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Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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This unique book explores stories from educational, community, social, health, therapeutic and therapy perspectives, acknowledging a range of diverse social and cultural views in which stories are used and written by esteemed storytellers, artists, therapists and academics from around the globe. Storytelling is a major activity of human communication;it is an age-old tradition, used in many ways by different societies at different moments. Storytelling and stories can be entertaining, therapeutic and educative. The book is like the old saying a 'stitch in time'-stories are a way of dealing with difficulties before they become real problems. The book perfectly fits the context of arts, arts in health and creative arts therapies in that, through the cross-section of chapters, it touches on every single function of storytelling. The book is fascinating in the way it harnesses our day-to-day realities as seen from the storytelling perspective. It is divided into five parts, each created around a particular theme, with chapters from renowned world-class scholars on aspects of stories and storytelling. The first part is dedicated to COVID-19 stories. Part II delves into stories and therapeutic texts. Part III paints a picture of how stories can be used in educational, community and social settings for general therapeutic purposes. This somehow connects with Part IV, which examines stories and therapeutic texts in a health and therapy context. The book provides a deeper understanding of the different contexts and settings in which stories are, can and should be used. Finally, it finishes with a moving story about memory loss. It is evident in this book that stories provide consolation and encouragement to continue search for answers to our human condition. The stories and therapeutic stories and ideas around them presented in this international handbook tell the underlying truth of human existence. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Recent complex and cross-boundary policy problems, such as climate change, pandemics, and financial crises, have recentred debates about state capacity, democratic discontent and the 'crisis of expertise'. These problems are contested and open to redefinition, misunderstanding, spin, and deception, challenging the ability of policymakers to locate, discriminate, comprehend, and respond to competing sources of knowledge and expertise. We argue that 'non-knowledge' is an under-explored aspect of responses to major policy crises. Key points: While discussed in recent work in sociology and other social sciences, non-knowledge has been given less explicit attention in policy studies, and is not fully captured by orthodox understandings of knowledge and evidence use. We outline three main forms of non-knowledge that challenge public agencies: amnesia, ignorance and misinformation. In each case, 'non-knowledge' is not simply the absence of policy-relevant knowledge. Amnesia refers to what is forgotten, reinvented or 'unlearned', while claims of ignorance involve obscuring or casting aside of relevant knowledge that could (or even should) be available. To be misinformed is to actively believe false or misleading information. In each instance, non-knowledge may have strategic value for policy actors or aid the pursuit of self-interest. Conclusions and implications: We demonstrate the relevance of non-knowledge through a brief case study, emerging from the inquiry into the COVID-19 hotel quarantine programme in the Australian state of Victoria. We argue that both amnesia and 'practical' forms of ignorance contributed to failures during the early part of the programme. © Policy Press 2023.
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Aims: COVID-19 leaves diverse sequalae beyond the acute illness, referred to as 'long COVID'. However, the aetiology, characteristics and risk factors of Long-COVID is still lacking. COVID-19 patients experience various stressful events and suffer emotional distress which causes post-traumatic stress disorders. This study aimed to investigate association between of perceived distress to COVID-19 infection and long COVID. Method(s): Data from 56 patients who visited the psychiatric department of our post-COVID clinic between March and June 2022 were analysed. All patients completed a subjective symptom checklist [32 symptoms in eight categories], selected cognitive function tests [digit span test, trail making test (TMT), and Stroop word colour interference test], and validated neuropsychological scales [Hospital Anxiety and Depression Scale (HAS and HDS), Pittsburgh sleep quality index (PSQI) and Impact of event scale-revised (IES-R)]. We classified patients into two groups, 'High distress group'(N = 37) and 'Low distress group (N = 19) through IES-R score (cut-off = 25). The frequency and severity of long COVID-symptoms between the two groups were compared with Mann-whitney and chi-square test. Result(s): The average age of the patients was 53.34 years, and 70.53 days had passed from the SARS-CoV-2 confirmation using RTPCR. 'High distress group' showed higher HAS (284 vs. 455, p = .01), HDS (197 vs. 387, p = .032), and PSQI (238 vs. 428, p = .05) scores and suffered shortness of breath, palpitation, tingling, subjective memory deficit more frequently. Regarding neurocognitive functioning, there was no difference between two groups. Conclusion(s): Managing perceived distress due to COVID-19 could alleviate the long-covid sequalae especially in neuropsychiatric area.
