Background
Single studies support the presence of several post‐COVID‐19 symptoms; however, there is no evidence for the synthesis of symptoms.
Objective
We attempt to provide an overview of the ...persistent symptoms that post‐COVID‐19 patients encounter, as well as the duration of these symptoms to help them plan their rehabilitation.
Design
Systematic review and meta‐analysis.
Participants
A total of 16 studies involving 8756 patients post‐COVID‐19 were included.
Methods
The CINAHL, PubMed, EMBASE, Scopus, and Web of Science databases were searched from 2019 to August 2021. Observational studies that reported data on post‐COVID‐19 symptoms were included. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal for Observational Studies. We included medium‐ to high‐quality studies. We used a random‐effects model for the meta‐analytical pooled prevalence of each post‐COVID‐19 symptom, and I2 statistics for heterogeneity.
Results
From the 2481 studies identified, 16 met the inclusion criteria. The sample included 7623 hospitalised and 1133 non‐hospitalised patients. We found the most prevalent symptoms were fatigue and dyspnea with a pooled prevalence ranging from 42% (27%–58%). Other post‐COVID‐19 symptoms included sleep disturbance 28% (14%–45%), cough 25% (10%–44%), anosmia/ageusia 24% (7%–47%), fever 21% (4%–47%), myalgia 17% (2%–41%), chest pain 11% (5%–20%), and headache 9% (2%–20%). In addition to physical symptoms, anxiety/depression was also prevalent 27% (8%–53%).
Conclusions
Fatigue and dyspnea were the most prevalent post‐COVID‐19 symptoms and experienced up to 12 months.
Relevance to clinical practice
Multiple persistent symptoms are still experienced until 12 months of post‐Covid 19. This meta‐analysis should provide some awareness to nurses to highlights the unmet healthcare needs of post‐COVID‐19 patients. Long‐term monitoring for the evaluation and treatment of symptoms and conditions and rehabilitation programs should be conducted.
La infección por coronavirus ha traído múltiples presentaciones existiendo confusión en definiciones como: COVID prolongado y síndrome post COVID; este último es el grupo de signos y síntomas que se ...presentan en un paciente luego de 3 meses de la infección. Objetivo: determinar la incidencia y las características clínicas del síndrome post COVID-19, en nuestro medio. Materiales y métodos: se realizó una encuesta a través de Google académico a las personas adultas que viven en Tungurahua. Los resultados fueron consolidados en una base de datos y se dividieron en dos grupos, el grupo 1 el diagnóstico de COVID-19 por algún facultativo, el grupo 2 fue de control, se realizó un análisis de frecuencia de los signos y síntomas y se analizó la relación con el diagnóstico previo de COVID-19. Resultados: Un gran número de pacientes presentaba algún síntoma, el más frecuente fue: pérdida del olfato (37 – 5,7%), luego adinamia, efluvio telógeno, hipogeusia, fatiga, ansiedad y depresión (4,5%; 4,5%; 3.7%; 3,3%; 3,3 % respectivamente), casi la mitad de los pacientes recibió tratamiento sintomático (49%) y un porcentaje importante (46 %) antibióticos, siendo la duración menor de 15 días en su mayoría. Conclusiones y recomendaciones: Las manifestaciones post COVID-19 son numerosos y muy frecuentes, por lo tanto, se requiere el conocimiento de todas las ramas de la salud, para poder tomar los correctivos y evitar estas manifestaciones que han producido limitaciones temporales tanto en lo personal como en lo laboral a una gran parte de la población afectada.
Background
Previous studies have reported Blood type O to confer a lower risk of SARS‐CoV‐2 infection, while secretor status and other blood groups have been suspected to have a similar effect as ...well.
Study design and methods
To determine whether any other blood groups influence testing positive for SARS‐CoV‐2, COVID‐19 severity, or prolonged COVID‐19, we used a large cohort of 650,156 Danish blood donors with varying available data for secretor status and blood groups ABO, Rh, Colton, Duffy, Diego, Dombrock, Kell, Kidd, Knops, Lewis, Lutheran, MNS, P1PK, Vel, and Yt.
