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1.
Archives of Physical Medicine and Rehabilitation ; 2023.
Article in English | ScienceDirect | ID: covidwho-2176393

ABSTRACT

Objective To examine the prevalence, severity, and correlates of depression, anxiety, and suicidal ideation in people with traumatic brain injury (TBI) assessed before and during the COVID-19 pandemic. Design Retrospective cohort study using data collected through the TBI Model Systems (TBIMS) network at 1, 2, 5, 10, 15, 20, 25, or 30 years post-TBI. Setting United States-based TBIMS rehabilitation centers with telephone assessment of community residing participants. Participants Adults (72.4% male, mean age 47.2 years) who enrolled in the TBI Model Systems National Database and completed mental health questionnaires pre-pandemic (1/1/2017-2/29/2020;n=5000) or during pandemic (4/1/2022-6/30/2021;n=2009) Interventions Not applicable. Main Outcome Measure Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 questionnaires. Results Separate linear and logistic regressions were constructed with demographic, psychosocial, injury-related, and functional characteristics, along with a binary indicator of COVID pandemic period (pre-pandemic vs. during pandemic), as predictors of mental health outcomes. No meaningful differences in depression, anxiety, or suicidal ideation were observed before versus during the COVID-19 pandemic. Correlations between predictors and mental health outcomes were similar before and during the pandemic. Conclusions Contrary to our predictions, the prevalence, severity, and correlates of mental health conditions were similar before and during the COVID-19 pandemic. Results may reflect generalized resilience and are consistent with the most recent findings from the general population that indicate only small, transient increases in psychological distress associated with the pandemic. While unworsened, depression, anxiety, and suicidal ideation remain prevalent and merit focused treatment and research efforts.

2.
Clinical and Translational Imaging ; 10(SUPPL 1):S91-S92, 2022.
Article in English | EMBASE | ID: covidwho-1894690

ABSTRACT

Background-Aim: Post-mortem studies showed that in patients with COVID-19 the poor prognosis is due not only to the worsening of the ventilation function but it can be related to the perfusion impairment due to massive pulmonary thrombosis or micro-thromboembolism. We aimed to investigate the clinical impact of lung perfusion (Q) scintigraphy in patients discharged after COVID-19 disease but still symptomatic for dyspnea. Methods: 33 patients (pts), discharged at least 1 month after COVID- 19, underwent Q scan at T0 (1-3 months after acute disease) and at T1 (after 6 months if lung perfusion defects were evident at T0). Inclusion criteria were (1) residual dyspnea: mild (12/33pts), at minimal motor activity (9/33) and after prolonged effort (12/33), (2) No thromboembolism at CT pulmonary angiography during hospitalization. Exclusion criteria were: previous history of lung disease (e.g. Cancer, COPD, emphysema) or abnormal pulmonary CT findings (e.g. lung bullae). Planar and Q-SPECT/CT images were obtained for evaluation of lobar or segmental or subsegmental peripheral perfusion defects for each bronchopulmonary segment. Perfusion images were qualitatively and semiquantitatively analysed. Q-lung software by GE Healthcare was used for SPECT/CT images for obtaining percent evaluation of pulmonary lobar perfusion (counts/volume % for each lobe), considering as normal a value of defect within: - 5%/each lobe, if represented in ≥ 1 lobe. Q-scan was then compared with high resolution CT (HRCT) obtained during hospitalization in the acute phase (T-acute) and repeated after 1-3 months (T0). Significant pulmonary perfusion defects at Q scan were considered for addressing targeted therapy. Results: At T0: preserved lung perfusion was observed in 17/33 pts, thus excluding the vascular cause for the symptoms. Lung perfusion defects were detected in 16/33 patients who underwent T0 and T1 control. Defects were scored as following: severe (7 pts with dyspnea at minimal motor activity), at least one wedge-shaped peripheral defect estimated as ≥ 50% of a pulmonary segment without corresponding HRCT abnormalities, suggesting a new CTPA within 3 months and an appropriate therapeutic strategy;moderate (6 pts with dyspnea after prolonged effort): consisting in multiple (>3) subsegmental defects;-mild: (3 pts with mild dyspnea ≤ 3 sub-segmental defects). At T1 lung perfusion improvement (≥ 10% vs pathological lobe in T0), was observed in a total of 8/16 pts. Conclusions: In the age of precision medicine, Q scan-SPECT/CT in pts with recent COVID-19 can address clinical knowledge and management of SARS-CoV-2-induced lung abnormalities, suggesting the differential diagnosis with respiratory disease of different etiology and the appropriate patient-centered therapeutic strategies.

4.
European Journal of Nuclear Medicine and Molecular Imaging ; 48(SUPPL 1):S404-S404, 2021.
Article in English | Web of Science | ID: covidwho-1609910
5.
Clin Nutr ESPEN ; 43: 369-376, 2021 06.
Article in English | MEDLINE | ID: covidwho-1193264

ABSTRACT

BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge. METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected. RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission. CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.


Subject(s)
COVID-19/complications , Hospitalization , Malnutrition/complications , Nutritional Status , Sarcopenia/etiology , Weight Loss , Adult , Aged , Appetite , Female , Hospitals , Humans , Length of Stay , Male , Malnutrition/epidemiology , Middle Aged , Nutrition Assessment , Obesity/complications , Obesity/epidemiology , Pandemics , Patient Discharge , Prospective Studies , Risk Factors , SARS-CoV-2 , Smell , Taste
6.
International Journal of Infectious Diseases ; 101:233-234, 2020.
Article in English | Web of Science | ID: covidwho-1086038
7.
Wound Management & Prevention ; 66(9), 2020.
Article in English | ProQuest Central | ID: covidwho-1052629

ABSTRACT

Britton et al discuss how COVID-19 is changing skin from the perspective of post-acute care wound experts from across US. The US continues to face the coronavirus disease 2019 (COVID-19) pandemic, with infection and fatality rates increasing, an economic crisis looming, and confronting racial inequities becoming essential. COVID-19 has created the perfect storm for skin and wound issues. Wound specialists working with the adverse effects created by COVID-19 also recognize how darker skin is and always has been at higher risk for underrecognized skin and wound impairments. Despite the global challenges presented by COVID-19, there is some light at the end of this tunnel, as human resilience and innovation bring new practices and technologies that may leave us in a better situation after the pandemic has passed.

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