To characterize practices and knowledge regarding PA counseling at a large tertiary hospital.

Cross-sectional observational study.

Physicians with an active medical practice within the university hospital were invited to respond to an online survey.

A questionnaire designed to capture information on medical training, life habits and knowledge about PA.

Sedentary behavior, clinical practice and self-efficacy were assessed by Likert-type questions, whereas regular practice, previous training, and knowledge of PA were evaluated through dichotomous questions (answers: "yes or no" or "true or false").

Response rate was 11.5 % (50.6 % female, 44.9 ± 12.8 years), 67.7 % were physically active, and 63.3 % had 4 to 8 h/day of sedentary behavior. Only 40.7 % had previous training on PA, 99.7 % recognized the importance of recommending PA, but only a small part (48.4 %) recommended PA in all consultations (the main barrier was lack of specific training). In addition, 69.2 %, 58.7 % and 65.5 % rated their abilities to collect PA history, assess contraindications, and engage the patient as good/excellent, respectively. Knowledge of PA was rated as low to very low, with correct answers ranging from 49 % to 17 % and as low as ∼10 % (when considering the pediatric population).

Although physicians recognize the importance of PA counseling and have high perceived self-efficacy in relation to counseling skills, few put them into practice. This may be due to insufficient training on PA and/or the complexity of services provided at the tertiary hospital. The present results corroborate the need for improvements in medical training on PA.

BackgroundPost-exertional malaise (PEM) is a complex phenomenon characterized by extreme fatigue, reduced endurance, and muscular and joint pains. Physical activity (PA) has recognized health benefits, including reducing the risks of chronic diseases and mortality. During the pandemic, a general decline in PA was measured, but the profile of the various components of PA and sedentariness in patients with PEM resulting from post-COVID-19 syndrome (PCS-19) remains scarce. It is relevant to observe the impact of these discomforts on PQ after their occurrence.ObjectiveThis study examines the detailed PA and sedentary profile of individuals affected by PEM associated with PCS-19.MethodsAn online questionnaire disseminated via social media platform evaluated PA and sedentariness before and after COVID-19 diagnostic.ResultsIndividuals with PEM (n = 154) became more sedentary and inactive post-COVID-19. Specifically, PA at work decreased in women and those whose last infection occurred over a year ago. Walk decreased for women but increased for men. Bike journeys generally decreased after COVID-19. The severity of PEM, the pace of recovery, and fear of malaise influenced PA changes.ConclusionsThe PCS-19 leads to increased sedentary behavior and a decline in PA, particularly at work, and is more pronounced among women and those more severely affected by PEM. These findings are critical for post-COVID PA resumption, including for workers who go back to work and who regain normal duties while being potentially deconditioned.

IntroductionIndividuals with severe coronavirus disease 2019 (COVID-19) may present respiratory and motor complications, requiring rehabilitation programs (RP) for long periods. However, access to cardiopulmonary rehabilitation is poor. Cardiopulmonary telerehabilitation is an alternative for cardiopulmonary dysfunction, improving functional capacity, dyspnea, and quality of life. Moreover, few clinical trials verified the effectiveness of telerehabilitation using functional exercise for post-COVID symptoms. Thus, the present study aimed to verify the effects of cardiopulmonary telerehabilitation using functional and accessible exercises in individuals after COVID-19 hospital discharge.MethodsThis blinded, randomized, and controlled clinical trial and included 67 adult individuals after COVID-19 hospital discharge. Participants were randomized into the groups of telerehabilitation (TG; n = 33) and control (CG; n = 34). TG underwent an individualized exercise program (functional and accessible exercises) supervised by a physical therapist (videoconference), and CG received guidance on general care and self-monitoring of vital signs (videoconference). The primary outcome was performance and physiological responses on the 6-minute step test (6MST). Secondary outcomes were performance on the 2-minute stationary walk test (2MSWT), 30-second chair stand test (30CST), and quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire physical functioning concept (PF).ResultsFunctional capacity (6MST) improved by 28 ± 17 steps in TG and 15 ± 26 in CG (p = 0.04). For secondary outcomes, performance on 2MSWT increased by 39 ± 6 steps in TG and 10 ± 6 in CG (p = 0.00); 30CST by 3 ± 1 repetitions in TG and 1.5 ± 0.5 in CG (p = 0.05); and PF (SF-36) by 17 ± 4 points in TG and 12 ± 4 in CG (p = 0.00). Also, peak oxygen uptake VO2peak (6MST) improved by 3.8 ± 1 mL min-1 kg-1 in TG and 4.1 ± 1 in CG (p = 0.6), and heart rate demand (6MST) by 11 ± 37% in TG and -4 ± 19% in CG (p = 0.04).ConclusionsCardiopulmonary telerehabilitation using functional exercises improved the exercise and functional capacity assessed using 6MST, 30CST, and 2MSWT and the quality of life of individuals after COVID-19 hospital discharge.

Post-acute COVID-19 patients who were discharged from hospitals during the epidemic faced significant challenges, not only physical sequelae, but also psychological distress, anxiety, and depression. It is already known that continued exercise improves psychosocial components, but few studies have explored the impact of multimodal rehabilitation programs, including therapeutic education, in this type of patient. There are no studies that explore the application of these programs through asynchronous telerehabilitation, which would open up new therapeutic windows.

This pilot single-blinded randomized controlled trial included 35 post-discharge COVID-19 patients allocated to two intervention arms: an asynchronous telerehabilitation group (ATG) and a booklet-based rehabilitation group (BRG). The aim was to analyze the preliminary changes in depression, anxiety, stress, and social support comparing both groups.

The ATG exhibited statistically significant reductions in depression (p = 0.048) and stress (p = 0.033) compared to the BRG after intervention. While both groups showed improvements in psychosocial variables, the ATG demonstrated consistent lower depression levels at 3- and 6-month follow-ups (p = 0.010, p = 0.036 respectively) and notably higher social support at 3- and 6-month follow-ups (p = 0.038, p = 0.028 respectively).

This pilot study suggests that a multimodal rehabilitation program using asynchronous telerehabilitation provides substantial benefits in terms of alleviating psychological distress and improving social support in discharged COVID-19 patients. These data will enable for larger studies to confirm these results.

To evaluate the impact of eight weeks of Pilates Method on physical fitness and sleep quality of individuals with post-COVID-19 syndrome.

Randomized clinical trial blinded conducted with fifty-nine individuals with post-COVID-19 syndrome. The participants were randomly allocated to the Pilates group (PG; n = 20), supervised physical exercise group (SPEG; n = 20) and control group (CG; n = 19). The intervention occurred twice a week for eight weeks in a total of 16 sessions. The primary outcome was distance covered in the 6-min walk test and the secondary outcomes were the profile of the sample, post-exercise fatigue and sleep quality.

