<p>  </p> <p>While evidence suggests that the mental health consequences of coronavirus disease 2019 (COVID-19) can persist for several months following infection, little is known about the longer-term mental health consequences and whether certain sociodemographic groups may be particularly impacted. The study objectives were to characterize the longer-term mental health consequences of COVID-19 infection and examine whether such consequences are more pronounced in Black people and people with lower socioeconomic status. 277 Black and White adults (age ≥ 30 years) with a history of COVID-19 (cases; tested positive ≥ 6 months prior to participation) or no history of COVID-19 infection (controls) completed a 45-minute online questionnaire battery. Unadjusted <em>t</em>-tests revealed that cases had greater depressive (<em>d</em> = 0.24), anxiety (<em>d</em> = 0.34), PTSD (<em>d</em> = 0.32), and insomnia (<em>d</em> = 0.31) symptoms than controls. These differences remained significant for symptoms of anxiety, PTSD, and insomnia after adjusting for age, sex, race, education, income, and smoking status. No case-control differences were detected for perceived stress and general psychopathology. Cases had more than double the odds of clinically significant symptoms of anxiety (<em>OR</em> = 2.22) and PTSD (<em>OR</em> = 2.40). Case-control status was more strongly and positively associated with depressive, anxiety, PTSD, perceived stress, and general psychopathology symptoms at lower education levels. Race and income were not moderators of the relationships. The mental health consequences of COVID-19 may be significant, widespread, and persist for at least 6 months after infection, and people with lower education levels may face a greater burden of these consequences.</p>

Acute Respiratory Distress Syndrome (ARDS) is common in COVID-19 patients and is associated with high mortality. The aim of this observational study was to describe patients’ characteristics and outcome, identifying potential risk factors for in-hospital mortality and for developing Long-COVID symptoms. This retrospective study included all patients with COVID-19 associated ARDS (cARDS) in the period from March 2020 to March 2021 who were invasively ventilated at the intensive care unit (ICU) of the University Hospital Dresden, Germany. Between October 2021 and December 2021 patients discharged alive (at minimum 6 months after hospital discharge—midterm survival) were contacted and interviewed about persistent symptoms possibly associated with COVID-19 as well as the quality of their lives using the EQ-5D-5L-questionnaire. Long-COVID was defined as the occurrence of one of the symptoms at least 6 months after discharge. Risk factors for mortality were assessed with Cox regression models and risk factors for developing Long-COVID symptoms by using relative risk (RR) regression. 184 Patients were included in this study (male: n = 134 (73%), median age 67 (range 25–92). All patients were diagnosed with ARDS according to the Berlin Definition. 89% of patients (n = 164) had severe ARDS (Horovitz-index < 100 mmHg). In 27% (n = 49) extracorporeal membrane oxygenation was necessary to maintain gas exchange. The median length of in-hospital stay was 19 days (range 1–60). ICU mortality was 51%, hospital mortality 59%. Midterm survival (median 11 months) was 83% (n = 55) and 78% (n = 43) of these patients presented Long-COVID symptoms with fatigue as the most common symptom (70%). Extreme obesity (BMI > 40 kg/m2) was the strongest predictor for in-hospital mortality (hazard ratio: 3.147, confidence interval 1.000–9.897) and for developing Long-COVID symptoms (RR 1.61, confidence interval 1.26–2.06). In-hospital mortality in severe cARDS patients was high, but > 80% of patients discharged alive survived the midterm observation period. Nonetheless, most patients developed Long-COVID symptoms. Extreme obesity with BMI > 40 kg/m2 was identified as independent risk factor for in-hospital mortality and for developing Long-COVID symptoms.

