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Found 386 results
  1. Content Article
    This multihospital prospective study in Surgery aimed to determine whether strict adherence to an enhanced recovery after surgery protocol leads to improvement in outcomes, compared with less strict compliance. The study looked at all consecutive anatomic lung resection patients on the thoracic enhanced recovery after surgery pathway from May 2021 to March 2023 and compared this cohort with a historical control from January 2019 to April 2021. The authors found that enhanced recovery after surgery protocols improve outcomes after anatomic lung resection, and that increasing compliance to individual elements further improves patient outcomes. They argue that continued efforts should be directed at increasing compliance to individual protocol elements.
  2. Content Article
    We are seeing more and more people who have been devastated by the long-lasting impact of Covid-19. Long Covid is a relatively new condition which is still being studied and the need for more awareness and advocacy has never been greater. Scientists are carrying out large-scale clinical trials and researchers are on the hunt for new therapies in the hope that patients with Long Covid will finally see improvements in treatment and support for their symptoms.  In this Top picks blog, shared on International Long Covid Awareness Day, we highlight 12 recent research papers on Long Covid. 
  3. Content Article
    More than 3 years after the onset of the Covid-19 global pandemic, a wave of evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to postacute sequelae in pulmonary and broad array of extrapulmonary organ systems—including increased risks and burdens of cardiovascular disorders, neurologic and mental health disorders, metabolic disorders (diabetes and dyslipidemia), kidney disorders and gastrointestinal disorders. However, up until now, evidence is mostly limited to the first year postinfection. Bowe et al. built a cohort of 138,818 individuals with SARS-CoV-2 infection and 5,985,227 noninfected control group from the US Department of Veterans Affairs and followed them for 2 years to estimate the risks of death and 80 prespecified postacute sequelae of Covid-19 (PASC) according to care setting during the acute phase of infection. They found that the increased risk of death was not significant beyond 6 months after infection among nonhospitalised but remained significantly elevated through the 2 years in hospitalised individuals. Within the 80 prespecified sequelae, 69% and 35% of them became not significant at 2 years after infection among nonhospitalised and hospitalised individuals, respectively. In summary, while risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection.
  4. Content Article
    This study compared the blood of patients with confirmed Covid-19 infection with that of uninfected controls. The authors found that there were changes to serum proteins in the blood of patients experiencing Long Covid. This indicates activation of the immune system’s complement cascade, altered coagulation and tissue injury. At the cellular level, Long Covid was linked to aggregates comprising monocytes and platelets. These findings provide knowledge of potential biomarkers for diagnosis and may inform directions for treatments.
  5. News Article
    Nearly 70 healthcare workers with Long Covid will take their fight to the High Court later to sue the NHS and other employers for compensation. The staff, from England and Wales, believe they first caught Covid at work during the pandemic and say they were not properly protected from the virus. Many of them say they are left with life-changing disabilities and are likely to lose income as a result. The Department of Health said "there are lessons to be learnt" from Covid. The group believe they were not provided with adequate personal protective equipment (PPE) at work, which includes eye protection, gloves, gowns and aprons. In particular, they say they should have had access to high-grade masks, which help block droplets in the air from patient's coughs and sneezes which can contain the Covid virus. But the masks they were given tended to be in line with national guidance. Rachel Hext, who is 36, has always insisted that she caught Covid in her job as a nurse in a small community hospital in Devon. "It's devastating. I live an existence rather than a life. It prevents me doing so much of what I want to do. And it's been four years." Her list of long Covid symptoms includes everything from brain fog and extreme fatigue to nerve damage, and deafness in one ear. Solicitor Kevin Digby, who represents more than 60 members of the group, describes their case as "very important". He says: "It's quite harrowing. These people really have been abandoned, and they are really struggling to fight to get anything. "Now, they can take it to court and hope that they can get some compensation for the injuries that they've suffered." Read full story Source: BBC News, 6 March 2024 Related reading on the hub: Healthcare workers with Long Covid: Group litigation – a blog from David Osborn The pandemic – questions around Government governance: a blog from David Osborn
  6. Content Article
    The South East London Long Covid programme has released 10 short animated films to help people with their recovery.  The films offer guidance, tools, and tips on how to help manage symptoms and reduce the risk of ongoing issues.
  7. Content Article
    This cohort study in the Lancet aimed to evaluate the overall effect of vaccination to prevent Long Covid symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2). The results showed that vaccination against Covid-19 consistently reduced the risk of Long Covid symptoms, which highlights the importance of vaccination to prevent persistent Covid-19 symptoms, particularly in adults.