After the intervention, only the PG increased the distance covered in the 6-min walk test (p < 0.001; d = 0.762) and reduced the score on the modified BORG scale after exercise (p < 0.010; d = -0.835) and the Pittsburgh Sleep Quality Index (p < 0.005; d = -0.699). Furthermore, the PG covered a greater distance compared to the SPEG in the 6-min walk test [95%CI (26.129-179.770); p < 0.010; d = 1.021] and exhibited a greater reduction in fatigue levels compared to the CG [95%CI (-2.352 to -0.162); p < 0.050; d = 0.919].

Eight weeks of Pilates Method improve the physical fitness and sleep quality of individuals with post-COVID-19 syndrome.

COVID-19 became a pandemic disease in 2020, with multisystem involvement and high renal morbidity during the acute phase. Some affected patients began to present new or persistent symptoms in a condition known as Long COVID. The study aimed to evaluate renal function using clinical and laboratory findings, and to establish the frequency and staging of renal function decline in Long COVID patients, as well as the associated factors.

This is a cross-sectional observational study that selected participants from a Long COVID clinical care program between 2020 and 2022.

A total of 246 patients were selected for this study, and renal function decline was found in 83 (33.7%). Patients over 60 years (29.6%) and those who developed glycaemic alterations (41.8%) exhibited a higher prevalence of renal outcomes in long COVID. Some laboratory test as LDH levels and glycated hemoglobin seems to have a statistic relation with a decrease in renal function (p < 0.05).

A decline in renal function was common in patients with Long COVID in this study, and older age and glycaemic alterations were relevant to this condition. Some laboratory markers can be used to predict this outcome.

Harmonizing core outcome domains allows for pooling data, comparing interventions, and streamlining research evaluation. At the same time clinicians require concise and feasible measures for routine practice. Considering the heterogeneity of post-COVID-19 condition, a biopsychosocial approach requires sufficient coverage of the psychosocial dimension with assessments. Previous recommendations for core outcome sets have serious limitations regarding the psychosocial aspects of post-COVID-19 condition. This paper specifically focuses on psychosocial outcomes for adults with post-COVID-19 condition, providing both a comprehensive set of outcome domains for research and a streamlined clinical core set tailored for routine clinical use.

In a structured Consensus Development Approach, the European Network to improve diagnostic, treatment, and healthcare for patients with persistent somatic symptoms (EURONET-SOMA) developed psychosocial core outcome domains and assessments regarding post-COVID-19 condition. The experts identified variables and instruments which should be considered in studies on adults suffering from post-COVID-19 condition, and which are feasible in the clinical setting and relevant for research.

We identified three higher-order dimensions with each encompassing several domains: The first higher-order dimension, "outcomes", encompasses (1) the classification/ diagnostics of post-COVID-19 condition, (2) somatic symptoms (including fatigue), (3) the psychopathological status and mental comorbidities, (4) the physical status and somatic comorbidities, (5) neurocognitive symptoms, and (6) illness consequences. The second higher-order domain "mechanisms" encompasses (7) cognitive components, (8) affective components, (9) behavioral components, (10) social components, and (11) psychobiological bridge markers (e.g., neuroimmunological and psychoneuroendocrinological variables). The third higher-order domain, "risk factors", includes factors such as (12) socioeconomic status and sociocultural factors, (13) pre-existing mental and somatic health issues, (14) personality factors (e.g., neuroticism), (15) adverse childhood experiences, (16) ongoing disability or pension claim, and (17) social media use. For each domain, specific instruments are suggested for research purposes and clinical use.

The recommended core domains help to increase consistency in a biopsychosocial approach to post-COVID-19 condition across investigations, improve synergies, and facilitate decision-making when comparing different interventional approaches. It allows to better identify relevant subgroups in heterogeneous post-COVID-19 condition populations offering practical tools for routine clinical practice through the clinical core set.

To investigate the recovery trajectories of physical function, activity performance, cognitive and psychological functions, and health related quality of life, as well as potential interaction effects, in individuals with COVID-19 treated in an intensive care unit (ICU).

This prospective cohort study included patients with confirmed COVID-19 infection, treated in an ICU. Clinical assessments and self-ratings of functioning, disability and health were performed > 1 month and > 12 months after discharge from hospital.

Among the 65 included individuals (mean age 56.6, SD 11) significant improvements in physical and psychological function were observed over time, although not reaching population norms. Cognition remained unchanged (MoCA median 27, IQR 4). At the 12-month follow-up, physical limitations in activity (RAND-36) were found to be associated with dyspnea (mMRC-Dyspnea), mental and physical fatigue (MFI-20), and walking endurance (6-minute walk test) (r2 0.509 p < 0.001). Role limitations due to physical health (RAND-36) was found to be associated with physical and mental fatigue (MFI-20) and pain (r2 0.530 p < 0.001).

Despite improvements in functioning and health in this group of predominantly younger age recovery did not reach population norms. These results highlight persistent impairments and activity limitations that may necessitate long-term healthcare interventions.

Evidence about rehabilitation of post COVID-19 condition is scarce. Yoga has been found beneficial in other chronic conditions and can be delivered in a digital format at home. The aim of the study was to explore the feasibility of teleyoga in persons with post COVID-19 condition by assessing adherence, safety, limited efficacy and experiences.

Pre-post mixed-method design. Participants were recruited from a post COVID-19 rehabilitation clinic. The intervention included standardised live-streamed teleyoga sessions twice/week for 7 weeks and individual yoga using a digital application during 12 weeks. Adherence to the teleyoga intervention was measured by registration of participation and by analysing the log in the application. Safety was measured by registration of serious adverse events. Limited efficacy examined trends in the predicted direction for better outcome in patients with a post-COVID condition in the 6-minute walk test, gait speed, cognition, health-related quality-of-life, mental distress, sleep and exercise motivation. We also assessed patients' experiences after the intervention.

Nine women and 2 men were enrolled, aged between 27 and 61 years, and duration of post COVID-19 3-12 months. Adherence: Half of the participants participated in more than 50% of the online yoga sessions. They enjoyed the digital format and the social aspect of the online yoga sessions. Some participants experienced that the yoga sessions of 60 min were too long. People with post COVID-19 felt motivated to participate, however they felt conflicted when other commitments took time away from yoga. Adherence to the yoga application varied, 6 patients used it less than 50% of the recommended time.

