Some COVID-19 patients experience persistent chronic fatigue six months after infection, finds study

A team of scientists from Germany has recently revealed that almost 50% of patients present with moderate to severe chronic fatigue syndrome six months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 

Background

Infection with SARS-CoV-2 is associated with a wide variety of symptoms, ranging from mild fever and cough to severe pulmonary and cardiovascular complications. Although almost 80% of coronavirus disease 2019 (COVID-19) patients remain asymptomatic or mildly symptomatic, a growing pool of evidence indicates that a significant fraction of COVID-19 patients present with persistent symptoms referred to as ‘long COVID’. Most commonly reported symptoms of long COVID are fatigue, cognitive impairment, and post-exertional malaise (worsening of symptoms after minor physical or mental exertion).

In the current study, the scientists have investigated mild to moderate COVID-19 patients who present with persistent fatigue and other related symptoms. They have also investigated whether these patients meet the diagnostic criteria for chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS), which is a neurological disease characterized by severe mental and physical fatigue, chronic pain, and sleep disorder.

Study design

A total of 42 COVID-19 patients presented with moderate to severe intensity chronic fatigue, exertion intolerance, cognitive dysfunction, and pain six months after SARS-CoV-2 infection were investigated in the study. All participants were diagnosed with mild to moderate COVID-19. A team of experienced clinical immunologists, rheumatologists, neurologists, and cardiologists was involved for an accurate diagnosis of ME/CFS in these patients based on the Canadian Consensus Criteria. The intensity and duration of post-exertional malaise (symptoms lasting for more than 14 hours) was considered to be the main diagnostic criterion for ME/CCFS.

Important observations

Of all enrolled patients, 32 had mild COVID-19 and 10 had moderate COVID-19 because of pneumonia. The numbers of male and female patients were 29 and 13, respectively, and the average age of the patients was 36 years (age range: 22 – 62 years).

Of 42 enrolled patients, 19 met the diagnostic criteria for ME/CFS and were found to have severe fatigue and functional impairment, severe stress intolerance, and hypersensitivity to noise, light, and temperature. The scientists categorized these patients as Chronic COVID-19 Syndrome/Chronic Fatigue Syndrome (CCS/CFS). The rest of the patients who were not diagnosed with ME/CFS mainly because of the relatively shorter duration of post-exertional malaise (2 – 10 hours) were referred to as CCS. The patients with ME/CFS showed significantly reduced hand grip strength than those without ME/CFS.

After 6 months of SARS-CoV-2 infection, all participants were found to have fatigue with different intensities. The most commonly observed symptoms were post-exertional malaise, cognitive impairment, and muscle pain. Although patients without ME/CFS exhibited less severe symptoms, most of them had severely impaired daily life activities. The majority of enrolled patients (n=28) were either unable to work or required a reduced work schedule because of post- Covid-19 symptoms.

In the study cohort, autonomic dysfunction was observed in most of the patients, with no significant difference in symptom intensity between patients with and without ME/CFS. The increase in systolic and diastolic blood pressure at standing position was significantly lower in patients with ME/CFS than those without it. Among patients with ME/CFS, four were diagnosed with postural tachycardia syndrome.         

Regarding biochemical parameters, only two patients in the entire study cohort showed mildly elevated C-reactive protein levels, indicating the absence of robust inflammatory response. Almost 50% of patients showed increased levels of interleukin 8 (IL-8), which is a clinical feature of severe COVID-19 patients. Moreover, a low level of mannose-binding lectin was observed in 22% of patients, indicating impaired immune functioning. An indication of autoimmune disorder was noticed in the study cohort as elevated levels of antinuclear antibody were found in 3 ME/CFS patients and 6 non-ME/CFS patients.

Study significance

The study reveals that even mildly affected COVID-19 patients can develop a severe chronic syndrome characterized by moderate to severe fatigue and exertion intolerance. Because most of the post-COVID symptoms considered in this study did not differ significantly between patients with and without ME/CFS, the scientists suggest that chronic COVID-19 syndrome is a more appropriate terminology than ME/CFS in defining long-term symptoms related to SARS-CoV-2 infection.

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Weak Upper Body Strength in women associated with depression, anxiety

Weak upper and lower body fitness can cause serious depression and anxiety in midlife women, a recent study suggests.

Although several studies have previously linked depression in midlife women with self-reported low physical activity, this new study evaluates objective measures of physical performance in relation to depression and anxiety in premenopausal, perimenopausal and postmenopausal women.

Depression and anxiety are prevalent symptoms experienced by midlife women. This latest study of more than 1,199 women aged 45-69 years found , in fact that 15% of participants, especially those of younger age, reported depression and or anxiety.

Because depression can cause disability, reduced quality of life, mortality, and heart disease, researchers felt it was important to identify potentially modifiable risk factors that could reduce morbidity and mortality. 

The study observed significant associations of objective physical performance measures with depression and anxiety.

Specifically, they found that weak upper body strength ( hand grip strength) and poor lower body strength ( longer duration to complete the repeated chair stand test) were associated with elevated depression and or anxiety symptoms.

According to the researchers, future trials will be needed to determine whether strengthening exercises that improve physical performance might similarly help reduce depression and anxiety in midlife women.

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The stronger you are, the healthier your brain is

Turns out, muscular strength, measured by handgrip, is an indication of how healthy our brains are. Using data from the 475,397 participants from all around the UK, a research showed that on average, stronger people performed better across every test of brain functioning used. Tests included reaction speed, logical problem solving, and multiple different tests of memory.

