Abstract
Background
In
2021,
the
American
Academy
of
Physical
Medicine
and
Rehabilitation
established
Multi‐Disciplinary
Post‐Acute
Sequelae
SARS‐CoV‐2
Infection
Collaborative
to
provide
guidance
from
Long
COVID
clinics
for
evaluation
management
COVID.
The
collaborative
previously
published
eight
consensus
statements
using
a
primarily
symptom‐based
approach.
However,
symptoms
most
often
do
not
occur
in
isolation.
Aims
This
compendium
aims
equip
clinicians
with
an
efficient,
up‐to‐date
clinical
resource
evaluating
managing
adults
experiencing
symptoms.
primary
intended
audience
includes
physiatrists,
care
physicians,
other
who
first‐line
assessment
symptoms,
especially
settings
where
subspecialty
is
readily
available.
provides
holistic
framework
management,
symptom‐specific
considerations,
updates
on
prevalence,
health
equity,
disability
pathophysiology,
emerging
evidence
regarding
treatments
under
investigation.
Because
closely
resembles
infection‐associated
chronic
conditions
(IACCs)
such
as
myalgic
encephalomyelitis/chronic
fatigue
syndrome,
this
may
also
be
helpful
these
related
conditions.
Methods
Guidance
was
developed
by
collaborative's
modified
Delphi
multidisciplinary
group
whose
members
include
pulmonologists,
cardiologists,
psychiatrists,
neuropsychologists,
neurologists,
occupational
therapists,
physical
speech
language
pathologists,
patients,
government
representatives.
Over
40
centers
are
represented
collaborative.
Results
defined
National
Academies
Sciences,
Engineering,
“an
IACC
that
occurs
after
infection
present
at
least
3
months
continuous,
relapsing
remitting,
or
progressive
disease
state
affects
one
more
organ
systems.”
current
global
prevalence
estimated
6%.
Higher
has
been
identified
among
female
gender,
certain
racial
ethnic
groups,
individuals
live
nonurban
areas.
anyone
can
develop
being
infected
virus.
wide
variety
symptom
clusters.
common
exaggerated
diminished
energy
windows,
postexertional
malaise
(PEM)/postexertional
exacerbation
(PESE),
cognitive
impairment
(brain
fog),
dysautonomia,
pain/myalgias,
smell
taste
alterations.
Holistic
should
traditional
history,
examination,
additional
diagnostic
testing,
indicated.
A
positive
COVID‐19
test
during
acute
required
diagnose
COVID,
currently,
there
no
single
laboratory
finding
definitively
confirming
ruling
out
diagnosis
basic
recommended
all
patients
possible
consideration
labs
procedures
guided
patient's
specific
Current
strategies
focus
supportive
care.
Critical
considerations
conservation
addressing
comorbidities
modifiable
risk
factors.
Additionally,
(1)
it
essential
validate
experience
reassurance
their
taken
seriously
because
many
have
had
dismissed
loved
ones
clinicians;
(2)
activity
recommendations
must
carefully
tailored
tolerance
overly
intense
trigger
PEM/PESE
worsened
muscle
damage;
(3)
treatment
delivered
humility
persistent
unknowns
To
date,
limited
data
guide
medication
specifically
context
As
such,
use
generally
follows
standard
practice
indications
dosing,
extra
attention
prioritize
patient
preference
via
shared
decision‐making
cautious
medications
improve
some
(eg,
cognitive/attention
impairment)
but
worsen
PEM/PESE).
Numerous
trials
investigating
treatments.
return‐to‐work
process
challenging
fluctuate,
vary
nature,
affect
multiple
functional
areas
cognitive),
manifest
“invisible
disability”
acknowledged
employers
coworkers.
Clinicians
help
return
work
identifying
suitable
workplace
accommodations
resources,
providing
necessary
documentation,
recommending
vocational
therapy
when
needed.
If
efforts
unsuccessful
significantly
worsens
impedes
recovery,
applying
warranted.
recognized
potential
Americans
Disabilities
Act.
Conclusion
contribute
overall
well‐being
manner
acknowledges
challenges
faced
uncertainties
field.
For
detailed
information
readers
reference
statements.
Archives of Physical Medicine and Rehabilitation,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 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
Abstract
Long
COVID
(also
known
as
post-acute
sequelae
of
SARS-CoV-2
infection
[PASC]
or
post-COVID
syndrome)
is
characterized
by
persistent
symptoms
that
extend
beyond
the
acute
phase
infection,
affecting
approximately
10%
to
over
30%
those
infected.
