| Author | doi | Year | Country | Experimental Dates | Aim of the study | Study Design | Type of rehabilitation service | Research Question | LFRI | Covid Phases | Population | N° of participants | Clinical presentation | Intervention | Comparator | Outcomes | Adverse events | Diagnostic test | Sensitivity | Specificity | Types of validity | Attributes of reliability | Main findings |
| Barros‐Leite | 10.1002/jmv.27410 | 2021 | Brazil | From April 2020 to July 2020 | To evaluate the main functional alterations in the short term after the discharge from hospital, using a Telehealth service. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Ongoing | Post COVID-19 | 89 | N/A | N/A | N/A | Questionnaire: muscle pain, shortness of breath at rest or effort, coughing or choking, weight loss >5 kg, weakness or fatigue, difficulty in movements in daily life activities, difficulty in balance, or fear of falling, difficulty in walking, difficulty in changing decubitus, changes in sensitivity, anxiety/sadness; and in the mood, memory and understanding alterations. | This study reports about 89 COVID-19 patients (mean age 63.5 ±14 years, 55 % male, average total length of hospital internment was 18 ±16 days). They were assessed after discharge from the hospital. The main finding is represented by highlighting the four most prevalent functional changes in the short term after COVID-19 and hospital discharge: weight loss 5 kg (60.7%), muscle weakness (53%) and muscle/joint pain (43.8%), and a mental/emotional change with feelings of anxiety or sadness (46.1%). | This study reports about 89 COVID-19 patients (mean age 63.5 ±14 years, 55 % male, total hospital length 18 ±16 days). They were assessed after discharge from the hospital, but no information is available about the itnerval between hospital discharge and survey completion. The main finding is that the four most prevalent functional changes in the short term after COVID-19 and hospital discharge were weight loss of more than 5 kg (60.7%), muscle weakness (53%), muscle/joint pain (43.8%), and a mental/emotional change with feelings of anxiety or sadness (46.1%). | |||||
| Bell | 10.1371/journal.pone.0254347 | 2021 | USA | From May 2020 to February 2021. | To describe the prevalence of post-COVID-19 symptoms amongst individuals who were not hospitalized for COVID-19. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 303 | N/A | N/A | N/A | Symptoms related to post-acute sequelae of COVID-19 (PASC) | This study reports about 303 COVID-19 patients (mean age 44 years, 30% male). They were assessed at 3 months, 6 months, 9 months, and 12 months post-baseline of positive Covid-19 test. The main finding is represented by at least one symptom 30 days or longer past test-date in 68.7% of participants. For individuals with more than 60 days followup, the prevalence of PASC was 73%. The most common symptoms were fatigue (37.5%), shortness of breath (37.5%), brain fog (30.8%), and stress/anxiety (30.8%). | This study reports about 303 non-hospitalized subjects with a positive lab-confirmed COVID-19 test who were followed for a median of 61 days (range 30–250) (mean age 44 years, 30% male). The main finding is that 208 participants (68.7%) reported at least one symptom 30 days or longer after the test date. For individuals with more than 60 days follow-up, the prevalence of PASC was 77.1%. The most common symptoms were fatigue (37.5%), shortness of breath (37.5%), brain fog (30.8%), and stress/anxiety (30.8%). | |||||
| Bellinger | 10.1044/2021_PERSP-21-00024 | 2021 | USA | N/A | to demonstrate the effectiveness of PT, OT, and ST in the treatment of individuals recovering from COVID-19 and the medical complications associated. | Inception Cohort study | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 35 | N/A | 3 hours/day in-patient rehabilitation delivered by minimum two out of three therapy disciplines (PT, OT, and ST) | N/A | IRF PAI, 6MWT, Modified Barthel Index, Orientation Log, Cognitive Log | This study reports about 35 individuals inclusive of active COVID-19 and post COVID-19 patients who went through the inpatient rehabilitation facility over a 4-month period (mean age 68.7, range:31–99 years), 66% male. The mean length of stay for the sample population was 17.3 days (range: 5–36 days). The mean initial IRF PAI score was 58.3, whereas the mean discharge IRF PAI was 106.5, showing a mean difference of 48.2 points on this assessment (p<0.05). The 6MWT was administered to 20 active COVID-19 patients. The mean initial 6MWT score was 179 ft, whereas the mean discharge 6MWT score was 651.3 ft, showing a mean difference of 472.3 ft on this measure (p<0.05). The mBI was administered to 22 individuals inclusive of active COVID-19 patients. Out of a total possible score of 100, the mean initial mBI score was 56.86 (severe dependency), whereas the mean discharge mBI score was 85.82 (slight dependency), showing a mean difference in score of 28.95 (p<0.05). The Orientation Log and the Cognitive Log were administered to 18 active COVID-19 patients. Out of a total possible score of 30, the mean initial Orientation Log score was 23.23, whereas the mean discharge Orientation Log score was 25.6, showing a mean difference of 8.6 (p<0.05). Also, with a total possible score of 30, the mean initial Cognitive Log score was 19.47, whereas the mean discharge Cognitive Log score was 24.07, showing a mean difference of 4.14 (p<0.05). | This study reports about 35 individuals who proved positive at the COVID-19 test in the last 4 weeks and were admitted to an inpatient rehabilitation facility over a 4-month period (mean age 68.7, range:31–99 years), 66% male. The mean length of stay for the sample population was 17.3 days (range: 5–36 days). The mean initial IRF PAI score was 58.3, whereas the mean discharge IRF PAI was 106.5, showing a mean difference of 48.2 points on this assessment (p<0.05). The 6MWT was administered to 20 active COVID-19 patients. The mean initial 6MWT score was 179 ft, whereas the mean discharge 6MWT score was 651.3 ft, showing a mean difference of 472.3 ft on this measure (p<0.05). The mBI was administered to 22 individuals inclusive of active COVID-19 patients. Out of a total possible score of 100, the mean initial mBI score was 56.86 (severe dependency), whereas the mean discharge mBI score was 85.82 (slight dependency), showing a mean difference in score of 28.95 (p<0.05). The Orientation Log and the Cognitive Log were administered to 18 active COVID-19 patients. Out of a total possible score of 30, the mean initial Orientation Log score was 23.23, whereas the mean discharge Orientation Log score was 25.6, showing a mean difference of 8.6 (p<0.05). Also, with a total possible score of 30, the mean initial Cognitive Log score was 19.47, whereas the mean discharge Cognitive Log score was 24.07, showing a mean difference of 4.14 (p<0.05). | |||||
| Boesl | 10.3389/fneur.2021.738405 | 2021 | Germany | From September 2020 to April 2021 | To identify clinical phenotypes and subgroups of Post-Covid-19 Syndrome among patients referred to an outpatient Neurology Clinic | Cross-sectional study | N.A. | Epidemiology - Prevalence/Incidence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-Covid | COVID-19 | 100 | N/A | N/A | N/A | Epworth Sleepiness Scale for assessment of daytime sleepiness, Beck Depression Inventory Version I for assessment of mood, Fatigue Severity Scale for assessment of fatigue, Montreal Cognitive Assessment Scale for assessment of cognitive impairment. | This study reports about 100 COVID-19 patients (mean age 45.8 years, 33% male). They were assessed at 85 to 426 days from positive testing for SARS-CoV-2. The main finding is represented by cognitive impairment being the most frequent symptom reported in Post-Covid-19 Syndrome (72%). There were 30% of patients who reported cognitive deficits and scored below 26 points on the MoCA. Fatigue (67%), headache (36%), and persisting hyposmia (36%) were also frequently reported; 5.5% of all patients showed signs of severe depression. | This study reports about 100 COVID-19 patients (mean age 45.8 years, 33% male). They were assessed at 85 to 426 days from positive testing for SARS-CoV-2. The main finding is represented by cognitive impairment being the most frequent symptom reported in Post-Covid-19 Syndrome (72%). There were 30% of patients who reported cognitive deficits and scored below 26 points on the MoCA. Fatigue (67%), headache (36%), and persisting hyposmia (36%) were also frequently reported; 5.5% of all patients showed signs of severe depression. | |||||
