Prevalence and Impact of Post-Exertional Malaise on Recovery in Adults with Post COVID-19 Condition. A Systematic Review with Meta-Analysis

Archives of Physical Medicine and Rehabilitation, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

ObjectiveTo assess the prevalence of PEM in people with PCC; and change following rehabilitation interventions PCC.Data sourcesWe searched MEDLINE, Embase, Central, CINAHL, PsychINFO Clinical Trial Registries from inception until January 12th, 2024.Study SelectionWe included observational studies that measured adults PCC interventional PCC. Two independent researchers screened titles abstracts. Any discrepancies underwent full text review. articles at level. were resolved by consensus.Data ExtractionTwo extracted data eligible studies. We point-prevalence cross-sectional studies; period-prevalence longitudinal reviewers assessed risk bias (ROB). Discrepancies a senior research team member. For we used Cochrane Risk Of Bias In Non-randomized Studies - Exposure (ROBINS-E) tool. randomised controlled trials tool II – (RoB2). non-randomised Non-Randomized Interventions (ROBINS-I)1 to applied Grades Recommendation, Assessment, Development, Evaluation (GRADE) approach grade quality evidenceData SynthesisWe performed single-arm proportional meta-analysis synthesize estimates using logit transformation. conducted sensitivity analysis multilevel-mixed-effects logistic regression. This study is registered PROSPERO (CRD42024516682).The community-dwelling living was 36% (95% CI: 0.19 0.57; 2,263 participants). (61 patients) found decrease frequency intensity episodes tailored program centered on integrating pacing approaches. None reported an increase symptoms' individually therapeutic exercise component (5 892 patients).ConclusionsOur confirms there large burden PCC, highlighting critical challenge for healthcare systems urgent need more inclusive rigorous research, offer safe effective solutions meet variable needs experience PEM.There subgroup patients do not PEM; limited evidence supervised, tailored, symptom-titrated active components may trigger this Our results are insufficient reporting percentage baseline before enrolling programs, number non-validated, unstandardized tools measure hence strengthen methods future

Language: Английский

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Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: A population-based, nested case-control study

PLoS Medicine, Journal Year: 2025, Volume and Issue: 22(1), P. e1004511 - e1004511

Published: Jan. 23, 2025

Background Self-reported health problems following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are common and often include relatively non-specific complaints such as fatigue, exertional dyspnoea, concentration or memory disturbance sleep problems. The long-term prognosis of post-acute sequelae COVID-19/post-COVID-19 (PCS) is unknown, data finding correlating organ dysfunction pathology with self-reported symptoms in patients non-recovery from PCS scarce. We wanted to describe clinical characteristics diagnostic findings among persisting for >1 year assessed risk factors persistence versus improvement. Methods This nested population-based case-control study included subjects aged 18–65 years ( n = 982) age- sex-matched control without 576) according an earlier questionnaire (6–12 months after infection, phase 1) consenting provide follow-up information undergo comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, laboratory testing four university centres southwestern Germany (phase 2, another 8.5 [median, range 3–14 months] 1). mean age the participants was 48 years, 65% were female. At 67.6% at 1 developed persistent PCS, whereas 78.5% recovered remained free related PCS. Improvement associated mild index previous full-time employment, educational status, no specialist consultation not attending a rehabilitation programme. development new initially intercurrent secondary SARS-CoV-2 status. Patients less frequently never smokers (61.2% 75.7%), more obese (30.2% 12.4%) higher values body mass (BMI) fat, had lower status (university entrance qualification 38.7% 61.5%) than continued recovery. Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness anxiety/depression/sleep predominant symptom clusters. Exercise intolerance post-exertional malaise (PEM) >14 h compatible myalgic encephalomyelitis/chronic fatigue reported by 35.6% 11.6% patients, respectively. In analyses adjusted sex-age class combinations, centre qualification, significant differences between those recovery observed performance three different tests, scores perceived stress, subjective cognitive disturbances, dysautonomia, depression anxiety, quality, quality life. handgrip strength (40.2 [95% confidence interval (CI) [39.4, 41.1]] 42.5 CI [41.5, 43.6]] kg), maximal oxygen consumption (27.9 [27.3, 28.4]] 31.0 [30.3, 31.6]] ml/min/kg weight) ventilatory efficiency (minute ventilation/carbon dioxide production slope, 28.8 [28.3, 29.2]] 27.1 [26.6, 27.7]]) significantly reduced relative group adjustment centre, education, BMI, smoking use beta blocking agents. There measures systolic diastolic cardiac function rest, level N-terminal brain natriuretic peptide blood levels other measurements (including complement activity, markers Epstein–Barr virus [EBV] reactivation, inflammatory coagulation markers, serum cortisol, adrenocorticotropic hormone dehydroepiandrosterone sulfate). Screening viral (PCR stool samples spike antigen plasma) subgroup negative. Sensitivity (pre-existing illness/comorbidity, obesity, medical care infection) revealed similar findings. PEM pain worse results almost all tests. A limitation that we objective on exercise capacity cognition before infection. addition, did unable attend clinic whatever reason illness, immobility social deprivation exclusion. Conclusions this study, majority working recover second their illness. Patterns essentially similar, dominated complaints. Despite signs deficits capacity, there major investigations, our do support persistence, EBV adrenal insufficiency increased turnover pathophysiologically relevant history disease might help stratify cases severity.

