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1.
Lancet Respir Med ; 9(5): 533-544, 2021 05.
Article in English | MEDLINE | ID: covidwho-1931217

ABSTRACT

Cough is one of the most common presenting symptoms of COVID-19, along with fever and loss of taste and smell. Cough can persist for weeks or months after SARS-CoV-2 infection, often accompanied by chronic fatigue, cognitive impairment, dyspnoea, or pain-a collection of long-term effects referred to as the post-COVID syndrome or long COVID. We hypothesise that the pathways of neurotropism, neuroinflammation, and neuroimmunomodulation through the vagal sensory nerves, which are implicated in SARS-CoV-2 infection, lead to a cough hypersensitivity state. The post-COVID syndrome might also result from neuroinflammatory events in the brain. We highlight gaps in understanding of the mechanisms of acute and chronic COVID-19-associated cough and post-COVID syndrome, consider potential ways to reduce the effect of COVID-19 by controlling cough, and suggest future directions for research and clinical practice. Although neuromodulators such as gabapentin or opioids might be considered for acute and chronic COVID-19 cough, we discuss the possible mechanisms of COVID-19-associated cough and the promise of new anti-inflammatories or neuromodulators that might successfully target both the cough of COVID-19 and the post-COVID syndrome.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Cough/etiology , Inflammation/etiology , Nervous System Diseases/etiology , Neuroimmunomodulation , Cough/physiopathology , Humans , Inflammation/physiopathology , Nervous System Diseases/physiopathology , SARS-CoV-2 , Syndrome
2.
J Med Internet Res ; 23(2): e26292, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1574360

ABSTRACT

BACKGROUND: Chronic low back pain is the most prevalent chronic pain condition worldwide and access to behavioral pain treatment is limited. Virtual reality (VR) is an immersive technology that may provide effective behavioral therapeutics for chronic pain. OBJECTIVE: We aimed to conduct a double-blind, parallel-arm, single-cohort, remote, randomized placebo-controlled trial for a self-administered behavioral skills-based VR program in community-based individuals with self-reported chronic low back pain during the COVID-19 pandemic. METHODS: A national online convenience sample of individuals with self-reported nonmalignant low back pain with duration of 6 months or more and with average pain intensity of 4 or more/10 was enrolled and randomized 1:1 to 1 of 2 daily (56-day) VR programs: (1) EaseVRx (immersive pain relief skills VR program); or (2) Sham VR (2D nature content delivered in a VR headset). Objective device use data and self-reported data were collected. The primary outcomes were the between-group effect of EaseVRx versus Sham VR across time points, and the between-within interaction effect representing the change in average pain intensity and pain-related interference with activity, stress, mood, and sleep over time (baseline to end-of-treatment at day 56). Secondary outcomes were global impression of change and change in physical function, sleep disturbance, pain self-efficacy, pain catastrophizing, pain acceptance, pain medication use, and user satisfaction. Analytic methods included intention-to-treat and a mixed-model framework. RESULTS: The study sample was 179 adults (female: 76.5%, 137/179; Caucasian: 90.5%, 162/179; at least some college education: 91.1%, 163/179; mean age: 51.5 years [SD 13.1]; average pain intensity: 5/10 [SD 1.2]; back pain duration ≥5 years: 67%, 120/179). No group differences were found for any baseline variable or treatment engagement. User satisfaction ratings were higher for EaseVRx versus Sham VR (P<.001). For the between-groups factor, EaseVRx was superior to Sham VR for all primary outcomes (highest P value=.009), and between-groups Cohen d effect sizes ranged from 0.40 to 0.49, indicating superiority was moderately clinically meaningful. For EaseVRx, large pre-post effect sizes ranged from 1.17 to 1.3 and met moderate to substantial clinical importance for reduced pain intensity and pain-related interference with activity, mood, and stress. Between-group comparisons for Physical Function and Sleep Disturbance showed superiority for the EaseVRx group versus the Sham VR group (P=.022 and .013, respectively). Pain catastrophizing, pain self-efficacy, pain acceptance, prescription opioid use (morphine milligram equivalent) did not reach statistical significance for either group. Use of over-the-counter analgesic use was reduced for EaseVRx (P<.01) but not for Sham VR. CONCLUSIONS: EaseVRx had high user satisfaction and superior and clinically meaningful symptom reduction for average pain intensity and pain-related interference with activity, mood, and stress compared to sham VR. Additional research is needed to determine durability of treatment effects and to characterize mechanisms of treatment effects. Home-based VR may expand access to effective and on-demand nonpharmacologic treatment for chronic low back pain. TRIAL REGISTRATION: ClinicalTrials.gov NCT04415177; https://clinicaltrials.gov/ct2/show/NCT04415177. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/25291.