Indiana University-Purdue University Indianapolis (IUPUI) / While evidence suggests that the mental health consequences of coronavirus disease 2019 (COVID-19) can persist for several months following infection, little is known about the longer-term mental health consequences and whether certain sociodemographic groups may be particularly impacted. The study objectives were to characterize the longer-term mental health consequences of COVID-19 infection and examine whether such consequences are more pronounced in Black people and people with lower socioeconomic status. 277 Black and White adults (age ≥ 30 years) with a history of COVID-19 (cases; tested positive ≥ 6 months prior to participation) or no history of COVID-19 infection (controls) completed a 45-minute online questionnaire battery. Unadjusted t-tests revealed that cases had greater depressive (d = 0.24), anxiety (d = 0.34), PTSD (d = 0.32), and insomnia (d = 0.31) symptoms than controls. These differences remained significant for symptoms of anxiety, PTSD, and insomnia after adjusting for age, sex, race, education, income, and smoking status. No case-control differences were detected for perceived stress and general psychopathology. Cases had more than double the odds of clinically significant symptoms of anxiety (OR = 2.22) and PTSD (OR = 2.40). Case-control status was more strongly and positively associated with depressive, anxiety, PTSD, perceived stress, and general psychopathology symptoms at lower education levels. Race and income were not moderators of the relationships. The mental health consequences of COVID-19 may be significant, widespread, and persist for at least 6 months after infection, and people with lower education levels may face a greater burden of these consequences.

No description available.

This thesis examined the sensitivity of the EQ-5D-5L instrument in measuring health-related quality of life (HRQoL) among patients with persistent symptoms following COVID-19, including fatigue, memory and concentration problems, and dyspnea. Additionally, it was analyzed whether adding these symptoms to the EQ-5D-5L improved the explained variance for HRQoL. Patients from Uppsala University Hospital, Sweden, answered a survey that included questions on five dimensions of health represented by the EQ-5D-5L and an additional question on general health score called EQ-VAS. Multiple linear regression, Spearman’s rank correlation coefficient, and Least Absolute Shrinkage and Selection Operator (LASSO) were used to examine the sensitivity of the EQ-5D-5L. For the explanatory analysis, the Adjusted 𝑅2 was used to evaluate explanatory power with and without the presence of the symptoms. The results showed that the EQ-5D-5L dimensions explained a moderate proportion of the variance for fatigue and memory/concentration problems and a weak proportion for dyspnea. The explanatory analysis provided findings that fatigue significantly improved the explained variance of EQ-VAS by 5.5%, adding memory/concentration problems only improved it marginally, and adding dyspnea was non-significant. Additionally, strong to moderate correlations between fatigue and memory/concentration problems were found with multiple dimensions of the EQ-5D-5L. These findings suggest that the EQ-5D-5L instrument may be a valuable tool in assessing HRQoL in patients with persistent COVID-19 symptoms and that adding fatigue to the EQ-5D-5L could be beneficial for improving explanatory power to HRQoL in patients suffering from infectious disease. / COMBAT post-covid

The intent of this thesis is to provide an in-depth overview of the neurological manifestations associated with long COVID. The review aimed to assess the cognitive functioning symptoms associated with SARS-CoV-2 post-infection (PASC), investigate the potential mechanisms by which SARS-CoV-2 affects the nervous system, contributing to cognitive fatigue, brain fog, and cognitive dysfunction, and explore the parallels between SARS-CoV-2 and Alzheimer’s Disease. Neuroinflammation emerges as a shared element among these mechanisms, significantly impacting cognitive function. The parallels between COVID-19 and Alzheimer's Disease offer insights into how Alzheimer's affects cognition, aiding in understanding COVID-19's impact. The review underscores a notable gender disparity: women exhibit a greater susceptibility to the adverse effects of COVID-19, yet research in this domain remains limited. It advocates for further investigation into sex-specific differences and emphasizes the importance of understanding and spreading awareness about long COVID's impact on neurocognitive function and the nervous system, given the tendency among many medical professionals to underestimate its significance.

