Tag: Scotland

A Cross-Sectional Study of Symptom Prevalence, Frequency, Severity, and Impact of Long-COVID in Scotland: Part II

Abstract:

Background: There has been some effort to map the prevalence, frequency, and severity of symptoms of long-COVID at local and national levels. However, what is frequently absent from such accounts is details of the impact the disease and its symptoms have had on those living with the condition. In this manuscript, we present details of impact to work, caring, and mental health gathered using a cross-sectional survey.

Methods: Data were collected using an online survey which was available from 21st April 2022 to 5th August 2022. Included participants had either self-diagnosed or confirmed long-COVID, were living in Scotland, and were ≥18 years old. Hospitalisation during initial COVID-19 infection was an exclusion criterion. Participants were asked to report on the impact of their illness on everyday activities such as working, studying, or caring. They also completed an assessment of their current mood.

Results: People with long-COVID were often severely impacted in their ability to work and study. Severe impact on work and study were predicted by more severe and more frequent fatigue, more severe pain, and more severe cognitive impairment. Respondents’ ability to care for child dependants was also associated with more severe and more frequent fatigue, as well as more severe cognitive impairments. More severe pain associated with greater impact on adult care. Negative mood correlated most strongly with frequency and severity of neurological symptoms, including lack of attention, loss of smell, impaired sense of smell, loss of taste, impaired sense of taste, and loss of appetite.

Conclusions: Long-COVID has a significant impact on ability to work, study, and care for dependants. The severity of this impact is associated with specific symptom burden, including fatigue, pain, and cognitive impairment.

Source: Mclaughlin M, Cerexhe L, Macdonald E, Ingram J, Sanal-Hayes NEM, Hayes LD, Meach R, Carless D, Sculthorpe N. A Cross-Sectional Study of Symptom Prevalence, Frequency, Severity, and Impact of Long-COVID in Scotland: Part II. Am J Med. 2023 Jul 19:S0002-9343(23)00461-8. doi: 10.1016/j.amjmed.2023.07.009. Epub ahead of print. PMID: 37478960. https://www.amjmed.com/article/S0002-9343(23)00461-8/fulltext (Full text)

A Cross-Sectional Study of Symptom Prevalence, Frequency, Severity, and Impact of Long-COVID in Scotland: Part I

Abstract:

Background: Commonly reported symptoms of long-COVID may have different patterns of prevalence and presentation across different countries. While some limited data has been reported for the UK, national specificity for Scotland is less clear. We present a cross-sectional survey to examine the symptom prevalence, frequency and severity of long-COVID for people living with the condition in Scotland.

Methods: An online survey was created in the English language and was available between 21st April 2022 and 5th August 2022. Participants were included if they were ≥18 years old, living in Scotland, and had self-diagnosed or confirmed Long-COVID; and excluded if they were hospitalised during their initial infection. Within this article we quantify symptom prevalence, frequency, severity, and duration.

Results: Participants (n=253) reported the most prevalent long-COVID symptoms to be post-exertional malaise (95%), fatigue/tiredness (85%), and cognitive impairment (68%). Fatigue/tiredness, problems with activities of daily living (ADL), and general pain were most frequently occurring, whilst sleep difficulties, problems with ADL, and nausea were the most severe. Scottish Index of Multiple Deprivation associated with symptom number, severity and frequency, while vaccine status, age, sex, and smoking status had limited or no association.

Conclusions: These findings outline the challenges faced for those living with long COVID and highlight the need for longitudinal research to ascertain a better understanding of the condition and its longer-term societal impact.

Source: Mclaughlin M, Cerexhe L, Macdonald E, Ingram J, Sanal-Hayes NEM, Hayes LD, Meach R, Carless D, Sculthorpe N. A Cross-Sectional Study of Symptom Prevalence, Frequency, Severity, and Impact of Long-COVID in Scotland: Part I. Am J Med. 2023 Jul 20:S0002-9343(23)00460-6. doi: 10.1016/j.amjmed.2023.07.004. Epub ahead of print. PMID: 37481021. https://www.amjmed.com/article/S0002-9343(23)00460-6/fulltext (Full text)

Chronic fatigue syndrome. Immunological findings vary between populations

Comment on: Longitudinal study of outcome of chronic fatigue syndrome. [BMJ. 1994]

 

Editor,-We were interested in Andrew Wilson and colleagues’ paper investigating predictors of the long term outcome of the chronic fatigue syndrome in patients in Australia. We have investigated the association between immune activation and presumed cutaneous anergy in 68 Scottish patients with the syndrome (19 cases conformed to the Centers for Disease Control’s criteria, 18 cases had been diagnosed by a consultant, 28 cases had been diagnosed by a general practitioner, and three patients referred themselves) and 22 family contacts. We assessed delayed hypersensitivity responses (using Multitest antigens and tuberculin skin tests) and evaluated peripheral blood activation markers (CD8, CD38/ CD llb/HLA-DR) using flow cytometry. Patients were classified into three groups on the basis of current severity of illness and mobility.

