No, Is the Subject Area "Medical services" applicable to this article? 2020;15(11):e0240784. Department of Physiotherapy, Jena University Hospital, Jena, Germany, Christina Lemhfer,Dana Loudovici-Krug&Norman Best, Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany, Christian Sturm&Christoph Gutenbrunner, You can also search for this author in Overall, it is thus difficult to estimate the magnitude and direction of potential biases arising from participant selection. This is consistent with our findings that 49% of respondents reported at least one limitation of activities and/or restrictions in participation. We screened all SARS-CoV-2-positive individuals for whom contact information was available for eligibility. Med Sci Monit. CAS No, Is the Subject Area "Fatigue" applicable to this article? Fathi M, Vakili K, Sayehmiri F, Mohamadkhani A, Hajiesmaeili M, Rezaei-Tavirani M, et al. Meanwhile, 55 (52%) participants reporting such symptoms stated not having fully recovered. Methodology, Further investigations should be carried out here to detect the reasons and risks for long-term incapacity to work. Long-term pulmonary consequences of coronavirus disease 2019 (COVID-19): what we know and what to expect. The mean values of the SF-36 questionnaire in the physical sum score was 49.2 points, which is in the range of the normal population (48.4 points) (Fig.4). A total of 96 (25%) participants reported to suffer from mMRC grade 1 dyspnea or higher (Table 2). 2020;17(9):e1003346. We used the Dutch value set for calculating EQ-5D-5L index scores, as no value set or guidance on the most appropriate value set for Switzerland is available, and we judged the population of the Netherlands to be relatively similar to the Swiss population. Quality of life after acute respiratory distress syndrome: a meta-analysis. Overall, 111 (26%) participants reported that they had not fully recovered at six to eight months after SARS-CoV-2 infection (Table 2). 2020;54(16):94959.
The capacity constraints in SARS-CoV-2-testing up to June 2020 may have selected for a population with a higher risk of experiencing severe disease as only those qualified for testing at that time. Yes PLoS One. Among all participants, 233 (55%) participants having a score indicating fatigue, with a median FAS score of 22 (IQR 19 to 25) (Table 2). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Additional funding specific to this study was provided by the Department of Health of the Canton of Zurich and the University of Zurich Foundation. The study was prospectively registered on the International Standard Randomised Controlled Trial Number registry (ISRCTN14990068) and was approved by the responsible ethics committee of the Canton of Zurich, Switzerland (Kantonale Ethik-Kommission Zrich; BASEC-Nr. No, Is the Subject Area "General practitioners" applicable to this article?
Virol Sin.
PubMed Central Findings regarding longer-term sequalae are similar to those from prior coronavirus outbreaks [34], with 40% of severe acute respiratory syndrome (SARS) survivors reporting chronic fatigue up to four years after infection [35]. B. in der Durchfhrung der tglichen Routine, der Bewltigung von Stress, der Erledigung von Aufgaben im Haushalt, die Pflege/Untersttzung anderer sowie bei der Fhigkeit sich zu entspannen. Coronavrus infections are known to lead to Severe Acute Respiratory Syndrome (SARS) [1, 2]. In conclusion, this retrospective questionnaire-based survey shows that among patients with mild to moderate SARS-CoV-2 infection in the early stage of the disease, 84% of respondents reported activity and participation limitations, mainly in performing daily routines, coping with stress, household management, caring for / supporting others, and difficulties with leisure activities.
All analyses were performed using R version 4.0.2 [23]. Yes Borrelia burgdorferi) infections [3640]. Available from: URL: http://docs.dpaq.de/17738-20210616_bifg_epaper_post-covid_bf.pdf. PLoS ONE 16(7): Article Cancer J.
