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Bohmwald K, Diethelm-Varela B, Rodríguez-Guilarte L, Rivera T, Riedel CA, González PA, Kalergis AM. Pathophysiological, immunological, and inflammatory features of long COVID. Front Immunol 2024; 15:1341600. [PMID: 38482000 PMCID: PMC10932978 DOI: 10.3389/fimmu.2024.1341600] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/09/2024] [Indexed: 04/12/2024] Open
Abstract
The COVID-19 pandemic continues to cause severe global disruption, resulting in significant excess mortality, overwhelming healthcare systems, and imposing substantial social and economic burdens on nations. While most of the attention and therapeutic efforts have concentrated on the acute phase of the disease, a notable proportion of survivors experience persistent symptoms post-infection clearance. This diverse set of symptoms, loosely categorized as long COVID, presents a potential additional public health crisis. It is estimated that 1 in 5 COVID-19 survivors exhibit clinical manifestations consistent with long COVID. Despite this prevalence, the mechanisms and pathophysiology of long COVID remain poorly understood. Alarmingly, evidence suggests that a significant proportion of cases within this clinical condition develop debilitating or disabling symptoms. Hence, urgent priority should be given to further studies on this condition to equip global public health systems for its management. This review provides an overview of available information on this emerging clinical condition, focusing on the affected individuals' epidemiology, pathophysiological mechanisms, and immunological and inflammatory profiles.
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Affiliation(s)
- Karen Bohmwald
- Millennium Institute on Immunology and Immunotherapy. Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
| | - Benjamín Diethelm-Varela
- Millennium Institute on Immunology and Immunotherapy. Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Linmar Rodríguez-Guilarte
- Millennium Institute on Immunology and Immunotherapy. Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Thomas Rivera
- Millennium Institute on Immunology and Immunotherapy. Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia A. Riedel
- Millennium Institute on Immunology and Immunotherapy, Departamento de Ciencias Biológicas, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Pablo A. González
- Millennium Institute on Immunology and Immunotherapy. Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alexis M. Kalergis
- Millennium Institute on Immunology and Immunotherapy. Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Noonong K, Chatatikun M, Surinkaew S, Kotepui M, Hossain R, Bunluepuech K, Noothong C, Tedasen A, Klangbud WK, Imai M, Kawakami F, Kubo M, Kitagawa Y, Ichikawa H, Kanekura T, Sukati S, Somsak V, Udomwech L, Ichikawa T, Nissapatorn V, Tangpong J, Indo HP, Majima HJ. Mitochondrial oxidative stress, mitochondrial ROS storms in long COVID pathogenesis. Front Immunol 2023; 14:1275001. [PMID: 38187378 PMCID: PMC10766822 DOI: 10.3389/fimmu.2023.1275001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Significance This review discusses the coronavirus disease 2019 (COVID-19) pathophysiology in the context of diabetes and intracellular reactions by COVID-19, including mitochondrial oxidative stress storms, mitochondrial ROS storms, and long COVID. Recent advances The long COVID is suffered in ~10% of the COVID-19 patients. Even the virus does not exist, the patients suffer the long COVID for even over a year, This disease could be a mitochondria dysregulation disease. Critical issues Patients who recover from COVID-19 can develop new or persistent symptoms of multi-organ complications lasting weeks or months, called long COVID. The underlying mechanisms involved in the long COVID is still unclear. Once the symptoms of long COVID persist, they cause significant damage, leading to numerous, persistent symptoms. Future directions A comprehensive map of the stages and pathogenetic mechanisms related to long COVID and effective drugs to treat and prevent it are required, which will aid the development of future long COVID treatments and symptom relief.
