change after a COVID-19 infection remain unclear. Here we investigated cognitive changes over a period of 2.5 years among 1,245 individuals aged 60 years or older who survived infection with the original SARS-CoV-2 strain in Wuhan, China, and 358 uninfected spouses. We show that the overall incidence of cognitive impairment among older COVID-19 survivors was 19.1% at 2.5 years after infection and hospitalization, evaluated using the Telephone Interview for Cognitive Status-40. Cognitive decline primarily manifested in individuals with severe COVID-19 during the initial year of infection, after which the rate of decline decelerated. Severe COVID-19, cognitive impairment at 6 months and hypertension were associated with long-term cognitive decline. These findings reveal the long-term cognitive trajectory of the disease and underscore the importance of post-infection cognitive care for COVID-19 survivors.

Stigma Perceptions of Public Employees Concerning Covid-19 Disease

Abstract Aim: The Covid-19 pandemic has caused people to be exposed to negative attitudes and stigma. The aim of the study was to investigate the stigma perceptions of public employees concerning Covid-19 and to determine variables thought to be related. Materials and Methods: Study adopted descriptive design was conducted between 4/11/2021 and 1/1/2022. 351 employees in two public workplaces responded to the research. The Stigmatization of Covid-19 Questionnaire was delivered to the employees through online platform. The participation rate was 63.8%. Data were analyzed using the SPSS 20.0 Package program. Results: The majority of the participants (42.5%) fell within the age group of 36-45 years. 69.2% of them were male, and 61.8% were workers. While the mean score of self-stigma associated with Covid-19 was 50.61±9.73, stigma toward others was 78.68±13.01. There was a statistically significant difference between the mean scores of age, gender, education, marital status, history of previous Covid, and stigma toward others. Conclusion: Self-stigma perceptions of employees were low while the toward others were high. The factors such as age, gender, education, marital status, previous experience of Covid-19 affected employees’ perceptions of stigma associated with Covid-19. The findings of the study highlight the importance of intervening early to provide psychological or social support for employees.