Follow-up of patients with post covid-19 condition after a multidisciplinary team assessment: a pilot study
DOI:
https://doi.org/10.2340/jrm-cc.v7.24581Keywords:
Post covid-19 syndrome, residual symptoms, rehabilitationAbstract
Objective: To follow up patients with post-COVID-19 condition (PCC) 6 months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave.
Methods: A prospective pilot study conducted in a clinical setting of patients (n = 22) with PCC referred from primary healthcare to a specialist clinic for a 2 day-multidisciplinary team assessment followed by a subsequent rehabilitation plan. Data were collected through questionnaires filled in prior to the team assessment and 6 months later.
Results: Fifteen of the initial 22 patients participated in the follow-up. No statistically significant improvements were seen in any of the questionnaires after 6 months. However, 76.9% of the participants perceived the intervention as being helpful. This differed between the genders, where all the women 100% (n = 8) perceived it as being helpful, compared with 40% (n = 2) of the men (p = 0.012).
Conclusions: Based on these findings, the benefit of a multidisciplinary team assessment of PCC is not fully convincing. However, since the participants themselves perceived the intervention as being helpful, the team assessment seems to be of some value. Further studies with larger populations would be of interest.
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References
Ochani R, Asad A, Yasmin F, Shaikh S, Khalid H, Batra S, et al. COVID-19 pandemic: from origins to outcomes. A comprehensive review of viral pathogenesis, clinical manifesta-tions, diagnostic evaluation, and management. Infez Med 2021; 29: 20–36.
WHO. COVID-19 weekly epidemiological update. WHO; 2022, p. 106. [Cited 2022 October 2] Available from: www.who.int
Folkhälsomyndigheten. Bekräftade fall av Covid-19 i Sverige. [cited 2022 Nov 1]. Available from: https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa.
Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep 2021; 11: 16144.
https://doi.org/10.1038/s41598-021-95565-8 DOI: https://doi.org/10.1038/s41598-021-95565-8
Willi S, Lüthold R, Hunt A, Hänggi NV, Sejdiu D, Scaff C, et al. COVID-19 sequelae in adults aged less than 50 years: a systematic review. Travel Med Infect Dis 2021; 40: 101995.
https://doi.org/10.1016/j.tmaid.2021.101995 DOI: https://doi.org/10.1016/j.tmaid.2021.101995
Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397: 220–232.
https://doi.org/10.1016/S0140-6736(20)32656-8 DOI: https://doi.org/10.1016/S0140-6736(20)32656-8
Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis 2022; 22: e102–e107.
https://doi.org/10.1016/S1473-3099(21)00703-9 DOI: https://doi.org/10.1016/S1473-3099(21)00703-9
National Institute for Health and Care Excellence. Clinical guidelines. COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (NICE); 2020.
Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med 2021; 27: 626–631.
https://doi.org/10.1038/s41591-021-01292-y DOI: https://doi.org/10.1038/s41591-021-01292-y
Anaya JM, Rojas M, Salinas ML, Rodríguez Y, Roa G, Lozano M, et al. Post-COVID syndrome. A case series and comprehensive review. Autoimmun Rev 2021; 20: 102947.
https://doi.org/10.1016/j.autrev.2021.102947 DOI: https://doi.org/10.1016/j.autrev.2021.102947
Alkodaymi MS, Omrani OA, Fawzy NA, Shaar BA, Almamlouk R, Riaz M, et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect 2022; 28: 657–666.
https://doi.org/10.1016/j.cmi.2022.01.014 DOI: https://doi.org/10.1016/j.cmi.2022.01.014
Socialstyrelsen (2021). Postcovid – kvarstående eller sena symtom efter covid-19 Stöd till beslutsfattare och personal i hälsooch sjukvården (del 2) https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/ovrigt/2021-4-7351.pdf.
Eriksson G, Tham K, Kottorp A. A cross-diagnostic validation of an instrument measuring participation in everyday occupations: the Occupational Gaps Questionnaire (OGQ). Scand J Occup Ther 2013; 20: 152–160.
https://doi.org/10.3109/11038128.2012.749944 DOI: https://doi.org/10.3109/11038128.2012.749944
Guidetti S, Utbult M, Kamwesiga J, Eriksson G. Perceived occupational gaps among the Ugandan general population – a pilot study. S Afr J Occup Ther 2019; 49: 17–23.
https://doi.org/10.17159/2310-3833/2019/vol49n3a4 DOI: https://doi.org/10.17159/2310-3833/2019/vol49n3a4
Grimby G, Frändin K. On the use of a six-level scale for physical activity. Scand J Med Sci Sports 2018; 28: 819–825.
https://doi.org/10.1111/sms.12991 DOI: https://doi.org/10.1111/sms.12991
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.
https://doi.org/10.1111/j.1600-0447.1983.tb09716.x DOI: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Johansson BBK, Rönnbäck L. Evaluation of the Mental Fatigue Scale and its relation to cognitive and emotional functioning after traumatic brain injury or stroke. Int J Phys Med Rehabil 2013; 2: 1–7.
