ABSTRACT
Background: This study aimed to evaluate chronic pain and fatigue in COVID-19 patients after 12 months of hospitalization. Methods: We studied the COVID-19 patients discharged from Hospital, between March 10 to April 20, 2020. Results: A total of 157 patients were included in this study. Forty-three patients (27.4%) complained of chronic fatigue and muscle weakness in the last six months. The visual analog fatigue scale (VAFS) score of 3.84 ± 1.48 was obtained. Forty patients (25.5%) were suspected of Chronic Fatigue Syndrome (CFS). Twenty-four patients (15.3%) had severe chronic pain or exacerbation of previous chronic pain, most of which were reported in the lower back (70.8%) and lower extremities (66.7%). Pain intensity had a mean score of 2.33 ± 0.87 and was mainly described as muscle cramps, persistent dull pain, and boring and numbing. In women, chronic pain and fatigue, extended hospital stays, ICU admission, and depressed mood were common than in men. For these pain and fatigue, 37% used nonsteroidal anti-inflammatory drugs, and 16.3% used antidepressants. Only one person had applied for physiotherapy, and none of the patients had received psychotherapy Conclusions: Fatigue and chronic pain in patients recovering from COVID-19 are common complications, even after 12 months of illness.
ABSTRACT
Background: Many longitudinal studies have indicated patients with cystic fibrosis (CF) were twice as likely as the general population to be living in food insecurity (FI). The individuals who are at highest risk for serious illness associated with COVID-19 include people with chronic illness who are the same individuals most adversely affected by the economic burden. The direct relation between early nutritional health and later lung health means long-lasting effects of FI. Asa result, our aim was to address FI inour CF center's 2 locations, New York City and Stamford, Connecticut, which serve 110 patients. Methods: Initially, a visiting pulmonary fellow asked about FI with standardized screening questions via telephone calls. Due to concerns of privacy intrusion, the social worker (SW) and dietitian (RD) took on the responsibility of asking the screening questions creating a safe space for response. The 2 screening questions asked were: 1) Within the past 12 months, we worried whether our food would run out before we got money to buy more. 2) Within the past 12 months, the food we bought just didn't last and we didn't have enough money to get more. Available responses were often true, sometimes true, never true, or refuse to answer. Fundraising for the $100 gift cards distributed to families was accomplished with Wilton Interfaith Action Committee (Wi-ACT), in Wilton, Connecticut. A post gift card distribution survey that asked items purchased was conducted in the clinic and by phone. Results: We screened 90 patients, and 15 patients were identified with FI. Five families who had internet access were able to enroll online for food delivery to their home. Of the 10 families who received the gift cards, 7 used the funds for food and 3 used for food and clothing. All 10 patients found the gift cards to be very helpful. Conclusion: The 2-question FI screening survey proved to be effective in identification of our patients in need. These interventions helped connect families with community resources and also tapped into creative ideas to secure financial support. This is an ongoing project that will include screening, referral, and securing othercommunity resources to meet family food insecure needs $Φgure
ABSTRACT
Introduction: Food insecurity (FI) is a concern in the cystic fibrosis (CF) population due to high associated medical costs. In addition, because of the high cost of living in the Greater NYC area, our patients are at particularly higher risk. Prior to this project, FI screening was not routinely included in clinic visits or documentation. Our initial SMART (Specific, Measurable, Attainable, Relevant, Timebased) aim was to implement FI screening and screen at minimum 30% of our patients by April 2020. We anticipated at least a 5% positive screening. Methods: Our center's Port CF patient list was reviewed to find eligible candidates. 88 patients were eligible for screening. Two validated questions were used (O'Keefe L, 2015). Question 1 (Q1) was, “We worried whether our food would run out before we got money to buy more;” and Question 2 (Q2) was, “The food we bought just didn't last and we didn't have money to get more.” A Likert scale was used for responses. Initially, fellows and medical students contacted families via phone. After family feedback, the social worker (SW) or the registered dietitian (RD) took over screening starting in February 2019. We retrospectively analyzed responses to our food insecurity questions. Once patients screened positive, families were referred to local organizations and CF-related funds to assist them. Positive families also received gift baskets during the holidays and gift cards to grocery stores. Results: 1 family responded being often worried about running out of food. 20 families responded sometimes true to Question 1, with 14 responding sometimes true to Q2. 56, 57 families responded never true respectively. 2 families refused to answer the question. 8 families had unrecorded responses, either due to not responding to email or phone calls and/ or the question being inappropriate during the clinic visit. 2 families were recorded by providers to be suspected of FI despite an answer of Never True. Overall, 40% of families reported some level of FI. Discussion: We surpassed our initial SMART aim goal by screening our eligible population. Barriers to screening included inappropriateness of FI discussion during clinic, prolonged visit times or cancelled appointments. For those who screened positive, there were difficulties to the referral process or challenges to reach organizations. The amount of FI in our CF population was higher than expected. COVID-19 pandemic will add to FI. There is direct correlation between BMI and lung function, reinforcing the importance of access to quality food. Moving forward the center would like to have more secure, ongoing access to resources like gift cards or a direct food pantry. We are also considering adding a family partner or patient to our team for input. Conclusion: FI is an important component that will become part of our clinic flow moving forward. We hope to include screening on an ongoing basis at every visit, especially with the economic results of COVID-19. Our center also plans to improve our access and referral process moving forward for those that screen positive.