Littérature scientifique sur le sujet « Sindrome post-COVID »

El síndrome post COVID-19 (o post COVID agudo) se caracteriza por la persistencia o prolongación de síntomas durante más de 4 semanas después de la infección inicial por SARS-CoV-2. La prevalencia del síndrome post COVID-19, va del 10% al 87% en los pacientes que tuvieron COVID-19. Este síndrome fue descartado inicialmente por muchos, pero ahora se la reconoce como una enfermedad multiorgánica, la cual refleja un desafío constante en la atención médica. Existen factores neuropsiquiátricos que, asociados a la inflamación del tubo digestivo y la activación del sistema nervioso entérico, son los mecanismos potenciales para el desarrollo del Trastorno de la Interacción Intestino Cerebro (DGBI) Post COVID agudo.

2019 m. pasaulyje prasidėjo SARS-CoV-2 viruso sukelta pandemija, kuri sukėlė daug iššūkių visai medikų bendruomenei. Augant COVID-19 infekcija persirgusių žmonių skaičiui, stebimi nauji su infekcija susiję liekamieji reiškiniai, kurie apibūdinami kaip pokovidinis sindromas. Vaikų amžiuje dėl negebėjimo apibūdinti, ką pacientas jaučia, šį sindromą įtarti ir diagnozuoti gali būti sudėtinga. Straipsnio tikslas – apžvelgti naujausius pokovidinio sindromo vaikų amžiuje literatūros duomenis. Metodika. Mokslinių darbų paieška atlikta naudojant kompiuterinę bibliografinę mokslinių darbų bazę „PubMed“, taip pat remtasi tarptautinių gairių ir oficialių organizacijų duomenimis. Analizuoti publikuoti moksliniai tyrimai ir straipsniai. Paieškose buvo vartojami reikšminiai žodžiai ir jų deriniai: long covid, post-covid conditions, covid infection in children. Rezultatai. Tiksli pokovidinio sindromo epidemiologija dar nežinoma, tačiau manoma, kad beveik pusė vaikų, persirgusių COVID-19 infekcija, jaučia ilgiau nei 12 savaičių išliekančius simptomus. Dažniausi aprašomi pokovidinio sindromo simptomai yra nuovargis ir dėmesio koncentracijos stygius, tačiau simptomų įvairovė didelė. Gydytojai ir pacientų tėvai turėtų atkreipti dėmesį į suprastėjusius vaiko pasiekimus, pasikeitusį elgesį, nuotaiką ir ieškoti kompetentingos pagalbos.

