Evaluation of Clinical Characteristics and Plasma Cortisol Concentrations in Individuals with COVID-19 and Post-COVID Syndrome

COVID-19 generates systematic alterations in humans both in active stages of infection and over time, called post-COVID syndrome. Cortisol is a hormone that is overexpressed in inflammation and cellular stress processes. Its main function is to return to physiological homeostasis, so its evaluation together with other clinical parameters can allow us to determine the degree of systemic affectation by COVID-19. Objective: To evaluate changes in clinical parameters and plasma cortisol concentrations in patients with active COVID-19 and post-COVID syndrome. Material and Methods: Healthy patients, in stages of mild infection, critical and with post-COVID syndrome, were recruited, obtaining, through clinical diagnoses and interviews, their main clinical characteristics, in addition to plasma, in which cortisol concentrations were determined using competitive ELISA. Results: The critical stage group had higher frequencies of comorbidities, clinical symptoms, as well as more altered laboratory parameters compared to the other subgroups. In the post-COVID syndrome group after the initial infection, most laboratory parameters recovered, however, several clinical symptoms remained latent over time. The determination of cortisol showed an increase in its concentration, being higher in patients in critical stage and with post-COVID syndrome. Conclusion: COVID-19 disease generates clinical alterations that trigger an increase in plasma cortisol. These alterations increase as the stages of infection become more severe and some of them remain altered in patients with post-COVID syndrome.

Effectiveness of simulation-based learning regarding management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students:A quasi-experimental study

Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.

Associations between Continuing Symptoms and Quality of Life in Post-COVID-19 Patients (2023)

COVID-19 is a multisystem disease that can cause various symptoms which last even after the acute stage and negatively impact the quality of life of patients. It is of utmost importance to comprehensively evaluate how COVID-19 affects not only patients’ physical and mental health, but also their family and social life. This knowledge plays a significant role in the creation of effective ways to assist those suffering from long COVID to address health-related quality of life issues in a timely manner.

Examining the Effectiveness of Virtual Training under the Kirkpatrick Model:A Post-COVID Study

Teaching and training through online tools were used by most Higher Education Institute(HEIs)worldwide during COVID-19 to cater to the needs of students who stay far away from educational institutions.After the pandemic,the virtual model of education and training became a trend.The students and teachers are also more used to this trend which is giving more opportunities to both learners and instructors.One of the notable benefits of virtual teaching and learning platform is that it provides a flexible environment to gain knowledge,skills,and attitude simultaneously along with formal off-line education.From the earlier studies it is found that the majority of studies have focused on traditional,offline training methods and only a few studies have focused on virtual training.Therefore,the present study examined the effectiveness of virtual training using the Kirkpatrick model.For this purpose,a research instrument based on the Kirkpatrick model was constructed and distributed among the UG and PG students in Mangalore City.A total of 143 responses were collected,of which 132 were completed responses and all of them were considered for analysis.Descriptive statistics and one sample t-test are employed to analyse and interpret the data.The findings revealed that virtual training is more effective compared to traditional and offline training methods.Henceforth,the training and education provided through virtual platforms made significant contributions to the employability of youngsters.

A cross-sectional study of post-COVID syndrome at a tertiary care center in Turkey

Objective:To investigate long-term symptoms after acute COVID-19,the link between symptoms and respiratory function,radiological changes in the post-COVID period,and risk factors for post-COVID syndrome.Methods:In this cross-sectional study,123 participants who were admitted within the first 3 months were categorized as group 1,and those who applied after 3 months were categorized as group 2.According to thoracic imaging and pulmonary function tests,patients were split into 3 groups as mild,moderate and severe.Results:At least one symptom was present in 91.9%and 61.8%in acute and post-COVID period,respectively.Pulmonary function tests were normal in 60(70.6%)in the first three months,and 30(78.9%)in 91-days to 1-year period after acute COVID-19 infection.After 3 months,22.4%of chest X-rays and 7.9%of computerized tomography revealed progression.Patients who developed acute complications(OR 9.91,95%CI 1.93-50.87),had 2 or more symptoms at admission(OR 7.73,95%CI 2.56-23.33),had 1%to 14%CT involvement(OR 3.05,95%CI 1.06-8.79),or had 50%or more CT involvement(OR 14.68,95%CI 1.24-172.55)had a higher risk of developing post-COVID syndrome.Conclusions:COVID-19 symptoms can last for long time.Severity of symptoms,acute complications,and the extent of radiological involvement may all contribute to elevated risk of post-COVID syndrome.As a result,patients with COVID-19 should be checked for long-term clinical difficulties on regular basis.

