Global prevalence of persistent neuromuscular symptoms and the possible pathomechanisms in COVID-19 recovered individuals: A systematic review and meta-analysis

This study was conducted to determine the prevalence of prolonged neuromuscular symptoms, including fatigue, anosmia, headache, myalgia, and joint pain in COVID-19 survivors hospitalized with mild, moderate, or severe infections worldwide. The search was conducted up to January 30th, 2021 using three databases (PubMed, Scopus, and Web of Science) to identify potentially eligible studies. Data on study characteristics, follow-up characteristics, and severity of COVID-19 during hospitalization were collected in accordance with PRISMA guidelines. The Newcastle-Ottawa scale was used to assess the quality of relevant articles. The estimated prevalence of specific prolonged neuromuscular symptoms and the association between COVID-19 severity and occurrence of prolonged neuromuscular symptoms was analyzed wherever appropriate. Database search yielded 4,050 articles and 22 articles were included for meta-analysis. The estimated prevalence of prolonged fatigue was recorded in 21.2% (95%CI: 11.9%–34.8%) of 3,730 COVID-19 survivors. Persistent anosmia was recorded in 239 of 2,600 COVID-19 survivors (9.7%, 95%CI: 6.1%–15.2%). In 84 out of 2,412 COVID-19 survivors (8.9%, 95%CI: 3.2%–22.6%), prolonged headache was observed. A total of 53 out of 1,125 COVID-19 patients (5.6%, 95%CI: 2.1%–14.2%) complained of persistent myalgia even after being discharged from the hospital. The prevalence of prolonged joint pain was in 15.4% (95%CI: 8.2%–27.2%) of subjects. Due to data scarcity on COVID-19 severity and prolonged neuromuscular symptoms, association analysis could not be conducted. Widespread concern regarding long-term impacts of COVID-19 was raised after several studies reported prolonged symptoms in COVID-19 survivors. Numerous theories have been proposed to address this concern; however, as the research on this pandemic is still ongoing, no explanation is definitive yet. Therefore, follow-up studies in COVID-19 survivors after recovery from COVID-19 are warranted to determine the pathogenesis of prolonged symptoms. PROSPERO registration: CRD42021242332.

Effects of Fatigue Running on Joint Mechanics in Female Runners: A Prediction Study Based on a Partial Least Squares Algorithm

Background: Joint mechanics are permanently changed using different intensities and running durations. These variations in intensity and duration also influence fatigue during prolonged running. Little is known about the potential interactions between fatigue and joint mechanics in female recreational runners. Thus, the purpose of this study was to describe and examine kinematic and joint mechanical parameters when female recreational runners are subject to fatigue as a result of running.Method: Fifty female recreational runners maintained running on a treadmill to induce fatigue conditions. Joint mechanics, sagittal joint angle, moment, and power were recorded pre- and immediately post fatigue treadmill running.Result: Moderate reductions in absolute positive ankle power, total ankle energy dissipation, dorsiflexion at initial contact, max dorsiflexion angle, and range of motion of the joint ankle were collected after fatigue following prolonged fatigue running. Knee joint mechanics, joint angle, and joint power remained unchanged after prolonged fatigue running. Nevertheless, with the decreased ankle joint work, negative knee power increased. At the hip joint, the extension angle was significantly decreased. The range motion of the hip joint, hip positive work and hip positive power were increased during the post-prolonged fatigue running.Conclusion: This study found no proximal shift in knee joint mechanics in amateur female runners following prolonged fatigue running. The joint work redistribution was associated with running fatigue changes. As for long-distance running, runners should include muscle strength training to avoid the occurrence of running-related injuries.

TOWARD A COHESIVE CLINICAL INTERPRETATION OF MENTAL DISORDERS IN SARS-COV-2 PANDEMIC: AN EXPERT OPINION

Аbstract. As the COVID-19 pandemic progresses, the observed increase in mental health issues requires more and more clinical attention. Mental disorders have become a major cause for disturbances in social adjustment, primarily due to disorders that fall into three clusters: prolonged fatigue (asthenia) with cognitive impairment; anxiety disorders with sleep disorders; and depression. The last two are also found in individuals who have not contracted SARS-CoV-2; they are seen as a result of their exposure to the stress of the pandemic. Therefore, to successfully manage the consequences of the pandemic, it is necessary to develop a cohesive clinical interpretation of mental disorders related to COVID-19 infection. Our proposed model would encompass all the above manifestations as follows: а) for the general population – by the triad of ‘nosogenic reactions’ with excessive (hyper-), normal (normo-) or ignoring (hyponosognostic) psychological responses to stress related to the semantics and individual significance of the SARS-CoV-2 diagnosis (nosos); b) for long COVID – by the biopsychosocial model as a typical combination of neurotoxic asthenia with cognitive impairment (Bonhoeffer’s neurobiological factor) that exacerbates ‘nosogenic’ anxiety and sleep disorders (psychological factor) and thus provokes a depressive response (as a social maladaptive factor)

Factors correlating with prolonged fatigue among emergency department nurses

Background Fatigue affects nurses negatively and leads to physical, cognitive and emotional problems that may influence nurses' quality of life. However, there is a lack of studies about prolonged fatigue and its relationship with socio-demographic characteristics and job-related psychosocial factors among nurses, especially emergency nurses, worldwide and in Jordan. Aims This study aims to assess the relationship between demographic factors, physical health, psychological distress and job-related psychosocial factors (psychological job demands, job control and social support) and prolonged fatigue among emergency department nurses in Jordan. Methods A descriptive correlational study using a convenience sample was used to recruit 153 emergency nurses. Physical health Questionnaire, General Health Questionnaire, Job Content Questionnaire and Checklist Individual Strength were used. Results The majority of emergency nurses experienced abnormally prolonged fatigue, moderate health, high psychological distress, high job demands and low job control and social support. Significant negative relationships were addressed between job control, social support and prolonged fatigue, whereas income had a negative weak relationship. Psychological distress and job demands had a positive weak relationship with prolonged fatigue. There was a significant positive weak relationship between psychological distress, job demands and prolonged fatigue. Job-related psychosocial factors (with exception of social support) and mental health were the predictors of prolonged fatigue. Conclusions Prolonged fatigue is a multidimensional phenomenon that can be affected by several factors such as job-related psychosocial factors and psychological health. These factors should be taken into consideration when testing and developing interventions to minimise prolonged fatigue among emergency nurses.