Two-Year Longitudinal Study Reveals That Long COVID Symptoms Peak and Quality of Life Nadirs at 6–12 Months Postinfection
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PROVIDER: S-EPMC10917418 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
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Project description:BackgroundCharacterizing the longevity and quality of cellular immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enhances understanding of coronavirus disease 2019 (COVID-19) immunity that influences clinical outcomes. Prior studies suggest SARS-CoV-2-specific T cells are present in peripheral blood 10 months after infection. Analysis of the function, durability, and diversity of cellular response long after natural infection, over a range of ages and disease phenotypes, is needed to identify preventative and therapeutic interventions.MethodsWe identified participants in our multisite longitudinal, prospective cohort study 12 months after SARS-CoV-2 infection representing a range of disease severity. We investigated function, phenotypes, and frequency of T cells specific for SARS-CoV-2 using intracellular cytokine staining and spectral flow cytometry, and compared magnitude of SARS-CoV-2-specific antibodies.ResultsSARS-CoV-2-specific antibodies and T cells were detected 12 months postinfection. Severe acute illness was associated with higher frequencies of SARS-CoV-2-specific CD4 T cells and antibodies at 12 months. In contrast, polyfunctional and cytotoxic T cells responsive to SARS-CoV-2 were identified in participants over a wide spectrum of disease severity.ConclusionsSARS-CoV-2 infection induces polyfunctional memory T cells detectable at 12 months postinfection, with higher frequency noted in those who experienced severe disease.
| S-EPMC8672777 | biostudies-literature
Project description:BackgroundLimited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19.MethodsWe conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19. Predictors of these outcomes, including demographics, pre-COVID-19 comorbidities, index COVID-19 hospitalization metrics, and life stressors, were evaluated using multivariable logistic regression.ResultsOf 790 COVID-19 patients who survived hospitalization, 451(57%) completed 6-month (N = 383) and/or 12-month (N = 242) follow-up, and 77/451 (17%) died between discharge and 12-month follow-up. Significant life stressors were reported in 121/239 (51%) at 12-months. In multivariable analyses, life stressors including financial insecurity, food insecurity, death of a close contact and new disability were the strongest independent predictors of worse mRS, Barthel Index, depression, fatigue, and sleep scores, and prolonged symptoms, with adjusted odds ratios ranging from 2.5 to 20.8. Other predictors of poor outcome included older age (associated with worse mRS, Barthel, t-MoCA, depression scores), baseline disability (associated with worse mRS, fatigue, Barthel scores), female sex (associated with worse Barthel, anxiety scores) and index COVID-19 severity (associated with worse Barthel index, prolonged symptoms).ConclusionsLife stressors contribute substantially to worse functional, cognitive and neuropsychiatric outcomes 12-months after COVID-19 hospitalization. Other predictors of poor outcome include older age, female sex, baseline disability and severity of index COVID-19.
| S-EPMC9637014 | biostudies-literature
Project description:PurposeTo examine patterns of health and symptoms associated with the initiation of adjuvant endocrine therapy (ET) for primary breast cancer treatment.Patients and methodsThe mind-body study (MBS) observational cohort participants provided self-reported data on physical and mental health, ET-related symptoms, as well as depression, fatigue, and sleep obtained at enrollment (after primary treatment, prior to initiation of ET) and 6 and 12 months later. Longitudinal trajectories of outcome variables among three patient groups (no ET, aromatase inhibitor [AI], or tamoxifen) were compared by using linear mixed models.ResultsTwo-thirds of the 186 women initiated ET, which was evenly split between AI and tamoxifen, and no significant differences were observed in self-reported measures among the groups at baseline or in covariate-adjusted analyses. Physical health scores were below normative levels initially and improved over time, but the AI group had a significantly lower score at 12 months (P = .05); mental health scores were within the normal range, were similar in each group, and did not change over time. The no-ET group showed either stable or declining symptom severity, whereas the ET groups often showed increased severity over time, and the AI group reported more severe musculoskeletal (P = .02), hot flash (P = .02), and cognitive problems (P = .006) at one or both of the follow-up time points compared with the no-ET group. The tamoxifen group had higher levels of hot flashes (P = .002), cognitive problems (P = .016), and bladder problems (P = .02) than the no-ET group.ConclusionAttention should be given to the increased symptom burden associated with ET, and better efforts should be made to address patient-reported outcomes.
