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Kaplan K, Mendenhall E. Framing Long Covid through Patient activism in the United States: Patient, Provider, Academic, and Policymaker Views. Soc Sci Med 2024; 350:116901. [PMID: 38688088 DOI: 10.1016/j.socscimed.2024.116901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
In 2020, when COVID-19 patients first recognized their complex and progressive symptoms, patient activists defined "Long Covid" on social media. While patient support groups are by no means new, the predominance of online support groups and those leveraging the power of social media has become a defining characteristic of Long Covid. In this article, we argue that naming Long Covid served as a powerful conduit of legitimacy for patient activists in media, medicine, and policy. We conducted 57 in-depth qualitative interviews with patients (n = 22), clinicians (n = 20), and policy and academic experts (n = 15). We found naming was not a primary area of contention. In contrast, patients found pride and a sense of identity within the terms. Many clinicians struggled with diagnostics because Long Covid lacks clear biological tests, while patients were consistently disappointed by the lack of positive tests and clarity around their symptomatology. The heterogeneity of the Long Covid experience, as well as the diversity of symptoms, further provides opportunities for contestation and disbelief among clinicians and policymakers not only in diagnostics but also in disability rights. Thus, the power of patient activism has transformed how the condition is perceived among and between patients, clinicians, policymakers, and the media in unprecedented ways that will likely have longstanding impacts on how IACCs are viewed in medicine and the public alike.
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Affiliation(s)
- Kenton Kaplan
- Walsh School of Foreign Service, Georgetown University, Washington D.C, USA
| | - Emily Mendenhall
- Walsh School of Foreign Service, Georgetown University, Washington D.C, USA.
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Torres F, Shedd C, Kaza V, Bollineni S, Banga A, Mohanka MR, Ladikos N, Wijesinha M, Mahan LD, Lawrence A, Joerns J, Terada L, Timofte I. Outpatient management of Post-COVID syndrome - single center experience. Heart Lung 2024; 67:137-143. [PMID: 38759575 DOI: 10.1016/j.hrtlng.2024.05.004] [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: 01/07/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND COVID patients continue to experience unremitting symptoms that extend far beyond the initial illness. While there is rapid accumulation of data on acute COVID treatment in hospitalized patients, little is known regarding post-COVID management. OBJECTIVES To describe our center's experience treating post-COVID sub-syndromes encountered in Post-COVID Lung Clinic. METHODS We retrospectively reviewed data on 98 post-COVID patients evaluated in our clinic between 07/01/2020-12/31/2022. We encountered three distinct post-COVID subtypes: 1) respiratory complaints associated with increased O2 requirements and abnormal CT findings (post-COVID interstitial lung disease [ILD]), 2) respiratory complaints associated with tachycardia (post-COVID dyspnea-tachycardia syndrome [DTS]). Post-COVID ILD patients (n = 28) received steroids in combination with cell cycle inhibitor (mycophenolate mofetil-MMF). Post-COVID DTS patients (n = 16) were treated with metoprolol. 3) A third, undifferentiated group presented with mild respiratory complaints and normal spirometry (n = 17) and was followed in clinic without initiation of a specific treatment. RESULTS In treated post-COVID ILD patients, mean oxygen requirements at rest (1.96 ± 1.79 L/NC) decreased to 0.89 ± 1.29 L/NC at 6 months follow-up, p = 0.005. In patients with post-COVID DTS, mean heart rate at rest decreased (98 ± 15 bpm to 79 ± 11 bpm) at 6 months follow-up, p = 0.023. 60 % of patients reported an improvement in exertional dyspnea. CONCLUSIONS Our descriptive study presents a single center outpatient COVID-19 clinic experience. We encountered 3 post-COVID sub-syndromes and describe their treatments: post-COVID interstitial lung disease [ILD] treated with a novel regimen of MMF and steroids, post COVID dyspnea-tachycardia syndrome [DTS] treated with metoprolol, and a third subgroup with mild undifferentiated symptoms without specific treatment.
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Affiliation(s)
- Fernando Torres
- The University of Texas Southwestern Medical Center, United States
| | - Christine Shedd
- The University of Texas Southwestern Medical Center, United States.
| | - Vaidehi Kaza
- The University of Texas Southwestern Medical Center, United States
| | | | - Amit Banga
- The University of Texas Southwestern Medical Center, United States
| | - Manish R Mohanka
- The University of Texas Southwestern Medical Center, United States
| | - Nicholas Ladikos
- The University of Texas Southwestern Medical Center, United States
| | - Marniker Wijesinha
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, United States
| | - Luke D Mahan
- The University of Texas Southwestern Medical Center, United States
| | - Adrian Lawrence
- The University of Texas Southwestern Medical Center, United States
| | - John Joerns
- The University of Texas Southwestern Medical Center, United States
| | - Lance Terada
- The University of Texas Southwestern Medical Center, United States
| | - Irina Timofte
- The University of Texas Southwestern Medical Center, United States
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3
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Cagino L, Seagly K, Noyes E, Prescott H, Valley T, Eaton T, McSparron JI. Outcomes and Management After COVID-19 Critical Illness. Chest 2024; 165:1149-1162. [PMID: 38104961 DOI: 10.1016/j.chest.2023.11.044] [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: 10/06/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023] Open
Abstract
TOPIC IMPORTANCE COVID-19 has caused > 7 million deaths worldwide since its onset in 2019. Although the severity of illness has varied throughout the pandemic, critical illness related to COVID-19 persists. Survivors of COVID-19 critical illness can be left with sequelae of both the SARS-CoV-2 virus and long-term effects of critical illness included within post-intensive care syndrome. Given the complexity and heterogeneity of COVID-19 critical illness, the biopsychosocial-ecological model can aid in evaluation and treatment of survivors, integrating interactions among physical, cognitive, and psychological domains, as well as social systems and environments. REVIEW FINDINGS Prolonged illness after COVID-19 critical illness generally can be classified into effects on physical, cognitive, and psychosocial function, with much interaction among the various effects, and includes a wide range of symptoms such as ICU-acquired weakness, prolonged respiratory symptoms, cognitive changes, post-traumatic stress disorder post-traumatic stress disorder, anxiety, and depression. Risk factors for COVID-19 critical illness developing are complex and include preexisting factors, disease course, and specifics of hospitalization in addition to psychological comorbidities and socioenvironmental factors. Recovery trajectories are not well defined, and management requires a comprehensive, interdisciplinary, and individualized approach to care. SUMMARY The onset of vaccinations, new therapeutics, and new strains of SARS-CoV-2 virus have decreased COVID-19 mortality; however, the number of survivors of COVID-19 critical illness remains high. A biopsychosocial-ecological approach is recommended to guide care of COVID-19 critical illness survivors.
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Affiliation(s)
- Leigh Cagino
- Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
| | - Katharine Seagly
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Emily Noyes
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Hallie Prescott
- Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor, MI; VA Center for Clinical Management Research, Ann Arbor, MI
| | - Thomas Valley
- Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor, MI; VA Center for Clinical Management Research, Ann Arbor, MI
| | - Tammy Eaton
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI; VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, Ann Arbor, MI
| | - Jakob I McSparron
- Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
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Vazirani R, Feltes G, Hoyo RSD, Viana-Llamas MC, Raposeiras-Roubín S, Romero R, Alfonso-Rodríguez E, Uribarri A, Santoro F, Becerra-Muñoz V, Pepe M, Castro-Mejía AF, Signes-Costa J, Gonzalez A, Marín F, Lopez-País J, Cerrato E, Vázquez-Cancela O, Espejo-Paeres C, López Masjuan Á, Velicki L, El-Battrawy I, Ramakrishna H, Fernandez-Ortiz A, Nuñez-Gil IJ. Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes-Results from a Multi-Center International Prospective Registry (HOPE-2). J Clin Med 2024; 13:2596. [PMID: 38731127 PMCID: PMC11084489 DOI: 10.3390/jcm13092596] [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: 03/12/2024] [Revised: 03/31/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Acute cardiac injury (ACI) after COVID-19 has been linked with unfavorable clinical outcomes, but data on the clinical impact of elevated cardiac troponin on discharge during follow-up are scarce. Our objective is to elucidate the clinical outcome of patients with elevated troponin on discharge after surviving a COVID-19 hospitalization. Methods: We conducted an analysis in the prospective registry HOPE-2 (NCT04778020). Only patients discharged alive were selected for analysis, and all-cause death on follow-up was considered as the primary endpoint. As a secondary endpoint, we established any long-term COVID-19 symptoms. HOPE-2 stopped enrolling patients on 31 December 2021, with 9299 patients hospitalized with COVID-19, of which 1805 were deceased during the acute phase. Finally, 2382 patients alive on discharge underwent propensity score matching by relevant baseline variables in a 1:3 fashion, from 56 centers in 8 countries. Results: Patients with elevated troponin experienced significantly higher all-cause death during follow-up (log-rank = 27.23, p < 0.001), and had a higher chance of experiencing long-term COVID-19 cardiovascular symptoms. Specifically, fatigue and dyspnea (57.7% and 62.8%, with p-values of 0.009 and <0.001, respectively) are among the most common. Conclusions: After surviving the acute phase, patients with elevated troponin on discharge present increased mortality and long-term COVID-19 symptoms over time, which is clinically relevant in follow-up visits.
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Affiliation(s)
- Ravi Vazirani
- Cardiology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (R.V.); (A.F.-O.)
| | - Gisela Feltes
- Cardiology Department, Hospital Vithas Arturo Soria, 28043 Madrid, Spain;
| | - Rafael Sánchez-del Hoyo
- Research Methodological Support Unit and Preventive Department, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain;
| | - María C. Viana-Llamas
- Cardiology Department, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain;
| | | | - Rodolfo Romero
- Emergency Department, Hospital Isabel Zendal, Hospital Universitario de Getafe, 28905 Madrid, Spain;
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
| | - Emilio Alfonso-Rodríguez
- Cardiology Department, Bellvitge Biomedical Research Institute (IDIBELL), Hospital Universitario de Bellvitge, 08908 Barcelona, Spain;
| | - Aitor Uribarri
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | | | - Víctor Becerra-Muñoz
- Cardiology Department, Hospital Clínico Universitario Virgen de la Victoria, 29010 Malaga, Spain;
| | - Martino Pepe
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Alex F. Castro-Mejía
- Hospital General del Norte de Guayaquil IESS “Los Ceibos”, Guayaquil 090615, Ecuador;
| | - Jaime Signes-Costa
- Pneumology Department, Hospital Clínico de Valencia, INCLIVA, University of Valencia, 46010 Valencia, Spain;
| | - Adelina Gonzalez
- Anesthesiology Department, Hospital Universitario Infanta Sofia, 28702 Madrid, Spain;
| | - Francisco Marín
- Cardiology Department, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, 30120 Murcia, Spain;
| | - Javier Lopez-País
- Cardiology Department, Complejo Hospitalario Universitario de Ourense, 32004 Orense, Spain;
| | - Enrico Cerrato
- Cardiology Department, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, 10098 Rivoli, Italy;
| | - Olalla Vázquez-Cancela
- Preventive Department, Hospital Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Carolina Espejo-Paeres
- Cardiology and Emergency Department, Hospital Universitario Príncipe de Asturias, 28805 Madrid, Spain;
| | - Álvaro López Masjuan
- Cardiology Department, Hospital Universitario Juan Ramón Jimenez, 21005 Huelva, Spain;
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
- Institute of Cardiovascular Diseases Vojvodina, 21204 Sremska Kamenica, Serbia
| | - Ibrahim El-Battrawy
- Institute of Physiology, Department of Cellular and Translational Physiology, Medical Faculty, Ruhr University of Bochum, 44801 Bochum, Germany;
- Institut für Forschung und Lehre (IFL),Molecular and Experimental Cardiology, Ruhr University of Bochum, 44801 Bochum, Germany
- Department of Cardiology, St. Josef-Hospital of the Ruhr University Bochum, 44801 Bochum, Germany
| | | | | | - Ivan J. Nuñez-Gil
- Cardiology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain; (R.V.); (A.F.-O.)
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
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Van Herck M, Pagen DME, van Bilsen CJA, Brinkhues S, Konings K, den Heijer CDJ, Mujakovic S, Ter Waarbeek HLG, Burtin C, Janssen DJA, Hoebe CJPA, Spruit MA, Dukers-Muijrers NHTM. Impact of post-COVID-19 condition on health status and activities of daily living: the PRIME post-COVID study. Thorax 2024; 79:457-464. [PMID: 38499346 DOI: 10.1136/thorax-2023-220504] [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: 05/23/2023] [Accepted: 01/28/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVE To assess health and activities of daily living (ADL) in SARS-CoV-2-positive adults with and without post-COVID-19 condition (PCC) and compare this with negative tested individuals. Furthermore, different PCC case definitions were compared with SARS-CoV-2-negative individuals. METHODS All adults tested PCR positive for SARS-CoV-2 at the Public Health Service South Limburg (Netherlands) between June 2020 and November 2021 (n=41 780) and matched PCR negative individuals (2:1, on age, sex, year-quarter test, municipality; n=19 875) were invited by email. Health (five-level EuroQol five-dimension (EQ5D) index and EuroQol visual analogue scale (EQVAS)) and ADL impairment were assessed. PCC classification was done using the WHO case definition and five other common definitions. RESULTS In total, 8409 individuals (6381 SARS-CoV-2 positive; 53±15 years; 57% female; 9 (7-11) months since test) were included. 39.4% of positives had PCC by the WHO case definition (EQVAS: 71±20; EQ5D index: 0.800±0.191; ADL impairment: 30 (10-70)%) and perceived worse health and more ADL impairment than negatives, that is, difference of -8.50 points (95% CI -9.71 to -7.29; p<0.001) for EQVAS, which decreased by 1.49 points (95% CI 0.86 to 2.12; p<0.001) in individuals with PCC for each comorbidity present, and differences of -0.065 points (95% CI -0.074 to -0.056; p<0.001) for EQ5D index, and +16.72% (95% CI 15.01 to 18.43; p<0.001) for ADL impairment. Health and ADL impairment were similar in negatives and positives without PCC. Replacing the WHO case definition with other PCC definitions yielded comparable results. CONCLUSIONS Individuals with PCC have substantially worse health and more ADL impairment than negative controls, irrespective of the case definition. Authorities should inform the public about the associated burden of PCC and enable adequate support.
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Affiliation(s)
- Maarten Van Herck
- Department of Research and Education, Ciro, Horn, The Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, The Netherlands
- REVAL, Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Demi M E Pagen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Céline J A van Bilsen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge & Innovation, South Limburg Public Health Service, Heerlen, The Netherlands
| | - Kevin Konings
- Department of Process & Information Management, Communication & Automation, South Limburg Public Health Service, Heerlen, The Netherlands
| | - Casper D J den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Suhreta Mujakovic
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
| | - Henriëtte L G Ter Waarbeek
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
| | - Chris Burtin
- REVAL, Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Daisy J A Janssen
- Department of Research and Education, Ciro, Horn, The Netherlands
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Social Medicine, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Martijn A Spruit
- Department of Research and Education, Ciro, Horn, The Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, The Netherlands
- Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Preiss A, Bhatia A, Aragon LV, Baratta JM, Baskaran M, Blancero F, Brannock MD, Chew RF, Díaz I, Fitzgerald M, Kelly EP, Zhou A, Carton TW, Chute CG, Haendel M, Moffitt R, Pfaff E. EFFECT OF PAXLOVID TREATMENT DURING ACUTE COVID-19 ON LONG COVID ONSET: AN EHR-BASED TARGET TRIAL EMULATION FROM THE N3C AND RECOVER CONSORTIA. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.20.24301525. [PMID: 38343863 PMCID: PMC10854326 DOI: 10.1101/2024.01.20.24301525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Preventing and treating post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as Long COVID, has become a public health priority. In this study, we examined whether treatment with Paxlovid in the acute phase of COVID-19 helps prevent the onset of PASC. We used electronic health records from the National Covid Cohort Collaborative (N3C) to define a cohort of 426,352 patients who had COVID-19 since April 1, 2022, and were eligible for Paxlovid treatment due to risk for progression to severe COVID-19. We used the target trial emulation (TTE) framework to estimate the effect of Paxlovid treatment on PASC incidence. We estimated overall PASC incidence using a computable phenotype. We also measured the onset of novel cognitive, fatigue, and respiratory symptoms in the post-acute period. Paxlovid treatment did not have a significant effect on overall PASC incidence (relative risk [RR] = 0.98, 95% confidence interval [CI] 0.95-1.01). However, it had a protective effect on cognitive (RR = 0.90, 95% CI 0.84-0.96) and fatigue (RR = 0.95, 95% CI 0.91-0.98) symptom clusters, which suggests that the etiology of these symptoms may be more closely related to viral load than that of respiratory symptoms.