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Objectives: Many people were infected by COVID-19 and for a minority of them, symptoms persisted beyond twenty days. These symptoms are multi-systemic, fluctuating, and impact the quality of life. Long COVID was first defined by patients themselves in the spring of 2020 to describe their recovery problems. Specifically, long COVID is defined as "a constellation of physical and mental symptoms which can persist or emerge afterwards, generating a multi-systemic and disabling syndrome, which varies from patient to patient and fluctuates over time". The persistence of COVID symptoms, the decrease in the quality of life, the uncertainly about the future sometimes accompanied by a low level of social support perceived in the medical and personal entourage may have triggered the occurrence of a depressive disorder in patients with long COVID. The objective of this research was to study the effect of long COVID symptoms, of uncertainty and the impairment of quality of life on the development of depressive symptoms, while identifying the impact of moderating variables such as coping strategies and social support. Material(s) and Method(s): Two hundred and fourteen participants with long COVID (aged 18-68, M = 44, SD = 11), including 93 % females (n = 200) and 7% males (n = 14), participated in this cross-sectional quantitative study between the months of April and June 2022. They described their symptoms and responded to five scales: the Evaluation of Intolerance of Uncertainty Scale (EII), the Coping Strategies Checklist (WCC), the Medical Outcome Study Short Form 36-item health survey (MOS SF-36), the Perceived Social Support Questionnaire (QSSP), and the Hospital Anxiety and Depression Scale (HADS). Result(s): 91% of the participants reported symptoms of fatigue (n = 171), 52% a loss of concentration (n = 111), 51% pain (n = 110), 49 % trouble sleeping (n = 104), and 41% memory problems (n = 88). Compared with the general population, they presented a poorer quality of life, as well as high scores for anxiety, depression, and intolerance of uncertainty. Scores on coping strategies were also higher than the norms for the general population, and scores on satisfaction with social support were generally good. It was also found that the variables of intolerance of uncertainty, quality of life, and depression all correlated with each other. Furthermore, the regression analysis revealed predictors of depression. The areas of quality of life and emotional well-being (beta = -0.41, t(199) = -6.23, P < 0.01) and fatigue/energy (beta = -0.16, t(199) = -2.83, P < 0.01) were negative predictors of depression, as was the problem-focused coping score (beta = -0.14, t(199) = -2.84, P < 0.05). Symptoms of the disorder related to concentration difficulties (beta = 0.27, t(199) = 5.16, P < 0.01) and those impacting projects (beta = 0.18, t(199) = 3.31, P < 0.01) were positive predictors of depression. The second finding of this study is that people treated specifically for their long COVID had significantly lower scores for anxiety and intolerance of uncertainty despite lower scores for certain dimensions of quality of life. The individuals who took part in our study also developed more problem-based coping strategies and reported more availability of and satisfaction with social support. Lastly, in terms of quality of life, the treated population expressed better mental health. Conclusion(s): The study showed that, in addition to the effects of long COVID symptoms, quality of life, and coping strategies on the onset of symptoms of depression, the specific treatment of patients with long COVID seemed to constitute in itself a protective factor against depression and anxiety. It therefore would seem essential that any patient suffering from long COVID should receive multidisciplinary care specific to this pathology.Copyright © 2023 Elsevier Masson SAS