Persons with post COVID-19 experienced symptoms due to their disease, which could increase during the yoga sessions that made it harder to participate. There were no reported serious adverse events. Limited efficacy: Participants expressed that they breathed more consciously and experienced relaxation and reduction of stress and anxiety. After 7 weeks of teleyoga there was a significant improvement in cognitive function (p-value = 0.048). No differences were found in the physical tests, health-related quality-of-life, anxiety and depression, sleep or in exercise motivation.

Adherence to the online yoga sessions was quite low and might be improved with shorter yoga sessions. Online yoga was safe, but some participants experienced an increase in symptoms. Teleyoga was associated with improved cognition, breathing and relaxation. The results show that online yoga could be feasible for people post COVID-19, but adaptation of the yoga-program may be required, especially as many patients experience an increase of symptoms. Furthermore, the teleyoga should be more flexible with regards to the duration and the number of sessions. As few participants were adherent to the application, the relevance and usefulness of this needs to be further explored.

Background and Objectives: Long COVID-19 syndrome may cause difficulties in functionality during daily life in young people. Our objective was to investigate the respiratory and functional sequelae in young adults with asymptomatic or mild COVID-19 compared with healthy peers 3-6 months and 6-12 months after COVID-19 infection. Materials and Methods: Participants aged 18-25 who had COVID-19 within the last 3-6 months (Post-COVID Group 1, n = 25) and 6-12 months (Post-COVID Group 2, n = 25) and age-gender-matched healthy controls (n = 25) were included in this study. Respiratory functions and muscle strength were measured. Physical function was assessed with 6 min walking test (6MWT) and an Incremental Shuttle Walk Test (ISWT). The 1 min sit-to-stand test (1-MSTST) and hand grip strength (HGS) were used to assess muscle performance. Fatigue and dyspnea severity were questioned. Results: The FVC%pred (p = 0.023) and MEP (p = 0.034) were higher, and 1-MSTST repetitions were lower in Post-COVID Group-1 compared to Post-COVID Group-2 (p = 0.029). The PEF%pred (p = 0.025), MEP (p = 0.001), and ISWT distance were lower in Post-COVID Group-2 compared to healthy controls. The number of 1-MSTST repetitions and 6MWT distance were lower in Post-COVID Group-1 (p = 0.003, p = 0.001) and Post-COVID Group-2 (p = 0.003, p = 0.017) than in healthy controls. Exercise-induced blood lactate change during the ISWT, HGS, fatigue, and dyspnea were not significantly different between post-COVID groups and healthy controls. Conclusions: Young adults who pass asymptomatic or mild SARS-CoV-2 infection exhibit a decline in FVC%pred, PEF%pred, lower extremity muscle performance, and physical function within 3-6 months. In addition, the deterioration in respiratory and physical functions becomes apparent within 6-12 months.

Almost 20% of patients affected by COVID-19 develop dermatological symptoms after recovery. This condition is termed as post-COVID-19 syndrome and is characterized by a state of hyperinflammation, as well as deregulations in the humoral response of CD8+ T-cells. Since there is no specific treatment for these injuries, the treatment of choice depends on the symptoms; thus, it is essential to provide a description of the type and nature of the injuries presented. In the present study, a systemic review was performed using the PICO strategy in the repositories of PubMed, Google Scholar, Embase and Scopus using the key words 'POST-COVID and skin symptoms'. A total of 44 studies were included in the present systematic review. In these studies, the majority of subjects exhibited non-specific symptoms, commonly referred to as 'skin rash', affecting up to 27.4% of the population. According to the studies, a maximum prevalence of 50% of alopecia was observed among the affected subjects. Additionally, several studies reported the prevalence of other lesions, including pruritus (25%), subcutaneous nodules (12%), dermatitis (9.4%), edema (9%) and pigmentation changes (6%). Dermatological lesions associated with autoimmunity were also identified, with these findings being more pronounced among females and in patients with a history of severe COVID-19. Finally, several studies investigated the presence of autoantibodies, revealing a maximum prevalence of 41% for autoantibodies targeting the epidermis. Specifically, the prevalence was 12.9% for the Wuhan variant, 5.7% for the Alpha variant and 5% for the Delta variant. Although mostly benign, post-COVID-19 syndrome produces marked dermatological alterations for hair health, mainly among females. This, together with the development of lesions with an autoimmune component, constitutes an emerging therapeutic need.

Fatigue is the most prevalent symptom within the post-COVID condition (PCC). Furthermore, many patients suffer from decreased physical performance capacity and post-exertional malaise. Although exercise has been proposed as an effective therapeutic strategy for PCC, there is limited evidence on individualised and symptom-titrated exercise interventions in patients with fatigue and PEM. Therefore, we conducted a multi-centre randomised controlled trial to investigate the effectiveness of an individualised and symptom-titrated exercise program. We measured fatigue, health-related quality of life, hand-grip strength, endurance capacity and PEM before and after the 10-week intervention. A total of 118 individuals with PCC were included in the final intention-to-treat analysis. All tests and training sessions took place in commercial fitness and health facilities. We found significant effects on fatigue severity, health-related quality of life and physical performance capacity. Adjusting the individual exercise load to daily fatigue has proven to be an effective and safe strategy in PCC patients with fatigue. Under the guidance of qualified professionals and by utilising symptom-titrated training recommendations, commercial fitness and health facilities present an appropriate setting for outpatient exercise rehabilitation in PCC.

Long COVID refers to symptoms that appear 3 months after initial infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of Coronavirus disease 2019 (COVID-19), and last for at least 2 months, not attributable to other diagnoses. This health issue significantly burdens patients' quality of life, the economy, and society. Improving the af-termath of COVID-19 is a crucial global health issue in the post-pandemic era. According to current results, it is evident that developing a simple, low-cost respiratory training method that can be easily used at home by themselves with long Coronavirus disease 2019 symptoms (long COVID) is an important and urgent issue. The incentive spirometer is widely used in physical, speech, and respiratory therapy, as well as in preventing postoperative pulmonary infections and improving sputum clearance. However, to date, the role of incentive spirometer respiratory training in long COVID symptoms is still limited. In this literature review is presented to explore the effectiveness of incentive spirometer respiratory training in alleviating symptoms among individuals recovering from long COVID. We also compile non-invasive assessment methods, with the aim to enable individuals to undergo training and assessments conveniently at home or in the community. In this review, a literature review approach was utilized to explore the effectiveness of incentive spirometer intervention in alleviating long-term COVID symptoms. This study is to synthesize the findings of articles published during January 2019 and December 2023 retrieved from PubMed/CINAHL/MEDLINE/ Google Scholar without re-strictions on study type. We ultimately identified seven articles and have summarized similar past studies. This review could contribute to improving symptoms related to long COVID by incentive spirometer respiratory training and serve as practical reference material for clinical medical staff and provide insights for healthcare policymakers in de-veloping guidelines for future research directions, clinical guidance, and educational strategies in the context of nursing care.

