ABSTRACT
The COVID-19 pandemic has altered people's lifestyles around the world. Prevention of recurrent episodes of the disease and mitigation of its consequences are especially associated with effective post-COVID-19 rehabilitation in patients. The aim of the study was to evaluate the effects of the drug Likopid (glucosaminylmuramyl dipeptide, GMDP) for post-COVID-19 rehabilitation in patients. Material and methods. Patients who recovered from mild to moderate COVID-19 (n=60, mean age 54+/- 11.7 years) were randomized into the observation group (n=30, 15 men and 15 women) who received 2 courses of Licopid (1 mg twice a day) and the comparison group (n=30, 15 men and 15 women). Analysis of the phenotypic and functional characteristics of the innate immune cellular factors was carried out before the start of immunomodulatory therapy, immediately after the end of the course, and also after 6 months observations. In order to assess the quality of life of all patients, we used the SF-36 Health Status Survey and the Hospital Anxiety and Depression Scale questionnaires. Results. During assessing the effect of immunomodulatory therapy on the parameters of innate immunity of patients at the stage of rehabilitation after COVID-19, an increase in the protective cytolytic activity of CD16+ and CD8+Gr+ cells, as well as a persistent increase in TLR2, TLR4 and TLR9 expression was found, which indicates the antigen recognition recovery and presentation at the level of the monocytic link of the immune system. The use of GMDP as an immunomodulatory agent resulted in an 8-fold reduction in the frequency and severity of respiratory infections due to an increase in the total monocyte count. As a result of assessing patients' quality of life against the background of the therapy, a positive dynamic in role functioning was revealed in patients. In the general assessment of their health status, an increase in physical and mental well-being was noted during 6 months of observation. The comparison group showed no improvement in the psychoemotional state. Discussion. The study demonstrated the effectiveness of GMDP immunomodulatory therapy in correcting immunological parameters for post-COVID-19 rehabilitation in patients. The data obtained are consistent with the previously discovered ability of GMDP to restore impaired functions of phagocytic cells and induce the expression of their surface activation markers, which in turn contributes to an adequate response to pathogens. Conclusion. The study revealed that the correction of immunological parameters with the use of GMDP in COVID-19 convalescents contributed not only to a decrease in the frequency and severity of respiratory infections, but also to an improvement in the psycho-emotional state of patients, and a decrease in anxiety and depression.Copyright © Eco-Vector, 2023. All rights reserved.
ABSTRACT
Objective. To evaluate some parameters of the psychosomatic state, cytokine levels (IL-6, IL-8, IL-17A), and free radical status (levels of nitrates and nitrites, antioxidant plasma activity) in convalescent patients after severe COVID-19. Patients and methods. We examined 64 patients who had severe COVID-19 and underwent either a 30-35-day course of inpatient rehabilitation after their discharge from a hospital for infectious diseases or a 60-65-day course of outpatient rehabilitation at the Ambulatory Center of Nalchik, Clinical Hospital No 1. Results. We surveyed patients after severe COVID-19 and found that they required a long rehabilitation. Many of them reported asthenic syndrome, psycho-emotional disorders, and other complaints upon discharge from the hospital. Serum levels of proinflammatory cytokines remained high in patients after severe COVID-19 even 30-35 days following their discharge (p < 0.05). Serum levels of IL-6, IL-8, nitrites, and nitrates remained elevated on days 60-65 following discharge (p < 0.05), despite comprehensive therapy in a rehabilitation department. Plasma antioxidant activity was reduced, whereas IL-17A level normalized by this time. Conclusion. Our findings suggest that currently used rehabilitation measures for COVID-19 are insufficient. Adequate rehabilitation of convalescent COVID-19 patients requires proper monitoring of their immune system condition, as well as new effective methods for immune correction and restoration of their psychoemotional status after the acute phase of the disease.Copyright © 2022, Dynasty Publishing House. All rights reserved.
