Comparison of Persistent Symptoms After COVID-19 and Other Non-SARS-CoV-2 Infections in Children

Introduction: The data on long COVID in children is scarce since children and adolescents are typically less severely affected by acute COVID-19. This study aimed to identify the long-term consequences of SARS-CoV-2 infection in children, and to compare the persistent symptom spectrum between COVID-19 and community-acquired infections of other etiologies.Methods: This was an ambidirectional cohort study conducted at the Children's Clinical University Hospital in Latvia. The study population of pediatric COVID-19 patients and children with other non-SARS-CoV-2-community-acquired infections were invited to participate between July 1, 2020, and April 30, 2021.Results: In total, 236 pediatric COVID-19 patients were enrolled in the study. Additionally, 142 comparison group patients were also enrolled. Median follow-up time from acute symptom onset was 73.5 days (IQR; 43–110 days) in the COVID-19 patient group and 69 days (IQR, 58–84 days) in the comparison group. Most pediatric COVID-19 survivors (70%, N = 152) reported at least one persistent symptom, but more than half of the patients (53%, N = 117) noted two or more long-lasting symptoms. The most commonly reported complaints among COVID-19 patients included persistent fatigue (25.2%), cognitive sequelae, such as irritability (24.3%), and mood changes (23.3%), as well as headaches (16.9%), rhinorrhea (16.1%), coughing (14.4%), and anosmia/dysgeusia (12.3%). In addition, 105 (44.5%) COVID patients had persistent symptoms after the 12-week cut-off point, with irritability (27.6%, N = 29), mood changes (26.7%, N = 28), and fatigue (19.2%, N = 20) being the most commonly reported ones. Differences in symptom spectrum among the various age groups were seen. Logistic regression analysis showed that long-term persistent symptoms as fever, fatigue, rhinorrhea, loss of taste and/or smell, headaches, cognitive sequelae, and nocturnal sweating were significantly associated with the COVID-19 experience when compared with the controls.Conclusions: We found that at the time of interview almost three-quarters of children reported at least one persistent symptom, but the majority of patients (53%) had two or more concurrent symptoms. The comparison group's inclusion in the study allowed us to identify that symptom persistence is more apparent with COVID-19 than any other non-SARS-CoV-2 infection. More research is needed to distinguish the symptoms of long COVID from pandemic-associated complaints. Each persistent symptom is important in terms of child well-being during COVID-19 recovery.

Transcranial direct current electrical stimulation in combination with aerobic exercise is effective in reducing fatigue and pain in post-COVID-19 systemic autoimmune rheumatic patients

Objectives: Currently, no studies have assessed the efficacy of transcranial direct current stimulation (tDCS) to treat fatigue and pain associated with or potentiated by post-COVID-19 syndrome in patients with systemic autoimmune rheumatic diseases (SARDs). Methods: This study included nine patients with different types of SARDs. All patients had previously confirmed RT-PCR test for COVID-19 as well as significant, persistent fatigue and pain that began to worsen after infection. Anodal tDCS was administered in five daily sessions (2mA, 20 minutes) over the C3 or C4 10/20 EEG positions, with the cathode placed at Fp1 or Fp2. Concomitantly, patients were involved in an aerobic exercise program by treadmill walking. All participants were evaluated using specific questionnaires and strength assessment by handgrip and physical function by timed-up-and go test and sit-to-stand test at baseline (within one week before tDCS protocol), and one week after tDCS protocol. During all procedures, the patients’ treatments remained unchanged. Results: The sample was composed of eight women and one man with a mean age of 48.7±9.6. After the tDCS protocol, the pain and fatigue significantly improved by a visual analog scale (P<0.05). The physical function also improved 9.5±2.7 vs. 6.8±0.8 (P=0.001) for timed-up-go-test and 10.3±3.7 vs. 15.1±4.0 (P=0.037) for sit-to-stand test. No subject experienced adverse events. One-hundred percent of patients adhered to all protocols. Conclusions: The present study showed tDCS in combination with aerobic exercise was effective in improving the physical function, and reducing fatigue/pain in SARDs patients with post-COVID-19 syndrome.Clinical Trials: NCT04890483.

Chronic Fatigue Syndrome in Childhood Revisited: Not Common, But Not Unknown- Case Study and Literature Review

Lethargy is a common non-specific complaint to primary care and has a broad range of differentials. Chronic fatigue syndrome (CFS) should be considered when there is persistent fatigue affecting function and post- exertional malaise six months or longer and initial workup is not suggestive of other organic causes; it is a debilitating condition that would benefit from diagnosis and treatment. We present an adolescent with CFS, the disease timeline, its impact and outcome.

