Background: One of the most dreaded complications of COVID pneumonia is post-COVID residual lung fibrosis and lung function impairment. Objectives: To find out the extent and type of pulmonary ...function abnormality using spirometry, diffusion capacity, and 6-minute walk test and to co-relate with the clinical severity at the time of infection, in patients who have recovered from COVID19 pneumonia, in a tertiary care hospital in India. Materials and Methods: This is a prospective, cross-sectional study with a total 100 patients. Patients who have recovered from COVID pneumonia after one month of onset of symptoms and before 3 months who come for follow-up and have respiratory complaints undergo pulmonary function test will be recruited in the study. Results: In our study, the most common lung function abnormality detected was restrictive pattern in 55% of the patients (N = 55) followed by mixed pattern in 9% of patients (N = 9), obstructive in 5% of patients (N = 5), and normal in 31% of patients (N = 31). In our study, total lung capacity was reduced in 62% of the patients and normal in 38% of the patients and diffusion capacity of lung was reduced in 52% of the patients recovered from 52% of the individuals. Also, a 6-minute walk test was reduced in 15% of the patients and normal in 85% of the patients. Conclusion: Pulmonary function test can serve as an important tool in both diagnosis and follow-up of post-COVID lung fibrosis and pulmonary sequalae.
Background
The long‐term sequalae of COVID‐19 remain poorly characterized. We assessed persistent symptoms in previously hospitalized patients with COVID‐19 and assessed potential risk factors.
...Methods
Data were collected from patients discharged from 4 hospitals in Moscow, Russia between 8 April and 10 July 2020. Participants were interviewed via telephone using an ISARIC Long‐term Follow‐up Study questionnaire.
Results
2,649 of 4755 (56%) discharged patients were successfully evaluated, at median 218 (IQR 200, 236) days post‐discharge. COVID‐19 diagnosis was clinical in 1291 and molecular in 1358. Most cases were mild, but 902 (34%) required supplemental oxygen and 68 (2.6%) needed ventilatory support. Median age was 56 years (IQR 46, 66) and 1,353 (51.1%) were women. Persistent symptoms were reported by 1247 (47.1%) participants, with fatigue (21.2%), shortness of breath (14.5%) and forgetfulness (9.1%) the most common symptoms and chronic fatigue (25%) and respiratory (17.2%) the most common symptom categories. Female sex was associated with any persistent symptom category OR 1.83 (95% CI 1.55 to 2.17) with association being strongest for dermatological (3.26, 2.36 to 4.57) symptoms. Asthma and chronic pulmonary disease were not associated with persistent symptoms overall, but asthma was associated with neurological (1.95, 1.25 to 2.98) and mood and behavioural changes (2.02, 1.24 to 3.18), and chronic pulmonary disease was associated with chronic fatigue (1.68, 1.21 to 2.32).
Conclusions
Almost half of adults admitted to hospital due to COVID‐19 reported persistent symptoms 6 to 8 months after discharge. Fatigue and respiratory symptoms were most common, and female sex was associated with persistent symptoms.
Word cloud showing persistent symptoms 6–8 months since hospital discharge in people previously hospitalised with COVID‐19.
Using terror management theory as a theoretical base, and drawing upon pertinent tourism studies, this conceptual paper represents one of the first attempts to systematically identify and predict ...post-COVID travel and tourism behaviors. Several salient proximal and distal post-COVID travel behaviors are identified or predicted. Their psychological and phenomenological roots, behavioral manifestations, and potential impact on tourism are discussed. This research intends to offer some foundational building blocks to better understand travel and tourism behaviors and to inform tourism theory and practice in the post-COVID era.
•Examines post-COVID travel behaviors using the terror management theory.•Identifies and predicts proximal and distal post-COVID travel behaviors.•Discusses psychological roots of these behaviors and their impact on tourism.•Offers building blocks to understand travel behaviors in the post-COVID era.
