ObjectiveIdentify prevalence of self-reported swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19.DesignMulticentre prospective observational cohort study ...using questionnaire data at visit 1 (2–7 months post discharge) and visit 2 (10–14 months post discharge) from hospitalised patients in the UK. Lasso logistic regression analysis was undertaken to identify associations.Setting64 UK acute hospital Trusts.ParticipantsAdults aged >18 years, discharged from an admissions unit or ward at a UK hospital with COVID-19.Main outcome measuresSelf-reported swallow, communication, voice and cognitive compromise.ResultsCompromised swallowing post intensive care unit (post-ICU) admission was reported in 20% (188/955); 60% with swallow problems received invasive mechanical ventilation and were more likely to have undergone proning (p=0.039). Voice problems were reported in 34% (319/946) post-ICU admission who were more likely to have received invasive (p<0.001) or non-invasive ventilation (p=0.001) and to have been proned (p<0.001). Communication compromise was reported in 23% (527/2275) univariable analysis identified associations with younger age (p<0.001), female sex (p<0.001), social deprivation (p<0.001) and being a healthcare worker (p=0.010). Cognitive issues were reported by 70% (1598/2275), consistent at both visits, at visit 1 respondents were more likely to have higher baseline comorbidities and at visit 2 were associated with greater social deprivation (p<0.001).ConclusionSwallow, communication, voice and cognitive problems were prevalent post hospitalisation for COVID-19, alongside whole system compromise including reduced mobility and overall health scores. Research and testing of rehabilitation interventions are required at pace to explore these issues.
Abstract Background/Aims Axial Spondyloarthritis (AxSpA) is an inflammatory arthritis affecting 0.5-1.0% of people in the UK. Physical activity guidance for people living with AxSpA from the National ...Institute for Health and Care Excellence is vague. Individualised, structured aerobic exercise is recommended without any direction towards exercise type, frequency, intensity, or acknowledgement of physical limitations to an individual’s environment which may prevent exercise participation. Consequently, the proportion of people with AxSpA meeting the World Health Organisation physical activity recommendations (>150 minutes of moderate-intensity exercise per week) is significantly lower than the general population. Therefore, a short survey was administered to people with AxSpA to understand types of physical activities they would like to participate in, and any common barriers to exercise participation. Methods The National Axial Spondyloarthritis Society (NASS) invited subscribers to their e-newsletter with lived experience to complete a short online survey. Respondents were asked ‘which of the following activities would you like to include as part of your usual lifestyle?’ ‘What would prevent you from taking part in the activities above?’ and ‘Do you already include any of the physical activities in your usual lifestyle?’ Respondents were allowed to choose multiple options from a range of activities and barriers. Results 266 people living with AxSpA (68% women, 31% men, 1% non-binary, 94% white British/Irish) responded. Walking was most selected for activities respondents would like to be included as part of their lifestyle (83%), followed by stretching/flexibility exercises (61%), swimming (46%), weight training and resistance exercise (41%), and cycling (33%). Only eight respondents (3%) stated hydrotherapy which is traditionally advocated as exercise therapy in AxSpA. Worries about pain and flare ups (57%), fatigue (45%), time (39%), cost (27%), not knowing enough about how much activity to do (22%), and lack of available facilities (20%) were common barriers. Conclusion To maximise reach and benefit, exercise guidance needs to relate to exercise that people with AxSpA would like to or already do; the benefits of exercise can only be realised if people want to participate. The responses emphasise the need for guidance relating to inclusive models of exercise. This includes exercise such as walking that is flexible and adaptable to limitations of time and does not require additional cost, equipment, or facilities. The results also highlight the importance of including outcome assessments of pain, flare frequency, and fatigue. Disclosure M. Roberts: None. S. Qooja: None. A. Moorthy: Consultancies; AM has received speaker fees from Lilly, Novartis, Galapagos, and UCB. L. Bishop: Grants/research support; NCB has received funding from NASS..