| Bonizzato | 10.1007/s10072-021-05653-w | 2021 | Italy | N/A | To evaluate the effectiveness of an assessment model of the impact of COVID-19 on cognitive, psychological, and behavioral areas, for rehabilitation planning and long-term assistance needs. | Quasi-experimental study | Specialized postacute rehabilitation | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Mental functions b1) | Post-Covid | Post COVID-19 | 12 | N/A | Serial standardized cognitive assessment | N/A | Mini-Mental State Examination and Montreal Cognitive Assessment for global cognitive assessment. Digit and Corsi span forward and backward, Rey Auditory Verbal Learning, Spatial Recall Test, Symbol Digit Modalities Test, Trail Making Test, Stroop Test, Frontal Assessment Battery and phonemic fluency for cognitive evaluation. Anxiety and Depression Short Scale and Neuropsychiatry Inventory for behavioral and psychological symptoms. | This study reports about 12 COVID-19 patients (mean age 71.33 ± 10.08 year, 58.3% male). They were assessed at admission to the rehabilitation facility, though no other information about time elapsed from symptom onset was available. Results showed that at baseline (T0), 58.3% of the patients reported a score below cut-off at MMSE and 50% at MoCA. Although a significant amelioration was found only in NPI scores, a qualitative improvement has been detected at all tests, except for MoCA scores, in the T0-T1 trend analysis. A one-way repeated measures analysis of variance showed a significant variation in AD-R depression score, considering the three-assessment time (T0, T1, and T2): decreased from T0 to T1, then a significant increase was found from T1 to T2 (follow-up). | This study reports about 12 COVID-19 patients (mean age 71.33 ± 10.08 year, 58.3% male). Patients were tested at the arrival (T0) and discharge from their rehabilitative hospitalization (T1, after about a month) and after 3 months (T2). Only 8 subjects completed the assessment at T2. No other information about time elapsed from symptom onset was available. Results showed that at baseline (T0), 58.3% of the patients reported a score below cut-off at MMSE and 50% at MoCA. Although a significant amelioration was found only in NPI scores, a qualitative improvement has been detected at all tests, except for MoCA scores, in the T0-T1 trend analysis. A one-way repeated-measures analysis of variance showed a significant variation in AD-R depression score, considering the three-assessment time (T0, T1, and T2): decreased from T0 to T1, then a significant increase was found from T1 to T2 (follow-up). The choice of assessment tools should take into account the vulnerability of these patients in the immediate post-acute phase of the disease, but it does not rule out the possibility of detailed assessment at follow-up visits, when they usually have recovered part of their physical capacity. | |||||
| Cassar | 10.1016/j.eclinm.2021.101159 | 2021 | UK | N/A | to describe the time course evolution of cardiopulmonary symptoms, CMR, pulmonary function and CPET abnormalities in these patients from 2-3 months to 6 months and evaluate the relationship between symptoms and objective measures of cardiopulmonary health at 6 months | Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 58 | N/A | N/A | N/A | health questionnaires, cardiopulmonary MRI, spirometry, CPET, ECG, blood tests | This study reports about 58 COVID-19 patients (mean age 55±13), 59% male, 20 (34%) patients required non-invasive ventilation or intubation, and 16 (28%) received steroids as part of their care (median duration 5 days, IQR 4-10 days); Duration of hospitalization was 9 days (IQR 5-17). 98% had one or more symptoms (cardiopulmonary and non-cardiopulmonary) at 2-3 months from infection, reducing to 89% by 6 months. The prevalence of cardiopulmonary symptoms in patients was 83% at 2-3 months and dropped to 52% at 6 months (P=0.0001). At 6 months, symptoms of breathlessness (MRC) and fatigue (FSS) were worse in patients than controls (MRC grade≥2: 57% vs 10%, P<0.0001; Mean FSS≥4: 44% vs 17%,P=0.023); statistical significance was maintained after adjusting for a history of mild chronic lung disease. In patients, indexed RV end-diastolic volume decreased (mean difference -4.3 mls/m2, P=0.005) and function (RVEF) increased (mean difference +3.2%,P=0.0003) from 2-3 months to 6 months. At 6 months, RVEF tended to be lower in patients with severe illness (58.5±5.1% vs 62.1±6.9%,P=0.055). At 2-3 months, 60% of patients had lung parenchymal abnormalities, becoming less extensive with time, but were still more common compared to controls at 6 months (P<0.0001). Patients with parenchymal abnormalities had lower DLco compared to those without (77% vs 91%,P=0.009). Maximal VO2 was lower in patients at 2-3 months but was no longer so by 6 months (P=0.12 for comparison with controls). VE/VCO2 slope was abnormal in patients at 2-3 months and improved by 6 months (P=0.033). In spite of this, the VE/VCO2 slope remained borderline abnormal (median 31.3 (IQR 28.6-34.5)) versus controls (median 28.2 (IQR 26.7-30.0, P=0.002)). HRR in the first minute following exercise cessation was slower in patients compared to controls (16.6vs21.9 beats,P=0.018). By 6 months, HRR improved significantly (22.2 beats, P=0.001), and became comparable to controls (P=0.67). The severity of illness during admission was not associated with a reduction in peak or maximal oxygen consumption at 2-3 months and 6 months (P>0.20 for all comparisons). | This study reports about 58 COVID-19 patients (mean age 55±13), 59% male, 20 (34%) patients required non-invasive ventilation or intubation, and 16 (28%) received steroids as part of their care (median duration 5 days, IQR 4-10 days); Duration of hospitalization was 9 days (IQR 5-17). When requested to complete a survey at 2-3 months of infection, 83% of them had at least one cardiopulmonary symptom versus 33% of 30 healthy matched controls. 98% of patients had one or more symptoms (cardiopulmonary and non-cardiopulmonary), reducing to 89% in the 6 month follow-up. The prevalence of cardiopulmonary symptoms in patients dropped to 52% at 6 months (P=0.0001). At 6 months, symptoms of breathlessness (MRC) and fatigue (FSS) were still worse than in controls (MRC grade≥2: 57% vs 10%, P<0.0001; Mean FSS≥4: 44% vs 17%,P=0.023); statistical significance was maintained after adjusting for a history of mild chronic lung disease. In patients, indexed RV end-diastolic volume decreased (mean difference -4.3 mls/m2, P=0.005) and function (RVEF) increased (mean difference +3.2%,P=0.0003) from 2-3 months to 6 months. At 6 months, RVEF tended to be lower in patients with severe illness (58.5±5.1% vs 62.1±6.9%,P=0.055). At 2-3 months, 60% of patients had lung parenchymal abnormalities, becoming less extensive with time, but were still more common compared to controls at 6 months (P<0.0001). Patients with parenchymal abnormalities had lower DLco compared to those without (77% vs 91%,P=0.009). Maximal VO2 was lower in patients at 2-3 months but was no longer so by 6 months (P=0.12 for comparison with controls). VE/VCO2 slope was abnormal in patients at 2-3 months and improved by 6 months (P=0.033). In spite of this, the VE/VCO2 slope remained borderline abnormal (median 31.3 (IQR 28.6-34.5)) versus controls (median 28.2 (IQR 26.7-30.0, P=0.002)). HRR in the first minute following exercise cessation was slower in patients compared to controls (16.6vs21.9 beats,P=0.018). By 6 months, HRR improved significantly (22.2 beats, P=0.001), and became comparable to controls (P=0.67). The severity of illness during admission was not associated with a reduction in peak or maximal oxygen consumption at 2-3 months and 6 months (P>0.20 for all comparisons). | |||||
