Journal of Clinical Medicine

Research

11 pages, 921 KiB

Open AccessArticle

Variations and Predictors of Post-COVID Syndrome Severity in Patients Attending a Post-COVID Outpatient Clinic

by Christina Lemhöfer, Thomas Bahmer, Philipp Baumbach, Bianca Besteher, Andrea Boekel, Kathrin Finke, Katrin Katzer, Katja Lehmann-Pohl, Jan-Christoph Lewejohann, Dana Loudovici-Krug, Matthias Nowka, Christian Puta, Stefanie Quickert, Philipp Alexander Reuken, Martin Walter and Andreas Stallmach

J. Clin. Med. 2023, 12(12), 4013; https://doi.org/10.3390/jcm12124013 - 12 Jun 2023

Cited by 4 | Viewed by 2001

Abstract

A relevant proportion of patients suffer from long-lasting impairments following an acute SARS-CoV-2 infection. The proposed post-COVID syndrome (PCS) score may improve comparison in the course and classification of affected patients. A prospective cohort of 952 patients presenting to the post-COVID outpatient clinic [...] Read more.

A relevant proportion of patients suffer from long-lasting impairments following an acute SARS-CoV-2 infection. The proposed post-COVID syndrome (PCS) score may improve comparison in the course and classification of affected patients. A prospective cohort of 952 patients presenting to the post-COVID outpatient clinic at Jena University Hospital, Germany, was enrolled. Patients received a structured examination. PCS score was calculated per visit. A total of 378 (39.7%) and 129 (13.6%) patients of the entire population visited the outpatient clinic two or three times, respectively (female: 66.4%; age: 49.5 (SD = 13) years). The initial presentation took place, on average, 290 (SD = 138) days after acute infection. The most frequently reported symptoms were fatigue (80.4%) and neurological impairments (76.1%). The mean PCS scores of patients with three visits were 24.6 points (SD = 10.9), 23.0 points (SD = 10.9) and 23.5 points (SD = 11.5) (p = 0.407), indicating moderate PCS. Female sex (p < 0.001), preexisting coagulation disorder (p = 0.021) and coronary artery disease (p = 0.032) were associated with higher PCS scores. PCS is associated with a multitude of long-lasting problems. The PCS score has proven its capability to objectify and quantify PCS symptoms in an outpatient setting. The influence of therapeutic measures on various PCS aspects should be the subject of further analyses. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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15 pages, 1061 KiB

Open AccessArticle

Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

by Anke Steinmetz, Stefan Gross, Kristin Lehnert, Petra Lücker, Nele Friedrich, Matthias Nauck, Susanne Bahlmann, Jens Fielitz and Marcus Dörr

J. Clin. Med. 2023, 12(12), 3966; https://doi.org/10.3390/jcm12123966 - 10 Jun 2023

Cited by 6 | Viewed by 2023

Abstract

Post-COVID-19 syndrome (PCS) has been described as ‘the pandemic after the pandemic’ with more than 65 million people worldwide being affected. The enormous range of symptoms makes both diagnosis complex and treatment difficult. In a post-COVID rehabilitation outpatient clinic, 184 patients, mostly non-hospitalized, [...] Read more.

Post-COVID-19 syndrome (PCS) has been described as ‘the pandemic after the pandemic’ with more than 65 million people worldwide being affected. The enormous range of symptoms makes both diagnosis complex and treatment difficult. In a post-COVID rehabilitation outpatient clinic, 184 patients, mostly non-hospitalized, received a comprehensive, interdisciplinary diagnostic assessment with fixed follow-up appointments. At baseline, three in four patients reported more than 10 symptoms, the most frequent symptoms were fatigue (84.9%), decreased physical capacity (83.0%), tiredness (81.1%), poor concentration (73.6%), sleeping problems (66.7%) and shortness of breath (67.3%). Abnormalities were found in the mean values of scores for fatigue (FAS = 34.3), cognition (MoCA = 25.5), psychological alterations (anxiety, depression, post-traumatic stress disorder), limitation of lung function (CAT) and severity scores for PCS (PCFS, MCRS). Clinical abnormalities were found in elevated values of heart rate, breathing rate at rest, blood pressure and NT-proBNP levels. As the frequency of the described symptoms decreases only slowly but most often significantly over the course, it is important to monitor the patients over a longer period of time. Many of them suffer from an immense symptom burden, often without pre-existing clinical correlates. Our results show a clear association with objectifiable assessments and tests as well as pronounced symptoms. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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11 pages, 1629 KiB