Older and initially hospitalized individuals more frequently reported having seen a general practitioner. No imputation was applied for other missing data. The distribution of persisting symptoms was as follows: lassitude/fatigue (37.5%), sleep problems (30.1%), respiratory problems (26.0%), pain (26.0%), fear and anxiety (24.9%), restrictions on movement (18.4%), alterations of smell (17.3%) and taste (16.2%), cardiovascular problems (15.1%), bowel dysfunction (14.0%), muscular problems (12.0%), and bladder dysfunction (7.9%). Chest. However, the reported death rates vary within wide ranges due to methodological differences. Patients with uncomplicated COVID-19 have long-term persistent symptoms and functional impairment similar to patients with severe COVID-19: a cautionary tale during a global pandemic. It might be a sign that people may compensate for the remaining problems relatively good after mild and moderate COVID-19. CAS here. Contributed equally to this work with:
Gosain R, Miller K. Symptoms and symptom management in long-term cancer survivors. This includes acute, post-acute and long-term rehabilitation [14,15,16]. Results of two recent studies comparing outcomes in individuals with COVID-19 to individuals with influenza are suggestive of a higher burden of a wide range of longer-term sequalae associated with COVID-19 [8, 41]. chest ctisus ct telangiectasia diagnosis studies case Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. CAS Di Maria E, Latini A, Borgiani P, Novelli G. Genetic variants of the human host influencing the coronavirus-associated phenotypes (SARS, MERS and COVID-19): rapid systematic review and field synopsis. Department of Visceral and Transplantation Surgery, University Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland, Roles A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. Furthermore, the primarily electronic setup of our study may have influenced participation. Am J Phys Med Rehabil. Long-term COVID-19 symptoms in a large unselected population; 2020. For responses to the FAS and DASS-21 instruments, we replaced missing data with the mean of the scores from the other available items. The use of rehabilitative therapies should start at an early stage to enable a quick return to work.
Another limitation is that we could not differentiate the severity of the SARS-COV-2 infection, because we had to use an anonymous data sampling approach. The contents of the questionnaire and aim of the study were explained and cooperation was agreed upon. In the subgroup of participants aged between 18 and 64years, the values did not differ significantly (Table1). At six to eight months, 111 (26%) reported not having fully recovered. The need for rehabilitation was not explicitly in the focus of the questionnaire used for the study. Validation, 2020;99(6):4704. Book First, most participants included in this analysis were diagnosed with COVID-19 during the first pandemic wave in Switzerland.
2021;53(4):jrm00183. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Lemhfer C, Gutenbrunner C, Best N, Loudovici-Krug D, Schiller J, Bkel A, et al. b Problems in activity and participation 3months after infection. Data curation, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland, Roles Additionally, it is important to consider case detection rates and population subgroups infected when estimating the impact of COVID-19 on healthcare systems. https://doi.org/10.1007/s12250-020-00252-z. We based model selection on clinical and epidemiological reasoning and the Akaike Information Criterion (AIC). Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. 2005;127(6):211924. Article [23] and Lenzen-Schulte [21]. The long-term impact on activity and participation concerns only a minority of participants ranging from around 3 to 24%. Longer-term consequences after SARS-CoV-2 infection are becoming an important burden to societies and healthcare systems. Part of In addition, we asked participants to report any medical conditions that have been newly diagnosed since their acute illness and whether the condition was evaluated as COVID-19-related by their physician or themselves. During acute infection, 385 (89%) participants were symptomatic, with a median of 6 (IQR 3 to 8) symptoms reported. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. The response rate of 41% seems to be good in comparison to further surveys.
This may have several reasons for its existence.. The profile of alterations seems to relate to the above-mentioned non-specific symptoms and mental problems, within handling stress (24%), managing daily demands (18%) and problems with intimate relationships (12%) predominating. We report regression analysis results as odds ratios (OR) with corresponding 95% confidence interval (CI) and two-sided Wald-type statistical test. 27 (35%) of these diagnoses were considered as related to COVID-19 by their physician (Table 3). Google Scholar. Dasgupta A, Kalhan A, Kalra S. Long term complications and rehabilitation of COVID-19 patients. This was done for a maximum of two missing values for the FAS and for a maximum of one value for the DASS-21.
