Prevalence Of Persistent Symptoms Research Articles

Symptom burden, coagulopathy and heart disease, and quality of life at baseline and after 1-year follow-up following acute SARS-CoV-2 infection in a community medicine setting

Abstract Introduction Several studies assessing the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/COVID-19 on myocardial tissue through the medium of cardiac magnetic resonance (CMR) imaging have been published. These studies have generally been small or have focused on specific populations. The prevalence and severity of heart disease and coagulopathy in a community setting following recovery from severe COVID-19 infection are not well characterised. Purpose The aim of SETANTA (Study of HEarT DiseAse and ImmuNiTy After COVID-19 in Ireland) study was to investigate symptom burden and incidence of cardiac abnormalities after recovery from COVID-19 infection and correlate these results with immunological response, biomarkers of coagulation and quality of life. Methods The SETANTA study was a prospective, single-arm, cross-sectional study conducted in a community medicine setting. Patients with recent COVID-19 infection ≥ 6 weeks and ≤ 12 months before enrolment were enrolled. Primary outcomes of interest and inclusion/exclusion criteria are summarised in Figure 1. Results 100 patients were included in the study, 64% were female. Mean age was 45.2 years. The median (interquartile range) time interval between COVID-19 infection and enrolment was 189 [125, 246] days. 83% had at least one persistent symptom. 96% had positive serology for prior SARS-CoV-2 infection. CMR results are summarised in Figure 1. Late gadolinium enhancement and pericardial effusion was present in 2.2% and 8.3% respectively; left ventricular ejection fraction was below the normal reference limit in 17.4% of patients. Von Willebrand factor antigen was elevated in 32.7% of patients. Fibrinogen and D-Dimer levels were raised in 10.2% and 11.1% of patients, respectively. In total 99, 100 and 97 patients completed their 1, 6 and 12-month telephone follow-ups respectively. There were no significant serious adverse events reported at 6-months follow-up; one case of hospitalization for 7 nights for fever of unknown origin was reported at 12 months. All 100 patients completed their modified version of SAQ7 (Seattle Angina Questionnaire, short form) and EQ-5D-5L (EuroQol 5-dimension 5 level) questionnaires at baseline, while 75 and 72 patients, respectively, completed both their questionnaires at 6- and 12-month follow-up timepoints; responses are displayed as Figure 2 (SAQ7 as Panel A, and EQ-5D-5L as Panel B) and show improvement over time in terms of symptoms as well as quality of life though the follow-up period. Conclusions In a cohort of primary practice patients recently recovered from SARS-CoV-2 infection, prevalence of persistent symptoms and markers of abnormal coagulation were high, despite a lower frequency of abnormalities on cardiac MRI compared with prior reports of patients assessed in a hospital setting. Symptom burden improved over time and there were no major adverse events during follow-up to 1 year.Figure 1.Figure 2.

Prevalence and risk factors for long COVID and post-COVID-19 condition in Africa: a systematic review

An improved estimation of the clinical sequelae of SARS-CoV-2 infection is crucial in African countries, where the subject has received little attention despite more than 12 million reported cases and evidence that many more people were infected. We reviewed the evidence on prevalence, associated risk factors for long COVID, and systemic or sociocultural determinants of reporting long COVID. We conducted a systematic review, searching PubMed, the Living OVerview of Evidence platform, and grey literature sources for publications from Dec 1, 2019, to Nov 23, 2022. We included articles published in English, French, Spanish, or Portuguese that reported on any study type in Africa with participants of any age who had symptoms for 4 weeks or more after an acute SARS-CoV-2 infection. We excluded secondary research, comments, and correspondence. Screening and data extraction were performed by two reviewers. Summary estimates were extracted, including sociodemographic factors, medical history, prevalence of persistent symptoms, and symptoms and associated factors. Results were analysed descriptively. The study was registered on the Open Science Framework platform. Our search yielded 294 articles, of which 24 peer-reviewed manuscripts were included, reporting on 9712 patients from eight African countries. Only one study exclusively recruited children, and one other study included children as part of their study population. Studies indicated moderate to low risk of bias. Prevalence of long COVID varied widely, from 2% in Ghana to 86% in Egypt. Long COVID was positively associated with female sex, older age, non-Black ethnicity, low level of education, and the severity of acute infection and underlying comorbidity. HIV and tuberculosis were not identified as risk factors. Factors influencing reporting included absence of awareness, inadequate clinical data and diagnostics, and little access to health-care services. In Africa, research on long COVID is scarce, particularly among children, who represent the majority of the population. However, existing studies show a substantial prevalence across settings, emphasising the importance of vaccination and other prevention strategies to avert the effects of long COVID on individual wellbeing, the increased strain on health systems, and the potential negative effects on economically vulnerable populations. At a global level, including African countries, tools for research on long COVID need to be harmonised to maximise the usefulness of the data collected. None.

