Long-term Symptoms Research Articles

The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: staggered cohort study of data from the UK, Spain, and Estonia

Although vaccines have proved effective to prevent severe COVID-19, their effect on preventing long-term symptoms is not yet fully understood. We aimed to evaluate the overall effect of vaccination to prevent long COVID symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2). We conducted a staggered cohort study using primary care records from the UK (Clinical Practice Research Datalink [CPRD] GOLD and AURUM), Catalonia, Spain (Information System for Research in Primary Care [SIDIAP]), and national health insurance claims from Estonia (CORIVA database). All adults who were registered for at least 180 days as of Jan 4, 2021 (the UK), Feb 20, 2021 (Spain), and Jan 28, 2021 (Estonia) comprised the source population. Vaccination status was used as a time-varying exposure, staggered by vaccine rollout period. Vaccinated people were further classified by vaccine brand according to their first dose received. The primary outcome definition of long COVID was defined as having at least one of 25 WHO-listed symptoms between 90 and 365 days after the date of a PCR-positive test or clinical diagnosis of COVID-19, with no history of that symptom 180 days before SARS-Cov-2 infection. Propensity score overlap weighting was applied separately for each cohort to minimise confounding. Sub-distribution hazard ratios (sHRs) were calculated to estimate vaccine effectiveness against long COVID, and empirically calibrated using negative control outcomes. Random effects meta-analyses across staggered cohorts were conducted to pool overall effect estimates. A total of 1 618 395 (CPRD GOLD), 5 729 800 (CPRD AURUM), 2 744 821 (SIDIAP), and 77 603 (CORIVA) vaccinated people and 1 640 371 (CPRD GOLD), 5 860 564 (CPRD AURUM), 2 588 518 (SIDIAP), and 302 267 (CORIVA) unvaccinated people were included. Compared with unvaccinated people, overall HRs for long COVID symptoms in people vaccinated with a first dose of any COVID-19 vaccine were 0·54 (95% CI 0·44-0·67) in CPRD GOLD, 0·48 (0·34-0·68) in CPRD AURUM, 0·71 (0·55-0·91) in SIDIAP, and 0·59 (0·40-0·87) in CORIVA. A slightly stronger preventative effect was seen for the first dose of BNT162b2 than for ChAdOx1 (sHR 0·85 [0·60-1·20] in CPRD GOLD and 0·84 [0·74-0·94] in CPRD AURUM). Vaccination against COVID-19 consistently reduced the risk of long COVID symptoms, which highlights the importance of vaccination to prevent persistent COVID-19 symptoms, particularly in adults. National Institute for Health and Care Research.

APPLICATION OF REFLEXOTHERAPY ACCORDING TO THE “HEXAGRAM BALANCING” METHOD IN THE COMBINED REHABILITATION OF DISEASES OF THE RESPIRATORY SYSTEM WITH PSYCHOEMOTIONAL DISORDERS

Abstract. The article is devoted to one of the most urgent problems of medicine – complex treatment of bronchial asthma. Often, various diseases, especially those that occur with aggravated under the influence of psycho-emotional stress, depression, asthenia and other adverse psychosocial factors, are accompanied by long-term symptoms. Medicinal methods of treatment are not fully effective, so non-medicinal technologies should be resorted to. Combined treatment of bronchial asthma using іn rehabilitation reflexotherapy methods has been used for a long time, it is especially effective when there are also psychosomatic problems. The article as well presents the main theoretical principles of the “balancing of hexagrams” method and its practical implementation. A clinical case is also presented: bronchial asthma in the patient with psychoemotional disorders. The methods of acupuncture diagnosis are presented, the acupuncture diagnosis is characterized in detail, the description of acupuncture correction is given, the methods of medical correction used in treatment, the features of the “favorable” hexagram are considered. Thus, patients with bronchial asthma with psychoemotional disorders are found in the practice of a reflexologist. In the complex of therapeutic measures for bronchial asthma with psychoemotional disorders, the use of the acupuncture method “balancing hexagrams” can be effective. Purpose. To consider the peculiarities of the use of reflexotherapy by the method of “balancing hexagrams” in the complex rehabilitation of patients with diseases of the respiratory system with psycho-emotional disorders. Scientific novelty. For the first time in our country, the technique of making acupuncture prescriptions and acupuncture using the method of “balancing hexagrams” was used in the complex rehabilitation of patients with diseases of the respiratory system with psycho-emotional disorders. Methods. We consider one clinical case of the use of reflexotherapy using the method of “balancing hexagrams” in the complex rehabilitation of diseases of the respiratory organs with psycho-emotional disorders. Results. As a result of treatment using the “balancing hexagrams” method, the patient's condition improved: his psychoemotional state normalized, he was able to completely give up alcohol, went on a diet; his respiratory conditions improved. Conclusions. 1. Bronchial asthma occurs in the practice of a reflexologist, and with this disease, reflexotherapy methods are effective primarily for psycho-emotional disorders. 2. The use of the acupuncture method “balancing hexagrams” can be effective in the complex of treatment measures for bronchial asthma.