Although the number of SARS-CoV-2 new cases may be declining due to the implementation of the vaccine in the USA, there is a rising cohort of people with long-term effects from the virus. These ...long-term effects include loss of taste, heart palpitations, and chronic pain syndromes. In this commentary, we assess the current literature to appraise the knowledge of long-term COVID-19 effects related to long-term pain syndromes including testicular pain, headache, chronic pain, and chest pain.
Background
There is currently very limited information on the nature and prevalence of post‐COVID‐19 symptoms after hospital discharge.
Methods
A purposive sample of 100 survivors discharged from a ...large University hospital were assessed 4 to 8 weeks after discharge by a multidisciplinary team of rehabilitation professionals using a specialist telephone screening tool designed to capture symptoms and impact on daily life. EQ‐5D‐5L telephone version was also completed.
Results
Participants were between 29 and 71 days (mean 48 days) postdischarge from hospital. Thirty‐two participants required treatment in intensive care unit (ICU group) and 68 were managed in hospital wards without needing ICU care (ward group). New illness‐related fatigue was the most common reported symptom by 72% participants in ICU group and 60.3% in ward group. The next most common symptoms were breathlessness (65.6% in ICU group and 42.6% in ward group) and psychological distress (46.9% in ICU group and 23.5% in ward group). There was a clinically significant drop in EQ5D in 68.8% in ICU group and in 45.6% in ward group.
Conclusions
This is the first study from the United Kingdom reporting on postdischarge symptoms. We recommend planning rehabilitation services to manage these symptoms appropriately and maximize the functional return of COVID‐19 survivors.
Highlights
This is the first UK study reporting on longer term symptoms in individuals recovering from COVID‐19.
New illness‐related fatigue, breathlessness and psychological distress were commonly reported at 7 weeks after discharge from hospital with a clinically significant drop in the quality of life of many individuals.
Symptoms were present in both ward and ICU managed individuals, the prevalence being higher in those who required ICU care.
Rehabilitation care for COVID‐19 survivors must therefore be need‐focused, delivered by specialist multidisciplinary team and planned for the longer term to meet the needs of these individuals.
The reader will come to appreciate:Our current understanding of what Post Covid Syndrome (PCS) represents.The presentation and assessment of children and young people (CYP) with PCS.Management ...strategies to address symptoms and their impact on functioning.
Post Covid Syndrome (PCS) is a complex multi-system disorder with a spectrum of presentations. Severity ranges from mild to very severe with variable duration of illness and recovery. This paper discusses the difficulties defining and describing PCS. We review the current understanding of PCS, epidemiology, and predisposing factors. We consider potential mechanisms including viral persistence, clotting dysfunction and immunity. We review presentation and diagnosis and finally consider management strategies including addressing symptom burden, rehabilitation, and novel therapies.
There is an established literature on the symptoms and complications of COVID‐19 but the after‐effects of COVID‐19 are not well understood with few studies reporting persistent symptoms and quality ...of life. We aim to evaluate the pooled prevalence of poor quality of life in post‐acute COVID‐19 syndrome (PCS) and conducted meta‐regression to evaluate the effects of persistent symptoms and intensive care unit (ICU) admission on the poor quality of life. We extracted data from observational studies describing persistent symptoms and quality of life in post‐COVID‐19 patients from March 10, 2020, to March 10, 2021, following PRISMA guidelines with a consensus of two independent reviewers. We calculated the pooled prevalence with 95% confidence interval (CI) and created forest plots using random‐effects models. A total of 12 studies with 4828 PCS patients were included. We found that amongst PCS patients, the pooled prevalence of poor quality of life (EQ‐VAS) was (59%; 95% CI: 42%–75%). Based on individual factors in the EQ‐5D‐5L questionnaire, the prevalence of mobility was (36, 10–67), personal care (8, 1–21), usual quality (28, 2–65), pain/discomfort (42, 28–55), and anxiety/depression (38, 19–58). The prevalence of persistent symptoms was fatigue (64, 54–73), dyspnea (39.5, 20–60), anosmia (20, 15–24), arthralgia (24.3, 14–36), headache (21, 3–47), sleep disturbances (47, 7–89), and mental health (14.5, 4–29). Meta‐regression analysis showed the poor quality of life was significantly higher among post‐COVID‐19 patients with ICU admission (p = 0.004) and fatigue (p = 0.0015). Our study concludes that PCS is associated with poor quality of life, persistent symptoms including fatigue, dyspnea, anosmia, sleep disturbances, and worse mental health. This suggests that we need more research on PCS patients to understand the risk factors causing it and eventually leading to poor quality of life.
