ABSTRACT
Background: The symptoms of the COVID-19 acute phase are well studied, but the long-term sequelae (post-COVID condition) are still poorly characterised. The aim of this study was to evaluate the prevalence of persistent symptoms in previously hospitalised adult patients with COVID-19 and assess risk factors for the post-COVID condition Method: Ambidirectional cohort study of patients over 18 years hospitalised to Sechenov University Hospital Network, Moscow, Russia with clinically diagnosed or laboratory-confirmed COVID-19 between April 8 and July 10, 2020. Study participants were interviewed 6-8 months after discharge via telephone using a follow-up case report form (CRF) developed by ISARIC in collaboration with WHO. Identified symptoms were categorised according to organ systems. Risk factors were assessed by multivariate logistic regression. Results: Among 4,755 patients discharged from the hospitals, 2,649 were subsequently interviewed. The median age of patients was 56 years (46-66), and 1,353 patients (51.1%) were female. The follow-up median time was 217.5 days (200.4-235.5). 1,247 (47.1%) participants reported persistent symptoms (since discharge). The most frequent symptoms were fatigue (21.2%, 551/2599), shortness of breath (14.5%, 378/2614) and forgetfulness (9.1%, 237/2597). Female gender was associated with chronic fatigue with an odds ratio of 1.67 (95% confidence interval 1.39-2.02), neurological 2.03 (1.60-2.58), mental 1.83 (1.41-2.40), respiratory 1.31 (1.06-1.62) and dermatological symptoms 3.26 (2.36-4.57), GI disturbances 2.50 (1.64-3.89) and sensory problems 1.73 (2.06-2.89). Pre-existing asthma was associated with a higher risk of neurological 1.95 (1.25-2.98) and mood and behavioural changes 2.02 (1.24-3.18). Conclusion: Six to eight months after COVID-19 nearly half of patients have symptoms lasting since discharge. The main risk factor for the majority of the development of long-term symptoms was female sex. Asthma may also serve as a risk factor for the post-COVID condition. Further follow-up of patients reporting the persistence of COVID-19 symptoms and the development of interventional approaches for the prevention of post-COVID manifestations are needed.
ABSTRACT
Purpose: The stress, anxiety, depression, and isolation caused by COVID-19 have resulted in marked increases in the use of alcohol and other substances. For example, between February and April 2020, the number of drinks consumed per day increased by 29%. Further, individuals with substance use disorders (SUDs) who are in recovery face unique challenges during COVID-19, such as cancellations of in-person support group meetings. Communicating these issues and evidence-based solutions to policymakers who can act on it is therefore critical. However, research on optimizing science communication efforts to policymakers is limited. In the present study, we aim to test strategies for improving the reach of research on substance use (SU) and SUDs to policymakers. Methods: Rapid-cycle randomized controlled trials disseminating fact sheets via email to state and federal policymakers were conducted. All fact sheets contained research on SU or supporting individuals with SUDs. Participants were randomized into equal groups to receive different email subject lines and sender names. Indicators of credibility were manipulated (i.e., use of “Dr.” or “PhD” in the sender line compared to no title;use of jargon vs. none). Negative binomial regressions were conducted to test whether the experimental manipulations resulted in more email opens on a researchers' messages and clicks on their fact sheet clicks compared to a control email. Results: Results showed that the use of “PhD” in the sender line resulted in more email opens and clicks on the fact sheet than “Dr.” However, there was an interaction effect such that the use of “Dr.” in the sender line resulted in more opens when paired with the use of jargon. Conclusions: These results broadly suggest that the effects of credibility are more nuanced than one might expect. When communicating SU/SUD research to policymakers via email, the use of “PhD” in the sender line seems to be more effective at increasing opens and clicks than “Dr.”, unless jargon is used, which points to possible effects of policymaker norms and expectations. Ultimately, this work helps to inform strategies for increasing the reach of SU/SUD research messages, which is critical for improving the use of scientific research in policy processes intended to prevent or address SU/SUDs.