Значительная доля людей, столкнувшихся с коронавирусной инфекцией имеют осложнение в виде COVID-19-ассоциированной пневмонии и нуждаются в доступной и квалифицированной реабилитации. Цель работы - оценить влияние программы физической реабилитации на толерантность к физическим нагрузкам и функциональное состояние кардио-респираторной системы пациентов, перенесших COVID-19-ассоциированную пневмонию. В исследовании приняли 20 пациентов, перенесших COVID-19-ассоциированную пневмонию. В работе использовались следующие методы исследования: оценка толерантности к физической нагрузке оценивалась с помощью теста шестиминутной ходьбы, для оценки степени одышки после нагрузки использовалась шкала Борга, определяли сатурацию в покое и после проведения теста шестиминутной ходьбы, оценивалась частота сердечных сокращений до и после тестирования, а также выраженность одышки при повседневной деятельности оценивалась по шкале mMRC. Согласно полученным результатам, разработанная программа реабилитации повлияла на повышение толерантности к физическим нагрузкам, улучшение функционального состояния кардио-респираторной системы и субъективной переносимости физической нагрузки у пациентов, перенесших COVID-19-ассоциированную пневмонию. / A significant proportion of people who have experienced coronavirus infection have a complication in the form of COVID-19-associated pneumonia and need affordable and qualified rehabilitation. The aim of the work was to evaluate the impact of the physical rehabilitation program on exercise tolerance and the functional state of the cardio-respiratory system in patients who had undergone COVID-19-associated pneumonia. The study included 20 patients with COVID-19-associated pneumonia. Research methods were used in the work: assessment of exercise tolerance was assessed using a six-minute walk test, the Borg scale was used to assess the degree of dyspnea after exercise, saturation was determined at rest and after a six-minute walk test, heart rate was assessed before and after testing, as well as the severity of dyspnea during daily activities was assessed using the mMRC scale. According to the results obtained, the developed rehabilitation program influenced the increase in exercise tolerance, the improvement of the functional state of the cardio-respiratory system and the subjective exercise tolerance in patients who underwent COVID-19-associated pneumonia.

Background: Post COVID-19 Condition (PCC, also known as long COVID and post-acute sequelae of COVID-19) is a major public health concern with severe and pervasive impacts on physical and mental health. PCC is highly heterogeneous and may manifest as different clusters of symptoms of varying intensity and duration. The etiology of PCC remains uncertain, though several underlying pathophysiological mechanisms, such as cellular damage, inflammatory cytokines, and a hypercoagulable state, are thought to contribute to PCC inception and trajectory. Examination of potential serological markers of PCC, accounting for clinical covariates, may yield emergent pathophysiological insights. Objectives: Primary objectives of this thesis are to 1) Identify key clinical and potential serological predictors of PCC; 2) Acquire clinical and serological data in a large-scale prospective observational study; 3) Assess relationships between PCC and serological markers, accounting for clinical covariates; 4) Systematically review evidence to date on primary observational studies comparing serological response between people with and without persistent symptoms post COVID-19 recovery; 5) Discuss persisting gaps in knowledge and data quality, and propose strategies for resolve. Methods: This thesis is framed around three core efforts: 1) The design of survey questions and study materials, recruitment of participants, and data collection in a large-scale prospective cohort study launched in 2020; 2) The assessment of relationships between pre-defined serological predictors and PCC, accounting for clinical covariates; and 3) A robust rapid review of PCC onset and phenotype as functions of serological markers. Expert opinion was sought to define serological predictors. Clinical predictors were defined a priori based on systematic reviews meeting AMSTAR 2 guidelines. Conclusions: To address objectives, we described efforts to collect clinical and serological data from a large-scale prospective cohort study; identify PCC-cases and infected-controls; assess associations between pre-defined serological predictors (IgG titres targeting SARS-CoV-2 spike (S), nucleocapsid (N), and receiver binding domain (RBD) antigens, and efficient neutralization) and PCC; and synthesized findings from an extensive rapid review on PCC as a function of serological markers. Our multivariate analysis using Stop the Spread Ottawa data is, to our knowledge, the first Canadian study to report the direction and magnitude of association between selected serological predictors (anti-IgG response to S, N, and RBD SARS-CoV-2 antigens, and neutralizing efficiency) and PCC status and impact on quality of life. Finally, we described five potential strategies which may improve the accessibility, quality, and amalgamation of data pertaining to PCC: 1) Fostering comparability between studies to enable synthesis of multiple datasets; 2) Advancing the characterization and consensus on PCC phenotypes; 3) Employing innovative modelling strategies that could potentially yield novel insights; 4) Promoting robust collaboration and knowledge sharing among research teams; and 5) Engaging people with lived experience at all stages of research.

