Online News Coverage of COVID-19 Long Haul Symptoms.

A number of the people who have recovered from the acute effects of COVID-19 are facing long term sequelae from the infection. As the COVID-19 pandemic is still evolving, so is knowledge of the long-term effects of the virus on patients who still experience symptoms. Clearly, news media play a crucial role in distributing information and this distribution of information can, in turn, influence the actions of the public. The purpose of this study was to describe the content of news coverage of COVID-19 long haul symptoms currently posted on the internet. This study utilized Google News, a news aggregator service, and included the first 100 English language pieces of news. Video content and news article content were coded in depth for information on COVID-19 long haul symptoms. A total of 41% of news reports mentioned the length of time that the COVID-19 related symptoms persist. The length of time was reported to range from 1 month to more than 1 year. The symptom most commonly mentioned was tiredness or fatigue (74%), followed by difficulty breathing or shortness of breath (62 cases; 62%), and difficulty thinking or concentrating (50 cases; 50%). Other symptoms were mentioned less frequently. There were no statistically significant differences in any of the content including having video, written news reports, or both video and written news reports by source of the news reports based on consumer, professional, or television or internet-based news (p = .14). More complete coverage by online news media of the long-term effects of COVID-19 enhances public awareness of the post-acute syndromes, augments health providers' awareness of the range of chronic COVID-19 effects and the possibility of a second infection, increases the probability of patients' seeking and obtaining the proper care for their symptoms, and contributes to preventive actions for enhancing public health.

The Epidemiology of Long Coronavirus Disease in US Adults.

BACKGROUND: We estimated the prevalence of long COVID and impact on daily living among a representative sample of adults in the United States. METHODS: We conducted a population-representative survey, 30 June-2 July 2022, of a random sample of 3042 US adults aged 18 years or older and weighted to the 2020 US population. Using questions developed by the UK's Office of National Statistics, we estimated the prevalence of long COVID, by sociodemographics, adjusting for gender and age. RESULTS: An estimated 7.3% (95% confidence interval: 6.1-8.5%) of all respondents reported long COVID, corresponding to approximately 18 828 696 adults. One-quarter (25.3% [18.2-32.4%]) of respondents with long COVID reported their day-to-day activities were impacted "a lot" and 28.9% had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection more than 12 months ago. The prevalence of long COVID was higher among respondents who were female (adjusted prevalence ratio [aPR]: 1.84 [1.40-2.42]), had comorbidities (aPR: 1.55 [1.19-2.00]), or were not (vs were) boosted (aPR: 1.67 [1.19-2.34]) or not vaccinated (vs boosted) (aPR: 1.41 [1.05-1.91]). CONCLUSIONS: We observed a high burden of long COVID, substantial variability in prevalence of SARS-CoV-2, and risk factors unique from SARS-CoV-2 risk, suggesting areas for future research. Population-based surveys are an important surveillance tool and supplement to ongoing efforts to monitor long COVID.

Post-COVID-19 Syndrome Mechanisms, Prevention and Management.

As the population of patients recovering from COVID-19 grows, post COVID-19 challenges are recognizing by ongoing evidences at once. Long COVID is defined as a syndrome with a range of persistent symptoms that remain long after (beyond 12 weeks) the acute SARS-CoV-2 infection. Studies have shown that long COVID can cause multi-organ damages with a wide spectrum of manifestations. Many systems, but not limited to, including respiratory, cardiovascular, nervous, gastrointestinal, and musculoskeletal systems, are involved in long COVID. Fatigue and dyspnea are the most common symptoms of long COVID. Long COVID-19 may be driven by tissue damage caused by virus-specific pathophysiologic changes or secondary to pathological long-lasting inflammatory response because of viral persistence, immune dysregulation, and autoimmune reactions. Some risk factors like sex and age, more than five early symptoms, and specific biomarkers have been revealed as a probable long COVID predicator discussed in this review. It seems that vaccination is the only way for prevention of long COVID and it can also help patients who had already long COVID. Managing long COVID survivors recommended being in a multidisciplinary approach, and a framework for identifying those at high risk for post-acute COVID-19 must be proposed. Possible therapeutic options and useful investigation tools for follow-up are suggested in this review. In sum, as evidence and researches are regularly updated, we provide the current understanding of the epidemiology, clinical manifestation, suspected pathophysiology, associated risk factors, and treatment options of long COVID in this review.