| Hellgren | 10.1136/bmjopen-2021-055164 | 2021 | Sweden | From March to May 2020 | To evaluate the association of brain MRI findings, neurocognitive function and persisting fatigue at long-term follow-up after COVID-19 hospitalization in high-risk patients. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Nervous system structures (s1) and related functions (Mental functions b1) | Post-Covid | COVID-19 | 35 | N/A | N/A | N/A | Repeatable Battery for the Assessment of Neuropsychological Status for neurocognitive testing, Hospital Anxiety and Depression Scale for neuropsychological testing and Multidimensional Fatigue Inventory for fatigue testing, brain MRI. | This study reports about 35 COVID-19 patients (mean age 59 years, 80% male). They were assessed at 6.5 months after hospital discharge. The main finding is represented by abnormalities on MRI in 71% of patients; multiple white matter lesions were the most common finding. 46% of patients demonstrated impaired neurocognitive function, of which 29% had severe impairment. 74% of patients reported clinically significant fatigue. Patients with abnormalities on MRI had a lower Visuospatial Index (p=0.031) compared with the group with normal MRI findings. | This study reports about 35 COVID-19 patients (mean age 59 years, 80% male) who were assessed with a neurocognitive test battery and a brain MRI at 6.5 months after hospital discharge. The main finding is represented by abnormalities on MRI in 71% of patients; multiple white matter lesions were the most common finding. 46% of patients demonstrated impaired neurocognitive function, of which 29% had severe impairment. 74% of patients reported clinically significant fatigue. Patients with abnormalities on MRI had a lower Visuospatial Index (p=0.031) compared with the group with normal MRI findings. | |||||
| Kokhan | doi.org/10.24115/S2446-6220202173C1667p.607-612 | 2021 | Russia | N/A | to study the effect of pulmonary rehabilitation on the parameters of the respiratory activity of the lungs in patients with p neumonia associated with COVID-19 | Non randomised controlled trial | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 48 | N/A | exercise therapy in combination with breathing exercises Strelnikova and Shatalova | Standard exercise therapy | CAP-Sym-12, mMRS scale, Shtange and Genchi functional tests, anxiety and depression HADS, EQ-5D | This study reports about 48 COVID-19 patients (mean age 47± 9.1, range:39 to 67), 43,8 % male. In the control results, the intervention group received (p<0.05) the best result in comparison with the indicators of the control group. After the end of the cycle of exercise therapy in combination with a complex of breathing exercises, the intragorup differences were significant (p<0.05). Shtange and Genchi tests showed significant changes with significant differences between (p<0.05). Control testing of the psychological and emotional state showed a significant improvement of the emotional status. EQ-5D in the IG showed significant differences with the test of the CG (p <0.05). | This study reports about 48 COVID-19 patients (mean age 47± 9.1, range:39 to 67), 43,8 % male. At the end of treatment, the intragroup differences were significant in the experimental group (EG) (p <0.05). A decrease in the fatigability of the respiratory muscles and an increase in the resistance to hypoxia was observed in the experimental though not in the control group. No significant differences on HADS indices were recorded in any group. The best effect on the EQ-5D quality of life assessment was recorded in the EG. | |||||
| Lemhöfer | 10.1186/s12995-021-00337-9 | 2021 | Germany | N/A | to assess PostCOVID-Syndrome and QoL in patients with mild and moderate COVID-19 who did not need hospitalization or intensive care | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 | 365 | N/A | N/A | N/A | RehabNeS (activity and participation, QoL, Rehabilitation need/unfitness for work) | In this study a total of 422 questionnaires were returned to the study center, representing a response rate of 41%. 365 completely filled-in questionnaires were evaluated (mean age 49.8±16.9); 148 (40.5%) were male. 84% of patients experienced activity limitations and participation restrictions in the infection phase. 226 participants (61.9%) reported long-term symptoms. 38.1% of cases did not report any long-term symptoms. 179 participants (49.0%) reported long-term activity limitations and participation restrictions. In most cases the overall score of QoL was very good (25.6%) or good (52.6%). An average QoL was scored in 17.5% of patients. Bad (3.9%) or very bad (0.3%) QoL was reported in few cases. The mean values of the SF-36 questionnaire in the physical sum score were 49.2 points, which is in the range of the normal population (48.4 points). The Mental sum score was slightly reduced (45.7vs. 50.9 in normal population). Reduced average scores were found in particular in the following dimensions Role physical (70.8vs.82.4), Vitality (54.6vs. 60.0), Social function (74.5 vs. 86.4), Role emotional (69.5vs.89.1), and Mental health (69.2vs.72.5). | This study reports about 365 COVID-19 subjects (mean age 49.8±16.9); 148 (40.5%) were male, who completed the Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life. Up to 93.7% of participants had developed COVID-19 symptoms more than 3 months before the survey The main findings were that: 84% of patients experienced activity limitations and participation restrictions in the infection phase. 226 participants (61.9%) reported long-term symptoms. 179 participants (49.0%) reported long-term activity limitations and participation restrictions. In most cases, the overall score of QoL was very good (25.6%) or good (52.6%). An average QoL was scored in 17.5% of patients. Bad (3.9%) or very bad (0.3%) QoL was reported in few cases. The mean values of the SF-36 questionnaire in the physical sum score were 49.2 points, which is in the range of the normal population (48.4 points). The Mental sum score was slightly reduced (45.7vs. 50.9 in normal population). Reduced average scores were found in particular in the following dimensions Role physical (70.8vs.82.4), Vitality (54.6vs. 60.0), Social function (74.5 vs. 86.4), Role emotional (69.5vs.89.1), and Mental health (69.2vs.72.5). | |||||
| Mohamed | 10.1016/j.jbmt.2021.07.012 | 2021 | Turkey | N/A | To investigate the effect of aerobic exercise on immune biomarkers, disease severity, and progression in patients with COVID-19. | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 35 | N/A | standard medications and aerobic exercise for 40 min/session, 3 sessions/week, for 2 weeks | standard medications | total lymphocytes, leukocytes, monocytes, IL-6, IL-10, and TNF-a, IgA-S concentration, WURSS. | This study reports about 115 COVID-19 patients (mean age CG: 35.25±3.96, IG: 44.56±4.25); 15 male, 15 female. Wisconsin scale total score significantly decreased in the intervention group when compared to the control group after two weeks of intervention (P<0.05). Leucocytes, Lymphocytes, and Immunoglobulin-A significantly increased in the intervention group in comparison to the control group after two weeks of intervention (P<0.05). Within-group comparisons showed that the Wisconsin scale total score significantly decreased in both groups (control and intervention) after two weeks of treatment (P <0.05). Leucocytes, Lymphocytes, and Interleukin-10 significantly increased in both groups after two weeks of treatment (P<.05). After two weeks of treatment, Interleukin-6, and Immunoglobulin-A significantly increased in the intervention group (P<0.05). TNF-a increased significantly in the control group (P<0.05). | This study reports about 35 COVID-19 patients random assigned to two weeks aerobic exercise (IG) or standard medication (CG). Only 30 out of 35 completed the 2-week observation period (15 per group, 15 male) IG mean age 44.56±4.25; CG mean age 35.25±3.96. Within-group comparisons showed that the Wisconsin Upper Respiratory Symptom Survey total score significantly decreased in both groups (control and intervention) after two weeks of treatment (P <0.05), though more in the IG than CG. Leucocytes, Lymphocytes, and Interleukin-10 significantly increased in both groups (P<.05), though more in IG than CG. TNF-a increased significantly in the control group (P<0.05). | |||||