Post recovery manifestations have become another concern in patients who have recovered from coronavirus disease 2019 (COVID‐19). Numerous reports have shown that COVID‐19 has a variety of long‐term ...effects on almost all systems including respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems. We aimed to investigate the prevalence and characteristics of the post‐COVID syndrome among COVID‐19 survivors and to determine the factors associated with persistent symptoms. This prospective study enrolled in patients with COVID‐19 followed in hospital or outpatient clinics in Ankara City Hospital. We performed a special questionnaire to inquire about the presence of persistent symptoms beyond 12 weeks from the first diagnosis. Demographic data, comorbid diseases, characteristics of acute COVID‐19, presence of persistent symptoms by systems, and knowledge about outpatient clinic visits after recovery were assessed. Of a total of 1007 participants, 39.0% had at least one comorbidity, and 47.5% had persistent symptoms. Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%) followed by respiratory symptoms (25.4%). A total of 235 participants had visited outpatient clinics due to several reasons during the post‐COVID‐19 period, and 17 of them were hospitalized. Severe acute COVID‐19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms. Fully understanding the spectrum of the post‐COVID syndrome is essential for appropriate management of all its long‐term effects. Our study once again underlined the fact that the prevalence of post‐COVID syndrome is higher than expected and concerns many systems, and a multidisciplinary follow‐up should be provided to COVID‐19 survivors in the post recovery period.
Highlights
COVID‐19 has a variety of long‐term effects on almost all systems.
Respiratory, cardiovascular, gastrointestinal, neurological, psychiatric, and dermatological systems are affected in different degree.
We detected the prevalence of the post?COVID syndrome among COVID‐19 survivors as 47.5% on 1007 participant.
Fatigue/easy fatigability, myalgia, and loss of weight were the most frequent persistent symptoms (overall 29.3%), and followed by respiratory symptoms (25.4%).
Severe acute COVID‐19, hospitalization, and presence of comorbidity were independent factors for the development of persistent symptoms.
The coronavirus (COVID-19) pandemic is still evolving, causing hundreds of millions of infections around the world. The long-term sequelae of COVID-19 and neurologic syndromes post COVID remain ...poorly understood. The present study aims to characterize cognitive performance in patients experiencing cognitive symptoms post-COVID infection. Patients evaluated at a post COVID clinic in Northern Israel who endorsed cognitive symptoms were referred for neurologic consultation. The neurologic work-up included detailed medical history, symptom inventory, neurological examination, the Montreal Cognitive Assessment (MoCA), laboratory tests and brain CT or MRI. Between December 2020 and June 2021, 46 patients were referred for neurological consultation (65% female), mean age 49.5 (19–72 years). On the MoCA test, executive functions, particularly phonemic fluency, and attention, were impaired. In contrast, the total MoCA score, and memory and orientation subscores did not differ from expected ranges. Disease severity, premorbid condition, pulmonary function tests and hypoxia did not contribute to cognitive performance. Cognitive decline may affect otherwise healthy patients post-COVID, independent of disease severity. Our examination identified abnormalities in executive function, attention, and phonemic fluency. These findings occurred despite normal laboratory tests and imaging findings.
•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.
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