ABSTRACT
Background: Up to 80% of patients suffering from persistent symptoms more than six months after a COVID-19 infection complain about a variety of psychosomatic symptoms with no organ cause. Most patients suffer from chronic fatigue, pain, depression or difficulty concentrating. Experimental studies showed that these symptoms could be significantly improved after an open administration of placebos (“open-label placebo”) or with heart rate variability (HRV) biofeedback such as paced breathing. However, we insufficiently understand which patients benefit from which treatment. Methods: Patients (m/f) without organic causes for the complaints are randomised to three groups: an open-label placebo intervention (OLP), a paced breathing training (PBT) or no additional treatment (TAU). To detect a mean effect using a 2x3 ANOVA, N=90 patients will be included, and predictor analyses are performed. The OLP group takes 2 placebos/day and receives the information that placebos can significantly improve symptoms, e.g. via the activation of “self-healing powers”. The PBT group receives a standardized training to breath at 6 breaths/min for 10 min/day. At inclusion (T0) and after four (T1) and eight weeks (T2), treatment expectations, fatigue (FSMC), somatoform complaints, depressiveness, anxiety (PHQ), general health (SF-36) and quality of life, as well as cognitive performance using Corsi Span and Colour Stroop tests, will be assessed by questionnaires and tests, and an ECG will be recorded. Results: Preliminary results point to effective reductions of fatigue and other symptoms for both interventions compared to TAU, dependent on patients' individual factors such as treatment expectations, symptom severity during Covid-19 infection and at inclusion. HRV data will be analysed at the end of the study. Preliminary results will be presented at the conference. Conclusion: Patients with functional post-COVID syndromes can benefit from psychosomatic interventions aiming to improve treatment expectations and heart rate variability, depending on individual patients' factors. Patient-tailored interventions should be further investigated.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19), a disease caused by the new coronavirus (SARS-CoV-2), is a particular threat to old people. At the end of March 2020, the first and so far largest outbreak of the disease occurred in a retirement home in Hamburg. Methods: Analysis of procedures in dealing with a residential unit affected by SARS-CoV2, accommodating a risk group of 60 seniors with dementia is presented as well as a detailed presentation of post-mortem examination results of all 8 deceased tested positive for SARS-CoV2. Results: Out of 60 residents, 39 were infected by SARS-CoV2. Due to preventive procedures it was possible to stop further spreading of the infection to other residential areas. In all 8 fatal cases, the autopsy diagnosis was death due to COVID-19. Autopsies revealed all COVID-19 patients to have a fatal (broncho)pneumonia and signs of relevant pre-existing cardiac, renal and pulmonary conditions in all cases. In 75% (nâ¯= 6) of the cases a fresh venous thrombosis was found. In 66.7% (nâ¯= 4) of the cases thrombotic events were combined with peripheral pulmonary artery thromboembolisms. Conclusion: The cohort of SARS-CoV2 infected residents of a nursing home is characteristic for clinical and epidemiological features of the new coronavirus disease. Due to a centralized evaluation of all fatalities at the Institute of Legal Medicine in Hamburg, a detailed examination of all deceased positive for SARS-CoV2 was possible. Thereby, increased case fatality rates of approximately 20% could in all cases be assigned to a relevant number of pre-existing comorbidities of multiple organ systems, which was consistent with the clinical data available.