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August 12, 2022

Covid-19 roundup: Could cognitive rehabilitation help long Covid patients?

Daily Briefing

    Most vaccinated individuals ages 50 and older say they will get an updated booster in the fall, prescriptions of Paxlovid reach more than 1 million in July, and more in this week's roundup of Covid-19 news.

    Case study: Recovery clinics for Covid-19 long-haulers

      • Using an observational cohort study, researchers from the Netherlands recently proposed a list of core symptoms to better define long Covid. For the study, researchers analyzed data from the Lifelines Covid-19 and Dutch Lifelines cohort studies, which surveyed more than 1,700 patients regarding their Covid-19 symptoms between March 31, 2020, and Aug. 2, 2021. Among the Covid-19 patients, 21.4% had at least one core symptom, including chest pain, difficulty breathing, painful muscles, ageusia or anosmia, nausea, fatigue, and more, that worsened 90 to 150 days after their initial diagnosis, compared to 8.7% of controls. Overall, this suggests that 12.7% of patients experienced persistent somatic symptoms due to Covid-19. "After recovery from acute COVID-19, a substantial proportion of patients continue to experience symptoms of a physical, psychological, or cognitive nature," the researchers wrote. "These long-term sequelae of COVID-19 have been described as the next public health disaster in the making, and there is an urgent need for empirical data informing on the scale and scope of the problem to support the development of an adequate health-care response." (Short, MedPage Today, 8/4)
      • According to modeling from the Mayo Clinic, Covid-19 cases will likely begin to decrease nationwide over the next two weeks—marking the first time the health system's model has projected a decline in cases since March. According to the model, daily Covid-19 cases are expected to decrease by 2.6% over the next two weeks, with the average number of daily reported cases falling from 110,571.6 on August 5 to 107,662 by August 19. Similarly, the national Covid-19 case rate is expected to decrease from 35.8 cases per 100,000 people to 32.8 cases over the same time period. When it comes to Covid-19 hospitalizations and deaths, CDC's ensemble forecasts predict that they will largely be stable or have uncertain trends over the next four weeks. (Bean, Becker's Hospital Review, 8/8)
      • Cognitive rehabilitation is a type of therapy typically used by patients who have experienced concussions, strokes, or other conditions that impact the brain, and some medical centers are now offering it to long Covid patients who have persistent neurological symptoms, including brain fog and memory issues. In cognitive rehab, patients work with several experts, such as speech therapists and neuropsychologists, on exercises to improve different cognitive skills and practical strategies. "As patients become more aware of where difficulties occur and why, they can prepare for them and they start seeing improvement," said Lyana Kardanova Frantz, a speech therapist at Johns Hopkins University. "A lot of my patients say, 'I had no idea this [kind of therapy] could be so helpful.'" So far, many health experts say they are excited about the potential of cognitive rehab to help patients with long Covid. "Anecdotally, we're seeing a good number of people [with long covid] make significant gains with the right kinds of interventions," said Monique Tremaine, director of neuropsychology and cognitive rehabilitation at Hackensack Meridian Health’s JFK Johnson Rehabilitation Institute. (Graham, Kaiser Health News, 8/5)
      • Most people ages 50 and older who are already vaccinated plan to receive a booster shot once updated vaccines are available this fall, according to the University of Michigan's latest National Poll on Healthy Aging. Overall, the poll, which surveyed 863 participants in late July, found that 61% of individuals ages 50 and older said they were "very likely" to get a booster shot in the fall. The likelihood of getting a fall booster increased to 68% among those ages 65 and older, but decreased to 55% among those ages 50 to 64. According to Axios, the poll's findings may offer a look at how many people, particularly older adults, will get an updated booster shot in the fall. Similarly, a recent Axios-Ipsos poll found that adults ages 50 and older are more likely to get an annual booster if needed than younger adults. (Reed, Axios, 8/10)
      • 1.26 million courses of Pfizer's antiviral Paxlovid were prescribed in July, a 36% increase from June, according to HHS data. In addition, more Paxlovid was prescribed in July than in the months of January through May combined. According to an HHS spokesperson, there had been "a substantial gap in [Paxlovid] prescribing between individuals in high and low social vulnerability areas," but the agency has worked "to reduce the equity gap by more than two-thirds—from 31% to 10%." The Biden administration has also partnered with Pfizer to offer Paxlovid to 9,000 providers in more vulnerable areas where the drug is harder to access. "This will mean more product already positioned in their communities and readily available when needed," HHS said. (Gonzalez, Axios, 8/4)
      • Most Covid-19 patients who developed smell or taste dysfunction eventually recovered their senses at two years, according to a cross-sectional survey published in JAMA Otolaryngology-Head & Neck Surgery. For the study, researchers from Italy examined patients ages 18 and older who had tested positive for Covid-19 at Treviso General Hospital between March 19 and March 22, 2020, and followed up with them at four weeks, eight weeks, six months, and two years. Of the 168 eligible patients, 119 reported smell or taste dysfunction within 4 weeks. At each follow-up session, the number of patients reporting smell or taste dysfunction continued to decrease. At the two-year mark, 88.2% of patients who initially had smell or taste dysfunction reported a complete recovery, and 9.2% reported less severe symptoms. Only 2.5% reported that their symptoms had not changed or had worsened. "Contrary to what is often reported, patients should be reassured that recovery from smell or taste impairment may continue for many months after the onset," the researchers wrote. "These results apply to patients infected in the pre-Omicron period. COVID-19 driven by the SARS-CoV-2 Omicron variant has been indeed observed to less frequently and less severely affect chemosensory function." (Short, MedPage Today, 8/4)

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