Prevalence of long COVID complaints in persons with and without COVID-19.

We studied the prevalence and patterns of typical long COVID complaints in ~ 2.3 million individuals aged 18-70 years with and without confirmed COVID-19 in a Nation-wide population-based prospective cohort study in Norway. Our main outcome measures were the period prevalence of single-occurring or different combinations of complaints based on medical records: (1) Pulmonary (dyspnea and/or cough), (2) Neurological (concentration problems, memory loss), and/or (3) General complaints (fatigue). In persons testing positive (n = 75 979), 64 (95% confidence interval: 54 to 73) and 122 (111 to 113) more persons per 10 000 persons had pulmonary complaints 5-6 months after the test compared to 10 000 persons testing negative (n = 1 167 582) or untested (n = 1 084 578), respectively. The corresponding difference in prevalence of general complaints (fatigue) was 181 (168 to 195) and 224 (211 to 238) per 10 000, and of neurological complaints 5 (2 to 8) and 9 (6-13) per 10 000. Overlap between complaints was rare. Long COVID complaints were only slightly more prevalent in persons with than without confirmed COVID-19. Still, long COVID may pose a substantial burden to healthcare systems in the future given the lasting high incidence of symptomatic COVID-19 in both vaccinated and unvaccinated individuals.

Post-covid medical complaints following infection with SARS-CoV-2 Omicron vs Delta variants.

The SARS-CoV-2 Omicron (B.1.1.529) variant has been associated with less severe acute disease, however, concerns remain as to whether long-term complaints persist to a similar extent as for earlier variants. Studying 1 323 145 persons aged 18-70 years living in Norway with and without SARS-CoV-2 infection in a prospective cohort study, we found that individuals infected with Omicron had a similar risk of post-covid complaints (fatigue, cough, heart palpitations, shortness of breath and anxiety/depression) as individuals infected with Delta (B.1.617.2), from 14 to up to 126 days after testing positive, both in the acute (14 to 29 days), sub-acute (30 to 89 days) and chronic post-covid (≥90 days) phases. However, at ≥90 days after testing positive, individuals infected with Omicron had a lower risk of having any complaint (43 (95%CI = 14 to 72) fewer per 10,000), as well as a lower risk of musculoskeletal pain (23 (95%CI = 2-43) fewer per 10,000) than individuals infected with Delta. Our findings suggest that the acute and sub-acute burden of post-covid complaints on health services is similar for Omicron and Delta. The chronic burden may be lower for Omicron vs Delta when considering musculoskeletal pain, but not when considering other typical post-covid complaints.

Impact of the first wave of the COVID-19 pandemic on healthcare use in osteoarthritis: A population register-based study in Sweden.

Objective: To investigate whether the first wave of the COVID-19 pandemic impacted healthcare consultations (HCC) and hospitalization among people with and without osteoarthritis (OA). Methods: Using register data, we included individuals aged ≥35 years residing in Skåne region, Sweden, during 2009-2019 with (n â€‹= â€‹123,523) and without (n â€‹= â€‹552,412) a diagnosis of OA during January 1, 2009-December 31, 2019. We collected bi-weekly individual data on HCC/hospitalization between January and May for years 2017-2020. Treating the year 2020 as intervention and 2017-2019 as control as well as dividing data to pre- (January-February) and post-pandemic (March-May), we applied event study design to measure the dynamic effects of the COVID-19 pandemic on HCC/hospitalization. We used fixed-effect Poisson regressions for estimation and subgroup analyses by sex, age, and comorbidity were conducted among OA patients. Results: The impact of the pandemic on healthcare use was evident from mid-March 2020 (34-45%/12-25% reductions in in-person HCC/hospitalization) among people with OA relative to 2017-2019. Smaller reductions were seen in those without OA with 25-34%/8-16% reductions in in-person HCC/hospitalization. On contrary, there were increases in remote HCC following the pandemic (5-25% and 11-31% in people with and without OA, respectively). Among persons with OA, there were variations in the pandemic's effects by sex, age and comorbidity. Conclusion: Despite no lockdown in Sweden there were substantial reductions in in-person healthcare use during the first wave of COVID-19 pandemic with greater reductions among people with than without OA.

Experience of the COVID-19 pandemic as lived by patients with hip and knee osteoarthritis: an Italian qualitative study.

OBJECTIVE: To examine the experience of the COVID-19 pandemic as lived by people with hip and knee osteoarthritis (OA), in Italy. DESIGN: A qualitative study based on semi-structured interviews. SETTING: Urban and suburban areas in northern Italy. PARTICIPANTS: A total of 11 people with OA were enrolled through a purposeful sampling and completed the study. PRIMARY OUTCOME MEASURE: The experience of Italian people with OA during the COVID-19 pandemic. RESULTS: Four themes were brought to the forefront from the analysis of the interviews. (1) Being Stressed for the Limited Social Interactions and for the Family Members at High Risk of Infection, as the interviewees were frustrated because they could not see their loved ones or felt a sense of apprehension for their relatives. (2) Recurring Strategies to Cope with the Pandemic such as an active acceptance towards the situation. (3) Being Limited in the Possibility of Undergoing OA Complementary Treatments and Other Routine Medical Visits. (4) Being Unaware of the Importance of Physical Activity as First-Line Interventions which was an attitude already present before the pandemic. CONCLUSION: The COVID-19 pandemic and related restrictions impacted the quality of life and the care of individuals with hip and knee OA. The social sphere seemed to be the most hindered. However, the interviewees developed a good level of acceptance to deal with the pandemic. When it came to their care, they faced a delay of routine medical visits not related to OA and of other complementary treatments (eg, physical therapies) to manage OA. Finally, a controversial result that emerged from these interviews was that first-line interventions for OA (ie, therapeutic exercise) was not sought by the interviewees, regardless of the restrictions dictated by the pandemic. Policy-making strategies are thus necessary to support the awareness of the importance of such interventions.

The impact of first and second wave of COVID-19 on knee and hip surgeries in Sweden.

PURPOSE: To investigate the impact of COVID-19 in Sweden on rates of knee and hip surgeries. METHODS: We used healthcare data for the population of the southernmost region in Sweden (1.4 million inhabitants). We did an interrupted time-series analysis to estimate changes in rates and trends of joint replacements (JR), arthroscopies, and fracture surgeries for knee or hip in April-December 2020 compared to pre-COVID-19 levels adjusting for seasonal variations. RESULTS: We found a drop of 54% (95% CI 42%; 68%) and 42% (95% CI 32%; 52%), respectively, in the rate of JRs and arthroscopies in April 2020 when compared to the counterfactual scenario. This was followed by an increase that brought the rates of JRs and arthroscopies back to their predicted levels also during the beginning of the second wave (November-December 2020). Acute fracture surgeries were largely unaffected, i.e. did not show any decrease as observed for the other surgeries. CONCLUSIONS: In southern Sweden, we observed a marked decrease in elective knee and hip surgeries following the first wave of Covid-19. The rates remained close to normal during the beginning of the second wave suggesting that important elective surgeries for patients with end-stage osteoarthritis can still be offered despite an ongoing pandemic provided adequate routines and hospital resources.