It
presents
a
significant
clinical
challenge,
notably
due
pronounced
neurocognitive
such
brain
fog.
The
mechanisms
underlying
these
effects
are
multifactorial,
with
mounting
evidence
pointing
central
role
cerebromicrovascular
dysfunction.
This
review
investigates
key
pathophysiological
contributing
cerebrovascular
dysfunction
in
long
and
their
impacts
on
health.
We
discuss
how
endothelial
tropism
direct
vascular
trigger
dysfunction,
impaired
neurovascular
coupling,
blood–brain
barrier
disruption,
resulting
compromised
cerebral
perfusion.
Furthermore,
appears
induce
mitochondrial
enhancing
oxidative
stress
inflammation
within
cells.
Autoantibody
formation
following
also
potentially
exacerbates
injury,
chronic
ongoing
compromise.
These
factors
collectively
contribute
emergence
white
matter
hyperintensities,
promote
amyloid
pathology,
may
accelerate
neurodegenerative
processes,
including
Alzheimer’s
disease.
emphasizes
critical
advanced
imaging
techniques
assessing
health
need
for
targeted
interventions
address
complications.
A
deeper
understanding
essential
advance
treatments
mitigate
its
long-term
consequences.
European Journal of Physical and Rehabilitation Medicine,
Год журнала:
2024,
Номер
59(6)
Опубликована: Янв. 1, 2024
INTRODUCTION:
Until
the
last
update
in
February
2022,
Cochrane
Rehabilitation
COVID-19
Evidence-based
Response
(REH-COVER)
action
identified
an
increasing
volume
of
evidence
for
rehabilitation
management
COVID-19.
Therefore,
our
aim
was
to
identify
best
available
on
effectiveness
interventions
COVID-19-related
limitations
functioning
interest
adults
with
or
post
condition
(PCC).EVIDENCE
ACQUISITION:
We
ran
searches
17th,
2023,
following
databases:
PubMed,
EMBASE,
CENTRAL,
CINHAL,
and
Study
Register,
applying
a
publication
date
restriction
retrieve
only
papers
published
2022.
To
before
we
screened
reference
lists
previous
publications
included
REH-COVER
action,
covering
from
early
2020
end
This
current
review
includes
randomised
controlled
trials
concludes
rapid
living
systematic
reviews
action.
The
risk
bias
certainty
were
evaluated
all
studies
using
Risk
Bias
tool
GRADE,
respectively.
conducted
narrative
synthesis
evidence.
PROSPERO
registration
number:
CRD42022374244.EVIDENCE
SYNTHESIS:
After
duplicate
removal,
18,950
individual
records
53
RCTs
met
inclusion
criteria.
Our
findings
suggest
that
effect
breathing
strengthening
exercise
programs
dyspnea
physical
capacity
compared
no
treatment
non-severe
patients
is
uncertain.
Multicomponent
telerehabilitation
may
slightly
increase
educational
intervention
PCC.
There
is,
however,
uncertainty
about
its
lung
function
when
treatment.
Finally,
inspiratory
muscle
training
maximal
pressure
PCC
uncertain.CONCLUSIONS:
Interventions
are
part
comprehensive
pulmonary
approaches
benefit
tolerance
has
several
methodological
limit
clinical
relevance
findings.
cannot
provide
robust
suggestions
practice.
While
high-quality
being
conducted,
clinicians
should
consider
other
conditions
rehabilitate
context-specific
interventions.
Biomedicines,
Год журнала:
2023,
Номер
11(11), С. 3092 - 3092
Опубликована: Ноя. 18, 2023
A
post-COVID
condition
can
reduce
activity
and
quality
of
life,
resulting
in
a
significant
socioeconomic
health
burden.
Understanding
its
impact
on
patients'
is
important
for
the
development
personalized
rehabilitation
interventions.
An
independent
association
between
obesity
was
found
because
complications
comorbidities.Sixteen
patients
with
symptoms
(i.e.,
dyspnea,
pain,
poor
sleep
quality,
muscle
fatigue),
admitted
to
Istituto
Auxologico
Italiano,
Piancavallo
(VB),
Italy,
were
recruited
four-week
program
including
conventional
exercise
therapy,
nutritional
intervention,
psychological
support
whole-body
cryostimulation
(WBC).All
participants
attended
all
sessions
program.
