| Arnold DT |
10.1136/thoraxjnl-2020-216086 |
2020 |
UK |
N/A |
To report a prospectively recruited UK cohort of hospitalised patients with COVID-19. |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
163 |
N/A |
N/A |
N/A |
Baseline demographics, comorbidities, blood test results, chest radiograph, pulmonary function
testing, clinical data. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
In the present study 163 COVID-19 patients consecutively admitted to hospital were enrolled. At 8–12
weeks postadmission, survivors were invited to a systematic clinical and radiological follow-up. At
the follow up 74% patients reported at least one ongoing symptom: 39% breathlessness, 39% fatigue
and 24% insomnia. Fourteen percent of the patients had a abnormal radiograph follow-up. Eleven
patients had restrictive spirometry and 15 had a significant desaturation on the 1 minute STS test.
SF-36 scores demonstrated a reduction in reported health status across all domains compared with
age-matched population norms. Overall, the study show persistency of clinical and radiological
abnormalities at 8-12 weeks postadmission in COVID-19 patients. |
| Arnold DT |
10.1136/thoraxjnl-2020-216086 |
2020 |
UK |
N/A |
To report a prospectively recruited UK cohort of hospitalised patients with COVID-19. |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
163 |
N/A |
N/A |
N/A |
Baseline demographics, comorbidities, blood test results, chest radiograph, pulmonary function
testing, clinical data. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
In the present study 163 COVID-19 patients consecutively admitted to hospital were enrolled. At
8–12 weeks postadmission, survivors were invited to a systematic clinical and radiological
follow-up. At the follow up 74% patients reported at least one ongoing symptom: 39%
breathlessness, 39% fatigue and 24% insomnia. Fourteen percent of the patients had a abnormal
radiograph follow-up. Eleven patients had restrictive spirometry and 15 had a significant
desaturation on the 1 minute STS test. SF-36 scores demonstrated a reduction in reported health
status across all domains compared with age-matched population norms. Overall, the study show
persistency of clinical and radiological abnormalities at 8-12 weeks postadmission in COVID-19
patients. |
| Arzani P |
10.34171/mjiri.34.106
|
2020 |
Iran |
March 2020 |
To show the effects of pulmonary rehabilitation and exercise therapy in a patient with COVID-19.
|
Descriptive: Case Report |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Respiratory structures (s430) and related functions (Respiration b440-455) |
Post-acute |
COVID-19 |
1 |
Fever and dyspnea. |
Pulmonary rehabilitation and physical activity. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The case study reports of 49-year-old female COVID-19 patients. Because of COVID-19 related
pneumonia she needed hospitalization and suffered from severa dyspnea. On the third day of
admission pulmonary rehabilitation was started. Pulmonary rehabilitation involved, in the first
phase, when the patient was inconscious, mainly passive mobilization, in a second phase a
combination of active and passive mobilization and breathing exercises. She continued
rehabilitation for a week after discharge, using telerehabilitation with a smartphone. As soon
as the patient was able to move autonoumously she was encouraged to walk 50 meters every day.
