Harenwall Sari, Heywood-Everett Suzanne, Henderson Rebecca, Smith Joanne, McEnery Rachel, Bland Amy R
Primary Care Wellbeing Service, Bradford District Care NHS Foundation Trust, Shipley BD18 3LD, UK.
Department of Psychology, Manchester Metropolitan University, Manchester M15 6BH, UK.
J Clin Med. 2022 Oct 21;11(20):6214. doi: 10.3390/jcm11206214.
Post-traumatic stress symptoms (PTSS) and breathlessness have been well documented in the acute phase of COVID-19 as well as in Post-COVID-19 Syndrome (PCS), commonly known as Long-COVID. The present study aimed to explore whether PTSS and breathlessness interact to exacerbate fatigue among individuals recovering from PCS, similar to the effects evidenced in other health conditions that feature respiratory distress..
Outcome measures were collected from 154 participants reporting persistent fatigue following acute COVID-19 infection who were enrolled in a 7-week rehabilitation course provided by the Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT).
Hierarchical multiple linear regression revealed that fatigue severity was associated with a significant interaction between PTSS and breathlessness, even when controlling for pre-COVID health related quality of life (HRQoL), age, symptom duration and hospital admittance during the acute phase. Furthermore, improvements in fatigue following rehabilitation were significantly associated with improvements in PTSS.
PTSS may be an important therapeutic target in multidisciplinary rehabilitation for reducing fatigue in the recovery from PCS. It is therefore important that treatment for PCS takes a biopsychosocial approach to recovery, putting emphasis on direct and indirect psychological factors which may facilitate or disrupt physical recovery. This highlights the need for all PCS clinics to screen for PTSD and if present, target as a priority in treatment to maximise the potential for successful rehabilitation.
创伤后应激症状（PTSS）和呼吸急促在新冠疫情急性期以及新冠后综合征（PCS，通常称为长新冠）中已有充分记录。本研究旨在探讨PTSS和呼吸急促是否相互作用，加剧PCS康复者的疲劳，类似于在其他有呼吸窘迫特征的健康状况中所证实的效果。
从154名报告在急性新冠感染后持续疲劳的参与者中收集结果指标，这些参与者参加了布拉德福德地区护理国民保健服务信托基金（BDCFT）初级保健福利服务（PCWBS）提供的为期7周的康复课程。
分层多元线性回归显示，即使在控制急性期中新冠前与健康相关的生活质量（HRQoL）、年龄、症状持续时间和住院情况后，疲劳严重程度仍与PTSS和呼吸急促之间的显著相互作用相关。此外，康复后疲劳的改善与PTSS的改善显著相关。
PTSS可能是多学科康复中减轻PCS康复期疲劳的一个重要治疗靶点。因此，PCS的治疗采用生物心理社会康复方法很重要，强调可能促进或干扰身体康复的直接和间接心理因素。这突出了所有PCS诊所筛查创伤后应激障碍的必要性，如果存在该障碍，应将其作为治疗重点，以最大限度提高成功康复的可能性。
