Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus

European Heart Journal, Journal Year: 2022, Volume and Issue: 43(11), P. 1157 - 1172

Published: Feb. 7, 2022

Abstract Emerging as a new epidemic, long COVID or post-acute sequelae of coronavirus disease 2019 (COVID-19), condition characterized by the persistence COVID-19 symptoms beyond 3 months, is anticipated to substantially alter lives millions people globally. Cardiopulmonary including chest pain, shortness breath, fatigue, and autonomic manifestations such postural orthostatic tachycardia are common associated with significant disability, heightened anxiety, public awareness. A range cardiovascular (CV) abnormalities has been reported among patients acute phase include myocardial inflammation, infarction, right ventricular dysfunction, arrhythmias. Pathophysiological mechanisms for delayed complications still poorly understood, dissociation seen between ongoing objective measures cardiopulmonary health. long-term trajectory many chronic cardiac diseases which abundant in those at risk severe disease. In this review, we discuss definition its epidemiology, an emphasis on symptoms. We further review pathophysiological underlying CV injury, sequelae, impact multiorgan propose possible model referral post-COVID-19 services future directions research priorities clinical trials that currently underway evaluate efficacy treatment strategies sequelae.

Language: Английский

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COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force

European Respiratory Journal, Journal Year: 2020, Volume and Issue: 56(6), P. 2002197 - 2002197

Published: Aug. 13, 2020

Patients with COVID-19 or post-COVID-19 will most probably have a need for rehabilitation during and directly after the hospitalisation. Data on safety efficacy are lacking. Healthcare professionals cannot wait published randomised controlled trials before they can start these rehabilitative interventions in daily clinical practice, as number of patients increases rapidly. The Convergence Opinion Recommendations Evidence process was used to make interim recommendation hospital post-hospital phase patients, respectively.

Language: Английский

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Considerations for Postacute Rehabilitation for Survivors of COVID-19

JMIR Public Health and Surveillance, Journal Year: 2020, Volume and Issue: 6(2), P. e19462 - e19462

Published: May 4, 2020

Coronavirus disease (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported on December 31, 2019. Because it has only been studied for just over three months, our understanding of this is still incomplete, particularly regarding its sequelae and long-term outcomes. Moreover, very little written about rehabilitation needs patients with COVID-19 after discharge from care. The objective report to answer question “What services do survivors require?” asked within context a subacute hospital delivering geriatric inpatient outpatient services. Three areas relevant were identified. First, details how may present have summarized, including comorbidities, complications an intensive care unit stay or without intubation, effects virus multiple body systems, those pertaining cardiac, neurological, cognitive, mental health. Second, I suggested procedures design units survivors, staffing issues, considerations rehabilitation. Third, guidelines (physiotherapy, occupational therapy, speech-language pathology) following proposed respect recovery system as well mobility function. A thorough assessment individualized, progressive treatment plan which focuses function, disability, return participation in society will help each patient maximize their function quality life. Careful consideration environment ensure that all recover completely possible.

Language: Английский

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Rehabilitation of patients post-COVID-19 infection: a literature review

Journal of International Medical Research, Journal Year: 2020, Volume and Issue: 48(8)

Published: Aug. 1, 2020

Rehabilitation is important for patients with coronavirus disease 2019 (COVID-19) infection. Given the lack of guidelines in English on rehabilitation these patients, we conducted a review most recent reports. We performed this literature using principal research databases and included randomized trials, recommendations, quasi-randomized or prospective controlled clinical reports, guidelines, field updates, letters to editor. identified 107 studies database search, among which 85 were excluded after screening full text abstract. In total, 22 finally included. The complexity setting speed spread severe acute respiratory syndrome 2, leads rapid occupation beds intensive care unit, make it necessary discharge COVID-19 who have mild symptoms as soon possible. For reasons, formulate programs help them restore physical function reduce anxiety depression, particularly comorbidities those live alone rural settings, good quality life.