Of these, 36,068 tested positive for SARS‐CoV‐2 whereas 614,088 tested negative between 2020‐02‐17 and 2021‐08‐04. Associations between infection and blood groups were assessed using logistic regression models with sex and age as covariates.
Results
The Lewis blood group antigen Lea displayed strongly reduced SARS‐CoV‐2 susceptibility OR 0.85 CI0.79–0.93 p < .001. Compared to blood type O, the blood types B, A, and AB were found more susceptible toward infection with ORs 1.1 CI1.06–1.14 p < .001, 1.17 CI1.14–1.2 p < .001, and 1.2 CI1.14–1.26 p < .001, respectively. No susceptibility associations were found for the other 13 blood groups investigated. There was no association between any blood groups and COVID‐19 hospitalization or long COVID‐19. No secretor status associations were found.
Discussion
This study uncovers a new association to reduced SARS‐CoV‐2 susceptibility for Lewis type Lea and confirms the previous link to blood group O. The new association to Lea could be explained by a link between mucosal microbiome and SARS‐CoV‐2.
Introduction: Emerging evidence suggests that long-term pulmonary symptoms and functional impairment occurs in a proportion of individuals following SARS-CoV-2 infection. Although the proportion of ...affected patients remains to be determined, physicians are increasingly being confronted with patients reporting respiratory symptoms and impairment beyond the acute phase of COVID-19. In face of limited evidence, the Swiss Society for Pulmonology established a working group to address this area of unmet need and formulated diagnostic and treatment recommendations for the care of patients with pulmonary long COVID (LC). Method: The Swiss COVID Lung Study group and Swiss Society for Pulmonology (SSP) formulated 13 questions addressing the diagnosis and treatment of pulmonary LC. A survey within the SSP special interest groups involved in care of LC patients was conducted in Switzerland. A CORE process/Delphi-like process was used to formulate recommendations. Forty experienced pulmonologists replied to the first survey and 22 completed the second follow-up survey. Agreement of ≥70% consensus led to formulation of a recommendation. Results: The participants in the survey reached consensus and formulated a strong recommendation for regarding the following points. Patients hospitalized for COVID-19 should have a pulmonary assessment including pulmonary function tests. Symptomatic subjects affected by COVID-19, including those with mild disease, should benefit from a pulmonary follow-up. Persistent respiratory symptoms after COVID-19 should be investigated by a pulmonary follow-up including plethysmography, diffusion capacity measurement, and blood gases analysis. Individuals having suffered from COVID-19 and who present with persistent respiratory symptoms should be offered a rehabilitation. Additional questions were given moderateor weak recommendations for. The panel did not reach sufficient consensus for pharmacological therapy (e.g., therapy specifically targeting lung fibrosis) to formulate recommendations for LC drug treatment. Conclusion: The formulated recommendations should serve as an interim guidance to facilitate diagnosis and treatment of patients with pulmonary LC. As new evidence emerges, these recommendations may need to be adapted.
An extensive computer search (from January 2020 to January 2023) was conducted including literature from the PubMed, Scopus, MEDLINE, Web of Science, and EMBASE databases. According to preset ...criteria, a total of 58 articles were included in this review article. Generally, any patient who becomes infected with COVID-19 can develop post-COVID-19 conditions. The course of COVID-19 is divided into three main stages: acute COVID-19 (up to 4 weeks), post-acute COVID-19 (from 4 to 12 weeks), and post-COVID (from 12 weeks to 6 months). If a more protracted course of COVID (over 6 months) is demonstrated, the term “long-COVID” is used. Although the acute stage of COVID-19 infection most commonly manifests with acute respiratory symptoms, one very common symptom of the disease is pain, while the most common symptoms of post-COVID syndrome are shortness of breath, dry cough, fatigue, loss of olfactory and gustatory function, tightness and chest pain, sleep and mood disturbances, body aches, muscle and joint pain, sore throat, fever, and persistent headaches. All observations demonstrated a high incidence of chronic pain syndromes of various localization in the post- and long-COVID period. Post-COVID chronic pain might include a newly developed chronic pain as a part of post-viral syndrome; worsening of preexisting chronic pain due to the associated changes in the medical services, or a de novo chronic pain in healthy individuals who are not infected with COVID. Chronic pain during and post-COVID-19 pandemic is an important health issue due to the significant impacts of pain on the patients, health care systems, and society as well. Therefore, it is important that patients with chronic pain receive effective treatment according to their specific needs. Accordingly, the main goal of this review article is to provide a broad description about the post-COVID pain and to explore the impact of long COVID-19 on chronic pain patients, and also to give brief reports about the prevalence, risk factors, possible mechanisms, different presentations, and the management tools through a systematic approach.
