scholarly journals Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?

Author(s):  
Dominic Lee Sykes ◽  
Luke Holdsworth ◽  
Nadia Jawad ◽  
Pumali Gunasekera ◽  
Alyn H Morice ◽  
...  

Abstract The enduring impact of COVID-19 on patients has been examined in recent studies, leading to the description of Long-COVID. We report the lasting symptom burden of COVID-19 patients from the first wave of the pandemic. All patients with COVID-19 pneumonia discharged from a large teaching hospital trust were offered follow-up. We assessed symptom burden at follow-up using a standardised data collection technique during virtual outpatient clinic appointments. Eighty-six percent of patients reported at least one residual symptom at follow-up. No patients had persistent radiographic abnormalities. The presence of symptoms at follow-up was not associated with the severity of the acute COVID-19 illness. Females were significantly more likely to report residual symptoms including anxiety (p=0.001), fatigue (p=0.004), and myalgia (p=0.022). The presence of long-lasting symptoms is common in COVID-19 patients. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, and believe the biopsychosocial effects of COVID-19 may play a greater role in its aetiology.

1989 ◽  
Vol 10 (9) ◽  
pp. 416-421 ◽  
Author(s):  
Deirdre L. Church ◽  
Heather E. Bryant

AbstractFor several months in 1986, an outbreak of Streptococcus viridanspseudobacteremia occurred at a large teaching hospital. All sources of laboratory blood culture contamination were excluded. A retrospective epidemiological study indicated that one phlebotomist, “P,” collected a disproportionate number of the positive blood cultures. Further comparison of the paired blood culture results from the three months when the incidence was highest revealed a good concordance of results among all other phlebotomists (Kappa = 0.5), while P's results concurred with others less frequently than would be expected even by chance (Kappa < 0.0). Clinical follow-up showed that P did not routinely wear gloves while drawing blood and had eczema of the hands. Skin scrapings from the hands, right index finger/fingernail grew predominantlyS viridansspecies that were compatible with those recovered from contaminated blood cultures. This epidemic demonstrated the need for early detection of this source as a cause of nosocomial pseudobacteremia.


Author(s):  
Baiq Marwati ◽  
Wildan Wldan ◽  
Baehaqi Baehaqi

The purpose of this study is to obtain a picture of how the strategy of implementing clinical supervision of supervisors to improve teacher pedagogical competence. This study uses a qualitative approach supported by a quantitative approach to get a general picture of the implementation of clinical supervision. The location of this study was conducted in two Madrasah Tsanawiyah (MTs) in Masbagik sub-district, namely MTs Al-Ijtihad Danger and MTs Al Khaer Ambung Masbagik Timur. The type of data collected in this study is divided into 2 (two), namely primary data and secondary data. Research informants obtained by Snowball sampling and purposive sampling techniques. Data collection techniques in this study are using interviews, observation and documentation. 1) Interview, a data collection technique through question and answer with research subjects and informants. Research results indicate that: 1) The implementation of clinical supervision includes the stages: planning, implementation, evaluation, analysis and follow-up. Supervision planning is designed by arranging the supervision program and socializing it to the madrasa so that all teachers know it. The implementation phase includes initial meetings, observations, and feedback meetings. MGMP and work shop are solutions that are taken as a follow up from clinical supervsi which is a discussion forum to discuss the lack of teacher performance. 2) The initial meeting of clinical supervision is done by first establishing familiarity with the teacher so that it does not seem daunting, then examining the syllabus and lesson plans, agreeing on aspects that will be supervised in the supervision instrument and setting the supervision schedule. At the observation stage, observe and record all activities of teachers and students in the class as a reference in feedback meetings. Feedback is carried out in feedback meetings to assist teachers in solving problems experienced while doing learning in class. 3) Internal constraints that are sufficiently hampering the implementation of clinical supervision are those of the supervisor himself because he is hampered by the many activities and workloads of supervisors. To overcome this obstacle, the East Lombok district office of the Ministry of Religion continues to work to overcome the discrepancy in the number of supervisors through the recruitment of prospective supervisors annually based on an analysis of supervisor needs made by the chairperson of the pokjawas. While the efforts of the Chairperson of the Pokjawas are to form a supervisory supervision team that will be tasked with conducting clinical supervision so that all teachers have the opportunity to be supervised.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T Naylor