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Affiliation(s)
- Kunwadee Noonong
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Moragot Chatatikun
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat, Thailand
| | - Sirirat Surinkaew
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms, Walailak University, Nakhon Si Thammarat, Thailand
| | - Manas Kotepui
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Rahni Hossain
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | | | - Chanittha Noothong
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Aman Tedasen
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Wiyada Kwanhian Klangbud
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Motoki Imai
- Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Fumitaka Kawakami
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Department of Regulation Biochemistry, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
- Department of Health Administration, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Makoto Kubo
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Division of Microbiology, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
| | - Yoshimasa Kitagawa
- Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroshi Ichikawa
- Graduate School of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Suriyan Sukati
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Voravuth Somsak
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Lunla Udomwech
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Takafumi Ichikawa
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Department of Regulation Biochemistry, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Veeranoot Nissapatorn
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Jitbanjong Tangpong
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Hiroko P. Indo
- Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Amanogawa Galaxy Astronomy Research Center, Kagoshima University Graduate School of Engineering, Kagoshima, Japan
| | - Hideyuki J. Majima
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
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Matveeva N, Kiselev I, Baulina N, Semina E, Kakotkin V, Agapov M, Kulakova O, Favorova O. Shared genetic architecture of COVID-19 and Alzheimer's disease. Front Aging Neurosci 2023; 15:1287322. [PMID: 37927339 PMCID: PMC10625425 DOI: 10.3389/fnagi.2023.1287322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
The severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and the сoronavirus disease 2019 (COVID-19) have become a global health threat. At the height of the pandemic, major efforts were focused on reducing COVID-19-associated morbidity and mortality. Now is the time to study the long-term effects of the pandemic, particularly cognitive impairment associated with long COVID. In recent years much attention has been paid to the possible relationship between COVID-19 and Alzheimer's disease, which is considered a main cause of age-related cognitive impairment. Genetic predisposition was shown for both COVID-19 and Alzheimer's disease. However, the analysis of the similarity of the genetic architecture of these diseases is usually limited to indicating a positive genetic correlation between them. In this review, we have described intrinsic linkages between COVID-19 and Alzheimer's disease, pointed out shared susceptibility genes that were previously identified in genome-wide association studies of both COVID-19 and Alzheimer's disease, and highlighted a panel of SNPs that includes candidate genetic risk markers of the long COVID-associated cognitive impairment.
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Affiliation(s)
- Natalia Matveeva
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- Laboratory of Medical Genomics, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ivan Kiselev
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- Laboratory of Medical Genomics, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Natalia Baulina
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- Laboratory of Medical Genomics, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ekaterina Semina
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Viktor Kakotkin
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Mikhail Agapov
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Olga Kulakova
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- Laboratory of Medical Genomics, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Olga Favorova
- Institute of Medicine and Life Science, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
- Laboratory of Medical Genomics, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russia
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Ogarek N, Oboza P, Olszanecka-Glinianowicz M, Kocelak P. SARS-CoV-2 infection as a potential risk factor for the development of cancer. Front Mol Biosci 2023; 10:1260776. [PMID: 37753372 PMCID: PMC10518417 DOI: 10.3389/fmolb.2023.1260776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
The COVID-19 pandemic has a significant impact on public health and the estimated number of excess deaths may be more than three times higher than documented in official statistics. Numerous studies have shown an increased risk of severe COVID-19 and death in patients with cancer. In addition, the role of SARS-CoV-2 as a potential risk factor for the development of cancer has been considered. Therefore, in this review, we summarise the available data on the potential effects of SARS-CoV-2 infection on oncogenesis, including but not limited to effects on host signal transduction pathways, immune surveillance, chronic inflammation, oxidative stress, cell cycle dysregulation, potential viral genome integration, epigenetic alterations and genetic mutations, oncolytic effects and reactivation of dormant cancer cells. We also investigated the potential long-term effects and impact of the antiviral therapy used in COVID-19 on cancer development and its progression.
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Affiliation(s)
- Natalia Ogarek
- Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, The Medical University of Silesia, Katowice, Poland
| | - Paulina Oboza
- Students’ Scientific Society at the Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, The Medical University of Silesia, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, The Medical University of Silesia, Katowice, Poland
| | - Piotr Kocelak
- Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, The Medical University of Silesia, Katowice, Poland
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Hachinski V, Krishnamoorthy E, Kuey L, Kirmayer LJ. Brain health and mental health: Common vascular risk factors and practical implications. Alzheimers Dement 2023; 19:4248-4251. [PMID: 37216631 DOI: 10.1002/alz.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023]
Abstract
The pandemic dramatized the close links among cognitive, mental, and social health; a change in one reflects others. This realization offers the opportunity to bridge the artificial separation of brain and mental health, as brain disorders have behavioral consequences and behavioral disorders affect the brain. The leading causes of mortality and disability, namely stroke, heart disease, and dementia, share the same risk and protective factors. It is emerging that bipolar disorders, obsessive compulsive disorders, and some depressions share these risk factors, allowing their joint prevention through a holistic life span approach. We need to learn to focus on the whole patient, not simply on a dysfunctional organ or behavior to mitigate or prevent the major neurological and mental disorders by fostering an integrated approach to brain and mental health and addressing the common, treatable risk factors.