Subject(s)
COVID-19 , Chronic Pain/therapy , Health Behavior , Low Back Pain/therapy , Pain Management/methods , Virtual Reality , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Double-Blind Method , Female , Humans , Male , Middle Aged , Pandemics , Self Report , Time Factors , Young Adult
3.
Pain Rep ; 6(1): e893, 2021.
Article in English | MEDLINE | ID: covidwho-1550636

ABSTRACT

Pain is a common symptom accompanying the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Nonspecific discomfort such as sore throat and body ache are frequent. Parainfectious pain such as headache, myalgia, or neuropathic pain has also been reported. The latter seems to be associated with an autoimmune response or an affection of the peripheral neuromuscular system or the central nervous system because of the viral infection. Furthermore, chronic pain can be a complication of intensive care unit treatment due to COVID-19 itself (such as intensive care-acquired weakness) or of secondary diseases associated with the SARS-CoV-2 infection, including Guillain-Barré syndrome, polyneuritis, critical illness polyneuropathy, or central pain following cerebrovascular events. Data on long-lasting painful symptoms after clinically manifest COVID-19 and their consequences are lacking. In addition, preexisting chronic pain may be exacerbated by limited and disrupted health care and the psychological burden of the COVID-19 pandemic. Medical providers should be vigilant on pain during and after COVID-19.

4.
Lancet Respir Med ; 9(5): 533-544, 2021 05.
Article in English | MEDLINE | ID: covidwho-1537202

ABSTRACT

Cough is one of the most common presenting symptoms of COVID-19, along with fever and loss of taste and smell. Cough can persist for weeks or months after SARS-CoV-2 infection, often accompanied by chronic fatigue, cognitive impairment, dyspnoea, or pain-a collection of long-term effects referred to as the post-COVID syndrome or long COVID. We hypothesise that the pathways of neurotropism, neuroinflammation, and neuroimmunomodulation through the vagal sensory nerves, which are implicated in SARS-CoV-2 infection, lead to a cough hypersensitivity state. The post-COVID syndrome might also result from neuroinflammatory events in the brain. We highlight gaps in understanding of the mechanisms of acute and chronic COVID-19-associated cough and post-COVID syndrome, consider potential ways to reduce the effect of COVID-19 by controlling cough, and suggest future directions for research and clinical practice. Although neuromodulators such as gabapentin or opioids might be considered for acute and chronic COVID-19 cough, we discuss the possible mechanisms of COVID-19-associated cough and the promise of new anti-inflammatories or neuromodulators that might successfully target both the cough of COVID-19 and the post-COVID syndrome.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Cough/etiology , Inflammation/etiology , Nervous System Diseases/etiology , Neuroimmunomodulation , Cough/physiopathology , Humans , Inflammation/physiopathology , Nervous System Diseases/physiopathology , SARS-CoV-2 , Syndrome
5.
Ann Thorac Surg ; 112(5): e377-e380, 2021 11.
Article in English | MEDLINE | ID: covidwho-1474341

ABSTRACT

Postinfarction ventricular septal rupture (VSR) represents a well-known mechanical complication of myocardial infarction, determining cardiogenic shock with high mortality rates. Surgical correction requires significant expertise to avoid cardiac rupture, uncontrollable bleeding, residual shunts, heart failure, and death. In the last year, we observed a substantial increase of VSR at our hospital, related to the delayed presentation of people with acute chest pain to the emergency departments during the coronavirus disease 2019 pandemic. We discuss our innovative triple-layer patch technique in a recent consecutive series of 8 patients. This technique proved effective in all patients, with no residual shunt or cardiac rupture.


