Browsing by Author "Hughes, Thomas"

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    A distinct symptom pattern emerges for COVID-19 long-haul: a nationwide study
    (Springer Nature, 2022-09-23) Pinto, Melissa D.; Downs, Charles A.; Huang, Yong; El‑Azab, Sarah A.; Ramrakhiani, Nathan S.; Barisano, Anthony; Yu, Lu; Taylor, Kaitlyn; Esperanca, Alvaro; Abrahim, Heather L.; Hughes, Thomas; Giraldo Herrera, Maria; Rahamani, Amir M.; Dutt, Nikil; Chakraborty, Rana; Mendiola, Christian; Lambert, Natalie; Biostatistics, School of Public Health
    Long-haul COVID-19, also called post-acute sequelae of SARS-CoV-2 (PASC), is a new illness caused by SARS-CoV-2 infection and characterized by the persistence of symptoms. The purpose of this cross-sectional study was to identify a distinct and significant temporal pattern of PASC symptoms (symptom type and onset) among a nationwide sample of PASC survivors (n = 5652). The sample was randomly sorted into two independent samples for exploratory (EFA) and confirmatory factor analyses (CFA). Five factors emerged from the EFA: (1) cold and flu-like symptoms, (2) change in smell and/or taste, (3) dyspnea and chest pain, (4) cognitive and visual problems, and (5) cardiac symptoms. The CFA had excellent model fit (x2 = 513.721, df = 207, p < 0.01, TLI = 0.952, CFI = 0.964, RMSEA = 0.024). These findings demonstrate a novel symptom pattern for PASC. These findings can enable nurses in the identification of at-risk patients and facilitate early, systematic symptom management strategies for PASC.
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    A novel conceptual model of trauma-informed care for patients with post-acute sequelae of SARS-CoV-2 illness (PASC)
    (Wiley, 2022) Burton, Candace W.; Downs, Charles A.; Hughes, Thomas; Lambert, Natalie; Abrahim, Heather L.; Giraldo Herrera, Maria; Huang, Yong; Rahmani, Amir; Lee, Jung-Ah; Chakraborty, Rana; Pinto, Melissa D.; Biostatistics, School of Public Health
    Aim: This paper proposes a novel, trauma-informed, conceptual model of care for Post-Acute Sequelae of COVID-19 illness (PASC). Design: This paper describes essential elements, linkages and dimensions of the model that affect PASC patient experiences and the potential impact of trauma-informed care on outcomes. Data sources: PASC is a consequence of the global pandemic, and a new disease of which little is known. Our model was derived from the limited available studies, expert clinical experience specific to PASC survivors and publicly available social media narratives authored by PASC survivors. Implications for nursing: The model provides a critical and novel framework for the understanding and care of persons affected by PASC. This model is aimed at the provision of nursing care, with the intention of reducing the traumatic impacts of the uncertain course of this disease, a lack of defined treatment options and difficulties in seeking care. The use of a trauma-informed care approach to PASC patients can enhance nurses' ability to remediate and ameliorate both the traumatic burden of and the symptoms and experience of the illness. Conclusion: Applying a trauma-informed perspective to care of PASC patients can help to reduce the overall burden of this complex condition. Owing to the fundamentally holistic perspective of the nursing profession, nurses are best positioned to implement care that addresses multiple facets of the PASC experience. Impact: The proposed model specifically addresses the myriad ways in which PASC may affect physical as well as mental and psychosocial dimensions of health. The model particularly seeks to suggest means of supporting patients who have already experienced a life-threatening illness and are now coping with its long-term impact. Since the scope of this impact is not yet defined, trauma-informed care for PASC patients is likely to reduce the overall health and systems burdens of this complex condition.
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    The other COVID-19 survivors: Timing, duration, and health impact of post-acute sequelae of SARS-CoV-2 infection
    (Wiley, 2022) Lambert, Natalie; Survivor Corps; El-Azab, Sarah A.; Ramrakhiani, Nathan S.; Barisano, Anthony; Yu, Lu; Taylor, Kaitlyn; Esperança, Álvaro; Mendiola, Christian; Downs, Charles A.; Abrahim, Heather L.; Hughes, Thomas; Rahmani, Amir M.; Borelli, Jessica L.; Rana; Chakraborty, Rana; Pinto, Melissa D.; Biostatistics, School of Public Health
    Aims and objectives: To determine the frequency, timing, and duration of post-acute sequelae of SARS-CoV-2 infection (PASC) and their impact on health and function. Background: Post-acute sequelae of SARS-CoV-2 infection is an emerging major public health problem that is poorly understood and has no current treatment or cure. PASC is a new syndrome that has yet to be fully clinically characterised. Design: Descriptive cross-sectional survey (n = 5163) was conducted from online COVID-19 survivor support groups who reported symptoms for more than 21 days following SARS-CoV-2 infection. Methods: Participants reported background demographics and the date and method of their covid diagnosis, as well as all symptoms experienced since onset of covid in terms of the symptom start date, duration, and Likert scales measuring three symptom-specific health impacts: pain and discomfort, work impairment, and social impairment. Descriptive statistics and measures of central tendencies were computed for participant demographics and symptom data. Results: Participants reported experiencing a mean of 21 symptoms (range 1-93); fatigue (79.0%), headache (55.3%), shortness of breath (55.3%) and difficulty concentrating (53.6%) were the most common. Symptoms often remitted and relapsed for extended periods of time (duration M = 112 days), longest lasting symptoms included the inability to exercise (M = 106.5 days), fatigue (M = 101.7 days) and difficulty concentrating, associated with memory impairment (M = 101.1 days). Participants reported extreme pressure at the base of the head, syncope, sharp or sudden chest pain, and "brain pressure" among the most distressing and impacting daily life. Conclusions: Post-acute sequelae of SARS-CoV-2 infection can be characterised by a wide range of symptoms, many of which cause moderate-to-severe distress and can hinder survivors' overall well-being. Relevance to clinical practice: This study advances our understanding of the symptoms of PASC and their health impacts.