| Ozkeskin | doi.org/10.1016/j.msard.2021.103180 | 2021 | Turkey | N/A | To investigate the effect of COVID-19 disease on fatigue, sleep quality, physical activity, quality of life, and psychological status in people with MS | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Acute, post-acute, late-onset, or permanent on a pre-existing health condition | MS patients with COVID-19 | 46 | N/A | N/A | N/A | Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire Short Form (IPAQ-SF), the EuroQoL Instrument (EQ-5D-3L), the Fear of COVID-19 Scale (FCV-19S) and the Coronavirus Anxiety Scale (CAS) | This study reports about 104 people with MS (38.3 ±10.6 years, 72 women, 32 men). People with MS in the COVID-19 positive group had a significantly lower IPAQ-Total score (Metabolic Equivalent of Task (MET) minutes per week) (p=0.014). The FCV-19S scores of COVID-19 positive patients were significantly higher (p =0.006). On the other hand, EQ-5D-3L Index and EQ-5D-3L VAS scores were higher in the group with COVID-19 (p1 =0.021, p2 =0.014, respectively). FCV-19S, which had a statistically significant difference between the two case groups, had a moderate correlation with EDSS (r =-0.362). On the other hand, FCV-19S was weakly correlated with BMI and PSQI (r1 =-0.314, r2- =0.218, respectively). IPAQ-Total was moderately associated with MS duration, EDSS and FSS (r1 =-0.471, r2- =-0.389, r3 =-0.388, respectively). The EQ-5D-3L Index was moderately correlated with FSS (r1 =-0.404). There was a weak significant relationship between EQ-5D-3L Index and BMI, MS duration, PSQI and CAS (r=-0.471, r2- =-0.389, r3 =-0.388, r4 =-0.326, respectively). EQ-5D-3L was moderately associated with VAS and EDSS and PSQI (r1 =-0.393, r =-0.357, respectively). Lastly, there was a weak correlation between EQ-5D-3L VAS and BMI, MS duration and FSS (r1 =-0.304, r=-0.329, r3 =-0.316, respectively). | This study reports about 46 people with MS who developed COVID-19 infection 1-6 months before the survey (age 36.5 ± 11.2, 76% women). Their answers were compared to 58 COVID-19 negative people with MS (age: 39.7 ± 9.9, 63,7% women). Subjects with MS relapse from less than 6 months were excluded. People with MS in the COVID-19 positive group had a significantly lower IPAQ-Total score (Metabolic Equivalent of Task (MET) minutes per week) (p=0.014). The FCV-19S scores of COVID-19 positive patients were significantly higher (p =0.006). On the other hand, EQ-5D-3L Index and EQ-5D-3L VAS scores were higher in the group with COVID-19 (p1 =0.021, p2 =0.014, respectively). FCV-19S, which had a statistically significant difference between the two case groups, had a moderate correlation with EDSS (r =-0.362). On the other hand, FCV-19S was weakly correlated with BMI and PSQI (r1 =-0.314, r2- =0.218, respectively). IPAQ-Total was moderately associated with MS duration, EDSS and FSS (r1 =-0.471, r2- =-0.389, r3 =-0.388, respectively). The EQ-5D-3L Index was moderately correlated with FSS (r1 =-0.404). There was a weak significant relationship between EQ-5D-3L Index and BMI, MS duration, PSQI and CAS (r=-0.471, r2- =-0.389, r3 =-0.388, r4 =-0.326, respectively). EQ-5D-3L was moderately associated with VAS and EDSS and PSQI (r1 =-0.393, r =-0.357, respectively). Lastly, there was a weak correlation between EQ-5D-3L VAS and BMI, MS duration and FSS (r1 =-0.304, r=-0.329, r3 =-0.316, respectively). | |||||
| Rathi | 10.3390/medicines8090047 | 2021 | India | May 2021 | To assess the efficacy of ImmunoSEB and ProbioSEB CSC3 on COVID-19 induced fatigue | Randomised controlled trial | N/A | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 200 | Post-Covid-19 fatigue | ImmunoSEB (multi-enzyme formulation of Peptizyme SP, an enteric coated serratiopeptidase, bromelain, amylase, lysozyme, peptidase, catalase, papain, glucoamylase and lactoferrin) and ProbioSEB CSC3 (probiotics blend of Bacillus coagulans LBSC (DSM 17654), Bacillus subtilis PLSSC (ATCC SD 7280) and Bacillus clausii 088AE (MCC 0538)) administration | Placebo | Fatigue (CFQ-11), safety | This study reports about 200 healthy subjects randomly assigned to the control group (n: 100; mean age: 41.29 years (range 20–75)) and test group (n: 100; mean age: 41.17 years (range 20–75)). They were assessed on day 4, day 8, day 11, and day 14. The supplemental treatment resulted in the resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. The intervention was well tolerated and no adverse events were reported. | This study reports about 200 subjects with RT-PCR confirmed diagnosis of COVID-19 at any time, followed by a RT-PCR negative test, who were randomly assigned to the intervention group (n: 100; mean age: 41.17 years (range 20–75) or control group (n: 100; mean age: 41.29 years (range 20–75) . Subjects were still complaining of physical or mental fatigue. They were assessed on day 4, day 8, day 11, and day 14 after starting the assumption of supplemental treatment or placebo. The supplemental treatment resulted in the resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. The intervention was well tolerated and no adverse events were reported. | |||||
| Vannini | 10.1016/j.ejim.2021.10.004 | 2021 | Spain | From March 2020 to June 2020 | To evaluate the cardiopulmonary function and assess the pulmonary and myocardial injury objectively in SARS-CoV-2 survivors. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 41 | N/A | N/A | N/A | Static pulmonary function test, cardiopulmonary exercise test, and exercise test combined with echocardiography for cardiorespiratory function | This study reports about 41 COVID-19 patients (mean age 57,3 ± 13,7 years, 61% male). They were assessed at six months after the first SARS-CoV-2 positive smear. The main finding is represented by the altered results in cardiorespiratory residual function: 46,3% of patients presented a percent predicted peak oxygen uptake (%pVO2) < 80%. 27% of patients presented alteration of Total Lung Capacity (TLC) and/or Diffusion Capacity of CO (DLCO); 27%of patients presented an abnormal ventilatory response without datas of cardiac or pulmonary vascular sequelae, two patients presented oxygen desaturation with exercise and pathological Dead Space to Tidal Volume Ratio (Vd/VT) increment at exercise peak. 7% of patients presented impaired RV function. No data of LV contractility alteration and no exercise-induced arrhythmias was detected. Severe Pneumonia group and ARDS group presented a significant lower DLCO value respect to mild Pneumonia group. | This study reports about 41 COVID-19 patients (mean age 57,3 ± 13,7 years, 61% male). They were assessed six months after the first SARS-CoV-2 positive smear. The main finding is represented by the altered results in cardiorespiratory residual function: 46,3% of patients presented a percent predicted peak oxygen uptake (%pVO2) < 80%. 27% of patients presented alteration of Total Lung Capacity (TLC) and/or Diffusion Capacity of CO (DLCO); 27%of patients presented an abnormal ventilatory response without data of cardiac or pulmonary vascular sequelae, two patients presented oxygen desaturation with exercise and pathological Dead Space to Tidal Volume Ratio (Vd/VT) increment at exercise peak. 7% of patients presented impaired RV function. No data of LV contractility alteration and no exercise-induced arrhythmias were detected. The severe Pneumonia group and ARDS group presented a significantly lower DLCO value with respect to the mild Pneumonia group. | |||||
