Orthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (PoTS) and orthostatic hypotension (OH), are often reported in long covid, but published studies are small with ...inconsistent results. We sought to estimate the prevalence of objective OI in patients attending long covid clinics and healthy volunteers and associations with OI symptoms and comorbidities. Participants with a diagnosis of long covid were recruited from eight UK long covid clinics, and healthy volunteers from general population. All undertook standardized National Aeronautics and Space Administration Lean Test (NLT). Participants' history of typical OI symptoms (e.g., dizziness, palpitations) before and during the NLT were recorded. Two hundred seventy‐seven long covid patients and 50 frequency‐matched healthy volunteers were tested. Healthy volunteers had no history of OI symptoms or symptoms during NLT or PoTS, 10% had asymptomatic OH. One hundred thirty (47%) long covid patients had previous history of OI symptoms and 144 (52%) developed symptoms during the NLT. Forty‐one (15%) had an abnormal NLT, 20 (7%) met criteria for PoTS, and 21 (8%) had OH. Of patients with an abnormal NLT, 45% had no prior symptoms of OI. Relaxing the diagnostic thresholds for PoTS from two consecutive abnormal readings to one abnormal reading during the NLT, resulted in 11% of long covid participants (an additional 4%) meeting criteria for PoTS, but not in healthy volunteers. More than half of long covid patients experienced OI symptoms during NLT and more than one in 10 patients met the criteria for either PoTS or OH, half of whom did not report previous typical OI symptoms. We therefore recommend all patients attending long covid clinics are offered an NLT and appropriate management commenced.
The C19-YRS was the first scale reported in the literature for patient assessment and monitoring in Long Covid or Post-COVID syndrome. The scale has demonstrated content validity in a previous ...COVID-19 follow-up study. The growing number of patients with Post-COVID syndrome required the development of a self-report version (and a digital format) so that the scale can be completed by patients themselves. Individuals with Long Covid and clinicians providing care were involved in iterative changes to the scale. The self-report version of the scale captures symptom severity, functional disability and global health status. The C19-YRS digital format comprises a smartphone application for the patient and a web portal for the clinician to assess, triage and monitor patients remotely. The items have been shown to span all the components of the WHO ICF Framework for health condition.
From the moment of their discovery, chemosynthetic ecosystems in the deep sea have held intrinsic scientific value. At the same time that the scientific community is studying chemosynthetic ...ecosystems other sectors are either engaged in, or planning for, activities that may adversely impact these ecosystems. There is a need and opportunity now to develop conservation strategies for networks of chemosynthetic ecosystem reserves in national and international waters through collaboration among concerned stakeholders.
Human activities at deep-sea chemosynthetic habitats (vents and seeps) are increasing, often in advance of–or coincident with–discovery and development of conservation strategies. The timelines portrayed here track the discovery, conservation activities, and development of international regulatory infrastructure for exploration and exploitation of polymetallic sulfides (copper-, zinc-, and other metal-rich ores) at hydrothermal vents in the deep sea.
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► Chemosynthetic ecosystems have commercial, scientific, and biodiversity values. ► Ongoing and emerging human activities may adversely affect chemosynthetic ecosystems. ► The Dinard Guidelines call for establishment of networks of chemosynthetic ecosystem reserves.
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