<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.

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.

[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.

Two years after the first recorded outbreak of Covid-19 its long-term effects are still not completely understood. An unknown proportion of all covid patients go on to develop post-acute covid syndrome and suffer long-term symptoms and health effects long after the initial infection subsides. Project Crowdsourcing Långtidscovid-Sverige sent out in summer of 2021 an open online survey and gathered respondents through crowdsourcing to gather info about people in Sweden with prolonged health effects lasting at least three months after confirmed or suspected Covid-19 infection. In this thesis an explorative analysis of the aforementioned survey is conducted with its initial focus placed onthe progression of symptoms. Descriptive statistics are provided for the survey sample; hierarchical clusteringon principal components is performed; and association rule mining as well as sequence rule mining is used toextract frequently co-occurring symptoms. Women stand for 85.2% of all respondents, possibly indicating a skewed gender distribution in the sample. The average age of a respondent is 50 years old, but ranges between 18 and 80 years of age. The number of reported symptoms tend to diminish over time and symptoms within the 'air passages' category diminish on average quicker than other categories. Hierarchical clustering with Ward’s criterion revealed 4 clusters with an average silhouette coefficient of 0.246. The resulting clusters are not well-separated from each other and have some overlap in their bordering regions, and should therefore be interpreted with caution. Broadly speaking, individuals from cluster 1, 3 and 4 are distinguished primarily by their total number of symptoms reported, meanwhile cluster 2 is characterized by individuals that experience many symptoms early on and fewer symptoms later on. The most prevalent symptom over the entire period is fatigue (90.2%), closely followed by worsening symptomsafter physical activity (87.1%), problems with concentration (82.3%), headaches (79.5%), and brain fog (77.9%). There are several strong associations between various symptoms, especially for symptoms within the same category. Most symptoms have a sequential correlation with themselves and have an increased tendency to occur several times.

