'Post-COVID-19 chronic symptoms' – Author's reply

Seang, Sophie; Barizien, Nicolas; Tubiana, Roland; Truchis, Pierre de

doi:10.1016/j.cmi.2020.09.001

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…D'Cruz et al and Taboada et al, analyzing prospectively two cohorts of 119 and 91 severe/critical COVID-19 patients, respectively, showed the presence of dyspnoea on exertion (57%), asthaenia (37%), myalgia (37%), and arthralgia (29%) up to 2 months after symptoms onset and a general decrease in quality of life (mobility, usual activities, self-care, pain/discomfort, anxiety/depression) in 67% of patients at up to 6 months of follow-up ( 77 , 100 ). However, these widespread long-term symptoms were not only present in severe COVID-19 patients, but also in patients who had mild and moderate disease ( 72 , 76 , 80 , 94 , 98 , 146 , 159 ). Carvalho-Schneider et al, in a prospective study on 150 mild/moderate COVID-19 patients at 2 months of follow-up, highlighted dyspnea and asthenia, respectively, in 30 and 40% of patients ( 74 , 98 ).…”

Section: Resultsmentioning

confidence: 99%

“…They reported that of 3,729 doctors who answered a question about patients' persistent symptoms after COVID-19, a third said that they had seen or treated patients with long-term COVID-19 symptoms (144). Davido et al also reported that since mid-May they evaluated an average of 30 individuals per week for whom COVID-19 symptoms have not completely subsided, essentially young women (sex ratio 4:1) around 40 years old with no relevant medical history (145)(146)(147). Additionally, it was reported that female sex (mean age 47.22) is also a risk factor for poor health-related quality of life in Chinese COVID-19 patients (75).…”

Section: Widespread Persistent Symptomsmentioning

confidence: 99%

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Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

et al. 2021

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Whilst the entire world is battling the second wave of COVID-19, a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery, i. e., long-term COVID-19 symptoms. We aimed to assess the current evidence on the long-term symptoms in COVID-19 patients. We did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms. We included all type of papers that reported at least one long-term COVID-19 symptom. We screened studies using a standardized data collection form and pooled data from published studies. Cohort cross-sectional, case-report, cases-series, case-control studies, and review were graded using specific quality assessment tools. Of 11,361 publications found following our initial search we assessed 218 full-text articles, of which 145 met all selection criteria. We found that 20.70% of reports on long-term COVID-19 symptoms were on abnormal lung functions, 24.13% on neurologic complaints and olfactory dysfunctions, and 55.17% on specific widespread symptoms, mainly chronic fatigue, and pain. Despite the relatively high heterogeneity of the reviewed studies, our findings highlighted that a noteworthy proportion of patients who have suffered from SARS-CoV-2 infection present a “post-COVID syndrome.” The multifaceted understanding of all aspects of the COVID-19 pandemic, including these long-term symptoms, will allow us to respond to all the global health challenges, thus paving the way to a stronger public health.

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Section: Resultsmentioning

confidence: 99%

Section: Widespread Persistent Symptomsmentioning

confidence: 99%

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

et al. 2021

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“…A 3-month follow-up study of COVID-19 survivors, who notably did not experience a severe course of the illness, noted that 39 out of 55 patients had different degrees of pulmonary radiological abnormalities [ 128 ]. A French study noted that many patients after experiencing mild symptoms attributable to COVID-19 have a resurgence of persistent symptoms, including myalgia, intense fatigue, sensation of fever, shortness of breath, chest tightness, tachycardia, headaches, and anxiety [ 129 ]. Consistently, in Italy, 2 months after initial onset of COVID-19 symptoms, more than half of the individuals continued to experience fatigue, almost half still experienced shortness of breath, and almost one-third still experienced chest pain [ 130 ].…”

Section: Acute Endotheliitis and Pan-organ Involvement In Covid-19mentioning

confidence: 99%

Biological and Psychological Factors Determining Neuropsychiatric Outcomes in COVID-19

Tizenberg

Brenner

Lowry

et al. 2021

Curr Psychiatry Rep

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Purpose of Review We present biological and psychological factors implicated in psychiatric manifestations of SARS-CoV-2, as well as its neuroinvasive capability and immune pathophysiology. Recent Findings Preexisting mental illness leads to worse clinical outcomes in COVID-19. The presence of the virus was reported in the cerebrospinal fluid (CSF) and brain tissue post-mortem. Most common psychiatric manifestations include delirium, mood disorders, anxiety disorders, and posttraumatic stress disorder. “Long-COVID” non-syndromal presentations include “brain-fogginess,” autonomic instability, fatigue, and insomnia. Summary SARS-CoV-2 infection can trigger prior vulnerabilities based on the priming of microglia and other cells, induced or perpetuated by aging and mental and physical illnesses. COVID-19 could further induce priming of neuroimmunological substrates leading to exacerbated immune response and autoimmunity targeting structures in the central nervous system (CNS), in response to minor immune activating environmental exposures, including stress, minor infections, allergens, pollutants, and traumatic brain injury.