Background/Objectives
Several scoring systems have been specifically developed for risk stratification in COVID‐19 patients.
Design
We compared, in a cohort of confirmed COVID‐19 older patients, ...three specifically developed scores with a previously established early warning score. Main endpoint was all causes in‐hospital death.
Setting
This is a single‐center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID‐19.
Participants
We reviewed the clinical records of the confirmed COVID‐19 patients aged 60 years or more consecutively admitted to our ED over a 6‐week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort.
Measurements
International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol‐Coronavirus Clinical Characterization Consortium (ISARIC‐4C) score, COVID‐GRAM Critical Illness Risk Score (COVID‐GRAM), quick COVID‐19 Severity Index (qCSI), National Early Warning Score (NEWS).
Results
Median age was 74 (67–82) and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in‐hospital death. The ISARIC‐4C score had the highest area under ROC curve (AUROC) 0.799 (0.738–0.851), followed by the COVID‐GRAM 0.785 (0.723–0.838), NEWS 0.764 (0.700–0.819), and qCSI 0.749 (0.685–0.806). However, these differences were not statistical significant.
Conclusion
Among the evaluated scores, the ISARIC‐4C and the COVID‐GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID‐19.
Background
Longer‐term symptoms (long COVID) may be present in seemingly recovered patients for several months and can be debilitating.
Aim
To investigate the prevalence and type of symptoms in those ...with a prior COVID‐19 diagnosis.
Methods
This prospective, longitudinal observational study commenced in July 2020 investigating the longer‐term health impacts of COVID‐19. Participants were recruited via public health units and media publicity. Surveys were completed upon enrolment, and at 1, 3, 6 and 12 months. Outcome measures included incidence of activity limitations and symptoms against health and vaccination status, age and gender.
Results
Overall, 339 participants were recruited. At 3 months after COVID‐19, 66.8% reported symptoms, and 44.8% were still experiencing symptoms at 12 months. Fatigue was most common at every point (between 53.1% and 33.1%). Pain symptoms increased in relative prevalence over time, whereas respiratory/pulmonary‐type symptoms decreased substantially after 3 months. Females and younger people were more likely to experience symptoms in the early stages of long COVID (P < 0.01) and those with more comorbidities in the latter stages (P < 0.001). Vaccination showed a statistically significant protective effect against symptoms (P < 0.01–0.001).
Conclusion
Long‐term COVID‐19 symptoms exist among recovered patients up to 12 months after contracting the virus. Fatigue is a primary contributor, while chronic pain became more problematic after 6 months. Vaccination was a factor in preventing long‐term symptoms and aiding faster recovery from symptoms. Further work exploring additional contributors to symptom prevalence would assist in developing appropriate follow‐up care.
