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1.
Respir Res ; 23(1): 115, 2022 May 04.
Article in English | MEDLINE | ID: covidwho-1822194

ABSTRACT

BACKGROUND: Published studies suggest physical recovery from the COVID-19 is complex, with many individuals experiencing persistent symptoms. There is a paucity of data investigating the longer-term trajectory of physical recovery from COVID-19. METHODS: A prospective longitudinal design was utilised to investigate the impact COVID-19 has on physical functioning at 10-weeks (T1), 6-months (T2) and 1-year (T3) post-hospital discharge. Objective measures of recovery included 6-Minute Walk Test Distance (6MWTD), frailty (Clinical Frailty Scale), quantification of falls following hospital-discharge, return to work status and exercise levels. Subjective markers included symptoms (COVID-19-Specific Patient Concerns Assessment), fatigue (Chalder Fatigue Score) and health-related quality of life (HrQOL) [Short-Form-36 Health Survey Questionnaire (SF-36-II)]. Univariate analysis was performed using t-test, Wilcoxon rank-sum, and Chi-squared test, paired analysis using one-way analysis of variance and Krustal Wallis testing and correlation analysis with Spearman correlation tests. RESULTS: Sixty-one subjects participated. Assessments were conducted at a median of 55 days(T1), 242 days(T2), and 430 days(T3) following hospital-discharge. 6MWTD improved significantly overtime (F = 10.3, p < 0.001) from 365(209)m at T1 to 447(85)m at T3, however remained below population norms and with no associated improvement in perceived exertion. Approximately half (n = 27(51%)) had returned to pre-diagnosis exercise levels at T3. At least one concern/symptom was reported by 74%, 59% and 64% participants at T1, T2 and T3 respectively. Fatigue was the most frequently reported symptom at T1(40%) and T2(49%), while issues with memory/concentration was the most frequently reported at T3(49%). SF-36 scores did not change in any domain over the study period, and scores remained lower than population norms in the domains of physical functioning, energy/vitality, role limitations due to physical problems and general health. Return-to-work rates are low, with 55% of participants returning to work in some capacity, and 31% of participants don't feel back to full-health at 1-year following infection. CONCLUSION: Hospitalised COVID-19 survivors report persistent symptoms, particularly fatigue and breathlessness, low HrQOL scores, sub-optimal exercise levels and continued work absenteeism 1-year following infection, despite some objective recovery of physical functioning. Further research is warranted to explore rehabilitation goals and strategies to optimise patient outcomes during recovery from COVID-19. CLINICAL MESSAGE: Hospitalised COVID-19 survivors report significant ongoing rehabilitation concerns 1-year following infection, despite objective recovery of physical functioning. Our findings suggest those who returned to exercise within 1-year may have less fatigue and breathlessness. The impact of exercise, and other rehabilitative strategies on physical functioning outcomes following COVID-19 should be investigated in future research.


Subject(s)
COVID-19 , Frailty , Cohort Studies , Dyspnea , Fatigue/diagnosis , Fatigue/epidemiology , Humans , Longitudinal Studies , Prospective Studies , Quality of Life
2.
Future Microbiol ; 17: 577-588, 2022 May.
Article in English | MEDLINE | ID: covidwho-1775595

ABSTRACT

Background: Whether long coronavirus disease pertains to children as well is not yet clear. Methods: The authors performed a survey in children suffering from persistent symptoms since initial infection. A total of 510 children infected between January 2020 and January 2021 were included. Results: Symptoms such as fatigue, headache, muscle and joint pain, rashes and heart palpitations and issues such as lack of concentration and short-term memory problems were particularly frequent and confirm previous observations, suggesting that they may characterize this condition. Conclusion: A better comprehension of long coronavirus disease is urgently needed.