Subject(s)
COVID-19/epidemiology , Cardiac Surgical Procedures/methods , Prostheses and Implants , Ventricular Septal Rupture/surgery , Aged , Comorbidity , Female , Humans , Male , Pandemics , Risk Factors , Ventricular Septal Rupture/diagnosis , Ventricular Septal Rupture/epidemiology
6.
Qual Health Res ; 31(11): 2019-2028, 2021 09.
Article in English | MEDLINE | ID: covidwho-1273207

ABSTRACT

People living with chronic pain experience multiple challenges in their daily activities. Chronic pain is complex and often provokes life circumstances that create increased social isolation. Living with chronic pain during the pandemic may add additional layers of complexity to their daily lives. The researchers endeavored to explore the experiences of people living with chronic pain during the COVID-19 pandemic. Researchers conducted semi-structured, open-ended interviews about how the pandemic influenced participants' lives. The interviews were recorded and analyzed using an applied philosophical hermeneutics approach. The findings were feeling socially isolated, losing their sense of livinghood, and experiencing augmented stress levels which, in most cases, aggravated their chronic pain. In addition to gaining an in-depth understanding of the needs of people living with chronic pain, these findings may guide policy decisions with the intention of improving health care access and the overall experiences of people living with chronic conditions during a pandemic.


Subject(s)
COVID-19 , Chronic Pain , Chronic Pain/epidemiology , Humans , Pandemics , Qualitative Research , SARS-CoV-2
7.
Am J Phys Med Rehabil ; 100(4): 307-312, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1266237

ABSTRACT

OBJECTIVE: The clinical manifestations of COVID-19 range from mild symptoms to severe pneumonia and severe organ damage. When evaluated specifically for pain, the data so far have shown that myalgia, headache, and chest pain can be seen in patients at varying rates; myalgia and headache, especially, are among the initial symptoms. DESIGN: This retrospective chart review, followed by a descriptive survey design study, was carried out by examining patients afflicted with COVID-19. After discharge, patients were asked about the severity and the body region of their pain, their use of analgesics, their mood and mental health, and their overall quality of life. RESULTS: A total of 206 patients with a mean age of 56.24 ± 16.99 yrs were included in the study. Pain during COVID-19 was found to be higher compared with the preinfectious and postinfectious states. The most frequent painful areas were reported to be the neck and back before the infection, whereas the head and limbs during the infection. The most frequently used analgesic during infection was paracetamol. There was no relationship between the patients' pain and anxiety and depression; the quality of life was found to be worse in patients with persistent pain. CONCLUSIONS: This study showed that the head and limbs were the most common painful body regions during COVID-19. It was also found that pain can continue in the postinfection period.


Subject(s)
COVID-19/epidemiology , Myalgia/diagnosis , Pain Measurement/statistics & numerical data , Adult , Aged , COVID-19/complications , Female , Headache/diagnosis , Humans , Low Back Pain/diagnosis , Male , Middle Aged , Myalgia/etiology , Neck Pain/diagnosis , Physical Examination , Primary Health Care/methods , Retrospective Studies
8.
Pain Rep ; 6(2): e935, 2021.
Article in English | MEDLINE | ID: covidwho-1262283