ABSTRACT
COVID-19 causes acute respiratory failure syndrome (SIRA), leading patients to require intubation in the intensive care unit (ICU). A common complication of this ventilatory support is dysphagia, which has a prevalence of up to 30%.This work aims to describe rehabilitation methods in patients with coronavirus infection based on levels of evidence according to the GRADE System, so a systematic review of the literature was carried out. The selected articles were divided into the following subtopics: diagnosis of dysphagia and rehabilitation in COVID patients. The gold standard for the diagnosis of dysphagia is the videofluoroscopic swallowing study (VFS). Fiberoptic Evaluation of Swallowing Assessment (FEES) has high sensitivity and specificity, although they have the disjunction of an aerosol-generating procedure (AGP);however, in a pandemic situation, the study of choice in the literature is VF. Once the diagnosis is made, it is necessary to initiate rehabilitation as soon as possible, even from hospitalization in patients who have hemodynamic stability to prevent long-term effects and promote normal swallowing even before discharge. In patients with COVID-19 infection dysphagia, the risk-benefit of assessment tools and therapy used for diagnosis should be decided to help to maintain social distancing. It becomes imperative to carry out clinical studies with high levels of evidence that allow us to generate Clinical Practice Guides for the benefit of our patients.Copyright © 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.
ABSTRACT
The COVID-19 pandemic has set tasks for health professionals, in particular, related to the rapid diagnosis of the disease and the provision of medical care to patients with a new coronavirus infection. All over the world, scientific work is being carried out on the study of the clinical and epidemiological characteristics of the dis-ease, the development of new means of its prevention and treatment. Epidemiological studies have identified a number of physiological and other factors that increase the risk of developing severe forms of the disease. Among them: old age, as well as concomitant diseases, including diabetes mellitus, cardiovascular diseases, chronic kidney disease and others. Changes in the balance of trace elements (ME) are considered as a risk factor for the development of severe forms of COVID-19. It is especially important that this factor can potentially be influenced, especially given the potential for replenishing the ME deficit in patients with COVID-19 for the purpose of early recovery and faster rehabilitation.Copyright © 2022 Tomsk Polytechnic University, Publishing House. All rights reserved.
ABSTRACT
Each year about 400 000 people in Russia get strokes. Whereas an acute treatment takes place in specialized intensive care units in hospitals, follow-up is handed over to general (rarely - private) practitioner. The majority of stroke survivors show low adherence to follow-up resulting in repeated hospitalizations and growth of multi-morbidity burden. With COVID-19 pandemic negatively affecting availability of medical services and increasing health risks for stroke survivors, a physician-patient relation becomes the means of persuading patients to health-promoting behaviour.Copyright © 2022 University of Latvia. All Rights Reserved.
ABSTRACT
Background: Spondyloptosis is caused by high force trauma. The vast majority of cases occur in the sagittal plane and at transition points where ridged sections meet more flexible regions. Lateral thoracic spondyloptosis is extremely rare and there is no current consensus on the optimal treatment plan. Case Description: Here we present a case of a previously physically healthy 24-year-old polytrauma patient after he was struck as a pedestrian by a motor vehicle. Of note the patient was found to have lateral spondyloptosis between T9-10 with complete spinal cord transection. The patient also sustained multi-ligamentous left knee injury, pelvic fractures, open comminuted left tibia and fibular fracture, lacerated liver, bilateral renal lacerations, ischemic bowel, and an aortic arch pseudoaneurysm. Conclusion(s): Lateral thoracic spondyloptosis is a devastating injury with an extreme rate of persistent neurologic deficits. There is no unanimously accepted treatment because of the rarity if the injury and the poor outcomes that patients face. Additionally, patients who experience high level trauma often develop severe psychiatric illness, and the importance of identifying risk factors and implementing care early may improve patient outcomes.Copyright © AME Medical Journal.
