Sleep in COVID-19 recovery period and its impacts on Quality Of Life

Introduction: According to the World Health Organization (WHO), the COVID-19 infection became a worldwide devastating health issue starting in December 2019 in China and then gradually was a global pandemic. PTSD after recovery from COVID-19 has been correlated to sleep problems, high anxiety level and depressive manifestations. These sleep problems have their drastic effect on the recovered patients' quality of life including physical, psychological and social domains. Objective(s): 1-To investigate the sleep in the post Coronavirus -19 period 2-If has an impact on the different items of patients' quality of life. Method(s): 1-Socio-demographic characteristics of 500 recovered COVID-19 patients 2-Insomnia Severity index a brief scale evaluating the patient's insomnia. The ISI evaluates the subjective complaints and results of insomnia as well as the level of dysfunctions from these sleep disturbances 3-Pittsburgh sleep quality index (PSQI):The Pittsburgh Sleep Quality Index (PSQI) is a scale that study the subjective sleep quality and different domains of sleep over a period of 1-month 4-Quality Of Life (QOL) by the SF36 Health Survey is a 36-item -report survey that evaluate eight domains of physical and mental wellbeing ranging from 0 to 100. Result(s): The mean score of insomnia severity index was 13.01+/-4.9. Regarding Pittsburgh sleep quality index , Sum of seven component scores was 15.37+/-4.43.Also QOL SF36 showed higher scores of the 8 domains including physical and mental Conclusion(s): High score of insomnia and sleep disturbances during the recovery period of COVID-19 infection which affecting the Quality Of Life.

Telehealth delivered Tai Chi intervention for managing aromatase inhibitor-induced arthralgia in breast cancer patients: TaiChi4Joint during the COVID-19 pandemic a Pilot study

Background: Estrogen receptor positive breast cancer (BC) is the most common type of breast cancer in postmenopausal women and aromatase inhibitors (AI) are the endocrine therapy of choice recommended for these patients. Up to 50% of those treated with an AI develop Arthralgia often resulting in poor adherence and decreased quality of life. Methods: This is a single arm longitudinal pilot study aiming to evaluate the safety, feasibility, acceptability and potential efficacy of TaiChi4Joint, a remotelydelivered 12-week Tai Chi intervention designed for the relief of AI-induced joint pain. Women diagnosed with stage 0-III BC who have been receiving an AI for at least 2 months and reporting arthralgia with a ≥ 4 score on a 0-10 scale for joint pain were eligible for study enrollment. Participants were encouraged to join Tai Chi classes delivered over ZOOM three times a week for 12 weeks. Program engagement strategies include the use of a private Facebook study group and box.com cloud for archiving live class recordings. The program utilizes Text messaging and emails with periodic positive quotes and evidence based information on Tai Chi for facilitating community bonding and class attendance. Participants were invited to complete the following assessments online at baseline, 1, 2 and 3 months intervals from study enrollment: Brief Pain Inventory (BPI), Western Ontario and McMaster University Osteoarthritis index (WOMAC), The Australian Canadian Osteoarthritis Hand Index (AUSCAN), Fatigue Symptom Inventory (FSI), Hot Flash Related Daily Interference Scale (HFRDIS), Pittsburg Sleep Quality Index (PSQI) and Center for Epidemiological Studies Depression (CES-D). Results: 55 eligible patients were invited to participate and 39 consented and completed the baseline assessments. 61% (median) Participants attended the classes, with no Tai Chi related adverse events reported. 22 of the 39 participants completed the 3-month follow up assessments with a 56% retention rate. Study participants reported improvement from baseline compared to 3 month as follows: For BPI (P = .000), AUSCAN pain subscale (P =.000), AUSCAN function subscale for 35 patients (P = .000), WOMAC (P = .000), CES-D (P = 0.001), FSI (P = 0.00) and PSQI (P = .000). However HFRDIS improved in 11 patients (P = 0.00) for the other 22 patients (P = 0.154). Conclusions: The COVID-19 global pandemic has resulted in the need to rethink how mind-body therapies can be delivered. This study demonstrated the feasibility, acceptability, and potential efficacy of a Telehealth based Tai Chi intervention for reducing AI-induced arthralgia. The intervention decreased patient reported pain, stiffness and improved sleep quality and depressive symptoms. With our promising findings, larger telehealth based trials of Tai Chi for AI-associated arthralgia are needed.