COVID-19 Survivors Research Articles

Keep Spirit, Even Though Covid-19 is in Your Life (Phenomenological Study on Covid-19 Survivors in Malang City)

Covid-19 is a disease that attacks the human respiratory system. The condition is caused by a virus called SARS-CoV-2, which is characterized by cough, fever, fatigue, and loss of smell. This study aims to understand the life journey of COVID-19 survivors, how they can survive in difficult times and what are the underlying things using a phenomenological approach. In conducting qualitative phenomenological research, four processes are passed: phone, phenomenological reduction, imaginative variation, and synthesis of meaning. In analyzing and interpreting the data by bracketing, horizontal exploring, meaning unit to get a structural description, innovative take to get a structural elucidation, and combining it to make a universal meaning and represent the respondent's experience. The selection of respondents using purposive sampling with the number of subjects three new students. The data collection instrument used a tape recorder with in-depth interview data collection techniques. The results of this study state that there are various ways that respondents have done in dealing with the covid-19 pandemic for themselves and their families, there is motivation as encouragement in themselves to be able to recover from the coronavirus, the role of the family as an emotional boost for respondents to achieve recovery, and still the lack of knowledge possessed by the community related to the transmission of the coronavirus and health protocols which resulted in a miss perception of covid survivors

General and orofacial symptoms associated with acute and long COVID in 80- and 90-year-old Swedish COVID-19 survivors

ObjectivesTo describe acute and long COVID-19 symptoms among older elderly Swedes and to find predictive factors for the development symptoms associated with acute and long COVID. Material and methodsA questionnaire about general and oral health was mailed to all 80-year-olds (born 1942, n = 6299) and 90-year-olds (born 1932, n = 1904) in two Swedish counties. Participants reporting COVID-19 were asked to complete an additional questionnaire. ResultsOverall response rate was 66 % (n = 5375). Affirmative responses to having been sick/tested positive for COVID-19 were reported by 577 persons. Response rate to the COVID-19 questionnaire was 49 %. The majority (88 %) reported some general symptoms during the acute stage while 44 % reported orofacial symptom/s. Reporting of any form of long-COVID general symptoms was 37 and 35 % for orofacial symptoms. Predictive factors for contracting COVID-19 (based on self-report from 2017) were living in elderly housing/senior care facility (OR 1.6, CI 1.0–2.3), large number (>10) of weekly social contacts (OR 1.5, CI 1.3–1.9), being married (OR 1.4, CI 1.1–1.7) and high school/university education (OR 1.3 CI 1.1–1–6). The highest odds ratio for general symptoms of long-COVID were a single complete denture (OR 5.0, CI 2.0–12.3), reporting bad breath (OR 3.7, CI 1.9–7.2) and daytime dry mouth (OR 2.2, CI 1.1–4.2). Regarding long-COVID orofacial symptoms, the highest risk factors were bad breath (OR 3.8, CI 1.9–7.5) and a single complete denture in one jaw (OR 3.4, CI 1.2–9.8). ConclusionLong-COVID general and orofacial symptoms are common among older elderly COVID-19 survivors Clinical significanceOral microorganisms may be responsible for development of long-COVID symptoms. Health personnel managing COVID-19 patients should carefully examine dental status, especially in those having acrylic-based removable dentures, for oral signs and symptoms. If found, rigorous oral hygiene procedures should be carried out including cleaning/disinfection of the denture.

Illness Experiences of Brazilian People Who Were Hospitalized Due to COVID-19 and Faced Long COVID Repercussions in Their Daily Life: A Constructivist Grounded Theory Study.

