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The Characteristics of Patients Who Develop Long-COVID Symptoms

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Nearly one-third of patients with symptomatic COVID-19 developed symptoms of postacute sequelae of SARS-CoV-2 (PASC), according to a study published in the Journal of General Internal Medicine.

Patients who have recovered from COVID-19 frequently report PASC symptoms such as fatigue, dyspnea, and anosmia. Prior studies describing PASC have focused on hospitalized adult patients or patients with mild COVID-19 treated in outpatient settings up to 9 months following infection. Cohorts of patients with PASC have included small proportions of individuals of minority groups. This is the first study to examine the association of ethnicity, social vulnerability, and insurance status with developing PASC, according to the researchers.

They analyzed data of 1038 participants (aged 60 years; interquartile range [IQR], 37 to 83 years; 42% Latino, 30% White) in the University of California Los Angeles (UCLA) Health COVID Ambulatory Monitory Program. The patients completed follow-up surveys at 30, 60, or 90 days after hospital discharge or outpatient diagnosis. Eighty percent of patients followed up after their illness.


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PASC were reported by 29.8% of patients at least 60 days after acute illness (30.8% of patients treated in hospitals, 26.5% of high-risk outpatients).

At 30 days, the most commonly reported symptoms were fatigue (73.2%), shortness of breath (63.6%), fevers and chills (51.5%), and muscle aches (50.6%). At 60 days, fatigue (31.4%), shortness of breath (13.9%), and loss of taste or smell (9.8%).

Fatigue was the most common symptom among both hospitalized and outpatient patients. About 15% of hospitalized patients experienced shortness of breath, and about 16% of outpatients experienced loss of taste or smell.

PASC patients in outpatient care were more likely to be younger, White, women, and commercially insured. Hospitalized patients were more likely to report PASC symptoms if they were women. Patients with history of organ transplant were less likely to develop PASC.

Hospitalization for COVID-19 (OR, 1.49 95% CI 1.04-2.14), having diabetes (odds ratio [OR], 1.39; 95% CI, 1.02-1.88), and higher body mass index (OR, 1.02; 95% CI, 1.0002–1.04), were linked with developing PASC. Patients with Medicaid (OR, 0.49; 95% CI, 0.31-0.77) or history of organ transplant (OR, 0.44; 95% CI, 0.26-9.76) were less likely to develop PASC.

The researchers said the lack of association between age or race with developing PASC may be influenced by access to the same health system with standardized follow-up, importance of risk factors for contracting COVID-19 compared with recovering from COVID-19, or variance in symptoms and expectations across demographic groups and ability of tools detecting PASC to realize those differences. Variation in symptoms between hospitalized patients and outpatient treated patients is likely due to differences in clinical phenotypes, according to the researchers.

Study limitations included potential self-report bias, referral bias, survivorship bias, evaluation of a limited number of PASC symptoms, no control group of patients with persistent symptoms following hospital admissions unrelated to COVID, and limited knowledge of pre-existing conditions.

“Understanding the effects of long COVID will allow for more effective education among patients and providers, and allow for appropriate healthcare resource utilization in the evaluation and treatment of PASC,” the researchers concluded.

Reference

Yoo SM, Liu TC, Motwani Y, et al. Factors associated with post-acute sequelaeof SARS-CoV-2 (PASC) after diagnosis of symptomatic COVID-19 in the inpatient and outpatient setting in a diverse cohort. J Gen Intern Med. Published online April 7, 2022. doi: 10.1007/s11606-022-07523-3

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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Bizarre Sunlight Loophole Melts Belly Fat Fast!

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