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Introduction: Since the onset of the COVID-19 pandemic, 775 million cases have been reported globally. While many individuals recover fully, a significant proportion develop persistent symptoms. Numerous studies have investigated the long-term symptoms of COVID-19; however, the full extent and impact of these symptoms remain inadequately understood. The aim of this study was to investigate the prevalence of self-reported persistent symptoms, focusing on respiratory symptoms and fatigue and the impact on functional status 2 years after hospitalization for COVID-19. Methods: This study is prospective and includes participants from a longitudinal multi-center cohort that follows patients previously hospitalized due to COVID-19 (n = 211). The current study encompasses the 2-year follow-up, using post-hospitalization questionnaire surveys. Analyzed data were collected before discharge and at the 2-year follow-up. Participants were grouped by age, sex and COVID-19 severity and group comparisons where conducted. Logistic regression analysis was used to study functional impairment. Results: Two years after hospital discharge due to COVID-19, 125 participants completed the 2-year follow-up. The mean age of participants was 66 years (SD 12.2), and 68% were male. The majority of participants reported present respiratory symptoms (n = 83, 69%) and fatigue (n = 98, 78%) at the 2-year follow-up. Persistent respiratory symptoms and fatigue impacted functional status substantially (p = <0.001, p = 0.028, respectively). No significant differences were observed among groups depending on age, sex, or severity of COVID-19. Conclusion: For some individuals regardless of age, sex or COVID-19 severity, respiratory symptoms and fatigue may persist for up to 2 years following COVID-19. Hence, having available support from professionals knowledgeable about COVID-19 is imperative. Further research is important to unravel the mechanisms of long-term symptoms following COVID-19 and to develop effective therapeutic and rehabilitative interventions. [ABSTRACT FROM AUTHOR]

Background/Objectives: Among the neuropsychiatric symptoms of long COVID, the following may be listed: sleep disturbances, headaches, anxiety, depression, dizziness, numbness, memory loss, and concentration difficulties. Various therapies have been implemented to mitigate these symptoms; however, health resort treatments that utilize a wide range of modalities stimulating multidirectional biological reactions may also be effective. The aim of this study was to assess the severity of neuropsychiatric symptoms in long COVID patients who qualified for health resort treatment, evaluate the effectiveness of health resort treatment in this group of patients, and evaluate the effect of balneological factors in the treatment course. Methods: A retrospective analysis of the medical records of 120 people with long COVID (69 women and 51 men) aged 42–79 who underwent health resort treatment in 2021 was performed. People were eligible for treatment at a lowland health resort based on a valid referral from a doctor. The treatment included balneological therapies, physical medicine modalities, exercise programs, health education, and psychological support. Patients assessed the severity of persistent neuropsychiatric symptoms on a 0–10 point scale before and after treatment. Results: After the treatment, the greatest improvement was noted in sleep disorders (2.47 ± 2.23 points vs. 0.86 ± 1.25 points, p < 0.00001) and dizziness (1.39 ± 1.94 points vs. 0.34 ± 0.76 points, p < 0.00001). The lowest improvement was observed in memory disorders (2.68 ± 2.5 points vs. 1 ± 1.4 points, p < 0.00001). Conclusions: Patients with long COVID who qualified for health resort treatment reported mild neuropsychiatric symptoms. Health resort treatment mitigates neuropsychiatric symptoms, as it is a complex approach. Treatment that includes balneological factors improves symptoms to a greater extent. This method of treatment should be integrated into the standard treatment for long COVID. [ABSTRACT FROM AUTHOR]

Background: Post-COVID-19 syndrome refers to a variety of symptoms that affect different organs in the body and can persist 28 days following exposure to COVID-19. Previous studies have shown that COVID-19 affects not only elderly individuals but also young adults. However, the influence of post-COVID-19 syndrome on young adults has not been studied sufficiently. Therefore, the aim of this study was to determine the prevalence and characteristics of post-COVID-19 manifestations in young adults. Methods: An analytical cross-sectional online questionnaire was distributed from July 2022 to July 2023 to health sciences students in Saudi Arabia. The study used a non-probability convenience sampling technique, and the sample size was calculated to be 464. The survey included questions about the participants' demographics, health records, COVID-19 results, duration of infection, and previous and current COVID-19 symptoms. Illness severity and management were evaluated using the COVID Experiences (COVEX) Symptoms and Diagnoses module, and Patient Health Questionnaire (PHQ-9) was used to assess depression. Results: According to the inclusion criteria, 428 participants were divided into three groups: those who fully recovered within 14 days of the acute phase (76.4%), those with prolonged symptoms that resolved within 28 days (16.8%), and those with persistent symptoms for more than 28 days (6.8%). The symptom development frequency during the acute phase significantly differed among the three groups: headache (p = 0.038), loss of smell and taste (p = < 0.001), and fatigue (p = 0.009). The symptoms that significantly differed between the prolonged group and persistent group during the post-COVID-19 syndrome phase were loss of smell and taste (p = < 0.001) and shortness of breath (p = < 0.001). The study results revealed that females are susceptible to long-COVID-19. This study revealed that the overall severity of post-COVID-19 symptoms was mild in this age group. The PHQ-9 score when comparing the three groups showed a significant association with depression (p = 0.035). Conclusion: The study results support the perception that not only can the geriatric population suffer from post-COVID-19 syndrome but also that young adults are prone to persistent symptoms such as loss of smell and taste, which may affect their mental health status. [ABSTRACT FROM AUTHOR]

Abstract Background Long COVID-19 is characterized by systemic deterioration of the entire body, leading to significant physical and mental disorders. Exercise training has the potential to improve persistent symptoms and cardiopulmonary functions. Method This was a single-center, randomized, controlled trial. Twenty-four patients aged 18 to 75 years who had a history of SARS-CoV-2 infection and long COVID symptoms. Patients were randomly allocated in a 1:1 ratio to receive either a 4-week exercise training program or an attention control group. The training group participated in 12 supervised aerobic sessions on a cycling ergometer over 4 weeks. The outcomes were to assess the impact of a 4-week aerobic exercise on the persistent symptoms and cardiopulmonary fitness, the surrogate endpoints of COVID-19 recovery and cardiopulmonary health. Results After the 4-week intervention, significant reductions were observed in the total number of symptoms in the training group. Specifically, 67.8% of patients in the training group exhibited reduced or completely resolved symptoms, in comparison to 16.7% in the control group (P = 0.013). After adjusting for gender, significant improvements in the training group were observed for exercise time (P group*time = 0.028), maximum load (P group*time = 0.01), and peak VO2 (P group*time = 0.001), as well as O2 pulse (P group*time = 0.042) and maximum heart rate (P group*time = 0.007). The score of Short Form-12, depression, anxiety, perceived stress, and insomnia did not show significant changes between groups (P group*time > 0.05). Conclusion A supervised aerobic training program has the potential to alleviate persistent symptoms and improve exercise tolerance in patients with long COVID-19. Further research is necessary to confirm these effects in a large population. This intervention could be easily implemented in non-hospital settings, potentially benefiting a broader range of individuals. Trial registration number ClinicalTrials.gov NCT05961462. Registered on July 25, 2023.

