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1.
Occup Ther Int ; 2022: 4590154, 2022.
Article in English | MEDLINE | ID: covidwho-1807690

ABSTRACT

Persons with post-COVID-19 conditions have prolonged symptoms and longer-term consequences which can prevent them from returning to previous everyday functioning. Fatigue is the most frequent symptom reported in literature. Occupational therapists (OTs) are specialized in client-centered problem analysis, counseling, and education to recover occupational engagement and performance in everyday life. Since the beginning of the COVID-19 pandemic, OTs have been challenged to respond with services adequate to the needs of this patient group. Energy management education (EME) was initially developed for persons with multiple sclerosis-related fatigue and then made independent of diagnosis suitable to persons living with chronic disease-related fatigue. EME, a structured self-management education, is becoming a part of the new services. This study was aimed at exploring the initial experiences of OTs using the EME protocol and materials with persons with postacute COVID-19 and/or post-COVID-19 condition-related fatigue and gathering their recommendations for improvements and adaptions. One online focus group discussion took place in May 2021 with OTs experienced in using the EME protocol. The topics addressed were the institutional context of the OTs and their experiences during the treatment. A thematic analysis was performed. According to nine OTs working in different settings in Switzerland, the EME protocol is exploitable in both in- and outpatient settings and was judged appropriate by them, even if the EME materials can be improved. The main challenges for the OTs were the short period their patients had lived with fatigue; the discrepancy between self-concept, self-perception, and performance; and the insecurity, fear, and anxiety related to recovery. Further research is needed to include the perspective of EME participants and to measure quantitative outcomes such as fatigue impact, self-efficacy, occupational performance, and quality of life. Until the existing EME protocol is improved, it is applicable to persons with post-COVID-19 condition-related fatigue.


Subject(s)
COVID-19 , Occupational Therapy , Fatigue/etiology , Fatigue/therapy , Focus Groups , Humans , Occupational Therapy/methods , Pandemics , Quality of Life
2.
BMJ Open ; 12(3): e051808, 2022 03 17.
Article in English | MEDLINE | ID: covidwho-1752873

ABSTRACT

OBJECTIVES: To determine the effectiveness of virtual reality (VR)-based intervention on the symptoms and rehabilitation management in patients with breast cancer. DESIGN: Systematic review and meta-analysis. STUDY SELECTION: We included all eligible randomised controlled trials and quasi-experimental studies (published in English and Chinese). PARTICIPANTS: Patients with breast cancer (≥18 years) undergoing cancer treatment. INTERVENTIONS: Any intervention administered to improve the symptoms and rehabilitation of patients with breast cancer. The control group was given conventional care. OUTCOMES: All outcomes were as follows: pain, fatigue, anxiety, depressive symptoms, cognitive function, and range of motion of upper limb in patients with breast cancer. DATA SOURCES: We searched PubMed, Embase, CENTRAL and SinoMed, four electronic databases, covering the database establishment period to January 2022. REVIEW METHODS: Two reviewers independently extracted content and data consistent with the prespecified framework and assessed risk bias. Random-effects meta-analysis was used to pool data across trials. Meta-analysis was performed using Review Manager V.5.4. RESULTS: A total of eight studies met the eligibility criteria and were included in this study. The combined effect size showed that VR was positive for improving patients' anxiety(standard mean differenc (SMD)=-2.07, 95% CI= (-3.81 to -0.34), I2=95%) and abduction of upper limbs (MD=15.54, 95% CI= (12.79 to 18.29), I2=0%), but fatigue (SMD=-0.92, 95% CI= (-4.47 to 2.62), I2=99%) was not. Qualitative analysis showed VR improved patients' depressive symptoms, pain and cognitive function. CONCLUSIONS: VR technology has a good effect on symptoms and rehabilitation management of patients with breast cancer, but the quality of evidence is low, and the sample size is small. To date, there are few intervention studies, therefore, giving precise recommendation or conclusion is difficult. We have a favourable view of this, and more clinical studies are needed in the future to improve the credibility of the results.