Open AccessArticle

Manifestation of Headache Affecting Quality of Life in Long COVID Patients

by Kana Fujita, Yuki Otsuka, Naruhiko Sunada, Hiroyuki Honda, Kazuki Tokumasu, Yasuhiro Nakano, Yasue Sakurada, Mikako Obika, Hideharu Hagiya and Fumio Otsuka

J. Clin. Med. 2023, 12(10), 3533; https://doi.org/10.3390/jcm12103533 - 18 May 2023

Cited by 9 | Viewed by 2197

Abstract

Objectives: The present study aimed to elucidate the characteristics of long COVID patients with headaches. Methods: A single-center retrospective observational study was performed for long COVID outpatients who visited our hospital from 12 February 2021 to 30 November 2022. Results: [...] Read more.

Objectives: The present study aimed to elucidate the characteristics of long COVID patients with headaches. Methods: A single-center retrospective observational study was performed for long COVID outpatients who visited our hospital from 12 February 2021 to 30 November 2022. Results: A total of 482 long COVID patients, after excluding 6, were divided into two groups: the Headache group of patients with complaints of headache (113 patients: 23.4%) and the remaining Headache-free group. Patients in the Headache group were younger (median age: 37 years) than patients in the Headache-free group (42 years), while the ratio of females (56%) in the Headache group was nearly the same as that in the Headache-free group (54%). The proportion of patients in the Headache group who were infected in the Omicron-dominant phase (61%) was larger than the proportions of patients infected in the Delta (24%) and preceding (15%) phases, and that trend was significantly different from the trend in the Headache-free group. The duration before the first visit for long COVID was shorter in the Headache group (71 days) than in the Headache-free group (84 days). The proportions of patients in the Headache group with comorbid symptoms, including general fatigue (76.1%), insomnia (36.3%), dizziness (16.8%), fever (9.7%), and chest pain (5.3%) were larger than the proportions of patients in the Headache-free group, whereas blood biochemical data were not significantly different between the two groups. Interestingly, patients in the Headache group had significant deteriorations of scores indicating depression and scores for quality of life and general fatigue. In multivariate analysis, headache, insomnia, dizziness, lethargy, and numbness were shown to be involved in the quality of life (QOL) of long COVID patients. Conclusions: The manifestation of headaches related to long COVID was found to have a significant impact on social and psychological activities. Alleviation of headaches should be a priority for the effective treatment of long COVID. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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10 pages, 2564 KiB

Open AccessArticle

A 14-Day Therapeutic Exercise Telerehabilitation Protocol of Physiotherapy Is Effective in Non-Hospitalized Post-COVID-19 Conditions: A Randomized Controlled Trial

by Cleofas Rodriguez-Blanco, Carlos Bernal-Utrera, Ernesto Anarte-Lazo, Juan Jose Gonzalez-Gerez and Manuel Saavedra-Hernandez

J. Clin. Med. 2023, 12(3), 776; https://doi.org/10.3390/jcm12030776 - 18 Jan 2023

Cited by 11 | Viewed by 2953

Abstract

The emergence of COVID-19 has led to serious public health problems. Now that the acute phase of the pandemic has passed, new challenges have arisen in relation to this disease. The post-COVID-19 conditions are a priority for intervention, as months after the onset [...] Read more.

The emergence of COVID-19 has led to serious public health problems. Now that the acute phase of the pandemic has passed, new challenges have arisen in relation to this disease. The post-COVID-19 conditions are a priority for intervention, as months after the onset of the disease, they continue to present symptoms, especially physical and respiratory symptoms. Our aim is to test the efficacy of a fourteen-day telerehabilitation program of respiratory and strength exercises in people with post-COVID-19 conditions. For this purpose, a randomized controlled trial was generated in which data from 48 patients were analyzed using the BS, 30STSTST, MD12, VAFS, and 6MWT tests. The obtained results showed the benefit of the intervention in generating great results with respect to the control group. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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11 pages, 2095 KiB

Open AccessArticle

Two-Years Follow-Up of Symptoms and Return to Work in Complex Post-COVID-19 Patients

by Erika Van Wambeke, Cécile Bezler, Anne-Marie Kasprowicz, Anne-Laure Charles, Emmanuel Andres and Bernard Geny

J. Clin. Med. 2023, 12(3), 741; https://doi.org/10.3390/jcm12030741 - 17 Jan 2023

Cited by 21 | Viewed by 24465

Abstract

Introduction: Many COVID-19 patients present with severe long-lasting symptoms. They might benefit from a coordination team to manage such complex situations, but late efficacy still needs to be determined. Population and Methods: Out of 105 contacts, 45 patients had two phone consultations separated [...] Read more.