| Dalbosco-Salas M | 10.3390/jcm10194428 | 2021 | Chile | From 1 August 2020, to 15 February 2021. | To evaluate the effectiveness of a telerehabilitation program conducted in primary care in post-COVID-19 patients | Cohort study | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 115 | N/A | 24 sessions of supervised home-based exercise training: warm-up (5 min), breathing exercises (3 min), aerobic and/or strength exercises (20–30 min), and stretching (5 min) | N/A | 1-min STST, SF-36, VAS for fatigue, and mMRC for dyspnea symptoms | This study reports about 115 COVID-19 patients (55.4% female; mean age of 55.6 ± 12.7 years). The duration between discharge of the acute COVID-19 phase and beginning of rehabilitation was 30 (27–35) days. Fifty-seven patients (50%) had antecedents of hospitalization (length of stay 29.9 ± 19.9 days; compared to non-Hospodalized they were mainly men 64% and older 59.7± 10.8 years). Out of them, 35 (30.4%) were admitted to the ICU. All outcome measures improved after the intervention. In the analysis of non-hospitalized versus hospitalized patients, all outcomes improved with exception of fatigue in non-hospitalized patients and general health perception in hospitalized patients. In the analysis of ICU-admitted patients versus non-ICU-admitted patients all outcomes improved with the exception of four dimensions in the SF-36 (bodily pain, general health perceptions, emotional role limitations, mental health). Although limited by the absence of a control group, this report showed that a telerehabilitation program applied in primary health care is feasible and was effective in improving physical capacity, quality of life and symptoms in adult survivors of COVID-19. | This study reports about 115 COVID-19 patients (55.4% female; mean age of 55.6 ± 12.7 years). The mean interval between hospital discharge and rehabilitation start was 30 (27–35) days. Fifty-seven patients (50%) had antecedents of hospitalization (length of stay 29.9 ± 19.9 days; compared to non-Hospitalized they were mainly men 64% and older 59.7± 10.8 years). Out of them, 35 (30.4%) were admitted to the ICU. All outcome measures improved after the intervention. In the analysis of non-hospitalized versus hospitalized patients, all outcomes improved with exception of fatigue in non-hospitalized patients and general health perception in hospitalized patients. In the analysis of ICU-admitted patients versus non-ICU-admitted patients all outcomes improved with the exception of four dimensions in the SF-36 (bodily pain, general health perceptions, emotional role limitations, mental health). Although limited by the absence of a control group, this report showed that a telerehabilitation program applied in primary health care is feasible and was effective in improving physical capacity, quality of life and symptoms in adult survivors of COVID-19. | |||||
| Foged F | 10.1136/bmjsem-2021- 001156 | 2021 | Denmark | From September to December 2020 | To investigate the fidelity, tolerability and safety of three different HIIT protocols in individuals that had recently been hospitalised due to COVID-19. | Randomised controlled trial | N/A | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 10 | N/A | Tree HIIT protocols, so-called 4×4, 6×1 and 10-20- 30. Each protocol duration: 38 min. A 1- week washout between protocols. | 10-point Likert scale (tolerability) | This study reports about 10 recently hospitalized individuals who had recovered from the acute phase of severe COVID-19 infection (mean age 61 ±8), 50% male, Duration of hospitalization was 7 days ±4; Time since discharge 40 days (22–145). All participants completed all three HIIT protocols with no adverse events. High intensities were achieved in all three protocols, although they differed in terms of time spent with a heart rate ≥85% of maximum in favor of 4×4 protocol. The three protocols were all well tolerated with similar Likert scale scores (mean value 8). These findings indicate that recently hospitalized individuals for severe COVID-19 may safely tolerate acute bouts of supervised HIIT. | |||||||
| Kokhan S | 10.24115/S2446-6220202173 | 2021 | Russia | From February to June 2021 | To assess the physical condition of the patients by severity and the effectiveness of the use of therapeutic physical culture as part of a comprehensive post-covid rehabilitation. | Quasi-experimental study | General outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 74 | N/A | Physical therapy and breathing exercises, daily for 14 days, for 30-60 minutes | N/A | Respiratory and heart rate, blood pressure, vital capacity, blood oxygen saturation, Kerdo vegetative index, Stange and Gench’s test, 6 MWT, EQ-5D: before and after the intervention | This study reports about 74 patients (mean age 53±12.6, 43% male) who had COVID-19 moderate to severe pneumonia. All were hospitalized and discharged with a health improvement. They underwent outpatient daily physical therapy and breathing exercises for 14 days, though no information about the time elapsed from symptom onset is available. The main findings are represented by: - significant improvement of the following symptoms: fatigue decreased by 2,3 times, cough by 2 times, chest pain by 1,7 times, decreased lung excursion by 2,7 times. - significant improvement of the following functional state indicators: heart rate, Kerdo vegetative index (it decreased by 2.3 times), saturation of blood with oxygen, expiratory breath hold test, inspiratory breath hold test, 6 MWT. So, this protocol seems to improve the mobility of the chest and form the correct stereotype of respiratory movements, contributing to a decrease in respiratory symptoms and to the absence of progression of respiratory failure. | ||||||
| Larinskiy N | 10.53350/pjmhs211561706 | 2021 | Russia | N/A | To evaluate the effectiveness of the low-frequency magnetic therapy with a ""running"" magnetic field in medical rehabilitation after COVID-19 pneumonia. | Non randomised controlled trial | General outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 42 | N/A | physical therapy + low-frequency magnetic therapy with a ""running"" magnetic field (N 20: induction: 20 mT; frequency: 100 Hz; exposure time: 20 min; 15 procedures) | physical therapy | Symptoms collection, Lung functions indicators, Indicators of exercise tolerance (Borg scale and 6MWT): before and after the intervention | This study reports about 42 patients (aged 40 to 65 years, 57.1% male) who had COVID-19 pneumonia. 22 people underwent drug and physical therapy, and starting from the 20th day after discharge from the hospital (no further information about the time elapsed from symptom onset is available), they received low-frequency magnetic therapy (main group). The remaining 20 patients did not receive magnetotherapy (control group). The main finding is represented by: an increase in the functional capabilities of the cardio-respiratory system in patients of both groups, an increase in chest excursions, an increase in the vital capacity of the lungs, the normalization of the act of breathing and ventilation of the lungs, and an improvement in the psychosomatic status of patients. In the main group, these changes are more pronounced than in the control group. | ||||||
| van Gassel RJJ | 10.1097/CCM.0000000000005089 | 2021 | The Netherlands | From March to June 2020 | To assess the impact of respiratory and skeletal muscle injury sustained during ICU stay on physical performance at 3 months following hospital discharge. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 46 | N/A | N/A | N/A | 6MWT, MRC sum score and hand- grip strengt, pulmonary function test, and a chest CT scan | This study reports about 46 COVID-19 patients (median age 62 (55, 68), 69.6% male) mechanically ventilated in ICU. During ICU admission, early physiotherapy was part of routine care. Following hospital discharge, 85% of ICU survivors were referred for clinical rehabilitation in a dedicated rehabilitation center. Three of them were still admitted to a rehabilitation center at the time of follow-up. Follow-up occurred at a median of 120 days (103, 135 days). The main finding is that: At 3 months after hospital discharge, physical performance assessed by 6MWT was below 80% of predicted in 48% of patients. Patients with impaired physical performance had more muscle weakness, lower lung diffusing capacity, and higher inter-muscular adipose tissue area. Reduced lung diffusing capacity and increased intermuscular adipose tissue were independently associated with physical performance, suggesting a key role for both pulmonary function and muscle quality in physical disability of severe COVID-19 survivors. | ||||||