ABSTRACT

The COVID-19 pandemic has acutely challenged health systems and catalyzed the need for widescale virtual care and digital solutions across all areas of health, including pediatric chronic pain. The objective of this rapid systematic review was to identify recommendations, guidelines, and/or best practices for using virtual care to support youth with chronic pain and their families (CRD42020184498). MEDLINE, CINAHL, Embase, APA PsychINFO, and Web of Science were searched the week of May 25, 2020, for English language peer-reviewed articles published since 2010 that (1) discussed children and adolescents aged <18 years reporting any type of chronic pain (ie, pain lasting >3 months); (2) focused on any type of virtual care (eg, telephone, telehealth, telemedicine, mHealth, eHealth, online, or digital); and (3) reported on guidelines, best practices, considerations, or recommendations for virtual care. Abstract and full text screening and data extraction were performed in duplicate. Meta-ethnography was used to synthesize concepts across articles. Of 4161 unique records screened, 16 were included addressing diverse virtual care and pediatric chronic pain conditions. Four key themes were identified: (1) opportunities to better leverage virtual care, (2) direct effective implementation of virtual care, (3) selection of virtual care platforms, and (4) gaps in need of further consideration when using virtual care to support youth with chronic pain and their families. No existing guidelines for virtual care for pediatric chronic pain were identified; however, best practices for virtual care were identified and should be used by health professionals, decision makers, and policymakers in implementing virtual care.

9.
10.
Pain Med ; 22(7): 1642-1650, 2021 07 25.
Article in English | MEDLINE | ID: covidwho-1258791

ABSTRACT

OBJECTIVES: Cancer-related neuropathic pain (CNP) affects an increasing proportion of cancer patients, given improved survival, but it remains difficult to treat. There are no studies on an extended intravenous ketamine protocol and its synergies with common neuropathy treatments to treat CNP. This study aims to 1) evaluate the safety and effectiveness of an intravenous ketamine protocol to treat refractory CNP and 2) uncover synergies between ketamine and common neuropathy treatments. METHODS: This is a single-center, retrospective review of 57 patients and 192 infusions, with prospective follow-up on 14 enrolled patients during the coronavirus disease 2019 (COVID-19) pandemic. RESULTS: The etiologies of CNP were as follows: 13 from tumor compression, 25 with chemotherapy-induced peripheral neuropathy, 13 from surgery, and 6 from radiation therapy. Overall, 42 of 57 patients (73.7%) were responders, and 71.8% of responders received >3 weeks of pain relief on their last infusion. Analysis of adjuvant treatments revealed that the combination of serotonin-norepinephrine reuptake inhibitors and ketamine resulted in an increase in responders compared with nonresponders (P < 0.01). Adverse events occurred in 32 of 192 infusions (16.7%). All side effects self-resolved or resolved with intervention per the adverse events protocol. During the pandemic, all 14 currently enrolled patients did not receive ketamine infusions. Thirteen of the 14 patients returned to baseline pain, with 61.5% increasing medications. All experienced worsened function, mobility, mood, or anorexia. CONCLUSION: Intravenous ketamine may be a safe and effective adjuvant treatment for CNP, especially with serotonin-norepinephrine reuptake inhibitors. Larger, prospective studies are warranted and should explore parameters to help prognosticate response to ketamine infusions.


Subject(s)
COVID-19 , Ketamine , Neoplasms , Analgesics/therapeutic use , Humans , Infusions, Intravenous , Neoplasms/complications , Neoplasms/drug therapy , Pain Management , Pandemics , Prospective Studies , Retrospective Studies , SARS-CoV-2
11.
Ital J Pediatr ; 47(1): 120, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1255952