The causative agent of severe acute respiratory syndrome, corona virus 2 (SARS-CoV-2), the etiological agent of the COVID-19 disease, can infect the heart, vascular tissues and circulating cells via angiotensin-converting enzyme 2 (ACE-2), a cell receptor host for the viral spike protein. The focus of this review article is on the prevalence, risk factors, pathogenesis, clinical course and sequelae of myocardial damage caused by the disease COVID-19. Emphasis is also placed on the interactions of platelets with the vascular endothelium, which includes consideration of the role of the SARS-CoV-2 virus protein in triggering the development of generalized endothelitis, which further in a circle triggers more intense activation of platelets. Acute cardiac lesion is a common extrapulmonary manifestation of COVID-19 with potential chronic consequences. Clinical manifestations include direct cardiac damage and indirect immune response mechanisms that affect the cardiovascular (CV) system and have implications for the treatment of patients after recovery from acute COVID-19 infection. The most common direct cardiovascular lesion is an acute heart lesion, present in more than 12% of all infected patients and defined by a significant increase in cardiac troponins in the serum and echocardiographic signs of damage to the myocardial texture due to inflammation, impairment of segmental mobility or global systolic and diastolic function of the left ventricle and sometimes inflammation of the pericardium. Arrhythmias, venous thromboembolism and cardiomyopathy are predominant KV manifestations described in the patient with COVID-19. An analysis of 72,314 confirmed cases of COVID - 19 (Wuhan) showed total mortality of 1663 patients or 2.3%, with presence of a previous KV disease in 10.5%, diabetes Mellitus in 7.3% and arterial hypertension in 6%. Cardiovascular complications because of COVID-19 associated with comorbidities were: myocardial lesion (20 %), cardiac arrhythmias (16%), myocarditis and fulminant myocarditis with lowered ejection fraction (10%), non-occlusive myocardial infarction and venous thromboembolism and acute' cardiac insufficiency and cardiogenic shock. Hypertension and diabetes are the most frequent_comorbidities in those infected with COVID-19, for whom hospitalization was necessary. A Denmark study based on the national register of over 5000 patients with hospitalized COVID19 revealed that the risk from the acute myocardial infarction and ischemic stroke was 5 and even 10 times higher , respectively , during the first 14 days after COVID-19 infections in comparison with the period which preceded the known infection. Numerous individual cases point to extremely high values and troponin T dynamics typicalfor non-occlusive myocardial infarction with normal coronary arteries. Mechanisms of indirect cardiovascular lesions are: dysregulation of inflammatory or immune responses of hyperinflammation, vascular thrombosis and activation of platelets, autoimmune phenomena and adaptive immunological dysfunction in vascular thrombosis associated with COVID-19. Cardiovascular dysfunction and disease are often fatal complications of a severe COVID-19 virus infection. Cardiac complications can occur even canin patients without basic cardiac insufficiency, as a part of acute infections and they are associated with a more severe form of COVID 19 disease and increased mortality. Of COVID-19 patients treated in the intensive care unit 61% died because they had acute respiratory distress syndrome (ARDS), 44% of them had severe cardiac arrhythmias and 31% percent of them experienced a shock syndrome. Elevated troponin levels were rare in survivors of uncomplicated COVID19 (1%-20%), common in critically ill patients (46%-100%), and almost universally elevated in critically ill (ie, those requiring intensive care or mechanical ventilation) and those who did not survive. Some autopsy findings suggested myocardial infiltration by mononuclear leukocytes and revealed some cases of severe myocarditis with a dilated phenotype. Among patients hospitalized with COVID-19, evidence about acute damage of cardiac functions are frequent _ and include the following: acute cardiac insufficiency (3%-33%), cardiogenic shock ( 9%-17%), ischemia or myocardial infarction (0.9%-11%), left ventricular dysfunction (10%-41%), right ventricular dysfunction (33%-47%), biventricular dysfunction (3%-15%), stress cardiomyopathy (2%-5.6%), arrhythmias (9%-17%), venous thromboembolism (23%-27%) and arterial thrombosis as secondary viral mediated coagulopathy. COVID - 19 is associated with abnormalities of cardiac structures and functions including echocardiographic evidence of left ventricular dysfunction, regional wall movement abnormalities and mild reduction of right ventricular function. Involvement of myocardial lesion because of SARS - CoV -2infection was very much widespread even in patients with mild symptoms.

2020), growing scientific evidence worldwide suggests that a small percentage of people who have developed COVID-19 and healed after the initial infection may experience a series of persistent symptoms over a period of more than 12 weeks, such as marked fatigue, shortness of breath, confusion, diarrhea, or other symptoms that cannot be explained by an alternative diagnosis. This status has been called “long COVID syndrome” or ”post COVID syndrome”.