She underwent a total of 42 physical training sessions in 3 weeks. At the end of the program the
patient scored better in all the outcome considered, including modified Borg scale, Saint
George’s Respiratory Questionnaire, SF36. |
| Battaglini D |
10.3389/fneur.2020.602114
|
2020 |
Italy |
From February 28 to June 30, 2020. |
To describe the type and the frequency of neurological complications in a cohort of critically
ill patients with COVID-19 receiving invasive mechanical ventilation in an intensive care unit
(ICU) and the effects of these complications on outcome. |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Mental functions b1) |
Acute |
COVID-19 |
94 |
N/A |
N/A |
N/A |
Clinical data, rate of neurological complications, invasive and non-invasive neuromonitoring
(e.g. transcranial Doppler, ONSD, and automated pupillometry). |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The study described a cohort of 94 patients referred to an ICU. Neurological complications were
detected in 50% of patients, and delirium was the most common manifestation. Patients with
neurological complications did not have an incresead ICU mortaliy, but had longer hospital (36.8
± 25.1 vs. 19.4 ± 16.9 days) and ICU (31.5 ± 22.6 vs. 11.5±10.1 days) stay. 53 patients
underwent noninvasive neuromonitoring. Patients with increased intracranial pressure measured
using ONSD (19%) had longer ICU stays. Overall, patients with neurological complications needed
longer ICU and hospital stays. |
| Cabrera Muras A |
10.1111/ene.14561 |
2020 |
Spain |
N/A |
To report a case of Bilateral Facial Nerve Palsy associated with COVID-19 and Epstein-Barr Virus
co-infection
|
Descriptive: Case Report |
N/A |
Epidemiology - Clinical presentation |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Acute |
COVID-19 with Epstein-Barr Virus co-infection |
1 |
He presented with significant asthenia with headache, myalgia, nausea, and vomiting; after a
week he presented right facial weakness; 2 weeks later he had diagnosis of bilateral facial
paresis |
Levofloxacin 500mg for 7 days; prednisone 60 mg/24h with a tapering schedule
|
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The patient referred to a an Emergency Room underwent a neurological examination that diagnosed
a bilateral facial palsy. The RT-PCR performed for SARS-CoV-2 showed positive results. Moreover,
he also had a positive heterophile test indicating a recent Epstein-Barr virus infection. Brain
MRI raised the diagnosis of bilateral facial neuritis. He was treated with prednisone and at a
follow-up examination 3 weeks later showed an almost complete facial palsy recovery
|
| Cardoso ER |
10.12659/AJCR.927011 |
2020 |
USA |
N/A |
To describe a case of superficial cerebral venous thrombosis and intracerebral hematoma in a
48-year-old man weeks after recovering from the acute phase of SARSCoV-2 infection |
Descriptive: Case Report |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Late-onset |
COVID-19 |
1 |
Left upper-limb numbness, weakness, and impairment of positional sensation. |
Enoxaparin anticoagulation therapy. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The 48-year-old male patient included in this case-study, 36 days after being diagnosed for
SARS-COV2 infection and 19 days after recovering from the infection and coming back to work,
presented sudden onset of left upper-limb numbness, weakness, and impairment of positional
sensation. CT scan showed a small acute cortical hemorrhage in the right parietal lobe, with a
rim of surrounding vasogenic edema. The patient remained neurologically stable during
hospitalization. He was treated with enoxaparin anticoagulation therapy with benefit, and he
slowly improved. At 4 and 8 weeks follow-up after the stroke, the only residual deficit was a
mild numbness of the left pointer finger. |
| Fayed I |
10.1016/j.jocn.2020.08.026 |
2020 |
USA |
N/A |
To report three cases of spontaneous intracranial hemorrhage in COVID-19 patients |
Descriptive: Case Series |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Acute |
COVID-19 |
3 |
Persistent Encephalopathy, Fixed and Dilated Pupils |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
This study reports a spontaneous intracranial hemorrhage (including intracerebral and
subarachnoid hemorrhages, ) in three severe COVID-19 patients (two females of 57 and
54-year-old, and a 71-year-old man) who required intubation and ventilatory support. The
hospital stays prior to hemorrhage was 20 days in two cases and 8 in the remainder.
The 57-year-old woman was subsequently discharged to an acute rehabilitation facility one week
later, the 54-year-old female progressed to brain death and expired due to asystole four days
later, while the man succumbed to multi-system organ failure one week later.
These cases support the predisposition of COVID-19 patients to the development of intracranial
hemorrhage during critical illness, maybe for the tropism of SARS-CoV-2 to the endothelial
lining of the cerebral vasculature via their angiotensin-converting enzyme (ACE) II receptors.