All data was collected through the Research Electronic Data Capture (REDCap) survey system. Writing review & editing, Roles ctisus ct chest diagnosis studies case PubMed These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Compared to studies relying on study site visits, the electronic setup may thus have increased the diversity of the study population. The symptom profile from our study demonstrates that, besides. : Disparities in post-intensive care syndrome during the COVID-19 pandemic: challenges and solutions, under review). Frequently observed symptoms are fatigue, headache, dyspnoea and anosmia [10, 11]. Data regarding the full burden of post-COVID-19 syndrome in the broader population of infected individuals is currently lacking. 170 (40%) participants reported at least one general practitioner visit related to COVID-19 after acute illness, and 10% (8/81) of initially hospitalized individuals were rehospitalized. Patients with longer artificial respiration periods and Intensive care treatment may develop SARS-CoV-2-independent symptoms, which have been described as Post-Intensive Care-Syndrome (PICS) (Flash MJ, Johnson SF, Nguemeni Tiako MJ, Tan-McGrory A, Betancourt JR, Lamas DJ, et al. No, Is the Subject Area "Dyspnea" applicable to this article? For this cross-sectional study, a new written survey instrument was developed in cooperation be-tween the University Hospital Jena (Institute for Physiotherapy), the Hannover Medical School (Department of Rehabilitation Medicine) and the last author in her work for the Association of Statutory Health Insurance Physicians of Bavaria; a new written survey instrument was developed in early summer 2020. Yes We enrolled participants into the study between 06 October 2020 and 26 January 2021, at a median of 7.2 months (range 5.9 to 10.3 months) after their diagnosis. Younger individuals and female participants more frequently reported symptoms of fatigue compared to older age groups and males, respectively. Further studies in hospitalized patients found that up to 20% of patients had to be rehospitalized [10], and up to 80% may require follow-up in primary care within 2 months of hospital discharge [11]. Fig 3 shows associations for having at least one further healthcare contact after initial COVID-19, based on multivariable logistic regression models adjusted for age, sex, initial hospitalization, and initial symptom severity. Descriptive statistics were calculated. Last, we did not evaluate the use of specialized medical (e.g., psychological/psychiatric care) or diagnostic services in our assessment. In total, 296 (69%) participants were categorized as non-recovered or experiencing fatigue, dyspnea or depression. In our study, we provide more detailed data on healthcare utilization incurring due to COVID-19. We evaluated the proportion of individuals reporting not to have fully recovered since SARS-CoV-2 infection, and the proportion reporting fatigue (Fatigue Assessment Scale), dyspnea (mMRC dyspnea scale) or depression (DASS-21) at six to eight months after diagnosis. here. Journal of Occupational Medicine and Toxicology Little is known if and to what extent patients with mild and moderate COVID-19 who did not need hospitalization or intensive care suffer from Post-COVID-Syndrome and how much QoL is affected. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. Risk factors for severe disease courses are old age, metabolic and renal disease, cardiovascular diseases, and obesity [7, 8]. These findings highlight the considerable long-term impact that COVID-19 may have both on affected individuals and healthcare systems worldwide. After the positive vote of the Ethics Committee of the Medical Faculty of the Friedrich Schiller University Jena (registration number 20201834-Bef), contact was made with two Bavarian community public health departments. In multivariable analyses, we found evidence for an association of grade 1 dyspnea with female sex, initial hospitalization, higher body mass index and presence of comorbidities, but not for initial symptom severity, smoking status or presence of a chronic respiratory condition (Fig 2 and S4 Table). 2006;60(5):5139. In multivariable analyses, we found evidence that individuals aged 40 years or older were less likely to experience fatigue compared to 1839 year-old participants (Fig 2 and S3 Table).
Similar chronic symptoms, in particular fatigue, have been also described in other viral (e.g. Hum Genomics. However, current evidence shows that post-COVID-19 syndrome does not only occur in individuals with severe disease requiring hospitalization or in older individuals with comorbidities, but also in young and previously healthy individuals with mild disease [3, 7, 9, 12, 13]. Clin Infect Dis. In most cases the overall score of QoL was very good (25.6%) or good (52.6%). This profile shows similarities with the long-term symptoms of other severe diseases, such as cancer or auto-immune syndromes [24]. This may include being unfit for work, with impact on personal income and the productivity of society. While these differences could be partly due to older participant populations and the restriction to hospitalized patients in their studies, we still observed lower proportions of non-recovery and persistent symptoms among hospitalized patients and older individuals. Phys Rehab Kur Med. Morfeld M, Bullinger M, Kirchberger I. Fragebogen zum Gesundheitszustand: SF-36; deutsche Version des Short form-36 health survey.Gttingen: Hogrefe; 2011. 2020;52(7):jrm00081. 2021;16(2):e0246190. 202001739). Supervision, Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC et al. Some of these symptoms can be seen as non-specific, others can be interpreted to result from infection or immune response in other organs or organ systems such as kidney, cardiovascular system, brain and the peripheral nervous system [9].
