Prevalence and determinants of post-COVID-19 syndrome among patients 6 months post-discharge from a teaching hospital in South India.

Background: The coronavirus disease 2019 (COVID-19) infection has affected millions of people worldwide in the last 4 years. Among those infected, the long-term COVID-19 syndrome, in which symptoms of COVID-19 persist for a variable period, is posing new challenges to the health system, but few studies are available in India that examine the post-COVID-19 syndrome, that is, 6 months and beyond COVID-19 infection. This study aimed to find the prevalence and determinants of post-COVID-19 syndrome among patients 6 months and beyond their infection. Methodology: This cross-sectional study was conducted among 300 patients who were admitted and discharged from Government Medical College, Thrissur, at least 6 months before with a diagnosis of COVID-19 infection. The data collection was performed using a semi-structured interview schedule through a telephonic interview. The analysis was performed using the Statistical Package for the Social Sciences (SPSS) software. Results: 21% of the patients studied had at least one persistent symptom at the end of 6 months, and 4.1% had more than one symptom. Among the symptoms persisting most commonly were fatigue (11%) and dyspnea (7.7%). Other than persisting symptoms, 21% of patients developed exertional dyspnea and 19% developed sleep disturbances during the 6 months after discharge. The factors that were associated with persistent symptoms in univariate analysis were increasing age, presence of chronic obstructive pulmonary disease (COPD), presence of chronic kidney disease (CKD), and admission to the intensive care unit (ICU). Conclusion: The study concludes that one-fifth of the patients still suffer from post-COVID-19 syndrome even 6 months after the COVID-19 infection. Our health systems should be prepared for the long-term management of COVID-19-infected people and prepare policies for the same.

Persistence of COVID-19 Symptoms and Quality of Life at Three and Twelve Months after Hospital Discharge.

Background and Objectives: Medical and public recognition of "long-COVID or post-COVID syndrome", as well as its impact on the quality of life (QoL), is required to better address the disease burden. Objectives: We aimed to describe the persistence of COVID-19 symptoms and QoL among patients at three and twelve months after their discharge from the hospital. Materials and Methods: We conducted an observational, prospective, and longitudinal analytic study from September 2021 to April 2022. To measure QoL, we used a validated version of the 36-item Short-Form Health Survey (SF-36). Results: We included 68 patients in the study. A total of 54 (79.4%) patients reported at least one persistent symptom at three months vs. 52 (76.4%) at twelve months (p = 0.804). Some persistent symptoms (myalgia, alopecia, and cough) decreased significantly at twelve months (50% vs. 30.9%, 29.4% vs. 13.2%, and 23.5% vs. 7.4%; respectively, p = 0.007); in contrast, other persistent symptoms (sleep-wake and memory disorders) were more frequent (5.9% vs. 32.4% and 4.4% vs. 20.6%; respectively, p = ≤0.001). Regarding QoL, a statistically significant improvement was observed in some scores over time, p = ≤0.037. At twelve months, dyspnea, myalgia, and depression were risk factors associated with a poor physical component summary (PCS), p = ≤0.027, whereas anxiety, depression, and fatigue were associated with a poor mental component summary (MCS), p = ≤0.015. Conclusion: As the proportion of persistent symptoms at twelve months is high, we suggest that patients must continue under long-term follow up to reclassify, diagnose, and treat new onset symptoms/diseases.

Pathology of COVID-19 Lung Disease.

The pathology of severe COVID-19 lung injury is predominantly diffuse alveolar damage, with other reported patterns including acute fibrinous organizing pneumonia, organizing pneumonia, and bronchiolitis. Lung injury was caused by primary viral injury, exaggerated immune responses, and superinfection with bacteria and fungi. Although fatality rates have decreased from the early phases of the pandemic, persistent pulmonary dysfunction occurs and its pathogenesis remains to be fully elucidated.

Persistent COVID-19 in immunocompromised patients-Israeli society of infectious diseases consensus statement on diagnosis and management.

