scholarly journals Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Author(s):  
Betty Raman ◽  
Mark Philip Cassar ◽  
Elizabeth M Tunnicliffe ◽  
Nicola Filippini ◽  
Ludovica Griffanti ◽  
...  

AbstractBackgroundThe medium-term effects of Coronavirus disease (COVID-19) on multiple organ health, exercise capacity, cognition, quality of life and mental health are poorly understood.MethodsFifty-eight COVID-19 patients post-hospital discharge and 30 comorbidity-matched controls were prospectively enrolled for multiorgan (brain, lungs, heart, liver and kidneys) magnetic resonance imaging (MRI), spirometry, six-minute walk test, cardiopulmonary exercise test (CPET), quality of life, cognitive and mental health assessments.FindingsAt 2-3 months from disease-onset, 64% of patients experienced persistent breathlessness and 55% complained of significant fatigue. On MRI, tissue signal abnormalities were seen in the lungs (60%), heart (26%), liver (10%) and kidneys (29%) of patients. COVID-19 patients also exhibited tissue changes in the thalamus, posterior thalamic radiations and sagittal stratum on brain MRI and demonstrated impaired cognitive performance, specifically in the executive and visuospatial domain relative to controls. Exercise tolerance (maximal oxygen consumption and ventilatory efficiency on CPET) and six-minute walk distance (405±118m vs 517±106m in controls, p<0.0001) were significantly reduced in patients. The extent of extra-pulmonary MRI abnormalities and exercise tolerance correlated with serum markers of ongoing inflammation and severity of acute illness. Patients were more likely to report symptoms of moderate to severe anxiety (35% versus 10%, p=0.012) and depression (39% versus 17%, p=0.036) and a significant impairment in all domains of quality of life compared to controls.InterpretationA significant proportion of COVID-19 patients discharged from hospital experience ongoing symptoms of breathlessness, fatigue, anxiety, depression and exercise limitation at 2-3 months from disease-onset. Persistent lung and extra-pulmonary organ MRI findings are common. In COVID-19 survivors, chronic inflammation may underlie multiorgan abnormalities and contribute to impaired quality of life.FundingNIHR Oxford and Oxford Health Biomedical Research Centres, British Heart Foundation Centre for Research Excellence, UKRI, Wellcome Trust, British Heart Foundation.

2021 ◽  
Vol 12 ◽  
Author(s):  
Austin Perlmutter

Since the start of the spread of the coronavirus disease 2019 (COVID-19) pandemic, an international effort has sought to better characterize associated extra-pulmonary health sequelae. The acute and or chronic detrimental impact of SARS-CoV-2 infection on mental health, especially depression, is increasingly described. Simultaneously the pandemic has influenced depressive symptomatology by modifying economic, social and political structures, in addition to affecting daily routines. In both cases, associated immunological perturbations favoring a pro-inflammatory state could underlie an increased risk for depressive symptomatology. A resultant elevation in global depressive burden could further tax mental health care infrastructure and contribute to a range of worse health outcomes including diminished quality of life. This suggests a critical and time-sensitive need to better understand immune interfaces between depression and COVID-19.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kristin E Ellison ◽  
Brad J Mikaelian ◽  
Karin F Hoth ◽  
Fausto G Devecchi ◽  
Athena Poppas ◽  
...  