Background: Should COVID-19 have a direct impact on the risk of depression, it would suggest specific pathways for prevention and treatment. In this retrospective population-based study, we aimed to examine the association of prior SARS-CoV-2 infection with depressive symptoms, distinguishing self-reported v. biologically confirmed COVID-19. Methods: 32 007 participants from the SAPRIS survey nested in the French CONSTANCES cohort were included. COVID-19 was measured as followed: ad hoc serologic testing, self-reported PCR or serology positive test results, and self-reported COVID-19. Depressive symptoms were measured with the Center of Epidemiologic Studies-Depression Scale (CES-D). Outcomes were depressive symptoms (total CES-D score, its four dimensions, and clinically significant depressive symptoms) and exposure was prior COVID-19 (no COVID-19/self-reported unconfirmed COVID-19/biologically confirmed COVID-19). Results: In comparison to participants without COVID-19, participants with self-reported unconfirmed COVID-19 and biologically confirmed COVID-19 had higher CES-D scores (β for one interquartile range increase [95% CI]: 0.15 [0.08–0.22] and 0.09 [0.05–0.13], respectively) and somatic complaints dimension scores (0.15 [0.09–0.21] and 0.10 [0.07–0.13]). Only those with self-reported but unconfirmed COVID-19 had higher depressed affect dimension scores (0.08 [0.01–0.14]). Accounting for ad hoc serologic testing only, the CES-D score and the somatic complaints dimension were only associated with the combination of self-reported COVID-19 and negative serology test results. Conclusions: The association between COVID-19 and depressive symptoms was merely driven by somatic symptoms of depression and did not follow a gradient consistent with the hypothesis of a direct impact of SARS-CoV-2 infection on the risk of depression. [ABSTRACT FROM AUTHOR]

Regardless of the cause, hypothyroidism should be treated with levothyroxine. The objectives of management are the normalization of TSH levels and the relief of symptoms. In general, the vast majority of patients who achieve normalization of TSH levels show a resolution of symptoms; however, for a small number of individuals, symptoms persist (despite adequate control of TSH). This scenario generates a dilemma in the therapeutic approach to these patients, because even when excluding other causes or concomitant diseases that can explain the persistence of symptoms, pharmacological management strategies are scarce. Consequently, the efficacy of some less conventional approaches to therapy, such as the use of LT3 monotherapy, desiccated thyroid extracts, and LT4/LT3 combinations, in addressing persistent hypothyroid symptoms have been evaluated in multiple studies. The majority of these studies did not observe a significant benefit from these "nonconventional" therapies in comparison to results with LT4 monotherapy alone. Nevertheless, some studies report that a significant proportion of patients prefer an alternative to monotherapy with LT4. The most common approach has been to prescribe a combination of LT4 and LT3, and this review describes and analyzes the current evidence of the efficacy of LT4/LT3 combination therapy vs. LT4 monotherapy in addressing persistent hypothyroidism symptoms to provide suggested guidelines for clinicians in the management of these patients. [ABSTRACT FROM AUTHOR]

Objectives This study aims to explore patients' and clinicians' experiences in managing and living with refractory disease (RD) and persistent physical and emotional symptoms (PPES) in patients with RA or polyarticular JIA from their perspectives through interviews and/or focus groups. Methods A qualitative exploration with 25 patients and 32 multidisciplinary rheumatology healthcare professionals (HCPs) was conducted to obtain participants respective understanding and experiences of managing RD/PPES and its impact on the patient–professional relationship. A pragmatic epistemology approach with framework analysis was employed. Results Four key themes were identified from both patients and professionals in the management of RD/PPES: risk/perpetuating factors/triggers; need for a patient-centred holistic approach to care, diagnosis and treatment; discordance and impact on the patient–practitioner relationship and current problems in managing RD/PPES. These themes covered 22 subthemes, with none being patient specific and seven being HCP specific. Suggestions for potential management strategies were highlighted throughout, such as involving other specialties or a multidisciplinary team, assessing/treating patient-reported outcome measures and psychosocial factors, patient (re)education, need for adjustments/aids or adaptations, checking the diagnosis and further investigations/imaging and optimizing medications. Conclusion Management strategies need to be developed that enable appropriate treatment plans for those with RD/PPES that account for wider biopsychosocial factors beyond inflammation and reduce discordance in the patient–practitioner relationship. [ABSTRACT FROM AUTHOR]

IntroductionSince the onset of the COVID-19 pandemic, 775 million cases have been reported globally. While many individuals recover fully, a significant proportion develop persistent symptoms. Numerous studies have investigated the long-term symptoms of COVID-19; however, the full extent and impact of these symptoms remain inadequately understood. The aim of this study was to investigate the prevalence of self-reported persistent symptoms, focusing on respiratory symptoms and fatigue and the impact on functional status 2 years after hospitalization for COVID-19.MethodsThis study is prospective and includes participants from a longitudinal multi-center cohort that follows patients previously hospitalized due to COVID-19 (n = 211). The current study encompasses the 2-year follow-up, using post-hospitalization questionnaire surveys. Analyzed data were collected before discharge and at the 2-year follow-up. Participants were grouped by age, sex and COVID-19 severity and group comparisons where conducted. Logistic regression analysis was used to study functional impairment.ResultsTwo years after hospital discharge due to COVID-19, 125 participants completed the 2-year follow-up. The mean age of participants was 66 years (SD 12.2), and 68% were male. The majority of participants reported present respiratory symptoms (n = 83, 69%) and fatigue (n = 98, 78%) at the 2-year follow-up. Persistent respiratory symptoms and fatigue impacted functional status substantially (p =

Objective: To evaluate and characterize the cognitive changes in COVID-19 participants at 6-month follow-up, and to explore a possible association with clinical symptoms, emotional disturbance and disease severity. Methods: This single-center longitudinal cohort study included participants aged 20 and 60 years old to exclude cognitive impairment age-associated with confirmed COVID-19 infection. The initial evaluation occurred 10 to 30 days after hospital or ambulatory discharge, with a subsequent follow-up at 6 months. Patients who had a history of cognitive impairment, neurological conditions, or serious psychiatric disorders were not included. Information on demographics and laboratory results was gathered from medical records. Cognitive outcomes were assessed with a neuropsychological battery including attention, verbal and visual memory, language and executive function tests. Results: A total of 200 participants were included in the study, and 108 completed the follow-up visit. At the 6-month follow-up, comparing the means from baseline with those of the follow-up evaluation, significant overall improvement was observed in verbal and visual memory subtests (p = 0.001), processing speed (p = 0.001), executive function (p = 0.028; p = 0.016) and naming (p = 0.001), independently of disease severity and cognitive complaints. Anxiety and depression were significantly higher in groups with Subjective Cognitive Complaints (SCC) compared to those without (p < 0.01 for both). Conclusions: Persistent symptoms are common regardless of disease severity and are often linked to cognitive complaints. Six months after COVID-19, the most frequently reported symptoms included headache, dyspnea, fatigue, cognitive complaints, anxiety, and depression. No cognitive impairment was found to be associated with the severity of COVID-19. Overall, neuropsychological and psychopathological improvement was observed at 6 months regardless of disease severity and cognitive complaints.

Persistent symptoms after an infection have been described for a number of infectious diseases, including Lyme disease. Studies have confirmed a moderate but consistent increase in the prevalence of such symptoms after Lyme disease, though the risk increase varies dependent on study design and the definition of persistent symptoms. Various possible predictors have been proposed, including a dysregulation of the immune system, metabolic changes, increased sensitization to pain signals, cognitive-behavioral factors, or—controversially—the persistence of the causative Borrelia bacteria or remnants thereof. Research on the precise roles of any of these factors is still ongoing. The lack of biological underpinning also makes it difficult to assess with certainty which patients' (generally nonspecific) persistent symptoms are etiologically related to the previous Lyme disease episode and which are not, particularly as these symptoms occur in the general population relatively frequently. The diagnostic criteria for posttreatment Lyme disease syndrome have shown their usefulness in both clinical and research settings but leave out a number of patients whose symptoms may fall just outside said criteria. Though the relationship between these symptoms and the previous Lyme disease episode may be very uncertain, we would argue that a uniform description and classification of these patients will aid in future research and patient management, regardless of the eventual underlying cause. Thus, we argue for an inclusive classification system for all persistent symptoms attributed to Lyme disease in order to promote validation of patient experiences and perspectives, while also maintaining scientific nuance regarding the very uncertain etiology of these patients' symptoms. [ABSTRACT FROM AUTHOR]