Subject(s)
Breast Neoplasms , Virtual Reality , Activities of Daily Living , Breast Neoplasms/therapy , Fatigue/etiology , Fatigue/therapy , Female , Humans , Upper Extremity
3.
Int J Environ Res Public Health ; 18(24)2021 12 16.
Article in English | MEDLINE | ID: covidwho-1595213

ABSTRACT

BACKGROUND: There have been significant advances in the medical treatment and management of multiple sclerosis pathogenesis, relapse and disease progression over the past 30 years. There have been advancements in the symptomatic treatment of multiple sclerosis, including management of secondary multiple sclerosis expressions such as walking, cognitive dysfunction, fatigue and depression. Scientific evidence and expert opinion suggest that exercise may be the single most effective non-pharmacological symptomatic treatment for multiple sclerosis. This article presents the historical context of exercise training within the multidisciplinary management of multiple sclerosis. We guide neurologists and healthcare providers on the recommended prescription of exercise and practical, theoretical methods to overcome barriers to exercise. METHOD: We undertook a critical search of the historical and current literature regarding exercise and multiple sclerosis from the viewpoint of exercise promotion by neurologists and the multidisciplinary care team. RESULTS: We highlight the ever-strengthening body of research indicating that exercise is safe and effective for improving symptoms of multiple sclerosis. Further, exercise training may be necessary for reducing disease progression. CONCLUSION: We seek to encourage neurologists and specialists in multidisciplinary healthcare teams to prescribe and promote exercise at diagnosis and across all stages of the disease trajectory using prescriptive guidelines as part of comprehensive MS care. Available tools include clinical education to dispel any historical myths related to exercise in multiple sclerosis, clinical exercise guidelines and behaviour change theory to overcome patients barriers to exercise.


Subject(s)
Multiple Sclerosis , Exercise , Exercise Therapy , Fatigue/therapy , Humans , Multiple Sclerosis/therapy , Neoplasm Recurrence, Local
4.
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
6.
Best Pract Res Clin Anaesthesiol ; 35(3): 269-292, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1401261

ABSTRACT

Coronaviruses belong to the family Coronaviridae order Nidovirales and are known causes of respiratory and intestinal disease in various mammalian and avian species. Species of coronaviruses known to infect humans are referred to as human coronaviruses (HCoVs). While traditionally, HCoVs have been a significant cause of the common cold, more recently, emergent viruses, including severe acute respiratory syndrome coronavirus (SARS-CoV-2) has caused a global pandemic. Here, we discuss coronavirus disease (COVID-19) biology, pathology, epidemiology, signs and symptoms, diagnosis, treatment, and recent clinical trials involving promising treatments.


Subject(s)
Antiviral Agents/administration & dosage , COVID-19/epidemiology , COVID-19/therapy , SARS-CoV-2 , Adenosine Monophosphate/administration & dosage , Adenosine Monophosphate/analogs & derivatives , Adrenal Cortex Hormones/administration & dosage , Alanine/administration & dosage , Alanine/analogs & derivatives , Animals , COVID-19/diagnosis , COVID-19/immunology , Coronavirus/drug effects , Coronavirus/immunology , Cough/epidemiology , Cough/therapy , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Fatigue/epidemiology , Fatigue/therapy , Fever , Heart Diseases/epidemiology , Heart Diseases/therapy , Humans , Positive-Pressure Respiration/methods , Prognosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/therapy , SARS-CoV-2/drug effects , SARS-CoV-2/immunology , Treatment Outcome
8.
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
9.
Rev. Assoc. Med. Bras. (1992) ; 67(1): 26-28, Jan. 2021. graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1270961

ABSTRACT

SUMMARY The novel coronavirus disease (COVID-19) has infected millions of people worldwide and generated many sequels in the survivors, such as muscular pain and fatigue. These symptoms have been treated through pharmacological approaches; however, infected people keep presenting physical limitations. Besides, the COVID-19 damage to the central nervous system has also been related to the presence of some physical impairment, so strategies that focus on diverse brain areas should be encouraged. Transcranial Direct Current Stimulation (tDCS) is a non-pharmacological tool that could be associated with pharmacological treatments to improve the central nervous system function and decrease the exacerbation of the immune system response. tDCS targeting pain and fatigue-related areas could provide an increase in neuroplasticity and enhancements in physical functions. Moreover, it can be used in infirmaries and clinical centers to treat COVID-19 patients.