The COVID‐19 outbreak has become one of the largest public health crises of our time. Governments have responded by implementing self‐isolation and physical distancing measures that have profoundly ...impacted daily life throughout the world. In this study, we aimed to investigate how people experience the activities, interactions, and settings of their lives during the pandemic. The sample (N = 604) was assessed in Ireland on the 25 March 2020, following the closure of schools and non‐essential businesses. We examined within‐person variance in emotional well‐being and how people spend their time. We found that while most time was spent in the home (74%), time spent outdoors (8%) was associated with markedly raised positive affect and reduced negative emotions. Exercising, going for walks, gardening, pursuing hobbies, and taking care of children were the activities associated with the greatest affective benefits. Home‐schooling children and obtaining information about COVID‐19 were ranked lowest of all activities in terms of emotional experience. These findings highlight activities that may play a protective role in relation to well‐being during the pandemic, the importance of setting limits for exposure to COVID‐19‐related media coverage, and the need for greater educational supports to facilitate home‐schooling during this challenging period.
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite pulmonary impairments being the most prevalent, extra-pulmonary ...manifestations of COVID-19 are abundant. Confirmed COVID-19 cases have now surpassed 57.8 million worldwide as of 22 November 2020. With estimated case fatality rates (number of deaths from COVID-19 divided by number of confirmed COVID-19 cases) varying between 1 and 7%, there will be a large population of recovered COVID-19 patients that may acquire a multitude of long-term health consequences. While the multi-organ manifestations of COVID-19 are now well-documented, the potential long-term implications of these manifestations remain to be uncovered. In this review, we turn to previous similar coronaviruses (i.e. SARS-CoV-1 and Middle East respiratory syndrome coronavirus MERS-CoV) in combination with known health implications of SARS-CoV-2 infection to predict potential long-term effects of COVID-19, including pulmonary, cardiovascular, hematologic, renal, central nervous system, gastrointestinal, and psychosocial manifestations, in addition to the well-known post-intensive care syndrome. It is necessary to monitor COVID-19 patients after discharge to understand the breadth and severity of long-term effects. This can be accomplished by repurposing or initiating large cohort studies to not only focus on the long-term consequences of SARS-CoV-2 infection, but also on acquired immune function as well as ethno-racial group and household income disparities in COVID-19 cases and hospitalizations. The future for COVID-19 survivors remains uncertain, and if this virus circulates among us for years to come, long-term effects may accumulate exponentially.
Background and purpose
Among post‐COVID‐19 symptoms, fatigue is reported as one of the most common, even after mild acute infection, and as the cause of fatigue, myopathy diagnosed by ...electromyography has been proposed in previous reports. This study aimed to explore the histopathological changes in patients with post‐COVID‐19 fatigue.
Methods
Sixteen patients (mean age = 46 years) with post‐COVID‐19 complaints of fatigue, myalgia, or weakness persisting for up to 14 months were included. In all patients, quantitative electromyography and muscle biopsies analyzed with light and electron microscopy were taken.
Results
Muscle weakness was present in 50% and myopathic electromyography in 75%, and in all patients there were histological changes. Muscle fiber atrophy was found in 38%, and 56% showed indications of fiber regeneration. Mitochondrial changes, comprising loss of cytochrome c oxidase activity, subsarcollemmal accumulation, and/or abnormal cristae, were present in 62%. Inflammation was found in 62%, seen as T lymphocytes and/or muscle fiber human leukocyte antigen ABC expression. In 75%, capillaries were affected, involving basal lamina and cells. In two patients, uncommon amounts of basal lamina were found, not only surrounding muscle fibers but also around nerves and capillaries.
Conclusions
The wide variety of histological changes in this study suggests that skeletal muscles may be a major target of SARS‐CoV‐2, causing muscular post‐COVID‐19 symptoms. The mitochondrial changes, inflammation, and capillary injury in muscle biopsies can cause fatigue in part due to reduced energy supply. Because most patients had mild–moderate acute affection, the new variants that might cause less severe acute disease could still have the ability to cause long‐term myopathy.
This study analyzes muscle biopsies from 16 patients experiencing persistent muscle fatigue 5–14 months after COVID‐19 infection. All patients displayed some histological changes. The changes included signs of muscle fiber damage and regeneration, mitochondrial changes, signs of inflammatory myopathy, capillary pathology, and nerve involvement. There was no correlation of the histopathological findings with the severity of the acute infection, and none of our patients had been referred to intensive care. The study confirms our previous electromyographic observation of myopathy.
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