Patient-reported outcome measures 3 and 6 months after pulmonary rehabilitation following COVID-19

Recent studies have suggested that pulmonary rehabilitation (PR) improves patient-reported outcome measures (PROMs) in patients recovering from COVID-19. Yet, there are hardly any studies that report the further course of recovery after PR. Therefore, we assessed PROMs regarding exertional dyspnea, fatigue, depression, anxiety, and quality of life (QoL) of 224 patients (Oage: 54.3+/-10.4;42% female) who were admitted to a three-week inpatient PR between 4/2020 and 4/2021 due to COVID-19. Data were assessed at the beginning (T1) and at the end (T2) of PR as well as 3 months (T3) and 6 months (T4) afterwards. Repeated measures ANOVAs were calculated to reveal significant changes. In line with previous results, we found significant reductions in symptom severity regarding all PROMs over the course of PR (dT1-T2 =0.910 to dT1-T2=1.538) and a significant increase in QoL (dT1-T2=-1.238). While the improvements in exertional dyspnea and QoL persisted after PR (PT2-T3 =0.321 and pT2-T3=0.358), each other variable significantly deteriorated again at T3 (dT2-T3=-0.386 to dT2-T3=-0.933). However, significant improvements between T1 and T4 could be detected in each variable (dT1-T4=0.567 to dT1-T4=0.696) except for anxiety (pT1-T4=0.708). The improvements were associated with an increase in QoL (dT1-T4=-1.010). Our results suggest that PR leads to significant improvements in clinically relevant PROMs. In most variables, the improvements may also persist after PR. Since we found no improvements in the further course, we conclude that the improvements were predominantly due to PR rather than to the natural course of recovery after COVID-19.

Negative association between fatigue and signs of sleep apnoea in patients after COVID-19

Both during and after the acute phase, COVID-19 is associated with a variety of clinical symptoms, many of which may persist even several months after the infection [1, 2]. One of the most common symptoms that is likely to persist is fatigue [1, 3]. Despite intensive research, little is known about the factors that contribute to the development and persistence of fatigue during and after COVID-19 [3]. Since sleep apnoea and particularly more severe forms are commonly associated with tiredness and exertion, an increased rate of sleep apnoea may explain at least in part the commonly mentioned fatigue symptoms.

Identifying the Effects of COVID-19 on Psychological Well-Being Through Unsupervised Clustering for Mixed Data

The COVID-19 pandemic has a strong worldwide impact on not only the health and economic sectors but also the (socio-)psychological functioning of individuals. Since psychological health is an important protective factor to prevent diseases, it is crucial to identify individuals with increased vulnerability during the crisis. 275 adults participated in a German online survey from April until August 2020 which investigated health-related, social, behavioral, and psychological effects of the COVID-19 pandemic. We here introduce an unsupervised clustering approach suitable for mixed data types combining the Gower distance with the Partitioning Around Medoids (PAM) algorithm k-Medoids. We were able to identify three clusters differing significantly in subjects’ well-being, psychological distress, and current financial and occupational concerns. The clusters also differed in age with younger persons reporting greater financial and occupational concerns, increased anxiety, higher psychological distress, and reduced subjective well-being. Features with the strongest impact on the clustering were examined using a wrapping method and the feature importance implemented in the random forest. Particularly, answers regarding financial and occupational concern, psychological distress, and current well-being were decisive for the assignment to a cluster. In summation, the clustering approach can identify persons with weakened psychological protective factors allowing them to provide tailored recommendations for preventive actions based on the cluster affiliation, e.g., via a web application. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

WIBCE – A Web Application Helping People to Reflect Their Infection Risk and Psychological Well-Being and Act Accordingly During the COVID-19 Pandemic

During COVID-19, there has been a need to gather reliable empirical data on the consequences for behavior and psychological well-being in society as well as to inform and educate individuals comprehensively. The WIBCE online survey tool offers the possibility to (1) inform, reflect, and empower participants to be more self-aware regarding psychological, medical, and behavioral factors, and (2) aggregate anonymously shared data to statistically analyze the impact of COVID-19. Thereby, it allows a one-time but also longitudinal (i.e., on a regular basis) participation. Analyzing the collected survey data from April to August 2020, we found two subgroups that differ fundamentally in terms of mental health and psychological well-being. These differences were present not only at one time point but could also be traced longitudinally. The knowledge of the cluster affiliation allows to provide participants specific, personalized feedback as well as individual recommendations. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.