Prevalence of persistent symptoms in patients with COVID-19 followed by the telemedicine area of ​​the Hospital de Clínicas of San Lorenzo

Introducción: con la evolución de la pandemia de COVID-19 se observó que esta infección se comporta como un iceberg: en el vértice se ubican las complicaciones en el contexto de la infección aguda y en la base se van acumulando aquellos síntomas que persisten en el tiempo e impiden al paciente su recuperación total. Objetivo: determinar la prevalencia de síntomas persistentes en pacientes diagnosticados con COVID-19 seguidos por el área de telemedicina del Departamento de Control de Infecciones del Hospital de Clínicas, San Lorenzo, Paraguay, durante el periodo agosto 2020- abril 2021. Metodología: se aplicó un diseño estudio observacional, descriptivo, retrospectivo de corte transversal, con muestreo no probabilístico de casos consecutivos. Se incluyeron 236 cuestionarios digitales de pacientes seguidos por el área de telemedicina entre agosto 2020 y abril 2021. Resultados: la edad media fue 36± 10 años, 71,2% fue del sexo femenino. El 61% de los pacientes provenía del Departamento Central y 58,9% fue personal de blanco. El 29,7% padecía de obesidad. El 86,9% presentó un cuadro leve. Presentaron síntomas persistentes el 66,9% siendo la fatiga la más común (66,5%) y los síntomas duraron menos de tres meses en 55%. Conclusiones: la edad promedio muestra mayoría de población joven, sobre todo mujeres y procedentes del Departamento Central. Más de la mitad califican como personal de blanco, la mayoría fueron obesos, casi todos presentaron un cuadro de COVID-19 leve y el síntoma persistente más frecuente fue la fatiga con una duración de menos que 3 meses.

Trial in progress: PREPARE—Exploring the activity of pseudoephedrine in treating retrograde ejaculation following retroperitoneal lymph node dissection (RPLND) in survivors of testicular cancer (TC).