  8. News Article
    People experiencing Long Covid have measurable memory and cognitive deficits equivalent to a difference of about six IQ points, a study suggests. The study, which assessed more than 140,000 people in summer 2022, revealed that Covid-19 may have an impact on cognitive and memory abilities that lasts a year or more after infection. People with unresolved symptoms that had persisted for more than 12 weeks had more significant deficits in performance on tasks involving memory, reasoning and executive function. Scientist said this showed that “brain fog” had a quantifiable impact. Prof Adam Hampshire, a cognitive neuroscientist at Imperial College London and first author of the study, said: “It’s not been at all clear what brain fog actually is. As a symptom it’s been reported on quite extensively, but what our study shows is that brain fog can correlate with objectively measurable deficits. That is quite an important finding.” Read full story Source: The Guardian, 29 February 2024
  9. Content Article
    Poor memory and difficulty thinking or concentrating (commonly referred to as “brain fog”) have been implicated in syndromes occurring after Covid-19 — a situation that has led to suggestions that Covid-19 may have lasting cognitive consequences. However, objective data on cognitive performance are largely lacking, and how long such deficits may persist and which cognitive functions are most vulnerable are unclear. In this observational study, Hampshire et al. invited 800,000 adults in a study in England to complete an online assessment of cognitive function. The authors estimated a global cognitive score across eight tasks. They hypothesised that participants with persistent symptoms (lasting ≥12 weeks) after infection onset would have objectively measurable global cognitive deficits and that impairments in executive functioning and memory would be observed in such participants, especially in those who reported recent poor memory or difficulty thinking or concentrating (“brain fog”). They found that participants with resolved persistent symptoms after Covid-19 had objectively measured cognitive function similar to that in participants with shorter-duration symptoms, although short-duration Covid-19 was still associated with small cognitive deficits after recovery. Longer-term persistence of cognitive deficits and any clinical implications remain uncertain.
  10. Content Article
    Patient engagement technologies (PETs) are tools used to guide patients through the perioperative period. This study in the American Journal of Surgery aimed to investigate the levels of patient engagement with PETs through the perioperative period and its impact on clinical outcomes. The authors found that use of PETs improves patient outcomes and experiences in the perioperative period. Patients who engage more frequently with PETs have shorter length of stay (LOS) with lower readmission and post-operative complication rates.
  11. Content Article
    Studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. This study in the American Journal of Surgery aimed to identify determinants of post-intensive care physical and mental health outcomes 6–12 months after injury. The authors found that: Delirium during an intensive care unit (ICU) stay is linked with long-term physical impairment in injury survivors who spent three or more days in the ICU. The use of ventilators in the ICU is another factor associated with long-term physical impairment and mental health symptoms in these patients. Delirium and ventilator use are potentially modifiable, suggesting opportunities for improving patient outcomes. They suggest that that this knowledge can inform the development of interventions that specifically target delirium and ventilator use to mitigate long-term impairments.
  12. Content Article
    This Lancet article highlights new evidence from analysis of population-based electronic health records for almost the entire population of the UK. The analysis showed that, as of 1 June 2022, a high proportion of the population had received fewer than the recommended number of Covid-19 vaccinations: 45·8% in England, 49·8% in Northern Ireland, 34·2% in Scotland and 32·8% in Wales. Combining the results across countries suggests that a substantial number of severe Covid-19 outcomes, including hospital admissions or deaths from Covid-19, might be prevented if recommended vaccination schedules were fully implemented. These findings reinforce the message that the role of vaccination in Covid-19 is to mitigate the severity of the illness, reducing the risk of complications and mortality, rather than avoiding all Covid-19 infections.
  13. Content Article
    In the fast-evolving realm of contemporary healthcare, surgical techniques have attained unprecedented levels of advancement, leading to substantial enhancements in patient care. However, the journey towards complete recovery extends far beyond the operating room, emphasising the importance of effective postoperative care. In this critical phase, patient partnerships play a pivotal role, ensuring a holistic and personalised approach to recovery.
  14. Content Article
    With a number of large-scale clinical trials underway and researchers on the hunt for new therapies, Long Covid scientists are hopeful that this is the year patients will finally see improvements in treating their symptoms. This article in Medscape makes five research-based predictions that could happen in 2024. They provide promising signs of progress in treating a debilitating and frustrating disease. The predictions are: We'll gain a better understanding of each Long Covid phenotype Monoclonal antibodies may change the game Paxlovid could prove effective for Long Covid Anti-inflammatories like metformin could prove useful Serotonin levels may be keys to unlocking Long Covid
  15. Content Article
    In this episode of the Medicine and the Machine podcast, Scottish GP Gavin Francis talks about the need to reconsider the importance of convalescence. He discusses the role of GPs in supporting patients through recovery after a hospital admission or period of illness and talks about a lack of awareness of the principles of convalescence amongst patients.
  16. Content Article
    Delayed discharges from hospital are a widespread and longstanding problem that can have a significant impact on both patients’ recovery and the efficiency and effectiveness of health and care services. In England, it has become normal practice for government to provide additional one-off funding to reduce delays every winter, as the problem is particularly acute during the colder months.