Subject(s)
COVID-19 , Mental Health , Child , Fatigue/diagnosis , Humans , SARS-CoV-2 , Surveys and Questionnaires
3.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 65(4): 471-480, 2022 Apr.
Article in German | MEDLINE | ID: covidwho-1748538

ABSTRACT

BACKGROUND AND OBJECTIVES: Employees from medical and nursing professions are at increased risk for a SARS-CoV­2 infection and thus more frequently affected by COVID-19 sequelae. Previous studies have identified post-viral fatigue as the most common sequelae. The aim of this study was to investigate risk factors and effects induced by clinically relevant fatigue symptoms following a COVID-19 infection of healthcare workers. METHODS: In the spring of 2021, 4315 insured members of the Statutory Accident Insurance and Prevention in the Health and Welfare Service were contacted for a written survey on their COVID-19 disease in 2020 and its sequelae. Information on Symptoms of acute infection, disease sequelae, and potential risk factors were collected, as well as the physical and mental health status after SARS-CoV­2 infection. The general fatigue scale of the Multidimensional Fatigue Inventory (MFI) was used as fatigue screening. Regression analyses and multivariate analyses of variance were calculated for data analysis. RESULTS: Of the respondents, 10.7% showed severe fatigue symptoms. Identified risk factors for clinical fatigue symptoms included preexisting mental and respiratory conditions and severity of acute infection. Furthermore, severe long-/post-COVID fatigue was associated with higher psychological distress, lower health-related quality of life, and more frequent incapacity to work. CONCLUSIONS: Severe long-/post-COVID fatigue is associated with a high level of distress, which requires specific rehabilitation approaches and poses a challenge to the social insurance agencies and accident insurers to develop appropriate rehabilitation concepts.


Subject(s)
COVID-19 , Fatigue/diagnosis , Fatigue/epidemiology , Fatigue/etiology , Germany/epidemiology , Health Personnel , Humans , Quality of Life , Risk Factors , SARS-CoV-2
4.
World J Pediatr ; 18(3): 149-159, 2022 03.
Article in English | MEDLINE | ID: covidwho-1729410

ABSTRACT

BACKGROUND: The majority of coronavirus disease 2019 (COVID-19) symptom presentations in adults and children appear to run their course within a couple of weeks. However, a subgroup of adults has started to emerge with effects lasting several months or more after initial infection, which raises questions about the long-term physical, mental and social health effects of COVID-19 in the pediatric population. The purpose of this review was to determine these impacts well into the second year of the pandemic. METHODS: A search was conducted using PubMed, Web of Science, Science Direct, and Cochrane between 11/1/2019 and 9/1/2021. Search inclusion criteria were as follows: (1) COVID-19 illness and symptoms in children; (2) severe acute respiratory syndrome coronavirus 2 in children; (3) English language; and (4) human studies only. RESULTS: The few studies that have documented long-term physical symptoms in children show that fatigue, difficulty in concentrating (brain fog), sleep disturbances, and sensory problems are the most reported outcomes. Most studies examining the impact of COVID-19 in pediatric populations have focused on initial clinical presentation, and symptoms, which are similar to those in adult populations. In addition, COVID-19 has had a moderate impact on children and adolescents' social environment, which may exacerbate current and future physiological, psychological, behavioral, and academic outcomes. CONCLUSIONS: There are limited studies reporting long physical symptoms of COVID-19 in the pediatric population. However, pediatric COVID-19 cases are underreported due to low rates of testing and symptomatic infection, which calls for more longitudinal studies. Children who have experienced COVID-19 illness should be monitored for long physiological, psychological, behavioral, and academic outcomes.


Subject(s)
COVID-19 , Adolescent , Adult , Child , Fatigue/diagnosis , Fatigue/epidemiology , Fatigue/etiology , Humans , Pandemics , Physical Examination , SARS-CoV-2
5.
BMC Public Health ; 22(1): 292, 2022 02 12.
Article in English | MEDLINE | ID: covidwho-1690932