TPS432 Background: Retrograde ejaculation is a known complication of RPLND occurring due to interruption of sympathetic nerve fibres intraoperatively. Whilst common immediately after surgery, the prevalence of persistent symptoms, and impact on health-related quality-of-life (HRQoL) in TC survivors is unknown. Whilst few effective treatments are available, alpha-sympathomimetics such as pseudoephedrine may form a viable treatment option due to effects on bladder neck constriction at sexual climax propagating antegrade ejaculation. Existing studies have shown pseudoephedrine may be helpful in individuals with retrograde ejaculation; however, these studies have only included a small number (n=5) of patients following RPLND. Methods: In a two-part, single-arm phase 2 clinical trial, participants with a history of TC receiving follow-up after RPLND at least >6 months prior will be invited to participate. In part A (ACTRN12622000537752), eligible participants complete questionnaires regarding survivorship issues including sexual function and fertility to explore the prevalence of retrograde ejaculation and HRQoL. Questionnaires include EORTC QLQ-C30, sexual function items from EORTC QLQ-TC26, Brief Male Sexual Function Inventory and tailored questions focusing on retrograde ejaculation. 15 out of a planned 50 participants (30%) have been enrolled and completed questionnaires. If retrograde ejaculation is reported, eligible participants are invited to enrol in Part B (ACTRN12622000542796), where if the participant has no contraindications to pseudoephedrine, nor are they receiving testosterone replacement and retrograde ejaculation is confirmed during screening, they receive a short course of pseudoephedrine hydrochloride. Pseudoephedrine will be given 60mg QID for one-day, followed by 60mg 4 hours and 1 hour prior to ejaculation to evaluate changes in ejaculation volume, sperm count within (any) antegrade ejaculate and within the post-ejaculatory urine. The primary endpoint is total sperm count in antegrade ejaculate of at least 39 million (5th centile) following treatment. We assumed that pseudoephedrine is ineffective if <10% of participants achieve a normal sperm count in antegrade ejaculate after treatment. Using an exact binomial power analysis for a one-sample proportion test, a sample size of 25 participants provides >80% power to detect 36% (9 out of 25) of participants achieving a normal sperm count against a reference proportion of 10% at the 0.05 significance level. 4 out of a planned 30 participants (16%) have been enrolled. All participants with retrograde ejaculation will be invited to an optional, semi-structured interview to further evaluate impact(s) of retrograde ejaculation on issues around sexual health, relationships, body image and masculinity. Clinical trial information: ACTRN12622000537752 , ACTRN12622000542796 .

The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis.

The aim of this study was to systematically synthesise the global evidence on the prevalence of persistent symptoms in a general post COVID-19 population. A systematic literature search was conducted using multiple electronic databases (MEDLINE and The Cochrane Library, Scopus, CINAHL, and medRxiv) until January 2022. Studies with at least 100 people with confirmed or self-reported COVID-19 symptoms at ≥28 days following infection onset were included. Patient-reported outcome measures and clinical investigations were both assessed. Results were analysed descriptively, and meta-analyses were conducted to derive prevalence estimates. This study was pre-registered (PROSPERO-ID: CRD42021238247). 194 studies totalling 735,006 participants were included, with five studies conducted in those <18 years of age. Most studies were conducted in Europe (n=106) or Asia (n=49), and the time to follow-up ranged from ≥28 days to 387 days. 122 studies reported data on hospitalised patients, 18 on non-hospitalised, and 54 on hospitalised and non-hospitalised combined (mixed). On average, at least 45% of COVID-19 survivors, regardless of hospitalisation status, went on to experience at least one unresolved symptom (mean follow-up 126 days). Fatigue was frequently reported across hospitalised (28.4%; 95% CI 24.7%-32.5%), non-hospitalised (34.8%; 95% CI 17.6%-57.2%), and mixed (25.2%; 95% CI 17.7%-34.6%) cohorts. Amongst the hospitalised cohort, abnormal CT patterns/x-rays were frequently reported (45.3%; 95% CI 35.3%-55.7%), alongside ground glass opacification (41.1%; 95% CI 25.7%-58.5%), and impaired diffusion capacity for carbon monoxide (31.7%; 95% CI 25.8%-3.2%). Our work shows that 45% of COVID-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at ∼ 4 months. Current understanding is limited by heterogeneous study design, follow-up durations, and measurement methods. Definition of subtypes of Long Covid is unclear, subsequently hampering effective treatment/management strategies. No funding.

Prevalence of persistent symptoms at least 1 month after SARS-CoV-2 Omicron infection in adults.