Early exercise intervention studies showed promising positive effects of physical exercising on post-COVID-19 symptoms; however, little is known about long-term training adherence and what influences it.

Semi-structured interviews were conducted with 17 participants of the 8‑week original exercise intervention study. Facilitators and barriers were identified via thematic analysis and compared between those participants who continued their regular exercise behavior (continuous exercise group, CEG, n = 7) and those who stopped exercising (discontinuous exercise group, DEG, n = 10). Physical performance parameters and questionnaires regarding psychological health dimensions and work ability were assessed analogously to the original study.

Qualitative analysis showed that two of the top three facilitators, (improving physical and mental health, sport has high priority) were the same in both groups. The respective third of the top three facilitators was (re)build physical and cognitive performance in the CEG and training in the group in the DEG. The top three barriers (exhaustion, sport has little priority, procrastination) were not only the same in both groups but also in the same order.

The strongest post-COVID-19 associated facilitator for long-term exercise adherence is when the need for further reconditioning is felt. The strongest post-COVID-19 associated barrier is exhaustion. Availability of exercising in a group is a key factor in increasing long-term exercise adherence.

The Coronavirus Disease 2019 (COVID-19) pandemic had a major global impact on health care, including the delivery, modality, and importance of outcomes in pulmonary rehabilitation (PR). This review discusses the impact of the pandemic on PR and the changes that were required to maintain its delivery. This article reviews the current evidence on PR during the COVID-19 pandemic period, focusing on delivery models, modalities, outcomes, perspectives, and barriers. A search of the MEDLINE, Embase, and SciELO databases and the Cochrane Library on this topic was conducted between December 1, 2019 and August 1, 2023. Studies were reviewed and relevant topics were included in this narrative. Rehabilitation of patients with severe acute COVID-19 and symptoms of long COVID has been challenging. The number of rehabilitation programs worldwide is still low, and community-based programs are still rare. Integrated programs with a multidisciplinary approach and exercise therapy with individualized prescription based on symptoms have been an interesting strategy. Telerehabilitation and outpatient rehabilitation are both effective in the treatment of patients with chronic obstructive pulmonary disease. However, the uptake of PR remains considerably low, and technological barriers for patients and lack of technological resources in low-income countries affect the delivery of these services in much of the world.

This study investigated the impacts of online and face-to-face Mat Pilates training in adults with persistent symptoms of long COVID on health outcomes. Forty-nine patients (52 ± 5.85 yr.) diagnosed with long COVID related to fatigue symptoms were randomly included in three groups: online Mat Pilates training (n = 16), face-to-face Mat Pilates training (n = 15), and a control group (n = 18) without training. Mat Pilates training was conducted three times a week for 12 weeks. Fatigue, functional capacity, anthropometrics, body composition, and cardiometabolic markers were assessed before and after the interventions. Two-factor Generalized Estimating Equation analyses identified significant differences with Bonferroni post hoc testing (p < 0.05). After the intervention, only the face-to-face Mat Pilates training group had an improved total, physical and mental fatigue, trunk isometric strength, upper limb muscle endurance strength, and aerobic capacity (p < 0.05). No changes were found in fat mass, muscle mass, free fat mass, % of fat, body mass, body mass index, or waist and hip circumferences. No significant changes were observed in blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, or blood pressure (p > 0.05). Our results highlight the potential of face-to-face Mat Pilates training as an effective intervention to mitigate persistent symptoms of long COVID related to fatigue and functional capacities.

Post-COVID-19 Syndrome (PCS) entails a spectrum of symptoms, including fatigue, reduced physical performance, dyspnea, cognitive impairment, and psychological distress. Given the effectiveness of exercise-based rehabilitation for PCS, this study examined the efficacy of rehabilitation for PCS patients, focusing on sex-specific differences.

Prospective cohort study during inpatient rehabilitation. Cardiopulmonary exercise testing and spirometry were performed at admission and discharge. Questionnaires were used to assess fatigue, health-related quality of life, wellbeing, and workability for up to 6 months.

145 patients (36% female, 47.1 ± 12.7 years; 64% male, 52.0 ± 9.1 years; p = 0.018) were referred to rehabilitation 262.0 ± 128.8 days after infection (female, 285.5 ± 140.6 days; male, 248.8 ± 112.0 days; p = 0.110). Lead symptoms included fatigue/exercise intolerance (81.4%), shortness of breath (74.5%), and cognitive dysfunction (52.4%). Women presented with higher relative baseline exercise capacity (82.0 ± 14.3%) than males (68.8 ± 13.3%, p < 0.001), but showed greater improvement in submaximal workload (p = 0.026). Men exhibited higher values for FEV1, FEV1/VC, PEF, and MEF and lower VC at baseline (p ≤ 0.038), while FEV1/VC improvement more in women (p = 0.027). Higher baseline fatigue and lower wellbeing was detected in women and correlated with impaired pulmonary function (p < 0.05). Disease perception including fatigue, health-related quality of life, wellbeing and workability improved with rehabilitation for up to six-month.

Rehabilitation improves cardiopulmonary fitness, pulmonary function and disease burden in women and men with long-term PCS. Women with PCS may benefit from intensified respiratory muscle training. Clinical assessment should include cardiopulmonary exercise testing and pulmonary function tests and fatigue assessments for all PCS patients to document limitations and tailor therapeutical strategies.

Long COVID-19 is characterized by systemic deterioration of the entire body, leading to significant physical and mental disorders. Exercise training has the potential to improve persistent symptoms and cardiopulmonary functions.

This was a single-center, randomized, controlled trial. Twenty-four patients aged 18 to 75 years who had a history of SARS-CoV-2 infection and long COVID symptoms. Patients were randomly allocated in a 1:1 ratio to receive either a 4-week exercise training program or an attention control group. The training group participated in 12 supervised aerobic sessions on a cycling ergometer over 4 weeks. The outcomes were to assess the impact of a 4-week aerobic exercise on the persistent symptoms and cardiopulmonary fitness, the surrogate endpoints of COVID-19 recovery and cardiopulmonary health.

