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      Physical and psychological reconditioning in long COVID syndrome: Results of an out-of-hospital exercise and psychological - based rehabilitation program

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          Abstract

          Background

          Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatment of this syndrome are still poorly understood, even if evidences suggest the potential role of physical rehabilitation in improving symptoms in these patients.

          Aim of the study

          The aim of the present study was to evaluate effectiveness, safety and feasibility of an out-of-hospital multidisciplinary rehabilitation (MDR) program, based both on physical and psychological reconditioning, in reducing symptoms and improving physical fitness and psychological parameters in patients with LCS.

          Methods

          Thirty consecutive patients with LCS (18 males, mean age 58 years) underwent an accurate medical screening process including anthropometric and muscular strength evaluation, cardiopulmonary exercise test, quality of life (QoL) and psychological appraisal before and after a MDR program.

          Results

          At baseline, all LCS patients were strongly symptomatic and showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during the exercise training sessions. After the MDR program, COVID-19 residual symptoms significantly decreased, and significant improvements in upper and lower limb muscular strength, cardiopulmonary parameters, perceived physical and mental health, depression and anxiety were observed.

          Conclusions

          The present study confirms the severe physical and psychological impairment of patients with LCS and suggests that a MDR program is effective, safe and feasible in these patients and could promote their physical and psychological recovery.

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          Most cited references44

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          Persistent Symptoms in Patients After Acute COVID-19

          This case series describes COVID-19 symptoms persisting a mean of 60 days after onset among Italian patients previously discharged from COVID-19 hospitalization.
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            The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

            A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
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              COVID-19 and mental health: A review of the existing literature

              Highlights • Subsyndromal mental health concerns are a common response to the COVID-19 outbreak. • These responses affect both the general public and healthcare workers. • Depressive and anxiety symptoms have been reported in 16–28% of subjects screened. • Novel methods of consultation, such as online services, can be helpful for these patients. • There is a need for further long-term research in this area, especially from other countries
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                Author and article information

                Journal
                Int J Cardiol Heart Vasc
                Int J Cardiol Heart Vasc
                International Journal of Cardiology. Heart & Vasculature
                The Authors. Published by Elsevier B.V.
                2352-9067
                16 July 2022
                August 2022
                16 July 2022
                : 41
                : 101080
                Affiliations
                [a ]Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy
                [b ]Federico II University Hospital, Naples, Italy
                [c ]Sub-Intensive Care COVID Unit, Pneumology Service, Dolo - Venice, Italy
                [d ]Non-critical COVID Area, Internal Medicine Service, Dolo - Venice, Italy
                [e ]Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
                [f ]Medical Direction, Azienda ULLS 3 Serenissima, Venice, Italy
                Author notes
                [* ]Corresponding author at: Franco Giada, Cardiovascular Rehabilitation and Sports Medicine Service, Noale - Venice, Italy.
                Article
                S2352-9067(22)00129-4 101080
                10.1016/j.ijcha.2022.101080
                9286763
                35854691
                68715802-311a-450d-bc9b-688d5734f917
                © 2022 The Authors

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 27 February 2022
                : 27 June 2022
                : 30 June 2022
                Categories
                Article

                long covid syndrome,multidisciplinary rehabilitation,psychological management,physical exercise training

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