  17. Content Article
    The pandemic is not gone but it is largely forgotten. Especially the first year, with its two devastating waves in which over 140,000 people died. The NHS reorganised itself completely to deliver care to the thousands of very sick Covid patients, alongside continuing care for other patients throughout. The system strained and buckled and staff were pushed to their limits and beyond. The impact continues today as the NHS is weaker, less resilient and with much longer waits than before. In this article, Christina Pagel looks back at the reality of the first year and its aftermath and hears anonymous testimony from staff at the NHS front line. “Staff sitting in literal cupboards crying alone because staff weren’t allowed to sit together & we couldn’t take all the death around us. It was utterly traumatising”
  18. News Article
    Nearly four years since the start of the coronavirus outbreak, you could be forgiven for believing the pandemic is behind us. But for many, it feels far from over. Close to two million people face a daily battle with debilitating symptoms of Long Covid – the lasting symptoms of the virus that remain after the infection is gone – with some now housebound, unable to walk and even partially blind. Alan Chambers, 49, is among those who have been grappling with the illness for years, having caught coronavirus in March 2020. Mr Chambers went from being “a fit, healthy, working member of the community who would do anything to help anyone” to being “ill and isolated in our bedroom”, blind in one eye and no longer able to walk unaided, his wife Vicki said. As of March, an estimated 1.9 million people in the UK have experienced coronavirus symptoms for more than four weeks, according to the latest figures from the Office for National Statistics. Of those, 1.5 million reported the condition had adversely affected their day-to-day activities. It comes as coronavirus case rates have shown an overall increase since July, with fears the approaching winter will bring a further surge in infections. Yet in May, the World Health Organisation (WHO) declared that coronavirus no longer represents a global health emergency, which was seen as a symbolic step towards the end of the pandemic. Dr Jo House, founding member and health advocacy lead at Long Covid Support, said the advocacy group now has 62,000 members, with about 250 more people joining every month. “In their words, they feel ‘forgotten, unheard, disbelieved, isolated, unemployed, disabled, immobile’. NHS England admitted to The Independent that access to necessary support, treatment and care for Long Covid patients is still lacking. It said there was “still more to do to ensure support is there for everyone who needs it”, so that patients requiring specialist assessment and treatment for Long Covid can access care in a timely way. Read full story Source: The Independent, 29 November 2023
  19. News Article
    Damage to the body’s organs including the lungs and kidneys is common in people who were admitted to hospital with Covid, with one in eight found to have heart inflammation, researchers have revealed. As the pandemic evolved, it became clear that some people who had Covid were being left with ongoing symptoms – a condition that has been called Long Covid. Previous studies have revealed that fewer than a third of patients who have ongoing Covid symptoms after being hospitalised with the disease feel fully recovered a year later, while some experts have warned Long Covid could result in a generation affected by disability. Now researchers tracking the progress of patients who were treated in hospital for Covid say they have found evidence the disease can take a toll on a range of organs. What’s more, they say the severity of ongoing symptoms appears to be linked to the severity of the Covid infection itself. “Even fit, healthy individuals can suffer severe Covid-19 illness and to avoid this, members of the public should take up the offer of vaccination,” said Prof Colin Berry, of the University of Glasgow, which led the CISCO-19 (Cardiac imaging in Sars coronavirus disease-19) study. “Our study provides objective evidence of abnormalities at one to two months post-Covid and these findings tie in with persisting symptoms at that time and the likelihood of ongoing health needs one year later,” Berry added. Read full story Source: The Guardian, 23 May 2022
  20. News Article
    Health officials are calling for urgent intervention from the government to meet the steep surge in demand for occupational therapy in the wake of the Covid-19 pandemic. According to healthcare professionals from both the NHS and the private care system, demand for occupational-therapy-led rehabilitation services in Britain has increased by a staggering 82 per cent over the past six months alone. Swelling pressure on already “overloaded” rehabilitation services has stirred up stark warnings from members of the Royal College of Occupational Therapists (RCOT), who say the level of demand for the service they provide “isn’t sustainable” as there isn’t a large enough workforce to meet the need. A revealing survey carried out by the college has raised grave questions about the prospect of providing timely rehabilitation for people recovering from short and long-term illnesses who need urgent support to enable them to carry out their daily activities. The survey of of 550 occupational therapists working in the UK found that 84 per cent are now supporting people whose needs have become more complex because of delays in treatment brought about by the pandemic. As a result of this, coupled with a wider increase in the number of people requiring help, 71 per cent of the RCOT’s respondents felt there were not enough occupational therapists to meet the demand. Read full story (paywalled) Source: The Independent, 22 May 2022
  21. News Article