Introduction: Many COVID-19 patients present with severe long-lasting symptoms. They might benefit from a coordination team to manage such complex situations, but late efficacy still needs to be determined. Population and Methods: Out of 105 contacts, 45 patients had two phone consultations separated by personalized support 15 and 22 months, respectively, after COVID infection. Self-reported symptoms, feelings of improvement and ability to return to work allowed us to determine the efficacy of the therapeutic strategy proposed. Results: Unlike what was expected, many post-COVID-19 patients directly contacted the coordination team and had significant pre-existing comorbidities. Despite exercise, respiratory, olfactory rehabilitations, cognition/speech therapy and/or psychological support, the more frequent self-reported symptoms (fatigue, neurocognitive disorders, muscles and joint pain) did not resolve. However, dyspnea, anxiety and chest pain were significantly reduced. Finally, 2/3 of the patients felt some degree of improvement and returned to work either partially or fully, but 1/3 remained complaining of symptoms and out of work as late as 22 months after COVID occurrence. All patients greatly appreciated the second phone consultation. Conclusions: In such complex situations, besides early and adapted rehabilitations and psychological help allowing better symptom management, relatively simple actions such as a phone call might be very useful to reduce patients’ feelings of abandonment. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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10 pages, 962 KiB

Open AccessArticle

Autonomic Nerve Involvement in Post-Acute Sequelae of SARS-CoV-2 Syndrome (PASC)

by Tae Hwan Chung and Antoine Azar

J. Clin. Med. 2023, 12(1), 73; https://doi.org/10.3390/jcm12010073 - 22 Dec 2022

Cited by 6 | Viewed by 4481

Abstract

The novel SARS-CoV-2 virus and resulting COVID-19 global pandemic emerged in 2019 and continues into 2022. While mortality from COVID-19 is slowly declining, a subset of patients have developed chronic, debilitating symptoms following complete recovery from acute infection with COVID-19. Termed as post-acute [...] Read more.

The novel SARS-CoV-2 virus and resulting COVID-19 global pandemic emerged in 2019 and continues into 2022. While mortality from COVID-19 is slowly declining, a subset of patients have developed chronic, debilitating symptoms following complete recovery from acute infection with COVID-19. Termed as post-acute sequelae of SARS-CoV-2 syndrome (PASC), the underlying pathophysiology of PASC is still not well understood. Given the similarity between the clinical phenotypes of PASC and postural orthostatic tachycardia syndrome (POTS), it has been postulated that dysautonomia may play a role in the pathophysiology of PASC. However, there have been only a few studies that have examined autonomic function in PASC. In this retrospective study, we performed an analysis of autonomic nerve function testing in PASC patients and compared the results with those of POTS patients and healthy controls. Our results suggest that a significant number of PASC patients have abnormal autonomic function tests, and their clinical features are indistinguishable from POTS. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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17 pages, 722 KiB

Open AccessArticle

Characteristics of a Danish Post-COVID Cohort Referred for Examination due to Persistent Symptoms Six Months after Mild Acute COVID-19

by Jane Agergaard, William M. Ullahammer, Jesper D. Gunst, Lars Østergaard and Berit Schiøttz-Christensen

J. Clin. Med. 2022, 11(24), 7338; https://doi.org/10.3390/jcm11247338 - 10 Dec 2022

Cited by 9 | Viewed by 1988

Abstract

Background: Post-COVID Clinics were recommended for patients with persistent symptoms following COVID-19, but no specific tests were suggested for evaluation. This study aimed to present a post-COVID clinic patient cohort and evaluate the use of a post-COVID symptom questionnaire (PCQ) score. Methods: Patients [...] Read more.