APPLICATION OF REFLEXOTHERAPY ACCORDING TO THE METHOD OF “BALANCING HEXAGRAMS” IN COMPLEX REHABILITATION OF NEUROPATHY OF THE RADIAL NERVE

Abstract. The article is devoted to one of the most pressing problems of neurology – neuropathy of peripheral nerves. Often, various diseases, especially those aggravated under the influence of psycho-emotional stress and other adverse psychosocial factors, are accompanied by long-term symptoms. Medicinal methods of treatment are not fully effective, so it is necessary to resort to non-medicinal technologies. Combined treatment of neuropathy of peripheral nerves by reflexotherapy methods has been used for a long time, mainly when there is a delay in the recovery of their functions, and first of all, their motor functions. Purpose. To consider the features of the use of reflexology by the method of "balancing hexagrams" in the complex rehabilitation of neuropathy of the radial nerve with a prolonged course. Scientific novelty. For the first time in our country, the method of making acupuncture prescriptions and acupuncture using the method of "balancing hexagrams" was used in the complex rehabilitation of neuropathy of the radial nerve with a prolonged course. Methods. We consider one clinical case of the use of reflexology using the method of "balancing hexagrams" in the complex rehabilitation of radial nerve neuropathy. The methods of clinical objective neurological examination, the method of syndromic diagnosis of traditional Chinese medicine, the pulse diagnosis method, and the tongue diagnosis method were used. Results. As a result of treatment using the "balancing hexagrams" method, the patient's condition improved: first of all, the functions of the radial nerve improved, the trophic and motor activity of the muscles it innervates has improved. Conclusions. 1. Patients with neuropathy of the radial nerve with a prolonged course are seen in the practice of a neurologist and a reflexologist. 2. The use of the acupuncture method "balancing hexagrams" can be effective in the complex of treatment measures for neuropathy of the radial nerve with a prolonged course.

Rescue subthalamic stimulation after unsatisfactory outcome of pallidal stimulation in Parkinson's disease: a case series and review.

Subthalamic nucleus (STN) and globus pallidus interna (GPi) are two main structures primarily targeted by deep brain stimulation (DBS) to treat advanced Parkinson's disease (PD). A subset of cases with unsatisfactory outcomes may benefit from rescue DBS surgery targeting another structure, while these patients' characteristics have not been well described and this phenomenon has not been well reviewed. This monocentric retrospective study included patients with PD, who underwent rescue STN DBS following an unsatisfactory outcome of the initial bilateral GPi DBS in a retrospective manner. A short review of the current literature was conducted to report the clinical outcome of rescue DBS surgeries. Eight patients were identified, and six of them were included in this study. The rescue STN DBS was performed 19.8 months after the initial GPi DBS. After 8.8 months from the rescue STN DBS, patients showed a significant off-medication improvement by 29.2% in motor symptoms compared to initial GPi DBS. Non-motor symptoms and the health-related quality of life were also significantly improved. Our findings suggest that the rescue STN DBS may improve off-medication motor and non-motor symptoms and quality of life in patients with failure of initial GPi DBS. The short review of the current literature showed that the target switching from GPi to STN was mainly due to poor initial outcomes and was performed by target substitution, whereas the switching from STN to GPi was mainly due to a gradual waning of benefits, long-term axial symptoms, dyskinesia, and dystonia and was performed by target addition.