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Affiliation(s)
- Vladimir Hachinski
- Department of Clinical Neurological Sciences, University of Western Ontario, Robarts Research Institute, London, Ontario, Canada
| | | | - Levent Kuey
- İstanbul Bilgi University Psychology Department, Istanbul, Turkey
| | - Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University and Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
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Ali RN, Sarkar S. Impact of opinion dynamics on the public health damage inflicted by COVID-19 in the presence of societal heterogeneities. Front Digit Health 2023; 5:1146178. [PMID: 37363273 PMCID: PMC10285391 DOI: 10.3389/fdgth.2023.1146178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Certain behavioral practices, such as wearing masks, practicing social distancing, and accepting vaccines, play a crucial role in impeding the spread of COVID-19 and reducing the severity of symptoms. Opinions regarding whether to observe such behavioral practices evolve over time through interactions via networks that overlap with but are not identical to the physical interaction networks over which the disease progresses. This necessitates the joint study of the dynamics of COVID-19 and opinion evolution. Methods We develop a mathematical model that can be easily adapted to a wide range of behavioral practices and captures in a computationally tractable manner the joint evolution of the disease and relevant opinions in populations of large sizes. Populations of large sizes are typically heterogeneous in that they comprise individuals of different age groups, genders, races, and underlying health conditions. Such groups have different propensities to imbibe severe forms of the disease, different physical contact, and social interaction patterns and rates. These lead to different disease and opinion dynamics in them. Our model is designed to effectively capture such diversities. Results Computations using our model reveal that opinion dynamics have a strong impact on fatality and hospitalization counts and the number of man-days lost due to symptoms both in the regular form of the disease and the extended forms, more commonly known as long COVID. We show that opinion dynamics in certain groups have a disproportionate impact on the overall public health attributes because they have high physical interaction rates, even when they have the lowest propensity to imbibe severe forms of the disease. This identifies a social vulnerability that malactors can utilize to inflict heavy public health damages through opinion campaigns targeting specific segments. Once such vulnerabilities are identified, which we accomplish, adequate precautions may be designed to enhance resilience to such targeted attacks and better protect public health. Discussion By recognizing and understanding the vulnerabilities, appropriate precautions can be developed to enhance resilience against targeted attacks and safeguard public health. Our study underscores the importance of considering opinion evolution alongside disease dynamics, providing insights into the interplay between behavioral practices, opinions, and disease outcomes. We believe that our model is a valuable tool for understanding the joint dynamics of COVID-19 and opinions. We hope that our findings will help to inform public health policy and facilitate evidence-based decision-making for public health interventions.
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Ancona G, Alagna L, Alteri C, Palomba E, Tonizzo A, Pastena A, Muscatello A, Gori A, Bandera A. Gut and airway microbiota dysbiosis and their role in COVID-19 and long-COVID. Front Immunol 2023; 14:1080043. [PMID: 36969243 PMCID: PMC10030519 DOI: 10.3389/fimmu.2023.1080043] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
The gut microbiota plays a crucial role in human health and disease. Gut dysbiosis is known to be associated with increased susceptibility to respiratory diseases and modifications in the immune response and homeostasis of the lungs (the so-called gut-lung axis). Furthermore, recent studies have highlighted the possible role of dysbiosis in neurological disturbances, introducing the notion of the "gut-brain axis." During the last 2 years, several studies have described the presence of gut dysbiosis during coronavirus disease 2019 (COVID-19) and its relationship with disease severity, SARS-CoV-2 gastrointestinal replication, and immune inflammation. Moreover, the possible persistence of gut dysbiosis after disease resolution may be linked to long-COVID syndrome and particularly to its neurological manifestations. We reviewed recent evidence on the association between dysbiosis and COVID-19, investigating the possible epidemiologic confounding factors like age, location, sex, sample size, the severity of disease, comorbidities, therapy, and vaccination status on gut and airway microbial dysbiosis in selected studies on both COVID-19 and long-COVID. Moreover, we analyzed the confounding factors strictly related to microbiota, specifically diet investigation and previous use of antibiotics/probiotics, and the methodology used to study the microbiota (α- and β-diversity parameters and relative abundance tools). Of note, only a few studies focused on longitudinal analyses, especially for long-term observation in long-COVID. Lastly, there is a lack of knowledge regarding the role of microbiota transplantation and other therapeutic approaches and their possible impact on disease progression and severity. Preliminary data seem to suggest that gut and airway dysbiosis might play a role in COVID-19 and in long-COVID neurological symptoms. Indeed, the development and interpretation of these data could have important implications for future preventive and therapeutic strategies.