ABSTRAK Penyintas Covid 19 cenderung mengalami Post Traumatic Stress Disorder sebesar 30,2% (Janiri, 2020). Perhimpunan Dokter Spesialis Kedokteran Jiwa Indonesia menyatakan sebanyak 80% mengalami gejala stres pasca trauma psikologis karena mengalami atau menyaksikan peristiwa tidak menyenangkan terkait Covid-19, 46% memiliki gejala berat, 33% sedang, 2% ringan, dan sisanya tidak bergejala. Gejala PTSD dapat dikurangi dengan intervensi psikoterapi yaitu CBT (Cognitif Behavior Therapy). Tujuan kegiatan Pengabdian kepada masyarakat ini adalah Meningkatkan pengetahuan masyarakat mengenai Pandemic Covid 19 dan Therapy Cognitive Behavior, dan memperkenalkan Therapy Cognitive Behavior sebagai salah satu terapi menurunkan Post Trauma Stres Disorder, ketidaknyamanan, kecemasan, masalah perilaku dan tekanan psikologis selama pandemic Covid 19. Berdasarkan hasil pre test sebelum dilakukan Cognitive Behavior Therapy diperoleh hasil sebanyak 4 orang tidak memiliki gejala PTSD, 27 orang memiliki gejala ringan dan 5 orang memiliki gejala PTSD sedang. Setelah dilakukan Cognitive Behavior Therapy ditemukan Post Trauma Distres Sindrom berada pada kategori tidak memiliki gejala sebanyak 10 orang dan 24 orang memiliki gejala PTSD pada kategori ringan dan 2 orang kategori sedang. Kesimpulan : Terapi Cognitive Behavior efektif menurunkan gejala Post Trauma Sindrom Disorder dialami penyintas Covid 19 dan keluarga sehubungan dengan adanya pandemic covid 19. Kata Kunci: CBT, PTSD, Pandemi Covid-19 ABSTRACT Janiri (2020) stated that 30.2% of the total 381 respondents who survived Covid 19 experienced Post Traumatic Stress Disorder. According to the Association of Indonesian Mental Medicine Specialists, as many as 80% of the 182 self-examination results experienced symptoms of psychological post-traumatic stress due to experiencing or witnessing unpleasant events related to Covid-19, 46% had severe symptoms, 33% moderate, 2% mild, and the rest did not. symptomatic. PTSD symptoms can be reduced by psychotherapy intervention, namely CBT (Cognitive Behavior Therapy). The purpose of this community service activity is to increase public knowledge about the Covid 19 Pandemic and Cognitive Behavior Therapy, and introduce Cognitive Behavior Therapy as a therapy to reduce Post Traumatic Stress Disorder, discomfort, anxiety, behavioral problems and psychological stress during the Covid 19 pandemic. Based on the results of the pre-test prior to Cognitive Behavior Therapy, it was found that 4 people did not have PTSD symptoms, 27 people had mild symptoms and 5 people had moderate PTSD symptoms. After doing Cognitive Behavior Therapy, it was found that the Post Traumatic Distress Syndrome was in the asymptomatic category as many as 10 people and 24 people had PTSD symptoms in the mild category and 2 people in the moderate category. Conclusion: Cognitive Behavior Therapy is effective in reducing the symptoms of Post Traumatic Syndrome Disorder experienced by Covid 19 survivors and their families in connection with the COVID-19 pandemic. Keywords: CBT, PTSD, COVID-19 pandemic

Infeksi Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) yang menyebabkan pandemi coronavirus disease of 2019 (COVID-19) pertama kali dilaporkan pada bulan Desember 2019. Sejak saat itu, berbagai negara mulai melaporkan adanya populasi anak yang dirawat dengan klinis demam persisten, renjatan kardiovaskuler, dan manifestasi hiperinflamasi multisistem pasca infeksi SARS-CoV-2 yang menyerupai sindrom renjatan toksik atau pun penyakit Kawasaki. Terminologi yang digunakan oleh Royal College of Paediatrics and Child Health (RCPCH) untuk kondisi klinis tersebut yaitu Pediatric Inflammatory Multisystem Syndrome Temporarily Associated with SARS-CoV-2 (PIMS-TS), yang selanjutnya lebih dikenal sebagai Multisystem Inflammatory Syndrome in Children (MIS-C) sesuai Centers for Disease Control (CDC) dan World Health Organization (WHO). Spektrum klinis, derajat berat, dan gejala MIS-C sangat beragam dengan gejala yang paling sering dilaporkan adalah demam persisten (97-100% pasien), bersamaan dengan manifestasi klinis pada sistem gastrointestinal (70% pasien), kardiovaskular, dan atau dermatologis. Hingga saat ini, patogenesis yang mendasari terjadinya MIS-C belum diketahui secara pasti. Tatalaksana kasus MIS-C memerlukan kolaborasi multidisiplin ilmu. Konsensus maupun pedoman baku untuk tata laksana MIS-C belum disepakati para ahli, namun secara umum terapi awal meliputi pemberian imunoglobulin intravena (IVIG) dan kortikosteroid.