Short-term Safety of Covaxin, Sinopharm, Sputnik V, and AstraZeneca COVID-19 Vaccines Among Iranian Healthcare Workers: A Cross-Sectional Study

Background: Several coronavirus disease 2019 (COVID-19) vaccines, utilizing different platforms, have successfully obtained emergency clinical use authorization to prevent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections. Most published data from COVID-19 vaccine trials have frequently observed mild-to-moderate side effects, with varying severity depending on various vaccine types. Objectives: This study aimed to estimate the prevalence of side effects associated with four types of COVID-19 vaccines among vaccinated healthcare workers following the first and second vaccine doses and to identify possible risk factors for COVID-19 vaccine side effects. Methods: This cross-sectional study was conducted from April 2021 to March 2022 by administering a questionnaire and conducting direct interviews with healthcare workers in Kerman, southeastern Iran, who had received 2 or more doses of COVID-19 vaccines. Results: Out of 861 individuals enrolled in the study, 38.7% received Sputnik, 32.4% AstraZeneca, 19.6% Covaxin, and 9.3% Sinopharm vaccines. Overall, the most common side effects after the first and second doses included general symptoms, fever and chills, injection site reactions, neurological symptoms, and gastrointestinal symptoms. Furthermore, the frequency of symptoms significantly reduced after the second dose. Conclusions: General symptoms and injection site reactions were significantly more common after receiving the first dose of vaccines compared to the second dose. No severe vaccine side effects were observed in this study. However, further research is required to evaluate the long-term symptoms and safety profiles of COVID-19 vaccines.

SARS-CoV-2's brain impact: revealing cortical and cerebellar differences via cluster analysis in COVID-19 recovered patients.

COVID-19 is a disease known for its neurological involvement. SARS-CoV-2 infection triggers neuroinflammation, which could significantly contribute to the development of long-term neurological symptoms and structural alterations in the gray matter. However, the existence of a consistent pattern of cerebral atrophy remains uncertain. Our study aimed to identify patterns of brain involvement in recovered COVID-19 patients and explore potential relationships with clinical variables during hospitalization. In this study, we included 39 recovered patients and 39 controls from a pre-pandemic database to ensure their non-exposure to the virus. We obtained clinical data of the patients during hospitalization, and 3months later; in addition we obtained T1-weighted magnetic resonance images and performed standard screening cognitive tests. We identified two groups of recovered patients based on a cluster analysis of the significant cortical thickness differences between patients and controls. Group 1 displayed significant cortical thickness differences in specific cerebral regions, while Group 2 exhibited significant differences in the cerebellum, though neither group showed cognitive deterioration at the group level. Notably, Group 1 showed a tendency of higher D-dimer values during hospitalization compared to Group 2, prior to p-value correction. This data-driven division into two groups based on the brain structural differences, and the possible link to D-dimer values may provide insights into the underlying mechanisms of SARS-COV-2 neurological disruption and its impact on the brain during and after recovery from the disease.

Predictor analysis of smell and taste loss onset and its significance in COVID-19 disease

Introduction. COVID-19 is defined as an infectious disease caused by the coronavirus. It manifests with various symptoms, including the loss of smell and taste. While the exact pathogenesis remains unclear, it is believed that these symptoms occur due to the virus?s impact on angiotensin receptors. Post-COVID syndrome, which includes various long-term symptoms, can develop after the initial illness. This study aimed to identify predictors of taste and smell loss during COVID-19, evaluate their prognostic significance for disease outcomes, and explore their connection to the respondents? constitutional characteristics. Material and Methods. The research was conducted using an online questionnaire completed 194 respondents who had recovered from COVID-19 disease (150 experienced taste and/ or smell loss, and 44 did not). In January and February 2022, two versions of the questionnaire were distributed based on the presence or absence of these symptoms. Results. Significant predictors of sensory loss include profession requiring interaction with people, non-smoking status, absence of allergies, and experiencing mild respiratory infection more than once a year. The presence of sensory loss does not necessarily indicate a milder clinical course of the disease. Post-COVID symptoms (gastrointestinal, cardiovascular, skin lesions, and reactivation of herpes simplex virus) occurred significantly more often in the group that experienced taste and/or smell loss. Conclusion. While there are predictors for the development of taste and/or smell loss, they are not the guarantee a better disease outcome. Post-COVID syndrome can manifest differently across various groups of respondents.

Multi-task localization of the hemidiaphragms and lung segmentation in portable chest X-ray images of COVID-19 patients.