Recovery rates of persistent post-COVID-19 olfactory dysfunction using psychophysical assessment:A longitudinal cohort study

Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-reported olfactory function.Few studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute recovery.Data anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of smell.This study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical OD.Methods:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time points.Participants had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not available.Results:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up assessment.Among participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year follow-up.Participants had reliable trends in self-rated versus psychophysically tested olfactory function at both time points.The total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at 1-year.Improvements in threshold,but not discrimination or identification,most significantly mediate improvement of total TDI score at follow-up.

Clinical-based phenotypes in children with pediatric post-COVID-19 condition

Background Pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of children.This study aimed to identify clinically meaningful phenotypes in children with PPCC,to better characterize and treat this condition.Methods Participants were children with physician-diagnosed PPCC,referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March 2023.Demographic factors and information on post-COVID symptoms,comorbidities,and impact on daily life were collected.Clinical clusters were identified using an unsupervised and unbiased approach for mixed data types.Results Analysis of 111 patients(aged 3–18 years)revealed three distinct clusters within PPCC.Cluster 1(n=62,median age=15 years)predominantly consisted of girls(74.2%).These patients suffered relatively more from exercise intolerance,dyspnea,and smell disorders.Cluster 2(n=33,median age=13 years)contained patients with an even gender distribution(51.5%girls).They suffered from relatively more sleep problems,memory loss,gastrointestinal symptoms,and arthralgia.Cluster 3(n=16,median age=11 years)had a higher proportion of boys(75.0%),suffered relatively more from fever,had significantly fewer symptoms(median of 5 symptoms compared to 8 and 10 for clusters 1 and 2 respectively),and experienced a lower impact on daily life.Conclusions This study identified three distinct clinical PPCC phenotypes,with variations in sex,age,symptom patterns,and impact on daily life.These findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.

新冠病症统一命名的建议

新冠疫情暴发三年多来,国内外出现多种有关新冠病症的名称,如国内有新型冠状病毒肺炎、新型冠状病毒感染等,国外有世卫组织命名的2019冠状病毒病以及倡用的新冠后症状,此外还有长新冠、新冠后综合征、新冠后遗症等较为常见的名称。目前已出现一定的混乱,需要正视。通过辨析,提出取舍意见,认为目前应与世卫组织一致,统一使用2019冠状病毒病、新冠后症状。根据术语学有关要求,同时提出规范名词的建议,为进一步审定新冠病症名称提供参考。

后疫情时代城市社区居住满意度评价体系的重构

城市社区居住满意度是评价与提升社区居住环境的重要标准之一。针对后疫情时代居住满意度评价体系与社区环境之间适配性不足的问题,研究梳理了后疫情时代相关文献研究与空间规划实践,从中提取新的影响因素作为“疫情补丁”,在整合原有居住满意度评价体系的基础上,重构具有“精度”与“尺度”的后疫情时代居住满意度评价体系。研究结果表明,后疫情时代的居住满意度评价体系可以从“社区—组团—单元—家宅”四个空间层级进行重构和落实,并提出空间维度支撑、社会要素调节与整体动态更新的优化策略。本研究结果为人民满意的城市社区的空间韧性提升和规划建设提供理论支撑与实践经验。

新型冠状病毒感染后认知功能障碍的研究现状

目的对新型冠状病毒(SARS-CoV-2)与认知功能障碍的关系及新冠后遗症中认知功能障碍的发生机制进行综述。方法检索中国知网和PubMed数据库,收集2020年1月1日至2023年10月30日中医、西医关于SARSCoV-2感染后认知功能障碍的相关报道。结果SARS-CoV-2感染后可能会出现认知功能障碍,这可能与SARSCoV-2病毒具有神经侵袭性、嗜神经性、神经毒力有关,或与感染后介导的过度炎症反应、血清素水平及病毒转移等因素有关;并发现部分中药单体具有改善SARS-CoV-2感染后认知功能障碍的作用。结论SARS-CoV-2感染后可能会出现短时间或长期的认知功能障碍,其具体机制有待临床和基础研究的进一步验证,中药在改善此症状中具有较好的研究潜力。