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Intro: The burden of post-COVID-related morbidity and mortality is significant yet undermined. We studied the morbidity and mortality outcomes of COVID-19 patients with moderate-to-severe diseases by 90-day post-hospitalization. Method(s): This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate to severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID severity category >=5;WHO scale >=5), between January and August 2021. We conducted telephone surveillance for 90 days post-discharge from the hospital, assessing for post- COVID complications and mortality. Relevant clinical data were extracted from medical records. Multiple logistic regression was employed to examine factors associated with post-COVID mortality after index hospitalization. Finding(s): Among 510 patients, 51%(n=260) were male with a mean age of 52.1 (14.65) years. A third had hypertension (39.8%) and diabetes (31.4%). Only 15.5% were partially vaccinated and 4.9% had complete vaccination before hospitalization. Nearly 65% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 25.7% received high flow oxygenation and 10% were mechanically ventilated. Approximately 23.3% (n=119) of patients were admitted to the intensive care unit. By 90-day post-hospitalization, 46% (n=203) reported residual symptoms: lethargy (14.5%), dyspnoea (12.2%), hair loss (7.5%), memory loss (6.3%), depression (3.9%), anxiety (2.7%) and 1.6% required home oxygen supplementation. Forty-four patients (8.5%) were re- hospitalized at least once, with 40.9% due to post-COVID complications. About 87% of patients attended their post-COVID clinic appointment. Nearly 13.5% (n=69) of patients died within 90 days after being discharged from the hospital. Adjusted for gender, comorbids and ventilatory status, age >=60 years (aOR 7.96;95%CI 3.75-16.92;p<0.001), diabetes (aOR 2.30;95%CI 1.12-4.72;p=0.024) and high oxygen requirement (aOR 3.41;95%CI 1.56-7.46;p=0.002), were associated with increased 90-day post-COVID mortality. Conclusion(s): Post-COVID morbidity and mortality are significant among survivors hospitalized for moderate- to-sever disease. Comprehensive care must be addressed to improve the outcomes of post-COVID patients.Copyright © 2023
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Background: HIV is a risk factor for severe acute COVID-19, but it is unknown whether HIV is a risk factor for long COVID. Method(s): We conducted a prospective observational cohort study of US adults with HIV (PWH) and HIV-seronegative adults with first SARS-CoV-2 infection within 4 weeks together with people who never had COVID-19. At enrollment, participants recalled the presence and severity of 49 long COVID-associated symptoms in the month prior to COVID-19. The same symptom survey was administered at 1, 2, 4, and 6 months post-COVID or post-enrollment for never- COVID participants. Post-COVID participants donated blood 1 and 4 months post-COVID, and never-COVID participants donated blood 0-1 times. Antibody titers to 18 coronavirus antigens and levels of 30 cytokines and hormones were quantified (Meso Scale Discovery). The Mann Whitney U test was used to compare continuous variables between groups, and Pearson's chi-squared test for categorical variables. Spearman correlation analyses were used to build networks of associations between cytokines and symptoms. Result(s): 341 participants enrolled between June 2021 and September 2022. Of these, 73 were PWH post-COVID, 121 were HIV-seronegative post-COVID, 78 were PWH never-COVID, and 69 were HIV-seronegative never-COVID. Over 85% of participants were vaccinated prior to COVID-19. Most participants with HIV were male sex at birth (83% post-COVID, 59% never-COVID), on ART ( >95%), with median CD4 counts >500. Over 60% of participants reported 1+ new or worsened symptoms 2-6 months post-COVID, with higher percentages in PWH at 2 months post-COVID (p< 0.05). PWH were more likely to report body ache, pain, confusion, memory problems, and thirst and had higher levels of creatine phosphokinase post-COVID than HIV-seronegative people. SARS-CoV-2 and non-SARS human coronavirus antibody titers did not differ between PWH and HIV-seronegative post-COVID participants. Cytokine associations with each other (network density) were significantly enriched at 1 month post-COVID in both PWH and HIV-seronegative people, with significantly less enrichment at 4 months post-COVID and in never- COVID participants. Levels of four analytes (cortisol, C5a, TGF-beta1, and TIM-3) associated with specific symptoms of long COVID. Conclusion(s): PWH may experience more symptoms post-COVID with a slightly different symptom profile than people without HIV. Inflammatory networks were active in PWH and people without HIV at 1 month post-COVID.