For more information about PLOS Subject Areas, click
In multivariable analyses, we found evidence for an association between healthcare use and initial hospitalization, having experienced severe to very severe symptoms, female sex, and age 40 years (Fig 3 and S7 Table). Citation: Menges D, Ballouz T, Anagnostopoulos A, Aschmann HE, Domenghino A, Fehr JS, et al. Similarly, 106 (25%) participants reported new or ongoing symptoms, with a higher percentage in females compared to males (Table 2). J Psychosom Res. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge. With regard to the analysis presented here, the specifications were summarized as 2 to 5 being conspicuous. https://doi.org/10.1093/cid/ciab103. In sensitivity analyses, we stratified results into time periods with limited testing (period before 25 June 2020, testing restricted to high-risk or severely symptomatic individuals) and increased testing (period after 25 June 2020, all symptomatic individuals could be tested). Most commonly reported symptoms were fatigue (64%), fever (63%), cough (50%) and loss of taste or smell (49%). https://doi.org/10.1016/j.arcmed.2021.03.010. July 2020. While differences in study populations and outcome measurement are likely to strongly affect the comparability of studies on post-COVID-19 syndrome, a relatively high prevalence of fatigue, dyspnea or exercise intolerance, and psychological symptoms have consistently been noted across studies [57, 12, 13]. Among non-recovered participants, 51 (46%) also described experiencing new or ongoing symptoms. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Given the clinical spectrum of patients with post-COVID syndrome, most of them will be managed by primary healthcare professionals, in conjunction with pre-existing or new co-morbidities, which, in turn, may increase the burden of COVID-19 on primary healthcare. Buitrago-Garcia D, Egli-Gany D, Counotte MJ, Hossmann S, Imeri H, Ipekci AM, et al. We defined age group, sex and initial hospitalization as a priori covariables in the models based on the findings of other studies. Reduced average scores were found in particular in the following dimensions Role physical (70.8 vs. 82.4), Vitality (54.6 vs. 60.0), Social function (74.5 vs. 86.4), Role emotional (69.5 vs. 89.1), and Mental health (69.2 vs. 72.5). The management and care of individuals with post-COVID-19 syndrome is likely to become a substantial burden for healthcare systems worldwide.
In 56 cases, one (15.3%); in 23 cases, two (6.3%); in 24 cases three (6.6%); and in 76 cases, four or more (20.8%) problems were reported (Fig. These examples show that Post-COVID-Syndrome may be an indication for rehabilitation interventions [13]. Supervision, [22] but clearly lower than that reported by Huang et al. PubMed Central The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
The capacity constraints in SARS-CoV-2-testing up to June 2020 may have selected for a population with a higher risk of experiencing severe disease as only those qualified for testing at that time. Yes PLoS One. Among all participants, 233 (55%) participants having a score indicating fatigue, with a median FAS score of 22 (IQR 19 to 25) (Table 2). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Additional funding specific to this study was provided by the Department of Health of the Canton of Zurich and the University of Zurich Foundation. The study was prospectively registered on the International Standard Randomised Controlled Trial Number registry (ISRCTN14990068) and was approved by the responsible ethics committee of the Canton of Zurich, Switzerland (Kantonale Ethik-Kommission Zrich; BASEC-Nr. No, Is the Subject Area "General practitioners" applicable to this article?
Virol Sin. PubMed Central Findings regarding longer-term sequalae are similar to those from prior coronavirus outbreaks [34], with 40% of severe acute respiratory syndrome (SARS) survivors reporting chronic fatigue up to four years after infection [35]. B. in der Durchfhrung der tglichen Routine, der Bewltigung von Stress, der Erledigung von Aufgaben im Haushalt, die Pflege/Untersttzung anderer sowie bei der Fhigkeit sich zu entspannen. Coronavrus infections are known to lead to Severe Acute Respiratory Syndrome (SARS) [1, 2]. In conclusion, this retrospective questionnaire-based survey shows that among patients with mild to moderate SARS-CoV-2 infection in the early stage of the disease, 84% of respondents reported activity and participation limitations, mainly in performing daily routines, coping with stress, household management, caring for / supporting others, and difficulties with leisure activities.
