long COVID syndrome

长型 COVID 综合征
  • 文章类型: Review
    背景:数字辅助技术有可能通过实施个人和独立的康复计划来满足长期COVID(也称为COVID-19后疾病)患者对适当治疗选择的迫切需要。然而,目标患者组的参与对于开发与该特定患者组的需求密切相关的数字设备是必要的。
    目标:参与式设计方法,比如共同创造,可能是实现可用性和用户接受度的解决方案。然而,目前尚无固定的方法来实施纳入患者的联合创作发展过程。这项研究解决了以下研究问题:与患者群体的参与相关的任务和挑战是什么?关于长期COVID患者的充分参与,可以学到什么教训?
    方法:首先,我们进行了一项基于3阶段滚雪球流程的文献综述,以确定在数字辅助设备和服务与患者组共同创建的背景下出现的任务和挑战.第二,我们进行了定性分析,试图从已确定的研究中提取相关发现和标准.第三,使用理论适应的方法,本文提出了关于长期COVID患者的现有共同创造概念的进一步发展建议.
    结果:患者积极参与医疗保健中的协同发展的挑战包括专业人员和患者之间的等级障碍和特定知识水平的差异。在长COVID的情况下,患者本身在处理症状方面仍然缺乏经验,并且很难组织成既定的团体。这放大了一般的障碍,并导致了群体身份的问题,权力结构,和知识创造,目前的共同创造方法没有充分解决这些问题。
    结论:跨学科方法适应以协作和包容性沟通为重点的协同发展方法,可以解决将长期COVID患者积极纳入发展过程的反复挑战。
    Digital assistive technologies have the potential to address the pressing need for adequate therapy options for patients with long COVID (also known as post-COVID-19 condition) by enabling the implementation of individual and independent rehabilitation programs. However, the involvement of the target patient group is necessary to develop digital devices that are closely aligned to the needs of this particular patient group.
    Participatory design approaches, such as cocreation, may be a solution for achieving usability and user acceptance. However, there are currently no set methods for implementing cocreative development processes incorporating patients. This study addresses the following research questions: what are the tasks and challenges associated with the involvement of patient groups? What lessons can be learned regarding the adequate involvement of patients with long COVID?
    First, a literature review based on a 3-stage snowball process was conducted to identify the tasks and challenges emerging in the context of the cocreation of digital assistive devices and services with patient groups. Second, a qualitative analysis was conducted in an attempt to extract relevant findings and criteria from the identified studies. Third, using the method of theory adaptation, this paper presents recommendations for the further development of the existing concepts of cocreation in relation to patients with long COVID.
    The challenges of an active involvement of patients in cocreative development in health care include hierarchical barriers and differences in the levels of specific knowledge between professionals and patients. In the case of long COVID, patients themselves are still inexperienced in dealing with their symptoms and are hardly organized into established groups. This amplifies general hurdles and leads to questions of group identity, power structure, and knowledge creation, which are not sufficiently addressed by the current methods of cocreation.
    The adaptation of transdisciplinary methods to cocreative development approaches focusing on collaborative and inclusive communication can address the recurring challenges of actively integrating patients with long COVID into development processes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    这篇重点综述的目的是建立关于中枢致敏的原因和机制的综合假设,以及使用系统手动疗法(SMT)的治疗方法的相关模型。理解中枢敏化的关键是牢牢掌握蓝斑去甲肾上腺素系统(LC-NA)的结构和功能。该系统使用精细的切换机制来控制多个系统的激活水平和速率。这篇综述评估了四个组成部分背后的机制和时间关系:显著刺激,威胁编码,异常传入输入,和氧化应激。中枢致敏的五阶段时间模型包括LC-NA系统的阶段性激活,显著的刺激,显著刺激的威胁编码,中央敏化,和神经退化。治疗的三个组成部分包括暂时减少传入内脏输入,将体液炎症活动从大脑转移到体外,并通过使LC和大脑中其他压力区域周围的含氧血液更多地可用来减少氧化应激。可以帮助减少内脏传入输入的SMT协议是GUOU,Barral和LAUG.应该将体液炎症活性从大脑转移或完全转移到体外的方案包括UD和DCS。通过使LC周围的氧合血液更容易获得,可以潜在地降低氧化应激的一种方案是CCCV。进一步讨论了未来的研究和假设检验策略以及局限性。