BACKGROUND: Immunocompromised patients with impaired humoral immunity are at risk for persistent COVID-19 (pCOVID), a protracted symptomatic disease with active viral replication. OBJECTIVES: To establish a national consensus statement on the diagnosis, treatment, management, isolation, and prevention of pCOVID in adults. SOURCES: We base our suggestions on the available literature, our own experience, and clinical reasoning. CONTENT: Literature on the treatment of pCOVID is scarce and consists of few case reports and case series. The available studies provide low-quality evidence for monoclonal antibodies, convalescent plasma, antiviral drugs, and immunomodulators. Different combination therapies are described. Continuous viral replication and antiviral treatment may lead to the development of mutations that confer resistance to therapy. IMPLICATIONS: To reduce the risk of resistance and improve outcomes, we suggest treating pCOVID with a combination of antibody-based therapy and two antiviral drugs for duration of 5-10 days. Immunomodulatory therapy can be added in patients with an inflammatory clinical picture. In cases of treatment failure or relapse, prolonged antiviral treatment can be considered. For the prevention of pCOVID, we suggest active and passive vaccination and early initiation of treatment for acute COVID-19. Additional research on pCOVID treatment is urgently needed.

Charting a path forward: Promising outcomes of convalescent plasma therapy in the care of severely B-cell depleted patients with persistent COVID-19.

BACKGROUND: Patients with severe B-cell depletion related to hematological malignancies or B-cell targeted therapy suffer from impaired antibody responses to SARS-CoV-2 and are at risk for prolonged COVID-19. In this population, COVID-19 convalescent plasma (CCP) may provide passive immunity, enhance immune response, and promote virus neutralization. This study evaluated outcomes of B-cell depleted patients with persistent COVID-19 treated with CCP. STUDY DESIGN AND METHODS: This analysis included all consecutive severely B-cell depleted patients with persistent COVID-19, receiving CCP at Rambam between 01.2022-02.2023. Persistent COVID-19 was defined as the presence of symptoms for ≥14 days in patients with negative SARS-CoV-2 nucleocapsid antibody test results. RESULTS: Twenty patients met inclusion criteria, 17 of whom had hematological malignancies, two suffered from rheumatoid arthritis and one had both. Twelve patients received anti-CD-20 treatment, one - CAR-T cells and three underwent stem cell transplantation. The median duration of COVID-19 symptoms was 27.5 days (range 14-97); 12 patients had mild-to-moderate COVID-19 and 8 had severe infection. Sixteen patients required hospitalization. The majority of patients received other COVID-19 therapies before CCP. Within a median of two days (range 1-16) post-infusion, 19/20 patients clinically improved. No CCP-associated adverse events were documented. COVID-19 symptoms recurred in 3 of the improved patients. Two patients died from COVID-19 on days 1 and 90 following the first CCP infusion. DISCUSSION: In severely B-cell depleted patients with persistent COVID-19, CCP is safe and associated with rapid clinical improvement. This subset of immunocompromised patients could particularly benefit from CCP administration.

Long-term health consequences of COVID-19 in survivors hospitalised at a tertiary care hospital and their correlation with acute COVID-19 severity and associated risk factors.

OBJECTIVES: To determine post-COVID syndromes in the Indian population, correlating a wide spectrum of post-COVID manifestations with acute disease severity and associated risk factors. BACKGROUND: Post-COVID Syndrome (PCS) is defined as signs and symptoms that develop during or after acute COVID-19 infection. DESIGN OF STUDY: This is a prospective observational cohort with repetitive measurements. METHODS: The study followed RT-PCR confirmed COVID-19-positive survivors discharged from HAHC Hospital, New Delhi, for a period of 12 weeks. The patients were interviewed over the phone at 4 weeks and 12 weeks from the onset of symptoms for evaluation of clinical symptoms and health-related quality of life parameters. RESULTS: A total of 200 patients completed the study. At the baseline, 50% of the patients were categorised as severe based on their acute infection assessment. At 12 weeks after symptom onset, fatigue (23.5%), hair loss (12.5%) and dyspnea (9%) were the main persistent symptoms. The incidence of hair loss (12.5%), memory loss (4.5%) and brain fog (5%) were found to be increased as compared to the acute infection period. Severity of the acute COVID infection behaved as an independent predictor for the development of PCS, with high odds of experiencing persistent cough (OR = 13.1), memory loss (OR = 5.2) and fatigue (OR = 3.3). Further, 30% of subjects in the severe group experienced statistically significant fatigue at 12 weeks (p < .05). CONCLUSION: From the results of our study, it can be concluded that there is a huge disease burden of post-COVID Syndrome (PCS). The PCS comprised multisystem symptoms ranging from serious complaints of dyspnea, memory loss and brain fog to non-serious complaints of fatigue and hair loss. Severity of the acute COVID infection behaved as an independent predictor for the development of PCS. Our findings strongly recommend vaccination against COVID-19, for protection from disease severity as well as prevention of PCS. RELEVANCE TO CLINICAL PRACTICE: The findings of our study support the multidisciplinary approach required for the management of PCS with a team comprising of physicians, nurses, physiotherapists and psychiatrists working in close coordination for the rehabilitation of these patients. As nurses are considered the most trusted professionals in the community and the class of health workers associated with rehabilitation, focus should be given to educating them on PCS, which would prove to be an important strategy for efficient monitoring and long-term management of COVID-19 survivors.