ABSTRACT

BACKGROUND: Work fatigue is a work-related condition that affects physicians' health, work attitude safety and performance. Work fatigue affects not only medical workers but can also leave a negative impact on patients. With the burden of the COVID-19 pandemic as well as the economic crisis Lebanese doctors have been facing in the last 2 years, the aim of our study was to validate the 3D-Work Fatigue Inventory (3D-WFI) among Lebanese physicians and assess the rate and correlates of work fatigue (physical, mental and emotional). METHODS: A cross-sectional study was undertaken through an anonymous self-administered questionnaire between October 2020 and January 2021. The SPSS AMOS software v.24 was used to conduct confirmatory factor analysis (CFA). To validate the 3D-WFI, multiple indices of goodness-of-fit were described: the Relative Chi-square (χ2/df) (cut-off values:< 2-5), the Root Mean Square Error of Approximation (RMSEA) (close and acceptable fit are considered for values < 0.05 and < 0.11 respectively), the Tucker Lewis Index (TLI) and the Comparative Fit Index (CFI) (acceptable values are ≥0.90). RESULTS: A total of 401 responses was collected; 66.1, 64.8 and 65.1% respondents had an intermediate to high level of emotional, mental and physical work fatigue respectively. The fit indices obtained in the CFA of the 3D-WFI items fitted well: CFI =0.98, TLI =0.98, RMSEA = 0.05; 95% CI 0.046-0.063; pclose = 0.20) and χ2(136) = 295.76. The correlation coefficients between the three factors (Factor 1 = Physical work fatigue, Factor 2 = Mental work fatigue, Factor 3 = Emotional work fatigue) were adequate as well: Factor 1-Factor 2 (r = 0.70), Factor 1-Factor 3 (r = 0.52) and Factor 2-Factor 3 (r = 0.65). In addition, feeling pressured by long working hours during the pandemic, having more hours of night duty per month, more stressful events in life, and higher depression were significantly associated with more physical and mental work fatigue. Higher depression and having more stressful events in life were significantly associated with more emotional work fatigue. CONCLUSION: Work fatigue in Lebanese physicians seems to be associated with higher level of everyday stress, high work load and depression. Hospitals and local health authorities can use these results for early interventions that aim to reduce work fatigue and ensure the wellbeing of Lebanese physicians.


Subject(s)
COVID-19 , Physicians , Cross-Sectional Studies , Factor Analysis, Statistical , Fatigue/diagnosis , Fatigue/epidemiology , Humans , Pandemics , Psychometrics , Reproducibility of Results , SARS-CoV-2 , Students , Surveys and Questionnaires
6.
Neurol Sci ; 43(2): 1007-1014, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1669827

ABSTRACT

OBJECTIVES: To evaluate the concordance between Google Maps® application (GM®) and clinical practice measurements of ambulatory function (e.g., Ambulation Score (AS) and respective Expanded Disability Status Scale (EDSS)) in people with multiple sclerosis (pwMS). MATERIALS AND METHODS: This is a cross-sectional multicenter study. AS and EDSS were calculated using GM® and routine clinical methods; the correspondence between the two methods was assessed. A multinomial logistic model is investigated which demographic (age, sex) and clinical features (e.g., disease subtype, fatigue, depression) might have influenced discrepancies between the two methods. RESULTS: Two hundred forty-three pwMS were included; discrepancies in AS and in EDDS assessments between GM® and routine clinical methods were found in 81/243 (33.3%) and 74/243 (30.4%) pwMS, respectively. Progressive phenotype (odds ratio [OR] = 2.8; 95% confidence interval [CI] 1.1-7.11, p = 0.03), worse fatigue (OR = 1.03; 95% CI 1.01-1.06, p = 0.01), and more severe depression (OR = 1.1; 95% CI 1.04-1.17, p = 0.002) were associated with discrepancies between GM® and routine clinical scoring. CONCLUSION: GM® could easily be used in a real-life clinical setting to calculate the AS and the related EDSS scores. GM® should be considered for validation in further clinical studies.


Subject(s)
Multiple Sclerosis , Search Engine , Cross-Sectional Studies , Disability Evaluation , Fatigue/diagnosis , Fatigue/epidemiology , Humans , Multiple Sclerosis/diagnosis
7.
J Neurol Sci ; 434: 120162, 2022 Mar 15.
Article in English | MEDLINE | ID: covidwho-1654797