新型冠状病毒诱发的炎症后肺纤维化治疗新进展

新型冠状病毒(SARS-CoV-2)感染属于全球重大突发公共卫生事件,对全球卫生系统造成重大威胁。SARS-CoV-2感染康复后部分患者长时间存在多种呼吸道症状,这被称为SARS-CoV-2感染急性期后遗症,SARSCoV-2感染后肺纤维化(PCPF)作为其中一种后遗症可不同程度影响患者的呼吸功能和生活质量。有关PCPF的治疗是目前研究的热点,本文就PCPF的治疗方法做一综述,旨在改善PCPF患者的预后。

基层新型冠状病毒感染后病症诊治及照护广东专家推荐意见

新型冠状病毒感染后病症(PCC)定义为在有可能或确诊严重急性呼吸综合征冠状病毒2型(SARSCoV-2)感染的3个月后,出现无法用其他诊断来解释的、至少持续2个月的症状。PCC是生物学因素、心理学因素及社会文化因素综合作用的结果,具有患病数较多、发病机制复杂、症状多样、长期照护需求大的特点。PCC的诊断被视为排除性诊断,可划分为“非重度COVID-19多器官后遗症”“肺纤维化后遗症”“肌痛性脑脊髓炎或慢性疲劳综合征”“体位性直立性心动过速综合征”“重症监护后综合征”和“医学或临床后遗症”6种亚型,在整体性评估的基础上,可在多学科协作的模式下,通过药物、膳食、运动、心理干预、患者教育等方法进行治疗和照护。

国医大师王庆国辨治新型冠状病毒感染后失眠经验探讨

新型冠状病毒感染后失眠是在核酸转阴后持续存在的一种以失眠为主要症状的疾病。王庆国教授通过大量的临床观察和总结,认为新型冠状病毒感染后失眠的核心病机为“太少不和,营卫失调”,故而从枢机、营卫入手予以柴胡桂枝汤加减,配合单药、对药或角药燮理阴阳,每获良效。文章从病、证、方、药的角度总结王教授临证经验,并附典型医案以飨同道。

基于主客交理论辨治新冠后症状

主客交理论为明代医家吴又可所创,指瘟疫后期正邪相争、胶固缠绵的病理特征。后世医家相继对其发挥,指导瘟疫、内伤杂病等治疗。疫疠毒邪致病深重,引发脏器损伤,恢复期常遗留长期症状,影响患者生活质量。新冠后症状的病机特点以正气损伤(伤气、伤阴、伤形、伤神)和余邪未尽(夹湿、夹痰、夹瘀)为主,病机与主客交相符,因正气虚损,无力托邪外出,邪与血交浑,出现多系统症状,并有形成痼疾的风险。治疗上,注重扶正,及时溃散血中伏藏之毒邪,并随其所得而攻之,兼以祛湿、化痰、利水、清热、散瘀,重视肺间质纤维化防治,临床可仿三甲散化裁治疗。梳理主客交理论源流及内涵,基于主客交理论探讨新冠后症状的病因病机与诊治思路,以期对新冠后症状的中医诊疗提供参考与借鉴。

后疫情时代联合办公发展变化分析

联合办公在前疫情时代构建了一种以互信和核心价值共享为基础的灵活办公模式,受益于科学技术的进步、共享经济的崛起和新型工作组织出现的推动,以社区化、开放性和合作性为特点,快速发展并日益成为现代办公的重要方式。然而,随着新冠疫情的爆发和全球蔓延,联合办公空间在新冠疫情期间的发展,因远程办公的快速发展和防疫政策的实施而受到了巨大的阻碍。为保证联合办公空间的经营者对后疫情时代多变的需求和变化快速做出响应,联合办公的演进需要转向不同的模式,包括空间的可配置性、满足心理预期的隐私模式、更高效的协作模式和工作环境的数字化模式。

后新冠疫情时代广州市茶艺馆经营现状调查研究

为探明后疫情时代广州市茶艺馆的经营现状,以广州市11个区人气前五的茶艺馆为对象,以“大众点评”为信息收集途径,通过线上检索资料自行填写对茶艺馆经营者的问卷,再结合线上线下双线程向茶艺馆消费者有针对性地发放问卷。结果表明,设计风格上趋同严重。装修风格中,参考“现代新中式风格”的茶艺馆占比高达94%;在茶艺馆功能类型上,大多茶艺馆重视商务交流功能,70%的茶艺馆专门配备了电子屏等硬件设施;座位设置中,每家茶艺馆都设有包间;服务项目上,有个别茶艺馆关注到独立个体对茶饮及茶空间的需求,“一人行”等单人饮茶项目始露苗头。针对后疫情时代的广州市内茶艺馆的现状从经营者与消费者两个视角有针对性地提出未来发展建议,希望能加深对后疫情时代背景条件下广州茶艺馆经营现状的认识,同时为该地区茶艺馆的未来发展提供理论指导,并为后疫情时代其他城市茶艺馆的研究与发展等提供参考。