The COVID-19 can cause long-term symptoms in the patients after they overcome the disease. Given that this disease mainly damages the respiratory system, these symptoms are often related with breathing problems that can be caused by an affected diaphragm. The diaphragmatic function can be assessed with imaging modalities like computerized tomography or chest X-ray. However, this process must be performed by expert clinicians with manual visual inspection. Moreover, during the pandemic, the clinicians were asked to prioritize the use of portable devices, preventing the risk of cross-contamination. Nevertheless, the captures of these devices are of a lower quality. The automatic quantification of the diaphragmatic function can determine the damage of COVID-19 on each patient and assess their evolution during the recovery period, a task that could also be complemented with the lung segmentation. We propose a novel multi-task fully automatic methodology to simultaneously localize the position of the hemidiaphragms and to segment the lung boundaries with a convolutional architecture using portable chest X-ray images of COVID-19 patients. For that aim, the hemidiaphragms' landmarks are located adapting the paradigm of heatmap regression. The methodology is exhaustively validated with four analyses, achieving an 82.31% 2.78% of accuracy when localizing the hemidiaphragms' landmarks and a Dice score of 0.9688 0.0012 in lung segmentation. The results demonstrate that the model is able to perform both tasks simultaneously, being a helpful tool for clinicians despite the lower quality of the portable chest X-ray images.

No significant difference in long-term symptoms after intraoperative gallbladder perforation with gallstones left in the abdomen

No significant difference in long-term symptoms after intraoperative gallbladder perforation with gallstones left in the abdomen

Delineating the impact of childhood traumatic brain injury (TBI) on long-term depressive symptom severity: Does sub-acute brain morphometry prospectively predict 2-year outcome?

Despite evidence of a link between childhood TBI and heightened risk for depressive symptoms, very few studies have examined early risk factors that predict the presence and severity of post-injury depression beyond 1-year post injury. This longitudinal prospective study examined the effect of mild-severe childhood TBI on depressive symptom severity at 2-years post-injury. It also evaluated the potential role of sub-acute brain morphometry and executive function (EF) in prospectively predicting these long-term outcomes. The study involved 81 children and adolescents with TBI, and 40 age-and-sex matched typically developing (TD) controls. Participants underwent high-resolution structural magnetic resonance imaging (MRI) sub-acutely at five weeks post-injury (M = 5.55; SD = 3.05 weeks) and EF assessments were completed at 6-months post-injury. Compared to TD controls, the TBI group had significantly higher overall internalizing symptoms and were significantly more likely to exhibit clinically significant depressive symptoms at 2-year follow-up. The TBI group also displayed significantly lower EF and altered sub-acute brain morphometry in EF-related brain networks, including the default-mode network (DMN), salience network (SN) and central executive network (CEN). Mediation analyses revealed significant indirect effects of CEN morphometry on depression symptom severity, such that lower EF mediated the prospective association between altered CEN morphometry and higher depression symptoms in the TBI group. Parallel mediation analyses including grey matter morphometry of a non-EF brain network (i.e., the mentalising network) were not statistically significant, suggesting some model specificity. The findings indicate that screening for early neurostructural and neurocognitive risk factors may help identify children at elevated risk of depressive symptoms following TBI. For instance, children at greatest risk of post-injury depression symptoms could be identified based in part on neuroimaging of networks implicated in EF and post-acute assessments of executive function, which could support more effective allocation of limited intervention resources.

The prevalence of post-COVID-19 vaccination syndrome and quality of life among COVID-19-vaccinated individuals

