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

Sari Harenwall,Angela Moore,Sherri Godsell,Amy Rachel Bland,Rebecca Henderson,Suzanne Heywood-Everett,Kirsty Shepherd,Ursula Philpot,Joanne Smith,Sarah Jordan

doi:10.1177/21501319211067674

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.

Highlights

There is increasing evidence to suggest that coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can have significant long-term effects on health
Evaluation of participant feedback (n = 76) showed that 96% of people felt more knowledgeable and informed about their symptoms, 100% felt the exercises throughout the course were helpful, 91% felt confident in implementing strategies to manage symptoms, and 99% of participants would recommend the course to others
We evaluated whether there were any significant differences in outcome measures between those that tested positive for acute COVID-19 infection and those that did not

Summary

Introduction

There is increasing evidence to suggest that coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can have significant long-term effects on health. Most individuals recover from COVID-19 within weeks, it is well established that some will present with persistent, long-term symptoms.[1] Persistent symptoms may develop during or following the acute infection, with those lasting for more than 12 weeks commonly referred to as “long. The National Institute for Health and Care Excellence (NICE) describes post COVID-19 syndrome as a set of persistent physical, cognitive, and/or psychological symptoms that continue for more than 12-weeks following the acute illness and are not explained by an alternative diagnosis. A recent study of 508 707 participants found that 37.7% of participants reported at least one persistent symptom for 12 weeks following acute infection, with 14.8% reporting at least three symptoms.[5] The incidence of post-COVID-19 syndrome is estimated at 10% to 35%, and for hospitalized patients, it has been reported to reach 85%.6. The incidence of post-COVID-19 syndrome is estimated at 10% to 35%, and for hospitalized patients, it has been reported to reach 85%.6 The Office for National Statistics (ONS) estimates 970 000 people in the UK are currently living with post-COVID-19 syndrome, with 66% of those reporting impacts to usual daily activities.[7]

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