Persistent post-COVID-19 symptoms pose an important health care burden. The Omicron variant has rapidly spread across the world and infected millions of people, largely exceeding previous variants. The potential for many of these people to develop persistent symptoms is a major public health concern. The aim of this study was to determine the prevalence and risk factors of post-COVID-19 symptoms associated with Omicron. We conducted a single-centre prospective observational study in Quebec, Canada, between December 2021 and April 2022. Participants were adults enrolled in the Biobanque Québécoise de la COVID-19 (BQC19). Cases were considered Omicron cases as more than 85% were estimated to be attributable to Omicron variant during that period. Adults with polymerase chain reaction (PCR)-confirmed COVID-19 were recruited at least 4 weeks after the onset of infection. Of 1,338 individuals contacted, 290 (21.7%) participants were recruited in BQC19 during that period. Median duration between the initial PCR test and follow-up was 44 days (IQR 31-56 d). A total of 137 (47.2%) participants reported symptoms at least 1-month post-infection. The majority (98.6%) had a history of mild COVID-19 illness. Most common persistent symptoms included fatigue (48.2%), shortness of breath (32.6%), and cough (24.1%). Number of symptoms during acute COVID-19 was identified as a risk factor for post-COVID-19 symptoms (OR 1.07 [95% CI 1.03% to 1.10%] p = 0.009). This is the first study reporting the prevalence of post-COVID-19 symptoms associated with Omicron in Canada. These findings will have important implications for provincial services planning.

Persistent symptoms, quality of life, and risk factors in long COVID: a cross-sectional study of hospitalized patients in Brazil

ObjectivesCOVID-19 has been associated with long-term consequences to patient wellness and quality of life. Data on post-COVID-19 conditions are scarce in developing countries. This study aimed to investigate long COVID in a cohort of hospitalized patients in Brazil. MethodsSurviving patients discharged from the hospital between July 1, 2020 and March 31, 2021 were assessed between 2 and 12 months after acute onset of COVID-19. The outcomes were the prevalence of persistent symptoms, risk factors associated with long COVID, and quality of life as assessed by the EuroQol 5D-3L questionnaire. ResultsOf 439 participants, most (84%) reported at least one long COVID symptom, at a median of 138 days (interquartile range [IQR] 90-201) after disease onset. Fatigue (63.1%), dyspnea (53.7%), arthralgia (56.1%), and depression/anxiety (55.1%) were the most prevalent symptoms. In multivariate analysis, dysgeusia (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.18-3.44, P <0.001) and intensive care unit (ICU) admission (OR 2.6, 95% CI 1.19-6.56, P = 0.03) were independently associated with long COVID. Fifty percent of patients reported a worsened clinical condition and quality of life. ConclusionLong-term outcomes of SARS-CoV-2 infection in a low- to middle-income country were relevant. Fatigue was the most common persistent symptom. ICU admission was an independent factor associated with long COVID. Dysgeusia could be a potential predictor of long COVID.

High Prevalence of Both Previous Infection with SARS-CoV-2 and Persistent Symptoms.

Universities are unique settings with large populations, congregate housing, and frequent attendance of events in large groups. However, the current prevalence of previous COVID-19 infection in university students, including symptomatic and asymptomatic disease, is unknown. Our goal therefore was to determine the prevalence of previous infection, risk factors for infection, and the prevalence of persistent symptoms following infection among university students. This was a cross-sectional study set in a large public university between January 22 and March 22, 2021. We surveyed students about demographics, risk factors, and symptoms, and simultaneously tested their saliva for IgA antibodies to SARS-CoV-2. To estimate the prevalence of previous infection we adjusted our intentional sample of a diverse student population for year in school and age to resemble the composition of the entire student body and adjusted for the imperfect sensitivity and specificity of the antibody test. Univariate and multiple regression analysis was used to identify independent risk factors for infection, and the proportion of students with persistent symptoms following acute infection was determined. A total of 488 students completed the survey, 432 had a valid antibody result, and 428 had both. The estimated prevalence of previous infection for 432 participants with valid antibody results was 41%. Of 145 students in our sample with a positive antibody test, 41.4% denied having a previous positive polymerase chain reaction (PCR) test for SARS-CoV-2 and presumably had an asymptomatic infection; in our adjusted analysis we estimate that approximately 2-thirds of students had asymptomatic infections. Independent risk factors for infection included male sex, having a roommate with a known symptomatic infection, and having two or fewer roommates. More frequent attendance of parties and bars was a univariate risk factor, but not in the multiple regression analysis. Of 122 students reporting a previous symptomatic infection, 14 (11.4%) reported persistent symptoms consistent with postacute COVID-19 a median of 132 days later. Previous COVID-19 infection, both symptomatic and asymptomatic, was common at a large university. Measures that could prevent resurgence of the infection when students return to campus include mandatory vaccination policies, mass surveillance testing, and testing of sewage for antigen to SARS-CoV-2.