Pendahuluan Keadaan hiperkoagulasi yang disebabkan oleh sindrom pernapasan akut berat karena infeksi coronavirus 2 (SARSCoV-2) menyebabkan peningkatan frekuensi terjadinya gangguan tromboemboli yang memicu terjadinya stroke iskemik akut karena oklusi pembuluh darah besar (AIS LVO) pada usia muda tanpa adanya faktor resiko/komorbid vaskular sebelumnya dengan angka kematian sebesar 44,2 % - 60%. Metode Kami melakukan pencarian literatur pada Pubmed dengan menggunakan kata kunci sebagai berikut stroke iskemik akut/AIS, oklusi pembuluh darah besar/LVO, Covid-19, SARS-CoV-2, trombektomi/MT dan tatalaksana stroke iskemik akut. Lalu meninjau literatur studi kohort observasional, studi kasus-kontrol, seri kasus, laporan kasus, tinjauan sistematis dan metanalisis yang diterbitkan antara Januari 2020 dan Mei 2022 yang menggambarkan tatalaksana pasien Covid-19 dengan AIS LVO. Artikel non-bahasa inggris tidak termasuk. Hasil Trombektomi mekanis adalah metode pengobatan invasif untuk AIS LVO yang menggunakan balon kateter yang dimasukkan ke dalam sistem arteri sehingga diperlukan Angiogram CT sebelum dilakukan pemindahan pasien ke pusat trombektomi untuk memastikan keberadaan LVO. Keberhasilan tindakan trombektomi mekanis dinilai dengan skor TICI 2b/3 yang menunjukan perfusi lengkap. Simpulan Infeksi Covid-19 memperburuk hasil klinis, meningkatkan resiko kematian dan dapat menimbulkan komplikasi berupa perdarahan intrakranial dan reoklusi arteri dini serta kekambuhan pada pasien AIS LVO pasca dilakukan trombektomi mekanis sehingga pemantauan berkala, deteksi cepat dan kepatuhan terhadap protokol pengendalian infeksi post MT sangatlah penting.

Abstract: At the beginning of 2020 the world was surprised by the emergence of COVID-19 disease which was subsequently declared a pandemic by WHO in March 2020. This pandemic caused a global health crisis that impacted everyone. Campus life has also changed in response to the current pandemic, resulting in an impact on students' psychological condition. Aim: This study aims to find out what are the psychological impacts of the COVID-19 pandemic on students. This research was conducted in the form of review literature that is to explain and discuss it by taking materials from various available at ClinicalKey and PubMed based on inclusion and exclusion criteria. Eleven literatures were obtained, which from various countries. The age of the sample is 17-29 years. Female students with total 421,145 (55.7%) students. The psychological impacts found were anxiety, depression, stress, post-traumatic stress syndrome, and post-traumatic growth. Female students, volunteers, first year, residence, viral infection, and various other factors are associated with existing psychological symptoms. In conclusion, various psychological impacts experienced by students during the COVID-19 pandemic. The role of the government for the procurement and optimization of health programs is indispensable. Parents as expected can provide support.Keywords: psychological impact, COVID-19, university student Abstrak: Pada awal tahun 2020 dunia dikejutkan dengan munculnya penyakit COVID-19 yang selanjutnya dideklarasikan sebagai pandemi oleh WHO pada bulan Maret 2020. Pandemi ini menyebabkan krisis kesehatan global yang berdampak pada semua orang. Kehidupan kampus turut berubah menanggapi pandemi yang sedang terjadi, mengakibatkan dampak pada kondisi psikologis mahasiswa. Penelitian ini bertujuan untuk mengetahui apa saja dampak psikologis pandemi COVID-19 pada mahasiswa. Penelitian ini dilakukan dalam bentuk literatur review yaitu memaparkan dan membahasnya dengan mengambil bahan dari berbagai yang tersedia di pangkal data ClinicalKey dan PubMed berdasarkan kriteria inklusi dan eksklusi. Didapatkan sebanyak sebelas literatur yang sesuai, yang berasal dari berbagai negara. Usia sampel yaitu, 17-29 tahun. Mahasiswa perempuan sebanyak 421.145 (55.7%). Dampak psikologis yang ditemukan adalah kecemasan, depresi, stress, sindrom stress pasca trauma, dan pertumbuhan pasca trauma. Mahasiswa perempuan, relawan, tahun pertama, tempat tinggal, infeksi virus, dan berbagai faktor lain dikaitkan dengan gejala psikologis yang ada. Sebagai simpulan, Berbagai dampak psikologis yang dialami oleh mahasiswa yang dimasa pandemi COVID-19. Peran pemerintah untuk pengadaan dan optimalisasi program kesehatan sangat diperlukan. Orang tua sebagai diharapkan dapat memberikan dukungan.Kata kunci: dampak psikologis, COVID-19, mahasiswa