All analyses were performed using R version 4.0.2 [23]. Yes Borrelia burgdorferi) infections [3640]. Available from: URL: http://docs.dpaq.de/17738-20210616_bifg_epaper_post-covid_bf.pdf. PLoS ONE 16(7): Article Cancer J.
Older and initially hospitalized individuals more frequently reported having seen a general practitioner. No imputation was applied for other missing data. The distribution of persisting symptoms was as follows: lassitude/fatigue (37.5%), sleep problems (30.1%), respiratory problems (26.0%), pain (26.0%), fear and anxiety (24.9%), restrictions on movement (18.4%), alterations of smell (17.3%) and taste (16.2%), cardiovascular problems (15.1%), bowel dysfunction (14.0%), muscular problems (12.0%), and bladder dysfunction (7.9%). Chest. However, the reported death rates vary within wide ranges due to methodological differences. Patients with uncomplicated COVID-19 have long-term persistent symptoms and functional impairment similar to patients with severe COVID-19: a cautionary tale during a global pandemic. It might be a sign that people may compensate for the remaining problems relatively good after mild and moderate COVID-19. CAS here. Contributed equally to this work with:
Gosain R, Miller K. Symptoms and symptom management in long-term cancer survivors. This includes acute, post-acute and long-term rehabilitation [14,15,16]. Results of two recent studies comparing outcomes in individuals with COVID-19 to individuals with influenza are suggestive of a higher burden of a wide range of longer-term sequalae associated with COVID-19 [8, 41]. chest ctisus ct telangiectasia diagnosis studies case Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. CAS Di Maria E, Latini A, Borgiani P, Novelli G. Genetic variants of the human host influencing the coronavirus-associated phenotypes (SARS, MERS and COVID-19): rapid systematic review and field synopsis. Department of Visceral and Transplantation Surgery, University Hospital Zurich, University of Zurich (UZH), Zurich, Switzerland, Roles A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. Furthermore, the primarily electronic setup of our study may have influenced participation. Am J Phys Med Rehabil. Long-term COVID-19 symptoms in a large unselected population; 2020. For responses to the FAS and DASS-21 instruments, we replaced missing data with the mean of the scores from the other available items. The use of rehabilitative therapies should start at an early stage to enable a quick return to work.
Another limitation is that we could not differentiate the severity of the SARS-COV-2 infection, because we had to use an anonymous data sampling approach. The contents of the questionnaire and aim of the study were explained and cooperation was agreed upon. In the subgroup of participants aged between 18 and 64years, the values did not differ significantly (Table1). At six to eight months, 111 (26%) reported not having fully recovered. The need for rehabilitation was not explicitly in the focus of the questionnaire used for the study. Validation, 2020;99(6):4704. Book First, most participants included in this analysis were diagnosed with COVID-19 during the first pandemic wave in Switzerland.
2021;53(4):jrm00183. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Lemhfer C, Gutenbrunner C, Best N, Loudovici-Krug D, Schiller J, Bkel A, et al. b Problems in activity and participation 3months after infection. Data curation, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland, Roles Additionally, it is important to consider case detection rates and population subgroups infected when estimating the impact of COVID-19 on healthcare systems. https://doi.org/10.1007/s12250-020-00252-z. We based model selection on clinical and epidemiological reasoning and the Akaike Information Criterion (AIC). Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. 2005;127(6):211924. Article [23] and Lenzen-Schulte [21]. The long-term impact on activity and participation concerns only a minority of participants ranging from around 3 to 24%. Longer-term consequences after SARS-CoV-2 infection are becoming an important burden to societies and healthcare systems. Part of In addition, we asked participants to report any medical conditions that have been newly diagnosed since their acute illness and whether the condition was evaluated as COVID-19-related by their physician or themselves. During acute infection, 385 (89%) participants were symptomatic, with a median of 6 (IQR 3 to 8) symptoms reported. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. The response rate of 41% seems to be good in comparison to further surveys.