PERSISTENCE OF SYMPTOMS AFTER COVID INFECTIONAMONG HEALTHCARE PROFESSIONALS: A CROSS SECTIONAL STUDY

Introduction: The symptomatology associated with covid-19 infection has been well described throughout the literature, however little data exists on the persistence of symptoms post the initialrecovery. Material and method: This is a descriptive cross-sectional observational study whose objectives were to determine the prevalence of persistent symptoms and to evaluate the quality-of-lifeamong health professionals diagnosedwith covid-19 in the Souss Massa region in September 2021. Results:One hundred and eighty-three healthcare professionals were included in the study, 123 (67%) of whom were women. The mean age was 35 ± 11 years with a range of 22 to 60 years. The main comorbidities were obesity, asthma and dysthyroidism. Participants with covid-19 infection were symptomatic 82% (152 cases) of the time and were evaluated on average 40 days after the onset of the first symptom. At the time of evaluation, 30% (54 cases) were completely cured, however 70% (129 cases) of participants maintained at least one chronic symptom. Of these symptoms, 59% (108 cases) reported fatigue, 28.4% (52 cases) cough, 18.6% (34 cases) headache and 22% (40 cases) anosmia. In addition, a decrease in quality of life was observed among 29% (53 cases) of the participants. Conclusion: Covid-19 can lead to prolonged illness and persistent symptoms, even among young adults and individuals with no or few comorbidities who have not been hospitalized. The persistence of symptoms impacts ones quality of life, both physically and mentally, which supports the need for regular assessment and monitoring of individuals post covid-19 recovery.

Concerns about the external validity of the study 'prevalence of persistent symptoms after treatment for Lyme borreliosis: A prospective observational cohort study'-authors´ reply.

Concerns about the external validity of the study 'prevalence of persistent symptoms after treatment for Lyme borreliosis: A prospective observational cohort study'-authors´ reply.

Concerns about the external validity of the study 'Prevalence of persistent symptoms after treatment for Lyme borreliosis: A prospective observational cohort study'.

Concerns about the external validity of the study 'Prevalence of persistent symptoms after treatment for Lyme borreliosis: A prospective observational cohort study'.

The Prevalence of Persistent Symptoms After COVID-19 Disease.

The Prevalence of Persistent Symptoms After COVID-19 Disease.

Symptom Frequency and Persistence in the First Year after Traumatic Brain Injury: A TRACK-TBI Study.

Symptom endorsement after traumatic brain injury (TBI) is common acutely post-injury and is associated with other adverse outcomes. Prevalence of persistent symptoms has been debated, especially in mild TBI (mTBI). A cohort of participants ≥17 years with TBI (n = 2039), 257 orthopedic trauma controls (OTCs), and 300 friend controls (FCs) were enrolled in the TRACK-TBI study and evaluated at 2 weeks and 3, 6, and 12 months post-injury using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). TBI participants had significantly higher symptom burden than OTCs or FCs at all times, with average scores more than double. TBI cases showed significant decreases in RPQ score between each evaluation (p < 0.001), decreasing ∼1.7 points per month between 2 weeks and 3 months and 0.2 points per month after that. More than 50% of the TBI sample, including >50% of each of the mild and moderate/severe TBI subsamples, continued to endorse three or more symptoms as worse than pre-injury through 12 months post-injury. A majority of TBI participants who endorsed a symptom at 3 months or later did so at the next evaluation as well. Contrary to reviews that report symptom resolution by 3 months post-injury among those with mTBI, this study of participants treated at level 1 trauma centers and having a computed tomography ordered found that persistent symptoms are common to at least a year after TBI. Additionally, although symptom endorsement was not specific to TBI given that they were also reported by OTC and FC participants, TBI participants endorsed over twice the symptom burden compared with the other groups.

