Post-Covid-19 Syndrome: Improvements in Health-Related Quality of Life Following Psychology-Led Interdisciplinary Virtual Rehabilitation

Abstract

Coronavirus disease 2019 (COVID-19) is increasingly recognized as having significant long-term impact on physical and mental health. The Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) is a psychology-led specialist interdisciplinary team of health professionals specializing in persistent physical symptoms (PPS) and Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) with an emphasis on holistic integrated care. The PCWBS quickly recognized the risk of the long-term effects of COVID-19, particularly for social, health and care staff, and developed a 7-week virtual rehabilitation course which was piloted in October 2020. The “ Recovering from COVID” course takes a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue (PVF) and is delivered by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, assistant psychologist, and a personal support navigator with support from a team administrator. The course focuses on understanding PVF, sleep optimization, nutrition, swallowing, activity management, energy conservation, stress management, breathing optimization, managing setbacks, and signposting to appropriate resources and services. Since the pilot, PCWBS has delivered 7 courses to support over 200 people suffering from post-COVID-19 syndrome. One hundred and forty-nine individuals that enrolled on the “ Recovering from COVID” course completed the EQ-5D-5L to assess Health-related quality of life (HRQoL) across 5 dimensions, including problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Subsequently, 76 individuals completed these measures at the end of the rehabilitation course showing that patient ratings were significantly improved. In response to the NIHR recommendation for rapid evaluation of different service models for supporting people with post-COVID-19 syndrome, this data offers hope that rehabilitation is effective in reversing some of the problems faced by people living with the long-term effects of COVID-19.

COVID-19 Pandemic-Revealed Consistencies and Inconsistencies in Healthcare: A Medical and Organizational View

“…The original research articles are dedicated to specific studies performed in different countries and population groups [ 28 , 29 , 30 , 31 , 32 , 33 ], with different approaches to selection criteria, key agents, nosology, and definitions [ 34 , 35 , 36 , 37 , 38 ], and different methods of diagnostics and treatment, as well as measuring the patients’ reported outcomes [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. The results range from an inconclusive interaction between COVID-19 and ME/CFS to assumptions about the analogy of post-COVID-19 syndrome with ME/CFS.…”

The Interactive Effects of Post-Traumatic Stress Symptoms and Breathlessness on Fatigue Severity in Post-COVID-19 Syndrome

“…Participants were enrolled on a 7-week rehabilitation course specifically targeting Health Care Professionals (HCPs) with persistent symptoms of COVID-19, offered by the Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) [ 41 ]. A total of 154 participants completed outcome measures detailing their pre-COVID-19 and current state of health.…”

The Advantages of an Integrative Approach in the Primary Healthcare of Post-COVID-19 and ME/CFS Patients

“…Various tools are used to elaborate the HRQoL, such as EuroQoL-5 Dimensions (EQ-5D-3L) [26,31] and (EQ-5D-5L) [12], 36-Item Health Survey (SF-36) [29,31], Pediatric Quality of Life Inventory (PedsQL) [28], overall health status reported on a Visual Analogue Scale (VAS) [12,27,30], Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF) [32], completed by people with ME/CFS, and Family Reported Outcome Measure (FROM-16) questionnaire [30,32], completed by family members. Simultaneously, HRQol widely affected by all post-COVID-19 domains [24] mostly is assessed by EuroQoL-5 Dimension EQ-5D-5L and VAS [33][34][35].…”

“…The predominant score of ME/CFS and PPCS patients' healthcare is related to primary healthcare, given that patients of these syndromes are mostly treated on an outpatient basis [36][37][38][39]. The unifying issues for these diseases are also complex and multisystem nature, which requires coordinated integrative multidisciplinary teamwork to achieve treatment goals [34,39]. Previous research demonstrated significant results of the interdisciplinary approach, such as the "Recovering from COVID" course, which took a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue and was led by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, and a personal support navigator [34].…”

“…Moreover, COVID-19 is associated with high rates of psychiatric symptoms, including anxiety, depression, fatigue, sleep disruption, and posttraumatic stress, and consistent risk factors for psychiatric symptoms include the history of a psychiatric disorder and female gender [40]. Researchers notified that while the exact etiology remains unknown, and future research is needed, it is now recognized that overlapping symptomology between post-COVID-19 syndrome and ME/CFS provides a promising avenue for the development of post-COVID-19 rehabilitation [34].…”