Spa therapy (balneotherapy) for rehabilitation of survivors of COVID-19 with persistent symptoms

Health Resort Treatment Mitigates Neuropsychiatric Symptoms in Long COVID Patients: A Retrospective Study

BACKGROUND/OBJECTIVES

Among the neuropsychiatric symptoms of long COVID, the following may be listed: sleep disturbances, headaches, anxiety, depression, dizziness, numbness, memory loss, and concentration difficulties. Various therapies have been implemented to mitigate these symptoms; however, health resort treatments that utilize a wide range of modalities stimulating multidirectional biological reactions may also be effective. The aim of this study was to assess the severity of neuropsychiatric symptoms in long COVID patients who qualified for health resort treatment, evaluate the effectiveness of health resort treatment in this group of patients, and evaluate the effect of balneological factors in the treatment course.

METHODS

A retrospective analysis of the medical records of 120 people with long COVID (69 women and 51 men) aged 42-79 who underwent health resort treatment in 2021 was performed. People were eligible for treatment at a lowland health resort based on a valid referral from a doctor. The treatment included balneological therapies, physical medicine modalities, exercise programs, health education, and psychological support. Patients assessed the severity of persistent neuropsychiatric symptoms on a 0-10 point scale before and after treatment.

RESULTS

After the treatment, the greatest improvement was noted in sleep disorders (2.47 ± 2.23 points vs. 0.86 ± 1.25 points, p < 0.00001) and dizziness (1.39 ± 1.94 points vs. 0.34 ± 0.76 points, p < 0.00001). The lowest improvement was observed in memory disorders (2.68 ± 2.5 points vs. 1 ± 1.4 points, p < 0.00001).

CONCLUSIONS

Patients with long COVID who qualified for health resort treatment reported mild neuropsychiatric symptoms. Health resort treatment mitigates neuropsychiatric symptoms, as it is a complex approach. Treatment that includes balneological factors improves symptoms to a greater extent. This method of treatment should be integrated into the standard treatment for long COVID.

Relying on the French territorial offer of thermal spa therapies to build a care pathway for long COVID-19 patients

BACKGROUND

Work on long COVID-19 has mainly focused on clinical care in hospitals. Thermal spa therapies represent a therapeutic offer outside of health care institutions that are nationally or even internationally attractive. Unlike local care (hospital care, general medicine, para-medical care), their integration in the care pathways of long COVID-19 patients seems little studied. The aim of this article is to determine what place french thermal spa therapies can take in the care pathway of long COVID-19 patients.

METHODS

Based on the case of France, we carry out a geographic mapping analysis of the potential care pathways for long COVID-19 patients by cross-referencing, over the period 2020-2022, the available official data on COVID-19 contamination, hospitalisations in intensive care units and the national offer of spa treatments. This first analysis allows us, by using the method for evaluating the attractiveness of an area defined by David Huff, to evaluate the accessibility of each French department to thermal spas.

RESULTS

Using dynamic geographical mapping, this study describes two essential criteria for the integration of the thermal spa therapies offer in the care pathways of long COVID-19 patients (attractiveness of spa areas and accessibility to thermal spas) and three fundamental elements for the success of these pathways (continuity of the care pathways; clinical collaborations; adaptation of the financing modalities to each patient). Using a spatial attractiveness method, we make this type of geographical analysis more dynamic by showing the extent to which a thermal spa is accessible to long COVID-19 patients.

CONCLUSION

Based on the example of the French spa offer, this study makes it possible to place the care pathways of long COVID-19 patients in a wider area (at least national), rather than limiting them to clinical and local management in a hospital setting. The identification and operationalization of two geographical criteria for integrating a type of treatment such as a spa cure into a care pathway contributes to a finer conceptualization of the construction of healthcare pathways.

A Preliminary Study of SARS-CoV-2's Permanence and Potential Infective Capacity in Mineromedicinal Waters of Copahue, Neuquén, Argentina

Copahue Thermal Center is characterized by the presence of mineromedicinal acidic waters with high temperatures, therapeutic peloids, and relevant consortia of extremophiles species, distributed in small natural pools which cannot be disinfected. The objective of this research was to investigate the survival of SARS-CoV-2 in Copahue's waters and its remaining infective capacity. In a first assay, a decrease of more than 50% of the initially viral load compared to the initially inoculated positive sample was detected for all the water samples analyzed. After that, two of the Copahue springs, which are used as an immersion bath in closed environments without going through any disinfection treatment, was selected to determine the viral viability. VERO cell infections were performed, with no cytopathic effect detected, but a strikingly high resistance of the virus, detecting its genome by real time PCR, during the seven days of study under laboratory conditions. SARS-CoV-2 survival in acid media was reaffirmed, which is a peculiarity for a covered virus. A decrease in the detectable viral load of the positive sample was found as the infection time passed, becoming completely negative in the subsequent blind passages. More research is needed to further study the feasibility of SARS-CoV-2 in mineromedicinal waters, especially natural acidic waters that cannot disinfected, in order to expand information about the risk to populations that are exposed to them.

Health management of patients with COVID-19: is there a room for hydrotherapeutic approaches?