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Affiliation(s)
- Giuseppe Ancona
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Alagna
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Alteri
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Multimodal Research Area, Bambino Gesù Children Hospital (IRCCS), Rome, Italy
| | - Emanuele Palomba
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Anna Tonizzo
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andrea Pastena
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Antonio Muscatello
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
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Hitch D, Deféin E, Lloyd M, Rasmussen B, Haines K, Garnys E. Beyond the case numbers: Social determinants and contextual factors in patient narratives of recovery from COVID-19. Aust N Z J Public Health 2023; 47:100002. [PMID: 36709621 PMCID: PMC9883019 DOI: 10.1016/j.anzjph.2022.100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/28/2022] [Accepted: 10/11/2022] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE This study aimed to describe and contextualise COVID-19 recovery from the perspective of patient-lived experience, to inform the evolving public health response to the pandemic. METHODS Narrative interviews were completed with 37 adult Australians between six and 10 months following their COVID-19 diagnosis. Verbatim transcripts were analysed thematically and trustworthiness was supported by multiple strategies to ensure rigour. RESULTS Three themes were identified: 1) trajectories of recovery, 2) back to 'some sort of normal' and 3) the importance of work. Resumed participation in activities of daily life, the influence of social determinants of health and the impact of contextual factors were prominent features in the recovery narratives. CONCLUSIONS The COVID-19 pandemic presents both challenges and opportunities for public health systems to formulate appropriate responses and make improvements. Behind the case numbers, patient narratives described the uncertainty, diversity and multiple pathways to recovery that need to inform public health policy. IMPLICATIONS FOR PUBLIC HEALTH Looking beyond the case numbers reveals a complex landscape characterised by uncertainty, diversity and multiple pathways to recovery. The pandemic presents challenges and opportunities for public health in Australia and New Zealand, lived experience expertise is crucial to the formulation of an effective response.
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Affiliation(s)
- Danielle Hitch
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia; School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia.
| | - Elle Deféin
- School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia
| | - Melanie Lloyd
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia
| | - Bodil Rasmussen
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia,University of Southern Denmark and Steno Diabetes Center, Odense, Denmark,School of Nursing and Midwifery, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia,Institute of Health Transformation, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia
| | - Kimberley Haines
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia,Centre for Integrated Critical Care, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia
| | - Eleanor Garnys
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia,School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia
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Roy R, McDonaugh B, O'Gallagher K. COVID-19 and the heart. Br Med Bull 2022; 144:4-11. [PMID: 36155748 PMCID: PMC9619476 DOI: 10.1093/bmb/ldac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is evidence for a bi-directional relationship between COVID-19 and the cardiovascular (CV) system. SOURCE OF DATA Published literature. AREAS OF AGREEMENT Pre-existing heart failure (HF) increases the risk of mortality with COVID-19. CV complications are recognized, including increased rates of acute coronary syndromes, HF, arrhythmia and myocarditis. Drugs targeting the angiotensin system are safe and may provide prognostic benefit. AREAS OF CONTROVERSY Vaccination as a cause of myocarditis remains a key area of contention. GROWING POINTS As the pandemic progresses, we are gaining more data about the long-term effects of COVID-19 on the CV system: long COVID, and medium-to-long-term increases in CV risk. AREAS TIMELY FOR DEVELOPING RESEARCH Large-scale longitudinal studies will shed light on long-term CV outcomes with COVID-19. Furthermore, the differential effects of COVID-19 variants on the CV system must be investigated.
