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Routen A, O'Mahoney L, Aiyegbusi OL, Alder Y, Banerjee A, Buckland L, Brightling C, Calvert M, Camaradou J, Chaturvedi N, Chong A, Dalrymple E, Eggo RM, Elliott P, Evans RA, Gibson A, Haroon S, Herrett E, Houchen-Wolloff L, Hughes SE, Jeyes F, Matthews K, McMullan C, Morley J, Shafran R, Smith N, Stanton D, Stephenson T, Sterne J, Turner GM, Ward H, Khunti K. Patient and public involvement within epidemiological studies of long COVID in the UK. Nat Med 2023; 29:771-773. [PMID: 36932242 DOI: 10.1038/s41591-023-02251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Affiliation(s)
- Ash Routen
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK.
| | - Lauren O'Mahoney
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
| | - Yvonne Alder
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Amitava Banerjee
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London (UCL), London, UK
| | - Lewis Buckland
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chris Brightling
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC), University of Birmingham, Birmingham, UK
| | - Jenny Camaradou
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nishi Chaturvedi
- Department of Population Science and Experimental Medicine, UCL, London, UK
| | - Amy Chong
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emma Dalrymple
- Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Rosalind M Eggo
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Paul Elliott
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Rachael A Evans
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Andy Gibson
- Department of Health and Social Sciences, University of West England, Bristol, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emily Herrett
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
| | - Flic Jeyes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Karen Matthews
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
- Department of Population Science and Experimental Medicine, UCL, London, UK
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK
| | - Jessica Morley
- Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Roz Shafran
- Great Ormond Street Institute of Child Health, UCL, London, UK
| | | | - David Stanton
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Jonathan Sterne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Grace M Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Helen Ward
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
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Chandan JS, Brown KR, Simms-Williams N, Bashir NZ, Camaradou J, Heining D, Turner GM, Rivera SC, Hotham R, Minhas S, Nirantharakumar K, Sivan M, Khunti K, Raindi D, Marwaha S, Hughes SE, McMullan C, Marshall T, Calvert MJ, Haroon S, Aiyegbusi OL. Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review. Int J Environ Res Public Health 2023; 20:3477. [PMID: 36834176 PMCID: PMC9967466 DOI: 10.3390/ijerph20043477] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Post-viral syndromes (PVS), including Long COVID, are symptoms sustained from weeks to years following an acute viral infection. Non-pharmacological treatments for these symptoms are poorly understood. This review summarises the evidence for the effectiveness of non-pharmacological treatments for PVS. METHODS We conducted a systematic review to evaluate the effectiveness of non-pharmacological interventions for PVS, as compared to either standard care, alternative non-pharmacological therapy, or placebo. The outcomes of interest were changes in symptoms, exercise capacity, quality of life (including mental health and wellbeing), and work capability. We searched five databases (Embase, MEDLINE, PsycINFO, CINAHL, MedRxiv) for randomised controlled trials (RCTs) published between 1 January 2001 to 29 October 2021. The relevant outcome data were extracted, the study quality was appraised using the Cochrane risk-of-bias tool, and the findings were synthesised narratively. FINDINGS Overall, five studies of five different interventions (Pilates, music therapy, telerehabilitation, resistance exercise, neuromodulation) met the inclusion criteria. Aside from music-based intervention, all other selected interventions demonstrated some support in the management of PVS in some patients. INTERPRETATION In this study, we observed a lack of robust evidence evaluating the non-pharmacological treatments for PVS, including Long COVID. Considering the prevalence of prolonged symptoms following acute viral infections, there is an urgent need for clinical trials evaluating the effectiveness and cost-effectiveness of non-pharmacological treatments for patients with PVS. REGISTRATION The study protocol was registered with PROSPERO [CRD42021282074] in October 2021 and published in BMJ Open in 2022.