Subject(s)
Humans , Transcranial Direct Current Stimulation , COVID-19 , Pain , Fatigue/etiology , Fatigue/therapy , SARS-CoV-2
10.
J Orthop Sports Phys Ther ; 51(5): 197-200, 2021 05.
Article in English | MEDLINE | ID: covidwho-1209238

ABSTRACT

SYNOPSIS: The term long COVID was coined by patients to describe the long-term consequences of COVID-19. One year into the pandemic, it was clear that all patients-those hospitalized with COVID-19 and those who lived with the disease in the community-were at risk of developing debilitating sequelae that would impact their quality of life. Patients with long COVID asked for rehabilitation. Many of them, including previously healthy and fit clinicians, tried to fight postviral fatigue with exercise-based rehabilitation. We observed a growing number of patients with long COVID who experienced adverse effects from exercise therapy and symptoms strikingly similar to those of myalgic encephalomyelitis (ME). Community-based physical therapists, including those in private practice, unaware of safety issues, are preparing to help an influx of patients with long COVID. In this editorial, we expose growing concerns about long COVID and ME. We issue safety recommendations for rehabilitation and share resources to improve care for those with postviral illnesses. J Orthop Sports Phys Ther 2021;51(5):197-200. doi:10.2519/jospt.2021.0106.


Subject(s)
COVID-19/complications , Fatigue Syndrome, Chronic/etiology , Fatigue Syndrome, Chronic/therapy , Fatigue/etiology , Fatigue/therapy , Exercise Therapy/adverse effects , Humans , Quality of Life , Rest
11.
Diabetes Metab Syndr ; 15(3): 869-875, 2021.
Article in English | MEDLINE | ID: covidwho-1193289

ABSTRACT

BACKGROUND AND AIMS: Long COVID is the collective term to denote persistence of symptoms in those who have recovered from SARS-CoV-2 infection. METHODS: WE searched the pubmed and scopus databases for original articles and reviews. Based on the search result, in this review article we are analyzing various aspects of Long COVID. RESULTS: Fatigue, cough, chest tightness, breathlessness, palpitations, myalgia and difficulty to focus are symptoms reported in long COVID. It could be related to organ damage, post viral syndrome, post-critical care syndrome and others. Clinical evaluation should focus on identifying the pathophysiology, followed by appropriate remedial measures. In people with symptoms suggestive of long COVID but without known history of previous SARS-CoV-2 infection, serology may help confirm the diagnosis. CONCLUSIONS: This review will helps the clinicians to manage various aspects of Long COVID.


Subject(s)
COVID-19/complications , COVID-19/epidemiology , COVID-19/etiology , COVID-19/pathology , COVID-19/therapy , Cough/epidemiology , Cough/etiology , Cough/therapy , Fatigue/epidemiology , Fatigue/etiology , Fatigue/therapy , Humans , SARS-CoV-2/physiology
12.
Australas Psychiatry ; 29(5): 560-561, 2021 10.
Article in English | MEDLINE | ID: covidwho-1166848
13.
Arch Pharm (Weinheim) ; 354(4): e2000378, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1162498

ABSTRACT

Many diseases as well as acute conditions can lead to fatigue, which can be either temporary or chronic in nature. Acute fatigue develops frequently after physical exercise or after alcohol hangover, whereas microbial infections such as influenza or COVID-19 and chronic diseases like Parkinson's disease or multiple sclerosis are often associated with chronic fatigue. Oxidative stress and a resulting disturbance of mitochondrial function are likely to be common denominators for many forms of fatigue, and antioxidant treatments have been shown to be effective in alleviating the symptoms of fatigue. In this study, we review the role of reactive oxygen and nitrogen species in fatigue and the antioxidant effects of the intake of molecular hydrogen. We propose that molecular hydrogen is well suited for the treatment of temporary and chronic forms of oxidative stress-associated fatigue.


Subject(s)
COVID-19 , Fatigue , Hydrogen , Oxidative Stress , Antioxidants/metabolism , Antioxidants/pharmacology , COVID-19/metabolism , COVID-19/physiopathology , Fatigue/etiology , Fatigue/metabolism , Fatigue/therapy , Humans , Hydrogen/metabolism , Hydrogen/pharmacology , Nitrogen , Oxidative Stress/drug effects , Oxidative Stress/physiology , Quantitative Structure-Activity Relationship , Reactive Oxygen Species , SARS-CoV-2
14.
Clin Neurophysiol ; 132(5): 1138-1143, 2021 05.
Article in English | MEDLINE | ID: covidwho-1128943