ABSTRACT

IMPORTANCE: Neurological and neuropsychiatric symptoms that persist or develop three months after the onset of COVID-19 pose a significant threat to the global healthcare system. These symptoms are yet to be synthesized and quantified via meta-analysis. OBJECTIVE: To determine the prevalence of neurological and neuropsychiatric symptoms reported 12 weeks (3 months) or more after acute COVID-19 onset in adults. DATA SOURCES: A systematic search of PubMed, EMBASE, Web of Science, Google Scholar and Scopus was conducted for studies published between January 1st, 2020 and August 1st, 2021. The systematic review was guided by Preferred Reporting Items for Systematic Review and Meta-Analyses. STUDY SELECTION: Studies were included if the length of follow-up satisfied the National Institute for Healthcare Excellence (NICE) definition of post-COVID-19 syndrome (symptoms that develop or persist ≥3 months after the onset of COVID-19). Additional criteria included the reporting of neurological or neuropsychiatric symptoms in individuals with COVID-19. DATA EXTRACTION AND SYNTHESIS: Two authors independently extracted data on patient characteristics, hospital and/or ICU admission, acute-phase COVID-19 symptoms, length of follow-up, and neurological and neuropsychiatric symptoms. MAIN OUTCOME(S) AND MEASURE(S): The primary outcome was the prevalence of neurological and neuropsychiatric symptoms reported ≥3 months post onset of COVID-19. We also compared post-COVID-19 syndrome in hospitalised vs. non-hospitalised patients, with vs. without ICU admission during the acute phase of infection, and with mid-term (3 to 6 months) and long-term (>6 months) follow-up. RESULTS: Of 1458 articles, 19 studies, encompassing a total of 11,324 patients, were analysed. Overall prevalence for neurological post-COVID-19 symptoms were: fatigue (37%, 95% CI: 24%-50%), brain fog (32%, 9%-55%), memory issues (27%, 18%-36%), attention disorder (22%, 10%-34%), myalgia (18%, 4%-32%), anosmia (12%, 7%-17%), dysgeusia (11%, 4%-17%) and headache (10%, 1%-21%). Neuropsychiatric conditions included sleep disturbances (31%, 18%-43%), anxiety (23%, 13%-33%) and depression (12%, 7%-21%). Neuropsychiatric symptoms substantially increased in prevalence between mid- and long-term follow-up. Compared to non-hospitalised patients, patients hospitalised for acute COVID-19 had reduced frequency of anosmia, anxiety, depression, dysgeusia, fatigue, headache, myalgia, and sleep disturbance at three (or more) months post-infection. Conversely, hospital admission was associated with higher frequency of memory issues (OR: 1.9, 95% CI: 1.4-2.3). Cohorts with >20% of patients admitted to the ICU during acute COVID-19 experienced higher prevalence of fatigue, anxiety, depression, and sleep disturbances than cohorts with <20% of ICU admission. CONCLUSIONS AND RELEVANCE: Fatigue, cognitive dysfunction (brain fog, memory issues, attention disorder) and sleep disturbances appear to be key features of post-COVID-19 syndrome. Psychiatric manifestations (sleep disturbances, anxiety, and depression) are common and increase significantly in prevalence over time. Randomised controlled trials are necessary to develop intervention strategy to reduce disease burden.


Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , Anxiety/etiology , Anxiety/psychology , COVID-19/complications , COVID-19/epidemiology , Fatigue/diagnosis , Headache/epidemiology , Humans
8.
Ann Neurol ; 91(3): 367-379, 2022 03.
Article in English | MEDLINE | ID: covidwho-1636023