These cases highlighted the need for heightened vigilance for intracerebral hemorrhage events
and scanning when practicable, in COVID-19 patients which have prolonged ventilatory support and
depressed neurologic examinations. |
| Ferraro F |
10.1002/jmv.26717 |
2020 |
Italy |
April - June 2020 |
To characterize the COVID-19 late consequences and to investigate the role of rehabilitation in
reducing COVID-19 related fatigue and improving functional outcome in a case series of
post-COVID-19 inpatients. |
Descriptive: Case Series |
Specialized postacute rehabilitation |
Epidemiology - Natural history/Determining and modifying factors |
Any other body structure and function-generic (s/b) |
Post-acute |
COVID-19 |
7 |
The 85.7% showed a COVID-19 related fatigue, but only Case 2, that needed ICU in the acute
phase, presented a severe perception of exertion (Borg CR10 scale=7). |
Rehabilitation plan (1-2 session per day of 30 minutes each for 6 days/week), consisting of a
progressively increased intensity physical exercises: a) posture changes; b) breathing control
exercises; c) passive mobilization of upper and lower limbs; d) passive muscle stretching; e)
muscle strengthening exercises of upper and lower limbs, trunk, and gluteus muscles, aimed at
reaching the control of sitting position and standing; f) balance and coordination exercises.
|
N/A |
Borg CR10 scale; HGS; 6MWT; SPPB; BI dyspnoea; FIM |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
After the rehabilitation treatment the 71.4% showed no fatigue and the other 2 cases reported
only a very light perception of exertion. We evidenced a considerably improvement of functional
outcome after rehabilitation, particularly showed by two patients: Case 2 (6MWT=306 vs 120 m;
10MWT=6 vs 15 sec; SPPB=9 vs 2) and Case 3 (6MWT=330 vs 100 m; SPPB=9 vs 2). The Authors
concluded that that a patient-tailored rehabilitation is mandatory for reducing fatigue and
improving functional outcome in ADL. |
| Galván-Tejada CE |
10.3390/ijerph17249367
|
2020 |
Mexico |
From 25 July to 20 September 2020. |
To identify the risk of presenting persistent symptoms in recovered from COVID-19 |
Analytical: Case-control study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Any other body structure and function-generic (s/b) |
Post-acute |
COVID-19 |
141 |
N/A |
N/A |
78 controls: people who do not meet clinical and laboratory criteria to diagnose SARS-CoV2 |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
A total of 219 participants were studied: 141 recovered (at least 14 days since the appearance
of symptoms) and 78 controls (without diagnosis of COVID-19). Fifty-one controls were free of
COVID-19 associated symptoms at the time of the interview (Symptom Questionnaire), while 27 had
at least one of the most significant symptom, which means that the risk of symptoms in the
controls is 0.3461, that is 34.61%. For the recovered population, 22 had no symptoms and 119 had
at least one symptom, that is, a risk of 0.8439 (84.39%). All symptoms show an associated risk
of persisting in people recovered from COVID19. The relative risk of the selected symptoms in
the recovered patients goes from 3 to 22 times, being infinite for the case of dyspnea, due to
the fact that there is no control that presents this symptom at the moment of the interview,
followed by nausea and the anosmia with a RR of 8.5. Therefore, public health strategies must be
rethought, to treat or rehabilitate, avoiding chronic problems in patients recovered from
COVID-19 |
| Kanjwal K |
10.19102/icrm.2020.111102
|
2020 |
USA |
N/A |
To report a case of POTS in an otherwise healthy female after COVID-19 infection. |
Descriptive: Case Report |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Cardiovascular functions (Heart b410) |
Late-onset |
COVID-19 |
1 |
Fatigue, headache, dizziness, chest pain, and palpitations, espe cially while getting up from
the sitting position. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
A patient recovered from a mild form of COVID-19, three to four weeks after diagnosis presented
fatigue, headache, dizziness, chest pain, and palpitations, especially while getting up from the
sitting position. Electrocardiography was negative for acute events. Physical examination
revealed a sitting heart rate of 86 bpm and blood pressure of 115/65 mmHg; after standing up,
however, her heart rate was 115 bpm and her blood pressure was 105/70 mmHg. Because of her
orthostatic increase in heart rate, she underwent head-up tilt-table testing and findings of the
test were suggestive of POTS. She was treated with Ivabradine with improvement of the symptoms
both subjectively and objectively at follow-up visit. |
| Livingston T |
10.1093/ptj/pzaa204 |
2020 |
USA |
N/A |
To illustrate how the technology and COVID-19 specific decision-making frameworks were used to
deliver acute rehabilitation. |
Descriptive: Case Series |
Rehabilitation in acute care |
Epidemiology - Natural history/Determining and modifying factors |
Any other body structure and function-generic (s/b) |
Acute |
COVID-19 |
2 |
N/A |
In-room video communication system and PT/OT co-treatment strategies. 1 case: For acute care
rehabilitation sessions co-treatments PT/OT of 30 minutes; on rehabilitation unit, session of
40-60-minute separate sessions per physical therapy and occupational therapy ; 2 case: 30
co-treatment minutes with a physical therapist and occupational therapist |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The two case reports (A 65-year-old and a 40-year-old, males) highlight a model of care that
used technology and two COVID-19 specific decision-making processes to provide safe and
patient-centered care.