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Background: Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. Little is known about the impact of therapies on post-acute COVID-19 (PACS). We aimed to compare the efficacy of these therapies in terms of death, hospitalization rate and PACS at 3 months. Method(s): We conducted a retrospective observational study including all eligible outpatients aged >=18 evaluated from April 2021 to March 2022 at our COVID-19 Clinic. Patients were stratified into 3 groups: mAbs, antivirals (oral and short-course remdesivir) and controls (eligible patients who refused treatment). Persistence of symptoms (fever, dysgeusia/anosmia, cough, pharyngodynia, dyspnea, chills, nasal congestion, myalgia, headache, gastrointestinal disease, and neuro-behavioural symptoms, such as asthenia, anxiety/mood disorder, memory and concentration deficit) were evaluated after 3 months. We estimated the associations between each considered outcome and treatment through univariate and multivariable logistic models adjusted by sex, age, vaccination, early COVID treatment, treatment group and number of comorbidities (when appropriate). Result(s): We included 649 patients (51.6% males, median age 67 years, 14% unvaccinated): 242 patients were treated with mAbs, 197 with antivirals and 210 received no treatment. Overall, 36.7% of subjects had cerebro-cardiovascular disease, 22% were obese and 50% had more than one comorbidity. Overall, 29 patients (4.5%) died or were hospitalized. Death or hospitalization was positively associated only with older ages with a significant linear trend (p for trend: 0.033). Data on PACS at 3 months were available for 323 (49.8%) patients. Females showed a positive association with long COVID, with an OR of 2.14 (95% CI: 1.30-3.53) as compared to men. Patients treated with antiviral drugs showed an inverse association with long COVID (OR: 0.43, 95% CI: 0.21-0.87 as compared to not treated patients). Patients who were treated with monoclonal antibodies showed an OR of 0.48 (95% CI: 0.25-0.92) as compared to those in the control group (Table 1). Conclusion(s): The impact of early COVID-19 therapies on PACS is unknown. Our results showed that these treatments, in particular mAbs, can reduce persistence of neuro-behavioural symptoms at 3 months. (Table Presented).
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Background: Transient global amnesia (TGA) is a sudden-onset transient memory impairment along with intact neurologic examinations. Even though it is a benign neurologic condition with many differential diagnoses, the incidence rate of TGA is reported to have increased since the onset of the pandemic. Therefore, this systematic scoping review aims to investigate TGA in that context. Methods: MEDLINE, Scopus, and Google Scholar databases were systematically searched for relevant articles with a string of specified keywords. Results: The primary search yielded 90 studies. After all the necessary screening rounds were carried out, we were left with six included studies. One study was also identified through a search in other relatively relevant databases. Finally, seven case reports were accepted including three TGA patients with positive and one with negative test for coronavirus disease -2019 (COVID-19), respectively. COVID-19 status was unclear in the others. Conclusion: The reported COVID-19 positive cases had presentations similar to those with TGA before the pandemic. Therefore, we think that TGA might occur concomitantly with the COVID-19 infection or due to the psychological impact of the pandemic. In the confirmed cases of TGA and COVID-19, the abnormal findings may be due to COVID-19 infection. However, the reports were not as complete as desired. Therefore, providing the readers with more detailed reports in future cases is recommended.
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Before the COVID-19 pandemic started Vitamin D was discussed as a preventative strategy in acute respiratory tract infections. There is a growing evidence of beneficial effects of vitamin D supplementation in COVID-19 patients. The term post-COVID-19 syndrome (PCS) describes new, returning or ongoing symptoms more than 12 weeks after COVID-19 infection which cannot be explained by any other disorders or illnesses. The most common symptoms of PCS includes fatigue, difficulty breathing, memory/concentration/sleep problems persistent cough, muscle aches, depression, and others. We conducted a retrospective analysis of vitamin D level in a PCS cohort without hospitalisation. Taking of blood samples was part of the routine assessment in PCS consultation hours. We found significant lower vitamin D levels in the PCS cohort compared to a non-COVID control group. Within the non-COVID cohort there were no differences regarding vitamin D levels. Our results recorded for the first-time decreased vitamin D values in a PCS cohort compared to a control group. There are several potential reasons for these observations. The decrease could be the consequence of overcoming the infection by consumption of vitamin D. The reduction could also be the consequence of a longer duration of illness without exposure to sunlight or malnutrition. Similarly, reduced outdoor exercise during the pandemic with its restriction could have influenced vitamin D levels. Finally, reduced physical activity because of ongoing PCS symptoms like fatigue or exercise intolerance might be a possible explanation for the drop in vitamin D levels.