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Affiliation(s)
| | - Abhishek Bhatia
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - John M. Baratta
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Monika Baskaran
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Iván Díaz
- New York University Grossman School of Medicine, New York, NY, USA
| | | | | | - Andrea Zhou
- University of Virginia, Charlottesville, VA, USA
| | - Thomas W. Carton
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Christopher G. Chute
- Johns Hopkins University School of Medicine, Public Health, and Nursing, Baltimore, MD, USA
| | - Melissa Haendel
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Emily Pfaff
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Bonora BM, Marassi M, Fogar P, Zuin J, Cappellari R, Marinello S, Ferrari A, Cattelan A, Avogaro A, Basso D, Fadini GP. Circulating haematopoietic stem cells and long-term outcomes of COVID-19. Eur J Clin Invest 2024; 54:e14150. [PMID: 38088242 DOI: 10.1111/eci.14150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/19/2023] [Accepted: 11/30/2023] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND AIMS An acute depletion of circulating haematopoietic stem/progenitor cells (HSPCs) occurs during COVID-19, especially among patients with a poorer disease course. We herein examined whether HSPCs levels at hospital admission for COVID-19 predict 1-year mortality and the long-COVID syndrome. MATERIALS AND METHODS Patients hospitalized for COVID-19 in an infectious disease ward were consecutively enrolled. Circulating HSPC levels were assessed by flow cytometry as cells expressing CD34 and/or CD133. Follow-up was performed for 12 months after hospitalization through the review of electronic medical records and demographic local registers. RESULTS The study included 100 patients, 36 of whom reported symptoms of long-COVID and 20 died during follow-up. The reduction of 1-SD of HSPCs was associated with a 3- to 5-fold increase in the risk of 1-year mortality. Age, admission hyperglycaemia, C-reactive protein peak, liver enzymes, the need of high-flow oxygen and/or invasive ventilation were predictors of mortality at univariate analysis. Among pre-existing comorbidities, coronary heart disease and chronic kidney disease, but not diabetes, were associated with 1-year mortality. In multivariate analyses, HSPCs remained significantly associated with 1-year mortality independently of confounders. The development of pneumonia an in-hospital treatment with glucocorticoids and convalescent plasma were associated with long-COVID symptoms at follow-up. HSPCs, diabetes and other comorbidities were not predictors of long-COVID. CONCLUSIONS In a cohort of patients hospitalized for COVID-19, lower HSPC levels at the time of admission were independent predictors of 1-year mortality. However, COVID-19 severity, but not HSPC level, was significantly associated with the development of long-COVID symptoms.
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Affiliation(s)
- Benedetta Maria Bonora
- Department of Medicine, University Hospital of Padova, Padua, Italy
- Veneto Institute of Molecular Medicine, Padua, Italy
| | - Marella Marassi
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | - Paola Fogar
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | - Jenny Zuin
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | | | - Serena Marinello
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | - Anna Ferrari
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | - Daniela Basso
- Department of Medicine, University Hospital of Padova, Padua, Italy
| | - Gian Paolo Fadini
- Department of Medicine, University Hospital of Padova, Padua, Italy
- Veneto Institute of Molecular Medicine, Padua, Italy
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Ramos AN. Long COVID challenges in Brazil: an unfinished agenda for the Brazilian Unified National Health System. CAD SAUDE PUBLICA 2024; 40:e00008724. [PMID: 38381866 PMCID: PMC10877692 DOI: 10.1590/0102-311xpt008724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
- Alberto Novaes Ramos
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Ceará, Fortaleza, Brasil
- Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, Brasil
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9
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Bielecka E, Sielatycki P, Pietraszko P, Zapora-Kurel A, Zbroch E. Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19-A Narrative Review. Int J Mol Sci 2024; 25:1837. [PMID: 38339115 PMCID: PMC10856065 DOI: 10.3390/ijms25031837] [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: 08/27/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Arterial hypertension is one of the most common and significant cardiovascular risk factors. There are many well-known and identified risk factors for its development. In recent times, there has been growing concern about the potential impact of COVID-19 on the cardiovascular system and its relation to arterial hypertension. Various theories have been developed that suggest a connection between COVID-19 and elevated blood pressure. However, the precise link between SARS-CoV-2 infection and the long-term risk of developing hypertension remains insufficiently explored. Therefore, the primary objective of our study was to investigate the influence of COVID-19 infection on blood pressure elevation and the subsequent risk of developing arterial hypertension over an extended period. To accomplish this, we conducted a thorough search review of relevant papers in the PubMed and SCOPUS databases up to 3 September 2023. Our analysis encompassed a total of 30 eligible articles. Out of the 30 papers we reviewed, 19 of them provided substantial evidence showing a heightened risk of developing arterial hypertension following COVID-19 infection. Eight of the studies showed that blood pressure values increased after the infection, while three of the qualified studies did not report any notable impact of COVID-19 on blood pressure levels. The precise mechanism behind the development of hypertension after COVID-19 remains unclear, but it is suggested that endothelial injury and dysfunction of the renin-angiotensin-aldosterone system may be contributory. Additionally, changes in blood pressure following COVID-19 infection could be linked to lifestyle alterations that often occur alongside the illness. Our findings emphasize the pressing requirement for thorough research into the relationship between COVID-19 and hypertension. These insights are essential for the development of effective prevention and management approaches for individuals who have experienced COVID-19 infection.
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Affiliation(s)
| | | | | | | | - Edyta Zbroch
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (E.B.); (P.S.); (P.P.); (A.Z.-K.)
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Gwaikolo C, Sackie-Wapoe Y, Badio M, Glidden DV, Lindan C, Martin J. Prevalence and determinants of post-acute sequelae of COVID-19 in Liberia. Int J Epidemiol 2024; 53:dyad167. [PMID: 38052015 PMCID: PMC10859153 DOI: 10.1093/ije/dyad167] [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: 01/24/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Evidence from resource-rich settings indicates that many people continue to have persistent symptoms following acute SARS-CoV-2 infection, called post-acute sequelae of COVID-19 (PASC). Only a few studies have described PASC in sub-Saharan Africa (SSA). We aimed to describe PASC in Liberia. METHODS We randomly sampled all people who were reported from the most populous county to the Liberian Ministry of Health (MOH) as having a laboratory-confirmed SARS-CoV-2 infection from June to August 2021. We interviewed individuals by phone 3 to 6 months later. Those with persistence of at least one symptom were considered to have PASC. RESULTS From among 2848 people reported to the MOH from Montserrado County during the period of interest, we randomly selected 650; of these, 548 (84.3%) were reached and 505 (92.2%) of those who were contacted were interviewed. The median age was 38 years (interquartile range (IQR), 30-49), and 43.6% were female. During acute infection, 40.2% were asymptomatic, 53.9% had mild/moderate disease and 6.9% had severe/critical disease. Among the 59.8% (n = 302) who were initially symptomatic, 50.2% (n = 152) reported at least one persistent symptom; the most common persistent symptoms were fatigue (21.2%), headache (16.2%) and cough (12.6%); 40.1% reported that PASC significantly affected their daily activities. Being hospitalized with moderate disease [adjusted prevalence ratio (aPR), 2.00 (95% CI, 1.59 to 2.80] or severe/critical disease [aPR, 2.11 (95% CI, 1.59 to 2.80)] was associated with PASC, compared with those not hospitalized. Females were more likely than males to report persistent fatigue [aPR, 1.67 (95% CI, 1.08 to 2.57)]. CONCLUSIONS Our findings suggest that persistent symptoms may have affected a large proportion of people with initially symptomatic COVID-19 in west Africa and highlight the need to create awareness among infected people and health care professionals.
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Affiliation(s)
- Cozie Gwaikolo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | - Moses Badio
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Christina Lindan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Jeffrey Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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11
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Pazukhina E, Rumyantsev M, Baimukhambetova D, Bondarenko E, Markina N, El-Taravi Y, Petrova P, Ezhova A, Andreeva M, Iakovleva E, Bobkova P, Pikuza M, Trefilova A, Abdeeva E, Galiautdinova A, Filippova Y, Bairashevskaia A, Zolotarev A, Bulanov N, DunnGalvin A, Chernyavskaya A, Kondrikova E, Kolotilina A, Gadetskaya S, Ivanova YV, Turina I, Eremeeva A, Fedorova LA, Comberiati P, Peroni DG, Nekliudov N, Genuneit J, Reyes LF, Brackel CLH, Mazankova L, Miroshina A, Samitova E, Borzakova S, Carson G, Sigfrid L, Scott JT, McFarland S, Greenhawt M, Buonsenso D, Semple MG, Warner JO, Olliaro P, Osmanov IM, Korsunskiy AA, Munblit D. Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID). BMC Med 2024; 22:48. [PMID: 38302974 PMCID: PMC10835884 DOI: 10.1186/s12916-023-03221-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/07/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections. METHODS A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the 'exposed cohorts' and 'reference cohort' was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC. RESULTS Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final 'matched' analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3-120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9-21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts. CONCLUSIONS Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.
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Affiliation(s)
- Ekaterina Pazukhina
- Laboratory of Health Economics, Institute of Applied Economic Studies, The Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia
- Center for Advanced Financial Planning, Macroeconomic Analysis and Financial Statistics, Financial Research Institute of the Ministry of Finance of the Russian Federation, Moscow, Russia
| | - Mikhail Rumyantsev
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Dina Baimukhambetova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elena Bondarenko
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nadezhda Markina
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yasmin El-Taravi
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Petrova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasia Ezhova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Margarita Andreeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ekaterina Iakovleva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Bobkova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Maria Pikuza
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasia Trefilova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elina Abdeeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aysylu Galiautdinova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yulia Filippova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasiia Bairashevskaia
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aleksandr Zolotarev
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nikolay Bulanov
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Audrey DunnGalvin
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- School of Applied Psychology, University College Cork, Cork City, Ireland
| | - Anastasia Chernyavskaya
- Department of Paediatrics and Paediatric Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elena Kondrikova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasia Kolotilina
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Svetlana Gadetskaya
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yulia V Ivanova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Irina Turina
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alina Eremeeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ludmila A Fedorova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Nikita Nekliudov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jon Genuneit
- Department of PediatricsPediatric Epidemiology, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Luis Felipe Reyes
- Universidad de La Sabana, School of Medicine, Chía, Colombia
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Caroline L H Brackel
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands
| | - Lyudmila Mazankova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Elmira Samitova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Svetlana Borzakova
- Department of Pediatrics, Russian Medical Academy of Continuing Professional Education of the Ministry of Health, Moscow, Russia
- Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, Russia
| | - Gail Carson
- ISARIC Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Louise Sigfrid
- ISARIC Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Janet T Scott
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy/Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, USA
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento Di Scienze Biotecnologiche Di Base, Cliniche Intensivologiche E Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Malcolm G Semple
- Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK
| | - John O Warner
- Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Piero Olliaro
- ISARIC Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ismail M Osmanov
- Department of Pediatrics, Russian Medical Academy of Continuing Professional Education of the Ministry of Health, Moscow, Russia
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Anatoliy A Korsunskiy
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
- Research and Clinical Center for Neuropsychiatry, Moscow, Russia.
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
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12
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Vo HT, Dao TD, Duong TV, Nguyen TT, Do BN, Do TX, Pham KM, Vu VH, Pham LV, Nguyen LTH, Le LTH, Nguyen HC, Dang NH, Nguyen TH, Nguyen AT, Nguyen HV, Nguyen PB, Nguyen HTT, Pham TTM, Le TT, Nguyen TTP, Tran CQ, Nguyen KT. Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam. Osong Public Health Res Perspect 2024; 15:33-44. [PMID: 38481048 PMCID: PMC10982660 DOI: 10.24171/j.phrp.2023.0261] [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: 09/15/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a "social vaccine" that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. METHODS A cross-sectional study was conducted at 18 hospitals and health centers in Vietnam from December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (using the 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. RESULTS Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD. Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63-2.12; p<0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97-0.99; p=0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96-0.99; p=0.001). CONCLUSION Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.
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Affiliation(s)
- Han Thi Vo
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Tien Duc Dao
- Institute of Oncology and Nuclear Medicine, Military Hospital, Ho Chi Minh, Vietnam
| | - Tuyen Van Duong
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
| | - Tan Thanh Nguyen
- Department of Orthopedics, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Director Office, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Binh Nhu Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam
- Department of Military Science, Vietnam Military Medical University, Hanoi, Vietnam
| | - Tinh Xuan Do
- Department of Psychiatry, Military Hospital 103, Hanoi, Vietnam
| | - Khue Minh Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Vinh Hai Vu
- Infectious and Tropical Diseases Department, Viet Tiep Hospital, Hai Phong, Vietnam
| | - Linh Van Pham
- Department of Pulmonary and Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
| | - Lien Thi Hong Nguyen
- Department of Pulmonary and Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
| | - Lan Thi Huong Le
- Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- Training and Direction of Healthcare Activity Center, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- Biochemistry Department, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
| | - Hoang Cong Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Nga Hoang Dang
- Training and Direction of Healthcare Activity Center, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
- Department of Quality Control, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
| | | | - Anh The Nguyen
- Director Office, Hospital for Tropical Diseases, Hai Duong, Vietnam
| | - Hoan Van Nguyen
- Infectious and Tropical Diseases Department, Viet Tiep Hospital, Hai Phong, Vietnam
- Department of Infectious Diseases, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | | | - Hoai Thi Thanh Nguyen
- Training and Direction of Healthcare Activity Center, Kien An Hospital, Hai Phong, Vietnam
| | - Thu Thi Minh Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Thuy Thi Le
- President Office, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
- Faculty of Medical Laboratory Science, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | - Thao Thi Phuong Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Cuong Quoc Tran
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Kien Trung Nguyen
- Department of Health Promotion, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
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Tana C, Raffaelli B, Souza MNP, de la Torre ER, Massi DG, Kisani N, García-Azorín D, Waliszewska-Prosół M. Health equity, care access and quality in headache - part 1. J Headache Pain 2024; 25:12. [PMID: 38281917 PMCID: PMC10823691 DOI: 10.1186/s10194-024-01712-7] [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: 12/01/2023] [Accepted: 01/03/2024] [Indexed: 01/30/2024] Open
Abstract
Current definitions of migraine that are based mainly on clinical characteristics do not account for other patient's features such as those related to an impaired quality of life, due to loss of social life and productivity, and the differences related to the geographical distribution of the disease and cultural misconceptions which tend to underestimate migraine as a psychosocial rather than neurobiological disorder.Global differences definition, care access, and health equity for headache disorders, especially migraine are reported in this paper from a collaborative group of the editorial board members of the Journal of Headache and Pain. Other components that affect patients with migraine, in addition to the impact promoted by the migraine symptoms such as stigma and social determinants, are also reported.
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Affiliation(s)
- Claudio Tana
- Center of Excellence on Headache and Geriatrics Clinic, SS Annunziata Hospital of Chieti, Chieti, Italy.
| | - Bianca Raffaelli
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health (BIH), Berlin, Germany
| | | | | | - Daniel Gams Massi
- Neurology Unit, Douala General Hospital, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Najib Kisani
- Department of Neurology, Mohammed VI University Hospital, Marrakech, Morocco
| | - David García-Azorín
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
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Hedberg P, Nauclér P. Post-COVID-19 Condition After SARS-CoV-2 Infections During the Omicron Surge vs the Delta, Alpha, and Wild Type Periods in Stockholm, Sweden. J Infect Dis 2024; 229:133-136. [PMID: 37665981 PMCID: PMC10786247 DOI: 10.1093/infdis/jiad382] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/16/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
Little is known about the post-COVID-19 condition (PCC) after infections with different SARS-CoV-2 variants. We investigated the risk of PCC diagnosis after primary omicron infections as compared with preceding variants in population-based cohorts in Stockholm, Sweden. When compared with omicron (n = 215 279, 0.2% receiving a PCC diagnosis), the adjusted hazard ratio (95% CI) was 3.26 (2.80-3.80) for delta (n = 52 182, 0.5% PCC diagnosis), 5.33 (4.73-5.99) for alpha (n = 97 978, 1.0% PCC diagnosis), and 6.31 (5.64-7.06) for the wild type (n = 107 920, 1.3% PCC diagnosis). These findings were consistent across all subgroup analyses except among those treated in the intensive care unit.