An Agenda for Advancing Research and Prevention at the Nexus of Work Organization, Occupational Stress, and Mental Health and Well-Being.

Work characteristics and worker well-being are inextricably connected. In particular, the characteristics of work organization shape and perpetuate occupational stress, which contributes to worker mental health and well-being outcomes. Consequently, the importance of understanding and addressing connections between work organization, occupational stress, and mental health and well-being-the focus of this Special Issue-increasingly demand attention from those affected by these issues. Thus, focusing on these issues in the long-haul truck driver (LHTD) sector as an illustrative example, the purpose of this commentary is as follows: (1) to outline current research approaches and the extant knowledge base regarding the connections between work organization, occupational stress, and mental health; (2) to provide an overview of current intervention strategies and public policy solutions associated with the current knowledge base to protect and promote worker mental health and well-being; and (3) to propose a two-pronged agenda for advancing research and prevention for workers during the 21st century. It is anticipated that this commentary, and this Special Issue more broadly, will both echo numerous other calls for building knowledge and engaging in this area and motivate further research within complementary current and novel research frameworks.

Treatment of Long-Haul COVID Patients With Off-Label Acyclovir.

The SARS-CoV-2 virus (COVID-19) became a global pandemic in March 2020. This novel, highly infectious virus caused millions of infections and deaths around the world. Currently, there are few medications that are available for the treatment of COVID-19. Those affected are most commonly given supportive care, with some experiencing symptoms for months. We report a series of four cases depicting the successful use of acyclovir in the treatment of the virus SARS-CoV-2 in patients with long-haul symptoms, especially those in the realm of encephalopathy and neurological problems. Treatment with acyclovir in these patients resolved their symptoms and lowered their IgG and IgM titers, supporting the use of acyclovir as a safe and effective treatment for COVID-19 neurologic symptoms. We suggest the use of the antiviral medication, acyclovir, as a treatment for patients with long-term symptoms and unusual presentations of the virus, such as encephalopathy or coagulopathy.

Corona With Lyme: A Long COVID Case Study.

The longevity of the coronavirus disease 2019 (COVID-19) pandemic has necessitated continued discussion about the long-term impacts of SARS-CoV-2 infection. Many who develop an acute COVID-19 infection will later face a constellation of enduring symptoms of varying severity, otherwise known as long COVID. As the pandemic reaches its inevitable endemicity, the long COVID patient population will undoubtedly grow and require improved recognition and management. The case presented describes the three-year arc of a previously healthy 26-year-old female medical student from initial infection and induction of long COVID symptomology to near-total remission of the disease. In doing so, the course of this unique post-viral illness and the trials and errors of myriad treatment options will be chronologized, thereby contributing to the continued demand for understanding this mystifying disease.

Social Media is not a Health Proxy: Differences Between Social Media and Electronic Health Record Reports of Post-COVID Symptoms

The COVID-19 pandemic transformed many aspects of health and daily life. A subset of people who were infected with the virus have ongoing chronic health issues that range in type of symptom and severity. In this study, we conducted a qualitative assessment of self-reported post-COVID symptoms from patients' electronic health records (EHR, n=564) and a randomized collection of Reddit and Twitter posts (n=500 for each). We show the inconsistencies in what types of symptoms are shared between platforms in addition to assessing the severity of the symptoms and how social media characterizations of post-COVID do not tell a complete story of this phenomenon. This research contributes to CSCW health literature by connecting digital traces of post-COVID with EHR data, critiquing the use of social media as a health proxy and points to its potential to add context to the analysis of traditional health data extracted from the EHR. © 2023 ACM.