Un nombre alarmant de personnes signalent une maladie persistante appelée COVID longue après leur infection par le virus SRAS-CoV-2. Il y a 650 million de cas de COVID-19 dans le monde, dont 10% de ces personnes développent des symptômes persistants. Parmi les symptômes observés, on remarque une fatigue profonde, de la myalgie, des troubles cognitifs, etc. Ces symptômes sont étonnamment similaires à ceux de l'encéphalomyélite myalgique (EM), une maladie chronique débilitante. L’EM est une maladie complexe souvent caractérisée par une fatigue profonde et le malaise après-effort. Environ 70% des patients atteints d'EM décrivent des épisodes d'infections virales comme élément déclencheur. Une autre maladie qui partage des symptômes similaires à l’EM est la fibromyalgie (FM). La FM est une autre maladie chronique et débilitante qui se caractérise par une douleur musculosquelettique et une sensibilisation centrale. Il n’existe toujours pas de traitement ni de test diagnostic à ce jour. Auparavant, nous avons découvert et validé onze microARN en tant que premier panel diagnostic pour l'EM et la FM. La majorité de ces petits ARN non codants participent à la régulation de gène, l'immunité et l'inflammation. Ce projet consiste à déterminer les trajectoires cliniques des personnes atteintes de la COVID longue à l’aide d’un nouveau test pronostic constitué de 11 miARN circulants permettant de différencier les diverses séquelles de la COVID longue. Par la suite, une recherche pan-génomique a permis d’établir une signature moléculaire plus précise pour chacun des six sous-groupes COVID longue. Nous proposons que les effets du virus SRAS-CoV-2 sur les microARN de l'hôte pourraient déclencher la persistance des symptômes de la COVID longue et que l’expression différentielle de certains microARN puissent contribuer au développement de différentes séquelles à long terme. Nous avons recruté des participants âgés de plus de 18 ans ayant été infectés par le virus SRAS- CoV-2, non-hospitalisés et présentant une COVID longue de plus de six mois et des sujets sains (groupe pré-pandemie) n’ayant pas reportés d’infection. L’analyse des symptômes a été réalisée à l’aide de trois questionnaires (SF-36, MFI-20, DSQ) complétés par tous les participants. Les niveaux d’expression de 11 microARN, précédemment identifiée dans l’EM, ont été mesurés par RT-qPCR dans des échantillons de plasma et la détermination des différentes trajectoires associées à des séquelles à long terme a été réalisée par analyse des composantes principales et validée par Random Forest Model (RFM). En stratifiant les patients selon leur signature de 11 miARN, nous avons évalué l’expression globale des 2549 miARN pour chaque séquelle et identifié de nouveaux miRNA spécifiques pour chacun des groupes à l’aide de la technologie microRNA array Agilent, une biopuce de la société Agilent. Nos données préliminaires nous ont permis d’identifier une signature moléculaire spécifique à chacune des séquelles de la COVID longue. Ces résultats nous permettrons de développer un nouveau test diagnostic basé sur les miRNA afin de prédire les conséquences à la suite de l’infection par le virus SRAS-CoV-2. / An alarming number of people are reporting a persistent illness called long COVID after their infection with the SARS-CoV-2 virus. There are an estimated 650 million cases of COVID-19 worldwide, with 10% of these people developing persistent symptoms. Among the symptoms observed, we notice profound fatigue, myalgia, cognitive disorders, etc. These symptoms are strikingly similar to those of myalgic encephalomyelitis (ME), a debilitating chronic disease. ME is a complex disease often characterized by profound fatigue and post-exertional malaise. Approximately 70% of ME patients describe episodes of viral infections as a trigger. Another disease that shares similar symptoms to ME is fibromyalgia (FM). FM is another chronic and debilitating disease that is characterized by musculoskeletal pain and central sensitization. There is still no treatment or diagnostic test to date. Previously, we discovered and validated eleven microRNAs as the first diagnostic panel for ME. Most of these small non-coding RNAs participate in gene regulation, immunity and inflammation. The objective of this project was to build a new diagnostic test to differentiate the various after-effects of long COVID using miRNAs. This project consists of determining the clinical trajectories of people with long COVID using a new prognostic test made up of 11 circulating miRNAs making it possible to differentiate the various after-effects of long COVID. Subsequently, a pan-genomic search made it possible to establish a more precise molecular signature for each of the six long COVID subgroups. We recruited participants aged over 18 years who had been infected with the SARS-CoV-2 virus, who were not hospitalized and had symptoms of long COVID for more than six months and healthy subjects (pre-pandemic group) who had not reported infection. The analysis of symptoms was carried out using three questionnaires (SF-36, MFI-20, DSQ) completed by all participants. The expression levels of 11 microRNAs previously identified in EM, from plasma samples were measured by RT-qPCR and the determination of the different trajectories associated with long-term sequelae was carried out by principal component analysis (PCA) and validated by Random Forest Model (RFM). By stratifying patients according to their signature of 11 miRNAs, we evaluated the overall expression of the 2549 miRNAs for each sequelae and identified new miRNAs specific for each of the groups using the Agilent microRNA array technology, a biochip from the company Agilent. Our preliminary data allowed us to identify a molecular signature specific to each of the after-effects of long COVID. These results will allow us to develop a new diagnostic test based on miRNAs in order to predict the consequences following infection by SARS-CoV-2 viruses.