COVID-19对高等教育的影响及我们的应对——基于国际组织相关报告的回溯性分析

文章选择联合国教科文组织及国际大学协会两大与高等教育相关的国际组织作为研究案例,以高等教育与COVID-19相关的研究报告作为分析样本,深度解读COVID-19对高等教育的教学、研究、公平和包容、国际交流、行政管理方面的影响,总结高等教育机构在危机不同时期的应对策略。最后提出后疫情时代高等教育变革的主要方向,即以可持续发展视角观照高等教育发展,以更系统的眼光统筹高等教育治理,以数字化转型推动高等教育创新发展,以高等教育国际合作维护全球共同利益。

COVID-19疫情期间大学生的创伤后成长及其预测因素研究

目的 了解新型冠状病毒肺炎(COVID-19)疫情期间大学生创伤后成长状况,探讨生命意义感、心理弹性对创伤后成长的预测效应。方法 采用生命意义感量表、心理弹性量表及创伤后成长量表,对上海市某高校822名大学生进行问卷调研。对数据进行整理和分析,探讨心理弹性、生命意义感和创伤后成长之间的相关性。结果 大学生创伤后成长总分为(60.87±20.82)分。男生与女生创伤后成长得分的差异无统计学意义(P>0.05)。低年级大学生创伤后成长得分显著高于高年级大学生(P<0.05),学业成绩较好者创伤后成长得分显著高于较差者(P<0.05)。生命意义感、心理弹性与创伤后成长,两两之间均呈显著正相关(P<0.01)。生命意义感和心理弹性能正向预测创伤后成长(调整R^(2)=0.446),且心理弹性通过生命意义感间接影响创伤后成长,中介效应占总效应的18.52%。结论 生命意义感在心理弹性与创伤后成长之间起部分中介作用。

成年人下呼吸道感染者痰液病原菌分布及多重耐药菌感染风险因素分析

目的探讨新型冠状病毒疾病(COVID-19)后疫情时期成人下呼吸道感染者痰标本中的病原菌分布、耐药性以及多重耐药菌(MDRO)感染的影响因素。方法回顾性分析2021年1月至2022年12月鹰潭184医院收治的316例成年人下呼吸道感染患者的临床资料,对其痰标本培养首次检出的107株病原菌进行菌种鉴定及药敏分析,依据药敏结果分为MDRO组(n=62)和非MDRO组(n=45),比较MDRO组和非MDRO组患者的临床资料,应用多因素Logistic回归分析探讨多重耐药菌感染的影响因素。结果107株病原菌中,检出比例位居前3的分别为肺炎克雷伯菌(29.91%)、大肠埃希菌(16.82%)、铜绿假单胞菌(14.95%),其中MDRO占比57.94%,非MDRO占比42.06%。肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和鲍曼不动杆菌对头孢唑林的耐药率分别为90.63%、57.89%、88.89%和81.25%,对头孢噻肟的耐药率分别为59.38%、52.63%、72.22%和68.75%,对氨曲南的耐药率分别为46.88%、42.11%、44.44%和87.50%。多重耐药菌组患者年龄≥60岁、住院天数≥7 d、接受有创治疗、白球比值<1、血红蛋白(Hb)水平<100 g/L以及C反应蛋白(CRP)≥30 mg/L的患者比例明显高于非多重耐药组,差异均有统计学意义(P<0.05)。患者年龄≥60岁、住院天数≥7 d是成年人下呼吸道感染MDRO的危险因素(P<0.05),而Hb水平≥100 g/L是保护性因素(P<0.05)。结论COVID-19后疫情时期,成人下呼吸道感染患者病原菌分布发生变化,对第一、二代头孢菌素普遍耐药严重,MDRO占比高。患者年龄、住院天数和Hb水平是后疫情时期成人下呼吸道MDRO感染的独立风险因素,合理干预这些风险因素,有利于临床控制MDRO传播。

COVID-19后遗症康复治疗系统的研究与设计

为帮助缓解新型冠状病毒肺炎患者的后遗症困扰,本文开发了一款基于Android平台和数字疗法的COVID-19后遗症康复治疗系统。该系统结合了计算机软硬件技术、开发平台应用以及算法设计框架,具有为患者提供个性化的康复治疗方案的功能。测试结果表明,该系统基本达到了设计要求。