BackgroundThere were many studies conducted to determine how immunization affects people with long-term COVID. The results of those studies have caused debate as they gave rise to varying outcomes. Some evidence indicates a change in, an improvement in, a continuation of, or even a worsening of long-term COVID symptoms following vaccination. The ratio of change in antibody titers was noticeably larger in the group of people whose illnesses became worse. Hence, this study aimed to explore potential post-COVID-19 vaccination syndrome (PCVS) in vaccinated individuals and also to assess their quality of life (QoL). MethodologyBetween September 2021 and May 2023, an ambidirectional, descriptive, follow-up cohort study was conducted, enrolling participants who were 18 years of age or older, met the vaccination requirements established by the Ministry of Health and Family Welfare, Government of India, and had completed the primary immunization series with the AZD1222® or BBV152® vaccine. The prevalence of PCVS and the QoL measured using EQ-5D-5L were assessed at 1 month, 6 months, and 12 months post-COVID-19 vaccination. ResultsAZD1222® vaccine was received by 84.28% (343) of the participants, and BBV152® vaccine was received by 15.72% (64) of the study participants. A month after the primary vaccination series, 52.8% (215) of the total participants had at least 1 PCVS, 39.8% (162) at 6 months, and 64.6% (263) at 12 months. Among those who had received vaccinations, the QoL increased at 6 months to 0.975±0.08 and declined at 12 months to 0.94±0.13 from 0.949±0.13 at 1 month after receiving a primary immunization. The overall prevalence of PCVS between AZD1222®-vaccinated individuals and BBV152®-vaccinated individuals at a month post-vaccination was 54.5% vs. 43.8%, at 6 months it was 41.1% vs. 32.8%, and at 12 months it was 65.59% vs. 59.4%. The QoL between AZD1222®-vaccinated individuals and BBV152®-vaccinated individuals at a month post-vaccination was 0.95±0.13 vs. 0.95±0.126, at 6 months it was 0.98±0.08 vs. 0.97±0.07, and at 12 months it was 0.94±0.12 vs. 0.92±0.20. However, there was no statistically significant difference in the prevalence of PCVS and QoL between AZD1222® and BBV152®-vaccinated individuals.The percentage of participants who had at least one PCVS was 83.9% (146) in the group that got booster doses and 50.2% (117) in the group that did not. The QoL was 0.9±0.15 in the group receiving booster dosages and 0.96±0.11 in the group not receiving them. There was a statistically significant difference in the prevalence of PCVS and QoL between booster dose recipients and no booster dose recipients. ConclusionIn the study, we observed the prevalence of PCVS and was similar to long-term COVID; it declined over time and increased following booster immunization. Contrary to PCVS prevalence, QoL rises with time and falls after booster doses. There is no difference in the prevalence of PCVS and the quality of life among AZD1222® and BBV152®.

Neurectomy and Myomectomy for Treatment of Spasmodic Dysphonia.

Spasmodic dysphonia (SD) is a debilitating neurological disorder affecting the muscles of voice production. Sudden involuntary movements of the vocal folds lead to phonatory breaks and to forced, strained, and strangled voice quality in adductor SD, or breathy breaks in abductor SD. There is currently no cure for spasmodic dysphonia, and the gold standard for treatment is the injection of botulinum toxin in small amounts to the intrinsic laryngeal musculature.1 However, botulinum treatment requires periodic reinjection, produces vocal instability immediately after injection, lacks uniform results among patients, and patients can develop antibodies to botulinum toxin. Long-term or permanent symptom relief would be ideal. We present four patients with adductor and one patient with abductor spasmodic dysphonia who underwent neurectomy and myomectomy for treatment. The mean age was 64 years (age range 45-83). The mean duration of adductor spasmodic dysphonia was 11.8 years. The duration of abductor spasmodic was 4 years. All patients had previously been treated with voice therapy and botulinum toxin A. The mean duration of follow up was 1.7 years. Four patients had subjective and objective improvement after surgery. One patient had subjective improvement.

What is the Prevalence of Persistent Symptoms in Older Adults after Covid-19 Infection? A Cohort Study

Aim: To compare the prevalence of persistent symptoms between older and younger adults infected with COVID-19 at 6-8 weeks following infection (baseline) and at 6-12 months (follow-up). Methods: A cohort study from the post-COVID service at Alfred Hospital, Melbourne, Australia. Participants completed standardized surveys at 6-8 weeks following infection (younger = 870, and older = 311), and 6-12 months later (younger = 84, and older = 37). The measurements included dyspnoea (Modified Medical Research Council Dyspnoea Scale – mMRC), fatigue (Fatigue Assessment Scale - FAS), anxiety and depression (Hospital Anxiety and Depression Scale - HADS), post-traumatic stress disorder (The Impact of Events Scale-Revised - IES-R) and quality of life (QoL) (Euroqol-5D questionnaire - EQ-5D). Results: At baseline, older adults had a lower prevalence of dyspnoea (mMRC: 21% vs. 31%, p<0.01), depression (HADS-D: 9% vs 26%, p<0.01), anxiety (HADS-A: 16% vs 36%, p<0.01), extreme fatigue (FAS: 9% vs 39%, p<0.01), post-traumatic stress (IES-R: 12% vs 27%, p<0.01) and reported better QoL (EQ-5D-5L-VAS: 69±18 vs 57±22, p<0.01) compared to younger adults, At follow-up, older adults continued to report a lower prevalence of symptoms than younger adults for anxiety (HADS-A: 17% vs 36%, p=0.03), extreme fatigue (FAS: 9% vs 44%, p<0.01), and better QoL (EQ-5D-VAS, 66±23 vs 56±21, p=0.03). Conclusion: Older adults experience fewer short-and long-term COVID-19 symptoms. Future research should focus on developing targeted interventions tailored to different age groups.