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Affiliation(s)
| | - Pontus Nauclér
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
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15
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Zhang H, Huang C, Gu X, Wang Y, Li X, Liu M, Wang Q, Xu J, Wang Y, Dai H, Zhang D, Cao B. 3-year outcomes of discharged survivors of COVID-19 following the SARS-CoV-2 omicron (B.1.1.529) wave in 2022 in China: a longitudinal cohort study. THE LANCET. RESPIRATORY MEDICINE 2024; 12:55-66. [PMID: 38000376 DOI: 10.1016/s2213-2600(23)00387-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND There is a paucity of data on the natural trajectory of outcomes in survivors of COVID-19 beyond 2 years after symptom onset, and no evidence exists on the effect of re-infection in people with long COVID symptoms. We aimed to investigate the 3-year health outcomes of COVID-19 survivors and the effect of omicron re-infection. METHODS In this single-centre, longitudinal cohort study, we recruited participants with confirmed COVID-19 who were discharged from the Jin Yin-tan hospital in Wuhan, China, between Jan 7 and May 29, 2020. Participants completed three follow-up visits at 6 months (June 16 to Sept 13, 2020), 1 year (Dec 16, 2020, to Feb 7, 2021), and 2 years (Nov 16, 2021, to Jan 10, 2022) since symptom onset (reported previously). At 1-year follow-up, community controls without a history of SARS-CoV-2 infection were recruited from two communities in Wuhan and at 2 years were matched (1:1) with survivors of COVID-19 who underwent pulmonary function tests. We did a 3-year follow-up from Feb 23, 2023, to April 20, 2023, after the omicron (B.1.1.529) wave in winter, 2022. All eligible survivors of COVID-19 and community controls matched at 2-year follow-up were invited to the outpatient clinic at the hospital to complete several face-to-face questionnaires, a 6-min walking test (6MWT), and laboratory tests. A subgroup of survivors of COVID-19 identified by stratified sampling on the basis of disease severity scale score during hospitalisation and community controls underwent pulmonary function tests. Survivors of COVID-19 who received high-resolution CT and showed abnormal lung images at 2-year follow-up were invited for another assessment. We identified participants with and without long COVID at 2 years. The primary outcomes were sequelae symptoms, omicron infection, lung function, and chest imaging at the 3-year follow-up. FINDINGS Of 1359 COVID-19 survivors who completed 2-year and 3-year follow-up, 728 (54%) had at least one sequelae symptom at 3 years after symptom onset and before omicron infection, mainly mild to moderate severity. During the omicron wave, participants with long COVID at 2 years had a significantly higher proportion of re-infection (573 [76%] of 753 vs 409 [67%] of 606 without long COVID; p=0·0004), pneumonia (27 [5%] of 568 vs seven [2%] of 403; p=0·012). 3 months after omicron infection, 126 (62%) of 204 survivors with long COVID at 2 years had newly occurring or worse symptoms, which was significantly higher than the proportion in the non-long COVID group (85 [41%] of 205; p<0·0001) and community controls (81 [40%] of 205; p<0·0001), and not significantly different between COVID-19 survivors without long COVID and matched community controls (85 [41%] of 205 vs 81 [39%] of 206; p=0·66). Re-infection was a risk factor for dyspnoea (odds ratio 1·36 [95% CI 1·04 to 1·77]; p=0·023), anxiety or depression (OR 1·65 [1·24 to 2·20]; p=0·0007), EuroQol visual analogue scale score (β -4·51 [-6·08 to -2·95]; p<0·0001), but not for reduced daily activity (0·72 [0·38 to 1·37]; p=0·32) at 3 years. Lung function of survivors at 3 years was similar to that of matched community controls. We found irregular line, traction bronchiectasis, subpleural lines and ground glass opacity at 3 years, but the volume ratio of lung lesion to total lung was only 0·2-0·3%. INTERPRETATION Most long COVID symptoms at 3 years were mild to moderate, with lung function recovering to levels of matched controls. Survivors with long COVID had a higher proportion of participants with re-infection and newly occurring or worse symptoms 3 months after omicron infection than those without long COVID. Re-infection had increased symptom occurrence but not increased reduced daily activity. Although the organ function of survivors of COVID-19 recovered over time, those with severe long COVID symptoms, abnormal organ function, or limited mobility require urgent attention in future clinical practice and research. FUNDING Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Natural Science Foundation of China.
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Affiliation(s)
- Hui Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship hospital, Capital Medical University, Beijing, China; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chaolin Huang
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, Hubei Province, China
| | - Xiaoying Gu
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yeming Wang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xia Li
- Hubei Provincial Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, Hubei Province, China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Qiongya Wang
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, Hubei Province, China
| | - Jiuyang Xu
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yimin Wang
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Pulmonary and Critical Care Medicine, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Huaping Dai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship hospital, Capital Medical University, Beijing, China; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Dingyu Zhang
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, Hubei Province, China; Hubei Clinical Research Center for Infectious Diseases, Wuhan, Hubei Province, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship hospital, Capital Medical University, Beijing, China; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.
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16
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Berezin L, Waseem R, Merikanto I, Benedict C, Holzinger B, De Gennaro L, Wing YK, Bjorvatn B, Korman M, Morin CM, Espie C, Landtblom AM, Penzel T, Matsui K, Hrubos-Strøm H, Mota-Rolim S, Nadorff MR, Plazzi G, Reis C, Chan RNY, Cunha AS, Yordanova J, Bjelajac AK, Inoue Y, Dauvilliers Y, Partinen M, Chung F. Habitual short sleepers with pre-existing medical conditions are at higher risk of Long COVID. J Clin Sleep Med 2024; 20:111-119. [PMID: 37858285 PMCID: PMC10758549 DOI: 10.5664/jcsm.10818] [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: 04/08/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023]
Abstract
STUDY OBJECTIVES Preliminary evidence suggests that the risk of Long COVID is higher among people with pre-existing medical conditions. Based on its proven adjuvant role in immunity, habitual sleep duration may alter the risk of developing Long COVID. The objective of this study was to determine whether the odds of Long COVID are higher among those with pre-existing medical conditions, and whether the strength of this association varies by habitual sleep duration. METHODS Using data from 13,461 respondents from 16 countries who participated in the 2021 survey-based International COVID Sleep Study II (ICOSS II), we studied the associations between habitual sleep duration, pre-existing medical conditions, and Long COVID. RESULTS Of 2,508 individuals who had COVID-19, 61% reported at least 1 Long COVID symptom. Multivariable logistic regression analysis showed that the risk of having Long COVID was 1.8-fold higher for average-length sleepers (6-9 h/night) with pre-existing medical conditions compared with those without pre-existing medical conditions (adjusted odds ratio [aOR] 1.84 [1.18-2.90]; P = .008). The risk of Long COVID was 3-fold higher for short sleepers with pre-existing medical conditions (aOR 2.95 [1.04-8.4]; P = .043) and not significantly higher for long sleepers with pre-existing conditions (aOR 2.11 [0.93-4.77]; P = .073) compared with average-length sleepers without pre-existing conditions. CONCLUSIONS Habitual short nighttime sleep duration exacerbated the risk of Long COVID in individuals with pre-existing conditions. Restoring nighttime sleep to average duration represents a potentially modifiable behavioral factor to lower the odds of Long COVID for at-risk patients. CITATION Berezin L, Waseem R, Merikanto I, et al. Habitual short sleepers with pre-existing medical conditions are at higher risk of long COVID. J Clin Sleep Med. 2024;20(1):111-119.
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Affiliation(s)
- Linor Berezin
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Rida Waseem
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Orton Orthopaedics Hospital, Helsinki, Finland
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Uppsala University, Uppsala, Sweden
| | - Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria
- Medical University Vienna, Postgraduate Master Program Medical Sleep Coaching, Vienna, Austria
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Maria Korman
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Charles M. Morin
- Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada
| | - Colin Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Anne-Marie Landtblom
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Thomas Penzel
- Sleep Medicine Center, Charite University Hospital Berlin, Berlin, Germany
| | - Kentaro Matsui
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sérgio Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital Federal University of Rio Grande do Norte, Natal, Brazil
| | - Michael R. Nadorff
- Department of Psychology, Mississippi State University, Starkville, Mississippi, Mississippi
| | - Giuseppe Plazzi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Catia Reis
- Universidade Católica Portuguesa, Católica Research Centre for Psychological Family and Social Wellbeing, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Rachel Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Juliana Yordanova
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | | | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Guide Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki Clinicum Unit, Helsinki, Finland
- Helsinki Sleep Clinic, Terveystalo Healthcare Services, Helsinki, Finland
| | - Frances Chung
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
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17
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Khan D, Fox PL. Aminoacyl-tRNA synthetase interactions in SARS-CoV-2 infection. Biochem Soc Trans 2023; 51:2127-2141. [PMID: 38108455 PMCID: PMC10754286 DOI: 10.1042/bst20230527] [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: 10/01/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Aminoacyl-tRNA synthetases (aaRSs) are ancient enzymes that serve a foundational role in the efficient and accurate translation of genetic information from messenger RNA to proteins. These proteins play critical, non-canonical functions in a multitude of cellular processes. Multiple viruses are known to hijack the functions of aaRSs for proviral outcomes, while cells modify antiviral responses through non-canonical functions of certain synthetases. Recent findings have revealed that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronaviral disease 19 (COVID-19), utilizes canonical and non-canonical functions of aaRSs, establishing a complex interplay of viral proteins, cellular factors and host aaRSs. In a striking example, an unconventional multi-aaRS complex consisting of glutamyl-prolyl-, lysyl-, arginyl- and methionyl-tRNA synthetases interact with a previously unknown RNA-element in the 3'-end of SARS-CoV-2 genomic and subgenomic RNAs. This review aims to highlight the aaRS-SARS-CoV-2 interactions identified to date, with possible implications for the biology of host aaRSs in SARS-CoV-2 infection.
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Affiliation(s)
- Debjit Khan
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Paul L. Fox
- Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A
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18
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Brehon K, Miciak M, Hung P, Chen SP, Perreault K, Hudon A, Wieler M, Hunter S, Hoddinott L, Hall M, Churchill K, Brown DA, Brown CA, Bostick G, Skolnik K, Lam G, Weatherald J, Gross DP. "None of us are lying": an interpretive description of the search for legitimacy and the journey to access quality health services by individuals living with Long COVID. BMC Health Serv Res 2023; 23:1396. [PMID: 38087299 PMCID: PMC10714615 DOI: 10.1186/s12913-023-10288-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to address needs. METHODS Our study was informed by the Levesque et al.'s (2013) "conceptual framework of access to health care." We used Interpretive Description, a qualitative approach partly aimed at informing clinical decisions. We recruited participants across five settings. Participants engaged in one-time, semi-structured, virtual interviews. Interviews were transcribed verbatim. We used reflexive thematic analysis. Best practice to ensure methodological rigour was employed. RESULTS Three key themes were generated from 56 interviews. The first theme illustrated the rollercoaster-like nature of participants' Long COVID symptoms and the resulting impact on function and health. The second theme highlighted participants' attempts to access Long COVID services. Guidance received from healthcare professionals and self-advocacy impacted initial access. When navigating Long COVID services within the broader system, participants encountered barriers to access around stigma; appointment logistics; testing and 'normal' results; and financial precarity and affordability of services. The third theme illuminated common factors participants liked and disliked about Long COVID services. We framed each sub-theme as the key lesson (stemming from all likes and dislikes) that, if acted upon, the health system can use to improve the quality of Long COVID services. This provides tangible ways to improve the system based directly on what we heard from participants. CONCLUSION With Long COVID services continuously evolving, our findings can inform decision makers within the health system to better understand the lived experiences of Long COVID and tailor services and policies appropriately.
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Affiliation(s)
| | | | - Pam Hung
- University of Alberta, Edmonton, Canada
| | | | | | - Anne Hudon
- University of Montreal, Montreal, Canada
| | | | | | | | - Mark Hall
- University of Alberta, Edmonton, Canada
| | | | - Darren A Brown
- Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK
| | | | | | - Kate Skolnik
- Alberta Health Services, Calgary, Canada
- University of Calgary, Calgary, Canada
| | - Grace Lam
- University of Alberta, Edmonton, Canada
- Alberta Health Services, Calgary, Canada
| | - Jason Weatherald
- University of Alberta, Edmonton, Canada
- Alberta Health Services, Calgary, Canada
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19
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Pooladgar P, Sakhabakhsh M, Soleiman-Meigooni S, Taghva A, Nasiri M, Darazam IA. The effect of donepezil hydrochloride on post-COVID memory impairment: A randomized controlled trial. J Clin Neurosci 2023; 118:168-174. [PMID: 37952347 DOI: 10.1016/j.jocn.2023.09.005] [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: 04/27/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Post-Coronavirus Disease (COVID-19) condition, known as "post-COVID syndrome," is associated with a range of complications persisting even after recovery. Among these complications, cognitive dysfunction, including memory impairment, has been relatively common observed, impacting executive function and quality of life. To date, no approved treatment exists for this specific complication. Therefore, the present clinical trial aimed to investigate the impact of Donepezil Hydrochloride on post-COVID memory impairment. METHODS A randomized, controlled trial (Approval ID: IRCT20210816052203N1) was conducted, enrolling 25 patients with post-COVID memory impairment. Participants with a history of hospitalization were randomly assigned to either the drug group (n = 10) or the control group (n = 15). Memory indices were assessed at baseline, one month, and three months later using the Wechsler Memory Scale-Revised test. SPSS software and appropriate statistical tests were employed for data analysis. RESULTS The statistical analysis revealed no significant difference in WMS-R subtest and index scores between the drug and control groups at the 4-week and 12-week follow-up periods. However, within the drug group, there was a notable increase in the visual reproduction I and verbal paired associates II subtests during the specified time intervals. CONCLUSION While donepezil 5 mg did not exhibit a significant overall increase in memory scales compared to the control group over time, our findings suggest that this medication may exert a positive effect on specific memory subtests. Further research and exploration are warranted to better understand the potential benefits of donepezil in managing post-COVID-related memory impairment. TRIAL REGISTRATION The study was approved by the Research Ethics Committee of Aja University of Medical Sciences (Approval ID: IR.AJAUMS.REC.1400.125) and registered in the Iranian Registry of Clinical Trials (IRCT) (Approval ID: IRCT20210816052203N1).