Dual anti-viral treatment for persistent COVID-19 in immunocompromised hemato-oncological patients is associated with a favorable prognosis and minor side effects.

In hemato-oncological patients, COVID-19 can present as a persistent infection with ongoing symptoms and viral replication over a prolonged period of time. Data are scarce on the preferred treatment options for these patients. We describe our experience with a five-day course of dual anti-viral treatment with remdesivir and nirmatrelvir/ritonavir for hemato-oncological immunocompromised patients with persistent COVID-19. Fifteen patients with a history of lymphoma, CLL, and MM were included. Eight were male, median age was 74. All patients had an immediate clinical and virological response. In 73 % of patients, PCR for SARS-CoV-2 became negative at the end of treatment and the rest had an increase in PCR cycle threshold (CT) values, with a median increase of 6 cycles. After a follow-up of three months, 60 % of patients remained in full clinical and virological remission. None required invasive mechanical ventilation or died. The side effects we observed, neutropenia, lactatemia and elevated transaminases, were mild and almost all transient in nature. We conclude that dual anti-viral treatment appears to be a valid treatment option for persistent COVID-19.

Anxiety but not menopausal status influences the risk of long-COVID-19 syndrome in women living in Latin America.

OBJECTIVE: To study sociodemographic and clinical factors associated with the long-COVID-19 syndrome among women living in Latin American countries using undirected and directed methods. METHOD: We studied 347 patients with COVID-19 (confirmed by polymerase chain reaction) living in nine Latin American countries between May 2021 and July 2022, including 70 premenopausal, 48 perimenopausal, and 229 postmenopausal women. We compared the sociodemographic and general health information of women with (n = 164) and without (n = 183) the long-COVID-19 syndrome. They also completed the Connor-Davidson Resilience Scale, the Fear of COVID-19 Scale, the Jenkins Sleep Scale, and the Menopause Rating Scale to define the minimum set of variables for adjustment. We designed a directed acyclic graph (DAG) to identify factors related to the long-COVID-19 syndrome. Data were submitted to categorical logistic regression analyses. Results are reported as means and standard deviations or ß-coefficients and 95 % confidence intervals. RESULTS: Women with long-COVID-19 syndrome had a poor lifestyle, severe menopause symptoms, hypertension, insomnia, depression, anxiety, chronic diseases/conditions, risk of hospitalization, sleep disturbance, and low menopause-related quality of life compared to women without the syndrome. The DAG identified the following long-COVID-19 covariates: age, obesity, anxiety, depression, cancer, lifestyle, smoking, and menstrual status. A multivariable logistic model with these covariates indicated that anxiety is the only factor to be significantly associated with long-COVID-19 syndrome, whereas other covariates were confounding factors. There was no significant influence of menopausal status on the long-COVID-19 syndrome. CONCLUSION: Among factors selected by the DAG, only anxiety was significantly associated with the long-COVID-19. There was no significant influence of the menopause status on the long-COVID-19 syndrome in the studied population.

Clinical Characterization of the Persistent COVID-19 Symptoms: A Descriptive Observational Study in Primary Care.