ABSTRACT

OBJECTIVE: The purpose of this study was to describe cerebrovascular, neuropathic, and autonomic features of post-acute sequelae of coronavirus disease 2019 ((COVID-19) PASC). METHODS: This retrospective study evaluated consecutive patients with chronic fatigue, brain fog, and orthostatic intolerance consistent with PASC. Controls included patients with postural tachycardia syndrome (POTS) and healthy participants. Analyzed data included surveys and autonomic (Valsalva maneuver, deep breathing, sudomotor, and tilt tests), cerebrovascular (cerebral blood flow velocity [CBFv] monitoring in middle cerebral artery), respiratory (capnography monitoring), and neuropathic (skin biopsies for assessment of small fiber neuropathy) testing and inflammatory/autoimmune markers. RESULTS: Nine patients with PASC were evaluated 0.8 ± 0.3 years after a mild COVID-19 infection, and were treated as home observations. Autonomic, pain, brain fog, fatigue, and dyspnea surveys were abnormal in PASC and POTS (n = 10), compared with controls (n = 15). Tilt table test reproduced the majority of PASC symptoms. Orthostatic CBFv declined in PASC (-20.0 ± 13.4%) and POTS (-20.3 ± 15.1%), compared with controls (-3.0 ± 7.5%, p = 0.001) and was independent of end-tidal carbon dioxide in PASC, but caused by hyperventilation in POTS. Reduced orthostatic CBFv in PASC included both subjects without (n = 6) and with (n = 3) orthostatic tachycardia. Dysautonomia was frequent (100% in both PASC and POTS) but was milder in PASC (p = 0.002). PASC and POTS cohorts diverged in frequency of small fiber neuropathy (89% vs 60%) but not in inflammatory markers (67% vs 70%). Supine and orthostatic hypocapnia was observed in PASC. INTERPRETATION: PASC following mild COVID-19 infection is associated with multisystem involvement including: (1) cerebrovascular dysregulation with persistent cerebral arteriolar vasoconstriction; (2) small fiber neuropathy and related dysautonomia; (3) respiratory dysregulation; and (4) chronic inflammation. ANN NEUROL 2022;91:367-379.


Subject(s)
Blood Pressure/physiology , COVID-19/complications , Cerebrovascular Circulation/physiology , Heart Rate/physiology , Inflammation Mediators/blood , Adult , COVID-19/blood , COVID-19/diagnosis , COVID-19/physiopathology , Fatigue/blood , Fatigue/diagnosis , Fatigue/physiopathology , Female , Humans , Male , Middle Aged , Orthostatic Intolerance/blood , Orthostatic Intolerance/diagnosis , Orthostatic Intolerance/physiopathology , Retrospective Studies
11.
Trials ; 22(1): 867, 2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1551219

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) results in debilitating long-term symptoms, often referred to as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), in a substantial subgroup of patients. One of the most prevalent symptoms following COVID-19 is severe fatigue. Prompt delivery of cognitive behavioural therapy (CBT), an evidence-based treatment that has shown benefit in reducing severe fatigue in other conditions, may reduce post-COVID-19 fatigue. Based on an existing CBT protocol, a blended intervention of 17 weeks, Fit after COVID, was developed to treat severe fatigue after the acute phase of infection with SARS-CoV-2. METHOD: The ReCOVer study is a multicentre 2-arm randomised controlled trial (RCT) to test the efficacy of Fit after COVID on severe post-infectious fatigue. Participants are eligible if they report severe fatigue 3 up to and including 12 months following COVID-19. One hundred and fourteen participants will be randomised to either Fit after COVID or care as usual (ratio 1:1). The primary outcome, the fatigue severity subscale of the Checklist Individual Strength (CIS-fatigue), is assessed in both groups before randomisation (T0), directly post CBT or following care as usual (T1), and at follow-up 6 months after the second assessment (T2). In addition, a long-term follow-up (T3), 12 months after the second assessment, is performed in the CBT group only. The primary objective is to investigate whether CBT will lead to a significantly lower mean fatigue severity score measured with the CIS-fatigue across the first two follow-up assessments (T1 and T2) as compared to care as usual. Secondary objectives are to determine the proportion of participants no longer being severely fatigued (operationalised in different ways) at T1 and T2 and to investigate changes in physical and social functioning, in the number and severity of somatic symptoms and in problems concentrating across T1 and T2. DISCUSSION: This is the first trial testing a cognitive behavioural intervention targeting severe fatigue after COVID-19. If Fit after COVID is effective in reducing fatigue severity following COVID-19, this intervention could contribute to alleviating the long-term health consequences of COVID-19 by relieving one of its most prevalent and distressing long-term symptoms. TRIAL REGISTRATION: Netherlands Trial Register NL8947 . Registered on 14 October 2020.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , COVID-19/complications , Fatigue/diagnosis , Fatigue/etiology , Fatigue/therapy , Humans , Multicenter Studies as Topic , Randomized Controlled Trials as Topic , SARS-CoV-2 , Treatment Outcome
13.
Respiration ; 101(2): 132-141, 2022.
Article in English | MEDLINE | ID: covidwho-1435123

