ABSTRACT
Background: Multimorbidity is most prevalent in older adults and is associated with higher symptom burden, lower quality of life, increased functional decline, and caregiver burden that warrants holistic intervention. Continued rise in the prevalence of multimorbidity is expected, especially among older adults. The COVID-19 pandemic required that a co-design event with patients, family caregivers, and health care providers discussing their preferences surrounding multimorbidity management be virtual. Objective(s): To discuss the challenges of organizing a virtual co-design event. Method(s): A virtual co-design event was held using Health Insurance Portability and Accountability Act-compliant Zoom technology. Patients (age 55 or older and living with multimorbidity), family caregivers, and health care providers interviewed in a prior phase of the project were invited to the codesign event. Data regarding participants' disease trajectory and improvement priorities were collected. The experiences of the study team, including event facilitators, were used to identify challenges and opportunities. Result(s): Four male patients, two female health care providers, and seven facilitators participated in the event. Five improvement priorities were identified: (1) patient-provider relationship, (2) communication, (3) availability of resources, (4) caregiver support, and (5) care coordination and follow-up. Conclusion(s): Virtual events could be a valuable tool to get diverse groups of participants to provide input;however, the recruitment process and the technological literacy of some older adults pose challenges. Using a virtual platform requires consideration of participants' access to technology, their technological literacy, the use of innovative human-centered design, and the need for holding multiple events to yield comprehensive data. Recruiting more diverse groups of participants-e.g., groups that include family caregivers and female patients-is critical, as they may present different needs and outcomes..
ABSTRACT
Objective: To examine risk factors for cardiac-related postacute sequelae of SARS-CoV-2 infection (PASC) in community-dwelling adults after acute COVID-19 infection. Methods: We performed a cross-sectional analysis among adults who tested positive for COVID-19. Outcomes were self-reported cardiac-related PASC. We conducted stepwise multivariable logistic regression to assess association between the risk factors (existing cardiovascular disease (CVD), pre-existing conditions, days since positive test, COVID-19 hospitalisation, age, sex, education, income) and cardiac-related PASC. Results: In a sample of 442 persons, mean (SD) age was 45.4 (16.2) years, 71% were women, 13% were black, 46% had pre-existing conditions, 23% had cardiovascular (CV) risk factors and 4% had CVD. Prevalence of cardiac PASC was 43% and newly diagnosed cardiac conditions were 27%. The odds for cardiac-related PASC were higher among persons with underlying pre-existing conditions (adjusted OR (aOR): 2.00, 95% CI: 1.28 to 3.10) and among those who were hospitalised (aOR: 3.03, 95% CI: 1.58 to 5.83). Conclusions: More than a third of persons with COVID-19 reported cardiac-related PASC symptoms. Underlying CVD, pre-existing diseases, age and COVID-19 hospitalisation are possible risk factors for cardiac-related PASC symptoms. COVID-19 may exacerbate CV risk factors and increase risk of complications.