You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2540184/pdf/bmj00440-0055b.pdf

 

Source: Abbot NC, Spence VA, Lowe JG, Potts RC, Hassan AH, Belch JJ, Beck JS. Chronic fatigue syndrome. Immunological findings vary between populations. BMJ. 1994 May 14;308(6939):1299. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2540184/

 

Chronic fatigue syndrome. Self help groups give valuable support

Editor,-Tony Delamothe’s article on myalgic encephalomyelitis was refreshingly objective,’ but this cannot be said of S M Lawrie and A J Pelosi’s editorial.2 Delamothe questions whether “medical journals keep doctors in the dark.”‘ We believe that the editorial was not even handed.

Within two weeks of publication of the article and editorial our paper on self help groups was published.3 Lawrie and Pelosi’s editorial stated, “if an illness is attributed entirely to external sources there will be little scope for self help.”2 Our results were quite different. The Moray Firth myalgic encephalomyelitis self help group has existed for the past seven years and has had one coordinator (AG). A representative sample of members was surveyed by questionnaire in 1988, 1989, and 1992; response rates were 44/53 (83%), 19/34 (56%), and 42/49 (86%) respectively. The results (table) contradict the statement in the editorial.

You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2540186/pdf/bmj00440-0054c.pdf

 

Source: Ho-Yen DO, Grant A. Chronic fatigue syndrome. Self help groups give valuable support. BMJ. 1994 May 14;308(6939):1298-9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2540186/

 

Chronic fatigue syndrome

SIR,

Dr Anthony David and colleagues (1) cite our paper (2) as one that makes inflated claims about the chtionic fatigue syndrome.

We first reported retrospectively an association between antibodies to coxsackie virus B and a group of symptoms similar to those previously described as myalgic encephalomyelitis. (3) We were faced with an ever increasing clinical problem of which we had little understanding, and the prospective investigation of coxsackie virus B antibody titres in these patients seemed a reasonable step forward. No widely accepted definition of the chronic fatigue syndrome existed in 1983, and we did not attempt to define it. We approached the problem from the opposite direction in that we had a definable test and we tried to show what happened to the results of this test in a group of ill patients.

Since 1983 much research into this syndrome has been carried out. It has taken a long time for a consensus to be agreed defining the syndrome. We believe that today’s definition that the syndrome cannot be diagnosed before six months has elapsed is acceptable. In our study 72% of our patients were still unwell six months into the illness.

The comparison made by Dr David and colleagues of their paper with ours is invalid. They questioned 611 general practice attenders whereas we reported on a group of 140 patients presenting over six months with what we believe to be the same illness.

In retrospect we think that what we observed was the slow spread of an infective agent through our town in 1983 and through neighbouring towns in our district in 1984 and 1985. The clinical syndrome coincided with a rise in the prevalence of coxsackie virus B antibodies in the general population from 10-12% in 1973-84 (we found 25% in 1983) to 55% in 1985-6. (4) Since then our clinical impression has been one of a return to normal; we see occasional new cases but not as many as in 1983.

The prevalence of this condition seems to depend on the activity of an infective agent of some kind, be it viral or otherwise, in the area of study at the time, and further research is made difficult by the wide fluctuations of prevalence that will be found from place to place and from time to time.

~B D CALDER

~P J WARNOCK Helensburgh G84 8BW

1 David A, Pelosi A, McDonald E, et al. Tired, weak, or in need of rest: fatigue among general practice attenders. BMJ 1990;301:1199-202. (24 November.)

2 Calder BD, Warnock PJ, McCartney RA, Bell EJ. Coxsackie B viruses and post-viral syndrome J R Coll Gen Pract 1987;37: 11-4.

3 Calder BD, Warnock PJ. Coxsackie B infections in Scottish general practice. J R Coll Gen Pract 1984;34:15-9.

4 Miller NA, Carmichael HA, Calder BD, et al. Antibody to coxsackie B virus in diagnosing postviral fatigue syndrome. BMJ (in press).

 

Source: B D Calder and P J Warnock. Chronic fatigue syndrome. BMJ. 1991 Jan 19; 302(6769): 181. PMCID: PMC1668832 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1668832/