COVID-19 and what comes after?

Hopkinson, Nicholas S; Jenkins, Gisli; Hart, Nicholas

doi:10.1136/thoraxjnl-2020-216226

Cited by 14 publications

(19 citation statements)

References 19 publications

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“…Our findings demonstrate the varying patterns and persistence of symptoms of Long-COVID, which do not necessarily appear to be associated with severity of the acute phase of the virus and are in keeping with those presented by other recent papers(7-12). The most common symptoms reported in this study of people with long-COVID were breathlessness and fatigue.…”

Section: Discussionsupporting

confidence: 92%

“…Severity of the initial phase varies dramatically between individuals, from mild flu-like symptoms to multi-organ failure and death (5). The pandemic response has largely focused on reducing hospitalisation and mortality from acute COVID-19 (6), however, a substantial proportion of people experience long term symptoms (7-13).…”

Section: Introductionmentioning

confidence: 99%

“…However, research on the patterns and persistence of longer term symptoms following acute COVID-19 (12) is still evolving, including the range and extent of symptoms and how the condition is experienced by those affected. Furthermore, much of the published data relate to people who have been hospitalised during the acute phase, rather than those who managed their acute illness in the community (7). The latter, much larger group, many of whom have never received a formal diagnosis of COVID-19 risk being overlooked by health and care services (19) and research.…”

Section: Introductionmentioning

confidence: 99%

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Patient symptoms and experience following COVID-19: results from a UK wide survey

Buttery

Philip

Williams

et al. 2021

Preprint

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Objectives To investigate the experience of people who continue to be unwell after acute COVID–19, often referred to as ′Long–COVID′, both in terms of their symptoms and their interactions with healthcare. Design We conducted a mixed–methods analysis (quantitative and qualitative) of responses to a survey accessed through a UK online post–COVID support and information hub between April 2020 and December 2020 about people′s experiences after having acute COVID–19. Participants Of 3290 respondents, 78% were female, median age range 45–54 years, 92.1% reported white ethnicity; 12.7% had been hospitalised. 494 respondents (16.5%) completed the survey between 4 and 8 weeks of the onset of their symptoms, 641 (21.4%) between 8 and 12 weeks and 1865 (62.1%) more than 12 weeks after. Results The ongoing symptoms most frequently reported were; breathing problems (92.1%), fatigue (83.3%), muscle weakness or joint stiffness (50.6%), sleep disturbances (46.2%), problems with mental abilities (45.9%) changes in mood, including anxiety and depression (43.1%) and cough (42.3%). Symptoms did not appear to be related to the severity of the acute illness or to the presence of pre–existing medical conditions. Analysis of free text responses revealed three main themes (1) Experience of living with COVID-19 – physical and psychological symptoms that fluctuate unpredictably; (2) Interactions with healthcare; (3) Implications for the future – their own condition, society and the healthcare system and the need for research Conclusion People living with persistent problems after the acute phase of COVID–19 report multiple and varying symptoms that are not necessarily associated with initial disease severity or the presence of pre–existing health conditions. Many have substantial unmet needs and experience barriers to accessing healthcare. Consideration of patient perspective and experiences will assist in the planning of services to address this.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient symptoms and experience following COVID-19: results from a UK wide survey

Buttery

Philip

Williams

et al. 2021

Preprint

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“…Weitere mögliche Pathomechanismen sind andauernde postinfektiöse strukturelle Gewebeschäden, inklusive Endothelschaden und gestörter Mikrovaskularisierung, Hyperkoagulabilität und Thrombosen, eine chronische Immundysregulation, (Hyper-)Inflammation bzw. Autoimmunität, Dysregulation des Renin-Angiotensin-Aldosteron-Systems (RAAS) sowie potenzielle Nebenwirkungen der COVID-19-Therapie [7,8].…”

Section: Introductionunclassified

S1-Leitlinie Post-COVID/Long-COVID

et al. 2021

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ZusammenfassungDie Deutsche Gesellschaft für Pneumologie hat die AWMFS1-Leitlinie Post-COVID/Long-COVID initiiert. In einem breiten interdisziplinären Ansatz wurde diese S1-Leitlinie basierend auf dem aktuellen Wissensstand gestaltet.Die klinische Empfehlung beschreibt die aktuellen Post-COVID/Long-COVID-Symptome, diagnostische Ansätze und Therapien.Neben der allgemeinen und konsentierten Einführung wurde ein fachspezifischer Zugang gewählt, der den aktuellen Wissensstand zusammenfasst.Die Leitlinie hat einen expilzit praktischen Anspruch und wird basierend auf dem aktuellen Wissenszugewinn vom Autorenteam stetig weiterentwickelt und adaptiert.

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“…Covid-19 is a respiratory infection, although it can be associated with both acute and long term systemic complications. Breathlessness is among the most common symptoms reported in people followed up after hospital admission,1 following infection identified in the community,2 and in those reporting that they have long-covid 3. Consistent with this, Ayoubkhani and colleagues report rates of respiratory disease, diabetes, and cardiovascular disease to be significantly raised in patients who had been hospitalised with covid-19; 770 (95% confidence interval 758 to 783), 127 (95% CI 122 to 132), and 126 (95% CI 121 to 131) diagnoses per 1000 person years, respectively 4…”

mentioning

confidence: 99%

Acknowledging breathlessness post-covid

Hopkinson

2021

BMJ

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reader in respiratory medicinehonorary consultant physicianCovid-19 is a respiratory infection, although it can be associated with both acute and long term systemic complications. Breathlessness is among the most common symptoms reported in people followed up after hospital admission, 1 following infection identified in the community, 2 and in those reporting that they have long-covid. 3 Consistent with this, Ayoubkhani and colleagues report rates of respiratory disease, diabetes, and cardiovascular disease to be significantly raised in patients who had been hospitalised with covid-19; 770 (95% confidence interval 758 to 783), 127 (95% CI 122 to 132), and 126 (95% CI 121 to 131) diagnoses per 1000 person years, respectively. 4 Given this sixfold higher rate of lung problems than the next nearest comparator, it is striking that in illustrating this The BMJ uses an image of a "warning sign" that includes cardiovascular disease, multiorgan disease, liver disease, and diabetes but omits respiratory involvement. The respiratory data are also omitted from the key bar chart in the paper. Of note, the authors regret that they "did not capture symptoms such as fatigue, disturbances in taste and smell, and anxiety, widely reported in post-covid syndrome," but not breathlessness.People with lung disease, and those looking after them, are accustomed to the relative neglect these conditions receive compared with the burden they cause, 5 but erasing lung disease and the experience of breathlessness from post-covid starts to look like Hamlet without the Prince.

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COVID-19 and what comes after?

Cited by 14 publications

References 19 publications

Patient symptoms and experience following COVID-19: results from a UK wide survey

Patient symptoms and experience following COVID-19: results from a UK wide survey

S1-Leitlinie Post-COVID/Long-COVID

Acknowledging breathlessness post-covid

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