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Affiliation(s)
- Roman Roy
- Cardiovascular Department, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | | | - Kevin O'Gallagher
- Cardiovascular Department, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.,British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London SE5 9NU, UK
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Abstract
Neuroinflammation is a process triggered by an attack on the immune system. Activation of microglia in response to an immune system challenge can lead to a significant impact on cognitive processes, such as learning, memory and emotional regulation. Long Covid is an ongoing problem, affecting an estimated 1.3 million people within the UK alone, and one of its more significant, and as yet unexplained, symptoms is brain fog. Here, we discuss the potential role of neuroinflammation in Long Covid cognitive difficulties. Inflammatory cytokines have been found to play a significant role in reductions in LTP and LTD, a reduction in neurogenesis, and in dendritic sprouting. The potential behavioural consequences of such impacts are discussed. It is hoped that this article will allow for greater examination of the effects of inflammatory factors on brain function, most particularly in terms of their role in chronic conditions.
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Erol N, Alpinar A, Erol C, Sari E, Alkan K. Intriguing new faces of Covid-19: persisting clinical symptoms and cardiac effects in children. Cardiol Young 2022; 32:1085-1091. [PMID: 34407902 PMCID: PMC8438511 DOI: 10.1017/s1047951121003693] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study was conducted to evaluate the persisting Covid-19-related symptoms of the cases included in our study and to assess their cardiac findings to determine the impact of Covid-19 on children's cardiovascular health. METHODS In this study, 121 children between the ages of 0- and 18 with Covid-19 were evaluated based on their history, blood pressure values, and electrocardiography and echocardiography results. These findings were compared with the findings of the control group which consisted of 95 healthy cases who were in the same age range as the study group and did not have Covid-19. The results were evaluated using the statistics program, SPSS 21. RESULTS There was no significant difference between the study group and the control group in terms of age, weight, and body mass index. The clinical symptoms (chest and back pain, dizziness, headache, palpitation, fatigue, shortness of breath, loss of balance, coughing) of 37.2% of the cases persisted for at least 1 month after Covid-19 recovery. Statistically significant differences were found in systolic blood pressure, left ventricular ejection fraction, relative wall thickness, and tricuspid annular plane systolic excursion. CONCLUSION The continuation of some cases' clinical symptoms post-recovery indicates that long Covid infection can be observed in children. The fact that statistically significant differences were observed between the echocardiographic parameters of the study and control groups suggests that Covid-19 may have effects on the cardiovascular system. To shed light on the long Covid cases among children and the infection's cardiac impacts, it would be beneficial to conduct more comprehensive studies on this matter.
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Affiliation(s)
- Nurdan Erol
- Health Sciences University, Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, Pediatric Clinics, Uskudar, Istanbul 34668, Turkey
| | - Abdullah Alpinar
- Health Sciences University, Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, Pediatric Clinics, Uskudar, Istanbul 34668, Turkey
| | - Cigdem Erol
- Istanbul University Informatics Department, Beyazit, Fatih, Istanbul 34452, Turkey
| | - Erdal Sari
- Health Sciences University, Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, Pediatric Clinics, Uskudar, Istanbul 34668, Turkey
| | - Kubra Alkan
- Health Sciences University, Zeynep Kamil Gynecology and Pediatrics Training and Research Hospital, Pediatric Clinics, Uskudar, Istanbul 34668, Turkey
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12
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Günl F, Mecate-Zambrano A, Rehländer S, Hinse S, Ludwig S, Brunotte L. Shooting at a Moving Target-Effectiveness and Emerging Challenges for SARS-CoV-2 Vaccine Development. Vaccines (Basel) 2021; 9:1052. [PMID: 34696160 PMCID: PMC8540924 DOI: 10.3390/vaccines9101052] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 02/06/2023] Open
Abstract
Since late 2019 the newly emerged pandemic SARS-CoV-2, the causative agent of COVID-19, has hit the world with recurring waves of infections necessitating the global implementation of non-pharmaceutical interventions, including strict social distancing rules, the wearing of masks and the isolation of infected individuals in order to restrict virus transmissions and prevent the breakdown of our healthcare systems. These measures are not only challenging on an economic level but also have a strong impact on social lifestyles. Using traditional and novel technologies, highly efficient vaccines against SARS-CoV-2 were developed and underwent rapid clinical evaluation and approval to accelerate the immunization of the world population, aiming to end the pandemic and return to normality. However, the emergence of virus variants with improved transmission, enhanced fitness and partial immune escape from the first generation of vaccines poses new challenges, which are currently being addressed by scientists and pharmaceutical companies all over the world. In this ongoing pandemic, the evaluation of SARS-CoV-2 vaccines underlies diverse unpredictable dynamics, posed by the first broad application of the mRNA vaccine technology and their compliance, the occurrence of unexpected side effects and the rapid emergence of variations in the viral antigen. However, despite these hurdles, we conclude that the available SARS-CoV-2 vaccines are very safe and efficiently protect from severe COVID-19 and are thereby the most powerful tools to prevent further harm to our healthcare systems, economics and individual lives. This review summarizes the unprecedented pathways of vaccine development and approval during the ongoing SARS-CoV-2 pandemic. We focus on the real-world effectiveness and unexpected positive and negative side effects of the available vaccines and summarize the timeline of the applied adaptations to the recommended vaccination strategies in the light of emerging virus variants. Finally, we highlight upcoming strategies to improve the next generations of SARS-CoV-2 vaccines.