After the 4-week intervention, significant reductions were observed in the total number of symptoms in the training group. Specifically, 67.8% of patients in the training group exhibited reduced or completely resolved symptoms, in comparison to 16.7% in the control group (P = 0.013). After adjusting for gender, significant improvements in the training group were observed for exercise time (Pgroup*time = 0.028), maximum load (Pgroup*time = 0.01), and peak VO2 (Pgroup*time = 0.001), as well as O2 pulse (Pgroup*time = 0.042) and maximum heart rate (Pgroup*time = 0.007). The score of Short Form-12, depression, anxiety, perceived stress, and insomnia did not show significant changes between groups (Pgroup*time > 0.05).

A supervised aerobic training program has the potential to alleviate persistent symptoms and improve exercise tolerance in patients with long COVID-19. Further research is necessary to confirm these effects in a large population. This intervention could be easily implemented in non-hospital settings, potentially benefiting a broader range of individuals.

ClinicalTrials.gov NCT05961462. Registered on July 25, 2023.

The presence of prolonged symptoms after COVID infection worsens the workability and quality of life. 200 adults with long COVID syndrome were enrolled after medical, physical, and mental screening, and were divided into two groups based on their performance. The intervention group (n = 100) received supervised rehabilitation at Department of Pulmonology, Semmelweis University with the registration number 160/2021 between 01/APR/2021-31/DEC/2022, while an age-matched control group (n = 100) received a single check-up. To evaluate the long-term effects of the rehabilitation, the intervention group was involved in a 2- and 3-month follow-up, carrying out cardiopulmonary exercise test. Our study contributes understanding long COVID rehabilitation, emphasizing the potential benefits of structured cardiopulmonary rehabilitation in enhancing patient outcomes and well-being. Significant difference was found between intervention group and control group at baseline visit in pulmonary parameters, as forced vital capacity, forced expiratory volume, forced expiratory volume, transfer factor for carbon monoxide, transfer coefficient for carbon monoxide, and oxygen saturation (all p < 0.05). Our follow-up study proved that a 2-week long, patient-centered pulmonary rehabilitation program has a positive long-term effect on people with symptomatic long COVID syndrome. Our data showed significant improvement between two and three months in maximal oxygen consumption (p < 0.05). Multidisciplinary, individualized approach may be a key element of a successful cardiopulmonary rehabilitation in long COVID conditions, which improves workload, quality of life, respiratory function, and status of patients with long COVID syndrome.

Post-COVID-19 subjects typically experience symptoms of fatigue, cognitive impairment, and sleep difficulty, which can be relieved by conventional aerobic exercise. Virtual Reality (VR) technology to support conventional exercise has recently gained much attention. Therefore, this study aimed to assess the effects of traditional treadmill exercise compared to virtual reality-simulated treadmill exercise on fatigue, cognitive function, sleep quality, and participant satisfaction with the exercise program in post-COVID-19 subjects.

This single-centered, randomized, parallel-group intervention study was conducted between December 2021 and March 2022. Sixteen of twenty post-COVID-19 subjects completed this study (n1 = 8, n2 = 8). Inclusion criteria were persistent dyspnea/fatigue, mild cognitive problems, and age from 30-60 years. Exclusion criteria were previous severe COVID-19 infection and ICU admission, concomitant respiratory or cardiovascular disease, and musculoskeletal or neurological disease. Eligible subjects were assigned randomly to two groups: a non-VR group that received traditional treadmill aerobic exercise only and a VR group that received treadmill exercise with non-immersive VR. Both groups received moderate-intensity exercise on a treadmill at [50-60 % (peak HR－resting HR) + resting HR] for 30-45 min, three times per week, and for four weeks. The outcome measures were the Chalder Fatigue Scale, Montreal Cognitive Assessment (MoCA) questionnaire, Pittsburgh Sleep Quality Index (PSQI), and participant satisfaction with the exercise program rated on a 5-point Likert scale.

Both groups showed significant improvements in the Chalder Fatigue Scale, the MoCA questionnaire, and the PSQI scores after training compared to baseline (p < 0.05), without significant differences between them (p > 0.05). However, participant satisfaction with the exercise program was significantly higher in the VR group than in the non-VR group (p = 0.037).

A moderate-intensity 4-week treadmill exercise program with and without non-immersive VR may improve fatigue, cognitive function, and sleep quality to the same extent in COVID-19 survivors. However, participant satisfaction with the exercise program could be greater after conventional treadmill training assisted by non-immersive VR than after conventional treadmill training alone in this cohort.

Pan African Clinical Trials Registry, PACTR202311561948428, retrospectively registered.

Background/Objectives: Long COVID covers many cardio-pulmonary symptoms, worsening individuals' health status. Health resort treatment applies balneological factors, physical medicine modalities, climate actions, and exercises that may be beneficial for COVID-19 survivors. This study aimed to assess the severity of the cardiopulmonary symptoms in people qualified for health resort treatment and its efficacy in this group of patients. Methods: Medical records of 239 people attending health resort treatment were analysed. A total of 122 people (71 women and 51 men) with a mean age of 64.35 years ± 8.66 years were enrolled in the analysis. The cardiopulmonary symptoms of long COVID were assessed twice: before and after health resort treatment. Results: Persisting COVID-19 symptoms do not differentiate between women and men. Health resort treatment reduces symptoms severity in both sexes. Age does not mediate the efficacy of health resort treatment. Conclusions: The persistent symptoms of COVID-19 are of low intensity in people qualified for health resort treatment and are independent of gender. Health resort treatment effectively mitigates dyspnoea, tightness of chest, and sputum in long COVID patients, so it should be implemented into the standard treatment course for COVID-19 survivors as a continuation of therapy.

This study aimed to determine the infection status, exercise habits, anxiety levels, and sleep quality in Chinese residents who recovered from infection during the period of coronavirus disease 2019 (COVID-19) period. It also aimed to investigate the influencing factors of recovery status and aid in improving intervention measures for COVID-19 recovery. This study is a sub-study nested within a cross-sectional investigation of infection and physical and mental health among partially recovered residents in all 34 provincial areas of China during the COVID-19 pandemic. A total of 1 013 participants (374 males and 639 females) completed the study. Cardiopulmonary endurance was significantly lower after infection than before infection (p ​< ​0.001). Women (3.92 ​± ​4.97) exhibited higher levels of anxiety than men (3.33 ​± ​4.54, p ​= ​0.015). The sleep score was significantly higher after infection (8.27 ​± ​7.05) than before infection (4.17 ​± ​4.97, p ​< ​0.001). The active and regular exercise groups exhibited significantly shorter durations of fever than the sedentary and irregular groups (p ​= ​0.033; p ​= ​0.021). Additionally, the active group demonstrated significantly fewer recovery days ([7.32 ​± ​3.24] days) than the sedentary group ([7.66 ​± ​3.06] days, p ​= ​0.035). We found a correlation between age and the recovery time of symptoms after COVID-19. We noted that a greater number of symptoms corresponded to poorer cardiopulmonary fitness and sleep quality. Individuals who engage in sedentary lifestyles and irregular exercise regimens generally require prolonged recovery periods. Therefore, incorporating moderate exercise, psychological support, sleep hygiene and other health interventions into post-COVID-19 recovery measures is imperative.