| S-EPMC4872009 | biostudies-literature
Project description:ObjectivesThis study aimed to describe the burden of illness and impact on health and working situation among former intensive care patients treated for COVID-19.MethodsA prospective cohort study was performed at one intensive care unit of a university hospital in Sweden during the first wave of COVID-19 in spring 2020. The burden of illness in health status, cognitive, physical, and psychological outcomes, and working situation were assessed at four and 12 months after discharge from intensive care, using nine validated instruments.ResultsForty-six participants treated for COVID-19 participated in both follow-ups and were included in this study. General fatigue was reported by 37 of 46 participants (82%) at both follow-ups (p = 1.000). For overall health status 28 (61%) participants at the first follow-up and 26 (57%) (p = 0.414) at the second reported lower values than the general population. Cognitive impairment was seen in 22 (52%) participants at four months and in 13 (31%) at 12 months (p = 0.029). The proportion of participants on sick-leave decreased between the first and second follow-up (24% vs 13%, p = 0.025), but the proportion of participants working full-time was almost the same at both follow-ups (35% vs 37%, p = 0.317).ConclusionsThe burden of illness of patients treated in intensive care due to COVID-19 included cognitive, physical, and psychological impacts. Cognitive functions were improved after 12 months, but no clear improvements could be distinguished in the physical or psychological outcome. Higher burden of illness was associated with inability to return to work.
| S-EPMC9376301 | biostudies-literature
Project description:Background"Long COVID" is characterized by a variety of symptoms and an important burden for affected people. Our objective was to describe long COVID symptomatology according to initial coronavirus disease 2019 (COVID-19) severity.MethodsPredi-COVID cohort study participants, recruited at the time of acute COVID-19 infection, completed a detailed 12-month symptom and quality of life questionnaire. Frequencies and co-occurrences of symptoms were assessed.ResultsAmong the 289 participants who fully completed the 12-month questionnaire, 59.5% reported at least 1 symptom, with a median of 6 symptoms. Participants with an initial moderate or severe acute illness declared more frequently 1 or more symptoms (82.6% vs 38.6%, P < .001) and had on average 6.8 more symptoms (95% confidence interval, 4.18-9.38) than initially asymptomatic participants who developed symptoms after the acute infection. Overall, 12.5% of the participants could not envisage coping with their symptoms in the long term. Frequently reported symptoms, such as neurological and cardiovascular symptoms, but also less frequent ones such as gastrointestinal symptoms, tended to cluster.ConclusionsFrequencies and burden of symptoms present 12 months after acute COVID-19 infection increased with the severity of the acute illness. Long COVID likely consists of multiple subcategories rather than a single entity. This work will contribute to the better understanding of long COVID and to the definition of precision health strategies.Clinical trials registrationNCT04380987.
| S-EPMC9379809 | biostudies-literature
Project description:Oral health-related quality of life (OHRQoL) could be affected not only by oral health but also by demographic and ecosocial factors. This research aimed to analyze the sociodemographic and clinical factors that may influence the OHRQoL of 12-year-old children.A representative sample was selected from Hong Kong. Periodontal status and caries were examined according to WHO criteria. Four orthodontic indices were used to assess malocclusion. Child Perception Questionnaires (CPQ11-14-ISF:8 and CPQ11-14-RSF:8) including four domains, namely oral symptoms (OS), functional limitations (FL), emotional well-being (EWB), and social well-being (SWB), were used to measure OHRQoL. Adjusted OR was calculated by ordinal logistic regression.Totally 589 eligible subjects (305 females, 284 males) were recruited. Males tended to rank higher in OS domain but lower in EWB domain (adjusted OR = 1.89 and 0.67). Mother's education was linked more closely with children's CPQ scores. Higher education levels were associated with better quality of life (adjusted OR = 0.45 and 0.37). Household income showed no effect on CPQ scores. Unhealthy periodontal conditions had a negative effect on EWB and total CPQ (adjusted OR = 1.61 and 1.63). High caries experience only had a negative effect on SWB (adjusted OR = 1.60). Malocclusion affected FL, EWB, SWB and total CPQ: all malocclusion severities affected SWB; only severe malocclusions affected FL, EWB and total CPQ.Males were more tolerant of oral symptoms than females were. Higher levels of mother's education led to better OHRQoL of their children. Unhealthy periodontal conditions affected emotional well-being, while high caries experience affected social well-being. All malocclusion severities had an effect on social well-being; severe malocclusion further caused functional limitations, worse emotional well-being, and hence worse OHRQoL.
| S-EPMC5547464 | biostudies-other
Project description:BackgroundSevere obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life (HRQoL). In addition to physiological factors, activity and participation, environmental factors, and personal factors are related to an individual's overall quality of life HRQoL. In Norway, a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management. The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course, and explored how well sociodemographic variables, paid work, social support, personal factors, and surgery predicted HRQoL at 12-month follow-up.MethodsA single-group longitudinal study was conducted. Data were collected by self-reported questionnaires. This article reports on those who had completed the questionnaire at the 12-month (n = 69) follow-up. HRQoL was assessed with the EQ-5D. Other standardized instruments measured employment, social support, self-efficacy, and surgery.ResultsAt the 12-month follow-up, participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS. Generalized linear model showed that having paid work, and social support were statistically significant predictors of HRQoL at the 12-month follow-up. Sex, self-efficacy, and surgery were not statistically significant associated with HRQoL.ConclusionsParticipation in paid work, and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL in obese people 12 months after participating in a learning and mastery course.Trial registrationThe study is registered in Clinical Trials: NCT01336725.