This may have several reasons for its existence.. The profile of alterations seems to relate to the above-mentioned non-specific symptoms and mental problems, within handling stress (24%), managing daily demands (18%) and problems with intimate relationships (12%) predominating. We report regression analysis results as odds ratios (OR) with corresponding 95% confidence interval (CI) and two-sided Wald-type statistical test. 27 (35%) of these diagnoses were considered as related to COVID-19 by their physician (Table 3). Google Scholar. Dasgupta A, Kalhan A, Kalra S. Long term complications and rehabilitation of COVID-19 patients. This was done for a maximum of two missing values for the FAS and for a maximum of one value for the DASS-21.
All data was collected through the Research Electronic Data Capture (REDCap) survey system. Writing review & editing, Roles ctisus ct chest diagnosis studies case PubMed These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Compared to studies relying on study site visits, the electronic setup may thus have increased the diversity of the study population. The symptom profile from our study demonstrates that, besides. : Disparities in post-intensive care syndrome during the COVID-19 pandemic: challenges and solutions, under review). Frequently observed symptoms are fatigue, headache, dyspnoea and anosmia [10, 11]. Data regarding the full burden of post-COVID-19 syndrome in the broader population of infected individuals is currently lacking. 170 (40%) participants reported at least one general practitioner visit related to COVID-19 after acute illness, and 10% (8/81) of initially hospitalized individuals were rehospitalized. Patients with longer artificial respiration periods and Intensive care treatment may develop SARS-CoV-2-independent symptoms, which have been described as Post-Intensive Care-Syndrome (PICS) (Flash MJ, Johnson SF, Nguemeni Tiako MJ, Tan-McGrory A, Betancourt JR, Lamas DJ, et al. No, Is the Subject Area "Dyspnea" applicable to this article? For this cross-sectional study, a new written survey instrument was developed in cooperation be-tween the University Hospital Jena (Institute for Physiotherapy), the Hannover Medical School (Department of Rehabilitation Medicine) and the last author in her work for the Association of Statutory Health Insurance Physicians of Bavaria; a new written survey instrument was developed in early summer 2020. Yes We enrolled participants into the study between 06 October 2020 and 26 January 2021, at a median of 7.2 months (range 5.9 to 10.3 months) after their diagnosis. Younger individuals and female participants more frequently reported symptoms of fatigue compared to older age groups and males, respectively. Further studies in hospitalized patients found that up to 20% of patients had to be rehospitalized [10], and up to 80% may require follow-up in primary care within 2 months of hospital discharge [11]. Fig 3 shows associations for having at least one further healthcare contact after initial COVID-19, based on multivariable logistic regression models adjusted for age, sex, initial hospitalization, and initial symptom severity. Descriptive statistics were calculated. Last, we did not evaluate the use of specialized medical (e.g., psychological/psychiatric care) or diagnostic services in our assessment. In total, 296 (69%) participants were categorized as non-recovered or experiencing fatigue, dyspnea or depression. In our study, we provide more detailed data on healthcare utilization incurring due to COVID-19. We evaluated the proportion of individuals reporting not to have fully recovered since SARS-CoV-2 infection, and the proportion reporting fatigue (Fatigue Assessment Scale), dyspnea (mMRC dyspnea scale) or depression (DASS-21) at six to eight months after diagnosis. here. Journal of Occupational Medicine and Toxicology Little is known if and to what extent patients with mild and moderate COVID-19 who did not need hospitalization or intensive care suffer from Post-COVID-Syndrome and how much QoL is affected. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. Risk factors for severe disease courses are old age, metabolic and renal disease, cardiovascular diseases, and obesity [7, 8]. These findings highlight the considerable long-term impact that COVID-19 may have both on affected individuals and healthcare systems worldwide. After the positive vote of the Ethics Committee of the Medical Faculty of the Friedrich Schiller University Jena (registration number 20201834-Bef), contact was made with two Bavarian community public health departments. In multivariable analyses, we found evidence for an association of grade 1 dyspnea with female sex, initial hospitalization, higher body mass index and presence of comorbidities, but not for initial symptom severity, smoking status or presence of a chronic respiratory condition (Fig 2 and S4 Table). 2006;60(5):5139. In multivariable analyses, we found evidence that individuals aged 40 years or older were less likely to experience fatigue compared to 1839 year-old participants (Fig 2 and S3 Table).
