ABSTRACT
The post lung transplant (LTx) rehabilitation program was required to rapidly reduce service provision during coronavirus (COVID 19) pandemic. This was achieved by minimising the group format, number of sessions and type of exercises performed, as it transitioned from a centre-based supervised program to a home based program. Aim : This retrospective study aimed to compare standardised outcome measures for LTx recipients from the non- COVID era (2019) to those from LTx recipients who completed rehabilitation at home during the COVID (2020). Study population included post LTx males & females > 18 years who underwent BSLTx or SLTx at The Alfred from March to August 2020, compared to a matched cohort transplanted between March-August in 2019. The 2019 post LTx rehabilitation program was a thrice weekly, 8 weekly supervised, group format consisting of 30 minutes cardiovascular training on treadmill and exercise bike plus resistance training for upper and lower limbs. During 2020 (COVID) the rehabilitation program was shortened to a twice weekly, individual, 2 - 3 week format followed by a home exercise program (HEP) using exercise diary and weekly phone follow up. COVID era patients were discharged from the gym to the HEP as soon as they were safe to exercise independently. Outcome measures -six minute walk test (6MWT), grip strength (GS) on a dynamometer and a sit to stand test in one minute (STS) were taken on entry to the rehabilitation program and three months post (3/12P). Quality of life (QOL) questionnaire was completed. Groups were well matched for LTx age, surgery and length of hospital stay. After 3 months, COVID era participants had not significantly increased 6MWD compared to Non -COVID era (-183m (-230 to -137)) STS improved significantly in both Non-COVID (p=0.001) and COVID (p=0.008). There was no improvement in QOL or GS for COVID group, but significant improvements for non-COVID QOL (p=0.001) and GS (p=0.05). The change to a HEP in COVID era may have negatively impacted the improvement in functional exercise capacity, GS and QOL for those LTx recipients. Further research is required to develop an optimal HEP model. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Opioid Use Disorder (OUD) is one of the most severe health care problems in the USA. People addicted to opioids need various treatments, including Medication-Assisted Treatment (MAT), proper counseling, and behavioral therapies. However, during the peak time of the COVID-19 pandemic, the supply of emergency medications was disrupted seriously. Patients faced severe medical care scarcity since many pharmaceutical companies, drugstores, and local pharmacies were closed. Import-export was also canceled to consent to the government emergency law, i.e., lockdown, quarantine, and isolation. These circumstances and their negative effects on OUD patient's psychology could have led them to a drop out of MAT medications and persuaded to resume illicit opioid use. This project involves collecting and analyzing a large volume of Twitter data related to MAT medications for OUD patients. We discover the Active MAT Medicine Users (AMMUs) on twitter. For this, we build a seed dictionary of words related to OUD and MAT and apply association rules to expand it. Further, AMMUs' tweet posts are studied 'before the pandemic' (BP) and 'during the pandemic' (DP) to understand how the drug behaviors and habits have changed due to COVID-19. We also perform sentiment analysis on Tweets to determine the impact of the COVID-19 pandemic on the psychology of AMMUs. Our analysis shows that the use of MAT medications has decreased around 30.54%, where the use of illicit drugs and other prescription opioids increased 18.06% and 12.12%, respectively, based on AMMUs' tweets posted during the lockdown compared with before the lockdown statistics. The COVID-19 pandemic and lockdown may result in the resumption of illegal and prescription opioid abuse by OUD patients. Necessary steps and precautions should be taken by health care providers to ensure the emergency supply of medicines and also psychological support and thus prevent patients from illicit opioid use. © 2021 IEEE.