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Case report Background: Neurological adverse effects (NAE) as headache and dizziness are commonly reported with COVID-19 vaccines but are transient and self-limited. However, few serious NAE have been recently described which can be fatal. Here we report two rare cases of encephalitis related to COVID-19vaccination BNT162b2 (Pfizer) and mRNA-1273 (Moderna) and the inherent challenges in their diagnosis. Method(s): We report two cases of acute encephalitis notified to the department of pharmacovigilance in the University Hospital of Monastir Results: Case n'1: Three weeks after receiving her first dose of mRNA-1273, a 35-year- old female, with a medical history of hypothyroidism and eczema was admitted to the intensive care unit as she had confusion and a febrile tonic-clonic seizure complicated with a status epilepticus and dysautonomia. CSF investigations were nonspecific, and the MRI head did not detect any abnormality. Common causes were excluded by an extensive workup (neoplastic, neuro-vascular, autoimmune and infectious causes). She received cefotaxime and acyclovir without any recovery. However, a spectacular recovery was noticed when receiving methylprednisolone. Case n'2: Three days after receiving her first dose of BNT162b2, a-40- year- old female, with a medical history of rheumatoid arthritis was admitted to the medical care unit as she had experienced a three-day history of headache, memory disturbance, severe cognitive disorders and 4 febrile tonic-clonic seizures. MRI head showed signs of bitemporal encephalitis and CSF investigations was with no findings. Extensive laboratory studies ran out alternative causes as neoplastic, autoimmune and infectious diseases. A twenty-one- day acyclovir regimen was administrated with no recovery. As the cognitive deficit is getting more severe, she got intravenous immunoglobulin therapy with a spectacular improvement. Conclusion(s): Based on the Naranjo Algorithm, this adverse NAR can be possibly (score = 6) induced by COVID-19 vaccines. The dramatic improvement after receiving either corticoids or immunoglobulin therapy supports an immune-mediated mechanism behind this acute presentation. Cases of acute encephalitis secondary to H1N1 influenza and poliomyelitis vaccines have been previously reported but those related to COVID-19 vaccines are still not yet elucidated due to the unproven causality. Further prospective studies are needed to evaluate the causal association between vaccine and NAE occurring vaccination.
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Methods: observational study, included 6000 COVID-19 indoor cases confirmed with RT-PCR. Retrospective analysis with treatment records, laboratory markers as IL-6, D-dimer, Ferritin, LDH, BSL, HBA1C. All cases undergone thorough interview in 'post covid care' outdoor setting regarding symptomatology, documnted vital signs abnormality, & workup as HBA1C, BSL, TFT, KFT, ECG, chest x-ray, HRCT thorax, BMD, Echocardiography, MRI brain whichever is necessary. Statistical analysis by using Chi square test and ANOVA. Observations: Long covid manifestations were documented in 36.06% (2517/6000) post COVID cases as- Fatigue 41.95%, dyspnea 35.98%, cough 31.96%, chest discomfort 26.95%, anosmia 8.76%, joint pain & headache 11.96% , dizziness, vertigo&insomnia 22.95% &alopecia 4.18% cases, Lung fibrosis in 16.66%, minimal lung abnormality 23.65%, pulmonary embolism 7.18% cases, palpitations 25.56%, chest pain 11.3%, arrythmias 5.53%, cardiac dysfunction 24.31%, PTSD 28%, Impaired memory with or without poor concentration (brain fog) 24.03%, Anxiety and or depression 6.33%, Reduction in quality of life 33%, Diabetes mellitus-new onset26%, transient34%, uncontrolled27%, Osteoporosis38.08%, thyroid dysfunction12.1%. CT severity score, Intensive care treatment with or without oxygen and or ventilator use & Laboratory parameters (D-dimer, IL6, LDH, Ferritin) during hospitalization has significant association with long covid manifestations (p<0.00001) Conclusion(s): Long covid in underestimated, improperly evaluated and halfheartedly treated during follow-up. All treated cases needs prompt evaluation, more awareness regrding its manifestations and its impact on quality of life is must.
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Covid19 may be associated with prolonged symptoms and post-recovery health impairment. We aim to evaluate persistent symptoms and lung function test (spirometry and 6 minute walk) in patients who were discharged from the hospital after recovery from COVID-19. Method(s): It is a retrospective cohort study including patients admitted to the COVID-19 unit of general hospital ISSSTE dr Belisario Dominguez from Chiapas Mexico, between May 2020 to December 2020. Clinical data were collected from medical records. The patients were evaluated through the follow-up consultation by trained physicians and were asked to respond to a specific questionnaire to collect symptoms after discharge, and spirometry and 6MW were performed at the same visit. Result(s): We enrolled 27 patients, 16 men and 11 women, after a mean of 163 days following admission. The average age was 54 years (21-78) was 1.36. The average length of hospitalization was 15.6 dias days. Twenty six patients (96%) had residual symptoms. The most frequently reported persistent symptoms were insomnia (62%), memory loss (58%), dyspnea and dizziness (54%), headaches (50%), myoarthralgia (46%), cough and tachycardia (35%) and chest pain (12%). Regarding spirometry, 9 patients had a normal study, in the remainder the study was restrictive and the average CFV% was 65%. The average in meters of the 6MW was 325 meters, only two patients had saturation less than 90% during the test (89 and 84%) but they concluded the study. Conclusion. Regarding spirometry, almost two-thirds have a restrictive pattern and 6MW is normal in practically all patients. Even after discharge, patients have persistent symptoms that affect their daily life.