Even during the endemic phase of the COVID-19 pandemic, the impact of persistent symptoms on patients and healthcare systems remains significant. Thus, a more comprehensive understanding of these symptoms is essential. Using data from the Japan Society and New Tobacco Internet Survey conducted in February 2023, this cross-sectional study investigated the prevalence of, and changes in, persistent COVID-19 symptoms. In total, 21,108 individuals responded to the survey. Of these, 29.1 % (6143) had a history of COVID-19. Our analysis found that arm/leg/joint pain (adjusted odds ratio [aOR]: 1.17; 95 % confidence interval [95 % CI]: 1.03–1.33), back pain (aOR: 1.13; 95 % CI: 1.01–1.27), chest pain (aOR: 1.53; 95 % CI: 1.20–1.96), malaise (aOR: 1.14; 95 % CI: 1.02–1.28), loss of taste (aOR: 2.55; 95 % CI: 1.75–3.72), loss of smell (aOR: 2.33; 95 % CI: 1.67–3.26), memory impairment (aOR: 1.27; 95 % CI: 1.04–1.56), and cough (aOR: 1.72; 95 % CI: 1.38–2.13) were independently associated with a history of COVID-19 contracted more than two months but less than six months previously. Further, back pain (aOR: 1.24; 95 % CI: 1.04–1.47) and loss of taste (aOR: 2.28; 95 % CI: 1.24–4.21) showed independent association with COVID-19 contracted more than 12 months previously. Various symptoms were independently associated with a history of COVID-19. While most patients tend to recover within a year after contracting COVID-19, certain symptoms, such as back pain and loss of taste, persist longer than a year, underscoring public health concerns and emphasizing the need for health care services to support patients suffering from persistent symptoms. [ABSTRACT FROM AUTHOR]

Background: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the variables that can exert influence and understanding their progression is essential for directing treatment strategies aimed at enhancing both independence and quality of life. Therefore, the aim of this study was to analyse the influence of sociodemographic and clinical variables on existence and their relationship with asthenia, anxiety symptoms and low mood. Methods: An analytical study secondary to an observational cross-sectional descriptive study. Results: Logistic regression showed significant univariate effects on asthenia [sex (p = 0.034); age (p = 0.042); Activities of Daily Living Questionnaire [ADQL (p = 0.002)] [physical functioning (p < 0.001) and general health (p = 0.014)] and multivariate [sex (p = 0.019), adult age (p = 0.01) and physical functioning (p = 0.04)]]; low mood [time of evolution (p = 0.028) and multivariate [time course (p = 0.007), ADLQ (p = 0.011), role physical (p = 0.013) and general health (p = 0.001)]] and anxiety [physical functioning (p = 0.046) and multivariate [physical functioning (p = 0.034), age (p = 0.011), time of evolution (p = 0.001) and ADQL (p = 0.011)]]. Conclusions: Increased age, gender and longer evolution time seem to favour the prevalence and occurrence of mental health symptoms; greater independence and good physical functioning are protective factors with respect to the occurrence of mental health-related symptoms in patients affected by post-COVID-19 condition. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and characterize the cognitive changes in COVID-19 participants at 6-month follow-up, and to explore a possible association with clinical symptoms, emotional disturbance and disease severity. Methods: This single-center longitudinal cohort study included participants aged 20 and 60 years old to exclude cognitive impairment age-associated with confirmed COVID-19 infection. The initial evaluation occurred 10 to 30 days after hospital or ambulatory discharge, with a subsequent follow-up at 6 months. Patients who had a history of cognitive impairment, neurological conditions, or serious psychiatric disorders were not included. Information on demographics and laboratory results was gathered from medical records. Cognitive outcomes were assessed with a neuropsychological battery including attention, verbal and visual memory, language and executive function tests. Results: A total of 200 participants were included in the study, and 108 completed the follow-up visit. At the 6-month follow-up, comparing the means from baseline with those of the follow-up evaluation, significant overall improvement was observed in verbal and visual memory subtests (p = 0.001), processing speed (p = 0.001), executive function (p = 0.028; p = 0.016) and naming (p = 0.001), independently of disease severity and cognitive complaints. Anxiety and depression were significantly higher in groups with Subjective Cognitive Complaints (SCC) compared to those without (p < 0.01 for both). Conclusions: Persistent symptoms are common regardless of disease severity and are often linked to cognitive complaints. Six months after COVID-19, the most frequently reported symptoms included headache, dyspnea, fatigue, cognitive complaints, anxiety, and depression. No cognitive impairment was found to be associated with the severity of COVID-19. Overall, neuropsychological and psychopathological improvement was observed at 6 months regardless of disease severity and cognitive complaints. [ABSTRACT FROM AUTHOR]

Objective: To characterize the cognitive profile of long COVID-19 subjects and its possible association with clinical symptoms, emotional disturbance, biomarkers, and disease severity. Methods: We performed a single-center cross-sectional cohort study. Subjects between 20 and 60 years old with confirmed COVID-19 infection were included. The assessment was performed 6 months following hospital or ambulatory discharge. Excluded were those with prior neurocognitive impairment and severe neurological/neuropsychiatric disorders. Demographic and laboratory data were extracted from medical records. Results: Altogether, 108 participants were included, 64 were male (59.25%), and the mean age was 49.10 years. The patients were classified into four groups: non-hospitalized (NH, n = 10), hospitalized without Intensive Care Unit (ICU) or oxygen therapy (HOSPI, n = 21), hospitalized without ICU but with oxygen therapy (OXY, n = 56), and ICU (ICU, n = 21) patients. In total, 38 (35.18%) reported Subjective Cognitive Complaints (SCC). No differences were found considering illness severity between groups. Females had more persistent clinical symptoms and SCC than males. Persistent dyspnea and headache were associated with higher scores in anxiety and depression. Persistent fatigue, anxiety, and depression were associated with worse overall cognition. Conclusions: No cognitive impairment was found regarding the severity of post-COVID-19 infection. SCC was not associated with a worse cognitive performance, but with higher anxiety and depression. Persistent clinical symptoms were frequent independent of illness severity. Fatigue, anxiety, and depression were linked to poorer cognitive function. Tests for attention, processing speed, and executive function were the most sensitive in detecting cognitive changes in these patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the prevalence and trajectory of persistent symptoms following COVID-19 and to investigate factors influencing these among employees in the health and welfare services in Germany.Methods: This exploratory, mixed retro- and prospective cohort study using paper-and-pencil questionnaires was conducted among insured persons of the German Social Accident Insurance Institution for the health and welfare services with a SARS-CoV-2 infection in 2020. The baseline survey in February 2021 was succeeded by two follow-up surveys after 8 and 13 months. Demographic data, information on the acute illness and persistent symptoms were collected. Kaplan-Meier curves were created to visualize the course of recovery. Factors influencing the time to recovery were analyzed using multivariate Cox regressions.Results: Of the 4,325 people contacted, 2,053 took part in the survey (response rate: 47%). 1,810 people were included in the analysis. The most common persistent symptoms at all three survey time points were fatigue, concentration and memory problems, and dyspnea. After three months, 76.2% (95% CI: 74.2–78.2%) of participants still reported symptoms, after 18 months this dropped to 67.2% (95% CI: 65.0–69.4%). Significant risk factors for persistent symptoms were female sex (HR: 0.72; 95% CI: 0.58–0.88), age over 50 years (HR: 0.63; 95% CI: 0.50–0.78), a higher number of pre-existing illnesses and a higher number of severe acute symptoms. Respiratory and hormone-metabolic pre-existing conditions as well as severe dyspnea, smell or taste disorders, fatigue and memory or concentration problems during the acute COVID-19 illness also reduced the probability of complete recovery. Compared to other professions, working as a doctor had a protective effect (HR: 1.42; 95% CI: 1.11–1.80).Conclusion: More than a year after a COVID-19 illness, two-thirds of the healthcare staff surveyed reported persistent symptoms. This high number emphasizes the importance of long-term consequences of the COVID-19 pandemic for public health and the need for suitable therapy and rehabilitation concepts, especially for healthcare staff with post-COVID syndrome.