Coproducing Support Together: Sustainable and Reciprocal Civic Disaster Relief during COVID-19

COVID-19 changed society in terms of employment, food security, and mental health, affecting all segments of the population. Surging demands for a wide range of support could not be met solely by government-led disaster assistance that experienced breakdowns in the initial phase of the pandemic. The nature of the pandemic as a global, long-haul disaster necessitated sustained, diverse, and extensive civic disaster relief to complement government response. In this paper, we explore how civic disaster relief groups carry out online and offline coordination activities to engage different actors and their positive effects on individuals and local communities, drawing on interviews with civic disaster relief organizers and volunteers in the United States. We interpret our findings with the lens of coproduction that can increase the sustainability, diversity, and extent of civic relief efforts. We then suggest design implications for coproducing disaster relief and discuss the importance and benefits of involving stakeholders who are less likely to be engaged in producing relief. © 2023 ACM.

Long COVID: a review and proposed visualization of the complexity of long COVID.

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2) infection, or Long COVID, is a prevailing second pandemic with nearly 100 million affected individuals globally and counting. We propose a visual description of the complexity of Long COVID and its pathogenesis that can be used by researchers, clinicians, and public health officials to guide the global effort toward an improved understanding of Long COVID and the eventual mechanism-based provision of care to afflicted patients. The proposed visualization or framework for Long COVID should be an evidence-based, dynamic, modular, and systems-level approach to the condition. Furthermore, with further research such a framework could establish the strength of the relationships between pre-existing conditions (or risk factors), biological mechanisms, and resulting clinical phenotypes and outcomes of Long COVID. Notwithstanding the significant contribution that disparities in access to care and social determinants of health have on outcomes and disease course of long COVID, our model focuses primarily on biological mechanisms. Accordingly, the proposed visualization sets out to guide scientific, clinical, and public health efforts to better understand and abrogate the health burden imposed by long COVID.

Risk of post-acute sequelae of SARS-CoV-2 infection associated with pre-coronavirus disease obstructive sleep apnea diagnoses: an electronic health record-based analysis from the RECOVER initiative.

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) has been associated with more severe acute coronavirus disease-2019 (COVID-19) outcomes. We assessed OSA as a potential risk factor for Post-Acute Sequelae of SARS-CoV-2 (PASC). METHODS: We assessed the impact of preexisting OSA on the risk for probable PASC in adults and children using electronic health record data from multiple research networks. Three research networks within the REsearching COVID to Enhance Recovery initiative (PCORnet Adult, PCORnet Pediatric, and the National COVID Cohort Collaborative [N3C]) employed a harmonized analytic approach to examine the risk of probable PASC in COVID-19-positive patients with and without a diagnosis of OSA prior to pandemic onset. Unadjusted odds ratios (ORs) were calculated as well as ORs adjusted for age group, sex, race/ethnicity, hospitalization status, obesity, and preexisting comorbidities. RESULTS: Across networks, the unadjusted OR for probable PASC associated with a preexisting OSA diagnosis in adults and children ranged from 1.41 to 3.93. Adjusted analyses found an attenuated association that remained significant among adults only. Multiple sensitivity analyses with expanded inclusion criteria and covariates yielded results consistent with the primary analysis. CONCLUSIONS: Adults with preexisting OSA were found to have significantly elevated odds of probable PASC. This finding was consistent across data sources, approaches for identifying COVID-19-positive patients, and definitions of PASC. Patients with OSA may be at elevated risk for PASC after SARS-CoV-2 infection and should be monitored for post-acute sequelae.

Late neurological consequences of SARS-CoV-2 infection: New challenges for the neurologist.