Long COVID is a multisystem condition that has multiple consequences for the physical, mental, and social health of COVID-19 survivors. The impact of the long COVID condition remains unclear, particularly among middle-aged and older adults, who are at greater risk than younger people of persisting symptoms associated with COVID-19. Therefore, we aimed to understand the experiences of middle-aged and older people who had been hospitalized for COVID-19 and the repercussions of long-term COVID symptoms in their daily lives. A qualitative study was carried out, adopting the framework of the constructivist grounded theory (CGT) proposed by Kathy Charmaz. Fifty-six middle-aged and older adult participants from the southern region of Brazil were recruited. Data were gathered from semi-structured telephone interviews. Concomitantly a comparative analysis was performed to identify categories and codes using the MaxQDA® software (version 2022). Three subcategories were identified: (1) experiencing COVID-19 in the acute phase; (2) oscillating between 'good days' and 'bad days' in long COVID; and (3) (re)constructing identity. These concepts interact with each other and converge upon the central category of this study: recasting oneself to the uniqueness of the illness experience of long COVID. Our findings provided insights related to the disruption in the lives of long COVID-19 sufferers who still live with persistent symptoms of the disease, including physical, social, family, emotional and spiritual repercussions. Likewise, this study may aid in developing friendly and welcoming social environments, lowering stigma and prejudice towards patients with long COVID, and fostering prompt and suitable policy support and mental health care for these individuals.

Exploring the Psychosocial Impacts on COVID-19 Survivors: A Qualitative Study of Life after COVID-19 Diagnosis and Quarantine in South Korea

COVID-19 infection and subsequent quarantine experiences during the pandemic may have profoundly affected many aspects of life among COVID-19 survivors. However, limited research has explored the changes these survivors experienced once they returned to their daily lives. This study aimed to explore COVID-19 survivors’ psychosocial impacts and their lives following infection and social quarantine during the initial phase of the pandemic in South Korea. Semistructured telephone interviews were conducted in June 2021, involving 15 COVID-19 survivors. All participants contracted COVID-19 between February 2020 and April 2021 in South Korea. This study used a qualitative methodology from phenomelogical perspectives to explore and understand the participants’ shared lived experiences. Thematic analysis identified four overarching themes and 12 subthemes among Korean COVID-19 survivors: (a) self-concept transformation; (b) changed relationship dynamics; (c) life perspective shifts; and (d) health awareness evolution. Recognizing the life changes experienced by COVID-19 survivors can inform the development of targeted peer support services and person-centered education. Focusing on health awareness and empowerment, these initiatives can promote personal growth, facilitate positive changes, and alleviate traumatic experiences for future survivors of diverse infectious diseases. Future research could investigate the long-term impact of COVID-19 on individuals’ lives and explore the mechanisms underlying these effects.

MALNUTRITION IN COVID-19 SURVIVORS: PREVALENCE AND RISK FACTORS

Abstract Nutritional status is a critical factor throughout COVID-19 disease course. Malnutrition is associated with poor outcomes in hospitalized COVID-19 patients. The aim of our study is to assess the prevalence of malnutrition and identify its risk factors in COVID-19 survivors. Study cohort included 1230 COVID-19 survivors aged 18-86 attending a post-COVID-19 outpatient service. Data on clinical parameters, anthropometry, acute COVID-19 symptoms, lifestyle habits were collected through a comprehensive medical assessment. Malnutrition was assessed according to Global Leadership Initiative on Malnutrition (GLIM) criteria. Our results showed that the prevalence of malnutrition was 22% at 4-5 months after acute disease. Participants who were not hospitalized during acute COVID-19 showed a higher rate of malnutrition compared to those who needed hospitalization (26% versus 19%, p< 0.01). Malnutrition was diagnosed in 25% COVID-19 survivors over 65 years of age compared to 21% younger participants (p< 0.01). After multivariable adjustment, the likelihood of being malnourished increased progressively and independently with advancing age (Odds ratio [OR] 1.02; 95% CI 1.01–1.03) and in male participants (OR 5.56; 95% CI 3.53–8.74). Malnutrition was associated with loss of appetite (OR 2.50; 95% CI 1.73–3.62), and dysgeusia (OR 4.05; 95% CI 2.30–7.21) during acute COVID-19. In the present investigation we showed that malnutrition was highly prevalent in a large cohort of COVID-19 survivors at 4-5 months from acute illness. Our findings highlight the need to implement comprehensive nutritional assessment and therapy as an integral part of care for COVID-19 patients