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Affiliation(s)
- Franziska Günl
- Institute of Virology (IVM), University of Münster, 48149 Münster, Germany; (F.G.); (A.M.-Z.); (S.R.); (S.H.); (S.L.)
| | - Angeles Mecate-Zambrano
- Institute of Virology (IVM), University of Münster, 48149 Münster, Germany; (F.G.); (A.M.-Z.); (S.R.); (S.H.); (S.L.)
- Interdisciplinary Centre for Clinical Research (IZKF), Medical Faculty, University of Münster, 48149 Münster, Germany
| | - Selina Rehländer
- Institute of Virology (IVM), University of Münster, 48149 Münster, Germany; (F.G.); (A.M.-Z.); (S.R.); (S.H.); (S.L.)
| | - Saskia Hinse
- Institute of Virology (IVM), University of Münster, 48149 Münster, Germany; (F.G.); (A.M.-Z.); (S.R.); (S.H.); (S.L.)
| | - Stephan Ludwig
- Institute of Virology (IVM), University of Münster, 48149 Münster, Germany; (F.G.); (A.M.-Z.); (S.R.); (S.H.); (S.L.)
- Interdisciplinary Centre for Clinical Research (IZKF), Medical Faculty, University of Münster, 48149 Münster, Germany
| | - Linda Brunotte
- Institute of Virology (IVM), University of Münster, 48149 Münster, Germany; (F.G.); (A.M.-Z.); (S.R.); (S.H.); (S.L.)
- Interdisciplinary Centre for Clinical Research (IZKF), Medical Faculty, University of Münster, 48149 Münster, Germany
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13
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Muirhead N, Muirhead J, Lavery G, Marsh B. Medical School Education on Myalgic Encephalomyelitis. ACTA ACUST UNITED AC 2021; 57:medicina57060542. [PMID: 34071264 PMCID: PMC8230290 DOI: 10.3390/medicina57060542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022]
Abstract
Background and objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex multi-system disease with a significant impact on the quality of life of patients and their families, yet the majority of ME/CFS patients go unrecognised or undiagnosed. For two decades, the medical education establishment in the UK has been challenged to remedy these failings, but little has changed. Meanwhile, there has been an exponential increase in biomedical research and an international paradigm shift in the literature, which defines ME/CFS as a multisystem disease, replacing the psychogenic narrative. This study was designed to explore the current UK medical school education on ME/CFS and to identify challenges and opportunities relating to future ME/CFS medical education. Materials and methods: A questionnaire, developed under the guidance of the Medical Schools Council, was sent to all 34 UK medical schools to collect data for the academic year 2018–2019. Results: Responses were provided by 22 out of a total of 34 medical schools (65%); of these 13/22 (59%) taught ME/CFS, and teaching was led by lecturers from ten medical specialties. Teaching delivery was usually by lecture; discussion, case studies and e-learning were also used. Questions on ME/CFS were included by seven schools in their examinations and three schools reported likely clinical exposure to ME/CFS patients. Two-thirds of respondents were interested in receiving further teaching aids in ME/CFS. None of the schools shared details of their teaching syllabus, so it was not possible to ascertain what the students were being taught. Conclusions: This exploratory study reveals inadequacies in medical school teaching on ME/CFS. Many medical schools (64% of respondents) acknowledge the need to update ME/CFS education by expressing an appetite for further educational materials. The General Medical Council (GMC) and Medical Schools Council (MSC) are called upon to use their considerable influence to bring about the appropriate changes to medical school curricula so future doctors can recognise, diagnose and treat ME/CFS. The GMC is urged to consider creating a registered specialty encompassing ME/CFS, post-viral fatigue and long Covid.