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Affiliation(s)
- Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Kirsty R. Brown
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nikita Simms-Williams
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Nasir Z. Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Jenny Camaradou
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - Dominic Heining
- Department of Microbiology, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
| | - Grace M. Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Samantha Cruz Rivera
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
| | - Richard Hotham
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Sonica Minhas
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Midlands Health Data Research UK, Birmingham B15 2TT, UK
| | - Manoj Sivan
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK
| | - Devan Raindi
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham B5 7EG, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham and Solihull Mental Health NHS Foundation Trust, Unit 1, B1, 50 Summer Hill Road, Birmingham B1 3RB, UK
| | - Sarah E. Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
- National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Melanie J. Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
- National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham B15 2TT, UK
- Health Data Research UK, London WC1E 6BT, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
- National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK
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3
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Subramanian A, Nirantharakumar K, Hughes S, Myles P, Williams T, Gokhale KM, Taverner T, Chandan JS, Brown K, Simms-Williams N, Shah AD, Singh M, Kidy F, Okoth K, Hotham R, Bashir N, Cockburn N, Lee SI, Turner GM, Gkoutos GV, Aiyegbusi OL, McMullan C, Denniston AK, Sapey E, Lord JM, Wraith DC, Leggett E, Iles C, Marshall T, Price MJ, Marwaha S, Davies EH, Jackson LJ, Matthews KL, Camaradou J, Calvert M, Haroon S. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med 2022; 28:1706-1714. [PMID: 35879616 PMCID: PMC9388369 DOI: 10.1038/s41591-022-01909-w] [Citation(s) in RCA: 317] [Impact Index Per Article: 158.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/21/2022] [Indexed: 01/11/2023]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook a retrospective matched cohort study using a UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine symptoms that are associated with confirmed SARS-CoV-2 infection beyond 12 weeks in non-hospitalized adults and the risk factors associated with developing persistent symptoms. We selected 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 propensity score-matched adults with no recorded evidence of SARS-CoV-2 infection. Outcomes included 115 individual symptoms, as well as long COVID, defined as a composite outcome of 33 symptoms by the World Health Organization clinical case definition. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the outcomes. A total of 62 symptoms were significantly associated with SARS-CoV-2 infection after 12 weeks. The largest aHRs were for anosmia (aHR 6.49, 95% CI 5.02-8.39), hair loss (3.99, 3.63-4.39), sneezing (2.77, 1.40-5.50), ejaculation difficulty (2.63, 1.61-4.28) and reduced libido (2.36, 1.61-3.47). Among the cohort of patients infected with SARS-CoV-2, risk factors for long COVID included female sex, belonging to an ethnic minority, socioeconomic deprivation, smoking, obesity and a wide range of comorbidities. The risk of developing long COVID was also found to be increased along a gradient of decreasing age. SARS-CoV-2 infection is associated with a plethora of symptoms that are associated with a range of sociodemographic and clinical risk factors.
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Affiliation(s)
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
- Midlands Health Data Research UK, Birmingham, UK.
- DEMAND Hub, University of Birmingham, Birmingham, UK.
| | - Sarah Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) - West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | - Puja Myles
- Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK
| | - Tim Williams
- Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK
| | - Krishna M Gokhale
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tom Taverner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kirsty Brown
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Anoop D Shah
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London, London, UK
| | - Megha Singh
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Farah Kidy
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Kelvin Okoth
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Richard Hotham
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nasir Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Neil Cockburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Siang Ing Lee
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Grace M Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
| | - Georgios V Gkoutos
- Midlands Health Data Research UK, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) - West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK
| | - Alastair K Denniston
- Midlands Health Data Research UK, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Elizabeth Sapey
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- PIONEER HDR-UK Data Hub in acute care, University of Birmingham, Birmingham, UK
| | - Janet M Lord
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- UK SPINE, University of Birmingham, Birmingham, UK
| | - David C Wraith
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Edward Leggett
- Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK
| | - Clare Iles
- Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Malcolm J Price
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | | | - Louise J Jackson
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Midlands Health Data Research UK, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) - West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
- PIONEER HDR-UK Data Hub in acute care, University of Birmingham, Birmingham, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Chandan JS, Brown K, Simms-Williams N, Camaradou J, Bashir N, Heining D, Aiyegbusi OL, Turner G, Cruz Rivera S, Hotham R, Nirantharakumar K, Sivan M, Khunti K, Raindi D, Marwaha S, Hughes SE, McMullan C, Calvert M, Haroon S. Non-pharmacological therapies for postviral syndromes, including Long COVID: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e057885. [PMID: 35410933 PMCID: PMC9002258 DOI: 10.1136/bmjopen-2021-057885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Postviral syndromes (PVS) describe the sustained presence of symptoms following an acute viral infection, for months or even years. Exposure to the SARS-CoV-2 virus and subsequent development of COVID-19 has shown to have similar effects with individuals continuing to exhibit symptoms for greater than 12 weeks. The sustained presence of symptoms is variably referred to as 'post COVID-19 syndrome', 'post-COVID condition' or more commonly 'Long COVID'. Knowledge of the long-term health impacts and treatments for Long COVID are evolving. To minimise overlap with existing work in the field exploring treatments of Long COVID, we have only chosen to focus on non-pharmacological treatments. AIMS This review aims to summarise the effectiveness of non-pharmacological treatments for PVS, including Long COVID. A secondary aim is to summarise the symptoms and health impacts associated with PVS in individuals recruited to treatment studies. METHODS AND ANALYSIS Primary electronic searches will be performed in bibliographic databases including: Embase, MEDLINE, PyscINFO, CINAHL and MedRxiv from 1 January 2001 to 29 October 2021. At least two independent reviewers will screen each study for inclusion and data will be extracted from all eligible studies onto a data extraction form. The quality of all included studies will be assessed using Cochrane risk of bias tools and the Newcastle-Ottawa grading system. Non-pharmacological treatments for PVS and Long COVID will be narratively summarised and effect estimates will be pooled using random effects meta-analysis where there is sufficient methodological homogeneity. The symptoms and health impacts reported in the included studies on non-pharmacological interventions will be extracted and narratively reported. ETHICS AND DISSEMINATION This systematic review does not require ethical approval. The findings from this study will be submitted for peer-reviewed publication, shared at conference presentations and disseminated to both clinical and patient groups. PROSPERO REGISTRATION NUMBER The review will adhere to this protocol which has also been registered with PROSPERO (CRD42021282074).
