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Correlation between fatigue and pulmonary involvement in the post-COVID-19 condition: a cross-sectional study 6-12 months after hospital discharge

Por: Kajiwara · M. S. · Lamas · C. A. · Luna · L. A. V. d. · Yokoyama · T. S. · de Oliveira · P. R. · Chate · R. C. · Sawamura · M. V. Y. · Imamura · M. · Carvalho · C. R. R. d. · Salge · J. M. · HCFMUSP COVID-19 task force · Araujo · Segurado · Montal · Miethke-Morais · Levin · Peron
Introduction

Post-COVID-19 conditions (PCC) may include pulmonary sequelae, fatigue and other symptoms, but its mechanisms are not fully elucidated.

Objective

This study investigated the correlation between fatigue and the presence of pulmonary abnormalities in PCC patients with respiratory involvement 6–12 months after hospitalisation.

Design

Cross-sectional study.

Setting

A tertiary hospital in Brazil.

Participants

315 patients, aged ≥18 years, were considered eligible based on SARS-CoV-2 infection confirmed by reverse transcription-PCR.

Methods

Pulmonary function tests (PFT), cardiopulmonary exercise tests (CPET), chest CT and hand grip were performed. The following scales were applied: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, Euroqol 5 Dimensions quality of life (EQ-5D) and Hospital Anxiety and Depression Scale (HADS). Participants were divided between the fatigue group (FACIT-F≤30) and the non-fatigue group (FACIT-F>30). For the statistical analysis, the primary outcome was the difference in the diffusing capacity of the lungs for carbon monoxide (DLCO) between groups. Considered secondary outcomes were differences in PFT, CPET, chest CT, hand grip, EQ-5D and HADS.

Results

The fatigue group had 81 patients (25.7%) against 234 (74.3%). PFT and CPET showed no significant difference in DLCO and oxygen consumption peak values between groups. The fatigue group had a lower workload (mean 55.3±21.3 watts vs 66.5±23.2 watts, p=0.003), higher breathing reserve (median 41.9% (33.8–52.5) vs 37.7% (28.9–47.1), p=0.028) and lower prevalence of ground glass opacity (60.8% vs 77.7%, p=0.003) and reticulation (36.7% vs 54.9%, p=0.005) in chest CT. The fatigue group had higher anxiety (57% vs 24%, p

Conclusion

Fatigue in patients with PCC 6–12 months after hospitalisation is relatively common and had weak correlation with pulmonary disorders. Our results suggested fatigue could be strongly related with peripheral disorders such as reduced musculoskeletal strength or psychosocial limitations.

Use of prescription opioids and other psychotropic drugs during pregnancy and their impact on the mother and developing child: protocol for a cohort study using linked administrative data from Manitoba and British Columbia, Canada

Por: Singal · D. · Dahl · L. · Brownell · M. · Dormuth · C. · Bolton · J. M. · Enns · J. E. · Hanlon-Dearman · A. · Katz · A. · Katz · L. Y. · Kelly · L. E. · Leong · C. · McGrail · K. · Nickel · N. C. · Ruth · C. · Dahl · M. · Kim · J. · Chateau · D.
Introduction

Opioids are prescribed to manage pain. Approximately 1 in 20 pregnant women in Canada are prescribed opioids during the prenatal period, which may occur concurrently with other psychotropic drug use. The health implications of the independent and concurrent prenatal use of these drugs are not fully understood; however, adverse neonatal and longer-term outcomes have been suggested. This protocol describes a study to update the epidemiology of prenatal exposure to opioid and other psychotropic drug use during pregnancy, providing an enhanced understanding of the potential impacts on the mother and child to help inform decisions regarding prescription and use.

Methods and analysis

The retrospective cohort study design uses population-based administrative data from Manitoba and British Columbia, Canada, to investigate the effect of prenatal opioid and concurrent psychotropic drug use on maternal and child outcomes. All mother–child dyads from 2000/2001 to 2019/2020 (approximately 1M pairs) will be identified and assigned to exposure groups based on the number of opioid and other psychotropic drug dispensations to the mother during the prenatal period. Maternal sociodemographic characteristics, prescribing patterns, short- and long-term child health and education outcomes and maternal outcomes will be examined.

Ethics and dissemination

The study was approved by the University of Manitoba Human Research Ethics Board (No. HS24397 – H2020:470) and the University of British Columbia Clinical Research Ethics Board (No. H21-02262). The study will generate findings that will add to the growing body of evidence of potential short- and long-term adverse effects on children exposed to these drugs prenatally and will help to inform safe prescribing guidelines during pregnancy. Results will be published in peer-reviewed journals.

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