BackgroundSurveillance remains fundamental to understanding the changes in epidemiological patterns regarding post-COVID conditions and reinfections. Persistent symptoms and reinfection in previously infected individuals are increasing being reported in many countries, but their associations among general populations were seldomly reported. Understanding the association with persistent symptoms of COVID-19 reinfection is essential to develop strategies to mitigate the long-term health and socio-economic impacts of the post-COVID conditions. This study aimed to investigate the incidence of COVID-19 persistent symptoms among previously infected Chinese community residents and explore associations of specific COVID-19 persistent symptoms with reinfection and other factors.MethodsA community-based survey was conducted in a southern city of China with about 20 million residents from August 3 to 24, 2023. Face-to-face questionnaires were distributed to a total of 1,485 residents to collect their information about COVID-19 infection, reinfection, specific ongoing persistent symptoms, and other COVID-19 related information. Multivariable logistic regression analysis was used to examine the association between specific persistent symptoms and reinfection of COVID-19, along with age, gender, and educational level.ResultsOf the 1,485 participants, 1,089 (73.3%) reported they had been infected with COVID-19. Among them, 89.1% reported having ongoing persistent symptoms and 14.2% reported had two or more times of infection. About 20% participants were infected 1 year or more since their initial infection. Fatigue, cough, and headaches were the top 3 symptoms being reported. Participants with reinfection were associated with a higher probability of reporting headaches (OR: 1.54, 95% CI: 1.06–2.25), loss of or change in smell and/or taste (OR: 1.90, 95% CI: 1.27–2.83), impaired sleep (OR: 1.55, 95% CI: 1.02–2.35), and brain fog (OR: 1.76, 95% CI: 1.12–2.76). Participants aged 45 and above and who had a bachelor’s or higher degree were more likely to report chest tightness or shortness of breath, impaired sleep, and brain fog.DiscussionDuring the post-emergency period of COVID-19 pandemic, the incidence of ongoing persistent symptoms among Chinese residents remains high. Individuals whose initial infection was longer than 1 year have the highest probability of reporting having multiple symptoms. Reinfection may increase the risk of reporting headaches, loss of or change in smell and/or taste, impaired sleep, and brain fog. It is important to maintain routine syndromic surveillance among previously infected people and provide recommendations for clinical management of individuals with multiple ongoing symptoms.

To systematically characterize and assess the effectiveness of multidisciplinary care for patients with persistent post-concussion symptoms (PPCS). Only studies describing multidisciplinary treatment, defined as intervention provided by no less than 2 healthcare disciplines, each with independent scopes of practice, for patients with PPCS were considered. A total of 8 of the 1357 studies identified were included. The studies were comprised of heterogenous patient populations, care delivery systems, healthcare providers, treatment approaches, and outcomes. Findings suggest multidisciplinary care, using a needs-based approach with individual- or group-based interventions, may be more beneficial than usual care to; 1) immediately reduce concussion-related symptom complaints and improve mood and quality of life in adolescents following sports-related concussion (SRC) and, 2) may produce immediate and lasting improvements in symptom complaints of young, primarily female, adults following a non-SRC. Future studies should clearly describe the decision-making processes used to deliver care through a needs-based approach and prioritize the inclusion of objective, performance-based measures to assess outcomes. Multidisciplinary care using a needs-based approach with the individual- and group-based interventions, may be more beneficial than usual care. Younger populations, particularly females, seem to benefit most from multidisciplinary care to decrease the burden of post-concussion symptoms. Multidisciplinary care teams should consider providing psychological support and education combined with cognitive retraining and pharmacologic intervention to address persistent post-concussion symptoms. [ABSTRACT FROM AUTHOR]

Objective: Recent studies on coronavirus disease 2019 (COVID-19) reported that symptoms persisted for weeks or even months in some patients and they are called long COVID, post-acute COVID-19, etc. The aim of this study is to examine the frequency of long COVID in health-care workers, identify the common symptoms, and assess the possible factors that may be associated. Methods: In this cross-sectional study a self-administered questionnaire was carried out. About half (48.1%) of the 131 participants evaluated had long COVID. The 41.3% of long COVID cases had chronic COVID. Results: The percentage of those who were hospitalized in inpatient clinics or intensive care units during infection was higher in long COVID patients (31.7% vs. 14.3%) as well as frequency of oxygen need (36.5% vs. 17.9%). Fatigue was the most frequent symptom (54%), followed by myalgia (47.6%) and arthralgia (42.9%). Conclusion: The study showed that approximately half of health-care workers who had COVID-19 suffer from long COVID. [ABSTRACT FROM AUTHOR]

Background: Persistent symptoms in coeliac disease (CD) can be due to not only poor gluten-free diet (GFD) adherence and complications of CD, but also functional gastrointestinal disorders such as irritable bowel syndrome (IBS). Although the role of a low fermentable oligo-, di-, and monosaccharides and polyols (FODMAP) diet is well-established in IBS, little data are available on its role in coeliac patients with persistent IBS-like symptoms despite a GFD. Methods: We systematically reviewed the literature in accordance with the PRISMA guidelines for studies evaluating the role of FODMAPs and/or a low-FODMAP diet in coeliac patients with persistent symptoms. PubMed and Embase were searched from inception to 16 January 2024 for eligible full-text papers. The study protocol was registered on Open Science Framework. Results: A total of 239 records were identified, and six papers were included. Of these, four were interventional studies comparing a low-FODMAP GFD to a regular GFD for persistent symptoms in 115 total coeliac patients (two randomized controlled trials and two open-label studies). A low-FODMAP GFD for a minimum of 4 weeks was significantly more effective than a regular GFD in reducing symptoms (p < 0.05 in 3/4 studies). Dietary FODMAP content of a conventional GFD was significantly lower than that of non-coeliac patients on a gluten-containing diet (both p < 0.05), especially regarding high-FODMAP grain products. However, coeliac patients consumed more servings of fruits/vegetables high in FODMAP. No relationship between FODMAP intake and persistence of symptoms was reported. Conclusions: A low-FODMAP diet may be beneficial for uncomplicated celiac patients with persistent IBS-like symptoms despite strict adherence to a GFD. [ABSTRACT FROM AUTHOR]

"Long COVID" is a term used to describe a condition when the symptoms and signs associated with coronavirus disease 2019 (COVID-19) persist for more than three months among patients infected with COVID-19; this condition has been reported globally and poses a serious public health issue. Long COVID can manifest in various forms, highlighting the need for appropriate evaluation and management by experts from various fields. However, due to the lack of clear clinical definitions, knowledge of pathophysiology, diagnostic methods, and treatment protocols, it is necessary to develop the best standard clinical guidelines based on the scientific evidence reported to date. We developed this clinical guideline for diagnosing and treating long COVID by analyzing the latest research data collected from the start of the COVID-19 pandemic until June 2023, along with the consensus of expert opinions. This guideline provides recommendations for diagnosis and treatment that can be applied in clinical practice, based on a total of 32 key questions related to patients with long COVID. The evaluation of patients with long COVID should be comprehensive, including medical history, physical examination, blood tests, imaging studies, and functional tests. To reduce the risk of developing long COVID, vaccination and antiviral treatment during the acute phase are recommended. This guideline will be revised when there is a reasonable need for updates based on the availability of new knowledge on the diagnosis and treatment of long COVID. [ABSTRACT FROM AUTHOR]

Objectives: Mental health problems and persistent COVID‐19 symptoms were prevalent in the context of COVID‐19. However, despite the long‐observed association between physical symptoms and mental health problems, such association has not been adequately examined in the context of COVID‐19. Our understanding of wider patterns of risk and vulnerability factors for mental health also remains limited. This study investigated the associations between general mental health, and persistent physical symptoms, and additional risk and vulnerability factors in the context of COVID‐19. Methods: Two hundred fourteen adults, living in the UK, recruited via social media, completed the online survey and were included in the analyses. Correlation and regression analyses were conducted to examine the associations of persistent physical symptoms and risk and vulnerability factors with measures of general mental health including depressive symptoms, anxiety and insomnia. Results: 78.5% of the participants reported between 1 and 26 persistent symptoms, and about 28%–92% of them associated these symptoms with COVID‐19 infection. Persistent physical symptoms were uniquely associated with all measures of mental health, β =.19–.32. Mental health history and worries were the most prominent risk factors, |β| =.12–.43. Conclusions: People who experience more persistent physical symptoms post‐COVID‐19 have poorer mental health. It may be important to consider and discuss the recovery from COVID‐19 beyond a negative COVID‐19 test. Multidisciplinary interventions that address the complex impact of COVID‐19 for people with long COVID are needed. [ABSTRACT FROM AUTHOR]