Cardiac resynchronization therapy (CRT) improves heart failure (HF) symptoms in patients (pts) with EF <35%, QRS >120ms, and NYHA class 3 and 4 HF. The aim of this study was to compare the effects of CRT in pts with EF <35%, QRS >130, and class 2 vs 3/4 HF. We enrolled 25 patients. All received ECGs, transthoracic echocardiograms, 6 minute walk tests, and Minnesota quality of life questionnaires pre-op and three months post-op. Fourteen pts were class 2, 10 patients were class 3, and 1 class 4. Ischemic cardiomyopathy accounted for 7 out of the 14 class 2 pts and 5 out of the 11 class 3/4 pts. As a group, all patients had a significant increase in 6 minute walk (1150 vs 1249, p=0.02), increase in EF (30% vs 39%, p<0.01), decreased QRS duration (162 vs 143, p=0.001), and improved quality of life scores (31.1 vs 21.7, p=0.03), comparing pre and post-op measurements. There was no significant difference in response of class 2 versus class 3/4 pts (see table ). Nonischemic pts had greater response than ischemic pts. Class 2 HF pts reported greater improvement in mental health than class 3 and 4. Younger patients reported greater functional improvement, while pts with higher BMI reported less physical benefit. Summary: Pts with NYHA class 2 symptoms derive similar hemodynamic benefit from CRT as pts with class 3/4 symptoms and may derive greater mental health benefits than class 3/4 pts. Comparison of Pre and Post-Implant Parameters Between Class 2 and 3/4 Patients


2021 ◽  
Vol 14 (4) ◽  
pp. 1417-1421
Author(s):  
Ismaa Rumani

The outcome of covid-19 patients with co-morbidities has reported to be poor. Post covid exercise-based rehabilitation may have a major role in improving exercise tolerance and quality of life in post-covid-19 patients with co-morbidities. This case report discusses the clinical scenario of a 35-year-old person who is a known case of stable rheumatic heart disease since 29 years and recently diagnosed with covid-19 moderate pneumonia. He was referred to post covid outpatient department for post-covid physiotherapy rehabilitation. After one month of structured exercise-based rehabilitation, improvement recorded in his SF-12 and 6-minute walk distance. COVID-19 patients with co-morbidities seemed to have a poor prognosis, according to various studies. Post covid exercise-based rehabilitation may have a major role in improving exercise tolerance and quality of life in post-covid-19 patients with co-morbidities. There is no structured rehabilitative protocol designed for such unusual combination as of now hence our study focuses on this lacunae. This case report discusses the clinical scenario of a 35-year-old person who is a known case of stable Rheumatic heart disease in the last 29 years and recently diagnosed with COVID-19 moderate pneumonia. He was referred to post covid outpatient department for post-covid physiotherapy rehabilitation. The individual followed a structured exercise-based rehabilitation protocol for one month 6 times/week and improvement recorded in his SF-12 and 6-minute walk distance. There was improvement in six-minute walk distance by 150 meters and rate of perceived exertion was also improved from 9 score to 7 in 6-20 borg scale post one month. In comparison to pre-Rehabilitation, SF-12 improved the quality of life in both physical and mental sore. This case report concluded that there was a definite improvement in the walking distance and quality of life of the patient after post COVID physiotherapy rehabilitation.


PsycCRITIQUES ◽  
2007 ◽  
Vol 52 (33) ◽  
Author(s):  
Itai Danovitch

2006 ◽  
Author(s):  
Bethanee Lemesurier ◽  
Jordan Tabb ◽  
Mary Pritchard ◽  
Theodore McDonald

2013 ◽  
Vol 44 (02) ◽  
Author(s):  
A Novak ◽  
K Klaus ◽  
R Seidl ◽  
H Werneck ◽  
M Schubert ◽  
...  

Physiotherapy ◽  
2009 ◽  
Vol 17 (4) ◽  
Author(s):  
Edyta Smolis-Bąk ◽  
Tomasz Chwyczko ◽  
Mariola Wójcicka ◽  
Ilona Kowalik ◽  
Barbara Kazimierska ◽  
...  

