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      Care Dependency in Non-Hospitalized Patients with COVID-19

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          Abstract

          Background: A large sample of “mild” COVID-19 patients still experience multiple symptoms months after being infected. These persistent symptoms are associated with many clinically relevant outcomes, including poor health status and impaired functional status. To date, no information is available about care dependency. Therefore, we aimed to explore the level of care dependency and the need for assistance with personal care in non-hospitalized COVID-19 patients. Methods: Members of two Facebook groups for COVID-19 patients with persistent complaints in The Netherlands and Belgium, and from a panel of people who registered at a website of the Lung Foundation Netherlands, were assessed for demographics, pre-existing comorbidities, health status, and symptoms. In addition, patients were asked about their dependence on others for personal care before and after the infection. The level of care dependency was assessed with the Care Dependency Scale (CDS) in members of the Belgian Facebook group ( n = 210). Results: The data of 1837 non-hospitalized patients (86% women; median (IQR) age: 47 (38–54)) were analyzed. Only a small proportion of patients needed help with personal care before COVID-19, but the care need increased significantly after the infection (on average 79 ± 17 days after the onset of symptoms; 7.7% versus 52.4%, respectively; p < 0.05). The patients had a median (IQR) CDS score of 72 (67–75) points, and 31% of the patients were considered as care-dependent (CDS score ≤ 68 points). Conclusions: COVID-19 has an important impact on care dependency in non-hospitalized patients. About three months after the onset of symptoms, a considerable proportion of non-hospitalized patients were to some degree dependent on others for personal care. This indicates that the impact of COVID-19 on patients’ daily lives is tremendous, and more attention is needed to identify optimal treatment strategies to restore patients’ independency.

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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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            Management of post-acute covid-19 in primary care

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              Clinical and Epidemiological Characteristics of 1,420 European Patients with mild‐to‐moderate Coronavirus Disease 2019

              Abstract Background The clinical presentation of European patients with mild‐to‐moderate Covid‐19 infection is still unknown. Objective To study the clinical presentation of Covid‐19 in Europe. Methods Patients with positive diagnosis of Covid‐19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analyzing the relationship between outcomes. Results 1,420 patients completed the study (962 females, 30.7% of health care workers). The mean age of patients was 39.17±12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by on 45.4%. The mean duration of Covid‐19 symptoms of mild‐to‐moderate cured patients was 11.5±5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose, and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild‐to‐moderate Covid19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients. Conclusion The clinical presentation of mild‐to‐moderate Covid‐19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild‐to‐moderate Covid‐19 that needs to be recognized as such by the WHO.
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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                12 September 2020
                September 2020
                : 9
                : 9
                : 2946
                Affiliations
                [1 ]Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; felipemachado@ 123456ciro-horn.nl (F.V.C.M.); roymeys@ 123456ciro-horn.nl (R.M.); jeannetdelbressine@ 123456ciro-horn.nl (J.M.D.); yvonnegoertz@ 123456ciro-horn.nl (Y.M.J.G.); maartenvanherck@ 123456ciro-horn.nl (M.V.H.); sarahwilke@ 123456ciro-horn.nl (S.H.-W.); fritsfranssen@ 123456ciro-horn.nl (F.M.E.F.); daisyjanssen@ 123456ciro-horn.nl (D.J.A.J.); martijnspruit@ 123456ciro-horn.nl (M.A.S.)
                [2 ]Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
                [3 ]Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
                [4 ]REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3500 Diepenbeek, Belgium; chris.burtin@ 123456uhasselt.be
                [5 ]Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands; hermanvijlbrief@ 123456longfonds.nl (H.V.); yvonnespies@ 123456longfonds.nl (Y.S.)
                [6 ]Department of Pulmonary Disease, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; Alex.vantHul@ 123456radboudumc.nl
                [7 ]Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
                Author notes
                [* ]Correspondence: anoukvaes@ 123456ciro-horn.nl ; Tel.: +31-(0)475-587-602
                Author information
                https://orcid.org/0000-0003-1910-7695
                https://orcid.org/0000-0002-4855-530X
                https://orcid.org/0000-0002-5203-1592
                https://orcid.org/0000-0003-3453-7220
                https://orcid.org/0000-0002-3333-6964
                https://orcid.org/0000-0001-6214-0365
                https://orcid.org/0000-0002-5514-2327
                https://orcid.org/0000-0002-1827-9869
                https://orcid.org/0000-0003-3822-7430
                Article
                jcm-09-02946
                10.3390/jcm9092946
                7564703
                32932582
                330d5977-a3c8-4d03-8b0c-9aca2c6a6d25
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 August 2020
                : 08 September 2020
                Categories
                Article

                covid-19,care dependency,activities of daily living
                covid-19, care dependency, activities of daily living

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