The economic burden of the post-COVID-19 condition: Underestimated long-term consequences of neuropsychological deficits

Voruz, Philippe; Assal, Frédéric; Péron, Julie Anne

doi:10.7189/jogh.13.03019

Cited by 5 publications

(6 citation statements)

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“…Additionally, the absence of cumulative neuropsychological deficits in the mild subgroup (confirming previous results at 6–9 months) [ 6 ] does not exclude the possibility of isolated neuropsychological deficits, as observed in previous studies [ 1 , 9 ]. These isolated deficits could have an impact on patients’ daily lives [ 9 , 47 ] and could be associated with brain modifications [ 48 ]. Thus, in line with our predictions, although the severity of respiratory symptoms in the acute phase may be a contributing factor for the presence of neuropsychological deficits after the infection, it is not the only predictor of what we may now call neuropsychological post-COVID-19 condition.…”

Section: Discussionmentioning

confidence: 99%

Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection: A follow-up assessment of the Geneva COVID-COG cohort

Voruz,

de Alcântara,

Nuber-Champier

et al. 2024

J Glob Health

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Background Despite numerous observations of neuropsychological deficits immediately following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, little is known about what happens to these deficits over time and whether they are affected by changes in fatigue and any psychiatric symptoms. We aimed to assess the prevalence of neuropsychological deficits at 6–9 months and again at 12–15 months after coronavirus disease 2019 (COVID-19) and to explore whether it was associated with changes in fatigue and psychiatric symptoms. Methods We administered a series of neuropsychological tests and psychiatric questionnaires to 95 patients (mean age = 57.12 years, standard deviation (SD) = 10.68; 35.79% women) 222 (time point 1 (T1)) and 441 (time point 2 (T2)) days on average after infection. Patients were categorised according to the severity of their respiratory COVID-19 symptoms in the acute phase: mild (no hospitalisation), moderate (conventional hospitalisation), and severe (hospitalisation in intensive care unit (ICU) plus mechanical ventilation). We ran Monte-Carlo simulation methods at each time point to generate a simulated population and then compared the cumulative percentages of cognitive disorders displayed by the three patient subgroups with the estimated normative data. We calculated generalised estimating equations for the whole sample to assess the longitudinal associations between cumulative neuropsychological deficits, fatigue, and psychiatric data (anxiety, depressive symptoms, posttraumatic stress disorder, and apathy). Results Most participants (>50%) exhibited a decrease in their neuropsychological impairments, while approximately 25% showed an escalation in these cognitive deficits. At T2, patients in the mild subgroup remained free of accumulated neuropsychological impairments. Patients with moderate severity of symptoms displayed a decrease in the magnitude of cumulative deficits in perceptual and attentional functions, a persistence of executive, memory and logical reasoning deficits, and the emergence of language deficits. In patients with severe symptoms, perceptual deficits emerged and executive deficits increased, while attentional and memory deficits remained unchanged. Changes in executive functions were significantly associated with changes in depressive symptoms, but the generalised estimating equations failed to reveal any other significant effect. Conclusion While most cumulative neuropsychological deficits observed at T1 persisted and even worsened over time in the subgroups of patients with moderate and severe symptoms, a significant proportion of patients, mainly in the mild subgroup, exhibited improved performances. However, we identified heterogeneous neuropsychological profiles both cross-sectionally and over time, suggesting that there may be distinct patient phenotypes. Predictors of these detrimental dynamics have yet to be identified.

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Section: Discussionmentioning

confidence: 99%

Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection: A follow-up assessment of the Geneva COVID-COG cohort

Voruz,

de Alcântara,

Nuber-Champier

et al. 2024

J Glob Health

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“…Beyond the acute phase, Long COVID poses persistent health issues with profound economic impacts. The symptoms hinder workforce productivity and lead to financial setbacks for patients and the broader economy [ 95 , 116 , 117 ]. A notable Swiss survey by the Federal Social Insurance Office reported an increasing percentage of disability insurance claims attributed to the post-COVID-19 condition [ 95 , 117 ].…”

Section: The Economic Ramifications Of Long Covid Worldwidementioning

confidence: 99%

“…Moreover, Long COVID exacerbates the already substantial healthcare costs associated with the COVID-19 pandemic. The prolonged medical care required to manage Long COVID symptoms, including specialist consultations, diagnostic tests, and rehabilitative services, contributes to higher healthcare expenditures [ 117 , 120 ]. This places an additional burden on healthcare systems, diverting resources that could be allocated to other critical areas, such as preventive measures or addressing other health concerns [ 120 ].…”