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“…The intensity of dyspnea (Borg Scale score), dysfunctional breathing, and of disability (MRCd) were also significantly reduced for the specific sample of patients with COVID-19. This might be due to (a) the airway clearance methods that cleared secretions and promoted re-expansion of the atelectatic lung [16]; (b) the diaphragmatic breathing that reduced respiratory rate, improved chest wall motion, and distribution of ventilation, decreased dyspnea and energy cost of breathing and improved exercise performance [17]; (c) the pursed-lips breathing that increased lung volumes and reduced breathing frequency [17,18], improved oxygen saturation and reduced arterial partial pressure of carbon dioxide (PCO2) [17]; (d) the deep breathing exercises that reversed atelectasis, increased oxygenation, alveolar recruitment, functional residual capacity, and tidal volumes and potentially removed secretions [19]; (e) the incentive spirometry that increased lung volumes and re-recruits atelectatic or collapsed areas of the lung [19]; and (f) the breathing retraining that reduced dysfunctional breathing which resulted in dyspnea [9,20].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Post-ICU Physiotherapy on Respiratory and Physical Functioning Status in Patients with COVID-19: A Pilot Study

Grammatopoulou

Sdravou

Gkiliri

et al. 2021

The 1st International Electronic Conference on Medicine

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Background and Objectives: According to recent physiotherapy recommendations (WHO, WCPT, 2020) for patients with COVID-19, after discharge from an ICU, they are expected to experience respiratory, physical, cognitive, and psychological problems due to the duration and nature of the immobilization and sedation, ventilation duration, and underlying morbidity. Moreover, only patients with a limitation in physical capacity and/or physical activity have an indication for physiotherapy. However, little is known about the effect of physiotherapy treatment on the functional capacity of patients with COVID-19. Purpose: The aim of the present study was to provide information for the effectiveness of physiotherapy intervention on the respiratory and physical functional status of patients with COVID-19, since there will be a great demand for physiotherapy treatment for these people soon. Materials and Methods: The Ethics Committee of the AHEPA University Hospital, School of Medicine, Health Sciences Faculty, Aristotle University of Thessaloniki, Greece granted approval for this study. This pilot clinical study was conducted from March to June 2020. The sample consisted of 11 patients with COVID-19, discharged from an ICU and hospitalized in the COVID-19 clinic of AHEPA University Hospital. All participants had an indication for physiotherapy, according to the recommendations, and a medical referral as well. The duration of their hospitalization ranged from two to six weeks. Among participants, there were seven males and four females, aged from 44–75 yrs, five smokers and six nonsmokers, four obese and seven nonobese. According to the recommendations, physiotherapy intervention was tailored to the patients’ needs and goals. Breathing exercises, early mobilization, and self-management for daily living were performed once a day, for five days a week, as tolerated. Measurement tools: Pulse oximeter (SpO2), respiratory rate (RR), the Borg scale (intensity of dyspnea), Medical Research Council scale for disability (MRCd), clinical evaluation for dysfunctional breathing (DB), Medical Research Council scale for muscle strength (MRCms), Berg balance scale, Sit to Stand test (leg strength and endurance), Time Up and Go test (TUG) (general mobility), 1 min walk test (1MWT) (aerobic capacity), and the Barthel Index (BI) (performance in daily activities). For the purposes of the study, two measurements were conducted: at admission and at discharge from the COVID-19 clinic. Results: Dependent sample tests showed a significant effect (p < 0.001) for the recommended physiotherapy treatment on respiratory variables: 6.9 (1.4)% for SpO2, 3.4 (0.9) breaths for respiratory rate, and 5.0 (1.3) for the Borg scale score. Significant improvements (p < 0.001) were additionally noted for physical functioning: 25.3 (13.0) for the Berg balance scale, 18.5 (11.2) for the MRCms score, 3 (1.3) s for the Sit to Stand test, 40.4 (40.6) s for the TUG efforts, 44.1 (25.5) s for 1MWT, and 65.9 (20.2) for BI. All patients displayed DB at admission to the COVID-19 clinic, while nine of them adopted a diaphragmatic breathing pattern at discharge. At admission to the COVID-19 clinic, all patients were at level five disability (MRCd), whereas at discharge 10 out of 11 patients improved (three at level four, four at level three, and three at level two). Conclusions: The present pilot study provided first evidence for the effectiveness of the WHO and WCPT physiotherapy recommendations on the respiratory and physical functioning status of patients with COVID-19. Further studies are needed to support these early findings.

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'Post-COVID-19 chronic symptoms' – Author's reply

Cited by 7 publications

References 6 publications

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

Biological and Psychological Factors Determining Neuropsychiatric Outcomes in COVID-19

The Effect of Post-ICU Physiotherapy on Respiratory and Physical Functioning Status in Patients with COVID-19: A Pilot Study

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