ABSTRACT

BACKGROUND: Children affected by Coronavirus disease 2019 (COVID-19) showed various manifestations. Some of them were severe cases presenting with multi-system inflammatory syndrome (MIS-C) causing multiple organ dysfunction. CASE PRESENTATION: We report the case of a 12-year-old girl with recent COVID-19 infection who presented with persistent fever, abdominal pain and other symptoms that meet the definition of MIS-C. She had lymphopenia and a high level of inflammatory markers. She was admitted to pediatric intensive care unit since she rapidly developed refractory catecholamine-resistant shock with multiple organ failure. Echocardiography showed a small pericardial effusion with a normal ejection fraction (Ejection Fraction = 60%) and no valvular or coronary lesions. The child showed no signs of improvement even after receiving intravenous immunoglobulin, fresh frozen plasma, high doses of Vasopressors and corticosteroid. His outcome was fatal. CONCLUSION: Pediatric patients affected by the new COVID-19 related syndrome may show severe life-threatening conditions similar to Kawasaki disease shock syndrome. Hypotension in these patients results from heart failure and the decreased cardiac output. We report a new severe clinical feature of SARS-CoV-2 infection in children in whom hypotension was the result of refractory vasoplegia.


Subject(s)
COVID-19/diagnosis , Systemic Inflammatory Response Syndrome/diagnosis , Biomarkers/blood , COVID-19/therapy , Child , Fatal Outcome , Female , Humans , Intensive Care Units, Pediatric , Systemic Inflammatory Response Syndrome/therapy
12.
Int J Environ Res Public Health ; 18(11)2021 05 24.
Article in English | MEDLINE | ID: covidwho-1244001

ABSTRACT

Changes in working styles and physical activities, and an increase in psychological stress during the coronavirus disease 2019 (COVID-19) pandemic, may have affected pain conditions among workers with pain; however, these associations are still poorly understood. Therefore, we conducted a web-based, cross-sectional study to investigate these changes among Japanese workers suffering from pain. A total of 1941 workers who were aged 20-64 years and suffered from body pain within 4 weeks prior to the study were included. Information was collected using a self-reported questionnaire between July and August 2020. Among the respondents, 15% reported that their pain worsened during the COVID-19 pandemic. Approximately half of the workers claimed to have decreased physical activity (47%) and increased psychological stress (47%) during the pandemic. Multivariable logistic regression analyses found that telework (odds ratio 2.27, 95% confidence interval 1.68-3.06), decreased physical activity (3.18, 2.38-4.27), and increased psychological stress (2.16, 1.64-2.84) were associated significantly with pain augmentation. The group of workers who participated in telework and had decreased physical activity comprised the highest proportion of those with augmented pain. Our findings suggest that measures, which consider physical activities, psychological aspects, and working styles, to alleviate pain may be required for the working population in the future.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Exercise , Humans , Japan/epidemiology , Pain , SARS-CoV-2 , Stress, Psychological/epidemiology , Teleworking
13.
Pain Rep ; 6(1): e885, 2021.
Article in English | MEDLINE | ID: covidwho-1238293

ABSTRACT

SARS-CoV-2 is a novel coronavirus that infects cells through the angiotensin-converting enzyme 2 receptor, aided by proteases that prime the spike protein of the virus to enhance cellular entry. Neuropilin 1 and 2 (NRP1 and NRP2) act as additional viral entry factors. SARS-CoV-2 infection causes COVID-19 disease. There is now strong evidence for neurological impacts of COVID-19, with pain as an important symptom, both in the acute phase of the disease and at later stages that are colloquially referred to as "long COVID." In this narrative review, we discuss how COVID-19 may interact with the peripheral nervous system to cause pain in the early and late stages of the disease. We begin with a review of the state of the science on how viruses cause pain through direct and indirect interactions with nociceptors. We then cover what we currently know about how the unique cytokine profiles of moderate and severe COVID-19 may drive plasticity in nociceptors to promote pain and worsen existing pain states. Finally, we review evidence for direct infection of nociceptors by SARS-CoV-2 and the implications of this potential neurotropism. The state of the science points to multiple potential mechanisms through which COVID-19 could induce changes in nociceptor excitability that would be expected to promote pain, induce neuropathies, and worsen existing pain states.

