Recent Advance Analysis of Recovery in Hospitalized People with COVID-19: A Systematic Review.

INTRODUCTION: COVID-19 is a public health emergency all around the world. Severe illness occurred in about 14% of patients and 5% of patients developed critical illness, but the prognosis for these patients remains unclear. OBJECTIVE: To describe the prognosis in hospitalized adults with COVID-19. METHODS: The MEDLINE, EMBASE, AMED, and COCHRANE databases were searched for studies published up to 28 June 2021 without language restrictions. Descriptors were related to "COVID-19" and "prognosis". Prospective inception cohort studies that assessed morbidity, mortality and recovery in hospitalized people over 18 years old with COVID-19 were included. Two independent reviewers selected eligible studies and extracted the available data. Acute respiratory distress syndrome (ARDS) and multiple organ failure (MOFS) were considered as outcomes for morbidity and discharge was considered for recovery. The Quality in Prognosis Studies (QUIPS) tool was used to assess risk of bias. Analyses were performed using Comprehensive Meta-Analysis (version 2.2.064). RESULTS: We included 30 inception cohort studies investigating 13,717 people hospitalized with COVID-19 from different countries. The mean (SD) age was 60.90 (21.87) years, and there was high proportion of males (76.19%) and people with comorbidities (e.g., 49.44% with hypertension and 29.75% with diabetes). Findings suggested a high occurrence of morbidity, mainly related to ARDS. Morbidity rates varied across studies from 19% to 36% in hospital wards, and from 13% to 90% in Intensive Care Units-ICU. Mortality rates ranged from 4% to 38% in hospital wards and from 8% to 51% in ICU. Recovery rates ranged up to 94% and 65% in hospital wards and ICU, respectively. The included studies had high risk of bias in the confounding domain. CONCLUSIONS: The prognosis of people hospitalized with COVID-19 is an issue for the public health system worldwide, with high morbidity and mortality rates, mainly in ICU and for patients with comorbidities. Its prognosis emphasizes the need for appropriate prevention and management strategies.

The Impact of Sport Activity Shut down during the COVID-19 Pandemic on Children, Adolescents, and Young Adults: Was It Worthwhile?

We conducted a national retrospective survey of 1764 athletes aged ≤25 years to investigate the benefit-risk balance of sport closure during the COVID-19 pandemic peaks in Italy. Univariate and multivariable analyses were carried out to investigate the association between sport practice during the study period and (1) the risk of SARS-CoV-2 infection in athletes and their families and (2) body mass index (BMI) change, and adherence to World Health Organization (WHO) guidelines for physical activity. The percentage of subjects with a positive SARS-CoV-2 test was similar in those participating and not taking part into sport activities (11% vs. 12%, respectively, p = 0.31). Restricting the analysis to subjects who practiced sports within an organized sport society/center, the risk of SARS-CoV-2 positivity was reduced for athletes who had never stopped their training (odds ratio (OR); 95% confidence intervals (CI): 0.62; 0.41-0.93). On the other side, responders who had stopped sport activity showed a 1% increase in BMI. Adherence to WHO guidelines for physical activity was significantly higher for athletes who had continued sport activities. In conclusion, sport closure and limitations had an important negative impact on the overall health of young athletes, being also not effective in reducing the spread of COVID-19.

Effects of SARS-CoV-2 pandemic on follow-up and pharmacological treatment of chronic diseases in undocumented migrants.

BACKGROUND: All over the world, the COVID-19 pandemic, not unlikely other epidemics, has hit harder people in low socioeconomic conditions.In Western countries, undocumented migrants are a growing component of this disadvantaged segment of the population.Their health conditions are frequently burdened by a number of chronic conditions, and they experience many difficulties in accessing public health services. Frequently, the only medical assistance they can get is provided by non-governmental organisations. METHODS: We studied the medical records (including pharmacological treatments) of all patients attending the outpatient clinics of Opera San Francesco (OSF; a big charity in Milano, Italy), in the first 5 months of 2020. These comprise the outbreak of the pandemic and the lockdown period. The 1914 patients (1814 undocumented migrants and 100 Italians) seen during the lockdown were compared with those seen in the same period of 2019 and with those seen in the preceding months of 2020. We especially focused on three chronic conditions: cardiovascular diseases, diabetes and psychiatric disorders. RESULTS: The number of consultations during the first 5 months of 2020 was much smaller than that of the same period of 2019. During the lockdown, we found 4048 consultations for 1914 patients, while they were 8051 in the same period of 2019 and 5681 in the first 2 months of 2020.The quantity of medicines dispensed by OSF showed a marked decrease in the period of the study and mainly during the lockdown.The decrease in consultations and dispensation of medicines was most evident for psychiatric patients and almost not existent for patients with diabetes. Female patients suffered a more pronounced reduction. CONCLUSIONS: Western countries need strategies to better assist the very poor during epidemics.Differences among different groups of disadvantaged persons should be taken into account when designing recovery plans.