Objective: In this study, a systematic review of the literature was performed to study the frequency of neurological symptoms and diseases in adult patients with COVID-19 that may be late consequences of SARS-CoV-2 infection. Methods: Relevant studies were identified through electronic explorations of Scopus, PubMed, and Google Scholar. We followed PRISMA guidelines. Data were collected from studies where the diagnosis of COVID-19 was confirmed and its late neurological consequences occurred at least 4 weeks after initial SARS-CoV-2 infection. Review articles were excluded from the study. Neurological manifestations were stratified based on frequency (above 5, 10, and 20%), where the number of studies and sample size were significant. Results: A total of 497 articles were identified for eligible content. This article provides relevant information from 45 studies involving 9,746 patients. Fatigue, cognitive problems, and smell and taste dysfunctions were the most frequently reported long-term neurological symptoms in patients with COVID-19. Other common neurological issues were paresthesia, headache, and dizziness. Conclusion: On a global scale of patients affected with COVID-19, prolonged neurological problems have become increasingly recognized and concerning. Our review might be an additional source of knowledge about potential long-term neurological impacts.

Severe COVID-19 as a Possible Mediator of Autoimmunity and Sjögren's Syndrome.

We treated a 65-year-old man for COVID-19 who was hospitalized urgently due to life-threatening respiratory decompensation and later developed cardiac arrest, both of which were successfully treated. Three days prior to the patient's urgent hospitalization, he had a high fever of over 38.0°C. Viral infection was diagnosed by polymerase chain reaction (PCR) on the day of admission, which was negative on the 11th day. Blood analysis on the second day was strongly positive for COVID-19 IgG antibodies, which continued for one year. Because of the acute increase in viral IgG antibodies, we performed other immunological analyses; Sjögren's syndrome antigen A (SS-A) and Sjögren's syndrome antigen B (SS-B) antibodies were positive, although he had no history of autoimmune diseases. Subsequent salivary-gland biopsy and pathological analysis confirmed the diagnosis of Sjögren's syndrome. The severe clinical manifestations and early antibody seroconversion in this case suggest COVID-19 as a mediator of autoimmunity and Sjögren's syndrome.

Potential of Black Seeds (Nigella sativa) in the Management of Long COVID or Post-acute Sequelae of COVID-19 (PASC) and Persistent COVID-19 Symptoms - An Insight.

BACKGROUND: Some individuals may experience symptoms persisting for many months after the recovery from COVID-19 and patients with Long COVID are managed mainly with symptomatic treatment and supportive care. OBJECTIVE: This review article focuses on the beneficial effects of black seeds (Nigella sativa) in the management of long COVID and persistent COVID symptoms. METHODS: The literature was searched in databases such as LitCOVID, Web of Science, Google Scholar, bioRxiv, medRxiv, Science Direct, EBSCO, Scopus, Embase, and reference lists to identify studies, which evaluated various effects of black seeds (N. sativa) related to signs and symptoms of long COVID. RESULTS: Black seeds (N. sativa) have shown potential anti-COVID, antiviral, anti-inflammatory, antioxidant, immunomodulatory, antihypertensive, anti-obesity, antidiabetic, antihyperlipidemic, and antiasthmatic properties in various clinical, animal, in vitro, in vivo, and in silico studies, which would help the patients recovered from COVID to mitigate Long COVID complications. CONCLUSION: Patients experiencing Long COVID may use black seeds (N. sativa) as adjunctive therapy in combination with symptomatic treatment and supportive care to prevent further deterioration and hospitalization. The safety and efficacy of N. sativa in patients with Long-COVID would further be established by future randomized controlled clinical trials.

Identification of spectrum of persistent post-COVID-19 symptoms and their duration in Central India: A pilot study.

Objectives: To uncover numerous post-COVID symptoms in individuals after SARS-CoV-2 infection and to raise concerns about the consequences for health care planning. Methodology: Patients declared negative with RTPCR and discharged from the hospital were followed up for three months. Results: The majority of patients who suffered from weakness since discharge are 63 (25.40%), body aches 40 (16.12%), loss of taste 26 (10.48%), and loss of smell 18 (7.25%). The total of reinfected patients in the 4th week was 9 (3.62%), in the 6th week 10 (4.03%), in the 8th week 7 (2.82%), and in the 12th week 11 (4.43%). A total of 54.7% of individuals still have the persistence of symptoms at the end of the 12th week. Conclusions: A significant number of participants developed long-term health issues as a result of post-COVID-19 syndrome. Our findings highlight the importance of initial preventive measures and patient-centered benefit programs in reducing post-COVID-19 complications.