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Affiliation(s)
- Parham Pooladgar
- Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehdi Sakhabakhsh
- Head of Department of Neurology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran.
| | | | - Arsia Taghva
- Cognitive Science and Behavioral Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Basic Science Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ilad Alavi Darazam
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Visentin A, Chatzikonstantinou T, Scarfò L, Kapetanakis A, Demosthenous C, Karakatsoulis G, Minga E, Chamou D, Allsup D, Cabrero AA, Andres M, Antic D, Baile M, Baliakas P, Besikli-Dimou S, Bron D, Chatzileontiadou S, Cordoba R, Correa JG, Cuéllar-García C, De Paoli L, De Paolis MR, Delgado J, Dimou M, Donaldson D, Catherwood M, Doubek M, Efstathopoulou M, Eichhorst B, Elashwah S, Enrico A, Espinet B, Farina L, Ferrari A, Foglietta M, Frederiksen H, Fürstenau M, García-Marco JA, García-Serra R, Collado R, Gentile M, Gimeno E, Glenthøj A, da Silva MG, Hakobyan YK, Herishanu Y, Hernández-Rivas JÁ, Herold T, Innocenti I, Itchaki G, Jaksic O, Janssens A, Kalashnikova ОB, Kalicińska E, Kater AP, Kersting S, Labrador J, Lad D, Laurenti L, Levin MD, Lista E, Lopez-Garcia A, Malerba L, Marasca R, Marchetti M, Marquet J, Mattsson M, Mauro FR, Morawska M, Motta M, Munir T, Murru R, Niemann CU, Rodrigues RN, Olivieri J, Orsucci L, Papaioannou M, Pavlovsky MA, Piskunova I, Popov VM, Quaglia FM, Quaresmini G, Qvist K, Rigolin GM, Ruchlemer R, Šimkovič M, Špaček M, Sportoletti P, Stanca O, Tadmor T, Capasso A, Del Poeta G, Gutwein O, Karlsson LK, Milosevic I, Mirás F, Reda G, Saghumyan G, Shrestha A, Te Raa D, Tonino SH, Van Der Spek E, van Gelder M, van Kampen R, Wasik-Szczepanek E, Wróbel T, Segundo LYS, Yassin M, Pocali B, Vandenberghe E, Iyengar S, Varettoni M, Vitale C, Coscia M, Rambaldi A, Montserrat E, Cuneo A, Stavroyianni N, Trentin L, Stamatopoulos K, Ghia P. The evolving landscape of COVID-19 and post-COVID condition in patients with chronic lymphocytic leukemia: A study by ERIC, the European research initiative on CLL. Am J Hematol 2023; 98:1856-1868. [PMID: 37772428 DOI: 10.1002/ajh.27093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/30/2023]
Abstract
In this retrospective international multicenter study, we describe the clinical characteristics and outcomes of patients with chronic lymphocytic leukemia (CLL) and related disorders (small lymphocytic lymphoma and high-count monoclonal B lymphocytosis) infected by SARS-CoV-2, including the development of post-COVID condition. Data from 1540 patients with CLL infected by SARS-CoV-2 from January 2020 to May 2022 were included in the analysis and assigned to four phases based on cases disposition and SARS-CoV-2 variants emergence. Post-COVID condition was defined according to the WHO criteria. Patients infected during the most recent phases of the pandemic, though carrying a higher comorbidity burden, were less often hospitalized, rarely needed intensive care unit admission, or died compared to patients infected during the initial phases. The 4-month overall survival (OS) improved through the phases, from 68% to 83%, p = .0015. Age, comorbidity, CLL-directed treatment, but not vaccination status, emerged as risk factors for mortality. Among survivors, 6.65% patients had a reinfection, usually milder than the initial one, and 16.5% developed post-COVID condition. The latter was characterized by fatigue, dyspnea, lasting cough, and impaired concentration. Infection severity was the only risk factor for developing post-COVID. The median time to resolution of the post-COVID condition was 4.7 months. OS in patients with CLL improved during the different phases of the pandemic, likely due to the improvement of prophylactic and therapeutic measures against SARS-CoV-2 as well as the emergence of milder variants. However, mortality remained relevant and a significant number of patients developed post-COVID conditions, warranting further investigations.
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Affiliation(s)
- Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | | | - Lydia Scarfò
- Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele, Milan, Italy
| | - Anargyros Kapetanakis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | | | - Georgios Karakatsoulis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
- Department of Mathematics, University of Ioannina, Ioannina, Greece
| | - Eva Minga
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Dimitra Chamou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - David Allsup
- Centre for Biomedicine, Hull York Medical School, Hull, UK
| | - Alejandro Alonso Cabrero
- Spanish Society of Hematology and Hemotherapy (SEHH: Sociedad Española de Hematología y hemoterapia), Madrid, Spain
- Hematology Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - Martin Andres
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Darko Antic
- University Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mónica Baile
- Hospital Clinico Universitario de Salamanca (CAUSA/IBSAL), Salamanca, Spain
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Clinical Genetics, Uppsala University Hospital, Uppsala, Sweden
| | | | | | - Sofia Chatzileontiadou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | - Raul Cordoba
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
| | | | | | - Lorenzo De Paoli
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale Amedeo Avogadro, Azienda Ospedaliero-Universitaria Maggiore della Carità Novara, Novara, Italy
| | | | | | - Maria Dimou
- 1st Internal Medicine Department, Propaedeutic, Hematology Clinical Trial Unit, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Michael Doubek
- Department of Internal Medicine-Hematology and Oncology, University Hospital, Brno, Czech Republic
- Faculty of Medicine, Department of Medical Genetics and Genomics, Masaryk University, Brno, Czech Republic
| | - Maria Efstathopoulou
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | - Barbara Eichhorst
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Salma Elashwah
- Medical Oncology Unit, Faculty of Medicine, Oncology Center Mansoura University (OCMU), Mansoura, Egypt
| | | | | | - Lucia Farina
- Hematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Angela Ferrari
- Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | | | | | - Moritz Fürstenau
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, University of Cologne, Cologne, Germany
| | - José A García-Marco
- Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Rocío García-Serra
- Department of Hematology, Hospital General Universitario, Valencia, Spain
- Fundaci_on de Investigaci_on del Hospital General Universitario, Valencia, Spain
| | - Rosa Collado
- Department of Hematology, Hospital General Universitario, Valencia, Spain
| | - Massimo Gentile
- Hematology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy
- Department of Pharmacy, Health and Nutritional Science, University of Calabria, Rende, Italy
| | - Eva Gimeno
- Department of Hematology, Hospital del Mar, Barcelona, Spain
| | - Andreas Glenthøj
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Yair Herishanu
- Department of Hematology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Tobias Herold
- Department of Medicine III, Laboratory for Leukemia Diagnostics, University Hospital, Munich, Germany
| | - Idanna Innocenti
- Hematology Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gilad Itchaki
- Meir Medical Center, Kfar-Saba, Israel
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Ann Janssens
- Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Оlga B Kalashnikova
- Federal State Budgetary Educational Institution of Higher Education Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | - Elżbieta Kalicińska
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland
| | - Arnon P Kater
- Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Sabina Kersting
- Department of Hematology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Jorge Labrador
- Hematology Department, Unit Research, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Deepesh Lad
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Luca Laurenti
- Hematology Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Mark-David Levin
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Enrico Lista
- Department of Hematology, Santa Chiara Hospital, Trento, Italy
| | - Alberto Lopez-Garcia
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
| | - Lara Malerba
- Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Pesaro, Italy
| | - Roberto Marasca
- Department of Medical Sciences, Section of Hematology, University of Modena and Reggio E., Modena, Italy
| | - Monia Marchetti
- Hematology Unit and BM Transplant Center, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Juan Marquet
- Hematology Department, Ram_on y Cajal University Hospital, Madrid, Spain
| | - Mattias Mattsson
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Francesca R Mauro
- Hematology Unit, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Marta Morawska
- Experimental Hematooncology Department, Medical University of Lublin, Lublin, Poland
- Hematology Department, St. John's Cancer Center, Lublin, Poland
| | - Marina Motta
- S.C. Ematologia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Talha Munir
- Consultant Haematologist, St James's Hospital, Leeds, UK
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS "G. Brotzu", Cagliari, Italy
| | - Carsten U Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jacopo Olivieri
- Hematology Clinic, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Lorella Orsucci
- S.C. Ematologia, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Maria Papaioannou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | | | - Inga Piskunova
- Consultative Hematology Department with a Day Hospital for Intensive High-Dose Chemotherapy, National Research Center for Hematology, Moscow, Russia
| | - Viola Maria Popov
- HematologyDepartment, Colentina Clinical Hospital, Bucharest, Romania
| | | | - Giulia Quaresmini
- Department of Oncology and Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Bergamo, Bergamo, Italy
| | - Kristian Qvist
- Hematologic Section, Department of Internal Medicine, Hospital Union West, Herning, Denmark
| | | | - Rosa Ruchlemer
- Department of Hematology, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel
| | - Martin Šimkovič
- Faculty of Medicine in Hradec Králové, 4th Department of Internal Medicine-Haematology, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
| | - Martin Špaček
- First Faculty of Medicine, 1st Department of Medicine-Hematology, Charles University and General Hospital in Prague, Prague, Czech Republic
| | - Paolo Sportoletti
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncological Research, University of Perugia, Perugia, Italy
| | - Oana Stanca
- Hematology Department, Coltea Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Tamar Tadmor
- Division of Hematology, Bnai-Zion Medical Center, Haifa, Israel
| | | | - Giovanni Del Poeta
- Department of Biomedicine and Prevention Hematology, University Tor Vergata, Rome, Italy
| | - Odit Gutwein
- Department of Hematology, Shamir Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Ivana Milosevic
- Faculty of Medicine, Clinical Centre of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | - Fatima Mirás
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gianluigi Reda
- Hematology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | | | - Amit Shrestha
- Hematology Unit, Nepal Cancer Hospital & Research Centre, Lalitpur, Nepal
| | - Doreen Te Raa
- Department of Hematology, Gelderse Vallei Ede, Ede, the Netherlands
| | - Sanne H Tonino
- Department of Hematology, Lymmcare, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Ellen Van Der Spek
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Michel van Gelder
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Ewa Wasik-Szczepanek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University in Lublin, Lublin, Poland
| | - Tomasz Wróbel
- Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland
| | - Lucrecia Yáñez San Segundo
- Hematology Department, University Hospital and Research Institute of Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Mohamed Yassin
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Doha, Qatar
| | | | | | - Sunil Iyengar
- Haemato-oncology Unit, The Royal Marsden Hospital, UK
| | - Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Candida Vitale
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Marta Coscia
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Alessandro Rambaldi
- Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncological Research, University of Perugia, Perugia, Italy
| | | | | | - Niki Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele, Milan, Italy
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Hendrickson KW, Hopkins RO, Groat DL, Stokes SC, Schroeder FM, Butler JM, Hirshberg EL. Patient experiences with SARS-CoV-2: Associations between patient experience of disease and coping profiles. PLoS One 2023; 18:e0294201. [PMID: 37983278 PMCID: PMC10659202 DOI: 10.1371/journal.pone.0294201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2, (SARS-CoV-2,) caused an influx of patients with acute disease characterized by a variety of symptoms termed COVID-19 disease, with some patients going on to develop post-acute COVID-19 syndrome. Individual factors like sex or coping styles are associated with a person's disease experience and quality of life. Individual differences in coping styles used to manage COVID-19 related stress correlate with physical and mental health outcomes. Our study sought to understand the relationship between COVID-19 symptoms, severity of acute disease, and coping profiles. METHODS An online survey to assess symptoms, functional status, and recovery in a large group of patients was nationally distributed online. The survey asked about symptoms, course of illness, and included the Brief-COPE and the adapted Social Relationship Inventory. We used descriptive and cluster analyses to characterize patterns of survey responses. RESULTS 976 patients were included in the analysis. The most common symptoms reported by the patients were fatigue (72%), cough (71%), body aches/joint pain (66%), headache (62%), and fever/chills (62%). 284 participants reported PACS. We described three different coping profiles: outward, inward, and dynamic copers. DISCUSSION Fatigue, cough, and body aches/joint pains were the most frequently reported symptoms. PACS patients were sicker, more likely to have been hospitalized. Of the three coping profiles, outward copers were more likely to be admitted to the hospital and had the healthiest coping strategies. Dynamic copers activated several coping strategies both positive and negative; they were also younger and more likely to report PACS. CONCLUSION Cough, fatigue, and body aches/joint pain are common and most important to patients with acute COVID-19, while shortness of breath defined the experience for patients with PACS. Of the three coping profiles, dynamic copers were more likely to report PACS. Additional investigations into coping profiles in general, and the experience of COVID-19 and PACS is needed.
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Affiliation(s)
- Kathryn W. Hendrickson
- The Oregon Clinic, Department of Pulmonary, Critical Care, and Sleep Medicine East, Portland, Oregon, United States of America
| | - Ramona O. Hopkins
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
- Intermountain Health, Center for Humanizing Critical Care, Murray, Utah, United States of America
| | - Danielle L. Groat
- Intermountain Health, Center for Humanizing Critical Care, Murray, Utah, United States of America
- Intermountain Health, Division of Pulmonary and Critical Care, Murray, Utah, United States of America
| | - Stephanie C. Stokes
- Intermountain Health, Strategic Research, Salt Lake City, Utah, United States of America
| | - Fiona M. Schroeder
- Intermountain Health, Strategic Research, Salt Lake City, Utah, United States of America
| | - Jorie M. Butler
- Intermountain Health, Center for Humanizing Critical Care, Murray, Utah, United States of America
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, United States of America
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States of America
- Informatics Decision-Enhancement and Analytic Sciences (IDEAS), Center for Innovation & Geriatrics Research, Education, and Clinical Center (GRECC), VA Salt Lake City Health Care System, Salt Lake City, UT, United States of America
| | - Eliotte L. Hirshberg
- Intermountain Health, Center for Humanizing Critical Care, Murray, Utah, United States of America
- Intermountain Health, Division of Pulmonary and Critical Care, Murray, Utah, United States of America
- Division of Pulmonology, School of Medicine, University of Utah, Salt Lake City, Utah, United States of America
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22
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Krishnan J, Woods CW, Holodniy M, Nicholson BP, Marconi VC, Ammons MCB, Jinadatha C, Pyarajan S, Wang-Rodriguez J, Garcia AP, Battles JK. Nationwide Genomic Surveillance and Response to COVID-19: The VA SeqFORCE and SeqCURE Consortiums. Fed Pract 2023; 40:S44-S47. [PMID: 38577303 PMCID: PMC10988620 DOI: 10.12788/fp.0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Background The US Department of Veterans Affairs (VA) has dedicated significant resources toward countering the COVID-19 pandemic. Sequencing for Research Clinical and Epidemiology (SeqFORCE) and Sequencing Collaborations United for Research and Epidemiology (SeqCURE) were developed as clinical and research consortiums, respectively, focused on the genetic COVID-19 surveillance. Observations Through genetic sequencing, VA SeqFORCE and SeqCURE collaborations contributed to the COVID-19 pandemic response and scientific understanding. Future directions for each program include the assessment of the unique impact of COVID-19 on the veteran population, as well as the adaptation of these programs to future infectious disease threats. We foresee the use of these established platforms beyond infectious diseases. Conclusions VA SeqFORCE and SeqCURE were established as clinical and research programs dedicated to sequencing COVID-19 as part of ongoing clinical and surveillance efforts. In the future, we anticipate that having these programs embedded within the largest integrated health care system in the US will enable the study of pathogens and pandemics beyond COVID-19 and at an unprecedented scale. The investment in these programs will form an integral part of our nation's response to emerging infectious diseases, with future applications to precision medicine and beyond.
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Affiliation(s)
- Jay Krishnan
- Duke University School of Medicine, Durham, North Carolina
- Durham Veterans Affairs Medical Center, North Carolina
| | - Christopher W. Woods
- Duke University School of Medicine, Durham, North Carolina
- Durham Veterans Affairs Medical Center, North Carolina
| | - Mark Holodniy
- Public Health National Program Office, Department of Veterans Affairs, Washington, DC
- Stanford University, California
| | - Bradly P. Nicholson
- Durham Veterans Affairs Medical Center, North Carolina
- Institute for Medical Research, Durham Veterans Affairs Medical Center, North Carolina
| | - Vincent C. Marconi
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia
- Emory University School of Medicine and Rollins School of Public Health, Atlanta, Georgia
| | - Mary Cloud B. Ammons
- Idaho Veterans Research and Education Foundation & Boise Veterans Affairs Medical Center
| | - Chetan Jinadatha
- Central Texas Veterans Health Care System, Temple
- Texas A&M University School of Medicine, Bryan
| | - Saiju Pyarajan
- Center for Data and Computational Sciences, Veterans Affairs Boston Healthcare System, Massachusetts
| | - Jessica Wang-Rodriguez
- National Pathology and Laboratory Medicine Service, Department of Veterans Affairs, Washington, DC
| | - Amanda P. Garcia
- Office of Research and Development, Department of Veterans Affairs, Washington, DC
| | - Jane K. Battles
- Office of Research and Development, Department of Veterans Affairs, Washington, DC
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Wolff D, Drewitz KP, Ulrich A, Siegels D, Deckert S, Sprenger AA, Kuper PR, Schmitt J, Munblit D, Apfelbacher C. Allergic diseases as risk factors for Long-COVID symptoms: Systematic review of prospective cohort studies. Clin Exp Allergy 2023; 53:1162-1176. [PMID: 37936547 DOI: 10.1111/cea.14391] [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: 06/16/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE The role of allergy as a risk factor for Long-COVID (LC) is unclear and has not been thoroughly examined yet. We aimed to systematically review and appraise the epidemiological evidence on allergic diseases as risk factors for LC. DESIGN This is an initial systematic review. Two reviewers independently performed the study selection and data extraction using Covidence. Risk of bias (RoB) and certainty of evidence (GRADE) were assessed. Random effects meta-analyses were used to pool unadjusted ORs within homogeneous data subsets. DATA SOURCES We retrieved articles published between January 1st, 2020 and January 19th, 2023 from MEDLINE via PubMed, Scopus, the WHO-COVID-19 database and the LOVE platform (Epistemonikos Foundation). In addition, citations and reference lists were searched. ELIGIBILITY CRITERIA We included prospective cohort studies recruiting individuals of all ages with confirmed SARS-CoV-2 infection that were followed up for at least 12 months for LC symptoms where information on pre-existing allergic diseases was available. We excluded all study designs that were not prospective cohort studies and all publication types that were not original articles. RESULTS We identified 13 studies (9967 participants, range 39-1950 per study), all assessed as high RoB, due to population selection and methods used to ascertain the exposures and the outcome. Four studies did not provide sufficient data to calculate Odds Ratios. The evidence supported a possible relationship between LC and allergy, but was very uncertain. For example, pre-existing asthma measured in hospital-based populations (6 studies, 4019 participants) may be associated with increased risk of LC (Odds Ratio 1.94, 95% CI 1.08, 3.50) and findings were similar for pre-existing rhinitis (3 studies, 1141 participants; Odds Ratio 1.96, 95% CI 1.61, 2.39), both very low certainty evidence. CONCLUSIONS Pre-existing asthma or rhinitis may increase the risk of LC.