| Wynberg E | 10.1093/cid/ciab759 | 2021 | The Netherlands | From 11 May 2020 to 1 May 2021 | To evaluate symptom onset, severity and recovery across the full spectrum of disease severity, up to one year after illness onset. | Inception Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 342 | N/A | N/A | N/A | Standardised symptom questionnaires were completed at enrolment, one week and month later, and monthly thereafter | This study reports about 342 COVID-19 patients (age 51 years,56% male) of whom 29% had mild, 42% moderate, 16% severe, and 12% critical disease. 73% of patients were enrolled prospectively (Median time from illness onset to enrolment was 9 days, from illness onset to follow up was 190 days) and the remaining retrospectively (median time 85 days and 349, respectively). The main findings were that: the proportion of participants who reported at least one persistent symptom at 12 weeks after illness onset was greater in those with severe/critical disease (86.7% compared to those with mild or moderate disease 30.7% and 63.8%); at twelve months after illness onset, 40.7% of subjects continued to report ≥1 symptom; recovery was slower in females compared to male participants and those with a BMI≥30 compared to BMI<25. So, COVID-19 symptoms persisted for one year after illness onset, even in some individuals with mild disease. Female sex and obesity were the most important determinants of speed of recovery from symptoms. | ||||||
| Zhao Y | 10.1016/j.ijid.2021.09.017 | 2021 | China | From January 16 to February 6, 2021. | To evaluate the long-term consequences of COVID-19 survivors one year after recovery, and to identify the risk factors associated with abnormal patterns in chest imaging manifestations or impaired lung function. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 94 | N/A | N/A | N/A | symptoms colelction, SF-36, HAMA-14, HAMD-24, 6MWT, CT, pulmonary function tests, and blood tests. | This study reports about 94 COVID-19 patients (mean age 48.11 years, 42.55% females, disease severity=3% mild, 51.1% moderate, 43.6% severe, 2% critical). The median duration from symptom onset to follow-up visit was 366 (355, 376) days, and the median time from hospital discharge to follow-up visit was 345 (333, 349) days. The main findings at 1-year follow-up are represented by: -61.70% of patients reported at least one symptom that did not exist before COVID-19 infection, including muscle fatigue (39.36%), insomnia (22.34%), joint paint (20.21%), headache (14.89%), hair loss (13.83%), and chest pain (13.83%). The frequency of muscle fatigue in severe/critical COVID-19 was higher than that of mild/moderate COVID-19. - There was a high proportion of patients with lung injury (71.28%) at CT scan and DLCO impairment (14.29%), although the severity of COVID-19 had no relation to abnormality of CT and DLCO. -Urea nitrogen concentration on hospital admission was significantly associated with impaired DLCO after 1 year of discharge. - IgG levels and neutralizing activity were significantly lower compared with those in the early phase. | ||||||
| Qin W | 10.1183/13993003.03677-2020 | 2021 | China | From January to February 2020 | To evaluate pulmonary function and clinical symptoms in COVID-19 survivors within 3 months after hospital discharge, and to identify risk factors associated with impaired lung function. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 647 | N/A | N/A | N/A | symptoms collection, Pulmonary function test , chest CT | This study reports about 647 COVID-19 patients (mean age 58± 15, 44% male, 61.7% were non-severe and the remaining 38.3% severe). They were assessed at 3 months of hospital discharge (no details about mean length of hospital stay). The main findings are represented by: -13%patients presented with weakness, 10% with palpitations and 9% with dyspnoea. The prevalence of those were markedly higher in severe patients than nonsevere patients. -Pulmonary function test results were available for 81 patients: of them 54% manifested abnormal pulmonary function (impaired DLCO) -Chest CT total severity score >10.5 on admission and ARDS were significantly associated with impaired D LCO. So, Pulmonary interstitial damage may contributed to abnormal DLCO at 3 months after discharge. | ||||||
| Yıldırım S | 10.1101/2021.08.17.21262177 | 2021 | Turkey | From 15 January to 5 March 2021 | To investigate the effect of COVID-19 on lung structure, pulmonary functional, exercise capacity and quality of life in patients discharge from ICU and medical ward at 6 month follow up | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 70 | N/A | N/A | N/A | pulmonary functional tests, 6MWT, SF-36 | This study reports about 70 COVID-19 patients (median age 56 years, 75% male). Patients were classified into 2 groups: ICU patients (44%, the time from the onset of symptoms to follow-up visit was 209 days) and non-ICU patients (followed in the pulmonary ward, the time from the onset of symptoms to follow-up visit was 190 days). The main findings are represented by: -ICU patients had higher CT scores than non-ICU patients at admission and 6 month-follow up. Advanced age and higher CT score at admission were risk factors for having radiological abnormalities at control CT. -79% of participants had at least one persistent symptom. ICU patients had a higher percentage of persistent symptoms (the most common: dyspnea, fatigue and muscle weakness) 90% vs 67%. Women had a higher percentage of persistent symptoms than men. -pulmonary function impairment was more frequent in ICU (the most common: FVC, PEF, PIF). Higher CT scores at follow-up were found to be associated with impairment of pulmonary function. -no differences in 6MWT - Impairment of quality of life was comparable between ICU and non-ICU patients (the scores were lower in female than male participants) A number of COVID-19 survivors especially with severe disease could not fully recover after 6 months of hospital discharge. | ||||||
| Pestelli | 10.23736/S0031-0808.21.04510-9 | 2021 | Italy | From December 2020 to April 2021 | To test a method based on a guided in/expiratory modulation to treat the lung inhomogeneity in people recovering from COVID-19. | Quasi-experimental study | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 20 | N/A | 3 15-min sessions/day using the I/E mode of the T-PEP®4 device, for 15 consecutive days | N/A | Lung function parameters, dyspnea, quality of life scores, 6MWT were assessed before and after treatment. | This is a pilot study of 20 patients with a mild-to-moderate obstructive syndrome (mean age 63.80±14.46 years; 60% male) recently discharged from hospital (within the first 4 weeks) following COVID-19 related pneumonia and receiving breathing treatment using the I/E mode of the T-PEP®4 device. The main finding is represented by the improvement in symptoms (chest pain during deep inspiration, chest tightness, inability to yawn, fatigue during ADL, desaturation ≥4% during ADL), lung function tests, respiratory muscle strength, exercise capacity, and quality of life. The treatment was safe (no adverse events or discomfort with the use of the device emerged) and patients showed a high level of adherence during the observation period. | ||||||
| Nehme | 10.7326/M21-0878 | 2021 | Switzerland | From 18 March to 15 May 2020 | To characterize the prevalence and longitudinal evolution of COVID-19 symptoms more than 7 months after diagnosis | Inception Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 410 | N/A | N/A | N/A | A standardized interview of symptoms consistent with COVID-19, with grading of intensity, at baseline, 30–45 Days and 7-9 months from diagnosis | This study reports about non-hospitalized COVID-19 patients who were assessed during the first 10 days from diagnosis (n=629, mean age 42.5 +13.5, male 39.1%), at 30-45 days (n=479), and at 7 -9 months (n=419, mean age 42.7 +12.9, male 32.9%) after diagnosis. The main finding is represented by: - at 7 to 9 months, 39.0% reported some symptoms, with the most common being fatigue(20.7%), followed by loss of taste or smell (16.8%), dyspnea (11.7%), and headache(10.0%). -Of the 311 participants with data at all 3 follow-up time points, 37% reported symptom resolution by 30 to 45 days and an additional 19% reported symptom resolution by 7 to 9 months (total of 56% with symptom resolution). So, almost a third of persons with mild to moderate COVID-19 have long-term symptoms at 30 to 45 days and 7 to 9 months from diagnosis, even though the prevalence of overall symptoms decreased with time. | ||||||