Detection of SARS-CoV-2 Genes in Stool Samples of COVID-19 Survivors Using the Real-Time Reverse Transcriptase Polymerase Chain Reaction Method

The spread of a pneumonia outbreak infected with the new coronavirus (COVID-19) from Wuhan, China, has spread globally. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the pathogen responsible for the pneumonic plague. The angiotensin conversion enzyme (ACE2) is the cellular receptor for SARS-CoV-2 entry. ACE2 is highly expressed in the epithelium of the stomach, duodenum and rectum. In infected patients, some patients infected with SARS-CoV-2 experience unusual symptoms, namely gastrointestinal symptoms, namely diarrhea, nausea and vomiting. This study aims to detect the presence of the SARS-CoV-2 gene in stool samples from COVID-19 survivors using the method real time RT-PCR as the gold standard for confirming COVID-19 with the RdRp and Helicase (ORF1b) target genes. There were 12 samples of COVID-19 survivors who met the inclusion criteria. The results showed that of the 12 samples, 2 samples were positive for SARS-CoV-2 RNA with Ct values of 32.79 and 36.86 which were detected on days 18 and 22 days after their respiratory tract tests were negative.

Assessing symptoms of long/post COVID and chronic fatigue syndrome using the DePaul symptom questionnaire-2: a validation in a German-speaking population

ABSTRACT Objective A subset of Covid-19 survivors will develop persisting health sequelae (i.e. Long Covid/LC or Post Covid/PC) similar to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). In the absence of a reliable biomarker to diagnose LC/PC and ME/CFS, their classification based on symptoms becomes indispensable. Hence, we translated and validated the DePaul Symptom Questionnaire−2 (DSQ-2), to offer a screening tool for the German-speaking population. Methods A sample of healthy adults, and adults with ME/CFS and LC/PC (N = 502) completed a reduced-item version of the DSQ-2 and SF-36 questionnaire online. We performed an exploratory factor analysis, assessed construct validity, diagnostic accuracy and compared the symptom profiles of individuals with ME/CFS versus LC/PC versus healthy adults. Results Exploratory factor analysis revealed a 10-factor solution with excellent internal consistencies. The sensitivity of the DSQ-2 was excellent. The specificity was moderate with moderate inter-rater reliability. Construct validity of the DSQ-2 was supported by strong negative correlations with physical health subscales of the SF-36. A visual comparison of the symptom profiles of individuals with ME/CFS versus LC/PC revealed a comparable pattern. Conclusion Despite lower symptom severity, individuals with LC/PC reported significantly stronger limitations in general health and physical functioning and were more likely to meet ME/CFS diagnostic criteria with ongoing sickness duration, suggesting that ME/CFS can be considered a long-term sequela of LC/PC. This study offers a translated and validated version of the reduced-item DSQ-2 that can guide medical evaluation and aid physicians in identifying a ME/CFS-like subtype of LC/PC.

Arterial Stiffness and Oxidized LDL Independently Associated With Post-Acute Sequalae of SARS-CoV-2.

COVID-19 survivors can experience lingering symptoms known as post-acute sequelae of SARS-CoV-2 (PASC) that appear in different phenotypes, and its etiology remains elusive. We assessed the relationship of endothelial dysfunction with having COVID and PASC. Data was collected from a prospectively enrolled cohort (n=379) of COVID-negative and COVID-positive participants with and without PASC. Primary outcomes, endothelial function (measured by reactive hyperemic index [RHI]), and arterial elasticity (measured by augmentation index standardized at 75 bpm [AI]), were measured using the FDA approved EndoPAT. Patient characteristics, labs, metabolic measures, markers of inflammation, and oxidized LDL (ox-LDL) were collected at each study visit, and PASC symptoms were categorized into 3 non-exclusive phenotypes: cardiopulmonary, neurocognitive, and general. COVID-negative controls were propensity score matched to COVID-negative-infected cases using the greedy nearest neighbor method. There were 14.3% of participants who were fully recovered COVID positive and 28.5% who were COVID positive with PASC, averaging 8.64 ± 6.26 total number of symptoms. The mean RHI was similar across the cohort and having COVID or PASC was not associated with endothelial function (P=0.33). Age (P<0.0001), female sex (P<0.0001), and CRP P=0.04) were positively associated with arterial stiffness, and COVID positive PASC positive with neurological and/or cardiopulmonary phenotypes had the worst arterial elasticity (highest AI). Values for AI (P=0.002) and ox-LDL (P<0.0001) were independently and positively associated with an increased likelihood of having PASC. There is evidence of an independent association between PASC, ox-LDL, and arterial stiffness with neurological and/or cardiopulmonary phenotypes having the worst arterial elasticity. Future studies should continue investigating the role of oxidative stress in the pathophysiology of PASC.

