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BACKGROUND: Post-COVID-19 syndrome has affected millions of people, with rehabilitation being at the center of non-pharmacologic care. However, numerous published studies show conflicting results due to, among other factors, considerable variation in subject characteristics. Currently, the effects of age, sex, time of implementation, and prior disease severity on the outcomes of a supervised rehabilitation program after COVID-19 remain unknown. METHODS: This was a non-randomized case-control study. Subjects with post-COVID-19 sequelae were enrolled. Among study participants, those who could attend an 8-week, supervised rehabilitation program composed the intervention group, whereas those who couldn't the control group. Measurements were collected at baseline and 8 weeks thereafter. RESULTS: Study groups (N = 119) had similar baseline measurements. Participation in rehabilitation (n = 47) was associated with clinically important improvements in the 6-min walk test (6MWT) distance, adjusted (for potential confounders) odds ratio (AOR) 4.56 (95% CI 1.95-10.66); 1-min sit-to-stand test, AOR 4.64 (1.88-11.48); Short Physical Performance Battery, AOR 7.93 (2.82-22.26); health-related quality of life (HRQOL) 5-level EuroQol-5D (Visual Analog Scale), AOR 3.12 (1.37-7.08); Montreal Cognitive Assessment, AOR 6.25 (2.16-18.04); International Physical Activity Questionnaire, AOR 3.63 (1.53-8.59); Fatigue Severity Scale, AOR 4.07 (1.51-10.98); Chalder Fatigue Scale (bimodal score), AOR 3.33 (1.45-7.67); Modified Medical Research Council dyspnea scale (mMRC), AOR 4.43 (1.83-10.74); Post-COVID-19 Functional Scale (PCFS), AOR 3.46 (1.51-7.95); and COPD Assessment Test, AOR 7.40 (2.92-18.75). Time from disease onset was marginally associated only with 6MWT distance, AOR 0.99 (0.99-1.00). Prior hospitalization was associated with clinically important improvements in the mMRC dyspnea scale, AOR 3.50 (1.06-11.51); and PCFS, AOR 3.42 (1.16-10.06). Age, sex, and ICU admission were not associated with the results of any of the aforementioned tests/grading scales. CONCLUSIONS: In this non-randomized, case-control study, post-COVID-19 rehabilitation was associated with improvements in physical function, activity, HRQOL, respiratory symptoms, fatigue, and cognitive impairment. These associations were observed independently of timing of rehabilitation, age, sex, prior hospitalization, and ICU admission. [ABSTRACT FROM AUTHOR]

Purpose: To assess the inter-reliability of the Short Physical Performance Battery (SPPB), the 1-min Sit to Stand test (1-MSTS), and the Chester Step Test (CST) via remote assessment in post-COVID-19 patients after hospitalization. Methods: Twenty-five post-COVID-19 patients randomly performed the functional tests via remote assessment using a software platform at home and via face-to-face assessment at the rehabilitation center 24–72 h apart. One day before the remote assessment, all participants had a 1-h guidance session regarding the platform use, safety instructions, and home equipment preparation. Results: Participants completed all tests for both assessment procedures without experience of adverse events. The mean age was 53 (SD = 10) years old, and the median days of hospitalization were 23 (IQR = 10–33). The inter-reliability was moderate for the total score in the SPPB: Cohen's kappa = 0.545 (95% CI: 0.234 to 0.838), excellent for the number of repetitions in the 1-MSTS: ICC = 0.977 (95% CI: 0.948 to 0.990) and good for the total number of steps in the CST: ICC = 0.871 (95% CI: 0.698 to 0.944). Conclusion: Remote functional assessments for SPPB, 1-MSTS, and CST indicated moderate to excellent inter-reliability in post-COVID-19 patients after hospitalization. IMPLICATIONS FOR REHABILITATION: Functional performance assessment in post-COVID-19 patients is considered important throughout the whole process of rehabilitation. The face-to-face assessment is the standard practice in the rehabilitation clinical setting however, new approaches by distance assessment are proposed when physical attendance is not feasible. The Short Physical Performance Battery (SPPB), the 1-minute Sit to Stand test (1-MSTS), and the Chester Step Test (CST) showed moderate to excellent reliability when performed remotely at home in post-COVID-19 patients after hospitalization. [ABSTRACT FROM AUTHOR]

