scholarly journals The impact of Post-COVID-Syndrome on functioning – results from a community survey in patients after mild and moderate SARS-CoV-2-infections in Germany

Author(s):  
Christina Lemhöfer ◽  
Christian Sturm ◽  
Dana Loudovici-Krug ◽  
Norman Best ◽  
Christoph Gutenbrunner

Abstract Background In COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptoms (now called Post-COVID-Syndrome) may have an impact on functioning and may also hinder to participation in social life in affected people. However, little is known about developing such syndrome a for patients with mild and moderate COVID-19 who did not need hospitalization or intensive care. Methods A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Descriptive statistics were calculated. Results In all, 97.5% of patients reported one symptom in the infection stage, such as fatigue, respiratory problems, limitations of the senses of taste and smell, fear and anxiety and other symptoms. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. In all, 61.9% of participants reported persisting symptoms more than 3 months after infection. These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Predominately, these were handling stress, carrying out daily routines, looking after one’s health, relaxing and leisure activities and doing house work. The impacts on quality of life and vocational performance were rather low. Conclusion The results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not severe and do not lead to frequent or serious issues with quality of life or work ability.

2021 ◽  
Author(s):  
Christina Lemhöfer ◽  
Christian Sturm ◽  
Dana Loudovici-Krug ◽  
Norman Best ◽  
Christoph Gutenbrunner

Abstract BackgroundIn COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptom (now called long-COVID) may have an impact on functioning and my hinder affected people to participate in social life. However, little is known if and to what extent patients with mild and moderate COVID-19 who did not need hospitalization or intensive care develop such a syndrome.MethodsA cross-sectional study in 1027 patients with mild or moderate COVID-19 has been performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) that includes Short Form 36 health questionnaire (SF-36) on health-related quality of life, was performed. Descriptive statistics were calculated. Results97.5 % of patients reported one symptom in infection phase such as fatigue, respiratory problems, limitations of the sense of taste and smell, as well as fear and anxiety and other symptoms. In this phase 84.1% of participants experienced activity limitations and participation restrictions such as carrying out daily routine, handling stress, getting household tasks done, care/support for others, and relaxing and leisure.61.9% of participants reported persisting symptoms after more than 3 months after infection. These were among others fatigue, sleep disturbances, respiratory problems pain, fears and anxiety, and restrictions in movement. 49% of the participants reported on activity limitations and participation restrictions. Predominately these were handling stress, carrying out daily routine, looking after one’s health, relaxing and leisure activities as well as doing house work.The impact on quality of life and vocational performance were rather low.ConclusionThe results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not very severe and do not lead to frequent or severe issues with quality of live or work ability.


2021 ◽  
Author(s):  
Yi-chang Chen ◽  
Keh-chung Lin ◽  
Shu-Hui Yeh ◽  
Chih-Hung Wang ◽  
Ay-Woan Pan ◽  
...  

Abstract Background: Joint contractures and degenerative osteoarthritis are the most common joint diseases in the elderly, can lead to limited mobility in the elderly with diseases, can exacerbate symptoms, such as pain, stiffness and disability, and can interfere with social participation and quality of life, affecting mental health. However, relevant studies on this topic are very limited. The purpose of this study is to investigate the relationship of demographic characteristics and joint contracture categories and sites with the quality of life, activity limitations, and participation restrictions of elderly residents in long-term care facilities.Methods: A cross-sectional observational study. Elderly individuals with joint contractures who were residents in long-term care facilities were recruited. The World Health Organization (WHO) Quality of Life and the WHO Disability Assessment Schedule 2.0 were used to survey the participants. Correlations, multiple linear regressions, and multiple analyses of variance, with joint contractures as the response variable, were used in the statistical analysis.Results: The final statistical analysis included 232 participants. The explanatory power of contracture sites on activities and participation had a moderate strength of association (η2 = .113). Compared with elderly residents with joint contractures and osteoarthritis in isolated upper limbs, elderly residents with joint contractures and osteoarthritis in both the upper and lower limbs had significantly worse activity and participation limitations. There were no significant differences in activity and participation between elderly residents with joint contractures affecting isolated upper limbs and elderly residents with joint contractures affecting isolated lower limbs (F1,226 = 2.604 and F1,226 =.674, n.s.). Osteoarthritis had the greatest impact on activity limitations and participation restrictions of elderly residents with joint contractures affecting both upper and lower limbs (F1,226 = 6.251, p = .014).Conclusions: Elderly residents in long-term care facilities who are minorities and have non-mainstream religious beliefs, history of stroke and osteoarthritis are at high risk of developing activity limitations and participation restrictions. Moreover, compared with other contractile sites, regardless of osteoarthritis, elderly residents with joint contractures affecting both upper and lower limbs had the most substantial activity limitations and participation restrictions.Trial registration: This study has been registered in the Chinese Clinical Trial Registry, Registration number and date: ChiCTR2000039889


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.


2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.


2008 ◽  
Vol 17 (9) ◽  
pp. 891-900 ◽  
Author(s):  
Brad J. Zebrack ◽  
Jaehee Yi ◽  
Laura Petersen ◽  
Patricia A. Ganz

2020 ◽  
Author(s):  
Claire CARDAILLAC ◽  
Stéphane Ploteau ◽  
Aurélie Le Thuaut ◽  
Vincent Dochez ◽  
Norbert Winer ◽  
...  