14.
Anaesthesiol Intensive Ther ; 53(2): 115-125, 2021.
Article in English | MEDLINE | ID: covidwho-1234879

ABSTRACT

INTRODUCTION: The Bronx is a borough of New York City that has been profoundly affected by the COVID-19 pandemic. Limited reports exist discussing the anaesthetic management of obstetric patients infected with COVID-19. We review a cohort of obstetric patients in the Bronx with COVID-19 and report their delivery data, anaesthetic management, and maternal-fetal outcomes. MATERIAL AND METHODS: We reviewed 92 pregnant patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who delivered between 1 February 2020 and 1 May 2020. Medical records were reviewed for patient characteristics, anaesthetic management, and clinical outcomes. Patients were stratified by mode of delivery and COVID-19 disease severity. RESULTS: Of the 92 deliveries, 49 (53%) were vaginal, 14 (15%) were scheduled caesareans, and 29 (32%) were unscheduled caesareans. 64 patients (70%) were asymptomatic for COVID-19 (mild disease: 18 patients [19%], moderate disease: 7 patients [8%], severe disease: 2 patients [2%], critical disease: 1 patient [1%]). 83 patients (90%) received neuraxial analgesia and/or anaesthesia, with combined spinal-epidural (CSE) and dural puncture epidural (DPE) as the most common techniques. 5 patients (5%) required general anaesthesia (GA) for caesarean delivery, 3 (3%) of whom were intubated for severe or critical COVID-19 disease. CONCLUSIONS: Given the risks associated with SARS-CoV-2 aerosol transmission, GA was avoided in all but the most critically ill patients. CSE and DPE were optimal for minimizing catheter failure rates and risk of conversion to GA. SARS-CoV-2 infection in obstetric patients may be associated with an increased risk for adverse outcomes including preeclampsia, preterm delivery, unscheduled caesarean delivery, and mechanical ventilation.


Subject(s)
COVID-19/complications , Delivery, Obstetric/methods , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/etiology , Pregnancy Outcome/epidemiology , Adult , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19 Testing , Female , Humans , New York City , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/physiopathology , Risk Factors , Young Adult
15.
J Prev Interv Community ; 49(2): 136-151, 2021.
Article in English | MEDLINE | ID: covidwho-1230993

ABSTRACT

Opioid related drug overdose deaths are a leading cause of death and injury in the United States. While research demonstrates that where people live has a major impact on drug use and abuse, most work looks at social dynamics at the county level or under the rubric of the urban/rural divide. Only recently, scholarship has become attuned to the post-industrialized areas located on the fringes of urban cores. Data presented in here are from field research conducted in McKeesport, Pennsylvania, a small river town located east of Pittsburgh. Once a thriving industrial city, it is now deteriorated and has documented high levels of overdose experience. Preliminary results suggest that McKeesport residents, even before the emergence of SARS-CoV-2 (COVID-19), practice social and physical distancing as a way of life; data indicate how the pandemic potentially exacerbates the risk of accidental opioid overdose among a population defined by both geographic and social isolation.


Subject(s)
COVID-19 , Drug Overdose/prevention & control , Law Enforcement , Pandemics , Drug Overdose/mortality , Health Policy , Humans , Interviews as Topic , Pennsylvania , Physical Distancing , Poverty Areas , Risk Factors , Rural Population , Social Isolation , United States/epidemiology
16.
Front Cardiovasc Med ; 8: 645135, 2021.
Article in English | MEDLINE | ID: covidwho-1231326