The use of in-room video communication system and PT/OT co-treatment strategies enabled patients
to receive both PT and OT services, while concurrently conserving PPE and reducing provider
contact. Furthermore, the capability for virtual rehabilitation following hospital discharge
allowed the rehabilitation team and patient to comfortably make an informed decision to
discharge the patient from the hospital to home. The authors developed also two decision-making
models regarding care delivery and discharge planning in the context of the challenges to
delivering care. Both patients with COVID-19 demonstrated functional gains after 2-4 weeks of
acute rehabilitation (length of stays: 7 days in acute care, 17 days in COVID-19 acute
rehabilitation unit; 17 days including 11 days in ICU) and discharged home.
The use of technology and decision-making models allows for delivery of safe acute
rehabilitation care that minimizes contact, conserves personal protective equipment, and
prepares for COVID-19 surges. |
| Meys R |
10.3390/jcm9123993 |
2020 |
The Netherlands and Belgium |
N/A |
To assess the respiratory-specific quality of life in addition to generic quality of life in
non-hospitalized COVID-19 patients |
Analytical: Cross-sectional study |
N/A |
Epidemiology - Prevalence |
Any other body structure and function-generic (s/b) |
Chronic |
COVID-19 |
210 |
N/A |
N/A |
The subjects were also categozied as Confirmed COVID-19, Symptom-Based COVID-19, and Suspected
COVID-19 |
The EQ-5D-5L, Clinical COPD Questionnaire |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
210 non-hospitalized patients (79 ± 17 days after symptom onset) were included in the study.
Both generic (EQ-5D) and respiratory-specific quality of life (CCQ) was affected in these
patients, approximately three months after the onset of symptoms. The combined use of the EQ-5D
and the CCQ could identify the broad impact of COVID-19 on quality of life.
The correlation between EQ-5D index score/EQ-VAS score and CCQ total score was moderate. Given
the moderate association and limited discriminative ability of both questionnaires, the combined
usage of the EQ-5D and the CCQ can be regarded as a promising approach to best describe the
quality of life in patients with COVID-19. This will help to reveal patients’ needs in order to
identify relevant rehabilitative interventions to effectively restore health and quality of
life. |
| Mizrahi B |
10.1038/s41467-020-20053-y |
2020 |
Israel |
From 1/3/2020 to 07/06/2020 |
To assess the longitudinal dynamics of symptoms prior to and throughout SARS-CoV-2 infection.
|
Descriptive: Historical cohort |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Any other body structure and function-generic (s/b) |
|
COVID-19 |
2471 |
N/A |
N/A |
6,227 negative cases and 147,679 individuals who had no record of a PCR test for SARS-CoV-2 |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The authors extracted data from primary-care electronic health records and nationwide
distributed surveys to assess the longitudinal dynamics of symptoms prior to and throughout
SARS-CoV-2 infection. Information was available for 206,377 individuals, including 2471 positive
cases. The two data sources were discordant, with survey data capturing most of the symptoms
more sensitively. The most prevalent symptoms included fever, cough, and fatigue.
Conjunctivitis, rash, sore throat, dyspnea and/or shortness of breath and speech disturbance,
had a higher prevalence in children who were positive to COVID-19 compared to positive adults.