Absence of Type I Interferon Autoantibodies or Significant Interferon Signature Alterations in Adults With Post-COVID-19 Syndrome.

Genetic defects in the interferon (IFN) system or neutralizing autoantibodies against type I IFNs contribute to severe COVID-19. Such autoantibodies were proposed to affect post-COVID-19 syndrome (PCS), possibly causing persistent fatigue for >12 weeks after confirmed SARS-CoV-2 infection. In the current study, we investigated 128 patients with PCS, 21 survivors of severe COVID-19, and 38 individuals who were asymptomatic. We checked for autoantibodies against IFN-α, IFN-β, and IFN-ω. Few patients with PCS had autoantibodies against IFNs but with no neutralizing activity, indicating a limited role of type I IFNs in PCS pathogenesis. In a subset consisting of 28 patients with PCS, we evaluated IFN-stimulated gene activity and showed that it did not correlate with fatigue. In conclusion, impairment of the type I IFN system is unlikely responsible for adult PCS.

The Role of Self-Compassion and Emotion Regulation: How to Predict Life Satisfaction in Covid-19 Survivors?

The Covid-19 phenomenon in Indonesia has an impact on the entire community, especially on Covid-19 survivors. The impact felt is not only physical, but also psychological aspects that can affect their life satisfaction. The purpose of this study was to examine the role of self-compassion and emotion regulation on the life satisfaction of Covid-19 survivors. The research method uses a quantitative approach, and the sampling technique uses purposive sampling technique. The measuring instruments used in this study are the Self-Compassion Scale (SCS), Emotional Regulation Questionnaire (ERQ), and Satisfaction Scale with Life (SWLS). Data analysis used multiple linear regression tests. The results showed that self-compassion and emotion regulation can predict life satisfaction with a significant value of 0.000. However, self-compassion has no significant effect on life satisfaction (p&gt;0.05), while emotion regulation has a significant positive correlation with life satisfaction (p=0.000). Another variable that was tested and had an association with life satisfaction was marital status. The effect of self-compassion and emotion regulation on life satisfaction is 18%. It can be concluded that it is important for individuals to have self-compassion that helps to accept the situation that occurs and emotion regulation that can increase one's life satisfaction to have better psychological well-being.Fenomena Covid-19 yang ada di Indonesia memberikan dampak pada seluruh masyarakat terutama pada penyintas Covid-19. Dampak yang dirasakan selain fisik yaitu aspek psikologis yang dapat mempengaruhi kepuasan hidup mereka. Tujuan dari penelitian ini untuk menguji peran dari self-compassion dan regulasi emosi terhadap kepuasan hidup penyintas Covid-19. Metode penelitian menggunakan pendekatan kuantitatif dan teknik sampling menggunakakan teknik purposive sampling. Alat ukur yang digunakan dalam penelitian ini yaitu Self-Compassion Scale (SCS), Emotional Regulation Questionnaire (ERQ), dan Satisfaction Scale with Life (SWLS). Analisis data menggunakan uji regresi linier berganda. Hasil penelitian menunjukkan bahwa self-compassion dan regulasi emosi dapat memprediksi kepuasan hidup dengan nilai signifikansi 0,000. Akan tetapi, self-compassion tidak memiliki pengaruh signfikan terhadap kepuasan hidup (p&gt;0,05), sedangkan regulasi emosi memiliki korelasi positif yang signifikan terhadap kepuasan hidup (p=0,000). Variabel lain yang diuji dan memiliki asosiasi dengan kepuasan hidup yaitu status pernikahan. Pengaruh self-compassion dan regulasi emosi terhadap kepuasan hidup sebesar 18%. Dapat disimpulkan bahwa penting bagi individu untuk memiliki self-compassion yang membantu untuk menerima situasi yang terjadi serta regulasi emosi yang dapat meningkatkan kepuasan hidup seseorang agar memiliki kesejahteraan psikologis yang lebih baik.

