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Table 1 Studies of Physical health, Neurological disorders, and Nutritional status during the COVID-19 pandemic

From: Strategies to evaluate outcomes in long-COVID-19 and post-COVID survivors

References

Design

Country

Sample size (N)

Male (%)

Mean age (years)

Categories (health care workers, patient, hospitalized/ICU, general public)

Physical health

Neurological disorders

Nutritional status

COVID-19 status

Main findings

N (%)

N (%)

N (%)

N (%)

[90]

Cross-sectional study

UK

431.051

55.8

57.2

Hospitalized

n.a

psychological distress, neuroticism

n.a

908 hospitalized for COVID-19

Association of lower cognitive function based on a test of verbal and numerical reasoning with a higher risk of COVID-19

[91]

Observational study

Italy

50

n.a

 

Hospitalized

DEPENDENCE for motor or respiratory functions

n.a

(90%) dysphagia and need of a modified diet’s consistency or nasogastric feeding (45%) high risk and (26%) moderate risk of malnutrition BMI improvement 14 (43.7%)

50 (100%) positive to COVID-19

three-step nutritional protocol to ensure optimal nutritional status and improve clinical outcomes in COVID19 patients in a rehabilitation unit

[92]

Web-based cross-sectional survey

Italy

2291

25.3

30.0

General public

n.a

poor sleep quality (57.1%), high anxiety (32.1%), high distress (41.8%), PTSD symptomatology (7.6%)

n.a

Positive to COVID-19 9 (0.4%)

Correlation between epidemic with anxiety, sleep disorders and PTSD

[93]

Multicenter study

India

906

35.7

29

Healthcare workers

Headache 289 (31.9%), Throat pain 304 (33.6%), no symptoms 302 (33.3%)

moderate to very-severe depression 48 (5.3%), moderate to extremely severe anxiety 79 (8.7%), moderate to extremely severe stress 20 (2.2%), and moderate to severe levels of psychological distress 34 (3.8%), Lethargy 241(26.6%), Insomnia 190(21.0%)

n.a

n.a

significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak

[94]

Web-based cross-sectional survey

Italy

2291

25.3

30.0

General public

n.a

Higher risk of psychopathological symptoms in females (OR 2,32) younger than 50 years (OR > 1,68). Higher risk of developing anxiety was higher in females (OR = 3,10 younger than 50 (OR > 1,47) and undergraduates (OR = 1,68)

Higher risk of PTSD symptomatology associated with female (OR 2,39)

n.a

9 (0.4%) positive to COVID-19

COVID-19 pandemic can be related to anxiety, changes in mood, high psychopathological symptomatology, and could be associated with the development of PTSD

[95]

Web-based cross-sectional survey

China

7236

45.4

35.3

Healthcare workers, General public

n.a

Generalized anxiety disorder, depressive symptoms and was significantly higher in general public,

Healthcare workers reported highest rate of poor sleep quality. Generalized anxiety disorder 2540 (35.1%), depressive symptoms 1454 (20.1%), poor sleep quality 1317 (18.2%)

n.a

n.a

Major mental health burden during COVID outbreak

[96]

Online survey

Canada

1908

19.6

42

n.a

40.5% of inactive and 22,4% of active individual became less active

33% of inactive and 40.3% of active became more active

28.3% of inactive altered their type of activity, 39.6% of active maintained their type

Inactive scored significantly lower on the mental health assessment than the active participants, however there is no significant difference in generalized anxiety.; inactive participants that were more active indicated higher levels of social, emotional and psychological health, and lower levels of anxiety; inactive with mild anxiety were more physically active than participants with moderate anxiety; inactive participants with severe anxiety spent fewer minutes in outdoor physical activity than individuals with low or mild anxiety

n.a

n.a

Strong association between physical activity and well-being;

[3]

Observational study

Italy

143

62.9

56.5

Hospitalized

Post covid-19: 53.1% of individuals showed fatigue, 43.4% dyspnoea, 27.3% joint pain, 21.7% chest pain, Fatigue 53%

n.a

n.a

143 (100%) patient’s post-recovery from COV19

This study found that in patients who had recovered from COVID-19, 87.4% reported persistence of at least 1 symptom, particularly fatigue and dyspnea

[97]

Web-based cross-sectional survey

China

994

14.5

Aged 25– 40 years (63.4%)

Healthcare workers

n.a

(36.9%) subthreshold mental health disturbances, (34.4%) mild disturbances, (22.4%) moderate disturbances, and (6.2%) had severe disturbance

n.a

None

These findings emphasize the importance of being prepared to support frontline workers through mental health interventions at times of widespread crisis

[98]

Web-based cross-sectional survey

China

9684

23.3

813 (64.7%) were aged 26–40 y

Healthcare workers

67 (60.9%) had fever, 66 (60.0%) myalgia or fatigue, 62 (56.4%) cough, 55 (50%) sore throat, 50 (45.5%) muscle ache

634 (50.4%) depression,560 (44.6%) anxiety, 427(34%) insomnia, 899 (71.5%) distress

n.a

110 (1%) positive to COVID-19

These findings suggest that front-line healthcare workers exposed to COVID-19 have a high risk of developing unfavorable mental health outcomes and may need psychological support