[pt] Prejuízos cognitivos persistentes foram descritos em pacientes pós-COVID-19 independentemente da severidade da infecção, indicando que mesmo pacientes com infecção de grau leve ou moderado podem apresentar complicações cognitivas contínuas. Estratégias não-farmacológicas para reabilitação cognitiva ainda não foram revisadas de maneira sistemática neste grupo de pacientes. Dessa forma, o objetivo do presente estudo foi sistematicamente identificar, resumir e avaliar estudos de intervenção não-farmacológica avaliando desfechos cognitivos em pacientes com prejuízos neuropsicológicos persistentes após casos de COVID-19. Uma busca sistemática por artigos foi conduzida no dia primeiro de Julho de 2022. No total, 833 artigos foram identificados, dos quais 13 estudos foram incluídos na revisão final. Dentre esses, 7 eram estudos de grupo e 6 estudos de caso de sujeito único. Os estudos de grupo incluíram entre 12 e 50 participantes, e 2 destes também incluíram grupos controle. A maior parte dos estudos (11/13) testou a efetividade de intervenções multimodais de reabilitação, em geral combinando exercícios físicos com estimulação cognitiva. Dentre outros protocolos, reabilitação respiratória, ocupacional, psicossocial e fonoaudiológica também foram investigados. Com exceção de dois artigos, todos estudos descreveram resultados positivos após os processos de intervenção, incluindo aumento em escores de testes neuropsicológicos, redução em percepção de fadiga cognitiva e aumento de funcionalidade em atividades da vida diária. No entanto, as diversas limitações da presente literatura indicam que tais resultados devem ser interpretados com cautela. / [en] Persistent cognitive impairment has been described in people after COVID-19 irrespective of infection severity, indicating that patients with mild to moderate infection may also experience persevering cognitive problems. Non-pharmacological strategies for cognitive rehabilitation and their outcomes in this group have so far not been systematically summarized. Therefore, the aim of this study was to systematically identify, summarize, and appraise non-pharmacological rehabilitation intervention studies assessing neuropsychological outcomes in people with cognitive impairment after COVID-19. On July 1st, 2022, a systematic search was conducted using PubMed, Web of Science, PsycNET, and CENTRAL. In total, 833 papers were retrieved, of which 13 were included. Among those, 7 were group studies and 6 were single-subject case reports. The group studies included between 12 and 50 participants, of which two studies also included a control group. Most of the studies (11/13) tested multimodal interventions, mainly combining physical exercise with cognitive stimulation. Respiratory rehabilitation, occupational and speech-language therapy, EEG neurofeedback, tDCS, and psychosocial interventions were also investigated. With the exception of two, all studies described positive post-intervention results, including increased cognitive performance, reduced cognitive fatigue, and improved physical functionality. However, limitations of the current literature suggest that results should be considered carefully.