Background: Post-COVID Clinics were recommended for patients with persistent symptoms following COVID-19, but no specific tests were suggested for evaluation. This study aimed to present a post-COVID clinic patient cohort and evaluate the use of a post-COVID symptom questionnaire (PCQ) score. Methods: Patients were referred from a population of approximately 1 million citizens. PCQ and standardized health scales were registered. Descriptive analyses were performed to assess the prevalence of symptoms, and correlation analyses was undertaken to asses convergent and discriminant trends between PCQ scores and health scales. Results: Of 547 patients, 447 accepted inclusion. The median age was 47 years and 12% of the patients were hospitalized. At a median of 6.3 (IQR 4.4–9.9) months after the onset of symptoms, 82% of the patients reported both physical exhaustion and concentration difficulties. Functional disability and extreme fatigue were reported as moderate to severe by 33% and 62% of the patients, respectively. The PCQ score correlated significantly with each of the standardized health scales. Conclusion: Patients referred to a Post-COVID Clinic were previously generally healthy. At the time of diagnosis, they reported multiple symptoms with severely affected health. The PCQ score could be used as valid measure of Post-COVID severity. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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11 pages, 1281 KiB

Open AccessArticle

Characteristics of Sleep Disturbance in Patients with Long COVID: A Retrospective Observational Study in Japan

by Naruhiko Sunada, Yasuhiro Nakano, Yuki Otsuka, Kazuki Tokumasu, Hiroyuki Honda, Yasue Sakurada, Yui Matsuda, Toru Hasegawa, Daisuke Omura, Kanako Ochi, Hideharu Hagiya, Keigo Ueda, Hitomi Kataoka and Fumio Otsuka

J. Clin. Med. 2022, 11(24), 7332; https://doi.org/10.3390/jcm11247332 - 9 Dec 2022

Cited by 13 | Viewed by 3917

Abstract

Objectives: The objective of this study was to determine the clinical and endocrinological features of sleep disturbance in patients with long COVID. Methods: This study was a single-center retrospective observational study for patients who visited the COVID-19 aftercare outpatient clinic (CAC) established in [...] Read more.

Objectives: The objective of this study was to determine the clinical and endocrinological features of sleep disturbance in patients with long COVID. Methods: This study was a single-center retrospective observational study for patients who visited the COVID-19 aftercare outpatient clinic (CAC) established in Okayama University Hospital in Japan during the period from 15 February 2021 to 29 July 2022. The long COVID patients were divided into two groups based on the presence or absence of sleep disturbance, and the clinical and laboratory characteristics of the patients were analyzed. Results: Out of 363 patients with long COVID, after excluding 6 patients, 60 patients (16.5%) (55% males, median age of 38 years) complaining of sleep disturbance were compared with 303 patients (83.5%) (43% males, median age of 40 years) without sleep-related symptoms. Although there were no significant differences in clinical backgrounds and severities of COVID-19 between the two groups by the multivariate analysis, the percentage of long COVID patients with sleep disturbance was significantly increased among patients infected in the Omicron-dominant phase. In addition, the prevalence rate of sleep disturbance in patients when infected in the Omicron phase (24.8%) was two-times higher than that in patients infected in the Delta phase (12.8%). Of note, the percentages of patients with sleep disturbance who also complained of general fatigue, headache, concentration loss, anxiety, low-grade fever, and brain fog symptoms were higher than the percentages of patients without sleep disturbance who had the same complaints. Among the types of sleep disturbance, the percentage of patients who complained of loss of sleep induction (75%) was much higher than the percentage of patients with early-awakening sleep disturbance (6.7%), and many of the patients with mid-awakening types of insomnia had brain fog symptoms. Endocrine examinations revealed that long COVID patients with sleep disturbance had significantly higher levels of plasma adrenocorticotropin and lower levels of serum growth hormone, suggesting the presence of hypothalamic–pituitary stress. Conclusion: The prevalence of sleep disturbance has been increasing in long COVID patients infected in the Omicron phase with a certain clinical and endocrine trend. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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12 pages, 642 KiB

Open AccessArticle

Do Comorbidities and Daily Medication before SARS-CoV-2 Infection Play a Role in Self-Reported Post-Infection Symptoms?

by Dovilė Važgėlienė, Raimondas Kubilius and Indre Bileviciute-Ljungar

J. Clin. Med. 2022, 11(21), 6278; https://doi.org/10.3390/jcm11216278 - 25 Oct 2022

Cited by 3 | Viewed by 1950

Abstract

This study investigated the associations between health status before SARS-CoV-2 infection and persistent symptoms after acute infection. Data were collected from participants older than 18 years and more than 28 days after acute SARS-CoV-2 infection using an online survey. Sociodemographic data, comorbidities, and [...] Read more.