Loss of taste and smell 3 weeks prior to testing, either self-reported or recorded by
physicians, were the most discriminative symptoms for COVID-19. Additional discriminative
symptoms included self-reported headache and fatigue and documentation of syncope, rhinorrhea,
and fever. Children had a significantly shorter disease duration. Long duration of symptoms,
specifically fatigue, myalgia, runny nose and shortness of breath was observed weeks after
recovery.
This study highlights the power of survey derived data to enhance understanding of the evolving
COVID-19 pandemic. The study provides additional information on the natural history of mostly
mild cases of COVID-19 and may alert physicians for the possibility of infec- tion and direct
the need for testing and self-isolation. |
| Ortelli P |
10.1016/j.jns.2020.117271
|
2020 |
Italy |
April and May, 2020 |
To provide a comprehensive clinical, neurophysiological, and neuropsychological profile of
fatigued patients suffering from neurological manifestations related to SARSCoV-2, who recovered
from the acute phase of COVID-19. |
Analytical: Cross-sectional study |
Specialized postacute rehabilitation |
Epidemiology - Prevalence |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
12 |
N/A |
N/A |
12 healthy controls |
Neuropsychological assessment and neurophysiological evaluation. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The 12 patients included in the study were all post-acute COVID-19 patients who suffered from
neurological complications, and were still suffering from fatigue. All patients met the World
Health Organization criteria defining the state of recovery from COVID-19. Neuropsychological
and neurophysiological examination were collected in both patients and healthy controls.
Neurophysiological examination was assessed before (PRE) and 2 min after (POST) a 1-min
fatiguing isometric pinching task and included: CMAP amplitude in FDI following ulnar nerve
stimulation, resting motor threshold, MEP amplitude and silent period duration in right FDI
following transcranial magnetic stimulation of the left motor cortex . Patients manifested
fatigue, apathy, executive deficits, impaired cognitive control, and reduction in global
cognition. Perceived exertion was higher in patients. CMAP and MEP were smaller in patients both
PRE and POST. Silent period duration did not differ between groups PRE, increased in controls
but decreased in patients POST. Taken all together, the study demonstrated the presence, in post
COVID-19 patients who suffered from neurological complications, of central neuromotor and
cognitive fatigue, apathy, and executive dysfunction. |
| Pancera S |
10.1097/MRR.0000000000000450 |
2020 |
Italy |
March - April 2020 |
To evaluate the feasibility of a subacute rehabilitation program for mechanically ventilated
patients with severe consequences of COVID-19 infection |
Descriptive: Case Series |
Specialized postacute rehabilitation |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
7 |
Seven male COVID-19 patients (age 37–61 years) referred for inpatient rehabilitation after ICU
stay (14–22 days) |
Pulmonary and physical rehabilitation, consisting of 11–24 treatment sessions for the duration
of rehabilitation stay (13–27 days), including 6–20 sessions in the COVID unit.
|
N/A |
BI, BID, MRC, SPPB |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The 6 mechanically ventilated patients were successfully weaned off before transfer to a
COVIDfree unit where they stayed for 7–19 days. At discharge, all patients increased limb muscle
strength and thigh circumference, reduced activity-related dyspnea, regained functional
independence and reported better quality of life. The Authors concluded that rehabilitation
might play a crucial role in the recovery of seriously ill post-COVID-19 patients. |
| Roberts P |
10.1016/j.apmr.2020.11.005 |
2020 |
USA |
from January 1 to April 30, 2020. |
To identify functional limitations in relation to demographic, medical, encounter
characteristics; and discharge destination, in COVID-19 patients admitted to acute care
hospitals |
Analytical: Cross-sectional study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Any Activity limitation and participation restriction (d) |
Post-acute |
COVID-19 |
230 |
N/A |
N/A |
Discharge Home (51) VS discharge institution (51) |
Demographic, encounter, medical, and functional variables were tested against the dependent
variable of discharge destination (discharge home vs discharge institution). |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
This is a cross-sectional, retrospective study of 230 adult patients with COVID-19 who were
discharged from 2 different types of hospitals within 1 health care system, from January 1 to
April 30, 2020: 165 were discharged home and 65 to an institution. In the group of people
discharged home, 88.2% had functional physical health deficits, 72.5% had functional mental
health deficits, and 17.6% experienced sensory deficits. In the matched cohort, individuals
discharged to an institution experienced greater physical (62.7% vs 25.5%) and mental health
(49.0% vs 23.5%, deficits than patients discharged home. Marital status and physical function
deficits were associated with an increase odds ratio of discharge to an institution. This
research highlights that functional status is a strong predictor for discharge destination to an
institution for patients with COVID-19. Patients who were older, in the acute care hospital
longer, and with comorbidities were more likely to be discharged to an institution.