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Affiliation(s)
- Nina Muirhead
- Buckinghamshire Healthcare NHS Trust, Amersham Hospital, Whielden Street, Amersham HP7 0JD, UK
- Correspondence:
| | - John Muirhead
- Boston Consultants Ltd., Solihull, West Midlands B93 8PG, UK;
| | - Grace Lavery
- School of Medicine, Cardiff University Medical School, Neuadd Meirionnydd, Cardiff CF14 4YS, UK;
| | - Ben Marsh
- University Hospitals Plymouth NHS Trust, Derriford Hospital, Derriford Road, Plymouth, Devon PL6 8DH, UK;
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14
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Bottemanne H, Gouraud C, Hulot JS, Blanchard A, Ranque B, Lahlou-Laforêt K, Limosin F, Günther S, Lebeaux D, Lemogne C. Do Anxiety and Depression Predict Persistent Physical Symptoms After a Severe COVID-19 Episode? A Prospective Study. Front Psychiatry 2021; 12:757685. [PMID: 34858230 PMCID: PMC8631493 DOI: 10.3389/fpsyt.2021.757685] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-month follow-up. Methods: We conducted a prospective study in patients previously hospitalized for COVID-19 followed up for 3 months. The Hospital Anxiety and Depression Scale (HAD-S) was administered by physicians at 1-month follow-up, and the presence of fatigue, dyspnea, and pain complaints was assessed at both 1 month and 3 months. Multivariable logistic regressions explored the association between anxiety and depression subscores and the persistence of each of the physical symptom at 3 months. Results: A total of 84 patients were included in this study (Median age: 60 years, interquartile range: 50.5-67.5 years, 23 women). We did not find any significant interaction between anxiety and the presence of fatigue, dyspnea, or pain complaints at 1 month in predicting the persistence of these symptoms at 3 months (all p ≥ 0.36). In contrast, depression significantly interacted with the presence of pain at 1 month in predicting the persistence of pain at 3 months (OR: 1.60, 95% CI: 1.02-2.51, p = 0.039), with a similar trend for dyspnea (OR: 1.51, 95% CI: 0.99-2.28, p = 0.052). Discussion and Conclusion: Contrary to anxiety, depression after an acute COVID-19 episode may be associated with and increased risk of some persistent physical symptoms, including pain and dyspnea.
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Affiliation(s)
- Hugo Bottemanne
- Paris Brain Institute - Institut du Cerveau et de la Moelle Épiniére, UMR 7225, UMR_S 1127, CNRS, INSERM, Sorbonne University, Service de Psychiatrie de l'Adulte, Hôpital de la Pitié-Salpêtriére, DMU Neurosciences, Assistance Publique-Hôpitaux De Paris, Paris, France
| | - Clément Gouraud
- Service de Psychiatrie de l'Adulte, DMU Psychiatrie et Addictologie, Hôpital Hôtel-Dieu, Université de Paris, Assistance Publique-Hopitaux de Paris, Paris, Paris, France
| | - Jean-Sébastien Hulot
- CIC 1418 and DMU CARTE, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne Blanchard
- Service de Néphrologie, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Brigitte Ranque
- Service de Médecine Interne, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Khadija Lahlou-Laforêt
- DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Frédéric Limosin
- DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Corentin Celton, Université de Paris, Paris, France
| | - Sven Günther
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France.,Service de Physiologie, Assistance Publique Hopitaux De Paris, Georges Pompidou European Hospital, Paris, France
| | - David Lebeaux
- Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Cédric Lemogne
- Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France.,Service de Psychiatrie de l'Adulte, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Assistance Publique Hopitaux De Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Université de Paris, Paris, France
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15
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Duncan E, Cooper K, Cowie J, Alexander L, Morris J, Preston J. A national survey of community rehabilitation service provision for people with long Covid in Scotland. F1000Res 2020; 9:1416. [PMID: 33953912 PMCID: PMC8063521 DOI: 10.12688/f1000research.27894.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Over 50 million cases of COVID-19 have been confirmed globally as of November 2020. Evidence is rapidly emerging on the epidemiology of COVID-19, and its impact on individuals and potential burden on health services and society. Between 10–35% of people with COVID-19 may experience post-acute long Covid. This currently equates to between 8,129 and 28,453 people in Scotland. Some of these people will require rehabilitation to support their recovery. Currently, we do not know how to optimally configure community rehabilitation services for people with long Covid. Methods: This national survey aimed to provide a detailed description of current community rehabilitation provision for people with long Covid in Scotland. We developed, piloted, and conducted a national electronic survey of current community rehabilitation service provision for people presenting with long Covid symptomatology. Our sample were the Allied Health Professions Directors of all 14 territorial NHS Health Boards in Scotland. Fixed response and narrative data were analysed descriptively. Results: Responses were received from all respondents (14/14), enabling a national picture to be gained. Almost all Health Boards (13/14) currently deliver rehabilitation for people with long Covid within pre-existing services.