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Affiliation(s)
- Doreen Wolff
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Karl Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Angela Ulrich
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Doreen Siegels
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Stefanie Deckert
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Antonia Anabella Sprenger
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Paula Ricarda Kuper
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Daniel Munblit
- Care for Long Term Conditions Division, King's College London, London, UK
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, University of Magdeburg, Magdeburg, Germany
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore City, Singapore
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Lewthwaite H, Byrne A, Brew B, Gibson PG. Treatable traits for long COVID. Respirology 2023; 28:1005-1022. [PMID: 37715729 DOI: 10.1111/resp.14596] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023]
Abstract
Long COVID, or post-acute COVID-19 sequelae, is experienced by an estimated one in eight adults following acute COVID-19. Long COVID is a new and complex chronic health condition that typically includes multiple symptoms that cross organ systems and fluctuate over time; a one-size-fits-all approach is, therefore, not likely to be appropriate nor relevant for long COVID treatment. 'Treatable Traits' is a personalized medicine approach, purpose-built to address the complexity and heterogeneity of complex chronic conditions. This comprehensive review aimed to understand how a treatable traits approach could be applied to long COVID, by first identifying the most prevalent long COVID treatable traits and then the available evidence for strategies to target these traits. An umbrella review of 22 systematic reviews identified 34 symptoms and complications common with long COVID, grouped into eight long COVID treatable trait clusters: neurological, chest, psychological, pain, fatigue, sleep impairment, functional impairment and other. A systematic review of randomized control trials identified 18 studies that explored different intervention approaches for long COVID prevention (k = 4) or management (k = 14). While a single study reported metformin as effective for long COVID prevention, the findings need to be replicated and consensus is required around how to define long COVID as a clinical trial endpoint. For long COVID management, current evidence supports exercise training or respiratory muscle training for long COVID treatable traits in the chest and functional limitation clusters. While there are studies exploring interventions targeting other long COVID treatable traits, further high-quality RCTs are needed, particularly targeting treatable traits in the clusters of fatigue, psychological, pain and sleep impairment.
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Affiliation(s)
- Hayley Lewthwaite
- Centre of Research Excellence Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Anthony Byrne
- Heart Lung Clinic, Department of Thoracic Medicine St Vincent's Hospital and Clinical School University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Bruce Brew
- Peter Duncan Neuroscience Research Unit, St. Vincent's Centre for Applied Medical Research, Darlinghurst, New South Wales, Australia
- Department of Neurology and Immunology, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Peter G Gibson
- Centre of Research Excellence Treatable Traits, College of Health, Medicine, and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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25
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Baimukhamedov C, Mirakhmedova K, Dossybayeva G. Long COVID: the time has come for globally acceptable definitions. Rheumatol Int 2023; 43:2155-2156. [PMID: 37543536 DOI: 10.1007/s00296-023-05414-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Chokan Baimukhamedov
- Department of General Practice N2, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.
- Shymkent Medical Centre of Joint Diseases, Shymkent, Kazakhstan.
| | - Khilola Mirakhmedova
- Department of Propaedeutics of Internal Diseases N1, Tashkent Medical Academy, Tashkent, Uzbekistan
| | - Gulzhan Dossybayeva
- Department of General Practice N2, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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26
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McNabb KC, Bergman AJ, Smith-Wright R, Seltzer J, Slone SE, Tomiwa T, Alharthi A, Davidson PM, Commodore-Mensah Y, Ogungbe O. "It was almost like it's set up for people to fail" A qualitative analysis of experiences and unmet supportive needs of people with Long COVID. BMC Public Health 2023; 23:2131. [PMID: 37904110 PMCID: PMC10617090 DOI: 10.1186/s12889-023-17033-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Almost twenty percent of adults with COVID-19 develop Long COVID, leading to prolonged symptoms and disability. Understanding the supportive needs of people with Long COVID is vital to enacting effective models of care and policies. DESIGN/METHODS This qualitative sub-study explored the experiences of people with Long COVID and their unmet needs. Participants enrolled in a larger study to evaluate the post-acute cardiovascular impacts of COVID-19 were invited to participate in subsequent in-depth interviews. Participants were enrolled purposively until saturation at 24 participants. Data were analyzed using thematic content analysis. RESULTS Participants focused on adaptations to life with Long COVID and their unmet needs in different life spheres. Three domains, 1) occupational and financial; 2) healthcare-related; and 3) social and emotional support, emerged as areas affecting quality of life. Although participants were motivated to return to work for financial and personal reasons, Long COVID symptoms often resulted in the inability to perform tasks required by their existing jobs, and unemployment. Those who maintained employment through employer accommodations still needed additional support. Participants encountered diagnostic challenges, challenges in accessing specialty appointments, insurance loopholes, high healthcare costs, and medical skepticism. Existing social networks provided support for completing daily tasks; however, those with Long COVID typically turned to others with similar lived experiences for emotional support. Participants found government support programs inadequate and difficult to access in all three domains. DISCUSSION We propose a five-pronged policy approach to support persons with Long COVID. These overarching recommendations are (1) improve public awareness of Long COVID; (2) improve clinical care quality and access; (3) implement additional school and workplace accommodations; (4) strengthen socioeconomic benefits and social services; and (5) improve research on Long COVID.
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Affiliation(s)
- Katherine C McNabb
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205, USA.
| | - Alanna J Bergman
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205, USA
| | | | - Jaime Seltzer
- Stanford University, Stanford School of Medicine, Palo Alto, USA
- The Myalgic Encephalomyelitis Action Network, Santa Monica, USA
| | - Sarah E Slone
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
| | - Tosin Tomiwa
- Johns Hopkins University, Johns Hopkins Institute for Clinical and Translational Research, Baltimore, USA
| | - Abeer Alharthi
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
| | | | - Yvonne Commodore-Mensah
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, USA
| | - Oluwabunmi Ogungbe
- Johns Hopkins University, Johns Hopkins School of Nursing, Baltimore, USA
- Johns Hopkins University, Johns Hopkins School of Medicine, Baltimore, USA
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Hetlevik Ø, Wensaas KA, Baste V, Emberland KE, Özgümüs T, Håberg SE, Rortveit G. Prevalence and predictors of post-COVID-19 symptoms in general practice - a registry-based nationwide study. BMC Infect Dis 2023; 23:721. [PMID: 37880583 PMCID: PMC10599052 DOI: 10.1186/s12879-023-08727-6] [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: 07/05/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND With Norwegian national registry data, we assessed the prevalence of post-COVID-19 symptoms at least 3 months after confirmed infection, and whether sociodemographic factors and pre-pandemic health problems were risk factors for these symptoms. METHODS All persons with a positive SARS-CoV-2 PCR test from February 2020 to February 2021 (exposed) were compared to a group without a positive test (unexposed) matched on age, sex, and country of origin. We used Cox regression to estimate hazard ratios (HR) for 18 outcome symptoms commonly described as post-COVID-19 related, registered by GPs. We compared relative risks (RR) for fatigue, memory disturbance, or shortness of breath among exposed and unexposed using Poisson regression models, assessing sex, age, education, country of origin, and pre-pandemic presence of the same symptom and comorbidity as possible risk factors, with additional analyses to assess hospitalisation for COVID-19 as a risk factor among exposed. RESULTS The exposed group (N = 53 846) had a higher prevalence of most outcome symptoms compared to the unexposed (N = 485 757), with the highest risk for shortness of breath (HR 2.75; 95%CI 2.59-2.93), fatigue (2.08; 2.00-2.16) and memory disturbance (1.41;1.26-1.59). High HRs were also found for disturbance of smell/taste and hair loss, but frequencies were low. Concerning risk factors, sociodemographic factors were at large similarly associated with outcome symptoms in both groups. Registration of the outcome symptom before the pandemic increased the risk for fatigue, memory disturbance and shortness of breath after COVID-19, but these associations were weaker among exposed. Comorbidity was not associated with fatigue and shortness of breath in the COVID-19 group. For memory disturbance, the RR was slightly increased with the higher comorbidity score both among exposed and unexposed. CONCLUSION COVID-19 was associated with a range of symptoms lasting more than three months after the infection.
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Affiliation(s)
- Øystein Hetlevik
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway.
| | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - Knut Erik Emberland
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway
| | - Türküler Özgümüs
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Guri Rortveit
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, Bergen, NO-5020, Norway
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Longobardi I, Goessler K, de Oliveira Júnior GN, Prado DMLD, Santos JVP, Meletti MM, de Andrade DCO, Gil S, Boza JASDO, Lima FR, Gualano B, Roschel H. Effects of a 16-week home-based exercise training programme on health-related quality of life, functional capacity, and persistent symptoms in survivors of severe/critical COVID-19: a randomised controlled trial. Br J Sports Med 2023; 57:1295-1303. [PMID: 37164620 DOI: 10.1136/bjsports-2022-106681] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Long-lasting effects of COVID-19 may include cardiovascular, respiratory, skeletal muscle, metabolic, psychological disorders and persistent symptoms that can impair health-related quality of life (HRQoL). We investigated the effects of a home-based exercise training (HBET) programme on HRQoL and health-related outcomes in survivors of severe/critical COVID-19. METHODS This was a single-centre, single-blinded, parallel-group, randomised controlled trial. Fifty survivors of severe/critical COVID-19 (5±1 months after intensive care unit discharge) were randomly allocated (1:1) to either a 3 times a week (~60-80 min/session), semi-supervised, individualised, HBET programme or standard of care (CONTROL). Changes in HRQoL were evaluated through the 36-Item Short-Form Health Survey, and physical component summary was predetermined as the primary outcome. Secondary outcomes included cardiorespiratory fitness, pulmonary function, functional capacity, body composition and persistent symptoms. Assessments were performed at baseline and after 16 weeks of intervention. Statistical analysis followed intention-to-treat principles. RESULTS After the intervention, HBET showed greater HRQoL score than CONTROL in the physical component summary (estimated mean difference, EMD: 16.8 points; 95% CI 5.8 to 27.9; effect size, ES: 0.74), physical functioning (EMD: 22.5 points, 95% CI 6.1 to 42.9, ES: 0.83), general health (EMD: 17.4 points, 95% CI 1.8 to 33.1, ES: 0.73) and vitality (EMD: 15.1 points, 95% CI 0.2 to 30.1, ES: 0.49) domains. 30-second sit-to-stand (EMD: 2.38 reps, 95% CI 0.01 to 4.76, ES: 0.86), and muscle weakness and myalgia were also improved in HBET compared with CONTROL (p<0.05). No significant differences were seen in the remaining variables. There were no adverse events. CONCLUSION HBET is an effective and safe intervention to improve physical domains of HRQoL, functional capacity and persistent symptoms in survivors of severe/critical COVID-19. TRIAL REGISTRATION NUMBER NCT04615052.
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Affiliation(s)
- Igor Longobardi
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | - Karla Goessler
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | | | - Danilo Marcelo Leite do Prado
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | - Jhonnatan Vasconcelos Pereira Santos
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | - Matheus Molina Meletti
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | | | - Saulo Gil
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | - João Antonio Spott de Oliveira Boza
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
| | - Fernanda Rodrigues Lima
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, University of Sao Paulo, SP, Brazil
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
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Abbott Z, Summers W, Niehaus W. Fatigue in Post-Acute Sequelae of Coronavirus Disease 2019. Phys Med Rehabil Clin N Am 2023; 34:607-621. [PMID: 37419535 DOI: 10.1016/j.pmr.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
Fatigue from post-acute sequelae of coronavirus disease 2019 is a complex constellation of symptoms that could be driven by a wide spectrum of underlying etiologies. Despite this, there seems to be hope for treatment plans that focus on addressing possible etiologies and creating a path to improving quality of life and a paced return to activity.
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Affiliation(s)
- Zachary Abbott
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, 12631 East 17th Avenue, Academic Office One, Mail Stop F493, Aurora, CO 80045, USA
| | - William Summers
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, 12631 East 17th Avenue, Academic Office One, Mail Stop F493, Aurora, CO 80045, USA
| | - William Niehaus
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, 12631 East 17th Avenue, Academic Office One, Mail Stop F493, Aurora, CO 80045, USA.
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30
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Al-Jabr H, Hawke LD, Thompson DR, Clifton A, Shenton M, Castle DJ, Ski CF. Interventions to support mental health in people with long COVID: a scoping review. BMC Public Health 2023; 23:1186. [PMID: 37340400 DOI: 10.1186/s12889-023-16079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION Long COVID (LC) is a multisystem disease with symptoms lasting weeks or months beyond the acute COVID-19 infection. Several manifestations are reported by people with LC, including effects on mental health, with varying degrees of psychological distress and disturbances to daily activities. Research conducted to identify effective interventions to support mental health among people with LC has been limited by the breadth and scope of studies. AIM This review aims to identify interventions being tested to support mental health of people with LC. METHODS A scoping review was conducted by searching five databases for articles published between January 2020 and early October 2022 to identify research evaluating interventions focused on improving mental health symptoms associated with LC. Results from all sources were checked for eligibility by two reviewers, and agreements were resolved by discussion. Gray literature and reference list of included studies and relevant reviews were scrutinised to identify any additional studies. Data extraction was conducted by one reviewer and checked by another reviewer for accuracy. RESULTS Of the 940 studies identified, 17 were included, the design of which varied but included mainly case studies (n = 6) and clinical trials (n = 5). Several interventions were described, ranging from single interventions (e.g., pharmacologic) to more holistic, comprehensive suites of services (pharmacologic and non-pharmacologic). Several mental health outcomes were measured, mostly anxiety and depression. All included studies were reported to be associated with improvements in participants' mental health outcomes. CONCLUSION This scoping review identified studies reporting on a variety of interventions to support mental health among people with LC. Although positive changes were reported by all studies, some were case studies and thus their findings must be interpreted with caution. There is a need for more research to be conducted to identify the impact of interventions on mental health of people with LC.
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Affiliation(s)
- Hiyam Al-Jabr
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Canada
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Andrew Clifton
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - Mark Shenton
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David J Castle
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Bogale KA, Zeru T, Tarkegn M, Balew M, Worku M, Asrat A, Adamu A, Mulu Y, Getachew A, Ambaw F. Awareness and care seeking for long COVID symptoms among Coronavirus disease survivors in Bahir Dar City, Northwest Ethiopia: phenomenological study. BMC Public Health 2023; 23:941. [PMID: 37226170 DOI: 10.1186/s12889-023-15889-0] [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: 03/27/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Corona Virus Disease (COVID-19) has long-term sequels that persisted for months to years and manifested with a spectrum of signs and symptoms. Presentations of long COVID-19 symptoms are heterogeneous, vary from person to person, and can reach up to over 200 symptoms. Limited studies are conducted on the awareness of long COVID-19. So, this study aimed to explore the awareness about and care seeking for long COVID-19 symptoms among COVID survivors in Bahir Dar City in 2022. METHODS A qualitative study with a phenomenological design was used. Participants of the study were individuals who survived five months or longer after they tested positive for COVID-19 in Bahir Dar city. Individuals were selected purposively. An in-depth interview guide was prepared and used to collect the data. Open Cod 4.03 software was used for coding and synthesizing. Thematic analysis was used to analyze the transcripts. RESULTS The themes emerged from the data were awareness, experience of symptoms and their effects, and care practices of long COVID-19. Although only one participant mentioned the common symptoms of long COVID-19 the survivors experienced general, respiratory, cardiac, digestive, neurological, and other symptoms. These symptoms include rash, fatigue fever, cough, palpitations, shortness of breath, chest pain, and abdominal pain, loss of concentration, loss of smell, sleep disorder, depression, joint and muscle pain. These symptoms brought various physical and psychosocial effects. The majority of the respondents described that long COVID-19 symptoms will go off by themselves. To alleviate the problems some of the participants had taken different measures including medical care, homemade remedies, spiritual solutions, and lifestyle modification. CONCLUSIONS The result of this study revealed that participants have a significant deficit of awareness about the common symptoms, risk groups, and communicability of Long COVID. However, they experienced the majority of the common symptoms of Long COVID. To alleviate the problems, they had taken different measures including medical care, homemade remedies, spiritual solutions, and lifestyle modification.