Correlation between chest computed tomography findings and pulmonary function test results in the post-recovery phase of COVID-19.

The radiological and functional lung sequelae in COVID-19 survivors remain unclear. We compared the chest computed tomography findings of COVID-19 patients with normal and abnormal pulmonary function test results in the post-recovery phase. The data of consecutive patients who underwent pulmonary function tests and chest computed tomography within 14 days after recovery from COVID-19 at two medical centers between May and October 2020 were collected retrospectively. Two thoracic radiologists who were blinded to the clinical information and pulmonary function test results classified the patients according to the computed tomography features, evidence of fibrotic-like changes, and semi-quantitative quantification of the extent of pulmonary abnormalities. The clinical characteristics and computed tomography findings of patients with normal pulmonary function test results were compared with those of patients with abnormal results. A total of 101 COVID-19 survivors, comprising 48 ambulatory and 53 hospitalized patients, were included at a median of 95 days from initial symptom onset. Computed tomography revealed fibrotic-like changes in 10.9% of patients. A reduction in the diffusion capacity of carbon monoxide was the most common lung function abnormality (19.8%). Abnormal diffusion capacity of carbon monoxide was associated with the presence and extension of lung opacities on chest computed tomography scans and fibrotic pulmonary abnormalities. The sensitivity, specificity, and accuracy of reduced diffusion capacity of carbon monoxide for detecting fibrotic-like pulmonary changes on chest computed tomography scans were 72.7%, 87.8%, and 86.1%, respectively. Our study suggests that the presence of an abnormal diffusion capacity of carbon monoxide in the post-recovery phase of COVID-19 is associated with a greater risk of long-term parenchymal lung disease, as evidenced by the presence of fibrotic-like changes on chest computed tomography scans, such as traction bronchiectasis and architectural distortion.

Association of long COVID with housing insecurity in the United States, 2022–2023

ObjectivesTo assess the association of Long COVID with housing insecurity in the United States. MethodsTo compare the prevalence of 3 binary indicators of housing insecurity between people with Long COVID (symptoms >3 months) and COVID-19 survivors who did not report long-term symptoms, we used survey-weighted regression models on 206,969 responses from the Household Pulse Survey, a representative cross-sectional survey of US households collected September 2022–April 2023. Among people with Long COVID, we additionally assessed whether functional impairment, current COVID-19 related symptoms, and symptom impact on day-to-day life were associated with a higher prevalence of housing insecurity. ResultsDuring the study period, 56,353 respondents with prior COVID-19 experienced symptoms lasting 3 months or longer (27%), representing an estimated 28 million US adults. After adjusting for demographic factors, people with Long COVID were 1.5–2 times as likely to experience significant difficulty with household expenses (Prevalence ratio [PR] 1.48, 95% CI 1.42–1.55), be behind on housing payments (PR 1.48, 95% CI 1.36–1.60), and face likely eviction or foreclosure (PR 1.86, 95% CI 1.58–2.18). The risk of housing insecurity was highest among low-income adults with Long COVID. Among people with Long COVID, functional limitation and current symptoms which impact day-to-day life were associated with higher prevalence of housing insecurity. ConclusionsCompared with COVID-19 survivors who do not experience long-term symptoms, people with Long COVID are more likely to report indicators of housing insecurity, particularly those of lower socio-economic status, and those with functional limitations or long-term COVID-19 related symptoms impacting day-to-day life. Policies are needed to support people living with chronic illnesses following SARS-CoV-2 infection.

The vital role of exercise and nutrition in COVID-19 rehabilitation: synergizing strength.