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Introduction: Patients with acute COVID syndrome have significant cognitive impairment. Although different research had focused on assessing the condition of these patients in the hospital period and in the short term, there are no studies that evaluated these alterations in the long term. The cognitive impairment of long COVID patients may be an important factor for the development of intervention programmes tailored to this population. Objetive: The main objetive of this study was to evaluate the presence of cognitive impairment in long COVID syndrome patients one year after infection. Patients and Methods: In this observational study, long COVID patients were included. These patients were evaluated one year after infection and they were compared to a control group matched by age and gender. Anxiety, depression, memory and concentration problems were measured with items from a comprehensive multi-system telephone screening tool called COVID-19 Yorkshire Rehabilitation Screening (C19-YRS). Result(s): A total of 455 patients and 451 controls were included in this study. Anxiety (p<0,05), depression (p<0,001), memory (p<0,001) and concentration (p<0,001) had shown significant results compared to the control group. Conclusion(s): This study found that long COVID syndrome patients had significant cognitive impairment one year after infection, with increased levels of anxiety, depression and difficulties in concentration and decreased memory. Early interventions for cognitive impairment may improve or prevent further deterioration.
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Introduction: Long-COVID patients are individuals that have ongoing symptoms persisting for weeks to months after SARS-CoV-2 infection. The incidence is increasing and more studies are necessary to deepen the knowledge of these patients. Objective(s): To investigate the clinical profile, symptomatology and sequelae of long-COVID patients. Method(s): In this observational study, long-COVID patients were included and evaluated by an internet survey. Sociodemographic data were obtained from the patient together with the COVID-19 Yorkshire Rehabilitation Screening Tool (C19-YRS). Consent of the patient was sought at the beginning of the survey. Result(s): Finally, 89 patients were included in the study. The main age was 43,34 +/-7,85 years, they were overweight, and non-smokers (84%), the 85,4% were females and the median time of infection was 8,18 +/-3,93 months. The results have shown significant impairments in dyspnea at rest or under exercise, personal care, pain, fatigue, psychological distress, and quality of life after COVID infection. Additionally, patients have referred sensitivity of the throat, voice and swallowing impairment, gastrointestinal disorders, and attention and memory problems. Conclusion(s): Patients with long- COVID present multiple sequelae that affect their health status, being necessary more future studies.
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Covid immunization commenced on 2nd Feb 2021 in Pakistan and as of 7th Sep 2021, over 84 million vaccine doses were administered in Pakistan, of which 72% procured by the government, 22% received through Covax and 6% were donated. The vaccines rolled out nationally included: Sinopharm, Sinovac and CanSinoBIO (China), AstraZeneca (UK), Moderna and Pfizer (USA), Sputnik (Russia), and PakVac (China/Pakistan). About half of the eligible population in Pakistan (63 m) had received at least one dose of Covid vaccine as of Sep 2021. Pakistan National Pharmacovigilance Centre (PNPC) in coordination with WHO, MHRA and Uppsala Monitoring Centre (UMC) established pharmacovigilance centers across Pakistan. The Covid vaccine AEFIs in Pakistan were mainly reported via NIMS (National Immunization Management System), COVIM (Covid-19 Vaccine Inventory Management System), 1166 freephone helpline and MedSafety. There have been 39,291 ADRs reported as of 30th Sept 2021, where most reported after the first dose (n = 27,108) and within 24-72 h of immunization (n = 27,591). Fever or shivering accounted for most AEFI (35%) followed by injection-site pain or redness (28%), headache (26%), nausea/vomiting (4%), and diarrhoea (3%). 24 serious AEFIs were also reported and investigated in detail by the National AEFI review committee. The rate of AEFIs reports ranged from 0.27 to 0.79 per 1000 for various Covid vaccines in Pakistan that was significantly lower than the rates in UK (~4 per 1000), primarily atrributed to underreporting of cases in Pakistan. Finally, Covid vaccines were well tolerated and no significant cause for concern was flagged up in Pakistan's Covid vaccine surveillance system concluding overall benefits outweighed risks.Copyright © 2022