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Affiliation(s)
- Kassawmar Angaw Bogale
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Taye Zeru
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Molalign Tarkegn
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Melashu Balew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Masetewal Worku
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Amhara Public Health Institute, Bahir Dar, Ethiopia
| | - Anemaw Asrat
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Ayinengida Adamu
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yared Mulu
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Rennes University, Rennes, France
| | - Atalay Getachew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Environmental Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Fentie Ambaw
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Srikanth S, Boulos JR, Dover T, Boccuto L, Dean D. Identification and diagnosis of long COVID-19: A scoping review. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2023; 182:1-7. [PMID: 37182545 PMCID: PMC10176974 DOI: 10.1016/j.pbiomolbio.2023.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/19/2023] [Indexed: 05/16/2023]
Abstract
Long COVID-19 (LC-19) is a condition that has affected a high percentage of the population that recovered from the initial disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). LC-19 diagnosis is currently poorly defined because of its variable, multisystem, episodic symptoms, and lack of uniformity in the critical time points associated with the disease. Considering the number of cases, workers' compromised efficiency or inability to return to their duties can affect organizations and impact economies. LC-19 represents a significant burden on multiple levels and effectively reduces quality of life. These factors necessitate the establishment of firm parameters of diagnoses to provide a foundation for ongoing and future studies of clinical characteristics, epidemiology, risk factors, and therapy. In this scoping review, we conducted a literature search across multiple publication sites to identify papers of interest regarding the diagnosis of LC-19. We identified 225 records of interest and categorized them into seven categories. Based on our findings, there are only 11 original papers that outline the diagnostic process in detail with little overlap. This scoping review highlights the lack of consensus regarding the definition and, thereby, the LC-19 diagnosis processes. Due to no clear directive and considering the many unknowns surrounding the natural history of the disease and further recovery/sequelae from COVID-19, continued discussion and agreement on a definition/diagnosis will help future research and management of these patients.
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Affiliation(s)
- Sujata Srikanth
- Center for Innovative Medical Devices and Sensors (REDDI Lab), Clemson University, Clemson, SC, USA; School of Nursing, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Jessica R Boulos
- Center for Innovative Medical Devices and Sensors (REDDI Lab), Clemson University, Clemson, SC, USA; Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Tristan Dover
- Center for Innovative Medical Devices and Sensors (REDDI Lab), Clemson University, Clemson, SC, USA
| | - Luigi Boccuto
- School of Nursing, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, USA
| | - Delphine Dean
- Center for Innovative Medical Devices and Sensors (REDDI Lab), Clemson University, Clemson, SC, USA; Department of Bioengineering, Clemson University, Clemson, SC, USA.
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Malesevic S, Sievi NA, Baumgartner P, Roser K, Sommer G, Schmidt D, Vallelian F, Jelcic I, Clarenbach CF, Kohler M. Impaired health-related quality of life in long-COVID syndrome after mild to moderate COVID-19. Sci Rep 2023; 13:7717. [PMID: 37173355 PMCID: PMC10175927 DOI: 10.1038/s41598-023-34678-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
A growing number of patients with SARS-CoV-2 infections experience long-lasting symptoms. Even patients who suffered from a mild acute infection show a variety of persisting and debilitating neurocognitive, respiratory, or cardiac symptoms (Long-Covid syndrome), consequently leading to limitations in everyday life. Because data on health-related quality of life (HRQoL) is scarce, we aimed to characterize the impact of Long-Covid symptoms after a mild or moderate acute infection on HRQoL. In this observational study, outpatients seeking counseling in the interdisciplinary Post-Covid consultation of the University Hospital Zurich with symptoms persisting for more than 4 weeks were included. Patients who received an alternative diagnosis or suffered from a severe acute Covid-19 infection were excluded. St. George's Respiratory Questionnaire (SGRQ), Euroquol-5D-5L (EQ-5D-5L), and the Short form 36 (SF-36) were distributed to assess HRQoL. 112 patients were included, 86 (76.8%) were female, median (IQR) age was 43 (32.0, 52.5) years with 126 (91, 180) days of symptoms. Patients suffered frequently from fatigue (81%), concentration difficulties (60%), and dyspnea (60%). Patients mostly stated impairment in performing usual activities and having pain/discomfort or anxiety out of the EQ-5D-5L. EQ index value and SGRQ activity score component were significantly lower in females. SF-36 scores showed remarkably lower scores in the physical health domain compared to the Swiss general population before and during the COVID-19 pandemic. Long-Covid syndrome has a substantial impact on HRQoL. Long-term surveillance of patients must provide clarity on the duration of impairments in physical and mental health.Trial registration: The study is registered on www.ClinicalTrials.gov , NCT04793269.
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Affiliation(s)
- Stefan Malesevic
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Department of Pulmonology, University Hospital Zurich, 8091, Zurich, Switzerland.
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Patrick Baumgartner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Katharina Roser
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Grit Sommer
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Dörthe Schmidt
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Florence Vallelian
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Ilijas Jelcic
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Christian F Clarenbach
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, 8091, Zurich, Switzerland
| | - Malcolm Kohler
- Department of Pulmonology, University Hospital Zurich, 8091, Zurich, Switzerland
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Cachay R, Watanabe-Tejada T, Cuno K, Gil-Zacarias M, Coombes C, Ballena I, Mejia F, Medina F, Gayoso O, Seas C, Otero L, Gotuzzo E. Long-term impact on cardiopulmonary function and quality of life among patients recovered from SARS-CoV-2 infection in a 6-month follow-up period in Lima, Peru: FUNCTION cohort study protocol. BMJ Open 2023; 13:e067365. [PMID: 37080629 PMCID: PMC10123859 DOI: 10.1136/bmjopen-2022-067365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION The sequelae of COVID-19 have been described as a multisystemic condition, with a great impact on the cardiovascular and pulmonary systems with abnormalities in pulmonary function tests, such as lower diffusing capacity of the lung for carbon monoxide (DLco) levels and pathological patterns in spirometry; persistence of radiological lesions; cardiac involvement such as myocarditis and pericarditis; and an increase in mental disorders such as anxiety and depression. Several factors, such as infection severity during the acute phase as well as vaccination status, have shown some variable effects on these post-COVID-19 conditions, mainly at a clinical level such as symptoms persistence. Longitudinal assessments and reversibility of changes across the spectrum of disease severity are required to understand the long-term impact of COVID-19. METHODS AND ANALYSIS A prospective cohort study aims to assess the impact of SARS-CoV-2 infection on cardiopulmonary function and quality of life after the acute phase of the disease over a 6-month follow-up period. Sample size was calculated to recruit 200 participants with confirmatory COVID-19 tests who will be subsequently classified according to infection severity. Four follow-up visits at baseline, month 1, month 3 and month 6 after discharge from the acute phase of the infection will be scheduled as well as procedures such as spirometry, DLco test, 6-minute walk test, chest CT scan, echocardiogram, ECG, N-terminal pro-B-type natriuretic peptide measurement and RAND-36 scale. Primary outcomes are defined as abnormal pulmonary function test considered as DLco <80%, abnormal cardiovascular function considered as left ventricular ejection fraction <50% and abnormal quality of life considered as a <40 score for each sphere in the RAND-36-Item Short Form Health Survey. ETHICS AND DISSEMINATION The study protocol was approved by the Institutional Ethics Committee of the Universidad Peruana Cayetano Heredia (SIDISI 203725) and the Ethics Committee of the Hospital Cayetano Heredia (042-2021). Protocol details were uploaded in ClinicalTrials.gov. Findings will be disseminated through peer-reviewed journals, scientific conferences and open-access social media platforms. TRIAL REGISTRATION NUMBER NCT05386485.
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Affiliation(s)
- Rodrigo Cachay
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Takashi Watanabe-Tejada
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Katiuska Cuno
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marcela Gil-Zacarias
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carolina Coombes
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Isabel Ballena
- Radiology Department, Clinica Medica Cayetano Heredia, Lima, Peru
| | - Fernando Mejia
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Felix Medina
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
- Cardiovascular Disease Department, Hospital Cayetano Heredia, Lima, Peru
| | - Oscar Gayoso
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
- Pulmonology Department, Hospital Cayetano Heredia, Lima, Peru
| | - Carlos Seas
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Larissa Otero
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
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Stufano A, Isgrò C, Palese LL, Caretta P, De Maria L, Lovreglio P, Sardanelli AM. Oxidative Damage and Post-COVID Syndrome: A Cross-Sectional Study in a Cohort of Italian Workers. Int J Mol Sci 2023; 24:ijms24087445. [PMID: 37108606 PMCID: PMC10139201 DOI: 10.3390/ijms24087445] [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: 02/21/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
In addition to the acute symptoms after infection, patients and society are also being challenged by the long-term effects of COVID-19, known as long COVID. Oxidative stress, as a pivotal point in the pathophysiology of COVID-19, could potentially be also involved in the development of the post-COVID syndrome. The aim of the present study was to evaluate the relationship between changes in oxidative status and the persistence of long-COVID symptoms in workers with a previous mild COVID-19 infection. A cross-sectional study was conducted among 127 employees of an Italian university (80 with a previous COVID-19 infection, and 47 healthy subjects). The TBARS assay was used to detect malondialdehyde serum levels (MDA), while total hydroperoxide (TH) production was measured by a d-ROMs kit. A significant difference in mean serum MDA values was found between previously infected subjects and healthy controls and (4.9 µm vs. 2.8 µm, respectively). Receiver-operating characteristic (ROC) curves showed high specificity and good sensibility (78.7% and 67.5%, respectively) for MDA serum levels. A random forest classifier identified the hematocrit value, MDA serum levels, and IgG titer against SARS-CoV-2 as features with the highest predictive value in distinguishing 34 long-COVID from 46 asymptomatic post-COVID subjects. Oxidative damage persists in subjects with previous COVID-19 infection, suggesting a possible role of oxidative stress mediators in the pathogenesis of long COVID.
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Affiliation(s)
- Angela Stufano
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Camilla Isgrò
- Department of Translational Biomedicine Neuroscience, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Luigi Leonardo Palese
- Department of Translational Biomedicine Neuroscience, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Paolo Caretta
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Anna Maria Sardanelli
- Department of Translational Biomedicine Neuroscience, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy
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DeVries A, Shambhu S, Sloop S, Overhage JM. One-Year Adverse Outcomes Among US Adults With Post-COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database. JAMA HEALTH FORUM 2023; 4:e230010. [PMID: 36867420 PMCID: PMC9984976 DOI: 10.1001/jamahealthforum.2023.0010] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Importance Many individuals experience ongoing symptoms following the onset of COVID-19, characterized as postacute sequelae of SARS-CoV-2 or post-COVID-19 condition (PCC). Less is known about the long-term outcomes for these individuals. Objective To quantify 1-year outcomes among individuals meeting a PCC definition compared with a control group of individuals without COVID-19. Design, Setting, and Participants This case-control study with a propensity score-matched control group included members of commercial health plans and used national insurance claims data enhanced with laboratory results and mortality data from the Social Security Administration's Death Master File and Datavant Flatiron data. The study sample consisted of adults meeting a claims-based definition for PCC with a 2:1 matched control cohort of individuals with no evidence of COVID-19 during the time period of April 1, 2020, to July 31, 2021. Exposures Individuals experiencing postacute sequelae of SARS-CoV-2 using a Centers for Disease Control and Prevention-based definition. Main Outcomes and Measures Adverse outcomes, including cardiovascular and respiratory outcomes and mortality, for individuals with PCC and controls assessed over a 12-month period. Results The study population included 13 435 individuals with PCC and 26 870 individuals with no evidence of COVID-19 (mean [SD] age, 51 [15.1] years; 58.4% female). During follow-up, the PCC cohort experienced increased health care utilization for a wide range of adverse outcomes: cardiac arrhythmias (relative risk [RR], 2.35; 95% CI, 2.26-2.45), pulmonary embolism (RR, 3.64; 95% CI, 3.23-3.92), ischemic stroke (RR, 2.17; 95% CI, 1.98-2.52), coronary artery disease (RR, 1.78; 95% CI, 1.70-1.88), heart failure (RR, 1.97; 95% CI, 1.84-2.10), chronic obstructive pulmonary disease (RR, 1.94; 95% CI, 1.88-2.00), and asthma (RR, 1.95; 95% CI, 1.86-2.03). The PCC cohort also experienced increased mortality, as 2.8% of individuals with PCC vs 1.2% of controls died, implying an excess death rate of 16.4 per 1000 individuals. Conclusions and Relevance This case-control study leveraged a large commercial insurance database and found increased rates of adverse outcomes over a 1-year period for a PCC cohort surviving the acute phase of illness. The results indicate a need for continued monitoring for at-risk individuals, particularly in the area of cardiovascular and pulmonary management.
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Affiliation(s)
| | | | - Sue Sloop
- Elevance Health, Inc, Indianapolis, Indiana
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Meringer H, Wang A, Mehandru S. The Pathogenesis of Gastrointestinal, Hepatic, and Pancreatic Injury in Acute and Long Coronavirus Disease 2019 Infection. Gastroenterol Clin North Am 2023; 52:1-11. [PMID: 36813418 PMCID: PMC9721275 DOI: 10.1016/j.gtc.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The gastrointestinal (GI) tract is targeted by severe acute respiratory syndrome coronavirus-2. The present review examines GI involvement in patients with long coronavirus disease and discusses the underlying pathophysiological mechanisms that include viral persistence, mucosal and systemic immune dysregulation, microbial dysbiosis, insulin resistance, and metabolic abnormalities. Due to the complex and potentially multifactorial nature of this syndrome, rigorous clinical definitions and pathophysiology-based therapeutic approaches are warranted.
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Affiliation(s)
- Hadar Meringer
- Henry D. Janowitz Division of Gastroenterology, Department of Medicine; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Icahn Building 11-02, New York, NY 10029, USA
| | - Andrew Wang
- Henry D. Janowitz Division of Gastroenterology, Department of Medicine; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Icahn Building 11-02, New York, NY 10029, USA
| | - Saurabh Mehandru
- Henry D. Janowitz Division of Gastroenterology, Department of Medicine; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Icahn Building 11-02, New York, NY 10029, USA.