Rehabilitation is a significant aspect of the health care system for these vulnerable patients.
|
| Sabayan B
|
10.1016/j.jstrokecerebrovasdis.2020.105454 |
2020 |
Iran |
February - March 2020
|
To present data on patients who initially presented with COVID-19 respiratory symptoms, but
subsequently developed ischemic stroke or subarachnoid hemorrhage |
Descriptive: Case Series |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
15 |
Fever, cough, dyspnea, myalgia, and COVID-19 respiratory symptoms
|
N/A |
N/A |
Type of stroke, NIHSS, mRS |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Interval time between systemic COVID-19 manifestations and neurological symptoms ranged from one
to 16 days (median: 7 days). Out of 15 COVID-19 patients, 14 had acute ischemic stroke and 1
patient had subarachnoid hemorrhage. Stroke severity in 2 patients (13%) was mild (NIHSS 6),
in 6 patients (40%) was moderate (NIHSS: 7-12) and in 7 patients (47%) was severe (NIHSS 13).
Six patients (40%) died. In those who survived, significant disability (mRS>2) was seen in all
but one patient. The Authors concluded that there is a need for further investigation of the
links between COVID-19 and cerebrovascular events. |
| Scelfo C |
10.2147/TCRM.S275779 |
2020 |
Italy |
March 2020 |
To report two cases of early lung fibrosis following COVID-19 pneumonia |
Descriptive: Case Series |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Respiratory structures (s430) and related functions (Respiration b440-455) |
Late-onset |
COVID-19 |
2 |
Both patients showed fever, cough, and dyspnoea. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
At one month later the onset of COVID-19 symptoms, Case 1 showed at the new contrast-enhanced CT
scan signs of reticular interstitial thickening; instead, after discharge, Case 2 showed the
presence of sub-pleural consolidations and reticular thickening involving the upper lobes. Thus,
the Authors concluded that these cases represent two examples of early lung fibrosis in patients
with COVID-19 pneumonia with different severity disease evolution and highlight the need for
long-term follow-up strategies. |
| Sinha RK |
10.26452/ijrps.v11iSPL1.3608 |
2020 |
India |
N/A |
To investigate the effectiveness of structured exercise protocol on functional performance in
COVID-19 patients |
Non randomised controlled trial |
Specialized postacute rehabilitation |
Micro - Interventions (efficacy/harms) |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
150 |
Functional impairment assessed by FIM (72.4±21.7) and POMA (11.9±3.6)
|
Exercise protocol consisting of three satgaes: Stage I, during ICU stay (deep breathing
exercises, bed mobility exercises, functional mobility in and around the bed); Stage II, during
Recovery Ward stay (Stage 1 exercises continuation, graded upper limb and lower limb,
strengthening exercises, and graded spinal exercises); Stage III, during isolation at home
(Stage I and II exercises
continuation, aerobic exercises) |
N/A |
FIM, POMA |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
There was a significant improvement in both FIM (72.4±21.7 vs 91.2±25.2, p<0.05) and POMA (11.9±3.6
vs 21.9±5.5, p<0.05). The authors suggest that the structured exercise protocol helped in
maintaining the physical functional performance of the subjects through-out the hospital stay
and also after discharge during follow up |
| Sonnweber T |
10.1183/13993003.03481-2020 |
2020 |
Austria |
April 2020 |
To systematically evaluate the persisting cardiopulmonary damage of COVID-19 patients 60 days
and 100 days after COVID-19 onset |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Respiratory structures (s430) and related functions (Respiration b440-455) |
Chronic |
COVID-19 |
145 |
N/A |
N/A |
N/A |
At 60 and 100 days after the COVID-19 onset, the following outcomes were assessed:
cardiorespiratory, gastrointestinal, and neurological symptoms, mMRC dyspnoea score, lung
function testing, low-dose CT scan of the chest |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
At the second follow-up visit (100 days after the onset), a relevant number of patients still