T4+T3 Combination Therapy: An Unsolved Problem of Increasing Magnitude and Complexity.

Thyroxine (T4)+triiodothyronine (T3) combination therapy can be considered in case of persistent symptoms despite normal serum thyroid stimulating hormone in levothyroxine (LT4)-treated hypothyroid patients. Combination therapy has gained popularity in the last two decades, especially in countries with a relatively high gross domestic product. The prevalence of persistent symptoms has also increased; most frequent are complaints about energy levels and fatigue (80% to 90%), weight management (70% to 75%), memory (60% to 80%), and mood (40% to 50%). Pathophysiological explanations for persistent problems are unrealistic patient expectations, comorbidities, somatic symptoms, related disorders (Diagnostic and Statistical Manual of Mental Disorders [DSM-5]), autoimmune neuroinflammation, and low tissue T3. There is fair circumstantial evidence for the latter cause (tissue and specifically brain T3 content is normalized by T4+T3, not by T4 alone), but the other causes are viewed as more relevant in current practice. This might be related to the ‘hype’ that has emerged surrounding T4+T3 therapy. Although more and better-designed trials are needed to validate the efficacy of T4+T3 combination, the management of persistent symptoms should also be directed towards alternative causes. Improving the doctor-patient relationship and including more and better information is crucial. For example, dissatisfaction with the outcomes of T4 treatment for subclinical hypothyroidism can be anticipated as recent trials have demonstrated that LT4 is hardly effective in improving symptoms associated with subclinical hypothyroidism.

Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)-A systematic review and meta-analysis.

There is an established literature on the symptoms and complications of COVID‐19 but the after‐effects of COVID‐19 are not well understood with few studies reporting persistent symptoms and quality of life. We aim to evaluate the pooled prevalence of poor quality of life in post‐acute COVID‐19 syndrome (PCS) and conducted meta‐regression to evaluate the effects of persistent symptoms and intensive care unit (ICU) admission on the poor quality of life. We extracted data from observational studies describing persistent symptoms and quality of life in post‐COVID‐19 patients from March 10, 2020, to March 10, 2021, following PRISMA guidelines with a consensus of two independent reviewers. We calculated the pooled prevalence with 95% confidence interval (CI) and created forest plots using random‐effects models. A total of 12 studies with 4828 PCS patients were included. We found that amongst PCS patients, the pooled prevalence of poor quality of life (EQ‐VAS) was (59%; 95% CI: 42%–75%). Based on individual factors in the EQ‐5D‐5L questionnaire, the prevalence of mobility was (36, 10–67), personal care (8, 1–21), usual quality (28, 2–65), pain/discomfort (42, 28–55), and anxiety/depression (38, 19–58). The prevalence of persistent symptoms was fatigue (64, 54–73), dyspnea (39.5, 20–60), anosmia (20, 15–24), arthralgia (24.3, 14–36), headache (21, 3–47), sleep disturbances (47, 7–89), and mental health (14.5, 4–29). Meta‐regression analysis showed the poor quality of life was significantly higher among post‐COVID‐19 patients with ICU admission (p = 0.004) and fatigue (p = 0.0015). Our study concludes that PCS is associated with poor quality of life, persistent symptoms including fatigue, dyspnea, anosmia, sleep disturbances, and worse mental health. This suggests that we need more research on PCS patients to understand the risk factors causing it and eventually leading to poor quality of life.