ABSTRACT

Background: The COVID-19 (coronavirus disease 2019) pandemic is reducing health care accessibility to non-life-threatening diseases, thus hiding their real incidence. Moreover, the incidence of potentially fatal conditions such as acute type A aortic dissection seems to have decreased since the pandemic began, whereas the number of cases of chronic ascending aortic dissections dramatically increased. We present two patients whose management has been affected by the exceptional sanitary situation we are dealing with. Case report: A 70-year-old man with chest pain and an aortic regurgitation murmur had his cardiac workup delayed (4 months) because of sanitary restrictions. He was then diagnosed with chronic type A aortic dissection and underwent urgent replacement of ascending aorta and aortic root. The delay in surgical treatment made the intervention technically challenging because the ascending aorta grew up to 80 mm inducing strong adhesions and chronic inflammation. The second case report concerns a 68-year-old woman with right lower-limb pain who was diagnosed with deep vein thrombosis. However, a CT scan to exclude a pulmonary embolism could not be realized until 5 months later because of sanitary restrictions. When she eventually got the CT scan, it fortuitously showed a chronic dissection of the ascending aorta. She underwent urgent surgery, and the intervention was challenging because of adhesions and severe inflammation. Conclusion: Delayed treatment due to sanitary restrictions related to COVID-19 pandemic is having a significant impact on the management of potentially life-threatening conditions including type A aortic dissection. We should remain careful to avoid COVID-19 also hitting patients who are not infected with the virus.

17.
Lung ; 199(3): 249-253, 2021 06.
Article in English | MEDLINE | ID: covidwho-1227841

ABSTRACT

This multicenter study presents prevalence data and associated risk factors of post-COVID-19 cough one year after hospital discharge in COVID-19 survivors. Individuals recovered from COVID-19 at three public hospitals in Madrid (Spain) were scheduled for a telephonic interview. They were systematically asked about the presence of respiratory symptoms, e.g., fatigue, dyspnea, chest pain, and cough after hospital discharge. Clinical and hospitalization data were collected from hospital records. Overall, 1,950 patients (47% women, mean age:61, SD:16 years) were assessed at 11.2 months (SD 0.5) after hospital discharge. Just 367 (18.8%) were completely free of any respiratory post-COVID -19 symptom. The prevalence of long-term cough, chest pain, dyspnea, and fatigue was 2.5%, 6.5%, 23.3%, and 61.2%, respectively. Clinical and hospitalization factors were not associated with long-term post-COVID-19 cough. In conclusion, the prevalence of post-COVID-19 cough one year after SARS-CoV-2 infection was 2.5% in subjects who had survived hospitalization for COVID-19. No clear risk factor associated to long-term post-COVID-19 cough was identified.


Subject(s)
COVID-19/complications , Cough/epidemiology , Cough/virology , Aged , Chest Pain/epidemiology , Chest Pain/virology , Dyspnea/epidemiology , Dyspnea/virology , Fatigue/epidemiology , Fatigue/virology , Female , Follow-Up Studies , Hospitalization , Humans , Male , Middle Aged , Prevalence , Risk Factors , SARS-CoV-2 , Spain/epidemiology , Time Factors
18.
Dent Med Probl ; 58(2): 215-218, 2021.
Article in English | MEDLINE | ID: covidwho-1224366

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has drastically changed the routine way of life and challenged the ways in which health and dental services are provided. During the 1st lockdown, practiced in most of the countries, routine dental procedures were suspended. Even after the lockdown was eased, visiting crowded dental clinics was still considered health-threatening, especially among populations at high risk of developing a severe reaction to COVID-19. Regretfully, in most cases, temporomandibular disorders (TMD) and bruxism were not included under the definition of emergency, leaving many patients without the possibility of consulting their dentists. A literature search, performed about 10 months after the declaration of the pandemic, found only a few studies dealing with TMD and bruxism during COVID-19. Most of the studies indicate adverse effects on subjects' psycho-emotional status (stress, anxiety, depression), which in turn lead to the intensification of subjects' TMD and bruxism symptoms, and increased orofacial pain. Unlike other oral pathologies, which require manual interventions, chronic orofacial pain can be addressed, at least at its initial stage, through teledentistry and/or consultation. Remote first aid for patients suffering from orofacial pain includes various kinds of treatment, such as the self-massage of tense and painful areas, stretching, thermotherapy, drug therapy, relaxation techniques, meditation, and mindfulness, all of which can be administered through the phone and/or the Internet. Relevant legal and ethical issues should be considered while using remote modes for the triage, diagnosis and treatment of chronic orofacial pain patients.