reported an impaired performance status and persisting symptoms including dyspnea (36%), night
sweat (24%), sleep disorders (22%), or hyposmia/anosmia (19%). Notably, severe symptoms, such as
a severely impaired performance status or severe dyspnea (mMRC 3-4) were only found in 2% and
4%, respectively. The authors concluded that relevant percentage of post-COVID-19 patients
presented with persisting symptoms and lung function impairment along with pulmonary
abnormalities more than 100 days after the diagnosis of COVID-19. |
| van der Sar S |
10.1016/j.rmed.2020.106272 |
2020 |
Netherlands |
From March 16 to April 15, 2020 |
To examine the impact of COVID-19 pneumonia on pulmonary function and HRQoL. |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Respiratory structures (s430) and related functions (Respiration b440-455) |
Post-acute |
COVID-19 |
101 |
N/A |
N/A |
N/A |
Pulmonary function testing, SF-36, Borg, mMRC, HADS. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
In this study, the majority of COVID-19 pneumonia survivors had abnormal diffusion capacity six
weeks after discharge. Namely, in a sample composed of 28 (27.7%) moderate cases of COVID-19
pneumonia and 73 (72.3%) severe cases, diffusion limitation was found in 71.7% of cases,
obstruction in 25.7% of cases, and restriction in 21.2% of cases. Clinical anxiety and
depression was still present after 6 weeks from discharge in respectively 12.5% and 16.6% of
patients. SF-36 was defcitary in all domains, except for bodily pain. Overall, in COVID-19
pulmonary function and health related quality of life after 6 weeks are still impaired. |
| Vilches-Moraga A |
10.1186/s12916-020-01856-8 |
2020 |
UK, Italy |
From 27 February to 10 June 2020. |
To investigate the association between pre-admission frailty and change in the level of care
needs on discharge from hospital in patients admitted with COVID-19 |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Any Activity limitation and participation restriction (d) |
Post-acute |
COVID-19 |
831 |
N/A |
N/A |
N/A |
Clinical Frailty Scale, increased care needs at discharge |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Of the 831 patients who were discharged (the median length of hospital stay was 12 days, IQR
6-24), 438 (47.0%) were already living with frailty prior to COVID 19 infection (≥ CFS 5), and
193 (23.2%) required an increase in the level of care provided. Multivariable analysis showed
that frailty was associated with an increase in care needs compared to patients without frailty
(CFS 1–3).
So, around a quarter of COVID-19 patients had increased care needs at discharge, and the
pre-admission frailty was strongly associated with the need for an increased level of care at
discharge. These results have implications for service planning and public health policy as well
as a person's functional outcome, suggesting that frailty screening should be utilized for
predictive modeling and early individualized discharge planning. |
| Woo MS |
10.1093/braincomms/fcaa205 |
2020 |
Germany |
until 14 July 2020 |
To establish a screening approach fto detect cognitive deficits in patients who suffered from
mild and moderate COVID-19 |
Analytical: Cross-sectional study |
N/A |
Epidemiology - Prevalence |
Nervous system structures (s1) and related functions (Mental functions b1) |
Chronic |
COVID-19 |
18 |
N/A |
N/A |
10 Healthy controls |
The interviews were either conducted by phone or directly with the patient: TICS-M, Fatigue
Assessment Scale, Patient Health Questionnaire-9 Depression Scale |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
In this cross-sectional study, the authors recruited mostly young patients 20– 105days (median,
85days) after recovery from mild to moderate disease. Out of them, 14 (78%) reported sustained
mild cognitive deficits and performed worse in the TICS-M for mild cognitive impairment compared
to 10 age-matched healthy controls. While short-term memory, attention, and concentration were
particularly affected by COVID-19, screening results did not correlate with hospitalization,
treatment, viremia, or acute inflammation. Additionally, TICS-M scores did not correlate with
depressed mood or fatigue.