INTRODUCTION: Evidence and clinical experience suggest that there are a range of signs of health issues that affect patients who have recovered from acute COVID-19 infection. This condition is commonly referred to as "persistent COVID-19," which is not connected with the severity of the disease. We have identified the prevalence and clinical-epidemiological characteristics of patients with COVID-19 and persistent symptoms treated in primary care centers. This is a descriptive observational study conducted between December 2020 and May 2022, the data were collected from digitized medical records and interviewing 1542 individuals with laboratory-confirmed SARS-CoV-2 infection. These patients were clinically followed for up to 1 year, based on the prevalence of symptoms. When stratifying by the risk of developing persistent COVID-19, 37.09% of the patients exhibited risk factors, with age (over 60 years) and cardiovascular risk factors predominating. The obtained prevalence of persistent COVID-19 at 90 days was 12.39%, with a slight predominance in females (55%) and a mean age of 45.8 years. The most affected systems were the cardiovascular, respiratory, and psychoneurological systems, with predominant symptoms of fatigue (41.88%), dyspnea (32.46%), and headache (14.66%), among others. The average duration of persistent symptoms was 178 days, equivalent to 6 months. In conclusion, over 10% of patients who recover from acute SARS-CoV-2 infection developed long-term consequences. OBJECTIVE: To measure the prevalence and clinical-epidemiological characteristics of individuals diagnosed with COVID-19 and persistent symptoms treated in primary care centers in Área Sanitaria Sur de Córdoba (Spain) between December 2020 and May 2022. METHODS: A retrospective observational study of the population of Área Sanitaria Sur de Córdoba was developed between December 2020 and May 2022. The scope of the study was 1542 individuals, and the prevalence of patients diagnosed with COVID-19 and persistent symptoms was determined based on laboratory-confirmed cases, randomly selected from adults who had progressed beyond the acute phase of the disease. All data were managed by the Área Sanitaria Sur de Córdoba (Spain). RESULTS: The risk factor of exhibiting one or more risk factors associated with developing persistent COVID-19 is 37.09%. The obtained prevalence of persistent COVID-19 at 90 days is 12.39%, it is higher in females (55%) than males and the mean age was 45.8 years. The most affected systems were the cardiovascular, respiratory, and psychoneurological systems, with predominant symptoms of fatigue (41.88%), dyspnea (32.46%), and headache (14.66%), among others. CONCLUSIONS: Results confirm that more than 10% of individuals recovering from acute SARS-CoV-2 infection showed long-term consequences and the observed persistent symptom duration was 178 days on average.

Longitudinal clinical phenotyping of post COVID condition in Mexican adults recovering from severe COVID-19: a prospective cohort study.

Introduction: Few studies have evaluated the presence of Post COVID-19 conditions (PCC) in people from Latin America, a region that has been heavily afflicted by the COVID-19 pandemic. In this study, we describe the frequency, co-occurrence, predictors, and duration of 23 symptoms in a cohort of Mexican patients with PCC. Methods: We prospectively enrolled and followed adult patients hospitalized for severe COVID-19 at a tertiary care centre in Mexico City. The incidence of PCC symptoms was determined using questionnaires. Unsupervised clustering of PCC symptom co-occurrence and Kaplan-Meier analyses of symptom persistence were performed. The effect of baseline clinical characteristics was evaluated using Cox regression models and reported with hazard ratios (HR). Results: We found that amongst 192 patients with PCC, respiratory problems were the most prevalent and commonly co-occurred with functional activity impairment. 56% had ≥5 persistent symptoms. Symptom persistence probability at 360 days 0.78. Prior SARS-CoV-2 vaccination and infection during the Delta variant wave were associated with a shorter duration of PCC. Male sex was associated with a shorter duration of functional activity impairment and respiratory symptoms. Hypertension and diabetes were associated with a longer duration of functional impairment. Previous vaccination accelerated PCC recovery. Discussion: In our cohort, PCC symptoms were frequent (particularly respiratory and neurocognitive ones) and persistent. Importantly, prior SARS-CoV-2 vaccination resulted in a shorter duration of PCC.

Evaluation of persistent COVID and SARS-CoV-2 reinfection in a cohort of patients on the island of Gran Canaria, Spain / Evaluación de la COVID-19 persistente y la reinfección por SARS-CoV-2 en una cohorte de pacientes en la isla de Gran Canaria, España

Introduction This study analyzed the impact of patients’ age, sex, vaccination, immunosuppressive treatment, and previous comorbidities on the risk of developing persistent COVID-19 or SARS-CoV-2 virus reinfection. Method Population-based observational retrospective study of a cohort of 110,726 patients aged 12 years or older, who were diagnosed with COVID-19 between June 1st, 2021 and February 28th, 2022 in the island of Gran Canaria. Results 340 patients suffered reinfection. The combination of advanced age, female sex and lack of complete or incomplete vaccination against COVID-19 was strongly predictive of reinfection (p<0.05). In the 188 patients who developed persistent COVID-19, the persistence of symptoms was more frequent in adult patients, women, and patients with a diagnosis of asthma. Complete vaccination was associated with a lower risk of reinfection ([OR] 0.05, 95%CI 0.04–0.07; p<0.05) and of developing persistent COVID-19 ([OR] 0.07, 95%CI 0.05–0.10; p<0.05). None of the patients with reinfection or persistent COVID-19 died during the period of the study Conclusions This study confirmed the link between age, sex, asthma and risk of persistent COVID-19. It was not possible to define the patient's comorbidities as a factor that influences the development of reinfection, but its association with age, sex, type of vaccine and hypertension was demonstrated. Higher vaccination coverage was associated with a lower risk of persistent COVID-19 or SARS-CoV-2 reinfection (AU)