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Wang S, Li Y, Yue Y, Yuan C, Kang JH, Chavarro JE, Bhupathiraju SN, Roberts AL. Adherence to Healthy Lifestyle Prior to Infection and Risk of Post-COVID-19 Condition. JAMA Intern Med 2023; 183:232-241. [PMID: 36745445 PMCID: PMC9989904 DOI: 10.1001/jamainternmed.2022.6555] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/04/2022] [Indexed: 02/07/2023]
Abstract
Importance Few modifiable risk factors for post-COVID-19 condition (PCC) have been identified. Objective To investigate the association between healthy lifestyle factors prior to SARS-CoV-2 infection and risk of PCC. Design, Setting, and Participants In this prospective cohort study, 32 249 women in the Nurses' Health Study II cohort reported preinfection lifestyle habits in 2015 and 2017. Healthy lifestyle factors included healthy body mass index (BMI, 18.5-24.9; calculated as weight in kilograms divided by height in meters squared), never smoking, at least 150 minutes per week of moderate to vigorous physical activity, moderate alcohol intake (5 to 15 g/d), high diet quality (upper 40% of Alternate Healthy Eating Index-2010 score), and adequate sleep (7 to 9 h/d). Main Outcomes and Measures SARS-CoV-2 infection (confirmed by test) and PCC (at least 4 weeks of symptoms) were self-reported on 7 periodic surveys administered from April 2020 to November 2021. Among participants with SARS-CoV-2 infection, the relative risk (RR) of PCC in association with the number of healthy lifestyle factors (0 to 6) was estimated using Poisson regression and adjusting for demographic factors and comorbidities. Results A total of 1981 women with a positive SARS-CoV-2 test over 19 months of follow-up were documented. Among those participants, mean age was 64.7 years (SD, 4.6; range, 55-75); 97.4% (n = 1929) were White; and 42.8% (n = 848) were active health care workers. Among these, 871 (44.0%) developed PCC. Healthy lifestyle was associated with lower risk of PCC in a dose-dependent manner. Compared with women without any healthy lifestyle factors, those with 5 to 6 had 49% lower risk (RR, 0.51; 95% CI, 0.33-0.78) of PCC. In a model mutually adjusted for all lifestyle factors, BMI and sleep were independently associated with risk of PCC (BMI, 18.5-24.9 vs others, RR, 0.85; 95% CI, 0.73-1.00, P = .046; sleep, 7-9 h/d vs others, RR, 0.83; 95% CI, 0.72-0.95, P = .008). If these associations were causal, 36.0% of PCC cases would have been prevented if all participants had 5 to 6 healthy lifestyle factors (population attributable risk percentage, 36.0%; 95% CI, 14.1%-52.7%). Results were comparable when PCC was defined as symptoms of at least 2-month duration or having ongoing symptoms at the time of PCC assessment. Conclusions and Relevance In this prospective cohort study, pre-infection healthy lifestyle was associated with a substantially lower risk of PCC. Future research should investigate whether lifestyle interventions may reduce risk of developing PCC or mitigate symptoms among individuals with PCC or possibly other postinfection syndromes.
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Affiliation(s)
- Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yiyang Yue
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Changzheng Yuan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Zhejiang University School of Public Health, Hangzhou, China
| | - Jae Hee Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shilpa N. Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Garazzino S, Denina M, Pruccoli G, Funiciello E, Ramenghi U, Fagioli F. Long COVID-19/post-COVID condition in children: do we all speak the same language? Ital J Pediatr 2023; 49:12. [PMID: 36670478 PMCID: PMC9859668 DOI: 10.1186/s13052-023-01417-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/13/2023] [Indexed: 01/21/2023] Open
Abstract
Post-COVID condition is a new and highly debated entity that is still to be outlined in its complexity, especially in the pediatric population. In response to the article by Trapani and colleagues, we report the results of a long-term follow-up conducted in the outpatient clinic of the Pediatric Infectious Diseases Unit on children admitted to our hospital with SARS-CoV-2 infection.
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Affiliation(s)
- Silvia Garazzino
- Unit of Pediatric Infectious Diseases, University of Turin, Regina Margherita Children’s Hospital, Turin, Italy
| | - Marco Denina
- grid.415778.80000 0004 5960 9283Pediatric Emergency Department, Regina Margherita Children’s Hospital, Turin, Italy
| | - Giulia Pruccoli
- Unit of Pediatric Infectious Diseases, University of Turin, Regina Margherita Children’s Hospital, Turin, Italy
| | - Elisa Funiciello
- Unit of Pediatric Infectious Diseases, University of Turin, Regina Margherita Children’s Hospital, Turin, Italy
| | - Ugo Ramenghi
- Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospital, Turin, Italy
| | - Franca Fagioli
- Department of Public Health and Pediatric Sciences, University of Turin, Regina Margherita Children’s Hospital, Turin, Italy
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Pick A. Is Long Covid a Functional Disorder? ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2023; 12:11795727221141193. [PMID: 36891136 PMCID: PMC9951108 DOI: 10.1177/11795727221141193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Anton Pick
- Consultant in Rehabilitation Medicine, Clinical Lead, Oxford Centre for Enablement Oxford University Hospitals NHS Foundation Trust, Oxford, England, UK
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Cooper E, Lound A, Atchison CJ, Whitaker M, Eccles C, Cooke GS, Elliott P, Ward H. Awareness and perceptions of Long COVID among people in the REACT programme: Early insights from a pilot interview study. PLoS One 2023; 18:e0280943. [PMID: 36701357 PMCID: PMC9879384 DOI: 10.1371/journal.pone.0280943] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Long COVID is a patient-made term describing new or persistent symptoms experienced following SARS-CoV-2 infection. The Real-time Assessment of Community Transmission-Long COVID (REACT-LC) study aims to understand variation in experiences following infection, and to identify biological, social, and environmental factors associated with Long COVID. We undertook a pilot interview study to inform the design, recruitment approach, and topic guide for the REACT-LC qualitative study. We sought to gain initial insights into the experience and attribution of new or persistent symptoms and the awareness or perceived applicability of the term Long COVID. METHODS People were invited to REACT-LC assessment centres if they had taken part in REACT, a random community-based prevalence study, and had a documented history of SARS-CoV-2 infection. We invited people from REACT-LC assessment centres who had reported experiencing persistent symptoms for more than 12 weeks to take part in an interview. We conducted face to face and online semi-structured interviews which were transcribed and analysed using Thematic Analysis. RESULTS We interviewed 13 participants (6 female, 7 male, median age 31). Participants reported a wide variation in both new and persistent symptoms which were often fluctuating or unpredictable in nature. Some participants were confident about the link between their persistent symptoms and COVID-19; however, others were unclear about the underlying cause of symptoms or felt that the impact of public health measures (such as lockdowns) played a role. We found differences in awareness and perceived applicability of the term Long COVID. CONCLUSION This pilot has informed the design, recruitment approach and topic guide for our qualitative study. It offers preliminary insights into the varied experiences of people living with persistent symptoms including differences in symptom attribution and perceived applicability of the term Long COVID. This variation shows the value of recruiting from a nationally representative sample of participants who are experiencing persistent symptoms.
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Affiliation(s)
- Emily Cooper
- Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
- * E-mail:
| | - Adam Lound
- Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
| | - Christina J. Atchison
- Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
| | - Matthew Whitaker
- School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Caroline Eccles
- REACT-Long Covid Public Advisory Group, Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
| | - Graham S. Cooke
- Department of Infectious Disease, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- National Institute for Health Research Imperial Biomedical Research Centre, London, United Kingdom
| | - Paul Elliott
- School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- National Institute for Health Research Imperial Biomedical Research Centre, London, United Kingdom
| | - Helen Ward
- Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- National Institute for Health Research Imperial Biomedical Research Centre, London, United Kingdom
- MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom
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Simonetti A, Bernardi E, Janiri D, Mazza M, Montanari S, Catinari A, Terenzi B, Tosato M, Galluzzo V, Ciciarello F, Landi F, Sani G. Suicide Risk in Post-COVID-19 Syndrome. J Pers Med 2022; 12:jpm12122019. [PMID: 36556240 PMCID: PMC9785632 DOI: 10.3390/jpm12122019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Post-acute sequelae of COVID-19 include several neuropsychiatric disorders. Little is known about the relationship between post-COVID-19 syndrome and suicidality. The aim of the study was to investigate the risk of suicide in subjects with persistent post-COVID-19 syndrome. One-thousand five-hundred eighty-eight subjects were assessed in the Post-Acute Care Service at the Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS of Rome. Assessment included: (a) sociodemographic characteristics; (b) symptoms during and after COVID-19; (c) psychopathological evaluation. Participants were divided in those with (SUI) or without (NON SUI) suicide risk according to the Mini International Neuropsychiatric Interview. Additionally, subjects with SUI were split into those with high (HIGH SUI) and low (LOW SUI) suicide risk. Between-group comparisons were made with t-tests for continuous variables and χ2 tests for categorical variables. SUI showed greater percentages of physical complaints during and after COVID-19, greater percentages of psychiatric history and presence of psychiatric history in relatives, greater percentages of subjects previously undergoing psychopharmacotherapy, and greater levels of anxiety, mixed depressive symptoms, general psychopathology than NON SUI. HIGH SUI showed greater number of symptoms during and after COVID-19 and higher levels of mixed depressive symptoms than LOW SUI. Percentages of subjects undergoing psychotherapy was higher in LOW SUI than HIGH SUI. Greater levels of physical complaints and psychopathology during post-COVID-syndrome might enhance the risk of committing suicide. Treatment of physical complaints and psychotherapy might reduce suicide risk.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Evelina Bernardi
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Delfina Janiri
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Marianna Mazza
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Antonello Catinari
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Beatrice Terenzi
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Matteo Tosato
- Department of Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Vincenzo Galluzzo
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Francesca Ciciarello
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Landi
- Department of Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Geriatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Neurosciences, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Binka M, Klaver B, Cua G, Wong AW, Fibke C, Velásquez García HA, Adu P, Levin A, Mishra S, Sander B, Sbihi H, Janjua NZ. An Elastic Net Regression Model for Identifying Long COVID Patients Using Health Administrative Data: A Population-Based Study. Open Forum Infect Dis 2022; 9:ofac640. [PMID: 36570972 PMCID: PMC9780702 DOI: 10.1093/ofid/ofac640] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background Long coronavirus disease (COVID) patients experience persistent symptoms after acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Healthcare utilization data could provide critical information on the disease burden of long COVID for service planning; however, not all patients are diagnosed or assigned long COVID diagnostic codes. We developed an algorithm to identify individuals with long COVID using population-level health administrative data from British Columbia (BC), Canada. Methods An elastic net penalized logistic regression model was developed to identify long COVID patients based on demographic characteristics, pre-existing conditions, COVID-19-related data, and all symptoms/conditions recorded >28-183 days after the COVID-19 symptom onset/reported (index) date of known long COVID patients (n = 2430) and a control group (n = 24 300), selected from all adult COVID-19 cases in BC with an index date on/before October 31, 2021 (n = 168 111). Known long COVID cases were diagnosed in a clinic and/or had the International Classification of Diseases, Tenth Revision, Canada (ICD-10-CA) code for "post COVID-19 condition" in their records. Results The algorithm retained known symptoms/conditions associated with long COVID, demonstrating high sensitivity (86%), specificity (86%), and area under the receiver operator curve (93%). It identified 25 220 (18%) long COVID patients among the remaining 141 381 adult COVID-19 cases, >10 times the number of known cases. Known and predicted long COVID patients had comparable demographic and health-related characteristics. Conclusions Our algorithm identified long COVID patients with a high level of accuracy. This large cohort of long COVID patients will serve as a platform for robust assessments on the clinical course of long COVID, and provide much needed concrete information for decision-making.
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Affiliation(s)
- Mawuena Binka
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Braeden Klaver
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Georgine Cua
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Alyson W Wong
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chad Fibke
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Héctor A Velásquez García
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Prince Adu
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Adeera Levin
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharmistha Mishra
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Beate Sander
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Hind Sbihi
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Naveed Z Janjua
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, British Columbia V6Z IY6, Canada
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Au L, Capotescu C, Eyal G, Finestone G. Long covid and medical gaslighting: Dismissal, delayed diagnosis, and deferred treatment. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100167. [PMID: 36092770 PMCID: PMC9448633 DOI: 10.1016/j.ssmqr.2022.100167] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/31/2022] [Accepted: 08/31/2022] [Indexed: 01/12/2023]
Abstract
While we know a lot more about Long Covid today, patients who were infected with Covid-19 early on in the pandemic and developed Long Covid had to contend with medical professionals who lacked awareness of the potential for extended complications from Covid-19. Long Covid patients have responded by labeling their contentious interactions with medical professionals, organizations, and the broader medical system as "gaslighting." We argue that the charge of medical gaslighting can be understood as a form of ontological politics. Not only do patients demand that their version of reality be recognized, but they also blame the experts who hold gatekeeping power over their medical care for producing a distorted version of said reality. By analyzing results from an online survey of Long Covid patients active on social media in the United States (n = 334), we find that experiences of contention and their reframing as "gaslighting" were common amongst our respondents. In short answer responses about their experience obtaining medical care for Long Covid, our respondents described encountering medical professionals who dismissed their experience, leading to lengthy diagnostic odysseys and lack of treatment options for Long Covid. Even though we are limited by characteristics of our sample, there is good reason to believe that these experiences and their contentious reframing as medical gaslighting are exacerbated by gender, class, and racial inequalities.
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Affiliation(s)
- Larry Au
- Department of Sociology, The City College of New York, NAC 6/135, 160 Convent Ave, New York, NY, 10031, USA
| | - Cristian Capotescu
- Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, Suite 1300, 61 Claremont Avenue, New York, NY, 10115, USA
| | - Gil Eyal
- Department of Sociology, Columbia University, Suite 501, 606 W 122nd St, New York, NY, 10027, USA
| | - Gabrielle Finestone
- Department of Sociology, Columbia University, Suite 501, 606 W 122nd St, New York, NY, 10027, USA
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45
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Mehta P, Rosas IO, Singer M. Understanding post-COVID-19 interstitial lung disease (ILD): a new fibroinflammatory disease entity. Intensive Care Med 2022; 48:1803-1806. [PMID: 36074167 PMCID: PMC9453725 DOI: 10.1007/s00134-022-06877-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Puja Mehta
- Centre for Inflammation and Tissue Repair, Division of Medicine, UCL Respiratory, University College London (UCL), Rayne 9 Building, London, WC1E 6JF, UK. .,Department of Rheumatology, University College London Hospital (UCLH), London, UK.
| | - Ivan O Rosas
- Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Mervyn Singer
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London (UCL), London, UK
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46
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O’Hare AM, Vig EK, Iwashyna TJ, Fox A, Taylor JS, Viglianti EM, Butler CR, Vranas KC, Helfand M, Tuepker A, Nugent SM, Winchell KA, Laundry RJ, Bowling CB, Hynes DM, Maciejewski ML, Bohnert ASB, Locke ER, Boyko EJ, Ioannou GN. Complexity and Challenges of the Clinical Diagnosis and Management of Long COVID. JAMA Netw Open 2022; 5:e2240332. [PMID: 36326761 PMCID: PMC9634500 DOI: 10.1001/jamanetworkopen.2022.40332] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
IMPORTANCE There is increasing recognition of the long-term health effects of SARS-CoV-2 infection (sometimes called long COVID). However, little is yet known about the clinical diagnosis and management of long COVID within health systems. OBJECTIVE To describe dominant themes pertaining to the clinical diagnosis and management of long COVID in the electronic health records (EHRs) of patients with a diagnostic code for this condition (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] code U09.9). DESIGN, SETTING, AND PARTICIPANTS This qualitative analysis used data from EHRs of a national random sample of 200 patients receiving care in the Department of Veterans Affairs (VA) with documentation of a positive result on a polymerase chain reaction (PCR) test for SARS-CoV-2 between February 27, 2020, and December 31, 2021, and an ICD-10 diagnostic code for long COVID between October 1, 2021, when the code was implemented, and March 1, 2022. Data were analyzed from February 5 to May 31, 2022. MAIN OUTCOMES AND MEASURES A text word search and qualitative analysis of patients' VA-wide EHRs was performed to identify dominant themes pertaining to the clinical diagnosis and management of long COVID. RESULTS In this qualitative analysis of documentation in the VA-wide EHR, the mean (SD) age of the 200 sampled patients at the time of their first positive PCR test result for SARS-CoV-2 in VA records was 60 (14.5) years. The sample included 173 (86.5%) men; 45 individuals (22.5%) were identified as Black and 136 individuals (68.0%) were identified as White. In qualitative analysis of documentation pertaining to long COVID in patients' EHRs 2 dominant themes were identified: (1) clinical uncertainty, in that it was often unclear whether particular symptoms could be attributed to long COVID, given the medical complexity and functional limitations of many patients and absence of specific markers for this condition, which could lead to ongoing monitoring, diagnostic testing, and specialist referral; and (2) care fragmentation, describing how post-COVID-19 care processes were often siloed from and poorly coordinated with other aspects of care and could be burdensome to patients. CONCLUSIONS AND RELEVANCE This qualitative study of documentation in the VA EHR highlights the complexity of diagnosing long COVID in clinical settings and the challenges of caring for patients who have or are suspected of having this condition.