Abstract Aim During the first peak of the COVID-19 pandemic, the BOA recommended that upper limb surgery for trauma should be avoided if possible, or performed as day-case if unavoidable, to reduce the risk of COVID-19 related negative outcomes. This audit assessed compliance with recommendations and impact on proportion of injuries managed conservatively due to COVID-19 risks, inpatient stay duration, COVID-19 infections, and corrective surgical intervention rates. Method Data was collected for all referrals to orthopaedics for upper limb fractures/dislocations at a large NHS teaching hospital in the North West over a 10-week period from April 4th to June 12th. Follow up was performed to 6 months after date of injury. Care was audited against the “British Orthopaedic Association Standard in Trauma: Management of patient with urgent orthopaedic conditions and trauma during the coronavirus pandemic”. Results A total of 112 patients were referred. 76% of patients were discharged from Emergency Department, with surgery indicated in 48%. Of those, 11% (n = 6) were not operated on due to COVID-19 risks and 1 patient from this group (16.7%) has required secondary corrective surgery. Surgery was completed as day-case procedure in 50%. COVID-19 swabs were not taken in 46% of referrals, 50% had a negative test and 4% positive. No patients tested positive after discharge following treatment. Conclusions Few cases were managed conservatively based on COVID-19 risk, and only 1 patient has required secondary surgery. More upper limb injuries may be managed conservatively, as per BOAST standards, with day-case procedures better utilised as an alternative.


2021 ◽  
Author(s):  
Michael Ewens ◽  
Stuart Haines ◽  
Laura Brown ◽  
Louise Buchanan ◽  
Dipesh Odedra

1994 ◽  
Vol 39 (3) ◽  
pp. 75-77 ◽  
Author(s):  
C.D. Selby ◽  
M.F. Sudlow

In a retrospective, case-note based, audit of the initial management of spontaneous pneumothoraces in a large teaching hospital, 38 events were identified in 37 patients admitted over 12 months to the end of September 1991. The initial management was intercostal tube drainage in 21 (55%), decided upon by middle grade staff, with a cost in terms of the duration of hospitalisation (median 7 (range 2–18) days), chest radiography (6 (3–10) films) and potential for complications including infections (3 wound, 2 chest). Aspiration was performed in only three cases, the remainder were managed by observation. We suggest that undue reliance is placed upon intercostal tube drainage to treat spontaneous pneumothoraces with aspiration alone performed too infrequently. Moreover, other deficiencies in management including the practise of drain clamping and incomplete follow-up were identified.


2008 ◽  
Vol 16 (4) ◽  
pp. 700-706 ◽  
Author(s):  
Emilia Campos de Carvalho ◽  
Fernanda Titareli Merizio Martins ◽  
Maria Célia Barcellos Dalri ◽  
Silvia Rita Marin da Silva Canini ◽  
Ana Maria Laus ◽  
...  

This descriptive, retrospective study aimed to analyze the relation between nursing data collection, diagnoses and prescriptions for 26 adult patients who were hospitalized at the intense care unit of a large teaching hospital for at least 24 hours. Through the analysis of medical records, 135 diagnoses and 421 nursing prescriptions were established, and 24 different diagnosis categories and 20 different items for prescriptions were identified. The most frequent diagnosis risk was that for infection, present in the medical records of 22 (84.60%) patients, with 175 prescriptions (42%) related to this diagnosis. The data the nurses collected were sufficient to establish the nursing diagnoses, and the majority of prescriptions (87.9%) were related to the diagnoses.


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