ABSTRACT
Background: Shoulder joint diseases such as rotator cuff tear, adhesive capsulitis, calcific tendinitis, shoulder instability, and glenohumeral osteoarthritis often require surgical treatment. Surgical outcomes can change significantly depending on whether the postoperative rehabilitation was appropriately performed. Current Concepts: The focus of postoperative rehabilitation should be to remove pain and restore functional movement through improving the dynamic stability of the rotator cuff and shoulder muscles. However, rehabilitation should not include activities that aggravate the injury. Therefore, rehabilitation treatment should be carried out with gradual increments in exercise intensity. Postoperative rehabilitation is not only related to exercise but may also include drug administration, such as steroid injection. In particular, many investigations have been performed to identify the clinical risks and benefits of steroid injection after rotator cuff repair. Notably, telemedicine can be used as a solution for the problematic situations that have been caused by coronavirus disease 2019 pandemic. Discussion and Conclusion(s): A thorough understanding and appropriate application of postoperative rehabilitation protocols are essential to improve surgical outcomes.Copyright © Korean Medical Association.
ABSTRACT
At present, there are isolated data on the clinical outcomes of COVID-19 in children, especially those who have experienced asymptomatic and mild forms of infection. Purpose(s): to analyze the nature and frequency of post-COVID symptoms in children during 12 months. after recovery. Materials and methods. The influence of demographic indicators, premorbid background, severity of infection and therapy in the acute period of the disease on the nature and frequency of symptoms in 1079 children who underwent laboratory-confirmed COVID-19 was studied. The results are presented with proportions (%) and calculation of 95% confidence interval according to Klopper-Pearson. Differences between groups were assessed using Pearson's chi-square test. Differences in the groups were considered statistically significant at p < 0,05. Results. Health disorders in the post-COVID period were observed in 8,5% of children, more often in schoolchildren aged 7-17 years (68.4%). Concomitant conditions were found in 38,0%. In most cases, the consequences were noted after a mild form of COVID-19 (77.2%), however, 13,0% of patients experienced an asymptomatic form of infection. Among convalescents, changes in the emotional sphere (2,1%), headache (1,8%), symptoms of asthenia (1,6%), cardiovascular (1,5%), dyspeptic (1,3%) were more often observed, cognitive (1,3%) disorders, neurotic disorders (1,0%), less often respiratory (0.8%), endocrine (0,4%) and visual (0,4%) systems, musculoskeletal system were involved (0.2%). Girls were significantly more likely to have vegetative disorders, while boys were significantly more likely to suffer from cognitive functions. Various antiviral therapy options (interferon-alpha, an oral antiviral drug, or a combination thereof) in the acute period of COVID-19 did not affect the possibility of post-COVID disorders, but there was a tendency to increase the frequency in children who did not receive etiotropic treatment (control group). In 14.1% of cases, post-COVID symptoms appeared late - after 5-10 months. after recovery. The course of rehabilitation therapy, including drug treatment and non-drug methods, made it possible to quickly restore the state of health of the observed children. Conclusion. In most cases, the violations were of a functional nature, due to a disorder of autonomic regulation. Rehabilitation and dispensary observation programs will allow timely restoration of the quality of life of children who have had COVID-19, including in a mild and asymptomatic form.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
The Corona Virus Disease 2019 (COVID-19) that occurred December of 2019 has a wide range of impacts, and its epidemic situation is grim. China has a large population of liver cancer, accounting for 50% of new cases of liver cancer worldwide. How to ensure the diagnosis, treatment and rehabilitation of liver cancer patients while preventing and controlling the epidemic situation is an issue that urgently need specialists pay attention to. The authors propose an overall management model for patients with liver cancer, combined with their own experience, in order to guide specialists to safely and effectively carry out clinical diagnosis and treatment of liver cancer during the prevention and control of epidemics, and to help liver cancer patients receive treatment.Copyright © 2020 by the Chinese Medical Association.