    Around 60,000 NHS staff members have post-traumatic stress after working through the Covid-19 pandemic, new research suggests. Nine out of 10 health workers say it will take them years to recover from the ordeal and one in four had lost a colleague to coronavirus, according to NHS Charities Together The charity, NHS staff and mental health experts are now calling for more support from the health service and UK government to support those struggling in the aftermath of the pandemic. “I think it’s quite clear there hasn’t been enough support to help NHS workers recover from their experiences during the pandemic. As a result, a lot of people are feeling incredibly jaded,” said Dr Ed Patrick, an NHS anaesthetist who worked in a Covid-19 intensive care unit from the beginning of the pandemic. On his experiences of working on the front lines of the health service, Dr Patrick said: “Like everyone else in the world, we lost our outlets for release. Everything was shut down and for NHS workers, our lives just became the hospital." He described the long and gruelling hours and the emotional burden of working at the height of the pandemic: “We all had an overwhelming feeling of powerlessness. There was also a deep sadness because everything you would normally do to help patients just wasn’t working. Read full story Source: The Independent, 17 May 2022
  22. News Article
    The NHS will miss its target to return cancer treatment waits to pre-covid levels by next March, a national cancer leader has said. When asked at the HSJ Cancer Forum whether the service would be back to “business as usual” performance by next spring, Liz Bishop, who sits on NHS England’s national cancer board, said: “I think it depends on what you mean by ‘business as usual’. “If you mean hitting the 62-day numbers, and the 104-day numbers, by next March, then no. If I am honest, I don’t think we will. “Do I know when that date will be? No, I don’t know. But what I do know is that everyone is working really hard to do it and get there.” NHSE initially said the number of patients waiting longer than 62 days for treatment following an urgent referral would return to pre-pandemic levels by March this year, but has since pushed this back to March 2023. Read full story (paywalled) Source: HSJ, 18 March 2022
  23. News Article
    More than half of people hospitalised with Covid-19 still have at least one symptom two years after they were first infected, according to the longest follow-up study of its kind. While physical and mental health generally improve over time, the analysis suggests that coronavirus patients discharged from hospital still tend to experience poorer health and quality of life than the general population. The research was published in the Lancet Respiratory Medicine. “Our findings indicate that for a certain proportion of hospitalised Covid-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully,” said the lead author, Prof Bin Cao, of the China-Japan Friendship hospital in China. Until now, the long-term health effects of Covid-19 have remained largely unknown, as the longest follow-up studies to date have spanned about a year. The absence of pre-Covid-19 health status data and comparisons with the general population in most studies also made it difficult to determine how well patients with Covid-19 have recovered. “Ongoing follow-up of Covid-19 survivors, particularly those with symptoms of long Covid, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programmes for recovery,” said Cao. “There is a clear need to provide continued support to a significant proportion of people who’ve had Covid-19, and to understand how vaccines, emerging treatments and variants affect long-term health outcomes.” Read full story Source: The Guardian, 11 May 2022
  24. News Article
    People suffering from long Covid have reacted with alarm to comments by government’s equalities watchdog that the condition should not be treated as a disability. Under the Equalities Act, anyone with a physical or mental impairment that has lasted for longer than 12 months and substantially impacted their ability to carry out normal day-to-day activities qualifies as disabled and is entitled to protection to ensure that they aren’t discriminated against in the workplace. This includes requesting that their employer makes “reasonable adjustments”, such as flexible working hours or home working, to ensure that they can continue working. In a tweet posted on Sunday night, the Equalities and Human Rights Commission (EHRC), which was set up to promote and enforce equality and non-discrimination laws said: “Discussions continue on whether ‘long Covid’ symptoms constitute a disability. Without case law or scientific consensus, EHRC does not recommend that ‘long Covid’ be treated as a disability.” The statement prompted immediate concern and confusion from long Covid support groups and unions. Dr Jenny Ceolta-Smith, an employment advocate for Long Covid Support and co-founder of Occupational Therapy for Long Covid, said: “There is already disbelief of workers’ long Covid symptoms within the workplace, and this harmful announcement by the EHRC may make it much harder for workers to gain the support that they need from colleagues and line managers. It may even mean more jobs are lost.” Read full story Source: The Guardian, 9 May 2022
  25. News Article
    Remdesivir has no significant effect on patients with Covid-19 who are already being ventilated but has a small effect against death or progression to ventilation among other patients admitted to hospital, the World Health Organization’s Solidarity trial has found. This appears to be a change from findings reported in February 2021, when preliminary trial data suggested that remdesivir “had little or no effect on patients admitted to hospital with Covid-19.” The updated results, published in the Lancet, reported that overall 14.5% of patients assigned to remdesivir died compared with 15.6% assigned to the control group. The release of these results has prompted questions about why it has taken so long to publish these data, especially considering WHO’s recommendation against the use of remdesivir in patients with Covid-19. Read full story Source: BMJ, 4 May 2022
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