    The purpose of this focused review is to develop a consolidated hypothesis as to the causes and mechanisms of central sensitization and a related model for a treatment approach using Systemic Manual Therapy (SMT). The key to understanding central sensitization is a firm grasp on structure and function of the Locus-coeruleus noradrenaline system (LC-NA). This system uses an elaborate switching mechanism to control the level and rate of activation of multiple systems. This review evaluates the mechanisms and temporal relationships behind four components: salient stimuli, threat coding, aberrant afferent input, and oxidative stress. The five-stage temporal model for central sensitization includes phasic activation of the LC-NA system, salient stimuli, threat coding of salient stimuli, central sensitization, and neural degeneration. The three components of treatment include temporarily reducing afferent visceral input, shifting humoral inflammatory activity away from the brain and outside the body, and reducing oxidative stress by making oxygenated blood more available around the LC and other stressed areas in the brain. The SMT protocols that could help in reduction of visceral afferent input are GUOU, Barral and LAUG. Protocols that should shift humoral inflammatory activity away from the brain or completely out of the body include UD and DCS. One protocol that can potentially reduce oxidative stress by making oxygenated blood more available around the LC is CCCV. Future research and hypothesis-testing strategies as well as limitations are further discussed.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    未经证实:长发COVID是一种症状持续超过4周的疾病。它影响5人中的1人,与急性感染的严重程度和病理机制密切相关,但尚待了解。
    未经评估:本文介绍了目前可用或正在研究的长期COVID综合征疗法。它特别关注正在进行的审判,并审查基本机制。对PubMed和clincaltrial.gov有关长期COVID综合征治疗的临床试验进行了全面的文献检索。
    未经证实:“长COVID”综合征是一种新的紧急情况,其特征是疲劳等多种症状,呼吸困难,认知和注意力障碍,睡眠障碍,创伤后应激障碍,肌肉疼痛,和浓度问题。尽管迄今为止有许多指导方针,目前还没有确定的长期COVID治疗方法。药理学研究正在研究作用于减少或调节全身性炎症的已知药物,或类似病理中使用的创新药物。康复现在似乎是最安全的治疗方法,而我们将不得不等待正在进行的药理学研究试验,以及基于对致病机制的更好理解计划新的试验。
    UNASSIGNED: Long-COVID is a condition characterized by the permanence of symptoms beyond 4 weeks after an initial infection. It affects 1 out of 5 people and is loosely related to the severity of acute infection and pathological mechanisms, which are yet to be understood.
    UNASSIGNED: This article looks at currently available and under-studied therapies for long-COVID syndrome. It particularly gives focus to ongoing trials and reviews the underlying mechanisms. A comprehensive literature search was performed on PubMed and clincaltrial.gov of clinical trials concerning the management of long-COVID syndrome.
    UNASSIGNED: \'Long-COVID\' syndrome is a new emergency characterized by several symptoms such as fatigue, dyspnea, cognitive and attention disorders, sleep disorders, post-traumatic stress disorder, muscle pain, and concentration problems. Despite the many guidelines available to date, there are no established treatments of long-COVID. Pharmacological research is studying known drugs that act on the reduction or modulation of systemic inflammation, or innovative drugs used in similar pathologies. Rehabilitation now seems to be the safest treatment to offer, whereas we will have to wait for the pharmacological research trials in progress as well as plan new trials based on a better understanding of the pathogenic mechanisms.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    Long COVID is a clinical syndrome characterized by profound fatigue, neurocognitive difficulties, muscle pain, weakness, and depression, lasting beyond the 3-12 weeks following infection with SARS-CoV-2. Among the symptoms, neurocognitive and psychiatric sequelae, including attention and memory alterations, as well as anxiety and depression symptoms, have become major targets of current healthcare providers given the significant public health impact. In this context, assessment tools play a crucial role in the early screening of cognitive alterations due to Long COVID. Among others, the general cognitive assessment tools, such