To compare the preliminary efficacy of asynchronous telerehabilitation in patients after acute coronavirus disease 2019 (COVID-19) on fatigue, physical condition, quality of life, and feasibility of this pilot study with that of a booklet format.

Randomized pilot study with 2 intervention arms: asynchronous telerehabilitation group and booklet-based rehabilitation group, with 2 follow-ups at 3 and 6 months.

Hospital.

Patients discharged after COVID-19 were recruited and evaluated (N=35).

The intervention consisted of a 12-week multimodal rehabilitation program via telerehabilitation or by a booklet.

Fatigue as the main outcome and functional status, quality of life, and feasibility as secondary outcomes were evaluated.

After the intervention, there was no significant difference between groups in fatigue, but there were significant differences in favor of the asynchronous telerehabilitation group for the 6-Minute Walk Test (p=.008), the 30-Second Sit-to-Stand Test (p=.019), and physical quality of life (p=.035). These improvements were maintained throughout the 6-month follow-up. Telerehabilitation was shown to be a viable option, without incidents and with a higher adhesion (p=.028) than the booklet format.

A multimodal rehabilitation program by means of asynchronous telerehabilitation appears as a more effective option than traditional formats in improving post-acute COVID-19 sequelae.

Several genetic markers have shown associations with muscle performance and physical abilities, but the response to exercise therapy is still unknown. The aim of this study was to test the response of patients with long COVID through an aerobic physical therapy strategy by the Nordic walking program and how several genetic polymorphisms involved in muscle performance influence physical capabilities. Using a nonrandomized controlled pilot study, 29 patients who previously suffered from COVID-19 (long COVID = 13, COVID-19 = 16) performed a Nordic walking exercise therapy program for 12 sessions. The influence of the ACE (rs4646994), ACTN3 (rs1815739), AMPD1 (rs17602729), CKM (rs8111989), and MLCK (rs2849757 and rs2700352) polymorphisms, genotyped by using single nucleotide primer extension (SNPE) in lactic acid concentration was established with a three-way ANOVA (group × genotype × sessions). For ACE polymorphism, the main effect was lactic acid (p = 0.019). In ACTN3 polymorphism, there were no main effects of lactic acid, group, or genotype. However, the posthoc analysis revealed that, in comparison with nonlong COVID, long COVID increased lactic acid concentrations in Nordic walking sessions in CT and TT genotypes (all p < 0.05). For AMPD1 polymorphism, there were main effects of lactic acid, group, or genotype and lactic acid × genotype or lactic acid × group × genotype interactions (all p < 0.05). The posthoc analysis revealed that, in comparison with nonlong COVID, long COVID increased lactic acid concentrations in Nordic walking sessions in CC and CT genotypes (all p < 0.05). Physical therapy strategy through Nordic walking enhanced physical capabilities during aerobic exercise in post-COVID19 patients with different genotypes in ACTN3 c.1729C>T and AMPD1 c.34C>T polymorphisms. These findings suggest that individuals who reported long COVID who presumably exercised less beforehand appeared to be less able to exercise, based on lactate levels, and the effect of aerobic physical exercise enhanced physical capabilities conditioned by several genetic markers in long COVID patients.

To develop a nursing diagnosis proposal derived from the concept of "disuse syndrome" based on an integrative review.

The conceptual derivation technique, proposed by Walker and Avant, was used in the following phases: an integrative review of the literature was carried out, applying the parameters of Whitermore and Knalf, where 43 articles were selected that covered the existence of the concept in the nursing discipline and other health sciences, the concepts were subsequently analyzed, and the new concept was redefined following the middle-range theory of causality and validation of nursing diagnoses proposed by Oliveira-Lopes et al.

The proposal of the new nursing diagnosis was developed, including the following elements: diagnostic label adult disuse syndrome, the corresponding definition, 25 defining characteristics, eight related factors, eight risk populations, and 14 associated problems.

The concept of the proposed new diagnosis describes adult disuse syndrome as a phenomenon that transcends the physiological component and should be viewed from a multidimensional view, expressing a clinical judgment related to a series of nursing diagnoses that appear together.

The results of this study will help nursing professionals to identify the phenomenon of adult disuse syndrome in any setting and in turn guide optimal care interventions that decrease the consequences of adult disuse syndrome.

Long COVID occurs when numerous symptoms begin 3 weeks after acute infection and last for 12 months or more. High-definition transcranial direct current stimulation (HD-tDCS) has been tested in patients with COVID-19; however, previous studies did not investigate the HD-tDCS use combined with inspiratory muscle training (IMT) for respiratory sequelae of long COVID.

Six individuals (four women and two men) aged between 29 and 71 years and presenting with respiratory sequelae of long COVID were included. They were submitted to an intervention that comprised HD-tDCS combined with IMT twice a week for 5 weeks. Lung function and respiratory muscle assessments were performed at baseline and after 5 weeks of intervention.

HD-tDCS may enhance the IMT effects by increasing respiratory muscle strength, efficiency, and lung function of individuals with long COVID.

Background: Poor cardiorespiratory fitness poses the highest risk of mortality. Long-COVID-19 survivors exhibit a reduced cardiorespiratory fitness (CRF). While exercise rehabilitation, such as cardiopulmonary exercise, is used for long-COVID-19 survivors, the effects of exercise on CRF in this population remain inconclusive. In this study, we aim to systematically summarise and synthesise whether exercise rehabilitation improves CRF among long-COVID-19 survivors. Methods: A comprehensive search was performed through PubMed, CINAHL, Embase, Scopus, and the Cochrane Library (since their inception to November 2023) and study reference lists. Studies presenting the effects of exercise rehabilitation on CRF (peak oxygen consumption (VO2peak) and six-minute walk distance (6MWD)) in long-COVID-19 survivors were identified. The standardised mean difference (SMD), mean difference (MD), and 95% confidence interval (CI) were used for analyses. The certainty of evidence was measured using a Grading of Recommendation Assessment, Development and Evaluation approach. Results: Twelve eligible studies (five RCTs and seven non-RCTs) with 682 participants were analysed. The meta-analysis showed significantly improved 6MWDs (MD 76.47, 95% CI 59.19-93.71, low certainty) and significantly greater 6MWDs (SMD 0.85, 95% CI 0.11-1.59, very low certainty) in the exercise rehabilitation group compared to the control group. A significantly improved 6MWD was found in subgroups of young to middle-aged adults and subgroups of patients who undertook aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. Conclusions: Exercise rehabilitation is effective for improving CRF, as measured by the 6MWD in long-COVID-19 survivors. Improvements are likely to be more pronounced in specific subgroups of young to middle-aged adults and patients undertaking aerobic exercise combined with resistance and respiratory exercise and centre-based training programs. However, recommendations for clinical practice are limited due to the very low evidence certainty.