| Noel-Savina | 10.1016/j.resmer.2021.100822 | 2021 | France | From April to September, 2020 | To describe the characteristics of persistent gas exchange abnormalities 4 months after severe COVID-19 pneumonia, in patients without prior cardiopulmonary disease. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 72 | N/A | N/A | N/A | DLCO, 6MWT, chest imaging | This study reports about 72 patients with severe COVID-19 pneumonia who were admitted to hospital, (mean age 60.5 years, 76.4% men, 76.1% required admission to an ICU, 31.9% developed venous thromboembolism during the acute phase). They were assessed at 4.3 months after diagnosis on average. The main finding is represented by: -After 4 months, 61.4% were still symptomatic (44.4% had dyspnoea, 30.6% asthenia, and 16.7% coughing) , 39% of patients had persistent functional abnormalities and 41% radiological abnormalities. -The main predictive factors for this respiratory impairment were disease severity during initial presentation and venous thromboembolism occurrence during the acute phase. A respiratory check-up after severe COVID-19 pneumonia may be relevant to improve future management of these patients. | ||||||
| Van Herck | 10.2196/30274 | 2021 | Netherlands, Belgium | From June 4 to June 11, 2020 | To (1) assess the severity of fatigue over time in members of online long COVID peer support groups, and (2) assess whether members of these groups experienced mental fatigue, physical fatigue, or both. | Inception Cohort study | N/A | Epidemiology - Natural history | Any other body structure and function-generic (s/b) | Post-Covid | COVID-19 | 239 | N/A | N/A | N/A | The Checklist Individual Strength–subscale subjective fatigue | This study reports about 239 COVID-19 patients (median age was 50 years (IQR 39-56), 82.8% were women; 25.9% were hospitalized during acute infectionì), who completed an online survey 10 weeks (SD 2) and 23 weeks (SD 2) after the onset of infection symptoms. The main finding is represented by the persistence of severe fatigue at approximately 3 and 6 months after the infection in the vast majority of patients (85.4%, and 78.7%, respectively). The fatigue does not resolve over time in all patients, even if they receive health care (during the first 10 weeks 65.7% received or sought care from at least one medical professional, whereas 37.7% received or sought care from at least one allied health care professional. At 6 months those percentages increased significantly to 81.2% and 68.6, respectively), so it remains unclear whether and to what extent fatigue will resolve spontaneously in the longer term. | ||||||
| Asadi‑Pooya | 10.1007/s12519-021-00457-6 | 2021 | Iran | From 19 February 2020 to 20 November 2020. | To identify the prevalence and also the full spectrum of symptoms/complaints of children and adolescents who are suffering from long COVID and to investigate the risk factors associated with the development of long COVID in children and adolescents who were hospitalized with COVID-19. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 58 | N/A | N/A | N/A | Symptoms | This study reports about 58 children hospitalized for COVID-19 (age between 6 and 17 years old, mean age 12.3±3.3 years, 48% male) after at least 3 months from discharge. Patients underwent a phone interview. The main finding is represented by the high prevalence of symptoms at the interview (44.8% of interviewed children).These symptoms included fatigue in 12 (21%), shortness of breath in 7 (12%), exercise intolerance in 7 (12%), weakness in 6 (10%), and walking intolerance in 5 (9%) individuals. Older age, muscle pain on admission, and intensive care unit admission were significantly associated with long lasting symptoms. | ||||||
| Eksombatchai | 10.1371/journal.pone.0257040 | 2021 | Thailand | N/A | To investigate lung function test, 6MWT and chest radiograph in hospitalized COVID-19 patients after recovery. | Cohort study | N/A | Epidemiology - Prevalence/Incidence | Respiratory structures (s430) and related functions (Respiration b440-455) | Ongoing | COVID-19 | 87 | N/A | N/A | N/A | PFT, 6MWT, chest x-ray. | This study reports about 87 COVID-19 hospitalized patients (mean age 39.6±11.8 years, 35 men and 52 women, 45 cases had mild symptoms; 35 had non-severe pneumonia, and 7 had severe pneumonia). The main findings is represented by the high rate of abnormal spirometry (17.2%) of COVID-19 survivors with both restrictive and obstructive defects. Severe COVID-19 pneumonia patients had higher prevalence rates of abnormal spirometry and residual fibrosis on the chest radiographs when compared to patients in the mild symptom and non-severe pneumonia groups. | ||||||
| Hazarika | 10.7759/cureus.17756 | 2021 | India | From May 1 to July 31, 2021. | To compare PFT at 3 months post ICU discharge in patients who received non-invasive oxygen therapy versus invasive mechanical ventilation during their ICU stay. | Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 74 | N/A | N/A | N/A | PFT, 6MWT, HRQOL | This study reports about 74 COVID-19 hospitalized patients (mean age 50 ± 13.78 years, 64.9% males, BMI 25.96 ± 3.39) followed up to 3 months after discharge. Patients were divided into two groups: 57 patients were in the Non-invasive therapy group and 17 patients in the Invasive mechanical ventilation group. The main findings are represented by the greater risk of impaired pulmonary function and reduced QOL post-ICU discharge in patients requiring invasive mechanical ventilation. | ||||||
| Hellemons | 10.1513/AnnalsATS.202103-340OC | 2021 | The Netherlands | From February 28, 2020, to January 31, 2021. | To evaluate the recovery of pulmonary function and radiological abnormalities, physical and mental health status, and HR-QoL over time up to 6 months after hospitalization for SARS-CoV-2 infection; and the predictors of the most clinically relevant sequelae in these domains. | Inception Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 92 | N/A | N/A | N/A | PFT, Physical and mental health status, HRQOL | This study reports about 92 COVID-19 hospitalized patients (mean age 58.2±12.3 years, 63% males) followed until 6 months after discharge. The main findings is represented by the reduced percentage of patients with impaired FVC from 25% at 6 weeks to 11% at 6 months. During the first 6 months after hospitalization for SARS-CoV-2 most patients demonstrated continuing recovery across all health domains, but persistent sequelae were frequent. Persistent fatigue and total hospital length were the main predictors of poor HRQoL at 6 months- | ||||||
| Mayer | 10.1097/CCE.0000000000000516 | 2021 | USA | From May 1, 2020, to January 1, 2021. | To examine the safety and feasibility of providing combined ICU Recovery Clinic appointments and 8 weeks of rehabilitation treatment initiated in the early recovery phase following acute respiratory failure due to COVID-19 and to explore whether the rehabilitation treatment could be delivered through telehealth. | Non randomised controlled trial | Specialized outpatient rehabilitation | Micro - Interventions (efficacy/harms) | Any Activity limitation and participation restriction (d) | Ongoing | COVID-19 | 32 | N/A | Eight weeks of pulmonary and physical rehabilitation delivered via telehealth | Eight weeks of pulmonary and physical rehabilitation delivered in person | Safety and feasibility of treatment, 6MWT, TUG, HRQOL. | This study reports about 32 COVID-19 post-ICU patients (mean age 57 ± 12 years, 62% males, mean hospital length of stay: 19.5 days, range 13-28). At hospital discharge (around 20 days after admission, or 2-4 weeks later, patients were allocated to two groups, based on their preference for rehabilitation delivery pathway: 22 patients followed an eight weeks program of pulmonary and physical rehabilitation delivered in-person, while 10 patients followed an eight weeks program of pulmonary and physical rehabilitation delivered via telehealth. The main findings is represented by the apparent safety and feasibility of the treatment delivered via telehealth and the similar results on all major outcomes in the two groups. | ||||||