Leveraging Serologic Testing to Identify Children at Risk For Post-Acute Sequelae of SARS-CoV-2 Infection: An Electronic Health Record-Based Cohort Study from the RECOVER Program.

Using an electronic health record-based algorithm, we identified children with Coronavirus disease 2019 (COVID-19) based exclusively on serologic testing between March 2020 and April 2022. Compared with the 131 537 polymerase chain reaction-positive children, the 2714 serology-positive children were more likely to be inpatients (24% vs 2%), to have a chronic condition (37% vs 24%), and to have a diagnosis of multisystem inflammatory syndrome in children (23% vs <1%). Identification of children who could have been asymptomatic or paucisymptomatic and not tested is critical to define the burden of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection in children.

Impact of SARS-CoV-2/COVID-19 on Provision of Medical Care to Patients With Systemic Autoimmune Rheumatic Disease and the Practice of Rheumatology.

The SARS-CoV-2 pandemic has had a significant impact on the healthcare field that resulted in changes to the way safe and effective medical care is delivered. The effects range from service disruption including ambulatory clinic closure due to both patient and provider concerns, to lack of capacity in hospital services. In rheumatology, there were other effects including viral infection-related autoantibody production, concerns about the use of systemic immunosuppression in the presence of an infectious pandemic and even concerns for viral infection-induced flares of rheumatic disease. Coronavirus disease 2019 (COVID-19) led to the rapid adoption of innovative technologies that permitted the introduction and increased use of telemedicine via a number of platforms. Rapid discoveries and innovations led to the development of diagnostic and therapeutic agents in the management of COVID-19. Scientific advancement and discoveries around COVID-19 infection, symptoms, autoantibody production, chronic sequela and the repurposing of rheumatic immunosuppressive agents led to improved survival and an expanded role for the rheumatologist. Rheumatologists may sometimes be involved in the diagnosis and management of the hospitalized COVID-19 patient. In the ambulatory clinic, a rheumatologist also helps to differentiate between symptoms of long COVID and those of systemic autoimmune rheumatic disease (SARD). Rheumatologists must also grapple with the concerns related to immunosuppressive therapy and the risk of COVID-19 infections. In addition, there are concerns around vaccine effectiveness in people with SARD and those on immunosuppressive medications. Although the SARS-CoV-2 pandemic and the effects on healthcare resulted in difficulties, both patients and providers have risen to the challenge. The long-term outcome of COVID-19 for the medical system and rheumatologists in particular is not yet fully understood and will need further study. This review concentrates on the changing role of the rheumatologists, improved understanding of rheumatic disease and immunosuppressive therapies in the wake of the pandemic and how this has led to an improvement in the care of patients with COVID-19.

Post-exertional malaise among people with long COVID compared to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

BACKGROUND: Long COVID describes a condition with symptoms that linger for months to years following acute COVID-19. Many of these Long COVID symptoms are like those experienced by patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). OBJECTIVE: We wanted to determine if people with Long COVID experienced post-exertional malaise (PEM), the hallmark symptom of ME/CFS, and if so, how it compared to PEM experienced by patients with ME/CFS. METHODS: A questionnaire that asked about the domains of PEM including triggers, experience, recovery, and prevention was administered to 80 people seeking care for Long COVID at Bateman Horne Center. Their responses were compared to responses about PEM given by 151 patients with ME/CFS using chi-square tests of independence. RESULTS: All but one Long COVID respondent reported having PEM. There were many significant differences in the types of PEM triggers, symptoms experienced during PEM, and ways to recover and prevent PEM between Long COVID and ME/CFS. Similarities between Long COVID and ME/CFS included low and medium physical and cognitive exertion to trigger PEM, symptoms of fatigue, pain, immune reaction, neurologic, orthostatic intolerance, and gastrointestinal symptoms during PEM, rest to recover from PEM, and pacing to prevent PEM. CONCLUSION: People with Long COVID experience PEM. There were significant differences in PEM experienced by people with Long COVID compared to patients with ME/CFS. This may be due to the newness of Long COVID, not knowing what exertional intolerance is or how to manage it.