Since the outset of the COVID-19 pandemic, the global healthcare community has faced the challenge of understanding and addressing the ongoing and multi-faceted SARS-CoV-2 infection outcomes. As millions of individuals worldwide continue to navigate the complexities of post-hospitalization recovery, reinfection rates, and the increasing prevalence of Long-COVID symptoms, comprehensive COVID-19 rehabilitation strategies are greatly needed. Previous studies have highlighted the potential synergy between exercise and nutrition, suggesting that their integration into patient rehabilitation programs may yield improved clinical outcomes for survivors of COVID-19. Our group aimed to consolidate existing knowledge following the implementation of patient, intervention, comparison, and outcome (PICO) search strategies on the distinct and combined impacts of exercise and nutrition interventions in facilitating the recovery of COVID-19 patients following hospitalization, with a specific focus on their implications for both public health and clinical practice. The incorporation of targeted nutritional strategies alongside exercise-based programs may expedite patient recovery, ultimately promoting independence in performing activities of daily living (ADLs). Nonetheless, an imperative for expanded scientific inquiry remains, particularly in the realm of combined interventions. This mini-review underscores the compelling prospects offered by an amalgamated approach, advocating for the seamless integration of exercise and nutrition as integral components of post-hospitalization COVID-19 rehabilitation. The pursuit of a comprehensive understanding of the synergistic effects and effectiveness of exercise and nutrition stands as a crucial objective in advancing patient care and refining recovery strategies in the wake of this enduring global health crisis.

Cognitive impairment after recovery from COVID-19: Frequency, profile, and relationships with clinical and laboratory indices

Cognitive impairment (CI) is regarded as a remarkable burden in COVID-19 survivors. Its prevalence and profile, and relationships with the disease clinical and laboratory indices, remain unclear.The present study investigated, in a large sample of patients recovered from COVID-19, the frequency of CI with both a face-to-face screening tool and comprehensive test battery (MCCB). The study also evaluated the profile of CI and its relationships with COVID-19 clinical and laboratory indices and with psychopathological features.Out of 1344 subjects assessed for eligibility, 736 completed the screening phase 11 months after the COVID-19 infection; 402 participated in the baseline phase and completed an in depth cognitive, clinical and laboratory assessment about one month later.More than one third of the screened subjects presented a CI (COG+); it was associated to age, education, male gender, COVID-19 severity, and presence of anosmia, dyspnea at rest and exertional dyspnea during the acute phase. COG+ subjects showed a higher severity of depression, anxiety and post-traumatic distress, and worse global functioning, than subjects without CI. The MCCB showed that 45% of the subjects had a CI involving attention, working memory, verbal learning, visual learning, and reasoning and problem solving. Finally, neurocognitive functioning was inversely correlated with LDH blood levels, a potential biomarker of disease severity.According to our findings, cognitive functioning should be routinely and periodically assessed in COVID-19 patients, especially in older subjects, who experienced more severe COVID-19 symptoms. In case of persisting dysfunctions cognitive training programs should be considered as treatment strategies.

Assessment of post-COVID-19 fatigue among female survivors 2 years after hospital discharge: a nested case–control study

BackgroundFatigue is a common symptom of long COVID syndrome. Compared to male survivors, females have a higher incidence of post-COVID fatigue. Therefore, long-term follow-up is necessary to understand which groups of females are more vulnerable to post-COVID fatigue.MethodsThis is a nested case–control study of female COVID-19 survivors who were discharged from two designated hospitals in Wuhan, China in 2020, and received 2-year follow-up from March 1 to April 6, 2022. All patients completed the Checklist Individual Strength-subscale subjective fatigue (CIS-fatigue), a chronic obstructive pulmonary disease (COPD) assessment test (CAT), and the Hospital Anxiety and Depression Scale (HADS; including the HADS-Anxiety [HADS-A] and the HADS-Depression [HADS-D]). Individuals with CIS-fatigue scores of 27 or higher were classified as cases. The risk factors for fatigue was analysed with multivariable logistic regression analysis.ResultsA total of 899 female COVID-19 survivors were enrolled for analysis, including 47 cases and 852 controls. Compared with controls, cases had higher CAT, HADS-A and HADS-D scores, and showed a higher prevalence of symptoms, including anxiety (cases vs. controls, 44.7% vs. 4.0%, p < 0.001), chest tightness (21.2% vs. 2.3%, p < 0.001), dyspnoea (19.1% vs. 0.8%, p < 0.001) and so on. In multivariable logistic regression analysis, age (OR, 1.03; 95% CI, 1.01–1.06; p = 0.02) and cerebrovascular disease (OR, 11.32; 95% CI, 2.87–43.00; p < 0.001) were risk factors for fatigue. Fatigue had a statistically significant moderate correlation with depression (r = 0.44, p < 0.001), but not with CAT ≥ 10.ConclusionFemale COVID-19 patients who had cerebrovascular disease and older age have higher risk of fatigue. Patients with fatigue have higher CAT scores, and are more likely to have concurrent depression.