Long-term clinical follow-up of patients suffering from moderate-to-severe COVID-19 infection: a monocentric prospective observational cohort study

ObjectivesVarious symptoms and considerable organ dysfunction persist following infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Uncertainty remains about the potential mid- and long-term health sequelae. This prospective study of patients hospitalized with coronavirus disease 2019 (COVID-19) in Liège University Hospital, Belgium aimed to determine the persistent consequences of COVID-19.MethodsPatients admitted to the University Hospital of Liège with moderate-to-severe confirmed COVID-19, discharged between 2 March and 1 October 2020, were recruited prospectively. Follow-up at 3 and 6 months after hospital discharge included demographic and clinical data, biological data, pulmonary function tests (PFTs) and high-resolution computed tomography (CT) scans of the chest.ResultsIn total, 199 individuals were included in the analysis. Most patients received oxygen supplementation (80.4%). Six months after discharge, 47% and 32% of patients still had exertional dyspnoea and fatigue. PFTs at 3-month follow-up revealed a reduced diffusion capacity of carbon monoxide (mean 71.6 ± 18.6%), and this increased significantly at 6-month follow-up (P<0.0001). Chest CT scans showed a high prevalence (68.9% of the cohort) of persistent abnormalities, mainly ground glass opacities. Duration of hospitalization, intensive care unit admission and mechanical ventilation were not associated with the persistence of symptoms 3 months after discharge.ConclusionThe prevalence of persistent symptoms following hospitalization with COVID-19 is high and stable for up to 6 months after discharge. However, biological, functional and iconographic abnormalities improved significantly over time.

The Frequency of Persistent Symptoms after Acute COVID-19 among Iraqi Patients

Background: Post–coronavirus disease 2019 (COVID-19) symptoms tend to persist in many survivors of COVID-19. Objectives: To find out the prevalence of persistent symptoms that continue to appear after the eradication of the COVID-19 infection among Iraqi survivors. We hypothesized that wearing a mask during the COVID-19 pandemic may lead to a lesser viral load in an individual who gets infected, thereby leading to milder symptoms and manifestations. Materials and Methods: Overall, 70 consecutive Iraqi patients diagnosed with COVID-19 during the period from early August to late September 2020 were enrolled in the study, and on a mean of 31 days after recovery, they were assessed for persistent symptoms after the acute COVID-19 infection. Results: The mean age ± SD was 40.5 ± 16.1 years old. On a mean of 31 days post-COVID-19 recovery, 91.4% of all the patients had at least one persistent symptom. The most common persistent symptoms recorded were fatigue (42.9%), dyspnea (32.8%), and chest pain (25.7%). There was a statistically significant difference (P = 0.002) among patients with hypertension, among whom 45.5% had persistent palpitation. Among patients with ischemic heart disease, 25% had constant chest pain, and 37.5% complained of palpitation post-recovery. Patients who had used masks before infection (85.4%) were managed at home, and they did not require hospitalization. Overall, 45.7% of those dyspneic during the infection period were still complaining of exertional dyspnea post-recovery (P = 0.041). Conclusion: A large proportion of the Iraqi patients with COVID-19 infection had persistent symptoms after recovery. The use of a mask before infection showed mild symptoms during the acute phase, and hospitalization or oxygen therapy was not indicated for them.

Persistent Symptoms in Non-critical COVID-19 Patients at Two Months Follow-Up in a District Hospital: A Descriptive Cross-sectional Study.

The corona virus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 belonging to corona viruses which are enveloped positive stranded RNA viruses. Non-critical coronavirus disease 2019 patients often lack follow up visits which has led to incomplete understanding of disease process. The aim of this study was to find out the prevalence of persistent symptoms in such patients during two months follow-up to a district hospital. This descriptive cross-sectional study was conducted in a district hospital from September 2020 to February 2021 among non-critical corona virus disease 2019 patients admitted to the isolation center of Nepal. Ethical approval was taken from the ethical review board of Nepal Health Research Council (reference number: 1707). Convenience sampling was done. Data was collected using a structured questionnaire. Data analysis was done using Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Out of 132 patients, 66 (50%) (41.5-58.5 at 95% Confidence Interval) patients had persistent symptoms at two-month follow-up. Forty-eight (36.4%) patients showed one symptom, 15 (11%) had two symptoms, and 3 (2%) had two or more symptoms. The most frequent symptom reported was fatigue in 17 (13%), cough in 15 (11%), myalgia in 9 (7%), and headache in 9 (7%). The prevalence of persistent symptoms at two months follow up in our study was lower than findings from other international studies.