Research progress of relationship in long-novel coronavirus syndrome and sarcopenia

At present, the major public health challenges caused by novel coronavirus infection have gradually subside. However, a large number of people are still suffering from long-novel coronavirus syndrome or post-novel coronavirus syndrome. The clinical manifestations of long coronavirus syndrome are related to multiple systems, such as respiratory, circulatory, nervous, digestive and musculoskeletal systems, with various long-term persistent symptoms after novel coronavirus infection. At the same time, the infection of the novel coronavirus is an important cause of frailty and sarcopenia in the elderly population. However, at present, the scholars have not paid enough attention to the skeletal muscle weakness caused by the novel coronavirus. Therefore, this paper focuses on the long-novel coronavirus syndrome and sarcopenia to explore the pathological mechanism of skeletal muscle attenuation caused by the SARS-CoV-2 mediated "cytokine storm", mitochondrial damage, hypoxia state and other links,so as to raise the attention of clinical and academic researchers and improve the clinical strategy of frailty and sarcopenia after novel coronavirus infection.

Evaluating the risk of sleep disorders in subjects with a prior COVID-19 infection.

Previous studies have reported a potential occurrence of sleep disorders in patients following a COVID-19 infection. However, these findings were based on surveys or retrospective studies with small sample sizes. This study examined if subjects with a previous COVID-19 infection in 2020 experienced sleep disorders in 2021. Using the 2019-2021 Utah All Payers Claims Database (APCD), adults (≥18 to 62 years old in 2019) covered by private insurance and Medicaid were identified. Sleep disorders were identified from the primary and secondary diagnosis in 2021. Baseline characteristics of subjects such as age, gender, race/ethnicity, type of insurance, and comorbid conditions were identified from the database. Entropy balancing was used to balance the baseline characteristics of subjects with and without a COVID-19 infection in 2020. Weighted logistic regression was used to identify significant factors that were associated with sleep disorders. A total of 413,958 subjects were included in the study. The average (SD) age was 38 (17) years old in 2019 and 58% were female. Among the subjects, about 39% had a COVID-19 infection in 2020. Those who had a COVID-19 infection in 2020 were 53% more likely to have a sleep disorder in 2021 (OR = 1.53; 95% Confidence Interval: 1.48-1.58). Sleep disorders could be one of long-term COVID-19 symptoms. More screening and observations for those who had a COVID-19 infection could be important to improve sleep related problems.

COVID-19 vaccine's long-term impact on neurological symptoms in Saudi Arabia

Objective: This study aimed to investigate the long-term neurological symptoms following COVID-19 vaccination in Saudi Arabia. Methods: A cross-sectional online survey was conducted from September to November 2023, collecting data from 847 participants who had received at least one dose of a COVID-19 vaccine. Results: The results revealed that the commonly reported symptoms were difficulty concentrating (37.4%, n=317), amnesia (32.8%, n=278), and insomnia (29.2%, n=247). Headaches (28.0%, n=237) had a higher significant association among females (76.4%, p-value

Impact on pulmonary, cardiac, and renal function and long-term quality of life after hospitalization for acute respiratory distress syndrome due to COVID-19: Protocol of the Post-COVID Brazil 3 study.

