ABSTRACT
Background: "Long COVID" or "post-COVID conditions" describes prolonged symptoms after the acute phase of coronavirus disease 2019 (COVID-19). However, there is a paucity of published reports on its treatment. Method(s): This retrospective cohort study included adult, non-hospitalized patients with COVID-19 symptoms at least one month after the onset who had been examined at the isolation facility in Miyagi prefecture between October 2020 and September 2021. Result(s): In total, 70 patients with a median age of 46 (21-69) years were included, and 37 were women (52.9%). The median time from onset to the end of treatment was 46 (28-396) days. Thirty-eight patients (53.5%) showed improvement in all symptoms, while four (5.7%) did not recover within the study period. The symptoms at six months with high residual rates were dizziness (33.3%), fatigue (14.3%), myalgia (14.3%), abdominal discomfort (14.3%), and taste dysfunction (11.8%). For treatment of prolonged symptoms, formulae of Kampo medicine (Japanese traditional medicine) were used alone or in combination with Western medications in 76%, 66%, 53%, and 66% of patients at 1-2 months, 2-3 months, 3-6 months, and over 6 months respectively. Kampo formulae with anti-inflammatory effects were used in the early period;however, tonifying formulae and blood stasis-resolving formulae were used in the late period. Conclusion(s): Non-hospitalized patients with COVID-19 may suffer from persistent symptoms after the acute phase of infection. For the management of long COVID, a comprehensive and holistic approach is needed. Kampo medicine should be considered as a treatment option for long COVID.Copyright © 2023 The Authors. Traditional & Kampo Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Oriental Medicine and Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine.
ABSTRACT
Purpose: Various infectious diseases have dramatically decreased during the COVID-19 pandemic. In Japan, the most frequent cause of HLH in children and adolescents and young adults was infection. In this study, we assessed the incidence of six hematological diseases including HLH, before and during the COVID-19 pandemic Methods:We analyzed the public dataset from the Blood Disease Registration maintained by the Japanese Society of Hematology. From 2016 to 2019, the mean number of patients registered was 42,406 +/- 5,046. In 2020, this figure was 46,471. To analyze changes in annual incidence, we calculated the mean and standard deviation for the 2016-2019 data, and compared this to the annual incidence of each disease in 2020 Results: The total incidence of HLH decreased to 73.7%, compared with the 2016-2019 mean incidence of HLH (152.0 vs. 206.3+/-10.2) Furthermore, HLH incidence in 2020 decreased by 77.5% in those less than 20 years old, and 77.9% in those over 20 years old. Similarly the incidence of IM and aITP decreased by 91.5% and 78.4% in 2020, compared to the respective mean incidences of IMand aITP from 2016 to 2019. The decrease in the number of IM and aITP patients was larger among those less than 20 years of age, compared to those 20 years of age or older (IM: 84.8% vs. 96.6%, and aITP: 52.6% vs 106.5%). On the other hand, the incidences of LCH, ALL, and B-NHL did not decrease in 2020 (LCH, 109.9%;ALL, 102.9%;and B-NHL 111.9%). CONCLUSION(S): The incidence of HLH decreased during the COVID-19 pandemic. Lifestyle changes may be implemented during theCOVID-19 pandemic, specifically social distancing, wearing of facemasks alcohol disinfection, and school closure, effectively reduced contact and droplet transmission.