Proteomic Evolution from Acute to Post-COVID-19 Conditions.

Many COVID-19 survivors have post-COVID-19 conditions, and females are at a higher risk. We sought to determine (1) how protein levels change from acute to post-COVID-19 conditions, (2) whether females have a plasma protein signature different from that of males, and (3) which biological pathways are associated with COVID-19 when compared to restrictive lung disease. We measured protein levels in 74 patients on the day of admission and at 3 and 6 months after diagnosis. We determined protein concentrations by multiple reaction monitoring (MRM) using a panel of 269 heavy-labeled peptides. The predicted forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) were measured by routine pulmonary function testing. Proteins associated with six key lipid-related pathways increased from admission to 3 and 6 months; conversely, proteins related to innate immune responses and vasoconstriction-related proteins decreased. Multiple biological functions were regulated differentially between females and males. Concentrations of eight proteins were associated with FVC, %, and they together had c-statistics of 0.751 (CI:0.732-0.779); similarly, concentrations of five proteins had c-statistics of 0.707 (CI:0.676-0.737) for DLCO, %. Lipid biology may drive evolution from acute to post-COVID-19 conditions, while activation of innate immunity and vascular regulation pathways decreased over that period. (ProteomeXchange identifiers: PXD041762, PXD029437).

Assessment of Pulmonary Functions in COVID-19 Survivors and Their Clinical Correlation at the 6-month Follow-up: A Prospective, Observational Study

Assessment of Pulmonary Functions in COVID-19 Survivors and Their Clinical Correlation at the 6-month Follow-up: A Prospective, Observational Study

Post-Traumatic Stress Risk Among COVID-19 Survivors in Colombia

BackgroundSymptoms of post-traumatic stress are common in people who have experienced a life experience that significantly threatened their physical or psychological integrity. Nevertheless, little information about post-traumatic stress disorder risk (PSTD-R) in Colombian COVID-19 survivors is available. ObjectiveTo establish the prevalence and variables associated with PTSD-R in a sample of COVID-19 survivors in Santa Marta, Colombia. MethodA cross-sectional study was designed with a non-probabilistic sample of adult COVID-19 survivors. Participants were demographically characterized and completed scales for depression risk, insomnia risk, and PTSD-R. ResultsThree hundred and thirty COVID-19 survivors between 18 and 89 years participated; 61.5% were women. The frequency of depression risk was 49.7%; insomnia risk, 60.6%; and PTSD-R, 13.3%. Depression risk (OR=41.4, 95% CI 5.5–311.6), insomnia risk (OR=5.3, 95% CI 1.8–18.7), low income (OR=3.5, 95% CI 1.4–8.7) and being married or free union (OR=2.7, 95% CI 1.1–6.2) were associated with PTSD-R. ConclusionsTwo out of every fifteen COVID-19 survivors are in PTSD-R. Depression and insomnia risk are strongly associated with PTSD-R among Colombian COVID-19 survivors. Studies that follow COVID-19 survivors long-term are needed.