Post COVID-19 pulmonary complications in outpatient setting: Insights from a cross-sectional study in a rural academic hospital.

OBJECTIVE: Post COVID-19 disease pulmonary complications are generally expected among the hospitalized or elderly patients with multiple comorbidities given the gravity of the disease among such patients. However, non-hospitalized patients with less severe symptoms from COVID-19 disease have also been experiencing significant morbidity and difficulty functioning their activities of daily living. Therefore, we aim to characterize post COVID-19 pulmonary complications (symptomatology, clinical and radiological findings) in patients who did not require hospitalization but had significant outpatient visits secondary to COVID-19 sequelae. METHODS: This is a two part cross-sectional study based on a retrospective chart review. Patients with COVID-19 disease not requiring hospitalization but followed up at pulmonology clinic with respiratory symptoms were analyzed twice in an interval of 12 months. 23 patients in first cross-section group (followed up from December 2019 to June 2021) and 53 patients in second group (followed up from June 2021 to July 2022) were included in the analyses. Differences in mean and percentage of baseline characteristics and clinical outcomes between the two groups are analyzed using unpaired t-tests and Chi-squared tests respectively. Post COVID-19 disease symptoms are classified in to 3 different groups (mild, moderate and severe) based on duration of symptoms and presence or absence of hypoxia. RESULTS: Dyspnea on exertion (DOE) was the common compliant in majority of patients in both cross-section groups (43.5% vs 56.6%). Mean age in years were 33 and 50 in first and second cross-section groups respectively. Majority of the patients had mild and moderate symptoms in both groups (43.5% vs 9.4%, P = 0.0007; 43.5% vs 83%, P = 0.005). Mean duration of symptoms in first cross-section group was 3.8 whereas 10.5 months (P = 0.0001) in second cross-section group. CONCLUSION: Our study outlines the burden of post COVID-19 disease pulmonary complications in patient group where these complications are less expected. Strategies for the implementation of multidisciplinary post COVID-19 care clinic along with mass vaccination awareness campaigns in rural US should be prioritized to mitigate this existing burden.

Post-acute Sequelae of SARS-CoV-2 Infection: Do Indians Fare Better?

INTRODUCTION: The uplift of SARS-CoV-2 infection has necessitated the understanding of long-term consequences in the affected population. This study was driven by a lack of Indian studies to estimate the torment of post-coronavirus disease 2019 (COVID-19) symptoms and the quality of life. METHODS:  This prospective observational study was conducted in a tertiary care centre in South India, between August and November 2020. SARS-CoV-2 hospitalised patients were telephonically questioned regarding the persistence of symptoms along with an assessment of the quality of life using the 15D questionnaire in the first, second, and fourth weeks. Since a majority of the patients had resolution of symptoms by four weeks, the study was not extended for a longer period. RESULTS: The study included 476 patients whose mean length of hospital stay was 7.67 days. Of the patients, 68.7% had mild severity, 24.8% had moderate disease, and 6.5% had severe disease. About 28.4% required oxygen, 8.2% required ICU care, and 1.3% required mechanical ventilation. Myalgia (13.9%), cough (1.3%), and dyspnoea (6.1%) were the predominant persistent symptoms in the fourth-week post-discharge. All the symptoms of health-related quality of life and physical performance improved by the fourth week, which was statistically significant. CONCLUSION: Our study findings are in stark contrast to the studies published from other regions of the world, which show a significant worsening of quality of life even among those with mild illness.