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Affiliation(s)
- Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK, Birmingham, UK
| | - Kirsty Brown
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | - Nasir Bashir
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - Dominic Heining
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Grace Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Samantha Cruz Rivera
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Richard Hotham
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK, Birmingham, UK
| | | | - Kamlesh Khunti
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Devan Raindi
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research and Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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5
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Rivas C, Anand K, Wu AFW, Goff L, Dobson R, Eccles J, Ball E, Kumar S, Camaradou J, Redclift V, Nasim B, Aksoy O. Lessons from the COVID-19 pandemic to improve the health and social care and wellbeing of minoritised ethnic groups with chronic conditions or impairments: protocol for the mixed methods intersectional asset-based study CICADA (Preprint). JMIR Res Protoc 2022; 11:e38361. [PMID: 35609311 PMCID: PMC9255363 DOI: 10.2196/38361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background The COVID-19 pandemic has inequitably impacted the experiences of people living with ill health/impairments or from minoritized ethnic groups across all areas of life. Given possible parallels in inequities for disabled people and people from minoritized ethnic backgrounds, their existence before the pandemic and increase since, and the discriminations that each group faces, our interest is in understanding the interplay between being disabled AND being from a minoritized ethnic group. Objective The overarching aim of the Coronavirus Chronic Conditions and Disabilities Awareness (CICADA) project, building on this understanding, is to improve pandemic and longer-term support networks, and access to and experiences of care, services, and resources for these underserved groups, both during the pandemic and longer term, thereby reducing inequities and enhancing social, health, and well-being outcomes. Methods This mixed methods study involves three “sweeps” of a new UK survey; secondary analyses of existing cohort and panel surveys; a rapid scoping review; a more granular review; and qualitative insights from over 200 semistructured interviews, including social network/map/photo elicitation methods and two subsequent sets of remote participatory research workshops. Separate stakeholder cocreation meetings, running throughout the study, will develop analyses and outputs. Our longitudinal study design enables the exploration of significant relationships between variables in the survey data collected and to the assessment of changes in variables over time, including consideration of varying pandemic contexts. The qualitative data will provide more granular detail. We will take a strengths and assets–based approach, underpinned by the social model of disability and by intersectional considerations to challenge discrimination. Our exploration of the social determinants of health and well-being is framed by the social ecological model. Results The CICADA project was funded by the Health and Social Care Delivery Research (HSDR) Programme of the United Kingdom (UK) National Institute for Health and Care Research (NIHR) in March 2021 and began in May 2021. Further work within the project (84 interviews) was commissioned in March 2022, a substudy focusing on mental health, specifically in Northeast England, Greater Manchester, and the Northwest Coast of the United Kingdom. Data collection began in August 2021, with the last participants due to be recruited in September 2022. As of January 2022, 5792 survey respondents and 227 interviewees had provided data. From April 2022, the time of article submission, we will recruit participants for the substudy and wave 2 of the surveys and qualitative work. We expect results to be published by winter 2022. Conclusions In studying the experiences of disabled people with impairments and those living with chronic conditions who come from certain minoritized ethnic groups, we are aiming for transformative research to improve their health and well-being. International Registered Report Identifier (IRRID) DERR1-10.2196/38361
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Affiliation(s)
- Carol Rivas
- Social Research Institute, University College London, London, United Kingdom
| | - Kusha Anand
- Social Research Institute, University College London, London, United Kingdom
| | - Alison Fang-Wei Wu
- Social Research Institute, University College London, London, United Kingdom
| | - Louise Goff
- Department of Nutritional Sciences, King's College London, London, United Kingdom
| | - Ruth Dobson
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Jessica Eccles
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Elizabeth Ball
- School of Health Sciences, City University London, London, United Kingdom
- Department of Obstetrics and Gynaecology,, The Royal London Hospital Barts Health National Health Service Trust, London, United Kingdom
| | - Sarabajaya Kumar
- Department of Political Science, University College London, London, United Kingdom
| | - Jenny Camaradou
- Social Research Institute, University College London, London, United Kingdom
| | - Victoria Redclift
- Social Research Institute, University College London, London, United Kingdom
| | - Bilal Nasim
- Social Research Institute, University College London, London, United Kingdom
| | - Ozan Aksoy
- Social Research Institute, University College London, London, United Kingdom
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Affiliation(s)
- Kirsty Brown
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK.
| | - Asma Yahyouche
- Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Jenny Camaradou
- University of Birmingham PPI, University of Birmingham, Birmingham B15 2TT, UK
| | - Grace Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
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Affiliation(s)
- Andrew Carr
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK
| | - James A Smith
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK
| | - Jenny Camaradou
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Oxford, UK
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK
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