Biomedical and Clinical Exercise Science Research Theme, University of Derby, Derby, UK; Healthy Living for Pandemic Event Protection Network (HL-Pivot), Illinois, Chicago, USA.
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
Prog Cardiovasc Dis. 2024 Mar-Apr;83:62-70. doi: 10.1016/j.pcad.2024.03.003. Epub 2024 Mar 8.
The Post Covid-19 Condition (commonly known as Long Covid) has been defined by the World Health Organisation as occurring in individuals with a history of probable or confirmed SARS CoV 2 infection, usually within 3 months from the onset of acute Covid-19 infection with symptoms that last for at least two months which cannot be explained by an alternative diagnosis. Long Covid is associated with over two hundred recognised symptoms and affects tens of millions of people worldwide. Widely reported reductions in quality of life(QoL) and functional status are caused by extremely sensitive and cyclical symptom profiles that are augmented following exposure to physical, emotional, orthostatic, and cognitive stimuli. This manifestation prevents millions of people from engaging in routine activities of daily living (ADLs) and has important health and well-being, social and economic impacts. Post-exertional symptom exacerbation (PESE) (also known as post-exertional malaise) is an exacerbation in the severity of fatigue and other symptoms following physical, emotional, orthostatic and cognitive tasks. Typically, this will occur 24-72 h after "over-exertion" and can persist for several days and even weeks. It is a hallmark symptom of Long Covid with a reported prevalence of 86%. The debilitating nature of PESE prevents patients from engaging in physical activity which impacts functional status and QoL. In this review, the authors present an update to the literature relating to PESE in Long Covid and make the case for evidence-based guidelines that support the design and implementation of safe rehabilitation approaches for people with Long Covid. This review also considers the role of objective monitoring to quantify a patient's response to external stimuli which can be used to support the safe management of Long Covid and inform decisions relating to engagement with any stimuli that could prompt an exacerbation of symptoms.
新冠后状况（俗称长新冠）已被世界卫生组织定义为在曾有 SARS-CoV-2 感染史的个体中发生，通常在急性新冠感染后 3 个月内出现，症状持续至少 2 个月，无法用其他诊断解释。长新冠与两百多种公认的症状有关，影响着全世界数千万人。广泛报道的生活质量（QoL）和功能状态下降是由极其敏感和周期性的症状谱引起的，这些症状谱在暴露于身体、情绪、体位和认知刺激后会加重。这种表现使数百万人无法从事日常活动，对健康和福祉、社会和经济都有重要影响。活动后症状恶化（PESE）（也称为活动后不适）是指在进行体力、情绪、体位和认知任务后，疲劳和其他症状的严重程度加重。通常，这会在“过度劳累”后 24-72 小时发生，并持续数天甚至数周。它是长新冠的一个标志性症状，报告的患病率为 86%。PESE 的衰弱性质使患者无法从事体力活动，从而影响功能状态和 QoL。在这篇综述中，作者对与长新冠中的 PESE 相关的文献进行了更新，并提出了循证指南的案例，以支持为长新冠患者设计和实施安全康复方法。这篇综述还考虑了客观监测的作用，以量化患者对外部刺激的反应，这可以用于安全管理长新冠，并为与任何可能引发症状恶化的刺激有关的参与做出决策提供信息。
