Strategies to evaluate outcomes in long-COVID-19 and post-COVID survivors

Abstract

SARS-CoV-2 infection can impact the physical, cognitive, mental health of patients, especially in those recovered in intensive care units. Moreover, it was proved that the effects of the virus may persist for weeks or months. The term long-COVID or post-COVID syndrome is commonly used for indicating a variety of physical and psychological symptoms that continue after the resolution of the acute phase. This narrative review is aimed at providing an updated overview of the impact of physical, cognitive, and psychological health disorders in COVID-19 survivors, by summarizing the data already published in literature in the last year. Studies cited were found through PubMed searches. We also presented an overview of the post-COVID-19 health consequences on three important aspects: nutritional status, neurological disorders, and physical health. Moreover, to activate a correct health planning policy, a multidisciplinary approach for addressing the post- COVID-19 issue, has been proposed. Finally, the involvement of health professionals is necessary even after the pandemic, to reduce expected post-pandemic psychosocial responses and mental health disorders.

Studying the post-COVID-19 condition: research challenges, strategies, and importance of Core Outcome Set development

“…Long-term health consequences of COVID-19 remain unknown, but reports suggest that prolonged symptom duration and limitations in functioning are common among hospitalised as well as non-hospitalised adults [13,14] and children [15,16]. The spectrum of longlasting symptoms is wide and varies from mild discomfort to severe adverse effects on physical, cognitive, and psychosocial health [17], with important wider implications on functioning, including employment and school attendance.…”

A SARS-CoV-2 Infection High-Uptake Program on Healthcare Workers and Cancer Patients of the National Cancer Institute of Naples, Italy

“…In addition to the high risk of SARS-CoV-2 infection for healthcare professionals, it has been seen that they have experienced several mental problems, such as anxiety, stress, and burnout syndrome, a further problem to the already complicated working conditions in the pandemic phase. This could suggest the design of ad hoc programs for the prevention of mental disorders alongside health surveillance [ 29 , 30 , 31 , 32 , 33 ]. In support of this, it was shown that work overload and stress represented risk factors in contracting infectious diseases; in particular, this risk increased as the number of working hours increased, exposing HCWs for a longer time to patients, viruses, and mental stress [ 34 ].…”

Neuropsychological Outcome of Critically Ill Patients with Severe Infection

“…After the acute phase, patients affected by COVID-19 infection may also experience a systemic disease that lasts for four or more weeks following the acute phase of infection. This condition, known as Long COVID, may present severe fatigue, breathlessness, neurocognitive deficits, headaches, joint pain, and a decline in the quality of life [57][58][59]. This clinical picture may be due to different factors, related to both hospitalization, such as post-intensive care syndrome (PICS) or social isolation, associated with the specific COVID-19 infection, and to the infection itself, such as residual inflammation or viral organ damage [58].…”

“…In this setting, neurocognitive impairment represents one of the most important factors affecting recovery, with patients experiencing difficulties in attention, concentration, memory, chronic fatigue, insomnia, depression and anxiety [58]. Carfì et al described that two months after discharge from the ICU, about 44% of COVID-19 patients showed a worsened quality of life, with more than 50% of them showing fatigue [60].…”

“…In addition to the acute-phase treatment, another fundamental factor to consider is the importance of a comprehensive follow-up in COVID-19 patients, even after hospitalization, in order to promptly recognize and treat any neurological, psychological or functional alterations. This kind of follow-up can be performed using all the validated scales that are commonly used for the general population, such as the Short Form Health Survey 36 (SF-36) for evaluation of the overall health status, and the Mini-Mental Test for evaluation of the neurocognitive and functional state [58].…”