Long-term Covid symptoms may be worsened by stressful circumstances: Study | Health

A new study suggests that the death of a loved one, financial or food poverty, or the development of a new disability are some of the best markers for assessing whether a patient is hospitalized. hospital for COVID-19 will suffer the signs of Long COVID one year later.

Led by researchers from NYU Grossman School of Medicine, the study found that adult patients with “major life stressors” – present in more than 50% of those followed track – at least twice as likely to succumb to depression, brain fog, fatigue, sleep problems and other long-term COVID-19 symptoms, study authors say. (Also read: Repeated COVID carries higher risk than first infection: Study )

Published online this week in the Journal of Neuroscience (JNS), the analysis also confirms the contribution of traditional factors to longer COVID risk as indicated by previous studies. – older age, the degree of disability begins and is initially more severe than the COVID-19 case.

“Our study is unique in that it explores the effects of life stressors – along with demographic trends and neurological events – as predictors of disability.” long-term cognitive and functional effects on quality of life in a large community,” said the study’s lead author. Jennifer A. Frontera, MD, professor in the Department of Neurology at NYU Langone Health. “Therapies that reduce trauma of the most stressful life events need to be a central part of long-term COVID treatment, with more research needed to confirm the best approaches.”

The study used standard telephone survey tools in the field – Modified Rankin Scale (mRS), Barthel Index, Montreal Perception Assessment (t-MoCA) and NIH/PROMIS Quality Neurological Life (NeuroQoL) – to measure levels of daily functioning, clear thinking (cognitive), anxiety, depression, fatigue and sleep quality. The team attempted to follow each of the 790 patients for six months and one year after being hospitalized for COVID-19 at NYU Langone Health from March 10, 2020 to May 20, 2020.

Of these survivors, 451 (57%) completed 6-month and/or 12-month follow-up, and of those, 17% died between discharge and 12-month follow-up and 51% reported significant life stresses at the age of 12-months.

In analyzes that compared factors against each other in terms of their contribution to worse outcomes, life stressors included financial insecurity, food insecurity, mortality at close contact and new disability were the strongest independent predictors of persistent COVID-19 symptoms. These stressors also best predict worse functional status, depression, fatigue, sleep scores, and decreased ability to participate in activities of daily living such as feeding, dressing. and shower.

Gender is also a contributing factor, as previous studies have found that women in general are more susceptible to autoimmune diseases that may have influenced the results. In addition, undiagnosed mood disorders may have been revealed by pandemic-related stressors.

Neurological long-term COVID may include more than one condition

A second study, led by Frontera and colleagues and published online September 29, 2022, in the journal PLOS ONE, found that patients diagnosed with COVID-19 neurological problems Prolonged symptoms can be divided into three groups of symptoms.

Because there is no current biological definition of COVID, many studies lump different symptoms into a common diagnosis and do not assess clinical relevance, Frontera said. The resulting ambiguity has caused “difficulty in evaluating treatment strategies.”

For the PLOS One study, the team collected data on symptoms, treatments received, and outcomes for 12 months after hospitalization with COVID-19, with treatment success measured again by standard metrics (Modified Rankin Scale, Barthel Index, NIH NeuroQoL). Three newly identified disease groups are:

Group 1: Few symptoms (most commonly headaches) receiving few treatment interventions Group 2: Many symptoms including anxiety and depression, who received several treatments, including medication antidepressant to psychotherapy. Group 3: Symptoms mainly in the lungs such as shortness of breath. Many patients also complain of headache and cognitive symptoms, and are primarily treated with physical therapy. The most severely affected patients (Symptom Group 2) had higher rates of disability, worse manifestations of anxiety, depression, fatigue and sleep disturbances. The most severely affected patients had higher rates of disability, worse measures of anxiety, depression, fatigue and sleep disturbances. All patients receiving treatment including psychiatric therapies reported improvement in symptoms, compared with 97% who received mainly physical or occupational therapy and 83% who received little intervention.

The Brookings Institution estimated in August 2022 that about 16 million working-age Americans (ages 18 to 65) have long-term COVID, of which 2 to 4 million have lost their jobs due to persistent COVID.

Along with Frontera, the authors of the JNS study from the Department of Neurology at NYU Langone Health are Sakinah Sabadia, Ariane Lewis, Aaron Lord, MD; Kara Melmed, Sujata Thawani, Laura Balcer; Thomas Wisniewski and Steven Galetta. The authors also include Dixon Yang of the Department of Neurology, at New York Presbyterian Medical Center, Columbia; Adam de Havenon at the Department of Neurology, Yale University School of Medicine; and Shadi Yaghi in the Department of Neurology at Brown University School of Medicine.

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