Introduction: Long COVID is commonly encountered by many individuals during the coronavirus 2019 pandemic. It is best diagnosed by a history consistent with acute coronavirus disease 2019 (COVID-19) followed by a prolonged recovery. An attempt has been made to enlist the sequel of long COVID clinically and to assess their risk factors. Materials and Methods: Confirmed COVID-19 patients admitted to our hospital were enquired about their persistent symptoms following infection after 3– 12 weeks for acute symptoms and after 12 weeks for chronic symptoms through the predesigned questionnaire schedule about their manifestations and followed up every month for 6 months. Results: A total of 152 patients were included in our study and found acute long COVID symptoms related to neurological (72.2%), respiratory (64.7%), and musculoskeletal (61.4%) system being most commonly affected. Chronic symptoms were comprised predominantly musculoskeletal (63.1%) followed by fatigue (43.4%) and neurological (29.6) manifestations. Risk factors estimate of postacute COVID-19 symptoms showed that females had increased risk with odds ratio (OR) (and 95% confidence intervals) (OR) of 2.412 (1.239–4.692), sedentary lifestyle OR 1.775 (1.345–2.762), body mass index (BMI) >23 OR 3.877 (1.613–6.144), and presence of comorbidities OR 2.526 (1.277–4.997). Similarly, risk factor estimate of Postchronic COVID-19 symptoms showed that females had increased risk with OR 1.879 (0.952–3.709), sedentary lifestyle OR 5.091 (2.853–9.085), BMI >23 OR 2.082 (1.005–4.134), and presence of comorbidities OR 1.851 (0.925–3.705). Conclusions: Long COVID symptoms noted were mainly related to musculoskeletal disorders, neurological, respiratory, and fatigue. This enumeration will help us to bring the further pathway to include this long COVID entity for preventive strategies in our regular setup at the primary care level.

Background: After recovery from acute Covid infection, many patients are found to be experiencing persistent symptoms. Objectives: To find out the proportion of patients with persistent symptoms after discharge from a Covid hospital and to assess post-Covid-19 functional status. Materials and Methods: A descriptive cross-sectional study was conducted among patients discharged from a Covid hospital. Records of patients were obtained from the medical records department. Data were collected by using a prevalidated close-ended questionnaire. The questionnaire consisted of information regarding the socio-demographic status, history of persistent symptoms, and functional status of patients. Patients were contacted and interviewed telephonically. History regarding common persistent symptoms and functional status was asked. Statistical analysis was done by using Epi info statistical software. Results: Out of 133 patients, persistent symptoms after discharge were reported among 92 (69%) patients. The common symptoms reported by the patients were fatigue (48.12%), weakness (42.10%), dyspnea (27.82%), and myalgia (12%). Loss of taste was reported by 10 (7.5%) and loss of appetite by 8 (6.01%). Seventy-four (55.63%) patients reported functional limitations. Conclusions: The proportion of persistent symptoms among Covid-19 patients after discharge was found to be high. More than half of the patients reported functional limitations. Patients should be screened for persistent symptoms and health care services should be provided.

BackgroundDespite the recovery from the COVID-19 pandemic, many people experience post-COVID-19 syndrome, which negatively impacts their health and function. This condition has become a significant public health problem that requires immediate attention.ObjectiveTo study the prevalence, clinical characteristics, and predictors of post-COVID-19 Syndrome in Qatar during 2022.MethodsAn analytic cross-sectional study was conducted among COVID-19 confirmed cases from January 2022 to July 2022 in Qatar. A simple random sample was employed to include (n = 588) participants from the list of cases and invited to participate in a telephone survey. The World Health Organization’s standard case definition for PCS was adopted.ResultsOut of 368, the prevalence of post-COVID-19 syndrome was 43.2% (n = 159). Most PCS cases were females (67.9%; n = 108), married (73.6%; n = 117), and university and higher educational level (83.6%; n = 133). However, 78.7% (n = 125) reported poor to moderate levels of social support. Only 30.2% (n = 48) of PCS patients had a history of chronic diseases, and 5.7% (n = 9) required hospital admission during acute illness. Among PCS cases, the most commonly reported symptoms were fatigue (75.5%), followed by anxiety (49.1%), forgetfulness (46.5%), mood alteration (45.3%), and general weakness (39.6%). The logistic regression revealed that female gender (AOR: 2.58 95%CI: 1.58–4.225, p

Infectious diseases have consistently served as pivotal influences on numerous civilizations, inducing morbidity, mortality, and consequently redirecting the course of history. Their impact extends far beyond the acute phase, characterized by the majority of symptom presentations, to a multitude of adverse events and sequelae that follow viral, parasitic, fungal, or bacterial infections. In this context, myriad sequelae related to various infectious diseases have been identified, spanning short to long-term durations. Although these sequelae are known to affect thousands of individuals individually, a comprehensive evaluation of all potential long-term effects of infectious diseases has yet to be undertaken. We present a comprehensive literature review delineating the primary sequelae attributable to major infectious diseases, categorized by systems, symptoms, and duration. This compilation serves as a crucial resource, illuminating the long-term ramifications of infectious diseases for healthcare professionals worldwide. Moreover, this review highlights the substantial burden that these sequelae impose on global health and economies, a facet often overshadowed by the predominant focus on the acute phase. Patients are frequently discharged following the resolution of the acute phase, with minimal long-term follow-up to comprehend and address potential sequelae. This emphasizes the pressing need for sustained vigilance, thorough patient monitoring, strategic health management, and rigorous research to understand and mitigate the lasting economic and health impacts of infectious diseases more fully. [ABSTRACT FROM AUTHOR]

Context: The COVID-19 pandemic had a profound global impact, leaving a lasting legacy in the form of post-COVID syndrome. This condition, experienced after recovering from the virus, manifests in symptoms, such as fatigue, cough, shortness of breath, joint pain, and brain fog, highlighting the virus's lingering influence on the human body. Aim: To Identify post-COVID syndrome symptoms among COVID-19 recovered patients from Karad Taluka. Materials and methods: A study involving 228 COVID-19-recovered individuals from a Karad tertiary care hospital used consecutive sampling. Data were collected via structured questionnaires, focused on post-COVID syndrome symptoms. Statistical analysis used: Frequency and percentage were used to analyze the presence of post-COVID syndrome symptoms. Results: A total of 228 COVID-19-recovered individuals were included in the study, of whom 53% were male and 47% were female. Most of the study subjects had 25 (10.9%) mild, 138 (60.5%) moderate, and 65 (28.5%) severe symptoms. Symptom-wise, the majority of the subjects experienced symptoms: fatigue 116 (50.8% moderate), shortness of breath 135 (58.3% moderate), cough 116 (50.8%), sore throat 115 (50.4% mild), chest pain (57% mild), joint pain 151 (66.2% severe), brain fog 103 (45% severe). Most (43%) experienced symptoms for 12 months, that is, 1 year. Conclusion: The results depict the recovered individuals continue to experience symptoms. The most common symptoms are fatigue, shortness of breath, and cough in varied severity (from mild, moderate, and severe). [ABSTRACT FROM AUTHOR]

Athletes typically experience a mild‐to‐moderate, self‐limiting illness following infection with the novel severe acute respiratory syndrome coronavirus 2. Some athletes, however, can develop prolonged symptoms, with breathlessness, cough, and chest tightness impacting return to training and competition. In athletes with persistent cardiopulmonary symptoms following COVID‐19, focus is usually placed on the identification and characterization of cardiac complications, such as myocarditis. In this review, we focus on summarizing the literature assessing pulmonary complications and physiological consequences associated with COVID‐19 illness in athletes. The review also provides recommendations for clinical assessment of the athlete with pulmonary issues following COVID‐19 and directions for future research. [ABSTRACT FROM AUTHOR]