Similar chronic symptoms, in particular fatigue, have been also described in other viral (e.g. Hum Genomics. However, current evidence shows that post-COVID-19 syndrome does not only occur in individuals with severe disease requiring hospitalization or in older individuals with comorbidities, but also in young and previously healthy individuals with mild disease [3, 7, 9, 12, 13]. Clin Infect Dis. In most cases the overall score of QoL was very good (25.6%) or good (52.6%). This profile shows similarities with the long-term symptoms of other severe diseases, such as cancer or auto-immune syndromes [24]. This may include being unfit for work, with impact on personal income and the productivity of society. While these differences could be partly due to older participant populations and the restriction to hospitalized patients in their studies, we still observed lower proportions of non-recovery and persistent symptoms among hospitalized patients and older individuals. Phys Rehab Kur Med. Morfeld M, Bullinger M, Kirchberger I. Fragebogen zum Gesundheitszustand: SF-36; deutsche Version des Short form-36 health survey.Gttingen: Hogrefe; 2011. 2020;52(7):jrm00081. 2021;16(2):e0246190. 202001739). Supervision, Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC et al. Some of these symptoms can be seen as non-specific, others can be interpreted to result from infection or immune response in other organs or organ systems such as kidney, cardiovascular system, brain and the peripheral nervous system [9].
For more information about PLOS Subject Areas, click
In multivariable analyses, we found evidence for an association between healthcare use and initial hospitalization, having experienced severe to very severe symptoms, female sex, and age 40 years (Fig 3 and S7 Table). Citation: Menges D, Ballouz T, Anagnostopoulos A, Aschmann HE, Domenghino A, Fehr JS, et al. Similarly, 106 (25%) participants reported new or ongoing symptoms, with a higher percentage in females compared to males (Table 2). J Psychosom Res. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge. With regard to the analysis presented here, the specifications were summarized as 2 to 5 being conspicuous. https://doi.org/10.1093/cid/ciab103. In sensitivity analyses, we stratified results into time periods with limited testing (period before 25 June 2020, testing restricted to high-risk or severely symptomatic individuals) and increased testing (period after 25 June 2020, all symptomatic individuals could be tested). Most commonly reported symptoms were fatigue (64%), fever (63%), cough (50%) and loss of taste or smell (49%). https://doi.org/10.1016/j.arcmed.2021.03.010. July 2020. While differences in study populations and outcome measurement are likely to strongly affect the comparability of studies on post-COVID-19 syndrome, a relatively high prevalence of fatigue, dyspnea or exercise intolerance, and psychological symptoms have consistently been noted across studies [57, 12, 13]. Among non-recovered participants, 51 (46%) also described experiencing new or ongoing symptoms. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Given the clinical spectrum of patients with post-COVID syndrome, most of them will be managed by primary healthcare professionals, in conjunction with pre-existing or new co-morbidities, which, in turn, may increase the burden of COVID-19 on primary healthcare. Buitrago-Garcia D, Egli-Gany D, Counotte MJ, Hossmann S, Imeri H, Ipekci AM, et al. We defined age group, sex and initial hospitalization as a priori covariables in the models based on the findings of other studies. Reduced average scores were found in particular in the following dimensions Role physical (70.8 vs. 82.4), Vitality (54.6 vs. 60.0), Social function (74.5 vs. 86.4), Role emotional (69.5 vs. 89.1), and Mental health (69.2 vs. 72.5). The management and care of individuals with post-COVID-19 syndrome is likely to become a substantial burden for healthcare systems worldwide.
In 56 cases, one (15.3%); in 23 cases, two (6.3%); in 24 cases three (6.6%); and in 76 cases, four or more (20.8%) problems were reported (Fig. These examples show that Post-COVID-Syndrome may be an indication for rehabilitation interventions [13]. Supervision, [22] but clearly lower than that reported by Huang et al. PubMed Central The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.