ABSTRACT
During the COVID-19 pandemic, social distancing protocols imposed the suspension of many activities in mental healthcare facilities, limiting the use of the facility to people in comprehensive care. With the advancement of vaccination, these buildings are gradually reopening for community use. However, managers and workers now face challenges in accommodating new design demands related to reducing the risk of contamination by COVID-19 within the building. This research adopted a multi-method approach in two phases, combining a post-occupancy evaluation with a cocreation activity to help mental healthcare workers and patients to suggest design changes in their environment. Three Psychosocial Care Centers (CAPS) in São Paulo were selected as case-study buildings. The first phase was the Post-Occupancy Evaluation (POE), in which the lead researcher conducted a walkthrough with the facility administrator, applied questionnaires to 100 employees, and conducted a walking interview with 12 patients. During Phase 02, a codesign activity entitled “Dream CAPS” was conducted with 25 healthcare workers and 12 patients. In this activity, participants were asked to customize a physical model of a mental healthcare facility, choosing the wall and floor finishings, the types of openings (windows, doors), furniture, and ornaments. Afterward, they participated in an interview with illustrated cards. All activities were audio-recorded and textual analysis qualified and categorized the content. Objective and subjective data analysis identified five characteristics of the built environment that prevented or increased risk of COVID-19 spread: Places that support risk mitigation procedures, access and circulation control, extended use of outdoor spaces, natural and artificial air renovation systems, and materials resistant to terminal cleaning. Patients participated in the activities but did not express opinions on the impact of architecture on airborne disease prevention. Healthcare workers claimed that environments that improve mental health must be attractive and prone to social interaction and relaxation without compromising biological safety. The combination of post-occupancy evaluation and codesign proved an excellent tool to identify the demands of mental healthcare buildings and discuss the solutions that must be implemented to deal with contemporary and future crises in a pandemic context. Copyright © 2022 Goulart and Ono.
ABSTRACT
Aim: We present the study protocol of a multicenter, retrospective observational study that aims to investigate the efficacy of the actual treatment (the efficacy of conventional and Kampo medicines) of patients with mild to moderate or suspected coronavirus disease (COVID-19). Methods: This study is designed as a multicenter, retrospective observational study. Outpatients and inpatients will be recruited from Japanese hospitals. The inclusion criteria are as follows: having or suspected to have COVID-19, mild to moderate COVID-19, symptomatic, ≥20 years of age, male or female, able to communicate in Japanese, and treated with conventional and Kampo medicine. The exclusion criteria are: unable to provide informed consent due to dementia, psychosis, or psychiatric symptoms, severe COVID-19, or determined unsuitable for this study. The sample size is set at 1000, as this number of people can be treated at the collaborating medical institutions during the study period. Results: The main outcome is the number of days without fever, with a body temperature of less than 37°C. The secondary outcome is set at common cold-like symptoms other than fever (fatigue, cough, shortness of breath, sputum, diarrhea) and severity of illness and hospitalization up to 14 days after the visit. Trial registration: The trial was registered in the University Hospital Medical Information Network (Reservation No. UMIN000041301) on August 4, 2020. Conclusion: Our study will explore the contribution of conventional and Kampo medicine in the treatment of patients with mild and moderate COVID-19.
ABSTRACT
Aim: Traditional Japanese (Kampo) medicine has been used to treat viral infectious diseases. In particular, saikatsugekito (a combination drug of kakkonto, shosaikoto, Platicodon glandiflorum root, and gypsum) has been reported to be useful during the past influenza pandemic. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, causing the novel coronavirus disease (COVID-19) to emerge as a pandemic. In this article, we conducted a literature review on the pharmacological activities of the components present in saikatsugekito against viral infection and respiratory inflammation. Methods: We searched PubMed and the Cochrane Library for English articles, as well as Ichushi and J-stage for Japanese articles. Articles published until January 1, 2000 were retrieved using the keywords ‘kakkonto’, ‘shosaikoto’, ‘Platycodon’, and ‘gypsum’. We then extracted articles on basic research investigating viral infections, inflammation, cytokine, the immune response, and lung tissue damage. Results: We extracted 28 eligible articles. Kampo medicines have antiviral activities by interfering with the attachment, internalization, replication, progeny virion release, and cell-to-cell spreading of single-strand RNA viruses. They also enhance the immunomodulating activities of the host, including cytokine production, regulation of multiple immune cells, and protection from lung tissue injury. Furthermore, Kampo medicine has been found to regulate body temperature and airway mucin release. Conclusion: The results demonstrated that Kampo medicine has therapeutic activities against single-strand RNA virus infections and respiratory inflammation, and may also have activities against SARS-CoV-2. Further research is required to investigate the activity of Kampo medicines, such as saikatsugekito, against SARS-CoV-2.