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Affiliation(s)
- Ann M. O’Hare
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
- Hospital and Specialty Medicine and Geriatrics and Extended Care Services, VA Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle
| | - Elizabeth K. Vig
- Hospital and Specialty Medicine and Geriatrics and Extended Care Services, VA Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle
| | - Theodore J. Iwashyna
- Pulmonary and Critical Care Medicine, Department of Health Policy & Management, School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Alexandra Fox
- Seattle Epidemiologic Research and Information Center, VA Puget Sound, Seattle, Washington
| | | | - Elizabeth M. Viglianti
- Department of Internal Medicine Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor
| | - Catherine R. Butler
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
- Hospital and Specialty Medicine and Geriatrics and Extended Care Services, VA Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle
| | - Kelly C. Vranas
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Oregon Health & Science University, Portland
| | - Mark Helfand
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Oregon Health & Science University, Portland
| | - Anaïs Tuepker
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Oregon Health & Science University, Portland
| | - Shannon M. Nugent
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Oregon Health & Science University, Portland
| | - Kara A. Winchell
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
| | - Ryan J. Laundry
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
| | - C. Barrett Bowling
- Geriatric Research Education and Clinical Center, Durham VA Medical Center, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
| | - Denise M. Hynes
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
- Oregon Health & Science University, Portland
- College of Public Health and Human Sciences and Center for Quantitative Life Sciences, Oregon State University, Corvallis
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina
- Department of Population Health Sciences, Duke University, Durham, North Carolina
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Amy S. B. Bohnert
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
- Departments of Anesthesiology and Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Emily R. Locke
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
- Seattle Epidemiologic Research and Information Center, VA Puget Sound, Seattle, Washington
| | - Edward J. Boyko
- Hospital and Specialty Medicine and Geriatrics and Extended Care Services, VA Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle
- Seattle Epidemiologic Research and Information Center, VA Puget Sound, Seattle, Washington
| | - George N. Ioannou
- Health Services Research & Development Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
- Hospital and Specialty Medicine and Geriatrics and Extended Care Services, VA Puget Sound Health Care System, Seattle, Washington
- Department of Medicine, University of Washington, Seattle
- Seattle Epidemiologic Research and Information Center, VA Puget Sound, Seattle, Washington
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47
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Infection with SARS-CoV-2 Variants Is Associated with Different Long COVID Phenotypes. Viruses 2022; 14:v14112367. [PMID: 36366465 PMCID: PMC9698829 DOI: 10.3390/v14112367] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 01/31/2023] Open
Abstract
COVID-19 has been associated with a broad range of long-term sequelae, commonly referred to as "long-COVID" or "post-COVID-19" syndrome. Despite an increasing body of literature, long COVID remains poorly characterized. We retrospectively analysed data from electronic medical records of patients admitted to the post-COVID-19 outpatient service of the Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy, between June 2020 and June 2021, 4-12 weeks after hospital discharge. A total of 428 patients, 41% women, median age 64 years, underwent a follow-up visit a median 53 days after hospital discharge. Overall, 76% patients reported at least one persistent symptom, including dyspnoea (37%), chronic fatigue (36%), insomnia (16%), visual disorders (13%) and brain fog (13%). Increasing oxygen support (OR 1.4, 95% CI 1.1-1.8), use of immunosuppressants (OR 6.4, 95% CI 1.5-28) and female sex (OR 1.8, 95% CI 1.1-2.9) were associated with a higher risk of long COVID symptoms. Comparison between symptomatic patients infected in the period March-December 2020 (prevalent circulation of wild-type SARS-CoV-2) with those infected in the period January-April 2021 (prevalent circulation of B.1.1.7 Alpha variant) showed a significant modification in the pattern of symptoms belonging to the neurological and cognitive/emotional categories. Our findings confirmed shortness of breath and chronic fatigue as the most frequent long COVID manifestations, while female sex and severe COVID-19 course were the main risk factors for developing lingering symptoms. SARS-CoV-2 variants may induce different long COVID phenotypes, possibly due to changes in cell tropism and differences in viral-host interaction.
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48
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Nevalainen OPO, Horstia S, Laakkonen S, Rutanen J, Mustonen JMJ, Kalliala IEJ, Ansakorpi H, Kreivi HR, Kuutti P, Paajanen J, Parkkila S, Paukkeri EL, Perola M, Pourjamal N, Renner A, Rosberg T, Rutanen T, Savolainen J, Haukka JK, Guyatt GH, Tikkinen KAO. Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial. Nat Commun 2022; 13:6152. [PMID: 36257950 PMCID: PMC9579198 DOI: 10.1038/s41467-022-33825-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022] Open
Abstract
We report the first long-term follow-up of a randomized trial (NCT04978259) addressing the effects of remdesivir on recovery (primary outcome) and other patient-important outcomes one year after hospitalization resulting from COVID-19. Of the 208 patients recruited from 11 Finnish hospitals, 198 survived, of whom 181 (92%) completed follow-up. At one year, self-reported recovery occurred in 85% in remdesivir and 86% in standard of care (SoC) (RR 0.94, 95% CI 0.47-1.90). We infer no convincing difference between remdesivir and SoC in quality of life or symptom outcomes (p > 0.05). Of the 21 potential long-COVID symptoms, patients reported moderate/major bother from fatigue (26%), joint pain (22%), and problems with memory (19%) and attention/concentration (18%). In conclusion, after a one-year follow-up of hospitalized patients, one in six reported they had not recovered well from COVID-19. Our results provide no convincing evidence of remdesivir benefit, but wide confidence intervals included possible benefit and harm.
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Affiliation(s)
- Olli P. O. Nevalainen
- grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland ,grid.502801.e0000 0001 2314 6254Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland ,Hatanpää Health Center, City of Tampere, Tampere, Finland ,grid.415018.90000 0004 0472 1956Pirkanmaa Hospital District, Tampere, Finland
| | - Saana Horstia
- grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sanna Laakkonen
- grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jarno Rutanen
- grid.502801.e0000 0001 2314 6254Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland ,grid.412330.70000 0004 0628 2985Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | | | - Ilkka E. J. Kalliala
- grid.15485.3d0000 0000 9950 5666Department of Obstetrics and Gynaecology, Helsinki University and University Hospital Helsinki, Helsinki, Finland ,grid.7445.20000 0001 2113 8111Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Hanna Ansakorpi
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland
| | - Hanna-Riikka Kreivi
- grid.7737.40000 0004 0410 2071Department of Pulmonology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pauliina Kuutti
- grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juuso Paajanen
- grid.7737.40000 0004 0410 2071Department of Pulmonology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Seppo Parkkila
- grid.412330.70000 0004 0628 2985Faculty of Medicine and Health Technology, Tampere University and Fimlab Ltd., Tampere University Hospital, Tampere, Finland
| | - Erja-Leena Paukkeri
- grid.412330.70000 0004 0628 2985Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Markus Perola
- grid.14758.3f0000 0001 1013 0499Department of Public Health and Welfare, Population Health Unit, Public Health Research Team, Finnish Institute for Health and Welfare, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Clinical and Molecular Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Negar Pourjamal
- grid.7737.40000 0004 0410 2071Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Andreas Renner
- grid.7737.40000 0004 0410 2071Department of Pulmonology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuomas Rosberg
- grid.413739.b0000 0004 0628 3152Department of Pulmonology, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | | | | | | | - Jari K. Haukka
- grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland ,grid.7737.40000 0004 0410 2071Clinicum/Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Gordon H. Guyatt
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Department of Medicine, McMaster University, Hamilton, ON Canada
| | - Kari A. O. Tikkinen
- grid.7737.40000 0004 0410 2071Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ,Department of Surgery, South Karelian Central Hospital, Lappeenranta, Finland
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49
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Tana C, Bentivegna E, Cho SJ, Harriott AM, García-Azorín D, Labastida-Ramirez A, Ornello R, Raffaelli B, Beltrán ER, Ruscheweyh R, Martelletti P. Long COVID headache. J Headache Pain 2022; 23:93. [PMID: 35915417 PMCID: PMC9340759 DOI: 10.1186/s10194-022-01450-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 06/28/2022] [Indexed: 02/07/2023] Open
Abstract
Headache is among the most frequent symptoms persisting or newly developing after coronavirus disease 2019 (COVID-19) as part of the so-called long COVID syndrome. The knowledge on long COVID headache is still limited, however growing evidence is defining the features of this novel condition, in particular regarding clinical characteristics, some pathophysiological mechanisms and first treatment recommendations. Long COVID headache can present in the form of worsening of a preexisting primary headache, or, more specifically, in the form of a new (intermittent or daily) headache starting during the acute infection or after a delay. It often presents together with other long COVID symptoms, most frequently with hyposmia. It can manifest with a migrainous or, more frequently, with a tension-type-like phenotype. Persistent activation of the immune system and trigeminovascular activation are thought to play a role. As there are virtually no treatment studies, treatment currently is largely guided by the existing guidelines for primary headaches with the corresponding phenotype. The present report, a collaborative work of the international group of the Junior Editorial Board of The Journal of Headache and Pain aims to summarize the most recent evidence about long COVID headache and suggests approaches to the diagnosis and treatment of this disorder.
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Affiliation(s)
- Claudio Tana
- Center of Excellence On Headache, Geriatrics and COVID-19 Clinic, SS Annunziata Hospital of Chieti, 66100, Chieti, Italy.
| | - Enrico Bentivegna
- Internal Medicine and Emergency Medicine, Sant' Andrea Hospital, Sapienza University, Rome, Italy
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - Andrea M Harriott
- Headache and Neuropathic Pain Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David García-Azorín
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Alejandro Labastida-Ramirez
- Headache Group, Wolfson Center for Age Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Raffaele Ornello
- Departement of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Bianca Raffaelli
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eloísa Rubio Beltrán
- Headache Group, Wolfson Center for Age Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ruth Ruscheweyh
- Department of Neurology, Ludwig Maximilians University, Munich, Germany.,German Migraine and Headache Society, Frankfurt, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Paolo Martelletti
- Internal Medicine and Emergency Medicine, Sant' Andrea Hospital, Sapienza University, Rome, Italy
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50
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Pazukhina E, Andreeva M, Spiridonova E, Bobkova P, Shikhaleva A, El-Taravi Y, Rumyantsev M, Gamirova A, Bairashevskaia A, Petrova P, Baimukhambetova D, Pikuza M, Abdeeva E, Filippova Y, Deunezhewa S, Nekliudov N, Bugaeva P, Bulanov N, Avdeev S, Kapustina V, Guekht A, DunnGalvin A, Comberiati P, Peroni DG, Apfelbacher C, Genuneit J, Reyes LF, Brackel CLH, Fomin V, Svistunov AA, Timashev P, Mazankova L, Miroshina A, Samitova E, Borzakova S, Bondarenko E, Korsunskiy AA, Carson G, Sigfrid L, Scott JT, Greenhawt M, Buonsenso D, Semple MG, Warner JO, Olliaro P, Needham DM, Glybochko P, Butnaru D, Osmanov IM, Munblit D, Artigas E, Avagyan A, Baziyants L, Belkina A, Berbenyuk A, Bezbabicheva T, Bezrukov V, Bordyugov S, Borisenko A, Bratukhina M, Bugaiskaya E, Chayka J, Cherdantseva Y, Degtyareva N, Druzhkova O, Dubinin A, Elifkhanova K, Eliseev D, Ezhova A, Frolova A, Ganieva J, Gorina A, Gorlenko C, Gribaleva E, Gudratova E, Ibragimova S, Kabieva K, Kalan Y, Kalinina M, Khitrina N, Kirillov B, Kiseljow H, Kislova M, Kogut N, Konova I, Korgunova M, Kotelnikova A, Kovygina K, Krupina A, Kuznetsova A, Kuznetsova A, Lavginova B, Lidjieva E, Listovskaya E, Lobova M, Loshkareva M, Lyubimova E, Mamchich D, Markina N, Maystrenko A, Mursalova A, Nagornov E, Nartova A, Nikolaeva D, Novoselov G, Ogandzhanova M, Pavlenko A, Perekosova O, Porubayeva E, Presnyakova K, Pushkareva A, Romanova O, Roshchin P, Salakhova D, Sarukhanyan I, Savina V, Shatrova J, Shishkina N, Shvedova A, Smirnov D, Solovieva V, Spasskaya O, Sukhodolskaya O, Suleimanov S, Urmantaeva N, Usalka O, Ustyan V, Valieva Y, Varaksina K, Varaksina M, Varlamova E, Vodianova M, Yegiyan M, Zaikina M, Zorina A, Zuykova E. Prevalence and risk factors of post-COVID-19 condition in adults and children at 6 and 12 months after hospital discharge: a prospective, cohort study in Moscow (StopCOVID). BMC Med 2022; 20:244. [PMID: 35794549 PMCID: PMC9257572 DOI: 10.1186/s12916-022-02448-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/21/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies assessing the prevalence of COVID-19 sequelae in adults and children were performed in the absence of an agreed definition. We investigated prevalence of post-COVID-19 condition (PCC) (WHO definition), at 6- and 12-months follow-up, amongst previously hospitalised adults and children and assessed risk factors. METHODS Prospective cohort study of children and adults with confirmed COVID-19 in Moscow, hospitalised between April and August, 2020. Two follow-up telephone interviews, using the International Severe Acute Respiratory and Emerging Infection Consortium survey, were performed at 6 and 12 months after discharge. RESULTS One thousand thirteen of 2509 (40%) of adults and 360 of 849 (42%) of children discharged participated in both the 6- and 12-month follow-ups. PCC prevalence was 50% (95% CI 47-53) in adults and 20% (95% CI 16-24) in children at 6 months, with decline to 34% (95% CI 31-37) and 11% (95% CI 8-14), respectively, at 12 months. In adults, female sex was associated with PCC at 6- and 12-month follow-up (OR 2.04, 95% CI 1.57 to 2.65) and (OR 2.04, 1.54 to 2.69), respectively. Pre-existing hypertension (OR 1.42, 1.04 to 1.94) was associated with post-COVID-19 condition at 12 months. In children, neurological comorbidities were associated with PCC both at 6 months (OR 4.38, 1.36 to 15.67) and 12 months (OR 8.96, 2.55 to 34.82) while allergic respiratory diseases were associated at 12 months (OR 2.66, 1.04 to 6.47). CONCLUSIONS Although prevalence of PCC declined one year after discharge, one in three adults and one in ten children experienced ongoing sequelae. In adults, females and persons with pre-existing hypertension, and in children, persons with neurological comorbidities or allergic respiratory diseases are at higher risk of PCC.
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Affiliation(s)
- Ekaterina Pazukhina
- Laboratory of Health Economics, Institute of Applied Economic Studies, The Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia.,Center for Advanced Financial Planning, Macroeconomic Analysis and Financial Statistics, Financial Research Institute of the Ministry of Finance of the Russian Federation, Moscow, Russia
| | - Margarita Andreeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ekaterina Spiridonova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Bobkova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasia Shikhaleva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yasmin El-Taravi
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Mikhail Rumyantsev
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aysylu Gamirova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anastasiia Bairashevskaia
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Petrova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Dina Baimukhambetova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Maria Pikuza
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elina Abdeeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Yulia Filippova
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Salima Deunezhewa
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nikita Nekliudov
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Polina Bugaeva
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nikolay Bulanov
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Sergey Avdeev
- Clinic of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Valentina Kapustina
- Department of Internal Medicine №1, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alla Guekht
- Research and Clinical Center for Neuropsychiatry, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - Audrey DunnGalvin
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,School of Applied Psychology, University College Cork, Cork City, Ireland
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Luis Felipe Reyes
- Universidad de La Sabana, Chía, Colombia.,Clínica Universidad de La Sabana, Chía, Colombia
| | - Caroline L H Brackel
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.,Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands
| | - Victor Fomin
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey A Svistunov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Lyudmila Mazankova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Elmira Samitova
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.,ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Svetlana Borzakova
- Pirogov Russian National Research Medical University, Moscow, Russia.,Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, Russia
| | - Elena Bondarenko
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anatoliy A Korsunskiy
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Gail Carson
- Nuffield Department of Medicine, ISARIC Global Support Centre, University of Oxford, Oxford, UK
| | - Louise Sigfrid
- Nuffield Department of Medicine, ISARIC Global Support Centre, University of Oxford, Oxford, UK
| | - Janet T Scott
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Matthew Greenhawt
- Department of Pediatrics, Section of Allergy/Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, USA
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Malcolm G Semple
- Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.,Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK
| | - John O Warner
- Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Piero Olliaro
- Nuffield Department of Medicine, ISARIC Global Support Centre, University of Oxford, Oxford, UK
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, USA.,Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Petr Glybochko
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Denis Butnaru
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ismail M Osmanov
- Pirogov Russian National Research Medical University, Moscow, Russia.,ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. .,Research and Clinical Center for Neuropsychiatry, Moscow, Russia. .,Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
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