High proportions of post-exertional malaise and orthostatic intolerance in people living with post-COVID-19 condition: the PRIME post-COVID study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Aug. 23, 2023

Abstract Background Exercise-based treatments can be harmful in people who were SARS-CoV-2 positive and living with post-COVID-19 condition (PL-PCC) have post-exertional malaise (PEM) or orthostatic intolerance (OI). Nevertheless, PEM OI are not routinely assessed by clinicians. We estimated proportions PL-PCC, as well PCC (PnL-PCC) negatives (i.e., never reported a test), identified associated factors. Methods Participants from the PRIME post-COVID study included. using validated questionnaires. was defined feeling unrecovered after infection. Multivariable regression analyses to stratified for sex. Results Data 3,783 participants analyzed. In proportion of 48.1% 41.2%, 29.3% 27.9% women men, respectively. Proportions higher PL-PCC compared negatives, OR=4.38 [95%CI:3.01-6.38]; men OR=4.78 [95%CI:3.13-7.29]; 3.06 [95%CI:1.97-4.76]; 2.71 [95%CI:1.75-4.21]. Associated factors age ≤60 years, ≥1 comorbidities alone. Conclusions High observed PL-PCC. Standard screening is recommended promote appropriate therapies. Trial registration ClinicalTrials.gov identifier: NCT05128695

Language: Английский

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Postural Orthostatic Tachycardia Syndrome Following SARS-CoV-2 Infection and COVID-19 Vaccination: A Comparative Review

Published: Oct. 13, 2023

Postural orthostatic tachycardia syndrome (POTS) and its related symptoms have been identified as a possible complication of COVID-19 infection vaccination recently gained attention. The diagnosis management POTS require great care attention, even under normal circumstances, due to complex nature. However, the pandemic complications further complicated this in COVID-19-related settings. objective study is enhance our comprehension POTS-like context COVID-19. To achieve this, we provide concise overview concept, potential underlying mechanisms, available clinical reports following vaccination, well manifestations scenarios with brief management.

Language: Английский

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We need better care for long covid and ME/CFS

BMJ, Journal Year: 2023, Volume and Issue: unknown, P. p2372 - p2372

Published: Oct. 17, 2023

Language: Английский

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Reducing variation in the quality of long covid care: Lessons from a national quality improvement collaborative and multi-site ethnography

Research Square (Research Square), Journal Year: 2023, Volume and Issue: unknown

Published: Dec. 8, 2023

Abstract Context Long covid (post covid-19 condition) is a complex condition with diverse manifestations and uncertain prognosis. There wide variation in how patients are investigated managed. have been calls for formal quality standards so as to reduce so-called “postcode lottery” of care. We aimed examine the nature long care unwarranted provided by services. Methods In mixed-method study (2021-2023), we ran improvement collaborative across 10 UK sites. also gathered data on origins current context each clinic, interviewed staff patients, observed 12 clinics (52 consultations) 34 multidisciplinary team (MDT) meetings (230 patient cases). Data collection analysis were informed relevant lenses from clinical (e.g. evidence-based guidelines), science cycles, reducing variation) philosophy knowledge. Results The made progress towards standardizing assessment management some topics, but much remained. Clinics had different histories path-dependencies, occupied place their healthcare ecosystem served varied caseload including (in most clinics) high proportion comorbidities. Dimensions prioritized related service accessibility, ease navigation), human qualities attentiveness, compassion). A key route was when local MDTs deliberated unusual, or challenging cases which guidelines no easy answers. such cases, collective learning occurred through idiographic reasoning , practitioners build lessons particular general. This contrasts nomothetic implicit guidelines, assumed go general findings trials) (management individual patients). Conclusion Not all services unwarranted. Largely because covid’s varied, universal ‘evidence-based’ hard define implement. this condition, resources may be better spent supporting team-based locally than attempting standardize widely differing Trial registration NCT05057260, ISRCTN15022307.

Language: Английский

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Prevalence of orthostatic intolerance in Long Covid clinic patients: A multicentre observational study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Dec. 18, 2023

Abstract Purpose Orthostatic intolerance (OI), including postural orthostatic tachycardia syndrome (PoTS) and hypotension (OH), are often reported in long covid, but published studies small with inconsistent results. We sought to estimate the prevalence of objective OI patients attending covid clinics healthy volunteers associations symptoms comorbidities. Methods Participants were recruited from 8 UK clinics, general population. All undertook standardised National Aeronautics Space Administration Lean Test (NLT). Participants’ history typical (e.g. dizziness, palpitations) prior during NLT recorded. Results 277 50 frequency-matched tested. Healthy had no or PoTS, 10% asymptomatic OH. 130 (47%) previous 144 (52%) developed NLT. 41 (15%) an abnormal NLT, 20 (7%) met criteria for PoTS 21 (8%) Of 45% OI. Relaxing diagnostic thresholds two consecutive one reading, resulted 11% participants meeting not volunteers. Conclusion More than half experienced more ten either OH, whom did report symptoms. recommend all offered appropriate management commenced. Trial registration numbers NCT05057260 , ISRCTN15022307

Language: Английский

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