ABSTRACT

BACKGROUND: Multicentre studies focussing on specific long-term post-COVID-19 symptoms are scarce. OBJECTIVE: The aim of this study was to determine the levels of fatigue and dyspnoea, repercussions on daily life activities, and risk factors associated with fatigue or dyspnoea in COVID-19 survivors at long term after hospital discharge. METHODS: Age, gender, height, weight, symptoms at hospitalization, pre-existing medical comorbidity, intensive care unit admission, and the presence of cardio-respiratory symptoms developed after severe acute respiratory syndrome coronavirus 2 infection were collected from patients who recovered from COVID-19 at 4 hospitals in Madrid (Spain) from March 1 to May 31, 2020 (first COVID-19 wave). The Functional Impairment Checklist was used for evaluating fatigue/dyspnoea levels and functional limitations. RESULTS: A total of 1,142 patients (48% women, age: 61, standard deviation [SD]: 17 years) were assessed 7.0 months (SD 0.6) after hospitalization. Fatigue was present in 61% patients, dyspnoea with activity in 55%, and dyspnoea at rest in 23.5%. Only 355 (31.1%) patients did not exhibit fatigue and/or dyspnoea 7 months after hospitalization. Forty-five per cent reported functional limitations with daily living activities. Risk factors associated with fatigue and dyspnoea included female gender, number of pre-existing comorbidities, and number of symptoms at hospitalization. The number of days at hospital was a risk factor just for dyspnoea. CONCLUSIONS: Fatigue and/or dyspnoea were present in 70% of hospitalized COVID-19 survivors 7 months after discharge. In addition, 45% patients exhibited limitations on daily living activities. Being female, higher number of pre-existing medical comorbidities and number of symptoms at hospitalization were risk factors associated to fatigue/dyspnoea in COVID-19 survivors 7 months after hospitalization.


Subject(s)
COVID-19/complications , Dyspnea/epidemiology , Dyspnea/virology , Fatigue/epidemiology , Fatigue/virology , Activities of Daily Living , Aged , COVID-19/diagnosis , COVID-19/psychology , Cohort Studies , Cross-Sectional Studies , Dyspnea/diagnosis , Fatigue/diagnosis , Female , Hospitalization , Humans , Incidence , Male , Middle Aged , Risk Factors , Sex Factors , Spain , Symptom Assessment , Time Factors
14.
Int J Public Health ; 66: 1604260, 2021.
Article in English | MEDLINE | ID: covidwho-1430755

ABSTRACT

Objectives: The chronic restrictions to mitigate the new SARS-CoV-2 virus may result in pandemic fatigue. This study set out to develop a short, reliable, valid, and gender-invariant instrument-the Pandemic Fatigue Scale (PFS). Methods: In the first phase, 300 students responded to a pilot questionnaire that allowed the reduction and refinement of the items. In the second phase, the validity, reliability, and invariance of the scale were explored among a sample of 596 participants. Results: Factor exploratory and confirmatory analyses confirmed a robust adjustment for the bifactorial structure that explained 79,36% of the variance. The two factors identified were 1) people's demotivation in continuing to follow the recommended protective behaviors (neglect) and 2) people's boredom regarding the pandemic-related information (boredom). The pattern of relations between the Pandemic Fatigue Scale and other variables-find through correlation, mediation, and path analyses-and the gender differences-find in the ANOVA analyses-provided strong evidence of the construct validity. Moreover, the PFS was shown to be invariant regarding gender in a multigroup factor confirmatory analysis. Conclusion: The instrument can be of utility for professionals and researchers to assess pandemic fatigue, a variable that can affect the adoption of protective measure to avoid catching and spreading the virus.


Subject(s)
COVID-19 , Fatigue , Pandemics , Surveys and Questionnaires , COVID-19/epidemiology , COVID-19/psychology , Fatigue/diagnosis , Humans , Public Health , Reproducibility of Results
17.
Sci Rep ; 11(1): 16144, 2021 08 09.
Article in English | MEDLINE | ID: covidwho-1349688

ABSTRACT

COVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17-87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.