2019 ◽  
Vol 31 (2) ◽  
pp. 222-228 ◽  
Author(s):  
Joshua L. Golubovsky ◽  
Arbaz Momin ◽  
Nicolas R. Thompson ◽  
Michael P. Steinmetz

OBJECTIVEBertolotti syndrome is a rare spinal condition that causes low-back pain due to a lumbosacral transitional vertebra (LSTV), which is a pseudoarticulation between the fifth lumbar transverse process and the sacral ala. Bertolotti syndrome patients are rarely studied, particularly with regard to their quality of life. This study aimed to examine the quality of life and prior treatments in patients with Bertolotti syndrome at first presentation to the authors’ center in comparison with those with lumbosacral radiculopathy.METHODSThis study was a retrospective cohort analysis of patients with Bertolotti syndrome and lumbosacral radiculopathy due to disc herniation seen at the authors’ institution’s spine center from 2005 through 2018. Diagnoses were confirmed with provider notes and imaging. Variables collected included demographics, diagnostic history, prior treatment, patient-reported quality of life metrics, and whether or not they underwent surgery at the authors’ institution. Propensity score matching by age and sex was used to match lumbosacral radiculopathy patients to Bertolotti syndrome patients. Group comparisons were made using t-tests, Fisher’s exact test, Mann-Whitney U-tests, Cox proportional hazards models, and linear regression models where variables found to be different at the univariate level were included as covariates.RESULTSThe final cohort included 22 patients with Bertolotti syndrome who had patient-reported outcomes data available and 46 propensity score–matched patients who had confirmed radiculopathy due to disc herniation. The authors found that Bertolotti syndrome patients had significantly more prior epidural steroid injections (ESIs) and a longer time from symptom onset to their first visit. Univariate analysis showed that Bertolotti syndrome patients had significantly worse Patient-Reported Outcomes Measurement Information System (PROMIS) mental health T-scores. Adjustment for prior ESIs and time from symptom onset revealed that Bertolotti syndrome patients also had significantly worse PROMIS physical health T-scores. Time to surgery and other quality of life metrics did not differ between groups.CONCLUSIONSPatients with Bertolotti syndrome undergo significantly longer workup and more ESIs and have worse physical and mental health scores than age- and sex-matched patients with lumbosacral radiculopathy. However, both groups of patients had mild depression and clinically meaningful reduction in their quality of life according to all instruments. This study shows that Bertolotti syndrome patients have a condition that affects them potentially more significantly than those with lumbosacral radiculopathy, and increased attention should be paid to these patients to improve their workup, diagnosis, and treatment.


2020 ◽  
Vol 103 (11) ◽  
pp. 1185-1193

Background: The systemic lupus erythematosus (SLE) patients oftentimes suffer from both physical and psychosocial challenges that may lead to low health-related quality of life (HRQoL). However, limited research has been done in this area. Objective: To examined mental health status and HRQoL among SLE patients in Thailand. Materials and Methods: The present study was a cross-sectional study conducted at the rheumatology clinic of four major hospitals in Thailand. The paper-based questionnaire consisted of demographic, health history such as depression, anxiety, stress Scale (DASS-21), and the Rosenberg self-esteem scale (RSE), and the disease-specific Lupus Quality of Life scale (LupusQoL). Depending on the variable’s level of measurement such as categorical or continuous, Spearman’s Rho or Pearson’s product moment correlation coefficients were used to explore the relationships among the variables. Hierarchical multiple regression was used to identify the predictors of LupusQoL. Results: Among the 387 participants, many might have experienced depression, anxiety, and stress (30%, 51%, and 29%, respectively). Self-esteem among the participants was good (31.8 out of 40). All eight domains of LupusQoL were affected with intimate relationship domain being impacted the most. The overall LupusQoL was significantly associated with the number of prescribed medications (r=–0.23), depression (r=–0.70), anxiety (r=–0.58), stress (r=–0.67), and self-esteem (r=0.59), p<0.001. Significant predictors of the overall LupusQoL were mental health status (depression, anxiety, and stress) and self-esteem, F (3, 81)=43.10, p<0.001, adjusted R²=0.60. Conclusion: SLE patients should be holistically assessed in both physical and psychological aspects. In addition to proper medical treatments, healthcare providers should use a multidisciplinary team approach to resolve the patients’ psychosocial issues, which in turn, may increase the patients’ quality of life. Self-care education may be necessary to help the patients manage the condition and decrease the number of medications. Keywords: Mental health, Quality of life, SLE, Thailand


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