Fatigue (11/14) and respiratory conditions (9/14) were the two most common presenting problems of patients. Most long Covid community rehabilitation services are delivered through a combination of face-to-face and digital contact (13/14). Conclusions: Community rehabilitation for people with long Covid is an emerging reality. This survey provides a national picture of current community rehabilitation for people with long Covid. We do not know how community rehabilitation can be optimally delivered for this population. This is vital as community rehabilitation services were already under pressure prior to the emergence of COVID-19. Further research is urgently required to investigate the implementation, outcomes and cost-effectiveness of differing models of community rehabilitation for this patient population.
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Affiliation(s)
- Edward Duncan
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG, UK
| | - Julie Cowie
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Lyndsay Alexander
- School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG, UK
| | - Jacqui Morris
- School of Health Sciences, University of Dundee, Dundee, DD1 4HJ, UK
| | - Jenny Preston
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK.,Douglas Grant Rehabilitation Centre, Ayrshire Central Hospital, Ayr, KA12 8SS, UK
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16
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Duncan E, Cooper K, Cowie J, Alexander L, Morris J, Preston J. A national survey of community rehabilitation service provision for people with long Covid in Scotland. F1000Res 2020; 9:1416. [PMID: 33953912 PMCID: PMC8063521 DOI: 10.12688/f1000research.27894.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 09/18/2023] Open
Abstract
Background: Over 50 million cases of COVID-19 have been confirmed globally as of November 2020. Evidence is rapidly emerging on the epidemiology of COVID-19, and its impact on individuals and potential burden on health services and society. Between 10-35% of people with COVID-19 may experience post-acute long Covid. This currently equates to between 8,129 and 28,453 people in Scotland. Some of these people will require rehabilitation to support their recovery. Currently, we do not know how to optimally configure community rehabilitation services for people with long Covid. Methods: This national survey aimed to provide a detailed description of current community rehabilitation provision for people with long Covid in Scotland. We developed, piloted, and conducted a national electronic survey of current community rehabilitation service provision for people presenting with long Covid symptomatology. Our sample were the Allied Health Professions Directors of all 14 territorial NHS Health Boards in Scotland. Fixed response and narrative data were analysed descriptively. Results: Responses were received from all respondents (14/14), enabling a national picture to be gained. Almost all Health Boards (13/14) currently deliver rehabilitation for people with long Covid within pre-existing services. Fatigue (11/14) and respiratory conditions (9/14) were the two most common presenting problems of patients. Most long Covid community rehabilitation services are delivered through a combination of face-to-face and digital contact (13/14). Conclusions: Community rehabilitation for people with long Covid is an emerging reality. This survey provides a national picture of current community rehabilitation for people with long Covid. We do not know how community rehabilitation can be optimally delivered for this population. This is vital as community rehabilitation services were already under pressure prior to the emergence of COVID-19. Further research is urgently required to investigate the implementation, outcomes and cost-effectiveness of differing models of community rehabilitation for this patient population.
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Affiliation(s)
- Edward Duncan
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG, UK
| | - Julie Cowie
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Lyndsay Alexander
- School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG, UK
| | - Jacqui Morris
- School of Health Sciences, University of Dundee, Dundee, DD1 4HJ, UK
| | - Jenny Preston
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
- Douglas Grant Rehabilitation Centre, Ayrshire Central Hospital, Ayr, KA12 8SS, UK
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