The study showed the relationships were consistently strong in both people aged under 55 and those aged over 55. "When taking multiple factors into account such as age, gender, body weight and education, our study confirms that people who are stronger do indeed tend to have better functioning brains," said researcher.

The study also showed that maximal handgrip was strongly correlated with both visual memory and reaction time in over one thousand people with psychotic disorders such as schizophrenia. He said: "We can see there is a clear connection between muscular strength and brain health. But really, what we need now, are more studies to test if we can actually make our brains healthier by doing things which make our muscles stronger - such as weight training."

He added, "The study raises the strong possibility that weight training exercises could actually improve both the physical and mental functioning of people with these conditions." 

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EXERCISES AND CARE FOR HAND PROBLEMS AS WE AGE

1)  Grip strength-One of the things elders often notice is the grip gets weaker. It could be due to various reasons, if it happens suddenly, it could be due to heart problems, diabetes or high blood pressure. Over time, when grip weakens, it could be due to brittle bones, arthritis or muscle loss. Simple exercise that can be done at home is to hold a tennis ball and squeeze as hard as possible from 3-15 seconds, relax and to repeat this 10 times daily with each hand. Or do 5 times in the morning with each hand and repeat in the evening. doing it regularly will help to improve your grip.

2) Tremors- Hands shaking is common for some after 50, but it could also be the effect of some medications- for mood stabilizers, seizures, migraine. Anxiety, stress, low blood sugar, exhaustion, too much caffeine can also cause hand tremors. An " active" tremor happens when you use both hands and " passive" tremor happens when hands are at rest.
An active tremor is usually harmless. Changing diet- less caffeine and changing life-style can help. A passive tremor is a more serious problem- brain tumour, or brain disease or Parkinson's. Consult your doctor for proper diagnosis and treatment.

3) Arthritis- inflames joints and is common in places where we had some sprains or fractures, even if they're treated. It may get worse as we age- with pain, swelling and loss of movements.
Your physician seeing your condition will recommend anti-inflammatory drugs or steroids which can ease pain and swelling for a long time. In some cases, splints to restrict the movement of the joints may help, but wearing them too long can lead to muscle loss.

4) Skin- as we age, we can see " liver spots"  or " age spots" due to exposure to Sun. Your skin ages and wrinkles, has less moisture, hence dry and itchy skin. Due to loss of loss tissues, veins are conspicuous. Protect your hands from harsh Sun's rays, by wearing cotton gloves, moisturizing lotions. Eat a healthy diet with plenty of vitamins, antioxidants, and omega-3 fatty acids also can help keep your skin and nails healthy.

5) Bruising- When it’s on the back of your hands and arms, it  is known as “purpura.” A light knock can cause it, and it’s more common on thin, wrinkled, or sun-damaged older skin. You’re also more likely to bruise if you take drugs like aspirin or other blood thinners, or drink alcohol often. It starts as blotches of red that turn purple, then darken and fade. It doesn’t usually hurt, but it can last longer than a normal bruise, often a few weeks.

 6)Dupuytren's Contracture-This is when the tissue just under the skin of your hand gets unusually thick. It can cause your fingers -- most often the ring and pinky fingers -- to bend into your palm. You may get lumps or thick cords (like string) in your palm as well. It sometimes affects the top of your knuckles or the soles of your feet, too.

 For many people, a mild case doesn’t cause major problems or pain, and it may not get worse, so your doctor might take a wait-and-see approach. If it is causing problems, she may suggest a type of stimulation with needles, shots, or possibly surgery to give you more movement in your hands. Treatment doesn’t always fix it completely, though, and it sometimes comes back.

 this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on. 
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Your handshake is the easiest way to predict heart attack

Testing the strength hand's grip could be a life-saver, as new study has shown that it's the easier and affordable way to predict heart attack and stroke risk.

As per an international study of almost 140000 adults from 17 culturally and economically diverse countries, weak grip strength is linked with shorter survival and a greater risk of having a heart attack or stroke.

The study also found that grip strength is a stronger predictor of death than systolic blood pressure, and the authors suggest that it could be used as a quick, low-cost screening tool by doctors or other healthcare professionals to identify high-risk patients among people who develop major illnesses such as heart failure and stroke.

The current study followed 139691 adults aged between 35 and 70 years living in 17 countries from The Prospective Urban-Rural Epidemiology (PURE) study for an average (median) of four years. Grip strength was assessed using a handgrip dynamometer.

The findings show that every 5kg decline in grip strength was associated with a 16 percent increased risk of death from any cause; a 17 percent greater risk of cardiovascular death; a 17 percent higher risk of non-cardiovascular mortality; and more modest increases in the risk of having a heart attack (7 percent) or a stroke (9 percent).

These associations persisted even after taking into account differences in other factors that can affect mortality or heart disease such as age, education level, employment status, physical activity level, and tobacco and alcohol use.

A low grip strength was linked with higher death rates in people who develop cardiovascular (eg, heart attack or stroke) and non-cardiovascular diseases (eg, cancer), suggesting that muscle strength can predict the risk of death in people who develop a major illness.

Lead author Dr Darryl Leong at the McMaster University, Hamilton, Canada, said that further research was needed to establish whether efforts to improve muscle strength were likely to reduce an individual's risk of death and cardiovascular disease.

The study is published in The Lancet. (ANI) 

 

 

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