With highly variable types of coronavirus disease 2019 (COVID-19) symptoms in both severity and duration, there is today an important need for early, individualized, and multidisciplinary strategies of rehabilitation. Some patients present persistent affections of the respiratory function, digestive system, cardiovascular function, locomotor system, mental health, sleep, nervous system, immune system, taste, smell, metabolism, inflammation, and skin. In this context, we highlight here that hydrothermal centers should be considered today as medically and economically relevant alternatives to face the urgent need for interventions among COVID-19 patients. We raise the potential benefits of hydrotherapy programs already existing which combine alternative medicine with respiratory care, physical activity, nutritional advice, psychological support, and physiotherapy, in relaxing environments and under medical supervision. Beyond the virtues of thermal waters, many studies reported medical benefits of natural mineral waters through compressing, buoyancy, resistance, temperature changes, hydrostatic pressure, inhalations, or drinking. Thermal institutions might offer individualized follow-up helping to unclog hospitals while ensuring the continuity of health care for the different clinical manifestations of COVID-19 in both post-acute and chronic COVID-19 patients. Our present review underlines the need to further explore the medical effectiveness, clinical and territorial feasibility, and medico-economic impacts of the implementation of post-COVID-19 patient management in hydrotherapeutic establishments.

Italian and Japanese public attention toward balneotherapy in the COVID-19 era

Italian and Japanese public widely use balneotherapy. The population interest in balneotherapy in coronavirus disease-2019 (COVID-19) era should be investigated. Therefore, we aimed to exploit Google Trends analysis, as a measure of peoples' interest in balneotherapy, in two countries, Italy and Japan. In this infodemiology study, Google Trends was queried for the lay terms widely used by the Italian population to refer to the balneotherapy setting (terme + termale) and by the Japanese to refer to the bathing place and balneotherapy facilities ( + スパ). The internet searches in 2020 were compared to overlapping time spans in 2016-2019 and were correlated with new confirmed cases/deaths. This study demonstrated that from February 23 to June 20, 2020, and from October 4 to December 26, 2020, the internet searches of the Italian words corresponding to balneotherapy were statistically significantly decreased; however, the internet searches were not significantly different in June 21 to October 3, 2020, compared to overlapping time spans in 2016-2019 in Italy. The study also showed that from March 15 to September 5, 2020, and from November 29 to December 26, 2020, the internet searches of the Japanese words corresponding to balneotherapy were statistically significantly decreased; however, the internet searches were significantly increased in September 13 to November 7, 2020, and were not significantly different in November 8 to 28, 2020, compared to overlapping time spans in 2016-2019 in Japan. There were significant negative correlations between the relative search volume and number of new cases (rho=-0.634; p<0.001)/deaths (rho=-0.856; p<0.001) in Italy and the number of new deaths (rho=-0.348; p=0.012) in Japan. Population interest in balneotherapy has changed in the COVID-19 era both in Italy and Japan. During the early stage of pandemic (March to June), the interest was lower. After this early stage, the interest showed a recovery in both countries. In Italy, the population interest reached to its prior levels in late June through early October, with a peak in August. In Japan, the recovery exceeded the prior 4-year levels in mid-September through early November. Then, both countries demonstrated a decline in interest: began in early October in Italy and late November in Japan. This information would allow us to understand/address the population response in the pandemic in respect of the balneotherapy and would guide the preparedness of healthcare providers and planners both in this pandemic and future similar situations.

Past and Future Trends in Medical Spas: A Co-Word Analysis

The present paper consists of a co-word analysis of the previous research in the medical spa field published in the Web Science Core Collection database. The study’s main purpose is to identify the past trends in the medical spa field from the tourist and medical perspectives and to anticipate the future research focuses in the field. In this regard, the article is based on four objectives that create a descriptive picture of the research in the medical spa area, such as (i) studying the current state of the art, (ii) analysing the most visible articles in the field, (iii) highlighting the leading research interests in medical spa research and (iv) anticipating new possible research trends that link cost-effective medical spa activity to COVID-19 post-recovery treatments. A total of 627 articles, published between 1997 and 2021 (March), were analysed, and the data were interpreted using the VOS Viewer software. The study results indicate that high interest in medical spas started to become observable in 2015, when the funding bodies became interested in this field and began supporting publishing and research regarding medical spas. The main subjects investigated in previous studies were related to the specific issues of the industry and tourism activity. They also considered the medical approach of the spa and the use of natural resources in treating different diseases. Except for these main interests, since 2020, it has started to become evident that another approach in the published studies may lead to a new trend in research. The study results show that researchers have begun to investigate the possibility of using medical spa resorts to aid post-COVID-19 recovery, which is considered a cost-efficient option for completing traditional treatment. This new focus in research proves that the medical spa field can rebrand itself as playing a supportive role in national healthcare systems in countries with a long tradition in balneotherapy, and gives a new developing trajectory to the medical spa industry.

Public interest in spa therapy during the COVID-19 pandemic: analysis of Google Trends data among Turkey

In Turkey, spas are widely used and preferred by patients who are seeking relief from their disability and pain. The spa therapy program is partly reimbursed by the national health insurance system. The objective of the present study was to leverage Google Trends to elucidate the public interest in spas in Turkey during the COVID-19 pandemic. Google Trends was queried to analyze search trends within Turkey for the Turkish term representing a spa (i.e., kaplıca) from January 01, 2016, to September 30, 2020. The relative search volume of "kaplıca" was statistically significantly decreased in the March 15-May 30, 2020 (- 73.04%; p < 0.001); May 31-July 25, 2020 (- 41.38%; p < 0.001); and July 26-September 19, 2020 (- 29.98%; p < 0.001) periods compared to similar periods of preceding 4 years (2016-2019). After June 1, 2020, the relative search volume was shown to have a moderate recovery, without reaching the level of 2016-2019. Public interest in spas showed an initial sharp decline between mid-March and May, with a moderate increase during the June-August period. This finding might be indicative of public preference in undertaking spa therapy during the COVID-19 period. In Turkey, spas might be used to increase places providing rehabilitation for both non-COVID-19 patients and survivors of COVID-19 with long-term symptoms during the pandemic.