ABSTRACT
COVID-19 has changed healthcare systems and imposed several restrictions on the delivery of pulmonary rehabilitation. To overcome this, telerehabilitation has emerged as a promising strategy. However, little is known about its effectiveness and safety. Aim(s): To present the preliminary results of the efficacy and safety of a pulmonary telerehabilitation program in a Portuguese hospital. Method(s): A pulmonary telerehabilitation program was made available by the hospital center in 2021. An initial face-toface assessment was performed in a multidisciplinary consultation. The program consisted of 3 weekly sessions and lasted 8 weeks, conducted by a rehabilitation nurse via videoconference. Patients received a kit consisting of a tensiometer, oximeter, cycle ergometer, elastic bands, and a Borg Scale. Result(s): From March 2021 to January 2022, 8 patients participated in the program. Improvements were observed in all variables evaluated: muscle strength of the lower limbs (range from19 Kg to 23 Kg) and upper limbs (range from 17 Kg to 19 Kg), 6 Minute Walk Test (range from 376.5 m to 403.5 m), Sit-to-Stand Test 1 Minute (range from 19 stands to 25 stands), Modified Medical Research Council (range from 2 to 3), COPD Assessment Test (range from 18 to 14), London Chest Activity of Daily Living (range from 25 to 19), Hospital Anxiety and Depression Scale (range from 16 to 12). There were no reports of adverse events. Conclusion(s): The threats and challenges posed by the COVID-19 pandemic present the opportunity to reorganize and improve the supply of rehabilitation care. Preliminary results from our program demonstrate that pulmonary telerehabilitation is an effective and safe alternative to traditional face-to-face intervention.
ABSTRACT
Introduction: La rééducation après une intervention chirurgicale est essentielle et conditionne le résultat fonctionnel final. Une application destinée aux patients présentant une lésion du ligament croisé antérieur (LCA) propose un programme d'auto-rééducation (Doct'up, Healing sas, Lyon, France). La pandémie COVID-19 au printemps 2020 a contraint les patients à suspendre leur rééducation postopératoire chez le kinésithérapeute pendant la période de confinement en France. Hypothèse: Une application d'auto-rééducation permet de limiter les conséquences de l'absence de rééducation chez le kinésithérapeute. Matériels et méthodes: Il s'agit d'une étude cas-témoin à partir de l'analyse rétrospective de données collectées de façon prospective incluant deux groupes de patients opérés d'une ligamentoplastie du LCA. Les patients du premier groupe (« App ») étaient opérés juste avant la période de confinement en mars 2020 en France durant la pandémie de COVID-19 et utilisaient uniquement l'application comme moyen de rééducation pendant le confinement. Un groupe de patient témoin apparié opéré 1 an plus tôt (« Standard ») bénéficiaient d'une kinésithérapie traditionnelle. Les 2 groupes bénéficiaient de la même technique de ligamentoplastie. Le critère de jugement principal était l'apparition d'un flexum à 6 semaines. Les critères de jugement secondaires étaient : le flexum du genou à 3 semaines et 6 mois, le réveil du muscle quadriceps et le verrouillage de l'extension du genou à 3 et 6 semaines et le taux de reprise chirurgicale pour syndrome du cyclope à 6 mois. Résultats: Trente-deux patients ont été inclus dans le groupe « App » et 101 patients dans le groupe « Standard ». Après auto-rééducation avec l'application seule, il n'existait pas de différence significative dans les 2 groupes concernant l'apparition d'un flexum à 6 semaines : 9,4% [28/32] vs 4,6% [87/101] p = 0,39. Il existait un meilleur réveil quadricipital (94% [30/32] vs 73% [74/101], p = 0,015) et un meilleur contrôle de l'extension avec cannes (78,1% [25/32] vs 40,6% [41/101], p = 0,0002) à 3 semaines. Il n'y a pas de différence entre les 2 groupes pour les autres critères étudiés (flexum à 3 semaines : 12,5% [4/32] vs 13,8% [14/101];flexum à 6 mois : 3,2% [1/32] vs 1% [1/101], réveil quadricipital à 6 semaines : 97% [31/32] vs 99% [100/101];verrouillage de l'extension avec cannes à 6 semaines : 96,9% [31/32] vs 93,1% [94/101], verrouillage de l'extension sans cannes à 3 semaines : 53,2% [17/32] vs 47,5% [48/101];verrouillage de l'extension sans cannes à 6 semaines : 93,7% [30/32] vs 82,2% [83/101], taux de syndrome du cyclope : 3,1% [1/32] vs 1% [1/101]). Discussion: Une application d'auto-rééducation après chirurgie du LCA utilisée dans le contexte de confinement imposée par la pandémie COVID-19 permet de limiter les conséquences liées à l'absence de kinésithérapeutes et a montré des résultats équivalents à ceux obtenus après rééducation standard avec un recul de 6 mois postopératoire. L'étude montre que l'auto-rééducation après chirurgie du genou est utile en postopératoire après chirurgie du LCA et pourrait être généralisée en complément des protocoles habituellement utilisés chez le kinésithérapeute. Niveau de preuve: IV;Étude rétrospective monocentrique de cohorte. © 2022 Elsevier Masson SAS