Language: Английский

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Exercise Therapy for Post–COVID-19 Condition—Does No Harm

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(4), P. e246959 - e246959

Published: April 4, 2024

Andrea Tryfonos, PhD; Kaveh Pourhamidi, MD, Gustav Jörnåker, MSc; Martin Engvall, MD; Lisa Eriksson, Sara Elhallos, BSc; Nicole Asplund; Mirko Mandić, Patrik Sundblad, Atif Sepic, Eric Rullman, Lars Hyllienmark, Helene Rundqvist, Tommy R. Lundberg, Thomas Gustafsson, PhD

Language: Английский

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Measuring Post-Exertional Malaise with DePaul Symptom Questionnaires: Challenges and Opportunities

OBM Neurobiology, Journal Year: 2025, Volume and Issue: 09(01), P. 1 - 30

Published: Feb. 5, 2025

Following mental or physical exertion, patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) experience Post-Exertional Malaise (PEM). Although self-report questions represent less expensive and invasive procedures to assess PEM, variability in the wording of symptom can cause reliability validity problems. If different PEM measures are used studies, this could create difficulties replicating findings, identifying biomarkers, determining effective treatments for patients. The objective article is describe challenges opportunities DePaul Symptom Questionnaires (DSQ) specific. five DSQ items identify 97% ME/CFS. A brief DSQ-PEM instrument has now been constructed that consists supplementary such as duration how quickly would recover from activities. more comprehensive called Questionnaire assesses a list triggers length recovery time PEM. In article, we show DSQ’s provide clues ME/CFS pathophysiology well these be outcome measures. Future research should focus on contrasting comparing ways eliciting assessing relationships between questionnaires examining impact treatment trials

Language: Английский

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Effect of a 4-week pulmonary telerehabilitation program for people with respiratory post-acute sequelae of COVID-19 – A randomised controlled trial

European Journal of Physiotherapy, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 10

Published: March 19, 2025

Language: Английский

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Health outcomes up to 3 years and post-exertional malaise in patients after hospitalization for COVID-19: a multicentre prospective cohort study (CO-FLOW)

The Lancet Regional Health - Europe, Journal Year: 2025, Volume and Issue: unknown, P. 101290 - 101290

Published: April 1, 2025

Language: Английский

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Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: population-based, nested case-control study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 22, 2024

Abstract Objective To assess risk factors for persistence vs improvement and to describe clinical characteristics diagnostic evaluation of subjects with post-acute sequelae COVID-19/post-COVID-19 syndrome (PCS) persisting more than one year. Design Nested population-based case-control study. Setting Comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, laboratory testing in four university health centres southwestern Germany (2022). Participants PCS cases aged 18 65 years (n=982) age sex-matched controls without (n=576) according an earlier questionnaire study (six 12 months after acute infection, phase 1) consenting provide follow-up information undergo assessment (phase 2, another 8.5 [median] 1). Main outcome measures Relative frequencies symptoms problems distribution symptom scores test results between persistent controls. Additional analysis included predictors changing case or control status over time adjustments potentially confounding variables. Results At the examination 2), 67.6% initial remained cases, whereas 78.5% continued report no related PCS. In adjusted analyses, among were mild index previous full-time employment, educational status, specialist consultation not attending a rehabilitation programme. Among controls, new worsening development intercurrent secondary SARS-CoV-2 infection status. less frequently never smokers, had higher values BMI body fat, lower Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness anxiety/depression/sleep predominant clusters, exercise intolerance post-exertional malaise >14 h (PEM) compatible ME/CFS (according Canadian consensus criteria) reported by 35.6% 11.6% respectively. significant differences stable (at 2) observed performances, perceived stress subjective cognitive disturbances, indicating dysautonomia, depression anxiety, sleep quality, fatigue, quality life. handgrip strength, maximal oxygen consumption, ventilator efficiency significantly reduced. However, there systolic diastolic cardiac function, level pro-BNP blood levels other measurements (including complement activity, serological markers EBV reactivation, inflammatory coagulation markers, cortisol, ACTH DHEA-S serum levels). Screening viral (based on PCR stool samples spike antigen plasma subgroup cases) was negative. Sensitivity analyses (pre-existing illness/comorbidity, obesity, PEM, medical care infection) revealed similar findings showed that PEM pain worse almost all tests. Conclusions This nested demonstrates majority do recover second year their illness, patterns remaining essentially similar, nonspecific dominated complaints. We found objective signs deficits reduced capacity likely be unrelated primary pulmonary dysfunction some but major pathology investigations. A history which associated severe as well disease may pragmatic means stratify severity. What is already known this topic Self-reported following have commonly been described persist months. They typically include relatively non-specific complaints such exertional dyspnoea, concentration memory disturbance problems. The incidence post-COVID-19 varying sociodemographic variables, pre-existing comorbidities, severity factors. long-term prognosis unknown differ different clusters. Evidence measurable single multiple organ correlation self-reported patients non-recovery from described. adds describes (need for) programme (the latter probably due reverse causation) PCS, changes clusters After comprehensive correlated symptoms, detected often longer lasting malaise, both physical (diminished consumption ventilatory efficiency), performances while investigations adjustment possible confounders.

Language: Английский

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Promoting equity, diversity, and inclusion in surveys: insights from a patient-engaged study to assess long COVID health-care needs in Brazil

Journal of Clinical Epidemiology, Journal Year: 2024, Volume and Issue: 173, P. 111423 - 111423

Published: June 14, 2024

Language: Английский

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Prevalence and measurement of post-exertional malaise in post-acute COVID-19 syndrome: A systematic review and meta-analysis

General Hospital Psychiatry, Journal Year: 2024, Volume and Issue: 91, P. 130 - 142

Published: Oct. 20, 2024

Language: Английский

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Editorial: Updating long COVID: mechanisms, risk factors, and treatment

Frontiers in Human Neuroscience, Journal Year: 2024, Volume and Issue: 18

Published: Sept. 19, 2024

Language: Английский

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