Section: The Economic Ramifications Of Long Covid Worldwidementioning

confidence: 99%

From Acute Infection to Prolonged Health Consequences: Understanding Health Disparities and Economic Implications in Long COVID Worldwide

Sweis,

Alnaimat,

Esparza

et al. 2024

IJERPH

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The COVID-19 pandemic has resulted in a growing number of patients experiencing persistent symptoms and physiological changes after recovering from acute SARS-CoV-2 infection, known as Long COVID. Long COVID is characterized by recurring symptoms and inflammation across multiple organ systems. Diagnosis can be challenging, influenced by factors like demographics, comorbidities, and immune responses. Long COVID impacts various organ systems and can have neuropsychological effects. Health disparities, particularly related to race, contribute to a higher burden of infection and ongoing symptoms in minority populations. Managing Long COVID entails addressing a spectrum of symptoms that encompass physical, cognitive, and psychological aspects. The recovery period for patients with Long COVID can vary significantly, influenced by factors like the severity of the disease, hospitalization, comorbidities, and age. Currently, there are no universally effective treatments, although certain interventions show promise, necessitating further research. Self-management and rehabilitation programs can provide relief, but more research is needed to establish their effectiveness. Preventive measures such as vaccination and the use of antiviral medications and metformin. It is imperative to conduct further research to develop evidence-based guidelines and gain a better understanding of the long-term implications of COVID-19. Long COVID could have substantial economic impact on the labor market, productivity, healthcare expenditures, and overall economic growth. To address the challenges patients with long-term complications face, there is a focus on strategies like promoting telework and flexible work arrangements to accommodate diverse symptoms, particularly chronic fatigue and other Long COVID effects. In conclusion, this review emphasizes the multifaceted complexity of Long COVID and the ongoing need to address its potential long-term health and economic impacts.

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“…The severity, timing, and impact of episodes of disability may be unpredictable throughout the day, as well as over time. Episodic disability experienced by people with Long COVID has further societal implications such as challenges returning to work for those who have left the workforce, and financial and housing insecurity (22)(23)(24)(25)(26)(27)(28).…”

Section: Total Manuscript Word Count: 6770 Introductionmentioning

confidence: 99%

Experiences of physiotherapists working with adults living with Long COVID in Canada: a qualitative study

Kim,

Lin,

Wong

et al. 2024

Preprint

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Objectives:To explore experiences of physiotherapists working with adults living with Long COVID in Canada.Design:Cross-sectional descriptive qualitative study involving online semi-structured interviews.Participants:We recruited physiotherapists in Canada who self-identified as having clinically treated one or more adults living with Long COVID in the past year.Data collection:Using an interview guide, we inquired about physiotherapists knowledge of Long COVID, assessment and treatment experiences, perspectives on physiotherapists roles, contextual and implementation factors influencing rehabilitative outcomes, and their recommendations for Long COVID rehabilitation. Interviews were audio-recorded, transcribed verbatim, and analyzed using a group-based thematic analytical approach. We administered a demographic questionnaire to describe sample characteristics.Results:Thirteen physiotherapists from five provinces participated; most were women (n=8;62%) and practised in urban settings (n=11;85%). Participants reported variable amounts of knowledge of existing guidelines and experiences working with adults living with Long COVID in the past year. Physiotherapists characterized their experiences working with adults living with Long COVID as a dynamic process involving: 1) a disruption to the profession (encountering a new patient population and pivoting to new models of care delivery), followed by 2) a cyclical process of learning curves and evolving roles of physiotherapists working with persons living with Long COVID (navigating uncertainty, keeping up with rapidly-emerging evidence, trial and error, adapting mindset and rehabilitative approaches, and growing prominence of roles as advocate and collaborator). Participants recommended the need for education and training, active and open-minded listening with patients, interdisciplinary models of care, and organizational- and system-level improvements to foster access to care.Conclusions:Physiotherapists experiences involved a disruption to the profession followed by a dynamic process of learning curves and evolving roles in Long COVID rehabilitation. Not all participants demonstrated an in-depth understanding of existing Long COVID rehabilitation guidelines. Results may help inform physiotherapy education in Long COVID rehabilitation.

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The economic burden of the post-COVID-19 condition: Underestimated long-term consequences of neuropsychological deficits

Cited by 5 publications

References 10 publications

Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection: A follow-up assessment of the Geneva COVID-COG cohort

Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection: A follow-up assessment of the Geneva COVID-COG cohort

From Acute Infection to Prolonged Health Consequences: Understanding Health Disparities and Economic Implications in Long COVID Worldwide

Experiences of physiotherapists working with adults living with Long COVID in Canada: a qualitative study

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