The aim of our study was to evaluate the physical performance, balance, gait and activities of daily living (ADL) of older individuals with long COVID syndrome (LCS).

A total of 124 individuals (49% women) with a mean age of 71.8 ± 5.8 years were included in the study. Participants were divided into two groups, older individuals with LCS in the LCS group and older individuals who were not diagnosed with COVID-19 in the CON (control) group. Physical performance of participants was evaluated with the Alusti Test, balance and gait assessment was evaluated with the Tinetti Balance and Gait Assessment (TBGA), and ADL were evaluated with the Barthel Index (BI).

In the evaluations between groups, the mean score of active muscular mobility of right and left upper extremities, transfer supine position to sitting, trunk in sitting position and standing, which are among the subparameters of the Alusti Test, were statistically significantly lower in LCS compared to CON (p < .05). TBGA total score and gait section mean score of TBGA were statistically significantly lower in LCS than in CON (p < .05). There was no significant difference between the groups in the balance section of the TBGA and the mean BI scores (p > .05).

It was concluded that physical performance parameters related to active muscular mobility of the upper extremity, transfer supine position to sitting, trunk in sitting position and walking in LCS were negatively affected by the disease, but this did not affect the level of balance and independence in ADL.

Introduction: Post-COVID-19 is an increasing chronic disease for which potential treatment options require further development and examination. A well-established approach to symptom management in post-COVID-19 patients could be e-Health interventions. To enhance the implementation and utilization of e-Health interventions, the needs and demands of patients should be taken into consideration. The aim of this study was to investigate needs and demands of post-COVID-19 patients concerning e-Health symptom management interventions. Methods: A total of 556 patients participated in this cross-sectional online survey study. Recruitment was performed from January 19 to May 24, 2022. Data related to the needs and demands for e-Health interventions were analyzed, along with medical and sociodemographic information. Results: The majority of the patients preferred interventions accessible on smartphones (95.3%). The favored content formats were applications (82.7%), interactive training (69.3%), or audio and video materials (61.1%). Furthermore, the preferred session length was about 10-20 min. The most desired topics included "quality of life," "information about how intensively I may exert myself or do sports," "adjustment to new life situation," and "handling physical changes." Conclusions: This study provides a detailed framework for the content and design of e-Health interventions to support patients managing their post-COVID-19 symptoms. The findings could significantly influence the further development of tailored e-Health interventions to address this pressing global health concern.

Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome.

The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups.

No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02).

Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.

Long COVID affects both children and adults, including subjects who experienced severe, mild, or even asymptomatic SARS-CoV-2 infection. We have provided a comprehensive overview of the incidence, clinical characteristics, risk factors, and outcomes of persistent COVID-19 symptoms in both children and adults, encompassing vulnerable populations, such as pregnant women and oncological patients. Our objective is to emphasize the critical significance of adopting an integrated approach for the early detection and appropriate management of long COVID. The incidence and severity of long COVID symptoms can have a significant impact on the quality of life of patients and the course of disease in the case of pre-existing pathologies. Particularly, in fragile and vulnerable patients, the presence of PASC is related to significantly worse survival, independent from pre-existing vulnerabilities and treatment. It is important try to achieve an early recognition and management. Various mechanisms are implicated, resulting in a wide range of clinical presentations. Understanding the specific mechanisms and risk factors involved in long COVID is crucial for tailoring effective interventions and support strategies. Management approaches involve comprehensive biopsychosocial assessments and treatment of symptoms and comorbidities, such as autonomic dysfunction, as well as multidisciplinary rehabilitation. The overall course of long COVID is one of gradual improvement, with recovery observed in the majority, though not all, of patients. As the research on long-COVID continues to evolve, ongoing studies are likely to shed more light on the intricate relationship between chronic diseases, such as oncological status, cardiovascular diseases, psychiatric disorders, and the persistent effects of SARS-CoV-2 infection. This information could guide healthcare providers, researchers, and policymakers in developing targeted interventions.

This study aims to investigate the effectiveness of tele-counseling to promote physical activity in COVID-19 survivors at the persistent phase.

Twenty-eight participants who suffered from COVID-19 were randomly assigned to intervention and control groups. Physical activity counseling was applied according to the transtheoretical model to the intervention group during 20 sessions. Second assessments were performed 6 weeks after the intervention. The physical activity, functional performance (4-meter gait speed; 4-MGS and 5-repetition Sit-To-Stand; STS test), exercise behavioral change and processes, quality of life, fatigue, mental health, severity of symptoms, and dyspnea were evaluated in groups.

The baseline demographic and clinical outcomes were similar (p > 0.05) except for physical role limitations and general health perceptions in groups. Five-repetition STS, 4-MGS, activity dyspnea, step counts, sitting time, physical role limitations, Exercise Processes of Change Scale (EPCS) total, and behavioral processes scores except for self-liberation significantly improved in the counseling group. Five-repetition STS, 4-MGS improved while dramatic relief, self reevaluation, self-liberation, and EPCS total scores deteriorated in the control group.

The tele-counseling intervention contributes to improving physical activity, functional performance, behavioral change, quality of life, and decreasing common problems related to COVID-19. The results of the tele-counseling intervention are promising in post-COVID-19 conditions.

Registration ID: NCT04853966.

After the SARS-CoV-2 pandemic we face a new global epidemic: the Post-COVID Syndrome. This novel condition has fluctuating progression and a wide range of symptoms, such as fatigue, headaches, muscle pain or breathlessness. Although its pathophysiology is not clear, a multiorganic affection is suspected, altering the immune, cardiorespitatory and nervous systems. Whereas there is no consensus over its treatment, most of the researches conclude the effectiveness of therapeutic exercise and a multicomponent rehabilitation, coordinating and cooperating between different health professionals. A functional, respiratory and strength evaluation prior to treatment prescription is highly recommended, since it will help professionals to precisely prescribe and objectively measure the evolution of our patients. In this article we suggest a few tests, adequate to primary health requirements, to evaluate our patients' initial condition, as well as the most secure way to initiate a therapeutic exercise programme, together with other healthcare providers.