<p><strong>Latar Belakang : </strong>Pandemi Novel Coronavirus Disease 2019 (COVID-19) yang disebabkan oleh virus SARS CoV-2 ini berawal dari Wuhan, China, menyebar ke lebih dari 200 negara dan mengakibatkan puluhan ribu kematian termasuk anak-anak. Tanda dan gejala umum infeksi COVID-19 antara lain gejala gangguan pernapasan akut seperti demam, batuk dan sesak napas. Masa inkubasi rata-rata 5-6 hari dengan masa inkubasi terpanjang 14 hari. Pada kasus COVID-19 yang berat dapat menyebabkan pneumonia, sindrom pernapasan akut, gagal ginjal, dan bahkan kematian. Tujuan penyuluhan pengabdian ini adalah untuk mengetahui kepatuhan anak- anak terhadap protokol kesehatan Covid-19 saat pergi belajar mengaji di Rt.003 Perumahan Sarana Indah Residence. <strong>Metode : </strong>Penelitian ini menggunakan <em>analisis deskriptif </em>dengan pendekatan kuantitatif, Pengisian Pre-Test dan Post-Test melalui <em>Google Formulir</em>. Kuesioner dibagikan melalui pesan pribadi <em>Whatsapp</em>. Sampel dalam penelitian ini berjumlah 34 orang, metode pengambilan sampel menggunakan <em>total sampling. </em>Program penyuluhan dilakukan secara lisan tentang etika batuk dan bersin, mencuci tangan yang baik dan benar dengan mengikuti 6 langkah, dan tentang protokol kesehatan seperti memakai masker, jaga jarak 1-2 meter, mencuci tangan pake sabun di air mengalir. <strong>Hasil : </strong>Setelah dilakukan penyuluhan dan edukasi didapatkan hasil bahwa pengetahuan, perilaku, dan sikap responden mengalami peningkatan yang cukup baik yaitu dengan presentase 70-95% (24-31 orang) dari jumlah responden sebanyak 34 orang.</p>

ABSTRAK Pandemi Covid-19 menyebabkan berbagai masalah psikologis, terutama pada pasien dengan penyakit komorbid, salah satunya yaitu diabetes melitus. Hal ini terbukti bahwa sebanyak 65% orang mengalamai masalah tersebut, antara lain depresi, cemas, gangguan tidur, hingga sindrom pasca trauma. Namun, hingga saat ini, gangguan psikologis tersebut masih dianggap sebelah mata. Hal ini juga terjadi di Dusun Kanoman, Pleret, Bantul. Sehingga pengabdian ini bertujuan untuk memeriksa status psikologis masyarakat yang menderita Diabetes Melitus di masa pandemic Covid. Kegiatan pengabdian meliputi pemeriksaan psikologis dengan menggunakan kuesioner Depression, Anxiety, and Stress 21 Scale (DASS 21) dan konsultasi. Kuesioner ini memeriksa depresi, cemas, dan stress yang dialami penderita diabetes melitus. Kemudian, hasil dianalisis menggunakan SPSS 25. Berdasarkan hasil diketahui bahwa 20% penderita mengalami depresi sedang, 13,3% mengalami cemas sedang, dan 6,7% mengalami stress ringan. Setelah pemeriksaan, peserta diarahkan ke meja konsultasi. Di meja tersebut, peserta diajarkan cara-cara untuk manajemen relaksasi seperti nafas dalam dengan disertai afirmasi positif, spiritual relaxation techniques, dan terapi musik. KATA KUNCI: Gangguan Psikologis; Covid-19; Diabetes Melitus ABSTRACT The Covid-19 pandemic caused various psychological problems, especially in patients with comorbid diseases, such as diabetes mellitus. It was proven that as much as 65% of people who experience these problems, including depression, anxiety, sleep disorders, and post-traumatic syndrome. However, until now, this psychological disorder is not still considered. This also happened in Kanoman, Pleret, Bantul. So that this service aimed to examine the psychological status of people suffering from Diabetes Mellitus during the Covid pandemic. Service activities include psychological examinations using the Depression, Anxiety, and Stress 21 Scale (DASS 21) questionnaire and consultation. This questionnaire examines depression, anxiety, and stress experienced by people with diabetes mellitus. Then, the results were analysed using SPSS 25. Based on the results, it was found that 20% of patients had got moderate depression, 13.3% moderate anxiety, and 6.7% mild stress. After the examination, participants were directed to the consultation table. At the table, participants had mental health promotion about relaxation management techniques such as deep breathing accompanied by positive affirmations, spiritual relaxation techniques, and music therapy.