| S-EPMC3462106 | biostudies-literature
Project description:PurposeTo describe health-related quality of life (HRQoL) and dyspnea of COVID-19, 2 and 12 months after an intensive care unit (ICU) stay.MethodsPatients discharged from the ICU between April and June 2020 and subsequently transferred to an inpatient rehabilitation facility were assessed 2 months and 12 months after ICU admission. HRQoL was assessed by the EuroQoL EQ-5D-3L (visual analog scale and time trade-off normalized to the French population algorithm) and dyspnea was assessed by the modified Medical Research Council (mMRC) dyspnea scale.ResultsWe enrolled 94 patients. Median EQ-5D-3L time trade-off was 0.80 (interquartile range, 0.36-0.91) at 2 months and 0.91 (0.52-1.00) at 12 months (P = 0.12). EQ-5D-3L visual analog scale was 70 (60-85) at 2 months and 70 (60-85) at 12 months (P = 0.07). The mMRC dyspnea scale was 3 (2-4) at ICU discharge, 1 (0-2), P < 0.001 at 2 months and 1 (1-2) at 12 months. At 12 months, 68 (76%) patients reported at least one symptom that was not present prior to ICU admission and 27 (61%) of the 44 patients who were previously working had returned to work. On multiple linear regression, factors associated with EQ-5D-3L were body mass index on ICU admission, tracheostomy, male gender and active smoking.ConclusionsTwelve months after ICU admission for COVID-19 and subsequent rehabilitation, a substantial proportion of patients reported alterations of HRQoL, dyspnea and symptoms that were not present prior to admission and a substantial proportion of these patients had not returned to work. Factors associated with a risk of poorer 12-month quality of life, may help to identify at-risk patients.
| S-EPMC8858438 | biostudies-literature
Project description:PurposePrevious studies usually examine the associations between psychological distresses and quality of life (QOL) with a variable-centred approach, while little is known about the effect of the individual variance in time-varying changes of psychological distresses on QOL. Therefore, this study aimed to examine whether individual variance in psychological distresses during the early phases post-earthquake would develop different QOL's levels among adolescent survivors 10-year after the Wenchuan earthquake.MethodsData were extracted from the Wenchuan Earthquake Adolescent Health Cohort Study. The current study included 744 adolescent survivors who effectively completed surveys at 6 months, 24 months, and 10 years after the earthquake. Self-report questionnaires were administered to collect information on socio-demographic characteristics, earthquake exposure, life events, anxiety symptoms, depressive symptoms, posttraumatic stress symptoms (PTSS), and QOL. Data were analysed using hierarchical multiple regression.ResultsTrajectories of psychological distresses were classified as follow: resistance (anxiety 40.73%; depression 54.70%; PTSS 74.46%), recovery (anxiety 17.20%; depression 9.27%; PTSS 10.35%), delayed dysfunction (anxiety 10.35%; depression 18.15%; PTSS 6.18%), and chronicity (anxiety 31.72%; depression 17.88%; PTSS 9.01%). After controlling covariates, hierarchical multiple regression only revealed that the anxiety trajectory with delayed dysfunction remained significantly predictive for four domains of QOL (physical health, psychological health, social relationships, and environment).ConclusionThe current study highlights the importance of focusing on the variations in trajectories of anxiety symptoms among disaster survivors and providing individualized mental health services to improve survivors' QOL.
| S-EPMC8343243 | biostudies-literature
Project description:According to the World Health Organization’s definition, long COVID is the persistence or development of new symptoms 3 months after the initial infection. Various conditions have been explored in studies with up to one-year follow-up but very few looked further. This prospective cohort study addresses the presence of a wide spectrum of symptoms in 121 patients hospitalized during the acute phase of COVID-19 infection, and the association between factors related to the acute phase of the disease and the presence of residual symptoms after one year or longer from hospitalization. The main results are as follows: (i) post-COVID symptoms persist in up to 60% of the patient population at a mean follow-up of 17 months; (ii) the most frequent symptoms are fatigue and dyspnea, but neuropsychological disturbances persist in about 30% of the patients (iii) when corrected for the duration of follow-up with a freedom-from-event analysis; only complete (2 doses) vaccination at the time of hospital admission remained independently associated with persistence of the major physical symptoms, while vaccination and previous neuropsychological symptoms remained independently associated with persistence of major neuropsychological symptoms.
| S-EPMC10003916 | biostudies-literature