[99]

Observational study

India

470

31.7

31

Healthcare workers, General public

n.a

60 (14.5%) participants showed anxiety, 42 (8.9%) depression, 31 (6.6%) stress, 36 (7.7%) post-traumatic stress disorder

Anxiety was higher among nonmedical health care workers than medical personnel (20.7% versus 10.8%; adjusted prevalence ratio, 1.85 [95% CI, 1.15–2.99]; P = 0.011)

Higher mean DASS-21 anxiety and stress subscale scores and higher IES-R total and subscale scores were observed in nonmedical health care workers

n.a

None

Nonmedical health care personnel are at highest risk for psychological distress during the COVID-19 outbreak. Early psychological interventions targeting this vulnerable group may be beneficial

[100]

Online survey

UK

153

48

71

General public

n.a

39 (31%) presented altered mental status, comprising 9 (23%) patients with unspecified encephalopathy and 7 (18%) encephalitis. 23 (59%) with altered mental status fulfilled the clinical case definitions for psychiatric diagnoses as classified by the notifying psychiatrist or neuropsychiatrist, and 21 (92%) of these were new diagnoses

6 (26%) had a neurocognitive (dementia-like) syndrome, and four (17%) had an affective disorder

n.a

114 (92%) confirmed

5 (4%) probable

5 (4%) possible

This study identified acute presentations of new-onset complications of COVID-19. Ischemic stroke was common in our cohort

[101]

Observational study

China

1738

Survey 1: 32.7; Survey 2: 25

Survey 1: 21,4–30,8y (53,1%); Survey 2: 21,4–30,8y (46,5%)

General public

n.a,

Measured by DASS-21

Mean score (SD), survey 1: 7,76 (7,74) stress, 6,16 (6,57) anxiety, 6,25 (7,16) depression; survey 2: 7,86 (7,93) stress, 6,15 (6,94) anxiety, 6,38 (7,39) depression. NS comparison between surveys

n.a

n.a

Protective factors included high level of confidence in doctors, perceived survival likelihood and low risk of contracting COVID-19, satisfaction with health information, personal precautionary measures. Governments should focus on effective methods of disseminating unbiased COVID-19 knowledge, correct containment methods, availability of essential services/commodities, and sufficient financial support

[102]

Web-based cross-sectional survey

China

2182

35.8

18-60y, n = 2,101 (96,3%)

Healthcare workers, General public

n.a

Medical health workers showed higher prevalence rates of insomnia (38.4 vs. 30.5%, p < 0.01), anxiety (13.0 vs. 8.5%, p < 0.01), depression (12.2 vs. 9.5%; p = 0.04), somatization (1.6 vs. 0.4%; p < 0.01), and obsessive–compulsive symptoms (5.3 vs. 2.2%; p < 0.01) than nonmedical health workers

n.a

n.a

During the COVID-19 outbreak, medical health workers had psychosocial problems and risk factors for developing them. They needed attention and recovery programs

[46]

Observation study

China

214

40.7

52.7

Hospitalized

Compared with patients with non-severe infection, patients with more severe infection had skeletal muscle injury 17 (19.3%) vs 6 (4.8%)

78 patients (36.4%) had neurologic manifestations:

Compared to patients with non-severe infection, patients with more severe infection had neurologic manifestations, such as acute cerebrovascular diseases 5 (5.7%)

vs 1 (0.8%), impaired consciousness 13 (14.8%) vs 3 (2.4%)

n.a

214 (100%) positive to COVID-19

During the pandemic, patients with neurologic manifestations should have SARS-CoV2 infection suspected, to avoid delayed diagnosis or misdiagnosis and to lose the ability to treat and prevent transmission

[56]

Observational study

China

201

63.7

51

Hospitalized

188 (93.5%) had Fever, 163 (81.1%) cough, 80 (39.8%) dyspnea, and 65 (32.3%) had fatigue or myalgia

66 (32.8%) had fever with fatigue, myalgia, or headache;

7 (3.5%) had nervous system disease

n.a

201 (100%) positive to COVID-19

Older age was associated with a high risk of developing ARDS and death: this may have been due to a weaker immune response from this category

[57]

Editorial

Europe

n.a

n.a

n.a

n.a

n.a

n.a

COVID-19 patient may have altered nutritional status characterized by malnutrition and body weight loss

n.a

The nutritional approach in SARS-CoV-2 patients in the ICU, internal medicine ward and general health care should not be underestimated, and dietary intervention should be an important part of the care provided to these patients..

[54]

Observational study

Denmark

498,151

32,775 (6.5%)

43

Hospitalized and non- hospitalized

Increased risk of receiving hospital diagnoses of dyspnoea and venous thromboembolism for SARS-CoV-2-positive individuals compared with negative individuals

No increased risk of serious complications of SARS-CoV-2 infection, ischaemic stroke, encephalitis, psychoses

n.a

1310 positive to COVID-19

For those with SARS-CoV-2 who do not require hospitalization, the risk of having serious complications such as venous thromboembolism, ischaemic stroke, and psychoses is low