Background. To assess the associations between anxiety and depressive symptoms and post- COVID-19 condition (PCC) by exploring the direction of these associations and their relevance in the definition of PCC. Methods. Nationwide survey among French adults, recruited between March and April, 2022, using a quota method to capture a representative sample of the general population with regard to sex, age, socioeconomic status, size of the place of residence, and region. We included all participants who met the World Health Organization (WHO) definition of PCC in addition to a random sample of participants infected with SARS-COV-2 for at least 3 months but without PCC. Self-reported anxiety and depressive symptoms, chronic anxiety and depression (for more than 3 years), and anxiety and depression were measured using the GAD-2 and PHQ-2 questionnaires, respectively. Results. In a sample of 1,095 participants with PCC and 1,021 participants infected with SARSCOV- 2 without PCC, 21% had self-reported anxiety and 18% self-reported depression, whereas 33% and 20% had current measured symptoms of anxiety and depression, respectively. The high prevalence of these symptoms cannot only be explained by the characterization of PCC, as only 13.4% of anxiety symptoms and 7.6% of depressive symptoms met the WHO criteria for PCC. Only one participant met the WHO criteria based on self-reported anxiety or depressive symptoms alone, as these were always combined with other symptoms in patients with PCC. Chronic symptoms were associated with PCC (aOR 1.27; 95% CI: 1.00-1.61). In addition, measured anxiety was associated with PCC (aOR = 1.29; 95% CI: 1.02-1.62). Conclusions. Pre-COVID-19 chronic anxiety and depression may play a role in the development of PCC or share vulnerability factors with it. Our results challenge the inclusion of anxiety and depression in the definition of PCC. [ABSTRACT FROM AUTHOR]

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Patients who have Lyme neuroborreliosis (LNB) might experience lingering symptoms that persist despite antibiotic drug therapy. We tested whether those symptoms are caused by maladaptive immune responses by measuring 20 immune mediators in serum and cerebrospinal fluid (CSF) in 79 LNB patients followed for 1 year. At study entry, most mediators were highly concentrated in CSF, the site of the infection. Those responses resolved with antibiotic therapy, and associations between CSF cytokines and signs and symptoms of LNB were no longer observed. In contrast, subjective symptoms that persisted after use of antibiotics were associated with increased levels of serum interferon-α (IFN-α), which were already observed at study entry, and remained increased at each subsequent timepoint. Highest IFN-α levels corresponded with severe disease. Although the infection serves as the initial trigger, sequelae after antibiotic therapy are associated with unremitting systemic IFN-α levels, consistent with the pathogenic role of this cytokine in interferonopathies in other conditions.

Abstract Most children infected with the SARS-CoV-2 virus have asymptomatic or mild disease with a short clinical course and excellent outcome; meanwhile, some children experienced persisting symptoms lasting > 12 weeks from the COVID-19 infection diagnosis. This study aimed to define the acute clinical course of SARS-CoV-2 virus infection and outcomes in children after recovery. This prospective cohort study was conducted on 105 children (aged

Infectious diseases have consistently served as pivotal influences on numerous civilizations, inducing morbidity, mortality, and consequently redirecting the course of history. Their impact extends far beyond the acute phase, characterized by the majority of symptom presentations, to a multitude of adverse events and sequelae that follow viral, parasitic, fungal, or bacterial infections. In this context, myriad sequelae related to various infectious diseases have been identified, spanning short to long-term durations. Although these sequelae are known to affect thousands of individuals individually, a comprehensive evaluation of all potential long-term effects of infectious diseases has yet to be undertaken. We present a comprehensive literature review delineating the primary sequelae attributable to major infectious diseases, categorized by systems, symptoms, and duration. This compilation serves as a crucial resource, illuminating the long-term ramifications of infectious diseases for healthcare professionals worldwide. Moreover, this review highlights the substantial burden that these sequelae impose on global health and economies, a facet often overshadowed by the predominant focus on the acute phase. Patients are frequently discharged following the resolution of the acute phase, with minimal long-term follow-up to comprehend and address potential sequelae. This emphasizes the pressing need for sustained vigilance, thorough patient monitoring, strategic health management, and rigorous research to understand and mitigate the lasting economic and health impacts of infectious diseases more fully.

Background and Objectives: COVID-19 is a disease caused by SARS-CoV-2 which belongs to a family of coronaviruses. After the acute phase of illness, the majority of the patients recover quickly but, in some cases, symptoms can persist for a variable duration, bringing into light another entity known as post-COVID syndrome. The objective was to estimate the burden of various persistent respiratory symptoms and lung function abnormalities among recovered patients of COVID-19 and also to correlate them with initial disease severity, demographic factors and comorbidities. Methods: Eighty-five post-COVID patients were recruited as per inclusion/exclusion criteria. Detailed history taking, physical examination and spirometry were done in all patients and data were correlated with baseline disease severity. Results: Fatigue and breathlessness were the most common symptoms followed by cough, chest pain and fever. Persistent symptoms and their severity were significantly higher in severe/moderate cases. Spirometry was abnormal in 45.88% of subjects and the most common pattern was restrictive type. It was seen that the likelihood of persistent symptoms and abnormal lung function increased significantly with the severity of COVID-19, age, comorbidities, hospital stay duration and steroid/oxygen therapy. Conclusion: The current study estimated the burden and array of various pulmonary sequelae encountered by post-COVID patients and elicited various risk factors associated with their occurrence after recovery from active infection. Awareness of these symptoms/sequelae and their risk factors is necessary for their follow-up and timely management, as the threat of this relatively new virus has still not abated. [ABSTRACT FROM AUTHOR]

Background: After recovery from acute Covid infection, many patients are found to be experiencing persistent symptoms. Objectives: To find out the proportion of patients with persistent symptoms after discharge from a Covid hospital and to assess post-Covid-19 functional status. Materials and Methods: A descriptive cross-sectional study was conducted among patients discharged from a Covid hospital. Records of patients were obtained from the medical records department. Data were collected by using a prevalidated close-ended questionnaire. The questionnaire consisted of information regarding the socio-demographic status, history of persistent symptoms, and functional status of patients. Patients were contacted and interviewed telephonically. History regarding common persistent symptoms and functional status was asked. Statistical analysis was done by using Epi info statistical software. Results: Out of 133 patients, persistent symptoms after discharge were reported among 92 (69%) patients. The common symptoms reported by the patients were fatigue (48.12%), weakness (42.10%), dyspnea (27.82%), and myalgia (12%). Loss of taste was reported by 10 (7.5%) and loss of appetite by 8 (6.01%). Seventy-four (55.63%) patients reported functional limitations. Conclusions: The proportion of persistent symptoms among Covid-19 patients after discharge was found to be high. More than half of the patients reported functional limitations. Patients should be screened for persistent symptoms and health care services should be provided. [ABSTRACT FROM AUTHOR]

Background: Both pulmonary tuberculosis (PTB) and chronic pulmonary aspergillosis (CPA) significantly affect health-related quality of life (HR-QoL). We aimed to determine the impact of CPA co-infection on the HR-QoL of Ugandans with PTB. Methods: We conducted a prospective study as part of a larger study among participants with PTB with persistent pulmonary symptoms after 2 months of anti-TB treatment at Mulago Hospital, Kampala, Uganda between July 2020 and June 2021. HR-QoL was assessed using St. George Respiratory Questionnaire (SGRQ) at enrollment and at the end of PTB treatment (4 months apart). SGRQ scores range from 0 to 100, with higher score representing a poorer HR-QoL. Results: Of the 162 participants enrolled in the larger study, 32 (19.8%) had PTB + CPA and 130 (80.2%) had PTB. The baseline characteristics of the two groups were comparable. Regarding overall health, a higher proportion of the PTB group rated their HR-QoL as "very good" compared to those who had PTB + CPA (68 [54.0%] versus 8 [25.8%]). At enrollment, both groups had comparable median SGRQ scores. However, at follow up, the PTB group had statistically significantly better SGRQ scores (interquartile range); symptoms (0 [0–12.4] versus 14.4 [0–42.9], p < 0.001), activity ((0 [0–17.1] versus 12.2 [0–35.5], p =.03), impact (0 [0–4.0] versus 3.1 [0–22.5], p = 0.004), and total scores ((0 [0–8.5] versus 7.6[(0–27.4], p = 0.005). Conclusion: CPA co-infection impairs HR-QoL of people with PTB. Active screening and management of CPA in patients with PTB is recommended to improve HR-QoL of these individuals. [ABSTRACT FROM AUTHOR]