Long COVID and post-infective fatigue syndrome – a review

Fatigue is a dominant feature of both acute and convalescent COVID-19 (sometimes termed ‘long-COVID’), with up to 46% of patients reporting fatigue lasting weeks to months. The investigators of the international Collaborative on Fatigue Following Infection (COFFI) conducted a systematic review of post-COVID fatigue, a narrative review on fatigue after other infections and made recommendations for clinical and research approaches to assessment of fatigue following COVID-19. In the majority of COVID-19 cohort studies, persistent fatigue was reported by a significant minority of patients, ranging from 13-33% at 16-20 weeks post symptom onset. Data from the prospective cohort studies in COFFI and others, indicate that fatigue is also a prevalent outcome from many acute systemic infections notably infectious mononucleosis, with a case rate for clinically-significant post-infective fatigue after exclusion of recognized medical and psychiatric causes, of 10-35% at 6 months. To better characterize post-COVID fatigue, the COFFI investigators recommend: application of validated screening questionnaires for case detection, standardized interviews encompassing fatigue, mood, and other symptoms, and investigative approaches to identify end-organ damage and mental health conditions.

Occupational Fatigue: Relationship With Personality Traits and Decent Work

Psychology of working theory (PWT) and psychology of working framework (PWF) offered a psychological view of decent work. The present study examined the associations among personality traits, decent work and Occupational Fatigue Exhaustion Recovery Scale (OFER). Two hundred and thirty four participants filled out the Big Five Questionnaire, the Italian version of the Decent Work Scale, and the Italian version of the OFER Scale. Hierarchical regressions showed that decent work explained incremental variance beyond personality traits with respect to OFER both considering total score and its three dimensions (chronic fatigue, acute fatigue, persistent fatigue). The present study underlined the value of decent work in relation to occupational fatigue beyond the contributions of personality, in particular in relation to the dimensions of Adequate compensation and Free time and rest for less occupational fatigue (both as total and as dimensions).

Post-stroke fatigue: A factor associated with inability to return to work in patients <60 years—A 1-year follow-up

This study investigated the association between post-stroke fatigue and inability to return to work/drive in young patients aged <60 years with first stroke who were employed prior to infarct while controlling for stroke severity, age, extent of disability, cognitive function, and depression. The Fatigue Severity Scale (FSS) was used to evaluate post-stroke fatigue in this 1-year prospective cohort study. Follow-ups were completed at 3, 6, and 12 months post rehabilitation discharge. A total of 112 patients were recruited, 7 were excluded, due to loss to follow-up (n = 6) and being palliative (n = 1), resulting in 105 participants (71% male, average age 49 ±10.63 years). Stroke patients receiving both inpatient and outpatient rehabilitation were consecutively recruited. Persistent fatigue remained associated with inability to return to work when controlling for other factors at 3 months (adjusted OR = 18, 95% CI: 2.9, 110.3, p = 0.002), 6 months (adjusted OR = 29.81, 95% CI: 1.7, 532.8, p = 0.021), and 12 months (adjusted OR = 31.6, 95% CI: 1.8, 545.0, p = 0.018). No association was found between persistent fatigue and return to driving. Fatigue at admission was associated with inability to return to work at 3 months but not return to drive. Persistent fatigue was found to be associated with inability to resume work but not driving. It may be beneficial to routinely screen post-stroke fatigue in rehabilitation and educate stroke survivors and employers on the impacts of post-stroke fatigue on return to work.

Literature Review: Pengaruh Edukasi Tentang Anemia Melalui Media Cetak Dan Media Audio Visual Kepada Remaja Putri

Anemia is a disease caused by the body's lack of iron nutrients, particularly in the formation of hemoglobin. The National Institute of Health, a 2011 case in which teenage girls are suffering from anemia (10 to 19 years old). In the case of anemia where HB does not reach the baseline, it can cause stress and persistent fatigue in the body's organs and can be inhibited activities and decreased of academic achievement. The purpose of this study is to find out the impact of nutrition education for students by providing printed media and audio-visual media relating with anemia, such as impact to knowledge, attitudes and behaviors. The method used by author in this study is some literatures related subject of this study. The result of the study will help the readers and health workers to know and able to make nutrition education plan about anemia for teenage girls by using printed media and audio-visual media. ABSTRAK Anemia adalah penyakit yang disebabkan oleh kekurangan asupan zat gizi besi didalam tubuh, di mana hal ini sangat berperan dalam membentuk hemoglobin. Remaja putri (10-19 tahun) merupakan salah satu kelompok yang sangat rawan mengalami anemia (National Institute of Health, 2011). Dalam kasus anemia, apabila kandungan Hb tidak mencapai batas normal dapat menyebabkan komplikasi seperti stres dan kelelahan yang berkelanjutan sehingga dapat menimbulkan rasa lelah, letih dan lesu pada organ tubuh dan mengganggu aktifitas serta mengakibatkan penurunan prestasi belajar. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh pemberian pendidikan gizi dengan menggunakan media cetak dan media audio-visual pada siswa terkait pengetahuan, sikap dan perilaku mengenai anemia. Metode yang digunakan penulis dalam kajian ini yaitu dengan menggunakan beberapa literatur yang berkaitan dengan judul kajian ini. Hasil dan pembahasan kajian ini akan membantu pembaca serta tenaga kesehatan dalam membuat perencanaan edukasi gizi kepada remaja putri mengenai anemia menggunakan media cetak dan media audio-visual.