Depuis l'émergence de la pandémie de SARS-CoV-2 en décembre 2019, plus de 675 millions de cas confirmés ont été signalés dans le monde, dont 4,6 millions de cas au Canada uniquement. Bien que la plupart des individus récupèrent sans séquelles, 10 à 20 % des survivants signalent des symptômes persistants au-delà de quatre semaines après une infection par le SARS-CoV-2, tels que la fatigue, les altérations cognitives, la toux, l'anxiété, la dépression, la douleur thoracique et autres, connus sous le nom de COVID longue ou de condition post-SARS-CoV-2 (PCC). Par conséquent, la physiopathologie, le diagnostic et la prise en charge de la PCC sont devenus un axe de recherche majeur. Pour contribuer à la compréhension de la PCC, nous avons mené le projet IPCO (Institut de Recherches cliniques de Montréal (IRCM) Post-COVID-19 Research Clinic), en posant comme hypothèses 1 que les personnes infectés par le SARS-CoV-2 au Québec présenteraient des signes et symptômes fréquents et variés post-phase aiguë, affectant différents systèmes d'organes, et 2 Les niveaux élevés de D-dimères dans PCC ne sont pas pertinents pour les événements thromboemboliques 3 que Chez les individus atteints de la PCC, la vaccination contre la COVID-19 réduirait les symptômes de la PCC en diminuant l'inflammation. Pour évaluer ces hypothèses, nous avons recruté des participants âgés de plus de 18 ans, un à 18 mois après l'infection aiguë, présentant au moins un symptôme persistant, et programmé des visites de base et de suivi à 3-6 mois, 1 an et 2 ans post-infection aiguë. Chaque visite comprenait des évaluations cliniques, des prélèvements, des évaluations en laboratoire, des questionnaires sur l'alimentation et le bien-être, ainsi que des évaluations de la physiologie pulmonaire et cardiaque. Sur la base d'une étude allemande qui a catégorisé les symptômes du PCC et les individuals en trois groupes de sévérité, nous avons classé nos participants en trois niveaux de sévérité : non/légère (score du PCC <10,75), modérée (10,75 < score du PCC < 26,25) et sévère (score du PCC > 26,25). Cette thèse présente les résultats de trois sous-études IPCO. Dans l'étude descriptive, nous avons observé que la fatigue, les problèmes de mémoire et les maux de tête étaient les symptômes de PCC les plus courants, la majorité de nos participants étant des femmes et ayant été traités en ambulatoire pendant la phase aiguë. Dans l'étude transversale, nous avons constaté des différences significatives dans les mesures de santé et de bien-être à tous les moments, mais aucune différence significative dans les résultats des tests physiologiques entre les groupes PCC non/léger, modéré et sévère. Dans l'étude longitudinale, les marqueurs de l'inflammation se sont améliorés au fil du temps, mais le taux métabolique basal et la masse grasse ont augmenté. Dans la deuxième étude, nous avons observé une forte prévalence de participants ayant des niveaux de D-dimères, qui n'étaient pas associés à des événements thromboemboliques, et aucune corrélation entre le niveau de D-dimères et les niveaux de cytokines et de chimiokines. Dans la troisième étude, nous avons observé que les participants vaccinés présentaient significativement moins de symptômes de PCC. Notre étude fournit une meilleure compréhension de la physiopathologie du PCC et de l'effet de la vaccination sur le profil clinique et inflammatoire du PCC, ce qui pourrait aider à la conception d'outils de gestion clinique et de recherche futurs. / Since the emergence of the SARS-CoV-2 pandemic in December 2019, over 675 million confirmed cases have been reported globally, with 4.6 million cases in Canada alone. Although most individuals recover without residual disease, 10-20% of survivors report symptoms persisting beyond four weeks after SARS-CoV-2 infection, such as fatigue, cognitive impairments, cough, anxiety, depression, chest pain, and others known as long-COVID or post SARS-CoV-2 condition (PCC). Consequently, the pathophysiology, diagnosis, and management of PCC have become a significant focus of research. To contribute to the understanding of PCC, we conducted the IPCO (Institut de Recherches cliniques de Montréal (IRCM) Post-COVID-19 Research Clinic) project, hypothesizing that 1 SARS-CoV-2 infected individuals in Quebec would present frequent and varied signs and symptoms post-acute phase, affecting different organ systems, and that 2 high D-dimer level in PCC is irrelevant to thromboembolic events , and 3 in individuals with PCC, COVID-19 vaccination would decrease PCC symptoms by reducing inflammation. To evaluate these hypotheses, we enrolled participants aged >18 years, one to 18 months post-acute infection, with at least one persistent symptom, and scheduled baseline and follow-up visits at 3-6 months, 1 year, and 2 years post-acute infection. Each visit involved clinical evaluations, sampling, laboratory evaluations, diet and well-being questionnaires, and pulmonary and cardiac physiology evaluations. Based on a German study that categorized PCC symptoms and individuals into three severity groups, we classified our participants into three severity levels: non/mild (PCC score < 10.75), moderate (10.75 < PCC score < 26.25), and severe (PCC score > 26.25). This thesis reports the results of three IPCO studies. In the descriptive study, we observed that fatigue, memory problems, and headaches were the most common PCC symptoms, with the majority of our participants being female and managed as outpatients during the acute phase. In the cross-sectional study, we noted significant differences in health and well-being measurements at all time points, but no significant difference in physiological tests' results between different severity groups. In the longitudinal study, markers of inflammation improved over time, but the basal metabolic rate and body fat increased. In the second study, we observed a high prevalence of participants having D-dimer levels in blood, which were not associated with thromboembolic events, and no correlation between D-dimer levels and blood cytokine/ chemokine levels. In the third study, we observed that vaccinated participants had significantly fewer PCC symptoms, fewer organ systems affected, higher well-being scores, and lower blood cytokine/chemokine levels than the non-vaccinated group. We also observed correlations between certain cytokines/chemokines, as well as between clinical parameters and certain cytokines/chemokines. Our study provides a better understanding of the pathophysiology of PCC and effect of vaccination on the clinical and inflammatory profile of PCC, which could assist future research and clinical management tool design.