Introduction: early respiratory rehabilitation is required for patients with Coronavirus virus disease 2019 (COVID-19) sequelae to reduce the risk of serious disabilities after hospital discharge. Methods: it was a comparative prospective study including patients with persistent symptoms one month after discharge. The patients were hospitalized at the pneumology department D of Abderahman Mami hospital for COVID-19 pneumonia. The study involved two groups: (G1) included patients who participated in respiratory muscle training program (twice a week during 6 weeks), and a control group (G2). The groups were matched based on age, sex and body mass index (BMI). Persistent symptoms and pulmonary lung function (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), total lung capacity (TLC) and diffusion capacity for carbon monoxide (DLCO), maximal inspiratory pressure (PI max) and maximal expiratory pressure (PE max), 6 Minute Walk distance (6-MWD) at baseline and after 6 weeks were compared between the two groups. Results: the two groups of patients were comparable in terms of age, sex, BMI, comorbidities, and extent of lung computed tomography (CT) lesions. Compared to G2, a significant improvement of persistent symptoms was noted in G1, including dry cough (p=0.002), dyspnea (p=0.001), chest pain (p=0.002), and fatigue (p=0.001). The mean of percutaneous oxygen saturation (SpO2) increased from 96.68% to 97.93% (p<0.01) in G1. A significant improvement in the percentages of change of FEV1 (p=0.005), FVC (p=0.003), TLC (p<0.001), DLCO (p<0.001), and 6-MWD (p=0.015) was also noted in G1 after this program. Nevertheless, only the percentage of FEV1 (p=0.02) increased in the control group. No impact of respiratory muscle training on PI max and PE max was noted. Conclusion: the present study demonstrated a significant improvement of persistent symptoms and exercise tolerance after short-term respiratory muscle training in patients suffering from COVID-19 sequelae. [ABSTRACT FROM AUTHOR]

More than a quarter of adults with concussion endure prolonged symptoms of >3 months. We developed the Concussion Education Self-Management program to help people manage persisting symptoms. Here, we assess feasibility, preliminary efficacy, and correlates of response. N = 80 adults participated in the program; ages ranged from 18 to 65 years and time post-injury ranged from 6 months to 18 years. Weekly sessions, delivered remotely and in groups, comprised education and strategies for management of cognitive, emotional, and physical symptoms. Primary outcome: Confidence to self-manage symptoms. Secondary outcomes: Quality of life; mood/anxiety/stress. Predictors of response: Self-reported cognitive, emotional and physical symptoms at intake. Pre- to post-program improvements were observed in confidence to self-manage, p < 0.03; quality of life, p < 0.001; depression, p < 0.001; anxiety, p < 0.001; and stress, p < 0.001. Considering confidence to self-manage, those with fewer cognitive and physical symptoms benefitted more (p's < 0.0005 and p < 0.01, respectively). This program shows promise for improving self-management of prolonged symptoms. Those with high symptom burden may need extra sessions to benefit. This is a cost-effective and scalable program that can reach people regardless of geographic location or impediments to travel. [ABSTRACT FROM AUTHOR]

Persistent postconcussion symptoms (PPCSs) are associated with lower health-related quality of life (HRQoL) in children and adolescents. Despite commonly cited criteria for PPCSs involving 3 or more complaints, many individuals experience just 1 or 2 symptoms that may still negatively affect HRQoL. To determine differences in HRQoL between children and adolescents with 0, 1 to 2, or 3+ parent-reported persistent symptoms at 1 month postconcussion. Prospective cohort study. Community practice clinics. Individuals aged 8 to 18 years presented for the initial visit within 3 days of a sport- or recreation-related concussion. One month later, parents or guardians reported persistent symptoms using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). Individuals with complete symptom data were analyzed (n = 236/245, n = 97 females, age = 14.3 ± 2.1 years). Participants were grouped by the number of discrete RPQ symptoms reported as worse than preinjury (0, 1–2, or 3+). Total summary and subscale scores on the Pediatric Quality of Life Inventory (PedsQL) 23-item HRQoL inventory and 18-item Multidimensional Fatigue Scale (MDFS). Kruskal-Wallis rank sum tests highlighted differences in PedsQL HRQoL and MDFS total scores across symptom groups (PedsQL HRQoL: χ22 = 85.53, P <.001; MDFS: χ22 = 93.15, P <.001). Dunn post hoc analyses indicated all 3 groups were statistically significantly different from each other (P <.001). The median (interquartile range) values for the Peds QL Inventory HRQoL totals were 93.5 (84.2–98.8) for those with 0 symptoms; 84.8 (73.9–92.4) for those with 1 to 2 symptoms; and 70.7 (58.7–78.0) for those with 3+ symptoms. The median (interquartile range) values for the MDFS totals were 92.4 (76.4–98.6) for those with 0 symptoms; 78.5 (65.6–88.9) for those with 1 to 2 symptoms; and 54.2 (46.2–65.3) for those with 3+ symptoms. Similar group differences were observed for each PedsQL HRQoL and MDFS subscale score. Children and adolescents whose parents reported 1 to 2 PPCSs had lower HRQoL and more fatigue than those with 0 symptoms. Across all 3 groups, those with 3+ persistent symptoms had the lowest HRQoL and most fatigue. These findings indicate the continued need for intervention in this age group to prevent and address PPCSs. [ABSTRACT FROM AUTHOR]

Aim: The study aims to determine persistent symptoms and effects of COVID-19 infection on the quality of life (QOL) at 1 and 3 months after the acute phase of the disease in mild, moderate and severe cases. Methods: The prospective observational study was conducted among patients with confirmed COVID-19 who had been treated and discharged after hospitalization from February 2021 to June 2021. All patients were interviewed at 1 and 3 months post discharge to assess persisting symptoms and health-related QOL. QOL was assessed using European Quality Of Life 5-Dimensions 3-Levels (EQ-5D-3L) and EuroQol-visual analogue scales (EQ-VAS). Results: In total, 388 out of 479 discharged following COVID-19 infection were included. The median age of patients was 48 years, with 62.6% male predominance. Most of the COVID-19 cases were mild (67.01%). Most common presenting symptom was fever (69.8%). EQ-5D-3L showed that the problems reported at 3-month follow-up were significantly less when compared to 1-month follow-up (p < 0.001), and QOL significantly improved after 3 months in non-intensive care unit (ICU) patients when compared to ICU patients (p = 0.007). The mean EQ-VAS score significantly improved at 3 months when compared to 1 month (80.34 ± 12.77 vs. 91.69 ± 12.34; P < 0.001). The severity of illness was correlated with QOL (p < 0.007). Conclusion: The study results demonstrate ongoing improvement in the QOL and persistent symptoms, while a minority still were symptomatic after 3 months post-COVID-19 illness.

Objective: The objective of this study is to assess the prevalence and predictors of symptom persistence associated with severe and critical coronavirus disease-2019 (COVID-19) after more than 120 days from the onset of the disease. Materials and Methods: This is a single-center, cross-sectional study of 125 adults who were admitted to King Khalid University Hospital (Riyadh, Saudi Arabia) with severe and critical COVID-19 between March 4 and December 1, 2020. Telephone interviews were conducted between April 1 and May 31, 2021, to collect data on COVID-19 symptoms persisting after more than 120 days from the onset of the disease. All of the participants had been discharged from the hospital and had resumed their normal lives. Symptoms of COVID-19 that had not been present before the onset of the disease were considered to be persistent if participants confirmed their continued presence at the time of the interview. The impact of chronic disease on persistent symptoms was considered. Results: About 42.4% (53/125) of patients had at least one or more persistent symptoms; 27.2% (34/125) had breathlessness, 5.6% (7/125) cough, and 4.8% (6/125) chest pain. These three symptoms had been present from the first presentation. Hair loss was reported by 14.4% (18/125), forgetfulness by 8% (10/125), difficulty in concentrating by 6.4% (8/125), and lack of energy by 4% (5/125). Those had manifested after more than 120 days from the symptom's onset. The major factors in suffering from persistent symptoms were intensive care unit (ICU) admission or/and fever (temperature >38°), or/and diarrhea. There was no correlation between persistent symptoms and chronic diseases. Conclusions: After more than 120 days from the confirmation of severe and critical COVID-19, more than one-third of discharged adults were found to have one or more persistent symptoms. These were mainly associated with the need for ICU admission, fever (temperature >38°), and diarrhea. More care needs to be given to COVID-19 patients in the presence of these factors and prolonged medical care would appear to be essential.