This study investigated the associations between health status before SARS-CoV-2 infection and persistent symptoms after acute infection. Data were collected from participants older than 18 years and more than 28 days after acute SARS-CoV-2 infection using an online survey. Sociodemographic data, comorbidities, and daily medication before infection, as well as acute and persistent symptoms were analysed. Among the 1050 participants (mean age 41 years, 88% women, 56% with higher education, 93% working), 538 (51%) reported being healthy and 762 (73%) reported not taking any daily medication prior to infection. Positive laboratory testing was reported by 965 (92%) participants; asymptomatic infection was reported by 30 (3%); and 999 (95%) stayed at home during their acute infection. Reduced physical capacity (40%), fatigue (39%), cognitive difficulties (30–34%), altered sense of smell (24%), headache (20%), tachycardia (20%), unstable mood (19%), hair loss (17%), and insomnia (17%) were the most often reported symptoms. Those taking daily medication before infection reported increased frequency of both acute and persistent symptoms, except for decreased frequency of persistent altered smell and taste. The presence of persistent symptoms was predicted by taking daily medication before infection and by the total number of acute symptoms. Comorbidities before infection did not predict persistent symptoms. Therefore, the role of medication needs further investigation in both acute SARS-CoV-2 infection and post-COVID-19 condition. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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10 pages, 288 KiB

Open AccessArticle

Headaches and Dizziness as Disabling, Persistent Symptoms in Patients with Long COVID–A National Multicentre Study

by Mª Pilar Rodríguez-Pérez, Patricia Sánchez-Herrera-Baeza, Pilar Rodríguez-Ledo, Sergio Serrada-Tejeda, Cristina García-Bravo and Marta Pérez-de-Heredia-Torres

J. Clin. Med. 2022, 11(19), 5904; https://doi.org/10.3390/jcm11195904 - 6 Oct 2022

Cited by 8 | Viewed by 2961

Abstract

Background: Currently, about 15% of coronavirus disease-19 (COVID-19) patients are affected by Long COVID worldwide; however, this condition has not yet been sufficiently studied. The aim of this study was to identify the impact of symptom persistence as well as clinical and socio-demographic [...] Read more.

Background: Currently, about 15% of coronavirus disease-19 (COVID-19) patients are affected by Long COVID worldwide; however, this condition has not yet been sufficiently studied. The aim of this study was to identify the impact of symptom persistence as well as clinical and socio-demographic variables in a cohort of people with Long COVID. Methods: We conducted a descriptive cross-sectional study of a sample of adult patients from different Spanish regions presenting with Long COVID. Data collection was conducted between April and July 2021. Functional status and dependency were assessed. Results: A multivariate linear regression was performed, and the model was statistically significant (F (7; 114) = 8.79; p < 0.001), according to the overall ALDQ score. The variables with a statistically significant effect on the degree of dependence were age (p = 0.014), time since diagnosis (p = 0.02), headaches (p = 0.031), and dizziness (p = 0.039). Functional status post-COVID showed a positive and significant relationship with the percentage of dependence (p < 0.001). Conclusions: People affected by Long COVID showed moderate dependency status and limitations in functionality. Those with neurological symptoms, such as dizziness and headaches, as well as older age, showed a higher degree of dependency. Improvements in dependency status occurred with increasing time since diagnosis. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

13 pages, 1011 KiB

Open AccessArticle

Association of Acute Headache of COVID-19 and Anxiety/Depression Symptoms in Adults Undergoing Post-COVID-19 Rehabilitation

by Justyna Mazurek, Błażej Cieślik, Patryk Szary, Sebastian Rutkowski, Jan Szczegielniak, Joanna Szczepańska-Gieracha and Robert Gajda

J. Clin. Med. 2022, 11(17), 5002; https://doi.org/10.3390/jcm11175002 - 26 Aug 2022

Cited by 4 | Viewed by 2140

Abstract

As a common non-respiratory symptom of COVID-19, headache should not be overlooked, and its characteristics should be recorded with scrutiny. Identifying risk factors associated with post-COVID headache will ensure immediate action and counseling for this population of patients. Therefore, the study aimed to [...] Read more.