as the Montreal Cognitive assessment, and more specific ones, including the State Trait Inventory of Cognitive Fatigue and the Digit Span, may be of help in investigating the main neurocognitive alterations. Moreover, appropriate neurorehabilitative programs using specific methods and techniques (conventional and/or advanced) through a multidisciplinary team are required to treat COVID-19-related cognitive and behavioral abnormalities. In this narrative review, we sought to describe the main neurocognitive and psychiatric symptoms as well as to provide some clinical advice for the assessment and treatment of Long COVID.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们进行了文献综述,以揭示性别对2019年冠状病毒病(COVID-19)后遗症和长COVID综合征的不同影响。
    两位作者在Embase中独立搜索了OvidSP,Medline,生物性,还有Derwent的药物档案.报告原件的出版物,综述中纳入了COVID-19后遗症(2020年8月前发布)和长COVID综合征(2021年6月前发布)的按性别分类数据.COVID-19后遗症(即症状发作后持续<4周)与性别之间的关系,在长COVID综合征(即症状发作后持续>4周)和性别之间,通过比值比(OR)和95%置信区间(CI)确定(统计显著性由95%CI不包括1定义)。
    在确定的4346种出版物中,23和12符合COVID-19后遗症和长COVID综合征的资格标准,分别。精神病/情绪类别中的COVID-19后遗症(OR=1.80;95%CI:1.35-2.41),ENT(OR=1.42;95%CI:1.39-1.46),肌肉骨骼(OR=1.15;95%CI:1.14-1.16),和呼吸(OR=1.09;95%CI:1.08-1.11)在女性中的可能性明显更高(与male),而男性肾后遗症(OR=0.83;95%CI:0.75-0.93)的可能性显著增加。女性患长期COVID综合征的可能性明显更大(OR=1.22;95%CI:1.13-1.32),与ENT的几率(OR=2.28;95%CI:1.94-2.67),GI(OR=1.60;95%CI:1.04-2.44),精神病/情绪(OR=1.58;95%CI:1.37-1.82),神经系统(OR=1.30;95%CI:1.03-1.63),皮肤病学(OR=1.29;95%CI:1.05-1.58),和其他疾病(OR=1.36;95%CI:1.25-1.49)在女性中显著更高,而内分泌疾病(OR=0.75;95%CI:0.69-0.81)和肾脏疾病(OR=0.74;95%CI:0.64-0.86)在男性中显著更高.
    观察到COVID-19后遗症和长COVID综合征的性别分类差异。很少有COVID-19研究报告按性别分列的数据,强调需要进一步进行基于性别的COVID-19疾病研究/报告。
    We conducted literature reviews to uncover differential effects of sex on sequelae from coronavirus disease 2019 (COVID-19) and on long COVID syndrome.
    Two authors independently searched OvidSP in Embase, Medline, Biosis, and Derwent Drug File. Publications reporting original, sex-disaggregated data for sequelae of COVID-19 (published before August 2020) and long COVID syndrome (published before June 2021) were included in the reviews. The association between COVID-19 sequelae (i.e. lasting <4 weeks after symptom onset) and sex, and between long COVID syndrome (i.e. lasting >4 weeks after symptom onset) and sex, was determined by odds ratio (OR) and 95% confidence interval (CI) (statistical significance defined by 95% CI not including 1).
    Of 4346 publications identified, 23 and 12 met eligibility criteria for COVID-19 sequelae and long COVID syndrome, respectively. COVID-19 sequelae in the categories of psychiatric/mood (OR = 1.80; 95% CI: 1.35-2.41), ENT (OR = 1.42; 95% CI: 1.39-1.46), musculoskeletal (OR = 1.15; 95% CI: 1.14-1.16), and respiratory (OR = 1.09; 95% CI: 1.08-1.11) were significantly more likely among females (vs. males), whereas renal sequelae (OR = 0.83; 95% CI: 0.75-0.93) were significantly more likely among males. The likelihood of having long COVID syndrome was significantly greater among females (OR = 1.22; 95% CI: 1.13-1.32), with the odds of ENT (OR = 2.28; 95% CI: 1.94-2.67), GI (OR = 1.60; 95% CI: 1.04-2.44), psychiatric/mood (OR = 1.58; 95% CI: 1.37-1.82), neurological (OR = 1.30; 95% CI: 1.03-1.63), dermatological (OR = 1.29; 95% CI: 1.05-1.58), and other (OR = 1.36; 95% CI: 1.25-1.49) disorders significantly higher among females and the odds of endocrine (OR = 0.75; 95% CI: 0.69-0.81) and renal disorders (OR = 0.74; 95% CI: 0.64-0.86) significantly higher among males.
    Sex-disaggregated differences for COVID-19 sequelae and long COVID syndrome were observed. Few COVID-19 studies report sex-disaggregated data, underscoring the need for further sex-based research/reporting of COVID-19 disease.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号