The clinical entity termed as long COVID has gained importance in the recent past. As this phenomenon is still evolving, it is important to document the magnitude of the syndrome during different time periods. This scoping review attempts to synthesize evidence generated from longitudinal studies which have follow-up periods beyond 3 months, up to 12 months. The review also documents the reported prevalence of long COVID for the different regions of the World Health Organization. Longitudinal studies published till March 2022 were systematically searched on PubMed, Google Scholar, and medRxiv. Among the identified 594 studies, 48 were included in this review. Data from selected studies were synthesized. The overall pooled prevalence of long COVID was 49% (40%–58%). The pooled estimates after 3 months, 4–6 months, 7–9 months, and 10–12 months were 44% (32%–57%), 50% (43%–57%), 49% (37%–62%), and 54% (46%–62%), respectively. Eastern Mediterranean Region (EMR) had the highest pooled prevalence of 63% (34%–92%] and the South East Asian Region (SEAR) had the least pooled estimate of 15% (10%–21%). The study brings out the high prevalence of long COVID even after 12 months of follow-up. It also shows the regional differences in the reported prevalence of the syndrome. This review highlights the need for well-planned follow-up studies, especially in developing nations to understand the magnitude and the pattern of long COVID-related symptoms as they emerge.

Objective: This study aims to investigate persistent symptoms, health satisfaction and general quality of life of COVID-19 survivors at 30, 90 and 180 days after Intensive Care Unit discharge. Method: Multicentric prospective cohort study of COVID-19 survivors discharged from eight hospitals in Curitiba – Paraná (Brazil) between September 2020 and January 2022. Eligible COVID-19 survivors were contacted by phone. Results: Sixty-two COVID-19 survivors responded to the three follow-up moments. The most persistent symptoms were fatigue, mild dyspnea and myalgia. Myalgia showed a significant reduction from 30 days to 180 days (p = 0.034). At 30, 90 and 180 follow-up days, most patients reported “good” general quality of life (59.7%, 62.9%, 51.6%, respectively) and “satisfactory” health status (43.5%, 48.4%, 46.8%, respectively). Conclusion: COVID-19 symptoms persisted to 180 days, fatigue more commonly. Nevertheless, most COVID-19 survivors reported good general quality of life and were satisfied with their health status.

This study aimed to describe the presence of disabling symptoms in currently working Long-COVID survivors by comparing the hospitalized and non-hospitalized one year after infection. Patients with Long-COVID syndrome (LCS) that have been infected by COVID-19 a year ago and were actually working were included. Participants that had been hospitalized due to COVID-19 were included in the LCS hospitalized group, and participants that had not been hospitalized were included in the LCS non-hospitalized group. The eligible patients were prompted to complete the latest self-report version of the COVID-19 Yorkshire Rehabilitation Screening Tool (C19-YRS). A total of 465 subjects were included in the study. Participants in the LCS hospitalized group were significantly older, had a significantly higher BMI, and had a significantly higher prevalence of women compared to the LCS non-hospitalized group. Additionally, participants in the LCS hospitalized group had obtained significantly worse results in symptom severity, functional disability, and global health perceived subscales of C19-YRS compared to the participants included in the LCS non-hospitalized group. We concluded that disabling symptoms are presented in patients with LCS at working age one year after infection and are higher in LCS hospitalized patients compared to LCS non-hospitalized patients. [ABSTRACT FROM AUTHOR]

Background: Ongoing symptoms in treated celiac disease (CD) are frequent and are commonly thought of as being due to infractions to a gluten-free diet (GFD) or complications. Aims: To study the etiology and natural history of clinically relevant events (CREs) throughout follow-up and identify predictors thereof to guide follow-up. Methods: CREs (symptoms/signs requiring diagnostic/therapeutic interventions) occurring in celiac patients between January-2000 and May-2021 were retrospectively collected between June and September 2021 and analysed. Results: One-hundred-and-eighty-nine adult patients (133 F, age at diagnosis 36 ± 13 years, median follow-up 103 months, IQR 54–156) were enrolled. CREs were very common (88/189, 47%), but hardly due to poor GFD adherence (4%) or complications (2%). Interestingly, leading etiologies were functional gastrointestinal disorders (30%), reflux disease (18%) and micronutrient deficiencies (10%). Age at diagnosis ≥ 45 years (HR 1.68, 95%CI 1.05–2.69, p = 0.03) and classical pattern of CD (HR 1.63, 95%CI 1.04–2.54, p = 0.03) were predictors of CREs on a multivariable Cox model. At 5 years, 46% of classical patients ≥ 45 years old at diagnosis were event-free, while this was 62% for non-classical/silent ≥ 45 years, 60% for classical < 45 years, and 80% for non-classical/silent < 45 years. Conclusions: CREs occurred in almost half of CD patients during follow-up, with functional disorders being very common. New follow-up strategies for adult CD may be developed based on age and clinical pattern at diagnosis. [ABSTRACT FROM AUTHOR]

Worldwide, about 10 percent of patients affected by long COVID require appropriate follow-up and intervention. The main objective of this study was to analyze the long-term impact of mild long COVID in the adult population, and to determine the effect of clinical and sociodemographic variables on health-related quality of life in those affected. Methods: A cross-sectional descriptive study of a sample of Spanish adult patients with persistent COVID-19 symptoms at least three months after diagnosis. Data collection took place between April and July 2021. The health-related quality of life of the sample was low, with worse results in the physical component summary (PCS) 24.66 (SD = 4.45) compared to the mental component summary (MCS) 45.95 (SD = 8.65). The multi-regression analysis showed significant differences by sex in the dimensions of physical functioning (p = 0.040); bodily pain (p = 0.036); and health transition (p = 0.018). Additionally, a longer time since infection had a significant effect on physical functioning (p = 0.039); general health (p = 0.037); vitality (p = 0.034); and general health transition (p = 0.002). The effect of occupational imbalance was significant for all dimensions. Conclusions: people with long COVID have a reduced quality of life. Sex, time since infection, and occupational imbalance are predictors of a worse quality of life. [ABSTRACT FROM AUTHOR]

Most children infected with the SARS-CoV-2 virus have asymptomatic or mild disease with a short clinical course and excellent outcome; meanwhile, some children experienced persisting symptoms lasting > 12 weeks from the COVID-19 infection diagnosis. This study aimed to define the acute clinical course of SARS-CoV-2 virus infection and outcomes in children after recovery. This prospective cohort study was conducted on 105 children (aged < 16 years) with confirmed COVID-19 infection at Jamal Ahmed Rashid Teaching Hospital, Sulaimaniyah, Iraq, from July to September 2021. The symptomatic and suspicious cases of COVID-19 infection in children were confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) on nasopharyngeal swabs. About 85.6% of children fully recovered at ≤ 4 weeks from initial COVID-19 infection diagnosis, 42% were hospitalized, while 15.2% reported long COVID-19 infection symptoms. The most commonly reported symptoms were fatigue (7.1%), hair fall (4.0%), lack of concentration (3.0%), and abdominal pain (2.0%). Children aged 11–16 showed a greater risk of long-term COVID-19 infection symptoms. We also observed a higher risk of long COVID infection symptoms in those who reported ongoing symptoms at 4–6 weeks of follow-up assessment (p = 0.01). Despite mild disease and complete recovery in most children, many suffered from long COVID infection symptoms. [ABSTRACT FROM AUTHOR]