Subject(s)
Bruxism , COVID-19 , Temporomandibular Joint Disorders , Bruxism/epidemiology , Bruxism/therapy , Communicable Disease Control , Humans , Pandemics , SARS-CoV-2 , Temporomandibular Joint Disorders/epidemiology , Temporomandibular Joint Disorders/therapy
19.
Turk J Gastroenterol ; 32(2): 148-154, 2021 02.
Article in English | MEDLINE | ID: covidwho-1220242

ABSTRACT

BACKGROUND: Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), have fever, dry cough, dyspnea, and fatigue. The disease has now become a global pandemic. The purpose of this study was to explore the relationship between COVID-19 and gastrointestinal (GI) symptoms. METHODS: We collected and analyzed data on patients with laboratory-confirmed COVID-19 by high-throughput sequencing or reverse transcription-polymerase chain reaction. We reviewed electronic medical records of 405 hospitalized COVID-19 patients in the Third Hospital of Wuhan. RESULTS: Among the 405 confirmed patients, 210 had no GI symptoms, 195 had GI symptoms, and the first symptom of 155 patients was GI. The prevalence of vascular and digestive diseases in the group with GI symptoms was significantly higher than in the group without GI symptoms. In patients with GI symptoms, the proportion with fever, cough, dysphoria, chest tightness, poor appetite, chest pain, and pharyngeal pain was significantly higher than in those without GI symptoms. There was no significant difference in imaging between the 2 groups. In patients with GI symptoms, the proportion with increased procalcitonin (PCT) level and decreased lymphocyte count was significantly higher than in those without GI symptoms. CONCLUSION: COVID-19 patients with GI symptoms had significantly more vascular and digestive system diseases and were more likely to have clinical manifestations of fever, cough, poor appetite, chest tightness, chest pain, insomnia, and pharyngeal pain. There were more patients with diarrhea, nausea, and vomiting. Patients with GI symptoms were more likely to have increased PCT and decreased lymphocyte count.


Subject(s)
COVID-19/complications , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/virology , SARS-CoV-2 , Adult , Aged , COVID-19/blood , COVID-19/virology , China/epidemiology , Diarrhea/blood , Diarrhea/epidemiology , Diarrhea/virology , Female , Humans , Lymphocyte Count , Male , Middle Aged , Nausea/blood , Nausea/epidemiology , Nausea/virology , Procalcitonin/blood , Vomiting/blood , Vomiting/epidemiology , Vomiting/virology
20.
Cureus ; 13(4): e14292, 2021 Apr 04.
Article in English | MEDLINE | ID: covidwho-1204354

ABSTRACT

Background The coronavirus disease 2019 (COVID-19) pandemic has been linked to a myriad of cardiac symptoms and disorders. Reports also suggest decreased hospital visits by patients with known cardiovascular disorders. Methodology To better elucidate the public interest in the information regarding "chest pain" during the COVID-19 pandemic, we conducted a Google Trends analysis from March 2019 to March 2021 to compare the internet searches between pre-COVID era and during the pandemic with country-wise [the United States (US) versus the United Kingdom (UK) versus India] variation. Results We observed a significantly rising public interest in "chest pain" internet searches during the peak COVID-19 pandemic. Rising trends were most prominent in the UK, followed by USA and India. Our analysis noted a spike in the trend of "chest pain" search in early March in the UK and USA, whereas in March and June 2020 for India. This shows an important temporal association between the surge of COVID-19 cases and the search for "chest pain" online. Conclusion Google Trends analyses indicate rising public interest in chest pain during the pandemic months and the possible association between COVID-19 and chest pain. These findings warrant further research, especially with increasing reports suggesting contradictory reports of decreased hospital visits by patients with known cardiovascular diseases.

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