Background: Smoking cessation is crucial for reducing complications of type 2 diabetes mellitus (T2DM), but associated weight gain can worsen glycemic control, discouraging quitting attempts. Varenicline, a partial agonist of α4β2 nicotinic receptors, aids smoking cessation. This study examines the effects of varenicline on body weight and metabolic parameters in patients with T2DM and prediabetes. Methods: Fifty-three patients were enrolled, of which 32 successfully quit smoking after a three-month course of varenicline and were examined after an additional month with no medication. Measurements taken at baseline, 2.5 months, and 4 months included body weight, blood pressure, resting metabolic rate (RMR), glycated hemoglobin (HbA1c), fasting glucose, blood lipids, C-reactive protein (CRP), appetite-related hormones, and physical activity. Results: Post-treatment, there were no significant changes in body weight, blood pressure, RMR, or glycemic control. Total (CHOL) and low-density lipoprotein (LDL-C) cholesterol decreased significantly at 4 months of the study (from 168 to 156 mg/dL, p = 0.013, and from 96 to 83 mg/dL, p = 0.013, respectively). Leptin levels increased (from 11 to 13.8 ng/dL, p = 0.004), as did glucagon-like peptide-1 (GLP-1) levels (from 39.6 to 45.8 pM, p = 0.016) at 4 months of follow-up. The percentage of participants who reported moderate-intensity activity increased from 28% to 56%, while those reporting high-intensity activity increased from 19% to 22%, respectively (p = 0.039). Conclusions: Our study showed that smoking cessation with varenicline in smokers with T2DM and prediabetes led to significant improvements in lipid profile, significant increase in plasma leptin and GLP-1 levels, and increased physical activity, without significant weight gain. Thus, smoking cessation without weight gain or deteriorated glycemic control is feasible for these smokers, with added benefits to lipid profiles, GLP-1 regulation, and physical activity. [ABSTRACT FROM AUTHOR]

Introduction: Smoking during pregnancy and the postpartum period poses significant risks to maternal and neonatal health. Despite initial reductions in smoking rates during pregnancy, many women relapse post-delivery, influenced by factors such as socioeconomic status, partner's smoking status, and depressive symptoms. This systematic review explores smoking cessation interventions specifically designed for the postpartum period. Methods: We searched the literature for studies related to tobacco cessation in the postpartum period, utilizing the electronic databases PubMed and Scopus. The search strategy was developed using the following keywords in all combinations: 'tobacco cessation', 'smoking cessation', 'quitting smoking', 'vaping cessation' and 'postnatal', 'postpartum', 'childbearing', and 'puerperium'. Various interventions were examined, including technology-based approaches, motivational interviewing, cognitive-behavioral and pharmacological interventions. Results: Factors associated with relapse included the partner's smoking status, depressive symptoms, and a lack of breastfeeding. Motivations for cessation included concerns for infant health, support from partners, and financial incentives. Methods for confirming smoking cessation included exhaled carbon monoxide measurement and salivary cotinine detection. Findings highlight the importance of ongoing support from health professionals, particularly during the postpartum period, to promote smoking cessation and prevent relapse. Additionally, interventions targeting family members' smoking behaviors and emphasizing the health benefits of breastfeeding are crucial. We also explored varenicline, nicotine replacement therapy, and electronic cigarettes as cessation aids, finding mixed attitudes among participants. Conclusions: Overall, this review underscores the need for tailored interventions and continued support to address smoking cessation during the vulnerable postpartum period, ultimately safeguarding the health of both mothers and infants. [ABSTRACT FROM AUTHOR]

Introduction: The introduction of electronic nicotine delivery systems (ENDS) has altered smoking status, particularly among adults of reproductive age. Despite perceptions of ENDS as safer alternatives to conventional cigarettes (CCs), their impact on perinatal outcomes remains poorly understood. This systematic review and meta-analysis aim to elucidate the effects of ENDS use during pregnancy on fetal health and pregnancy outcomes. Methods: We conducted a comprehensive literature search using Scopus, Medline (PubMed) and Web of Science, focusing on studies that examine the effects of ENDS on pregnancy and neonatal outcomes. We limited the search to publications in English. We selected articles based on their relevance to pregnancy outcomes associated with ENDS use. Due to the low heterogeneity among the included studies, we calculated odds ratios (ORs) using fixed effects models. Results: The search identified six relevant studies. Our meta-analysis included 4 studies for the outcome small-for-gestational age (SGA), 3 for the outcome preterm birth (PB) and 2 for the outcome low birth weight (LBW). The meta-analysis provided further statistical evidence, indicating that women who used e-cigarettes during pregnancy had significantly higher risks of SGA (OR=1.46; 95% CI: 1.07–1.99, I2=31.55%), PB (OR=1.40; 95% CI:1.03–1.91, I2=0%), and LBW (OR=1.55; 95% CI: 1.15–2.09, I2=0%) compared to nonusers. Conclusions: ENDS use during pregnancy is associated with significant adverse perinatal outcomes. These findings support public health policies promoting complete abstinence from both CC and ENDS among pregnant women to ensure the best perinatal outcomes. [ABSTRACT FROM AUTHOR]