Introducción Se analizó el impacto de la edad, el sexo, la vacunación, el tratamiento inmunosupresor y las comorbilidades previas del paciente sobre la condición de riesgo de desarrollar COVID-19 persistente o reinfección por el virus del SARS-CoV-2. Método Estudio retrospectivo observacional de base poblacional en una cohorte de 110.726 pacientes de 12 o más años de edad diagnosticados de COVID-19 entre el 1 de junio de 2021 y el 28 de febrero de 2022 en la isla de Gran Canaria. Resultados Trescientos cuarenta pacientes sufrieron reinfección por COVID-19. La combinación de edad avanzada, sexo femenino y falta de vacunación completa o incompleta contra la COVID-19 fue fuertemente predictiva de reinfección (p<0,05). En los 188 pacientes que desarrollaron COVID-19 persistente, la persistencia de síntomas fue más frecuente en pacientes en edad adulta, mujeres y pacientes con diagnóstico de asma. La vacunación completa se asoció con un menor riesgo de reinfección ([OR] 0,05, IC 95% 0,04-0,07; p <0,05) y de desarrollar COVID-19 persistente ([OR] 0,07, IC 95% 0,05-0,10; p <0,05). Ninguno de los pacientes con reinfección o COVID-19 persistente falleció durante el período del estudio. Conclusiones Este estudio confirmó el vínculo entre la edad, el sexo, el asma y el riesgo de COVID-19 persistente. No se pudo definir las comorbilidades del paciente como factor que influye en el desarrollo de reinfección, pero sí se demostró su asociación con edad, sexo e hipertensión arterial. Una mayor cobertura de vacunación se asoció a un menor riesgo de COVID-19 persistente o reinfección por SARS-CoV-2 (AU)

Effectiveness of Digital Physiotherapy Practice Compared to Usual Care in Long COVID Patients: A Systematic Review.

Long COVID syndrome has been recognized as a public health problem. Digital physiotherapy practice is an alternative that can better meet the needs of patients. The aim of this review was to synthesize the evidence of digital physiotherapy practice in Long COVID patients. A systematic review was carried out until December 2022. The review was complemented by an assessment of the risk of bias and methodological quality. A narrative synthesis of results was conducted, including subgroup analyses by intervention and clinical outcomes. Six articles, including 540 participants, were selected. Five articles were considered of high enough methodological quality. Parallel-group, single-blind, randomized controlled trials were the most commonly used research design. Tele-supervised home-based exercise training was the most commonly used intervention. Great heterogeneity in clinical outcomes and measurement tools was found. A subgroup analysis showed that digital physiotherapy is effective in improving clinical outcomes. Significant differences in favor of digital interventions over usual care were reported. Nevertheless, discrepancies regarding effectiveness were found. Improvements in clinical outcomes with digital physiotherapy were found to be at least non-inferior to usual care. This review provides new evidence that digital physiotherapy practice is an appropriate intervention for Long COVID patients, despite the inherent limitations of the review. Registration: CRD42022379004.

Successful Treatment of Persistent Symptomatic Coronavirus Disease 19 Infection With Extended-Duration Nirmatrelvir-Ritonavir Among Outpatients With Hematologic Cancer.

Persistent symptomatic coronavirus disease 2019 (COVID-19) is a distinct clinical entity among patients with hematologic cancer and/or profound immunosuppression. The optimal medical management is unknown. We describe 2 patients who had symptomatic COVID-19 for almost 6 months and were successfully treated in the ambulatory setting with extended courses of nirmatrelvir-ritonavir.

Clinical and Epidemiological Profiles of Primary Healthcare Professionals with COVID-19 Infection and Long COVID: An Observational Study.