| Nambi | 10.1177/026921552110369 | 2021 | Saudi Arabia | From March 2020 to April 2021. | To investigate the effects of different aerobic training protocols combined with resistance training in community-dwelling older adults with post-COVID-19 sarcopenia symptoms. | Randomised controlled trial | Rehabilitation services at home | Micro - Interventions (efficacy/harms) | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Post-Covid | COVID-19 | 76 | Post-Covid-19 sarcopenia | Resistance training + low intensity aerobic training for 30 minutes/session, 1 session/day, 4 days/week for 8 weeks. | Resistance training + high intensity aerobic training for 30 minutes/session, 1 session/day, 4 days/week for 8 weeks. | Muscle mass, muscle strength, kinesiophobia, HRQOL. | This study reports about 76 community-dwelling elderly men with post-COVID-19 sarcopenia (mean age 63.2 ± 3.1, 100% males). Patients were random allocated to two groups: 38 patients followed an eight weeks program of Resistance training + low intensity aerobic training, while 38 patients followed an eight weeks program of Resistance training + high intensity aerobic training. The main findings are the greater reduction in kinesiophopia and superior improvement in handgrip strength and HRQOL in the low intensity aerobic training group compared to the high intensity aerobic training group. | ||||||
| Qin | 10.1002/pmrj.12716 | 2021 | USA | From April 2020 to April 2021 | To describe patient-reported functional outcomes and fatigue symptoms 30 days after hospital discharge among adult survivors of hospitalization for COVID-19 and to explore potential risk factors for the above adverse functional outcomes in these patients. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any Activity limitation and participation restriction (d) | Ongoing | COVID-19 | 55 | N/A | N/A | N/A | The Health Assessment Questionnaire-Disability Index (HAQ-DI) and PROMIS Fatigue Short Form 7a; FRAIL scale and Hospital Anxiety and Depression Scale | This study reports about 55 hospitalized COVID-19 patients (mean age 59.1 ± 17.5 years, 47% males). All the patients answered a standardized telephone questionnaire administered 30 days after hospital discharge. The main findings is represented by the reduced independence in both basic ADLs and instrumental ADLs, and worsening of fatigue symptom severity, after hospitalization. | ||||||
| Yomogida | 10.15585/mmwr.mm7037a2 | 2021 | USA | From April 1 to December 10, 2020. | To identify trends in COVID-19 post-acute sequelae at two months follow-up. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any other body structure and function-generic (s/b) | Ongoing | COVID-19 | 363 | N/A | N/A | N/A | Symptoms | This study reports about 366 COVID-19 patients (patients were older than 18 years old, most of them – 39.3% - were in the age span 25-39 years, 43.2% males). Participants were interviewed by telephone at least 2 months after the positive test result (median =202 days; range = 78–368 days). The main findings is represented by the high prevalence of at least one symptom after 2 months (one third of the patients), with higher odds of sequelae among persons aged 40–54 years, females, and those with preexisting conditions. | ||||||
| Norrefalk | 10.2340/jrm.v53.188 | 2021 | Sweden | N/A | To assess functioning, activity, and disability, using an adapted list of ICF categories for patients with post-COVID syndrome. | Cross-sectional study | N/A | Epidemiology - Prevalence/Incidence | Any Activity limitation and participation restriction (d) | Post-Covid | COVID-19 | 100 | N/A | N/A | N/A | The Functional Compass COVID-19 | This study reports about 107 COVID-19 patients (mean age 44.5 ± 10.6 years, 18% males). Participants were recruited via Facebook sites and stakeholders’ organization for post-COVID syndrome in Sweden, and answered an online questionnaire (The Functional Compass COVID-19). The main findings is represented by the high rate of impaired functions in both ICF components of Body Functions and Activity. | ||||||
| Bouteleux | 10.1016/j.rmed.2021.106648 | 2021 | France | From April 1,2020 to April 1, 2021. | To describe the clinical and functional characteristics of real-life patients referred to ambulatory respiratory rehabilitation following SARS-CoV-2 infection and to describe the evolution of these patients over the course of rehabilitation. | Cohort study | Specialized outpatient rehabilitation | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 39 | N/A | Up to 3 months of outpatient respiratory rehabilitation. | N/A | PFT, 6MWT, HRQOL | This study reports about 39 COVID-19 patients (mean age 48 ± 15 years, 44% males, without comorbidities, and mostly mild to moderate SARS-CoV-2 infection, 64% not requiring hospitalization). Patients were divided in two groups at first evaluation, at more than 3 months of disease onset: 29 patients were included in the Prolonged Functional Sequalae group, 10 in the No Prolonged Functional Sequalae group. Prolonged Functional Sequalea was defined as persistence of rehabilitation requirement more than three months after disease onset. They all underwent pulmonary rehabilitation. The main findings is represented by the high frequency hyperventilation syndrome and poorer quality of life in the Prolonged Functional Sequalae group. However, both groups improved significantly at the end of the rehabilitation program. | ||||||
| Naik | 10.5582/ddt.2021.01093 | 2021 | India | From October, 2020 to February, 2021. | To describe the incidence and risk factors of post COVID-19 sequelae among the Northern Indian population. | Inception Cohort study | N/A | Epidemiology - Natural history | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 1234 | N/A | N/A | N/A | Persistent symptoms | This study reports about 1234 COVID-19 patients (mean age 41.6 ± 14.2, 69.4% males, 85.8% with mild disease, 10.9 with moderate, and 3.3 with severe disease). Patients were followed up for a median of 91 days (range 43-181 days). The main findings are the high prevalence of symptoms at follow-up (40.1% of patients). 9.9% patients had symptoms beyond 12 weeks of diagnosis/symptom-onset of COVID-19. Myalgias, fatigue and dyspnoea were the most common symptoms. Patients with hypothyroidism and hypoxia during acute illness were at higher risk of exhibiting persistent symtoms. | ||||||
| de Andrade-Junior MC | 10.3389/fphys.2021.640973 | 2021 | Brazil | From April 2020 to October 2020 | To evaluate the skeletal muscle mass and functional performance in intensive care patients with severe COVID-19 | Inception Cohort study | N/A | Epidemiology - Natural history | Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related functions b7) | Acute | COVID-19 | 32 | N/A | N/A | N/A | Ultrasound measurement of the rectus femoris, handgrip test, ICU mobility scale, and ICF: All evaluations were performed on days 1 and 10. | This study reports about 32 COVID-19 critically ill patients (93.8% male; age: 64.1 ± 12.6 years; severe illness 25% and critical illness 75%). They were assessed within 24 to 72 h following ICU admission (day 1) and at the 10th day. The main findings are that: There were significant reductions in the rectus femoris cross-section area (-30%), the thickness of the anterior compartment of the quadriceps muscle (−18.6%), and handgrip strength (−22.3%) from days 1 to 10. Patients showed increased mobility, improvement in respiratory function, but none of the patients returned to normal levels. | ||||||
| O’Connor RJ | 10.1002/jmv.27415 | 2021 | UK | N/A | To describe the first stage in establishing the initial psychometric properties of the C19‐YRS as an outcome measure for post covid syndrome using classical test theory. | Cross-sectional study | Community-based rehabilitation (CBR) | Micro - Outcome Measures | Respiratory structures (s430) and related functions (Respiration b440-455) | Post-Covid | COVID-19 | 188 | N/A | N/A | N/A | Clinical usefulness and psychometric properties of the C19-YRS (data quality, scaling assumptions, targeting, reliability, and validity) | This study reports about 188 COVID-19 patients that were referred into a Long COVID Community Rehabilitation Service; 84 % of them were not hospitalized (mean age 47.1 years, 34% males), the rest was hospitalized (mean age 51.9 years, 57% males). All the patients completed a self-report C19-YRS, at a median of 30 weeks after disease onset in the non-hospitalized group and 12 weeks in the hospitalized group. The main finding is represented by the verification of C19-YRS psychometric properties: missing data were low, scaling and targeting assumptions were satisfied, and internal consistency was high (Cronbach's α = 0.891). Relationships between the overall perception of health and patients' reports of symptoms, functioning, and disability demonstrated good concordance. |