As a common non-respiratory symptom of COVID-19, headache should not be overlooked, and its characteristics should be recorded with scrutiny. Identifying risk factors associated with post-COVID headache will ensure immediate action and counseling for this population of patients. Therefore, the study aimed to investigate the relationship between headache and psychological state (stress level, depression, and anxiety symptoms) in adults undergoing post-COVID-19 rehabilitation. In addition, we used mediation analysis to evaluate the mediation effect of psychological variables in the relationship between headache and quality of life. This cross-sectional study included 147 patients undergoing post-COVID-19 rehabilitation at the Public Hospital in Poland (64 males, 83 females, with mean age of 56.97 years). Psychological parameters were evaluated using the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-10), and the brief World Health Organization Quality of Life Scale (WHOQOL-BRIEF). Additionally, all participants completed a questionnaire related to COVID-19 symptoms and their severity, the place of COVID-19 treatment, and the need for oxygen therapy during hospitalization. Of all participants, 65% experienced headache during COVID-19. Of the participants with headache, there were significantly more females in this group (69% vs. 31%), and they were significantly younger (mean age 55.47 vs. 59.78 years). Participants with headache had a 27% higher HADS-D score, a 21% higher HADS-A score, and a 13% higher PSS-10 score. Moreover, gender and headache were found to be important predictor variables for total HADS and HADS-D, accounting for 11% and 7%, respectively. Mediation analysis has shown that the tested psychological variables mediated 39–68% of the total effect of headache influence on WHOQOL domains. In conclusion, our study demonstrated several relationships between headache that occurred during COVID-19 and symptoms of depression, anxiety, and perceived stress level during post-COVID rehabilitation also in the context of quality of life. Our results show that patients who experienced headaches during COVID-19 are at high risk of developing anxiety-depressive symptoms later. Female gender is associated with a higher prevalence of headache during COVID-19. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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Review

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12 pages, 562 KiB

Open AccessReview

Therapeutic Exercise Interventions through Telerehabilitation in Patients with Post COVID-19 Symptoms: A Systematic Review

by Carlos Bernal-Utrera, Gines Montero-Almagro, Ernesto Anarte-Lazo, Juan Jose Gonzalez-Gerez, Cleofas Rodriguez-Blanco and Manuel Saavedra-Hernandez

J. Clin. Med. 2022, 11(24), 7521; https://doi.org/10.3390/jcm11247521 - 19 Dec 2022

Cited by 18 | Viewed by 2462

Abstract

The worldwide incidence of COVID-19 has generated a pandemic of sequelae. These sequelae require multidisciplinary rehabilitative work to address the multisystemic symptoms that patients will present with now and in the future. The aim of the present systematic review is to analyze the [...] Read more.

The worldwide incidence of COVID-19 has generated a pandemic of sequelae. These sequelae require multidisciplinary rehabilitative work to address the multisystemic symptoms that patients will present with now and in the future. The aim of the present systematic review is to analyze the current situation of telerehabilitation in patients with COVID-19 sequelae and its effectiveness. Searches were conducted on the following databases: PubMed, Scopus, PEDro, and Web of Science (WOS). There was no complete homogeneity among the five selected articles, so we differentiated two clinical subgroups for the clustering of outcome measures: (group one) patients with post-discharge symptoms and (group two) patients with permanent symptoms or “long COVID-19” defined as persistent symptoms > 2 months. For group one, post-discharge sequelae, improvements were obtained in cardiovascular parameters, and physical test studies in group two presented very favorable results in all the cardiorespiratory measures and physical tests evaluated. Telerehabilitation through therapeutic exercise based on mixed protocols of aerobic, respiratory, and low-load strength exercises appear to be an effective and safe strategy for the recovery of short- and long-term post-COVID-19 sequelae. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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Other

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10 pages, 1752 KiB

Open AccessBrief Report

Symptomatic Characteristics of Hypozincemia Detected in Long COVID Patients

by Yui Matsuda, Kazuki Tokumasu, Yuki Otsuka, Naruhiko Sunada, Hiroyuki Honda, Yasue Sakurada, Yasuhiro Nakano, Toru Hasegawa, Mikako Obika, Keigo Ueda and Fumio Otsuka

J. Clin. Med. 2023, 12(5), 2062; https://doi.org/10.3390/jcm12052062 - 6 Mar 2023

Cited by 4 | Viewed by 2449

Abstract

Objectives: The aim of this study was to determine the characteristics of hypozincemia in long COVID patients. Methods: This study was a single-center retrospective observational study for outpatients who visited the long COVID clinic established in a university hospital during the period from [...] Read more.