Health professionals have been one of the groups most affected by the SARS-CoV-2 virus. Currently, there is little scientific evidence on the similarities and differences between COVID-19 infection and the development of long COVID in primary care (PC) workers. Therefore, it is necessary to analyse their clinical and epidemiological profiles in depth. This study was observational and descriptive, including PC professionals who were divided into three comparison groups based on the diagnostic test for acute SARS-CoV-2 infection. The responses were analysed using descriptive and bivariate analysis to examinate the relationship between independent variables and the presence or not of long COVID. Binary logistic regression analysis was also conducted, with each symptom as the dependent variable and each group as the independent variable. The results describe the sociodemographic characteristics of these population groups, revealing that women in the health sector are the most affected by long COVID and that being in this group is associated with its development. Furthermore, individuals with long COVID exhibited the highest number of symptoms and pathologies. Certain symptoms were found to be associated with long COVID development in this population, including an altered sense of smell, pneumonia, fever, and sore throat, among others. Similarly, altered senses of smell and taste, chest tightness, and joint pain, among others, were found to be associated with acute COVID-19 infection. Additionally, patients with pre-existing overweight or obesity were more likely to experience acute COVID-19 and develop long COVID. The data obtained can be crucial for improving the detection, diagnosis, and treatment of long COVID patients, ultimately leading to an enhancement in their quality of life.

Prevalencia de la COVID persistente: seguimiento al año de una cohorte poblacional ambulatoria / Chronic COVID prevalence: one-year follow-up of an outpatient population cohort

Antecedentes y objetivo: la evolución a largo plazo en pacientes con COVID-19 no es suficientemente conocida. El objetivo es estimar la prevalencia de la COVID persistente (estado post-COVID-19) a los 6 y 12 meses en una cohorte poblacional.Material y métodos: estudio observacional, ambispectivo, realizado en un centro de Atención Primaria, incluyendo pacientes de 18-65 años con COVID-19 diagnosticado entre julio y diciembre de 2020. Se hicieron entrevistas telefónicas a los 6 y 12 meses, analizando la persistencia de síntomas, estado de salud e inicio de psicofármacos.Resultados: de 143 pacientes, 116 completaron el seguimiento (edad media: 43,6 años, 59% hombres). El 95,7% tuvieron infección leve, siendo el síntoma más frecuente la fatiga (69,8%). El número de síntomas disminuyó tras 6 (p <0,001) y 12 meses (p <0,001), mejorando la percepción de salud (p <0,001) y disminuyendo el tratamiento con psicofármacos (p = 0,04). Tenían estado post-COVID-19 el 41,4% (intervalo de confianza [IC] 95% 32,8-50,5) y el 8,6% (IC 95% 5,0-17,9) a los 6 y 12 meses, respectivamente. Conclusiones: casi todos los pacientes recuperaron su estado de salud a los 12 meses, con una prevalencia de estado post-COVID-19 inferior a la descrita.(AU)

Background and objective: long-term course in COVID-19 patients is not sufficiently known. The aim is to estimate the prevalence of post-COVID-19 condition at six and 12 months in a population cohort.Material and methods: observational, ambispective study, performed in a primary care centre, including patients aged 18-65 years with COVID-19 diagnosed between July-December 2020. Telephone interviews were conducted at six and 12 months, analyzing the persistence of symptoms, state of health and commencing psychotropic drugs.Results: of 143 patients, 116 completed follow-ups (mean age 43.6 years, 59% male). A total of 95.7% had mild infection, the most common symptom being fatigue (69.8%). The number of symptoms decreased after six (P<0.001) and 12 months (P<0.001), which improved the perception of health (P<0.001) and reducing treatment with psychoactive drugs (P=0.04). A total of 41.4% (95% CI 32.8-50.5) and 8.6% (95% CI 5.0-17.9) had post-COVID-19 condition at six and 12 months, respectively.Conclusions: almost all the patients recovered their health status at 12 months, with a prevalence of post-COVID-19 condition lower than that reported.(AU)

Evaluation of persistent COVID and SARS-CoV-2 reinfection in a cohort of patients on the island of Gran Canaria, Spain.