Language: Английский

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Post-COVID-19 acute sarcopenia: physiopathology and management

Aging Clinical and Experimental Research, Journal Year: 2021, Volume and Issue: 33(10), P. 2887 - 2898

Published: July 30, 2021

Abstract In this review, we discuss the pathophysiologic and management aspects of acute sarcopenia in relation to SARS-CoV-2 infection. COVID-19 is as a multi-organ infectious disease characterized by severe inflammatory highly catabolic status, influencing deep changes body build, especially amount, structure, function skeletal muscles which would amount acutely developed sarcopenia. Acute may largely impact patients’ in-hospital prognosis well vulnerability post-COVID-19 functional physical deterioration. The individual outcome degree muscle mass loss be influenced multiple factors, including patient’s general pre-infection medical condition, older adults. This paper gathers information about how hyper-inflammatory involvement exacerbates immunosenescence process, enhances endothelial damage, due mitochondrial dysfunction autophagy, induces myofibrillar breakdown degradation. aftermath these complex immunological SARS-CoV-2-related phenomena, augmented anosmia, ageusia altered microbiota lead decreased food intake exacerbated catabolism. Moreover, imposed inactivity, lock-down, quarantine or hospitalization with bedrest intensify process. All deleterious mechanisms must swiftly put check multidisciplinary approach nutritional support, early cardio-pulmonary rehabilitation, psychological support cognitive training. proposed holistic patients appears essential minimize disastrous outcomes allow avoiding long syndrome.

Language: Английский

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Outpatient Pulmonary Rehabilitation in Patients with Long COVID Improves Exercise Capacity, Functional Status, Dyspnea, Fatigue, and Quality of Life

Respiration, Journal Year: 2022, Volume and Issue: 101(6), P. 593 - 601

Published: Jan. 1, 2022

<b><i>Background:</i></b> COVID-19 survivors face the risk of long-term sequelae including fatigue, breathlessness, and functional limitations. Pulmonary rehabilitation has been recommended, although formal studies quantifying effect in patients are lacking. <b><i>Methods:</i></b> We conducted a prospective observational cohort study consecutive admitted to an outpatient pulmonary center due persistent symptoms after COVID-19. The primary endpoint was change 6-min walk distance (6MWD) undergoing 6-week interdisciplinary individualized program. Secondary endpoints included post-COVID-19 status (PCFS) scale, Borg dyspnea Fatigue Assessment Scale, quality life. Further, changes function tests were explored. <b><i>Results:</i></b> Of 64 rehabilitation, 58 (mean age 47 years, 43% women, 38% severe/critical COVID-19) per-protocol-analysis. At baseline (i.e., mean 4.4 months infection onset), 6MWD 584.1 m (±95.0), impairment graded median at 2 (IQR, 2–3) on PCFS. On average, improved their by 62.9 (±48.2, <i>p</i> &#x3c; 0.001) reported improvement 1 grade PCFS scale. Accordingly, we observed significant improvements across secondary presence (<i>p</i> 0.001), fatigue life 0.001). Also, parameters (forced expiratory volume s, lung diffusion capacity, inspiratory muscle pressure) significantly increased during rehabilitation. <b><i>Conclusion:</i></b> In with long COVID, exercise status, dyspnea, 6 weeks personalized Future needed establish optimal protocol, duration, benefits as well cost-effectiveness

Language: Английский

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COVID-19: maintaining essential rehabilitation services across the care continuum

BMJ Global Health, Journal Year: 2020, Volume and Issue: 5(5), P. e002670 - e002670

Published: May 1, 2020

► Rehabilitation services are essential: They need to continue during a pandemic and after as they an essential component of high-value care offered for individuals across the lifespan optimise physical cognitive functioning reduce disability.► is affected: Globally, response COVID-19 shifting rehabilitation provided in all settings, introducing new burden on patients, families healthcare workers.► Measurement needed: A core set measures needs be adopted monitor health functional outcomes other patients at risk decline assess quality, availability accessibility today our nations recover.► Telerehabilitation necessary: Remote delivery necessary rapid scale-up telehealth could optimised if financial, infrastructure, resource, training cybersecurity barriers were addressed.► Collaboration can support home: Novel partnerships that include community enhance communication safe effective home-based rehabilitative strategies mitigate consequences reduced service capacity.► Direct providers personal protective equipment: settings should ensured equipment use it effectively.