The impact of COVID-19 on sport and physical activity has been a subject of considerable interest and concern. Padel satisfies the desire for social interaction and a return to sport after a period of inactivity. The aim of this study is to show a correlation between return to sport and related injuries in a population of Padel players. The study was carried out in a survey mode, consisting of a questionnaire with four sections and fifty questions on the biographical data of the individual, lifestyle before and after the pandemic, knowledge and playing level of Padel and injuries. The self-administered online questionnaire was developed and validated by a panel of physiotherapists, orthopaedic surgeons, and physiatrists with experience in clinical practice and/or musculoskeletal research. The study was conducted in a survey mode from a smartphone or computer via a link to a multiple-choice document. The link to the questionnaire was distributed via mailing lists, social media, and chat applications.

This systematic review and meta-analysis aims to evaluate the efficacy of pulmonary rehabilitation (PR) in improving dyspnea, fatigue, physical activity, quality of life, anxiety and depression in patients with Long COVID-19 (LC). The impact of PR on LC and a comparison of face-to-face and telerehabilitation approaches was explored.

This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. A literature search included PubMed, Web of Science, and Cochrane Library until January 2023. No language filters were applied. Randomized controlled trials, non-randomized controlled trials, and observational studies were included. The risk of bias was assessed using appropriate tools. Descriptive analysis and meta-analysis were performed. Forest plots presented results. Statistical analyses were conducted using the Metafor Package in R v.3.4.2.

This systematic review and meta-analysis included 16 studies on PR in LC patients. A total of 1027 adults were included. The studies varied in design, with seven observational studies, three quasi-experimental studies, and six randomized controlled trials. Dyspnea, physical function, quality of life, psychological state, and fatigue were assessed as outcomes. The review found that pulmonary rehabilitation had a significant positive effect on dyspnea, physical function, quality of life (both global and physical domain), anxiety, and depression. However, the effect on fatigue was not significant. Heterogeneity was observed in some analyses, and publication bias was found in certain outcomes. Age and study design were identified as potential moderators. Both face-to-face and telerehabilitation interventions improved the studied outcomes, with only differences in the physical domain of quality of life favoring the face-to-face group.

PR improved dyspnea, physical function, quality of life, and psychological state in LC patients, but not fatigue. Face-to-face and telerehabilitation have similar effects, except for physical quality of life.

Fatigue is a prominent symptom in post-COVID condition (PCC) sequelae, termed "long COVID." Herein, we aim to ascertain the effect of fatigue on psychosocial function in persons living with PCC.

This post hoc analysis evaluated the effects of vortioxetine on measures of fatigue as assessed by the Fatigue Severity Scale (FSS) in psychosocial function as measured by the Sheehan Disability Scale (SDS) in persons with PCC. We also evaluated the change in FSS on psychosocial functioning as measured by the Sheehan Disability Scale (SDS). This post hoc analysis obtained data from a recently published placebo-controlled study evaluating vortioxetine's effect on objective cognitive functions in persons living with PCC.

One hundred forty-four participants meeting World Health Organization (WHO) criteria for PCC were included in this analysis. At the end of 8 weeks of vortioxetine treatment, significant improvement of all domains was observed for psychosocial functioning. There was a significant between-group difference at treatment endpoint in the family, social, and work SDS subcategories (p < 0.001). There was a statistically significant interaction effect between the treatment condition time point and FSS effect on the SDS social (χ2 = 10.640, p = 0.014) and work (χ2 = 9.342, p = 0.025) categories but a statistically insignificant effect on the family categories ((χ2 = 5.201, p = 0.158)).

This post hoc analysis suggests that vortioxetine treatment significantly improves psychosocial function in persons with PCC. Our results also indicate that the improvement in psychosocial function was significantly mediated by improvement in measures of fatigue. Our results provide empirical support for recommendations to identify therapeutics for fatigue in persons living with PCC with a broader aim to improve psychosocial function in this common and severely impaired population.

Patients with kidney disease on Hemodialysis (HD) are susceptible to Coronavirus Disease (COVID-19) due to multiple risk factors.

This study aims to report the prevalence of antibodies against SARS-CoV-2 among patients on hemodialysis before vaccination in Brazil and to compare with clinical, demographic, and laboratory data.

Blood samples from 398 Chronic Kidney Disease (CKD) patients treated in three different private institutions in Rio de Janeiro State, Brazil were submitted to the total anti-SARS-CoV-2 testing. Kidney, liver, and hematological markers were also determined. Respiratory samples were tested by real-time PCR for SARS-CoV-2 RNA and positive samples were subjected to high-throughput sequencing on the MinION device.

Overall, anti-SARS-CoV-2 prevalence was 54.5 % (217/398) and two individuals had SARS-CoV-2 RNA with variant B.1.1. High anti-SARS-CoV-2 seroprevalence was found in male gender and those with hospital admission in the last 3-months before the inclusion in the study. Lower red blood cell count was observed in the anti-SARS-CoV-2 seropositive group. High levels of anti-SARS-CoV-2 were found in those who reported symptoms, had low levels of eosinophils and low hematocrit, and who practiced physical activity.

High prevalence of anti-SARS-CoV-2 was found in CKD patients before the universal immunization in Brazil suggesting that dialysis patients were highly exposed to SARS-CoV-2.

To date, it is unknown whether respiratory training interventions can benefit Long COVID-19 patients. The main objective was to analyze the effects of respiratory training on patients with Long COVID-19, concretely on respiratory muscle strength, lung function, dyspnea, and functional capacity.

We performed a systematic review following PRISMA statement using PubMed, Scopus, and PEDro (last search November 2023). The risk of bias was assessed using the Cochrane tool. We included randomized controlled trials testing the effect of respiratory training interventions in Long COVID-19 patients versus no intervention, control, or placebo intervention. The data was pooled, and a meta-analysis was complete.

We selected 7 studies, which included 572 patients. Meta-analysis results show significant differences in favor of respiratory training in respiratory muscle strength (MD = 13.71; 95% CI = 5.41; 22; p = 0.001), dyspnea (SDM = 1.39; 95% CI = 0.33; 2.46; p = 0.01) and functional capacity (SDM = 0.90; 95% CI = 0.37; 1.43; p = 0.0009), but not in lung function (MD = 0.28; 95%CI = -0.27; 0.83; p = 0.32).

The results of this systematic review with meta-analysis suggest that respiratory training improves respiratory muscle strength and functional capacity in Long COVID-19 patients, as well as dyspnea if combined with therapeutic exercise. However, respiratory training does not improve lung function in these patients.

CRD42022371820.