Preliminary neurocognitive finding from a multi‐site study investing long‐term neurological impact of COVID‐19 using ultra‐high field 7 Tesla MRI‐based neuroimaging

AbstractBackgroundGlobally, over six hundred million cases of SARS‐CoV‐2 have been confirmed. As the number of individuals in recovery rises, examining long‐term neurological effects, including cognitive impairment and cerebral microstructural and microvascular changes, has become paramount., We present preliminary cognitive findings from an ongoing multi‐site study investigating the long‐term neurological impacts of COVID‐19 using 7 Tesla MRI‐based neuroimaging.MethodsAcross 3 US and 1 UK sites, we identified adult (&gt; = 18) COVID‐19 survivors (CS) and healthy controls (HC) without significant pre‐existing medical, neurological, or psychiatric illness. Using the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS‐3) battery and Norms Calculator, 12 cognitive scores were adjusted for age, sex, and education and classified as either unimpaired or mild (&lt;9th percentile), moderate (&lt;2nd percentile), or severely impaired (&lt;1st percentile). The observed frequency of impairment across the two groups is reported along with proportional differences (PD) and confidence intervals (CI). Illness severity and time since infection were evaluated as potential associates of cognitive impairment.ResultsOver a period of 11 months, we enrolled 108 participants. At the time of reporting, 80 (46.3% female; mean age: 60.3 ± 8.6; 61 CS, 19 HC) had completed cognitive assessments. Of the participants for whom we ascertained time since symptom onset and illness severity (n = 51 and 43, respectively), 31.4% had their index COVID‐19 infection within the past year, and 60.5% had a severe to critical infection (Table 1). Table 2 reports observed frequency of impairment for each metric. Aggregating all 12 cognitive metrics, we found 45 (73.8%) of CS had at least one impairment [vs HC: 10 (52.6%)]. A significantly greater proportion of CS had at least one moderate to severe or severe impairment (Figure 1). CS also had significantly higher frequencies of presenting with two or more mild to severe impairments [PD 0.33 (0.13, 0.54)]. Illness severity and time since infection were not significantly associated with cognitive impairment.ConclusionOur preliminary results are consistent with potentially sustained COVID‐associated cognitive impairment in a subset of participants. Enrollment in the multi‐site cohort is ongoing, and updated results will be presented along with ultra‐high field MRI‐based neuroimaging correlates.

P202: Post-COVID syndrome presented with psychomotor change and suicidal ideations: a geriatric case report

Background:COVID-19 is notorious for its neuropsychiatric sequelae. Some patients present with anosmia and cognitive and attention deficits, also known as “brain-fog”. In COVID-19 survivors, psychiatric manifestations such as depression, fatigue, anxiety, and neurocognitive impairments, also known as the “post-acute COVID-19 syndrome” or “long COVID”, were reported in 35% of the patients after the infection. New-onset anxiety, depression, psychosis, seizures, and even suicidal behaviors are also reported. Inflammation was proposed to be the pathophysiology.Case Report:The 68 year-old married female who lived with her husband did not have psychiatric history before this year. She had covid-19 infection 3 months prior to her psychiatric hospitalization. Although she had recovered, she started to have depressed mood, disrupted sleep and anhedonia since then. She became easily anxious and could hardly feed her cats as usual. She was not able to make decisions. She no longer did house chores that she had been doing. Poor appetite led to a loss of body weight from 46 to 40kgs. She had blunted emotional response, and could not cry after her cat died. She went to clinic for help, BZD and antidepressants were given, but the condition persisted. One week prior to hospitalization, her speech became weak, murmuring and could not finish a long sentence. The physiological change can be observed using wearable device. After 3 weeks of treatment, her heat rate, activity and sleep improved. The progress was also recorded via wearable devices and clinical scales.Discussion:In our patient, the depression was associated with circadian rhythm disruption, suicidal ideations and psychomotor slowing. This may reveal some special features of post-COVID depression. In previous studies, antidepressants have proved to be effective in treating post-COVID-19 depression. Sigma receptors are one of the possible mechanisms. Besides, agomelatine, with its melatonergic activity of regulating circadian rhythm, is proposed to have the potential to inhibit the virus from entering CNS. The activity pattern and circadian rhythm change will be discussed.