Abstract Background Perineal pain due to episiotomy is commonly reported and can be severe enough to disturb the mother-infant dyad during the postpartum period. Its incidence at day 7 postpartum varies from 63% to 74%. Recent studies have already investigated the analgesic efficacy of perineal infiltration of ropivacaine after episiotomy, but have only focused on the immediate postpartum period (at 24 and 48 hours after birth). Large, adequately powered, multicenter, randomized controlled trials are required to evaluate the impact of ropivacaine infiltration on perineal pain and mid- and long-term quality of life before the widespread use of ropivacaine to prevent perineal pain after episiotomy can be recommended. Methods The ROPISIO study is a two-center, randomized, double-blind, placebo-controlled trial in La Roche sur Yon and Nantes, France. It will involve 272 women with vaginal singleton delivery and mediolateral episiotomy at term (≥ 37 weeks). Perineal infiltration (ropivacaine 75mg or placebo) will be administrated just after vaginal birth and before episiotomy repair. The primary outcome will be the analgesic efficacy at day 7 postpartum (mid-term), defined by the numerical rating scale of pain (ENS NRS) strictly superior to 3/10 on the perineal repair area. Secondary outcomes will be the analgesic efficacy (ENS NRS), the impact of pain on daily behavior, on the quality of life (36-Item Short Form Health Survey), on the occurrence of symptoms of postpartum depression (Edinburgh Postnatal Depression Scale) and on sexuality (Female Sexual Function Index) at 3 and 6 months (long-term) using validated online questionnaires. This study will have 90% power to show approximately 30% relative risk reduction in the incidence of perineal pain at day 7, from 70.0% to 50.0%. Discussion Ropivacaine is a promising candidate drug, inexpensive, easy to administer, and would be suitable to include in the routine management of deliveries in labor ward. This study will investigate if perineal ropivacaine infiltration just after birth can reduce mid- and long-term postpartum pain and increase quality of life in women with mediolateral episiotomy.


Author(s):  
Feliciano Villar ◽  
Rodrigo Serrat ◽  
Annette Bilfeldt ◽  
Joe Larragy

AbstractLiving in a long-term care (LTC) institution provides older people experiencing health and social problems with a comprehensive range of support services that address their quality of life. Despite access to such services, challenges arise in relation to their participation in key activities both within and outside the institution. This chapter examines such challenges, reviewing and describing ways to prevent exclusion along various domains, specifically social relationships, civic participation and socio-cultural life. Firstly, we discuss ways in which bio-medical models of care and the quality control systems, which are dominant in LTC services, standardise care, tending to put decisions exclusively in hands of staff, taking away residents’ autonomy, and ultimately curtailing rights and citizenship status. Secondly, we examine how LTC services might prevent such exclusion and promote older people’s participation in at least four respects: (1) prompting and supporting residents’ ability to take decisions on their own care, (2) favouring the maintenance and creation of social relationships, (3) enabling residents’ participation in the activities and management of the institution, and (4) guaranteeing residents’ rights and full access to citizenship. We discuss the impact and limitations of recent initiatives put into practice in these areas of practice.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
Amelia Austen ◽  
Carina Hou ◽  
Khushbu Patel ◽  
Keri Brady ◽  
Gabrielle G Grant ◽  
...  

Abstract Introduction Burn injuries can have major long-term effects on the health and quality of life for children and adolescents. This study narratively reviewed the health outcomes literature focusing on the impact of burn injury for children aged 5–18. Methods Literature targeting pediatric outcomes was reviewed to identify the effects of burns on children aged 5–18 (n=16). Inclusion criteria included studies that focused on the impact of burns on health and quality of life and were age-appropriate for this population. Articles were identified via PubMed, Web of Science, and manual reference checks. Data collected included the outcomes and health domains assessed in each article and the findings of the effects of the burn injury on those specific outcomes. The Preschool LIBRE Conceptual Model served as a ‘domains framework’ to guide the identification of outcomes and health domains. Results Long-term burn-specific outcomes and broad health domains identified were physical functioning (n=9), psychological functioning (n=12), social functioning (n=4), symptoms (n=8), and family (n=7). Some studies exclusively focused on one domain whereas others assessed two domains or more. Subdomains such as upper extremity functioning and functional independence were addressed in the physical functioning domain. Psychological functioning outcomes included subdomains such as emotional health and behavioral problems. Social functioning outcomes evaluated subdomains such as problems with peers and social participation. The symptoms domain addressed post-burn pain and itch. Family outcomes subdomains such as parental satisfaction with appearance and general family functioning were identified. Conclusions Burn-specific outcomes and health domains assessing the effects of burns on children aged 5–18 were identified among 16 studies. There is a need for a comprehensive assessment tool that more precisely measures the impact of burn injury across these domains. This work will inform the development of the School-Aged Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile – a new outcome metric for children and adolescents with burns. Applicability of Research to Practice This review is relevant to researchers and clinicians assessing health outcomes and measuring burn recovery in children aged 5–18.


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