ABSTRACT
Background: A proportion of patients with COVID-19 become critically ill, but few studies describe the functional outcomes and rehabilitation process of these patients. Objective(s): To describe the complications encountered and functional outcomes of critically ill COVID-19 patients requiring intubation and subsequent intensive care unit (ICU) management and rehabilitation. Method(s): Retrospective case note review was conducted on all patients requiring intubation and ICU admission and subsequently discharged from our hospital from February 15, 2020 to May 1, 2020. Demographics, preexisting medical conditions, complications encountered in ICU, ICU and General Ward Length of Stay, number of therapy sessions delivered, nutritional data, and functional outcomes on discharge were collected from electronic medical records and entered in a deidentified database. Result(s): Most patients developed significant breathlessness affecting post-ICU rehabilitation, a few patients developed ICU associated delirium while no patient developed ICU-associated weakness. All patients survived and could walk 20 m within 12 days post-extubation. Conclusion(s): Early ICU and sustained post-ICU rehabilitation of critically ill, intubated COVID-19 patients is feasible. Further studies could look into the outcomes of this group of patients, in particular the effect of nutrition and pulmonary training on functional outcomes. We strongly recommend an interdisciplinary rehabilitation team approach in managing critically ill COVID-19 patients. Copyright © The Author(s) 2022.
ABSTRACT
Safety monitoring of COVID-19 vaccination is paramount of importance. There are limited reports of Guillain-Barré syndrome (GBS) associated with the COVID-19 vaccination. The present study reported a case of GBS following the first dose of the Oxford-AstraZeneca SARS-CoV-2 vaccine. A 32-year-old man presented a history of progressive descending weakness and autonomic features within a month after receiving the Oxford-AstraZeneca SARS-CoV-2 vaccine. The neurological examination was consistent with acute polyneuropathy. The para-clinical investigations were in favor of acute demyelinating polyneuropathy. The patient was diagnosed with GBS, and IVIG was initiated as an acute treatment, which led to significant clinical recovery. We reported a case of GBS after receiving the Oxford-AstraZeneca vaccine. However, our findings dose not conclude a causal association between GBS and COVID-19 vaccination.
ABSTRACT
6 months following an acute infection with SARS-CoV-2 virus with a moderate or severe course of Corona Virus Disease 2019 (COVID-19), a majority of patients is still suffering from sequelae which are defined as „post COVID syndrome“ or „long COVID“. Symptoms are heterogenous and can be of respiratory, neurological, musculoskeltal, cardiovascular, mental or cognitive nature. As the virus entrance into the organism via the lungs, this organ is involved in a unique manner. As a consequence of COVID-19, abnormalities of the lungs may lead to impaired gas exchange and result in a reduced blood oxygenation, especially during exercise. In order to address the intensity and diversity of symptoms, an inpatient pulmonary rehabilitation program is recommended. Beside diagnostics and pharmaceutical optimization, the multimodal approach includes several therapeutic components like exercise training, breathing therapy and psychological counseling. According to constantly new insights into this field, therapies have to be adapted permanently. An optimal postacute care, which ideally already starts during hospital stay, targets the improvement of exercise capacity, health-related quality of life as well as a reduction of ongoing symptoms in order to optimize patients daily life self-sufficiency.
ABSTRACT
The coronavirus disease 2019 epidemic affected severely and rapidly the Oise department. The care of patients infected with this virus required a review of the organization of the units. The healthcare executive has been a key player in the management of this health crisis. Example in a follow-up care and rehabilitation service.