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Background-The COVID-19 pandemic, has been continuing for more than 2 years and more than 285 million cases of infection and 5.4 million deaths have been reported worldwide . In post COVID-19 conditions, general fatigue and post-exertional malaise are most common somatic sequelae It has been reported that some patients with COVID develop chronic fatigue syndrome . Hence, the present study has been conducted to investigate the presence of post covid somatic symptoms , their frequency, severity and prevalance of chronic fatigue syndrome in post-COVID-19 patients. METHODS-cross sectional study in the form of an online survey. total of 400 response were finally included after inclusion and exclusion criteria RESULTS: mean age was 36.1+/-7.7 years. the prevalence of CFS to be 12% of our study sample. The most frequent symptom among the patients who met the criteria of CFS was muscle pain (52.1%) followed by postexertional malaise lasting more than 24 hours (47.9%). Less common symptoms were unrefreshing sleep, impaired memory and sore throat CONCLUSION(S): the prevalence of chronic fatigue syndrome among the recovered COVID-19 patients was 12% and these patients show moderate to severe symptoms like fatigue, impaired memory, sore throat, tender lymph nodes, muscle pain, pain in several joints, new pattern of headache, unrefreshing sleep and postexertional malaise lasting more than 24 hours.
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Background: Persisting symptoms after SARS-COV-2 infection (COVID-19) have been widely reported in patients with critical disease, but also in those with mild or moderate illness. Our objective was to describe clinical characteristics, symptoms and the impact of treatment received in the acute phase in a cohort of postCOVID-19 patients at one-year follow-up according to their severity. Method(s): Outpatients with ongoing symptoms and those that required hospitalization were visited in the PostCOVID Unit from March 2020 to June 2021. A standardized symptom questionnaire was performed in the follow-up visit and demographic, clinical data and treatment received during the infection were collected. Subjects were divided according to their infection severity and data were compared. Result(s): At one-year of follow-up, 1966 patients were evaluated in the Post-COVID Unit of our center;1081 had mild infection, 542 moderate and 343 severe. At 12-month follow-up 728 (37%) subjects had persistent symptoms, being more frequent in mild disease compared to moderate and severe illness. The most common symptoms were dyspnea 472 (24%), fatigue 391 (19.8%), myalgia 237 (12%), anxiety 227 (11.5%) depressive symptoms 198 (10%) and memory loss 177 (8.9%). Subjects that received steroids, tocilizumab or remdesivir, presented a lower median (IQ) symptom duration [134 (64-256) vs. 258 (217-304) days, p<0.001]. Conclusion(s): Persisting symptoms are frequent after SARS-CoV-2 infection, also in less severe disease. Treatment received could have an impact on symptoms duration. Follow-up after discharge in specialized multidisciplinary postCOVID19 units is needed.
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After COVID-19 long-term sequelae are frequently reported. We aimed to longitudinally assess persistence and clusters of symptoms up to 12 months after hospitalization for COVID-19, and to assess determinants of the main persistent symptoms. In this multicenter prospective cohort study patients with COVID-19 are followed up at 3, 6, and 12 months after hospital discharge;we present interim results for persistent symptoms up to 12 months. Symptoms were clustered into physical, respiratory, cognitive, and fatigue symptoms. Of the 492 patients included, 97%, 95.5%, and 92.5% had at least 1 persisting symptom at 3, 6, and 12 months after discharge, respectively (p=0.010). Muscle weakness, exertional dyspnea, fatigue, and memory and concentration problems were the most prevalent symptoms at follow-up (>50%). Over time, muscle weakness, hair loss, and exertional dyspnea decreased significantly (p<0.001). Only the physical (p=0.025) and respiratory (p<0.001) symptom cluster declined significantly over time. Female gender was the most important predictor of persistent symptoms and co-occurrence of symptoms from all clusters. Shorter hospital stay and treatment with steroids were related to decreased muscle weakness;comorbidity and being employed were related to increased fatigue;and shorter hospital stay and comorbidity were related to memory problems. The majority of patients experienced COVID-19 sequelae up to 12 months after hospitalization. Only the physical and respiratory symptoms showed slow gradual decline. This finding stresses the importance of finding the underlying causes and effective treatments for post-COVID condition, beside adequate COVID-19 prevention.