Anthropometric
data
showed
statistically
changes
weight,
waist
circumference
body
mass
index.
Biochemical
analyses
reductions
lipid
inflammatory
profiles.
There
improvement
physical
performance,
reduction
pain
well-being.A
multidisciplinary
protocol
WBC,
designed
condition,
safe
feasible.
The
overall
improvements
demonstrate
that
effective
post
COVID
suggest
use
WBC
could
play
role
as
booster
programs.
European Archives of Psychiatry and Clinical Neuroscience,
Год журнала:
2024,
Номер
unknown
Опубликована: Июль 25, 2024
Abstract
Post-COVID
syndrome
(PCS)
describes
a
persistent
complex
of
symptoms
following
COVID-19
episode,
lasting
at
least
4
to
12
weeks,
depending
on
the
specific
criteria
used
for
its
definition.
It
is
often
associated
with
moderate
severe
impairments
daily
life
and
represents
major
burden
many
people
worldwide.
However,
especially
during
first
two
years
pandemic,
therapeutic
diagnostic
uncertainties
were
prominent
due
novelty
disease
non-specific
definitions
that
overlooked
functional
deficits
lacked
objective
assessment.
The
present
work
comprehensively
examines
status
PCS
as
depicted
in
recent
reviews
meta-analyses,
alongside
exploring
impairments.
We
searched
database
Pubmed
meta-analysis
evaluating
period
between
May
31,
2022,
December
2023.
Out
95
studies,
33
selected
inclusion
our
analyses.
Furthermore,
we
extended
upon
prior
research
by
systematically
recording
linked
identified
studies.
found
fatigue,
neurological
complaints,
exercise
intolerance
most
frequently
reported
symptoms.
In
conclusion,
over
past
eighteen
months,
there
has
been
notable
increase
quantity
quality
studies
PCS.
still
remains
clear
need
improvement,
particularly
regard
definition
necessary
diagnosing
this
syndrome.
Enhancing
aspect
will
render
future
more
comparable
precise,
thereby
advancing
understanding
ERJ Open Research,
Год журнала:
2024,
Номер
10(4), С. 00089 - 2024
Опубликована: Май 9, 2024
Background
There
is
evidence
to
support
COVID-19
rehabilitation
programmes
improving
persistent
symptoms;
however,
there
concern
that
therapies
include
an
exercise
component
may
increase
fatigue
and
post-exertional
symptom
exacerbation
(PESE).
The
objectives
of
the
present
study
were
determine
effect
a
6-week
programme
on
PESE
in
individuals
with
ongoing
symptoms.
Methods
After
routine
medical
assessment,
symptoms
enrolled
specific
programme.
included
symptom-titrated
exercise,
education
self-management
advice.
Fatigue
was
assessed
pre-
post-programme
using
Functional
Assessment
Chronic
Illness
Therapy
questionnaire
(FACIT).
Exercise
capacity
(Incremental
Endurance
Shuttle
Walking
Test
(ISWT
ESWT))
(DePaul
Symptom
Questionnaire
(DSQ))
also
post-programme.
Composite
scores
calculated
for
frequency
severity
domains
DSQ.
Results
148
patients
(median
(IQR)
age
59
(49–72)
years,
82
(55%)
female,
81
(54%)
hospitalised)
completed
FACIT
score
reduced
by
mean
(CI)
change
−5
(−7–
−4);
p<0.01.
increased
(65–99)
m
ISWT
398
(333–462)
s
ESWT
(n=148).
44
patients.
DSQ
composite
improved
20
(13–28)
19
(13–26)
points,
respectively
(p<0.01,
n=44).
Conclusion
These
data
demonstrate
potential
benefits
fatigue,
those
Journal of Occupational and Environmental Medicine,
Год журнала:
2024,
Номер
66(4), С. 349 - 357
Опубликована: Фев. 2, 2024
Abstract
Persistent
symptoms
are
common
after
acute
COVID-19,
often
referred
to
as
long
COVID.
Long
COVID
may
affect
the
ability
perform
activities
of
daily
living,
including
work.
occurs
more
frequently
in
those
with
severe
COVID-19.
This
guidance
statement
reviews
pathophysiology
COVID-19
and
provides
pragmatic
approaches
symptoms,
syndromes,
conditions
occupational
setting.
Disability
laws
workers’
compensation
also
addressed.