Introduzione. Ad oggi restano ancora da scoprire le implicazioni a lungo termine per i pazienti che sopravvivono, dopo ospedalizzaizone, all'infezione da SARS-CoV-2, soprattutto per coloro che hanno contratto una forma severa di COVID-19. Obbiettivo. Misurare il carico di malattia residua ancora rilevabile a circa tre mesi e un anno dalla dimissione in pazienti sottoposti a procedure invasive di ventilazione durante la degenza indice. Materiali e metodi. È stato condotto uno studio osservazionale monocentrico includendo pazienti dimessi vivi dal ricovero ospedaliero con diagnosi principale di COVID-19 e sottoposti a procedure ventilatorie durante la degenza ospedaliera. I sintomi e un'ampia gamma di indagini strumentali ed esami TC sono stati valutati dopo circa tre mesi e un anno dalla dimissione indice da un team multidisciplinare utilizzando procedure standardizzate. Risultati. Tra marzo e giugno 2020 sono stati arruolati 203 pazienti che hanno accettato di sottoporsi a una visita ambulatoriale dopo tre mesi dalla dimissione. Circa il 60% dei pazienti aveva almeno un sintomo, il 6,5% aveva un basso livello di saturazione durante la lettura dell'ossimetria e l'85,0% aveva almeno un'anomalia dell'analisi del sangue. Più del 20% dei pazienti presentava almeno il 50% del parenchima polmonare affetto da anomalie. Durante la visita è stata richiesta una consulenza specialistica per il 21,2% dei soggetti. A livello globale, poco più del 20% dei pazienti presentava ancora una grave malattia residua da COVID-19. La durata della degenza ospedaliera superiore a 30 giorni era significativamente associata al rischio di avere una malattia residua grave. Conclusione. Un'ampia percentuale di pazienti presentava ancora segni clinici e strumentali di malattia residua circa due mesi dopo la dimissione e ad un anno, seppur in una percentuale più ridotta si protraevano anomalie. Fornire una valutazione coordinata e multidisciplinare a lungo termine, attraverso la costruzione di protocolli standardizzati dovrebbe essere presa in considerazione per tali pazienti, anche alla luce della programmazione sanitaria futura.
Background. Long-term implications for patients surviving SARS-CoV-2 infection, mostly for those who experienced critical COVID-19, remain to be uncovered. Objective. To measure the burden of residual disease still detectable approximately three months and one year after discharge in patients underwent to mechanical ventilation during the index hospital stay. Methods. A single-center observational study was performed by including patients discharged alive from hospital admission with main diagnosis of COVID-19, and who underwent mechanical ventilation during hospital stay. Symptoms and a wide range of instrumental signs and CT exams were assessed after approximately three months and one years from index discharge by a multidisciplinary team using standardized procedures. Results. Between March and June 2020, 203 patients were enrolled and agreed to undergo an outpatient visit after two months since discharge. About 60% patients had at least one symptom, 6.5% had low level of saturation during oximetry reading and 85.0% had at least a blood test abnormality. More than 20% patients had at least 50% of the lung parenchyma affected by abnormalities. During the visit, a specialist consultation was requested for 21.2% of the subjects. Globally, just above 20% of the patients still presented severe COVID-19 Residual Illness. Duration of hospital stay longer than 30 days was significantly associated with the risk of having severe residual illness. Conclusion. A large proportion of patients still had clinical and instrumental signs of residual illness approximately two months after discharge. Provision of a coordinated, multidisciplinary long-term assessment should be considered for such patients experiencing critical COVID-19 disease, also in the light of future health planning