Subject(s)
Alopecia/diagnosis , Attention Deficit Disorder with Hyperactivity/diagnosis , COVID-19/complications , Dyspnea/diagnosis , Fatigue/diagnosis , Headache/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Alopecia/complications , Attention Deficit Disorder with Hyperactivity/complications , COVID-19/virology , Dyspnea/complications , Fatigue/complications , Headache/complications , Humans , Middle Aged , SARS-CoV-2/physiology , Young Adult
18.
Diabetes Metab Syndr ; 15(5): 102235, 2021.
Article in English | MEDLINE | ID: covidwho-1330757

ABSTRACT

BACKGROUND AND AIMS: Post Covid-19 syndrome (PCS) is a major cause of morbidity. In this article we intend to review the association and consequences of PCS and diabetes. METHODS: We reviewed all studies on "Long Covid", "Post COVID-19 Syndrome" and diabetes in PubMed and Google Scholar. RESULTS: The symptoms of PCS can be due to organ dysfunction, effects of hospitalisation and drugs, or unrelated to these. Type 2 diabetes mellitus has a bidirectional relationship with COVID-19. Presence of diabetes also influences PCS via various pathophysiological mechanisms. COVID-19 can add to or exacerbate tachycardia, sarcopenia (and muscle fatigue), and microvascular dysfunction (and organ damage) in patients with diabetes. CONCLUSION: PCS in patients with diabetes could be detrimental in multiple ways. Strict control of diabetes and other comorbidities, supervised rehabilitation and physical exercise, and optimal nutrition could help in reducing and managing PCS.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/etiology , COVID-19/therapy , Comorbidity , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Fatigue/diagnosis , Fatigue/epidemiology , Fatigue/etiology , Fatigue/therapy , Humans , SARS-CoV-2/physiology , Sarcopenia/diagnosis , Sarcopenia/epidemiology , Sarcopenia/etiology , Sarcopenia/therapy , Tachycardia/diagnosis , Tachycardia/epidemiology , Tachycardia/etiology , Tachycardia/therapy
19.
PLoS One ; 16(7): e0254999, 2021.
Article in English | MEDLINE | ID: covidwho-1325438

ABSTRACT

Over the past few months, the spread of the current COVID-19 epidemic has caused tremendous damage worldwide, and unstable many countries economically. Detailed scientific analysis of this event is currently underway to come. However, it is very important to have the right facts and figures to take all possible actions that are needed to avoid COVID-19. In the practice and application of big data sciences, it is always of interest to provide the best description of the data under consideration. The recent studies have shown the potential of statistical distributions in modeling data in applied sciences, especially in medical science. In this article, we continue to carry this area of research, and introduce a new statistical model called the arcsine modified Weibull distribution. The proposed model is introduced using the modified Weibull distribution with the arcsine-X approach which is based on the trigonometric strategy. The maximum likelihood estimators of the parameters of the new model are obtained and the performance these estimators are assessed by conducting a Monte Carlo simulation study. Finally, the effectiveness and utility of the arcsine modified Weibull distribution are demonstrated by modeling COVID-19 patients data. The data set represents the survival times of fifty-three patients taken from a hospital in China. The practical application shows that the proposed model out-classed the competitive models and can be chosen as a good candidate distribution for modeling COVID-19, and other related data sets.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Models, Statistical , Pandemics , SARS-CoV-2/pathogenicity , COVID-19/diagnosis , COVID-19/physiopathology , China/epidemiology , Cough/diagnosis , Cough/physiopathology , Fatigue/diagnosis , Fatigue/physiopathology , Fever/diagnosis , Fever/physiopathology , Hospitals , Humans , Monte Carlo Method , Survival Analysis
20.
J Prim Care Community Health ; 12: 21501327211030413, 2021.
Article in English | MEDLINE | ID: covidwho-1299318

ABSTRACT

OBJECTIVE: Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. METHODS: A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. RESULTS: The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). CONCLUSION: Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients' clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.


Subject(s)
COVID-19 , Cross-Sectional Studies , Fatigue/diagnosis , Fatigue/epidemiology , Fatigue/etiology , Female , Health Status , Humans , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires
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