Objectives: The aim of this study was to determine the characteristics of hypozincemia in long COVID patients. Methods: This study was a single-center retrospective observational study for outpatients who visited the long COVID clinic established in a university hospital during the period from 15 February 2021 to 28 February 2022. Characteristics of patients with a serum zinc concentration lower than 70 μg/dL (10.7 μmol/L) were compared with characteristics of patients with normozincemia. Results: In a total of 194 patients with long COVID after excluding 32 patients, hypozincemia was detected in 43 patients (22.2%) including 16 male patients (37.2%) and 27 female patients (62.8%). Among various parameters including the background characteristics of the patients and medical histories, the patients with hypozincemia were significantly older than the patients with normozincemia (median age: 50 vs. 39 years). A significant negative correlation was found between serum zinc concentrations and age in male patients (R = −0.39; p < 0.01) but not in female patients. In addition, there was no significant correlation between serum zinc levels and inflammatory markers. General fatigue was the most frequent symptom in both male patients with hypozincemia (9 out of 16: 56.3%) and female patients with hypozincemia (8 out of 27: 29.6%). Patients with severe hypozincemia (serum zinc level lower than 60 μg/dL) had major complaints of dysosmia and dysgeusia, which were more frequent complaints than general fatigue. Conclusions: The most frequent symptom in long COVID patients with hypozincemia was general fatigue. Serum zinc levels should be measured in long COVID patients with general fatigue, particularly in male patients. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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14 pages, 665 KiB

Open AccessStudy Protocol

The Greifswald Post COVID Rehabilitation Study and Research (PoCoRe)–Study Design, Characteristics and Evaluation Tools

by Anke Steinmetz, Susanne Bahlmann, Corinna Bergelt, Barbara M. Bröker, Ralf Ewert, Stephan B. Felix, Agnes Flöel, Robert Fleischmann, Wolfgang Hoffmann, Silva Holtfreter, Matthias Nauck, Katja Riemann, Christian Scheer, Dana Stahl, Antje Vogelgesang, Uwe Völker, Ulrich Wiesmann, Johanna Klinger-König, René Walk, Hans J. Grabe, Stefan Gross, Kristin Lehnert, Jens Fielitz and Marcus Dörr Show full author list Hide full author list

J. Clin. Med. 2023, 12(2), 624; https://doi.org/10.3390/jcm12020624 - 12 Jan 2023

Cited by 5 | Viewed by 3177

Abstract

(1) Background: COVID-19 is often associated with significant long-term symptoms and disability, i.e., the long/post-COVID syndrome (PCS). Even after presumably mild COVID-19 infections, an increasing number of patients seek medical help for these long-term sequelae, which can affect various organ systems. The pathogenesis [...] Read more.

(1) Background: COVID-19 is often associated with significant long-term symptoms and disability, i.e., the long/post-COVID syndrome (PCS). Even after presumably mild COVID-19 infections, an increasing number of patients seek medical help for these long-term sequelae, which can affect various organ systems. The pathogenesis of PCS is not yet understood. Therapy has so far been limited to symptomatic treatment. The Greifswald Post COVID Rehabilitation Study (PoCoRe) aims to follow and deeply phenotype outpatients with PCS in the long term, taking a holistic and comprehensive approach to the analysis of their symptoms, signs and biomarkers. (2) Methods: Post-COVID outpatients are screened for symptoms in different organ systems with a standardized medical history, clinical examination, various questionnaires as well as physical and cardiopulmonary function tests. In addition, biomaterials are collected for the analysis of immunomodulators, cytokines, chemokines, proteome patterns as well as specific (auto)antibodies. Patients are treated according to their individual needs, adhering to the current standard of care. PoCoRe’s overall aim is to optimize diagnostics and therapy in PCS patients. Full article

(This article belongs to the Special Issue Long COVID: Current Approaches and Clinical Challenges in Treatment and Rehabilitation)

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