INTRODUCTION: This study analyzed the impact of patients' age, sex, vaccination, immunosuppressive treatment, and previous comorbidities on the risk of developing persistent COVID-19 or SARS-CoV-2 virus reinfection. METHOD: Population-based observational retrospective study of a cohort of 110,726 patients aged 12 years or older, who were diagnosed with COVID-19 between June 1st, 2021 and February 28th, 2022 in the island of Gran Canaria. RESULTS: 340 patients suffered reinfection. The combination of advanced age, female sex and lack of complete or incomplete vaccination against COVID-19 was strongly predictive of reinfection (p<0.05). In the 188 patients who developed persistent COVID-19, the persistence of symptoms was more frequent in adult patients, women, and patients with a diagnosis of asthma. Complete vaccination was associated with a lower risk of reinfection ([OR] 0.05, 95%CI 0.04-0.07; p<0.05) and of developing persistent COVID-19 ([OR] 0.07, 95%CI 0.05-0.10; p<0.05). None of the patients with reinfection or persistent COVID-19 died during the period of the study. CONCLUSIONS: This study confirmed the link between age, sex, asthma and risk of persistent COVID-19. It was not possible to define the patient's comorbidities as a factor that influences the development of reinfection, but its association with age, sex, type of vaccine and hypertension was demonstrated. Higher vaccination coverage was associated with a lower risk of persistent COVID-19 or SARS-CoV-2 reinfection.

The definition of long COVID used in interventional studies.

INTRODUCTION: There has been little consensus for a specific definition of long COVID, though several organizations have created varying ones. We sought to examine the definition of long COVID used in ongoing clinical trials. METHODS: We searched 'long COVID' and related terms on both PubMed and clinicaltrials.gov for randomized studies that either included patients with long COVID or had a persistent or long-term COVID-related outcome and abstracted long COVID definition components. RESULTS: Of the 92 studies, a laboratory-only confirmed diagnosis of COVID-19 was stipulated in 54.3% (n = 50) studies. We found eight different time durations specified for how long symptoms needed to have occurred, ranging from 4 to 52 weeks, with 12 weeks being the most common (34.8%; n = 32). 35.9% (n = 33) did not specify a time duration. There were 57 different symptoms specified in total, with a median of one symptom identified per study (range 0-32). 8.7% of trials adhered to NICE or WHO definitions. CONCLUSION: Standardized definitions of long COVID should be applied in studies assessing this condition to unify and harmonize research on this topic.

Long COVID Symptomatology and Associated Factors in Primary Care Patients: The EPICOVID-AP21 Study.

Persistent COVID-19 condition includes a wide variety of symptoms and health problems of indeterminate duration. The present study examined the sociodemographic and clinical characteristics of the population with Long COVID seen in Primary Care using a questionnaire based on the existing scientific literature. It was an observational and descriptive study of the characteristics of the Spanish population with Long COVID over 14 years of age. The responses were analysed by means of a descriptive analysis of the variables recorded, in addition to a bivariate analysis to determine the existence of a relationship between persistent COVID-19 and variables such as gender, age, vaccination status or concomitant pathology. The results obtained clearly describe the sociodemographic characteristics of the population, highlighting the predominance of female gender and the prevalence of tiredness and fatigue. Furthermore, relevant information was obtained on the differences in symptomatology according to gender, age, previous pathologies and alterations derived from infection and/or vaccination. These data are important for better detection, diagnosis and treatment of Long COVID and the improvement of the quality of life of this population.

The psychological syndrome associated with Long-COVID: A study protocol.

Introduction: Chronic post-viral syndromes, including Long-COVID, are characterized by a range of persistent symptoms that occur following a viral infection. Psychological symptoms are prevalent in Long-COVID patients and can have a significant impact on their quality of life. However, the specific patterns of psychological symptoms, their associations with physical symptoms, and the factors predicting their severity remain poorly understood. Aims: This study aims to explore and systematically assess psychological symptoms in Long-COVID, to identify syndrome clusters based on these symptoms, to examine their relationship with physical symptoms, and to investigate the influence of pandemic-related variables. Methods: Descriptive, cross-sectional study with data collected through an online questionnaire across several EU countries, from February 2020 to December 2022. Participants were recruited using public relations, the social media and information campaigns directed at the public and health professionals using snowball sampling. Results: The findings will allow to phenotype Long-COVID related psychological symptom clusters based on self-reports. facilitating improved assessment and treatment approaches. Conclusions: The results will provide important knowledge for the public health management of the public healh management of Long COVID. The findings will contribute to a better understanding of the psychological symptoms associated with Long-COVID and the development of specific treatment guidelines for psychological burden associated with Long-COVID, thereby supporting management strategies to combat the after-effects of the COVID-19 pandemic, enhancing their overall well-being and quality of life.