Moreno-Pérez O, Merino E, Leon-Ramirez JM, Andres M, Ramos JM, Arenas-Jiménez J, et al. Post-acute COVID-19 syndrome. Incidence and risk factors: a Mediterranean cohort study. J Infect 2021; 82: 378–383.
https://doi.org/10.1016/j.jinf.2021.01.004 DOI: https://doi.org/10.1016/j.jinf.2021.01.004
Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 2011; 9: 90.
https://doi.org/10.1186/1741-7015-9-90 DOI: https://doi.org/10.1186/1741-7015-9-90
Townsend L, Dyer AH, Jones K, Dunne J, Mooney A, Gaffney F, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial in-fection. PLoS One 2020; 15: e0240784.
https://doi.org/10.1371/journal.pone.0240784 DOI: https://doi.org/10.1371/journal.pone.0240784
Poyraz B, Poyraz CA, Olgun Y, Gürel Ö, Alkan S, Özdemir YE, et al. Psychiatric morbidity and protracted symptoms after COVID-19. Psychiatry Res 2021; 295: 113604.
https://doi.org/10.1016/j.psychres.2020.113604 DOI: https://doi.org/10.1016/j.psychres.2020.113604
Gater R, Tansella M, Korten A, Tiemens BG, Mavreas VG, Olatawura MO. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings: report from the World Health Organization collaborative study on psychological problems in general health care. Arch Gen Psychiatry 1998; 55: 405–413.
https://doi.org/10.1001/archpsyc.55.5.405 DOI: https://doi.org/10.1001/archpsyc.55.5.405
Gerdle B, Åkerblom S, Stålnacke BM, Brodda Jansen G, Enthoven P, Ernberg M, et al. The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation – a SQRP study of more than 20,000 chronic pain patients. Scand J Pain 2019; 19: 693–711.
https://doi.org/10.1515/sjpain-2019-0016 DOI: https://doi.org/10.1515/sjpain-2019-0016
Corfield EC, Martin NG, Nyholt DR. Co-occurrence and symptomatology of fatigue and depression. Compr Psychiatry 2016; 71: 1–10.
https://doi.org/10.1016/j.comppsych.2016.08.004 DOI: https://doi.org/10.1016/j.comppsych.2016.08.004
Ceban F, Ling S, Lui LMW, Lee Y, Gill H, Teopiz KM, et al. Fatigue and cognitive impairment in post-COVID-19 syndrome: a systematic review and meta-analysis. Brain Behav Immun 2022; 101: 93–135.
https://doi.org/10.1016/j.bbi.2021.12.020 DOI: https://doi.org/10.1016/j.bbi.2021.12.020
Pearce M, Garcia L, Abbas A, Strain T, Schuch FB, Golubic R, et al. Association between physical activity and risk of depression: a systematic review and meta-analysis. JAMA Psychiatry 2022; 79: 550–559.
https://doi.org/10.1001/jamapsychiatry.2022.0609 DOI: https://doi.org/10.1001/jamapsychiatry.2022.0609
Razazian N, Kazeminia M, Moayedi H, Daneshkhah A, Shohaimi S, Mohammadi M, et al. The impact of physical exercise on the fatigue symptoms in patients with multiple scle-rosis: a systematic review and meta-analysis. BMC Neurol 2020; 20: 93.
https://doi.org/10.1186/s12883-020-01654-y DOI: https://doi.org/10.1186/s12883-020-01654-y
Pester BD, Crouch TB, Christon L, Rodes J, Wedin S, Kilpatrick R, et al. Gender differences in multidisciplinary pain rehabilitation: the mediating role of pain acceptance. J Context Behav Sci 2022; 23: 117–124.
https://doi.org/10.1016/j.jcbs.2022.01.002 DOI: https://doi.org/10.1016/j.jcbs.2022.01.002
Stenberg G, Fjellman-Wiklund A, Ahlgren C. “Getting confirmation”: gender in expectat-ions and experiences of healthcare for neck or back patients. J Rehabil Med 2012; 44: 163–171.
https://doi.org/10.2340/16501977-0912 DOI: https://doi.org/10.2340/16501977-0912
Sugiyama A, Takafuta T, Sato T, Kitahara Y, Yoshinaga Y, Abe K, et al. Natural course of post-COVID symptoms in adults and children. Sci Rep 2024; 14: 3884.
https://doi.org/10.1038/s41598-024-54397-y DOI: https://doi.org/10.1038/s41598-024-54397-y
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Copyright (c) 2024 Alexander Wigge, Johanna Philipson, Solveig Hällgren, Helena Filipsson, Britt-Marie Stålnacke
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