Whole-Body Vibration Exercise: A Possible Intervention in the Management of Post COVID-19 Complications?

Featured ApplicationCOVID-19 survivors had muscle fatigue or weakness, difficulty sleeping, and anxiety/depression. The WBV exercise can have clinical effects on the clinical conditions of post-COVID-19 in a similar way in different populations already studied.AbstractCOVID-19 infection frequently leaves the infected subjects with impairments of multi-organs, the so-called post COVID-19 syndrome, which needs to be adequately addressed. The perspective of this narrative review is to verify the possible role of whole-body vibration exercise in the post-COVID-19 rehabilitation of these patients. Publications reporting the use of WBV exercises to counteract fatigue, muscle weakness, neurological manifestations, pain, quality of life, quality of sleep, lung commitments, and mental conditions in different clinical conditions were selected. Considering all the findings described in the current review, it seems that WBV exercise might be potentially useful and effective in the rehabilitation of post COVID-19 syndrome, being able to positively influence fatigue, muscle weakness, and quality of life without any side-effects. Controlled studies are mandatory to define the best protocols to be proposed, which need to be tailored to the individual and clinical characteristics.

COVID-19 Lockdown and the Behavior Change on Physical Exercise, Pain and Psychological Well-Being: An International Multicentric Study.

OBJECTIVE: To evaluate the impact of the COVID-19 pandemic and the following lockdown on physical exercise (PEx) practice, pain, and psychological well-being. METHODS: A cross-sectional multicentric study was performed using a nonrandom convenience sampling from the general population (≥18 years-old) of 6 countries (Brazil, Italy, France, Portugal, Germany, and Spain) adopting social isolation (SI). The validated self-administered online survey (PEF-COVID19) was used. The tests T-test and Chi-square with Bonferroni correction were used for statistical analysis and a multivariate logistic regression model (p ˂ 0.05). RESULTS: We included 3194 replies and ~80% of the respondents were in SI. Brazilian sample was highly influenced by the pandemic considering PEx practice and habits, pain, anxiety, and stress (p ˂ 0.05). Among the European countries, Italy presented the major changes. The model to predict the non-practice of PEx during SI showed that the variables countries, smoking, SI, and PEx level were significant predictors (p ˂ 0.001). CONCLUSION: The pandemic changed the PEx practice and habits, and the psychological well-being of populations in different manners. Countries, smoking, SI, and PEx level were predictors for the non-practice of PEx. Public health strategies are suggested to avoid sedentary lifestyles and quality of life decrease.

The Impact of Social Isolation during the COVID-19 Pandemic on Physical and Mental Health: The Lived Experience of Adolescents with Obesity and Their Caregivers.

Adolescence is a complex developmental phase, made more complex by obesity and the social isolation imposed by the COVID-19 pandemic. The literature related to the impact of social isolation on obesity self-management in adolescents is scant and inconsistent. This paper describes the phenomenon from the perspectives of a sample of adolescents with obesity enrolled in an inpatients' multidisciplinary rehabilitation program for weight-loss and their caregivers, and its impact on different life domains. Individual semi-structured ad hoc interviews were conducted with 10 adolescent-caregiver dyads, and narratives were qualitatively investigated using an interpretative phenomenology approach to data. Twenty participants took part in the study. The major themes that emerged from this study fall into five basic categories: (1) COVID-19 as an opportunity to reconsider what makes a good life; (2) Persistence in life; (3) Empowering relationship; (4) Daily routine in quarantine; (5) Lives on hold. Understandings drawn from this study may assist health care professionals in providing holistic support, and guidance to adolescents with weight-related issues and their caregivers who experience social isolation during the COVID-19 pandemic.

Potential Application of Whole Body Vibration Exercise For Improving The Clinical Conditions of COVID-19 Infected Individuals: A Narrative Review From the World Association of Vibration Exercise Experts (WAVex) Panel.

COVID-19 is a highly infectious respiratory disease which leads to several clinical conditions related to the dysfunction of the respiratory system along with other physical and psychological complaints. Severely affected patients are referred to intensive care units (ICUs), limiting their possibilities for physical exercise. Whole body vibration (WBV) exercise is a non-invasive, physical therapy, that has been suggested as part of the procedures involved with pulmonary rehabilitation, even in ICU settings. Therefore, in the current review, the World Association of Vibration Exercise Experts (WAVEX) reviewed the potential of WBV exercise as a useful and safe intervention for the management of infected individuals with COVID-19 by mitigating the inactivity-related declines in physical condition and reducing the time in ICU. Recommendations regarding the reduction of fatigue and the risk of dyspnea, the improvement of the inflammatory and redox status favoring cellular homeostasis and the overall improvement in the quality of life are provided. Finally, practical applications for the use of this paradigm leading to a better prognosis in bed bound and ICU-bound subjects is proposed.