ABSTRACT

OBJECTIVE: A high proportion of patients experience fatigue and impairment of cognitive functions after coronavirus disease 2019 (COVID-19). Here we applied transcranial magnetic stimulation (TMS) to explore the activity of the main inhibitory intracortical circuits within the primary motor cortex (M1) in a sample of patients complaining of fatigue and presenting executive dysfunction after resolution of COVID-19 with neurological manifestations. METHODS: Twelve patients who recovered from typical COVID-19 pneumonia with neurological complications and complained of profound physical and mental fatigue underwent, 9 to 13 weeks from disease onset, a psychometric evaluation including a self-reported fatigue numeric-rating scale (FRS, Fatigue Rating Scale) and the Frontal Assessment Battery (FAB). Intracortical activity was evaluated by means of well-established TMS protocols including short-interval intracortical inhibition (SICI), reflecting GABAA-mediated inhibition, long-interval intracortical inhibition (LICI), a marker of GABAB receptor activity, and short-latency afferent inhibition (SAI) that indexes central cholinergic transmission. TMS data were compared to those obtained in a control group of ten healthy subjects (HS) matched by age, sex and education level. RESULTS: Post-COVID-19 patients reported marked fatigue according to FRS score (8.1 ± 1.7) and presented pathological scores at the FAB based on Italian normative data (12.2 ± 0.7). TMS revealed marked reduction of SICI, and disruption of LICI as compared to HS. SAI was also slightly diminished. CONCLUSIONS: The present study documents for the first time reduced GABAergic inhibition in the M1 in patients who recovered from COVID-19 with neurological complications and manifested fatigue and dysexecutive syndrome. SIGNIFICANCE: TMS may serve as diagnostic tool in cognitive disturbances and fatigue in post-COVID-19 patients.


Subject(s)
COVID-19/physiopathology , Cognitive Dysfunction/physiopathology , Fatigue/physiopathology , GABAergic Neurons/physiology , Motor Cortex/physiopathology , Transcranial Magnetic Stimulation/methods , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/therapy , Cognitive Dysfunction/etiology , Cognitive Dysfunction/therapy , Fatigue/etiology , Fatigue/therapy , Female , Humans , Male , Middle Aged
16.
Clin Microbiol Infect ; 27(1): 89-95, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-803353

ABSTRACT

OBJECTIVES: To describe the prevalence, nature and risk factors for the main clinical sequelae in coronavirus disease 2019 (COVID-19) survivors who have been discharged from the hospital for more than 3 months. METHODS: This longitudinal study was based on a telephone follow-up survey of COVID-19 patients hospitalized and discharged from Renmin Hospital of Wuhan University, Wuhan, China before 1 March 2020. Demographic and clinical characteristics and self-reported clinical sequelae of the survivors were described and analysed. A cohort of volunteers who were free of COVID-19 and lived in the urban area of Wuhan during the outbreak were also selected as the comparison group. RESULTS: Among 538 survivors (293, 54.5% female), the median (interquartile range) age was 52.0 (41.0-62.0) years, and the time from discharge from hospital to first follow-up was 97.0 (95.0-102.0) days. Clinical sequelae were common, including general symptoms (n = 267, 49.6%), respiratory symptoms (n = 210, 39%), cardiovascular-related symptoms (n = 70, 13%), psychosocial symptoms (n = 122, 22.7%) and alopecia (n = 154, 28.6%). We found that physical decline/fatigue (p < 0.01), postactivity polypnoea (p= 0.04) and alopecia (p < 0.01) were more common in female than in male subjects. Dyspnoea during hospitalization was associated with subsequent physical decline/fatigue, postactivity polypnoea and resting heart rate increases but not specifically with alopecia. A history of asthma during hospitalization was associated with subsequent postactivity polypnoea sequela. A history of pulse ≥90 bpm during hospitalization was associated with resting heart rate increase in convalescence. The duration of virus shedding after COVID-19 onset and hospital length of stay were longer in survivors with physical decline/fatigue or postactivity polypnoea than in those without. CONCLUSIONS: Clinical sequelae during early COVID-19 convalescence were common; some of these sequelae might be related to gender, age and clinical characteristics during hospitalization.


Subject(s)
Alopecia/epidemiology , COVID-19/epidemiology , Dyspnea/epidemiology , Fatigue/epidemiology , Survivors , Tachycardia/epidemiology , Adult , Alopecia/complications , Alopecia/physiopathology , Alopecia/therapy , COVID-19/complications , COVID-19/physiopathology , COVID-19/therapy , China/epidemiology , Convalescence , Dyspnea/complications , Dyspnea/physiopathology , Dyspnea/therapy , Fatigue/complications , Fatigue/physiopathology , Fatigue/therapy , Female , Humans , Length of Stay/statistics & numerical data , Longitudinal Studies , Male , Middle Aged , Patient Discharge , Risk Factors , SARS-CoV-2/pathogenicity , Severity of Illness Index , Tachycardia/complications , Tachycardia/physiopathology , Tachycardia/therapy
17.
Int J Stroke ; 15(6): 589-590, 2020 08.
Article in English | MEDLINE | ID: covidwho-768339
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