The results demonstrate that young patients who recovered from uncomplicated COVID-19 can have
sustained neuropsychologic deficits that can be unmasked by targeted screening. |
Yang ZL |
10.3389/fmed.2020.605088
|
2020 |
China |
January - February 2020 |
To analyze follow-up CTs of patients recovering from COVID-19 in Wuhan, focusing on fibrotic change
and its relevant risk factors
|
Descriptive: Historical cohort |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Respiratory structures (s430) and related functions (Respiration b440-455) |
Post-acute |
COVID-19 patients |
166 |
N/A |
N/A |
N/A |
Chest CT exam |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
Of the 166 COVID-19 patients included, at the follow-up CTs (obtained on 56 days after symptom
onset), the 46% (76/166) showed CT evidence of fibrotic change and 77% (127/166) were severe or
critical cases. Among patients with fibrotic change on CT, 84% (64/76) got a minimal or mild score
of fibrosis. The Authors concluded that an extended follow up by CT imaging and pulmonary function
testing is necessary to fully assess the sequela of COVID-19.
|
Zhang X |
10.7189/jogh-10-020514 |
2020 |
UK |
From March 16 to June 29, 2020 |
To analyse whether PA influences the risk of COVID-19. |
Analytical: Cohort study |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
|
COVID-19 |
1746 |
N/A |
N/A |
415,596 healthy controls |
Self-reported moderate-to-vigourous PA, AMPA, Clinical outcomes |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
The study analyzed the data from The UK Biobank, a prospective cohort study including more than
500000 participants aged from 40 to 69 years in the United Kingdom. In this study, participants who
have not been tested positive for SARS-CoV-2 and not died of COVID-19 were taken as controls. Using
multivariate logistic regression, AMPA is associated with a decreased probability of both overall
(OR 0.80, 95% CI.69 - 0.93) and outpatient (OR 0.74, 95% CI.58 - 0.95) COVID-19. on the other hand,
no association was found between self-reported PA and COVID-19 related outcomes. The author tested
causality by using Mendelian randomisation analyses that did not support casuality, possibly due to
insufficient power. The results indicate a protective effect of objectively measured PA and COVID-19
outcomes. |
Zhu S |
10.1371/journal.pone.0243883 |
2020 |
China |
From February 21 to April 7, 2020 |
To estimate the prevalence of disability and anxiety in Covid-19 survivors from eight
Provinces/centrally governed municipalities of the PR China at discharge from acute inpatient
treatment, and investigate relative risk of adverse outcomes by various determinants including
gender, age, comorbidity,setting, ethnicity and disease severity. |
Descriptive: Historical cohort |
N/A |
Epidemiology - Natural history/Determining and modifying factors |
Nervous system structures (s1) and related functions (Neuromusculoskeletal and movement related
functions b7) |
Post-acute |
COVID-19 |
432 |
N/A |
N/A |
N/A |
IADL, BI, Zung’s self-reported anxiety scale, clinical outcomes, demographical data, comorbidity,
setting. |
N/A |
N/A |
N/A |
N/A |
N/A |
N/A |
In this multi-center study patients were analyzed at discharge from different Chinese hospitals
after the acute phase. At discharge, 36.81% of patients presented at least one IADL problem, 16.44%
had at least moderate-dependence measured using BI, and 28.70% resulted positive for clinical
anxiety at Zung’s self-reported anxiety scale. Severe COVID-19 patients had eleveted adjusted risk
ratio of IADL limitations, ADL dependency and probable clinical anxiety. Overall, a singificative
number of discharged patients suffered from limitation in IADL, ADL dependency and clinical anxiety.
|