Prevalence of persistent symptoms after treatment for lyme borreliosis: A prospective observational cohort study.

SummaryBackgroundConcerns about long-lasting symptoms attributed to Lyme borreliosis (LB) are widespread in the Western world, while such symptoms are highly prevalent in the general population.MethodsIn the largest prospective study to date, adults with physician-confirmed LB were included at the start of antibiotic treatment. Primary outcomes, prevalence of persistent symptoms and symptom severity, were assessed using three-monthly standardised questionnaires during one year. Persistent symptoms were defined as impaired scores for fatigue (CIS, subscale fatigue), cognitive impairment (CFQ) or pain (SF-36, subscale bodily pain) ≥6 months, with onset <6 months. Outcomes were compared with a longitudinal general population and a tick-bite cohort without LB as a reference.FindingsOf 1135 LB patients (94•8% erythema migrans, 5•2% disseminated LB), 1084 fulfilled primary analysis criteria, as well as 1942 population and 1887 tick-bite controls. Overall prevalence of persistent symptoms in LB patients was 27•2% (95%CI, 24•7%-29•7%); 6•0% and 3•9% higher than in population (21•2%, 95%CI, 19•3%-23•1%; p < 0•0001) and tick-bite (23•3%, 95%CI 21•3%-25•3%; p = 0•016) cohorts, respectively. At 12 months, fatigue, cognitive impairment, and pain were significantly more severe in erythema migrans patients than in reference cohorts, while in disseminated LB patients, only pain was more severe.InterpretationIn treated LB patients, persistent symptoms were significantly more prevalent and symptoms were more severe than in individuals without LB, although the background prevalence was substantial. This suggests an association, either direct or indirect, between persistent symptoms and LB in a relatively small subset of patients.FundingZonMw; Dutch Ministry of Health, Welfare and Sport.

Long-term Outcomes of Children with Gastroesophageal Reflux Disease Who Underwent Fundoplication: A Single Center Experience

Background: Fundoplication is indicated in patient with gastroesophageal reflux disease ( GERD ) who need long-term medication, fail to response to optimal medication therapy, or have life-threatening complication. Objective: To evaluate the outcome of GERD patients at 12 months after fundoplication. Materials and Methods : This retrospective study includes children who were diagnosed GERD and underwent fundoplication between January 2006 and December 2018 at King Chulalongkorn Memorial Hospital. Studied outcomes were the need of antireflux medications, prevalence of persistent symptoms, GERD-related hospitalization rate, re-operation rate, and mortality rate at 12 months after fundoplication. Results: Overall, 59 patients (49% male) were included in the study. The median age [IQR] at the time of GERD diagnosis and fundoplication was 11 [5-48] and 18 [8 - 66] months, respectively. All children had comorbid conditions, the most common of which was neurological impairment ( n=48, 81% ). Fifty-seven and 2 patients underwent Nissen and Thal fundoplication, respectively. At 12-month follow-up, 30 ( 51% ) were prescribed antireflux medications and 25 ( 42% ) had persistent GERD symptoms. The median [IQR] hospitalization rate was 2.5 [2-3] times/year. Only 1 ( 1.7% ) patient, who had esophageal atresia and tracheoesophageal fistula, underwent reoperation due to fundoplication disruption. There were 9 deaths (15.3%). Causes of death were GERD-related aspiration pneumonia ( n=1 ) , sepsis ( n=5 ) , hospital-acquired pneumonia ( n=2 ) , and recurrent ependymoma ( n=1 ) . Conclusion: Most patients with GERD who have comorbid conditions have persistent symptoms and need continuing antireflux medications after fundoplication. Therefore, long-term follow-up of GERD patients following fundoplication is essential, particularly those at risk of a high failure rate of fundoplication.