The Unequal Pandemic Bambra, Clare; Lynch, Julia; Smith, Katherine E.
06/2021
eBook
Open access
Rated as a top 10 book about the COVID-19 pandemic by New Statesman: https://www.newstatesman.com/culture/2021/07/best-books-about-covid-19-pandemic
EPDF and EPUB available Open Access under ...CC-BY-NC- ND
It has been claimed that we are ‘all in it together’ and that the COVID-19 virus ‘does not discriminate’.
This accessible, yet authoritative book dispels this myth of COVID-19 as an ‘equal opportunity’ disease, by showing how the pandemic is a syndemic of disease and inequality.
Drawing on international data and accounts, it argues that the pandemic is unequal in three ways: it has killed unequally, been experienced unequally and will impoverish unequally.
These inequalities are a political choice: with governments effectively choosing who lives and who dies, we need to learn from COVID-19 quickly to prevent growing inequality and to reduce health inequalities in the future.
COVID-19 is an unequal pandemic.
Objective
Research on the psychological toll of the COVID‐19 pandemic is being conducted in various countries. This study aimed to examine risk factors for mental health problems among Israeli adults ...during this crisis.
Methods
A total of 204 participants took part in the study. They completed self‐report questionnaires assessing perceived stress, anxiety, quality of life, and various questions related to quarantine, pre‐existing health issues, and worries related to the virus. The study took place during the last two weeks of March 2020.
Results
The majority of participants reported relatively high levels of perceived stress and corona‐related worries, but low levels of anxiety. Female gender, younger age, corona‐related loneliness, and pre‐existing chronic illness were all related to higher levels of psychological distress and lower levels of quality of life.
Conclusions
While considering the preliminary nature of these results, the current study highlights risk factors for psychological distress in light of the corona pandemic. Attention should be given to sociodemographic variables that were identified as related to psychological distress, as well as to the important role of loneliness, when screening and treating people during this crisis. More research is needed in order to fully understand the scope and correlates of psychological difficulties during these challenging times.
El turismo es uno de los sectores económicos que presentan un mayor porcentaje en el PIB español. Por ello, las diferentes Comunidades Autónomas pusieron su foco en él mediante su promoción con ...diversas acciones de marketing para reactivar el turismo después de la pandemia por el COVID-19.Estas acciones fueron el objeto de estudio de esta investigación, pues se pretendió conocerlas e identificarlas mediante el análisis exploratorio y el análisis de contenido. Dichas acciones fueron las correspondientes a las estrategias del marketing de servicio propias del sector como son la marca territorio, los tipos de turismo, la seguridad del destino, la sostenibilidad, los precios, las herramientas comunicacionales y las tácticas de personal.
Background and purpose
Cognitive dysfunction has been observed following recovery from COVID‐19. To the best of our knowledge, however, no study has assessed the progression of cognitive impairment ...after 1 year. The aim was to assess cognitive functioning at 1 year from hospital discharge, and eventual associations with specific clinical variables.
Methods
Seventy‐six patients (aged 22–74 years) who had been hospitalized for COVID‐19 were recruited. Patients received neuropsychological assessments at 5 (n = 76) and 12 months (n = 53) from hospital discharge.
Results
Over half (63.2%) of the patients had deficits in at least one test at 5 months. Compared to the assessment at 5 months, verbal memory, attention and processing speed improved significantly after 1 year (all p < 0.05), whereas visuospatial memory did not (all p > 0.500). The most affected domains after 1 year were processing speed (28.3%) and long‐term visuospatial (18.1%) and verbal (15.1%) memory. Lower PaO2/FiO2 ratios in the acute phase were associated with worse verbal long‐term memory (p = 0.029) and visuospatial learning (p = 0.041) at 5 months. Worse visuospatial long‐term memory at 5 months was associated with hyposmia (p = 0.020) and dysgeusia (p = 0.037).
Conclusion
Our study expands the results from previous studies showing that cognitive impairment can still be observed after 1 year. Patients with severe COVID‐19 should receive periodic cognitive follow‐up evaluations, as cognitive deficits in recovered patients could have social and occupational implications.
Cognitive impairment can still be observed in almost 50% of formerly hospitalized patients with COVID‐19 at 1 year from respiratory clinical recovery. Clinicians should be aware that the ratio of arterial oxygen partial pressure to fractional inspired oxygen and hyposmia/dysgeusia might represent risk factors for the development of cognitive impairment in COVID‐19.
Background
Long‐COVID syndrome has become a new health concern. Many major clinical centers have experienced more patients with symptoms suggestive of autonomic dysfunction, especially postural ...orthostatic tachycardia syndrome (POTS) following COVID‐19. However, there is a lack of information regarding the incidence and associated factors in Asian population.
Methods
A retro‐prospective study was conducted to evaluate patients with symptoms suggestive of POTS or other autonomic dysfunctions. These symptoms last at least 3 months after PCR‐proven COVID‐19. Exclusion criteria were age under 18 years old, pregnancy, and pre‐COVID‐19 autonomic dysfunction symptoms. Patients with a symptom severity score greater than two were assessed with blood tests, 24‐h Holter, 24‐h ambulatory blood pressure, echocardiogram, and head‐up tilt table (HUTT).
Results
Seven hundred ninety‐three patients were interviewed at 146 ± 37 days after COVID‐19. The majority of patients were middle‐aged females (53%). Of those, 15 patients had the symptom severity score greater than 2. Out of those 15 patients, 12 had positive HUTT (1 demonstrating POTS, 10 neurocardiogenic syncope, and 1 orthostatic hypotension). Among those with positive HUTT patients, C‐reactive protein (CRP) was significantly higher (OR 1.01; p‐value 0.041). Fatigue and dyspnea on exertion were the two most complaint symptoms.