Evidence about long-term sequelae after hospitalization for acute respiratory distress syndrome due to COVID-19 is still scarce. To evaluate changes in pulmonary, cardiac, and renal function and in quality of life after hospitalization for acute respiratory distress syndrome secondary to COVID-19. This will be a multicenter case-control study of 220 participants. Eligible are patients who are hospitalized for acute respiratory distress syndrome due to COVID-19. In the control group, individuals with no history of hospitalization in the last 12 months or long-term symptoms of COVID-19 will be selected. All individuals will be subjected to pulmonary spirometry with a carbon monoxide diffusion test, chest tomography, cardiac and renal magnetic resonance imaging with gadolinium, ergospirometry, serum and urinary creatinine, total protein, and urinary microalbuminuria, in addition to quality-of-life questionnaires. Patients will be evaluated 12 months after hospital discharge, and controls will be evaluated within 90 days of inclusion in the study. For all the statistical analyses, p < 0.05 is the threshold for significance. The primary outcome of the study will be the pulmonary diffusing capacity for carbon monoxide measured after 12 months. The other parameters of pulmonary, cardiac, and renal function and quality of life are secondary outcomes. This study aims to determine the long-term sequelae of pulmonary, cardiac, and renal function and the quality of life of patients hospitalized for acute respiratory distress syndrome due to COVID-19 in the Brazilian population.

What patients tell us: Assessing feedback and perspectives of patients with post-treatment Lyme disease symptoms.

While most patients with Lyme disease fully recover within 6 months, a minority of patients develop significant and persistent symptoms after appropriate antibiotic treatment. With no clear pathophysiology or treatment, post-treatment Lyme disease (PTLDS) (also sometimes referred to as chronic Lyme) is a highly contested condition within the medical community. After conducting a phone survey of 25 patients who had visited an outpatient, academic center for Lyme and other tick-borne diseases, we collected and summarized patients’ perspectives and feedback of the care they received for ongoing Lyme-related symptoms. Findings from this phone survey demonstrated an extremely varied history with regards to experiences with diagnosis, treatment, and management of long-term symptoms. Key themes include a wide-ranging but life-altering self-reported symptomatology, pervasive doubts/frustrations in the medical system regarding treatment of PTLDS symptoms, and how often patients tried unconventional and nontraditional treatment methods. Importantly, patients were unified in their appreciation for an approachable and validating healthcare team even if they did not find complete resolution in their symptoms.

Síndrome Pós-COVID-19: investigação de sintomas fonoaudiológicos

ABSTRACT Purpose: to investigate speech-language-hearing symptoms in adults after the acute phase of COVID-19 and the impact of these persistent symptoms on their physical and emotional aspects, functional capacity, and social relationships. Methods: 204 adults who tested positive for COVID-19 between January 2021 and July 2022 and who completed an online questionnaire, addressing different variables. Data were analyzed with descriptive statistics. Results: the most prevalent symptoms up to 30 days after infection were tiredness (46%), memory loss (40.2%), and ageusia (26.5%). The most found long-term symptoms were memory loss (34.3%), tiredness (21.1%), and difficulties in starting a sentence or conversation (10.1%). Anosmia and ageusia were also cited. These persistent symptoms had an impact on their emotional aspect (33.3%), followed by the physical (26%) and occupational (25%) ones. Conclusion: this study found persistent symptoms after the acute phase of COVID-19, which can lead to speech-language-hearing disorders, such as impaired oral language and eating. These persistent symptoms impacted the participants’ emotional, physical, and occupational aspects.

Long-term psychiatric disorders in families of severe COVID-19 patients.

The present study aimed to describe in detail the changes to and assess the risk factors for poor long-term outcomes of psychiatric disorders in families of COVID-19 patients. A single-center, retrospective study using questionnaires. Family members of patients admitted to the intensive care unit (ICU) with severe COVID-19 participated. Psychiatric disorders refer to the psychological distress such as anxiety, depression, and posttraumatic stress disorder (PTSD) experienced by the patient's family. Forty-six family members completed the survey and were analyzed. Anxiety, depression, and PTSD occurred in 24%, 33%, and 2% of family members, respectively, and psychiatric disorders occurred in 39%. On multivariable analysis, living in the same house with the patient was independently associated with a lower risk of psychiatric disorders in families of COVID-19 patients (OR, 0.180; 95% CI, 0.036-0.908; p = 0.038). Furthermore, four family members overcame psychiatric disorders, and six family members newly developed psychiatric disorders during the one-year follow-up period. Approximately 40% of family members had long-term psychiatric disorders, and some of them overcame the psychiatric disorders, and some newly developed psychiatric disorders over the one-year follow-up. Living in the same house with the patient was possibly significantly associated with the reduction of long-term symptoms of psychiatric disorders, but this result must be interpreted with care. Further large studies are needed to examine the factors associated with the long-term mental status of family members.