Language: Английский

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Joint Statement on the Role of Respiratory Rehabilitation in the COVID-19 Crisis: The Italian Position Paper

Respiration, Journal Year: 2020, Volume and Issue: 99(6), P. 493 - 499

Published: Jan. 1, 2020

Due to the exponential growth of number subjects affected by coronavirus disease 2019 (COVID-19), entire Italian health care system had respond promptly and in a very short time with need semi-intensive intensive units. Moreover, trained dedicated COVID-19 teams consisting physicians were coming from different specialties (intensivists or pneumologists infectiologists), while respiratory therapists nurses have been recruited work on without rest. However, due still limited evolving knowledge COVID-19, there are few recommendations concerning rehabilitation physiotherapy interventions. The presentation this paper is result consensus promoted societies professionals who contacted pulmonologists directly involved treatment COVID-19. aim was formulate more proper common suggestions be applied hospital settings offering rehabilitative programs workforce planning for patients. Two main areas intervention identified: organization treatment, which described face emergency.

Language: Английский

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Systematic rapid "living" review on rehabilitation needs due to COVID-19: update to March 31st, 2020

European Journal of Physical and Rehabilitation Medicine, Journal Year: 2020, Volume and Issue: 56(3)

Published: July 1, 2020

INTRODUCTION: The outbreak of COVID-19 epidemics has challenged the provision health care worldwide, highlighting main flaws some national systems with respect to their capacity cope needs frail subjects. People experiencing disability due express specific rehabilitation that deserve a systematic evidence-based approach. aim this article is provide community updates on latest scientific literature COVID-19. first rapid "living" review will present results search performed up March 31st, 2020.EVIDENCE ACQUISITION: A in PubMed, Pedro, and Google Scholar was using terms: "COVID-19," "Coronavirus," "severe acute respiratory syndrome coronavirus 2," "rehabilitation," "physical therapy modalities," "exercise," "occupational therapy," "late complications." Papers published 2020, English, were included.EVIDENCE SYNTHESIS: Out 2758 articles retrieved, nine included review. Four them are "calls for action", three recommendations about interventions phase, two address people quarantined at home or restricted mobility lockdown, one provides Core Outcome Set be used clinical trials test efficacy strategies managing patients.CONCLUSIONS: All selected papers based previous not current pandemic. Main messages included: 1) early should granted inpatients COVID-19; 2) quarantine lockdown receive exercise programs reduce risk frailty, sarcopenia, cognitive decline depression; 3) telerehabilitation may represent option home. Further warranted order characterize emerging survivors adverse effects chronically disabled people.

Language: Английский

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Rehabilitation and respiratory management in the acute and early post-acute phase. "Instant paper from the field" on rehabilitation answers to the COVID-19 emergency

European Journal of Physical and Rehabilitation Medicine, Journal Year: 2020, Volume and Issue: 56(3)

Published: July 1, 2020

COVID-19 is a respiratory infectious disease that can cause respiratory, physical and psychological long-term dysfunctions in patients. First recommendations on management were published, but they not based the specific needs due to COVID-19. In this paper we share early experiences from clinical field Northern Italy, where epidemic started February. This summarizes second webinar (230 live attendees, 11,600 viewers of recorded version) organized by Italian Society Physical Rehabilitation Medicine about rehabilitation particular acute (Intensive Care Unit [ICU]) immediate post-acute phases. There need prepare for phase. ICU length stay relatively long, with immobilization prone position. Some problems are described, including severe muscle weakness fatigue, joint stiffness, dysphagia, (neuro)psychological problems, impaired functioning concerning mobility, activities daily life work. A lot yet unknown patients experience consequences as know literature postintensive care syndrome, has unique features be investigated understood. As colleague stated during Covinar: marathon, sprint…

Language: Английский

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