Conclusions
This study shows the incidence of autonomic dysfunction and POTS is 1.5% (12/793) and 0.1% POTS (1/793), respectively, in a primary care setting (among general post‐COVID‐19 patients). The most common symptoms for these patients were fatigue and dyspnea.
Study enrollment flow and associating factors.
•EEG research in Fibromyalgia, Chronic Fatigue Syndrome (ME/CFS) and Long COVID helps understand their dominant symptoms.•Fibromyalgia Syndrome and ME/CFS present differing EEG brainwave activity ...patterns.•EEG research in Long COVID shows mixed results so far and needs further investigations taking account of Long COVID phenotypes.
Fibromyalgia Syndrome (FMS), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID (LC) are similar multisymptom clinical syndromes but with difference in dominant symptoms in each individual. There is existing and emerging literature on possible functional alterations of the central nervous system in these conditions. This review aims to synthesise and appraise the literature on resting-state quantitative EEG (qEEG) in FMS, ME/CFS and LC, drawing on previous research on FMS and ME/CFS to help understand neuropathophysiology of the new condition LC.
A systematic search of MEDLINE, Embase, CINHAL, PsycINFO and Web of Science databases for articles published between December 1994 and September 2023 was performed.
Out of the initial 2510 studies identified, 17 articles were retrieved that met all the predetermined selection criteria, particularly of assessing qEEG changes in one of the three conditions compared to healthy controls. All studies scored moderate to high quality on the Newcastle-Ottawa scale. There was a general trend for decreased low-frequency EEG band activity (delta, theta, and alpha) and increased high-frequency EEG beta activity in FMS, differing to that found in ME/CFS. The limited LC studies included in this review focused mainly on cognitive impairments and showed mixed findings not consistent with patterns observed in FMS and ME/CFS.
Our findings suggest different patterns of qEEG brainwave activity in FMS and ME/CFS. Further research is required to explore whether there are phenotypes within LC that have EEG signatures similar to FMS or ME/CFS.
This could inform identification of reliable diagnostic markers and possible targets for neuromodulation therapies tailored to each clinical syndrome.
Long-COVID is defined by persistent symptoms following COVID-19 infection. Approximately 71% of individuals with long-COVID experience ongoing fatigue, post-exertional malaise, and cognitive ...impairments, which share pathological similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This similarity has prompted studies to explore the characteristics of long-COVID to gain a better understanding of ME/CFS. To gain insights, we investigated the clinical and laboratory characteristics of individuals with fatigue-dominant long-COVID.
We enrolled 100 subjects (36 males, 64 females) with long-COVID who had a higher score than 60 in modified Korean version of the Chalder Fatigue Scale (mKCFQ11) and higher than 5 in fatigue-focused Visual Analogue Scale (VAS). To investigate fatigue symptoms, the mKCFQ11, the Multidimensional Fatigue Inventory (MFI-20), and VAS for fatigue and brain-fog, along with the Short Form Survey (SF-12) were employed. We also measured three cytokines and cortisol levels for immunological and endocrinological indicators. As a cross-sectional observational study, the data were collected at a single point in time.
The mean scores on the measurements showed severe fatigue, and these scores were significantly correlated, with no differences based on sex, the post-COVID period, or age. Among the laboratory tests, plasma cortisol levels had a significant negative correlation with fatigue scores and a positive correlation with living quality. The negative correlation between cortisol levels and mKCFQ11 scores appeared to be more specific to mental fatigue than physical, which conflicted with other measurements.
Our findings provide the first insights into the characteristics of fatigue in individuals with long-COVID, particularly in terms of fatigue severity and cortisol levels. These results serve as valuable reference data for clinicians dealing with fatigue symptoms in long-COVID patients and for researchers exploring post-viral fatigue symptoms, including ME/CFS, in the future.
Background
Headache is identified as a common post‐COVID sequela experienced by COVID‐19 survivors. The aim of this pooled analysis was to synthesize the prevalence of post‐COVID headache in ...hospitalized and non‐hospitalized patients recovering from SARS‐CoV‐2 infection.
Methods
MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers, were searched up to 31 May 2021. Studies or preprints providing data on post‐COVID headache were included. The methodological quality of the studies was assessed using the Newcastle‐Ottawa Scale. Random effects models were used for meta‐analytical pooled prevalence of post‐COVID headache. Data synthesis was categorized at hospital admission/symptoms' onset, and at 30, 60, 90, and ≥180 days afterwards.
Results
From 9573 studies identified, 28 peer‐reviewed studies and 7 preprints were included. The sample was 28,438 COVID‐19 survivors (12,307 females; mean age: 46.6, SD: 17.45 years). The methodological quality was high in 45% of the studies. The overall prevalence of post‐COVID headache was 47.1% (95% CI 35.8–58.6) at onset or hospital admission, 10.2% (95% CI 5.4–18.5) at 30 days, 16.5% (95% CI 5.6–39.7) at 60 days, 10.6% (95% CI 4.7–22.3) at 90 days, and 8.4% (95% CI 4.6–14.8) at ≥180 days after onset/hospital discharge. Headache as a symptom at the acute phase was more prevalent in non‐hospitalized (57.97%) than in hospitalized (31.11%) patients. Time trend analysis showed a decreased prevalence from the acute symptoms’ onset to all post‐COVID follow‐up periods which was maintained afterwards.
Conclusion
This meta‐analysis found that the prevalence of post‐COVID headache ranged from 8% to 15% during the first 6 months after SARS‐CoV‐2 infection.
Headache is a common acute symptom of COVID‐19 and also a common post‐COVID‐19 symptom. The prevalence of post‐COVID headache ranged from 8% to 15% during the first 6 months after SARS‐CoV‐2 infection.
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