Persistent post-covid symptoms in healthcare workers.

BACKGROUND: Recent reports suggest a higher incidence of COVID-19 infections among healthcare workers (HCW). However, information about the long-term complications affecting this population is lacking. AIMS: Investigation of long-term impact of COVID-19 in HCW. METHODS: Seropositivity for SARS-CoV-2 antibodies was evaluated for the majority of HCW in an English teaching hospital 2 months following the peak of COVID-19 first wave. A questionnaire investigating the long-term complications was sent through global e-mail to HCW 4 months following the peak of the wave enquiring about the persistent health issues still affecting them at that point. RESULTS: Out of 3759 subjects tested for SARS-CoV-2 antibodies, 932 were positive (24%). Forty-five per cent of 138 HCW responding to the questionnaire reported persistent symptoms with 32% struggling to cope 3-4 months following the peak of the wave. Moderate-to-severe fatigue stood out as the most disabling symptom (39%) but mild-to-moderate shortness of breath, anxiety and sleep disturbance were almost universal in the subjects still struggling with symptoms. Only 16% consulted their general practitioner (GP) about their symptoms with only 2% taking sick leave after recovering from the acute illness. CONCLUSIONS: Our data suggest that about a third of HCW who responded to the survey were still struggling to cope with the symptoms of what is now known as long covid several months after the acute COVID-19 infections. The overwhelming majority of this group seem to be reluctant to neither seek medical advice nor take sick leave.

Current practice of prophylactic anticoagulation in Guillain-Barré syndrome.

OBJECTIVE: To document the incidence of venous thromboembolism in Guillain-Barré syndrome and current practice of anticoagulating these patients. DESIGN: Retrospective study. SETTING: Acute neurology and rehabilitation wards in a teaching hospital. SUBJECTS: Seventy-three patients with Guillain-Barré syndrome admitted to Addenbrooke's Hospital from 1995 to 1999. RESULTS: Out of 73 patients, 50 were anticoagulated (68%) for 5-490 days with mean of 72 days. Anticoagulation was discontinued in 28 patients when they could walk independently and in six who were still wheelchair dependent. Five patients developed clinical deep venous thrombosis (DVT) (7%), three of them had pulmonary emboli. Venous thrombosis occurred in the first two months after onset in four patients. Two patients were not anticoagulated when they developed their DVT and the other three were on enoxaparin; one of these three had a pulmonary embolism and died. CONCLUSION: Despite prophylactic anticoagulants being used in the majority of patients admitted with major problems of mobility, 6% (3 out of 50) still developed clinically detected DVT and two developed pulmonary embolism. While this incidence is considerably lower than data reported before routine anticoagulation became a standard practice, these data reinforce the need for anticoagulation and suggest that full anticoagulation might be needed to reduce the incidence of thromboembolic complications further.

Bone density in chronic low back pain: a pilot study.

BACKGROUND AND OBJECTIVE: Levels of physical activity in chronic low back pain patients are relatively low due to their fear of provoking pain. This may have a secondary impact on maintenance of bone mass. The objective of this study is to determine if patients with chronic low back pain are at a higher risk of bone demineralization. DESIGN: Bone mineral density (BMD) was measured in 25 chronic low back pain patients at the lumbar spine, hip and distal forearm. SETTING: A university hospital. SUBJECTS: Twenty-five chronic low back pain patients (mean age 45 years) enrolled on a residential back pain rehabilitation programme. RESULTS: Thirteen patients (52%) were osteopenic or osteoporotic in one or more sites. BMD at the lumbar spine was generally lower than the mean BMD of age-matched subjects (p = 0.04). There was no significant relationship between BMD and duration of pain, disability, sex or previous surgical intervention. CONCLUSIONS: Chronic low back pain patients have an increased incidence of osteopenia and osteoporosis. This finding reinforces the importance of motivating patients to incorporate exercise into daily life. Given the limited set of subjects used in the present study, further studies are required.