Of the 1,900,000 Canadians who have been infected by COVID-19, 8 to 15% will continue to experience COVID-19 related symptoms well after 12 weeks. The persistence of such symptoms is now defined as "long COVID" syndrome. Current evidence does not provide a clear understanding of the physical and cognitive impairments and functional limitations that persons with long COVID present. The objectives of this project are to describe the physical and cognitive impairments and functional limitations experienced by people with long COVID and compare the evolution over 6 months of people from three separate groups: a group of people with long COVID (long COVID Group), another group of people who contracted COVID-19 but did not experience persistent symptoms (acute COVID Group), and a group of people who did not contract COVID-19 (Control Group). One hundred and twenty adults in each of the three groups will be recruited and will take part in three evaluations within 6 months (baseline and 3 and 6 months after baseline). At baseline, all participants will complete questionnaires on sociodemographics, COVID symptomatology and comorbidity, and self-reported questionnaires on quality of life, functional status, sleep, pain-related disabilities, anxiety, depression, fatigue and cognitive function. Then, physical and cognitive tests will be performed in a laboratory to provide complementary results on impairments and functional limitations. Finally, participants will wear a fitness tracker watch to monitor their activity and sleep for 7 days. The participants will complete the same measures (questionnaires, lab measures, fitness tracker watch) at 3 and 6 months after baseline evaluations. This project will lead to a better understanding of the impairments/limitations experienced following COVID-19. Hence, these results will allow to identify the interventions needed by the population and ensure these are offered through effective healthcare pathways.
The objectives of this study are to: describe the physical and cognitive impairments and functional limitations experienced by individuals with long COVID using self-reported and objective clinical measures and compare the evolution over time of the physical and cognitive state and level of functioning between: a) people with long COVID, b) people who contracted COVID-19 but did not experience persistent symptoms, and c) people who did not contract COVID-19. One hundred and twenty adults with long COVID symptoms (Long COVID Group), 120 age- and sex-matched adults who contracted COVID-19 but did not experience persistent symptoms (Acute COVID Group) and 120 age- and sex-matched adults who did not contract COVID-19 (Control Group) will take part in three evaluations within 6 months (baseline and 3 and 6 months after baseline). The baseline evaluation will include 1) the completion of web-based self-administered questionnaires (quality of life, functional status, sleep, pain-related disabilities, anxiety, depression, fatigue and cognitive function); 2) an in-lab session at one of the two participating research centers (Centre interdisciplinaire de recherche en réadaptation et en intégration sociale \[Cirris\] in Quebec City, Centre de recherche de l'Hôpital Maisonneuve-Rosemont \[CRHMR\] in Montreal) during which participants will answer questions on sociodemographics, COVID-19 medical history and symptoms experienced, and will perform clinical tests to objectify cognitive and physical impairments and functional limitations (attention, memory, executive functioning, grip strength, balance, gait speed and endurance, oxygen consumption \[VO2\] and metabolic cost of walking), and 3) wearing a fitness tracker watch to monitor activity and sleep for 7 days. The participants will complete the same measures (questionnaires, lab measures, fitness tracker watch) at three and 6 months after baseline evaluation Statistical analyses for objective 1 will aim at presenting a sociodemographic and COVID history profiles of the Long COVID Group at baseline according to sex, gender, hospitalization, time since onset and comorbidities. Scores at baseline on self-reported and clinical variables will also be compared with the Acute COVID and Control Groups via three-group One-way ANOVA (maximum-likelihood ANOVA). For objective 2, repeated measures ANOVA will be used to compare the divergence in longitudinal performance across groups in self-reported and clinical variables (generalized ANOVA for repeated measures). Gaining a greater understanding of the physical and cognitive state and level of functioning of persons with long COVID and on characteristics of those who will have a poorer outcome will help better define healthcare needs of these persons and guide the development of appropriate medical and rehabilitation interventions. Best practices in terms of medical and rehabilitation services in cases of long COVID are still just emerging and offering appropriate services to persons suffering from long COVID may contribute to improving outcomes such as long-term physical and cognitive impairments and functional limitations, as well as health-related quality of life.
Study Type
OBSERVATIONAL
Enrollment
360
No intervention
Université Laval
Québec, Canada
Health-related quality of life (HRQoL) baseline
5-level EQ-5D (EQ-5D-5L): generic HRQoL self-reported questionnaire that contains 5 questions covering 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression
Time frame: Baseline
Health-related quality of life (HRQoL) at 3 months
5-level EQ-5D (EQ-5D-5L): generic HRQoL self-reported questionnaire that contains 5 questions covering 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression
Time frame: 3-month follow-up
Health-related quality of life (HRQoL) at 6 months
5-level EQ-5D (EQ-5D-5L): generic HRQoL self-reported questionnaire that contains 5 questions covering 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression
Time frame: 6-month follow-up
Comorbidities
Self- Administered Comorbidity Questionnaire (SCQ): generic questionnaire with 13 common medical conditions.
Time frame: Baseline
Sleep Quality
Pittsburgh Sleep Quality Index (PSQI): evaluates the quality and patterns of sleep over the last month.
Time frame: Baseline
Sleep Quality
Pittsburgh Sleep Quality Index (PSQI): evaluates the quality and patterns of sleep over the last month.
Time frame: 3-month follow-up
Sleep Quality
Pittsburgh Sleep Quality Index (PSQI): evaluates the quality and patterns of sleep over the last month.
Time frame: 6-month follow-up
Pain & Pain-Related Disabilities
Brief Pain Inventory Short Form (BPI-SF): designed to evaluate the intensity of, and the impairment caused by pain.
Time frame: Baseline
Pain & Pain-Related Disabilities
Brief Pain Inventory Short Form (BPI-SF): designed to evaluate the intensity of, and the impairment caused by pain.
Time frame: 3-month follow-up
Pain & Pain-Related Disabilities
Brief Pain Inventory Short Form (BPI-SF): designed to evaluate the intensity of, and the impairment caused by pain.
Time frame: 6-month follow-up
Anxiety
General Anxiety Disorder (GAD-7): assesses the seven core symptoms of generalized anxiety disorder by asking how frequent participants have been bothered by symptoms of anxiety.
Time frame: Baseline
Anxiety
General Anxiety Disorder (GAD-7): assesses the seven core symptoms of generalized anxiety disorder by asking how frequent participants have been bothered by symptoms of anxiety.
Time frame: 3-month follow-up
Anxiety
General Anxiety Disorder (GAD-7): assesses the seven core symptoms of generalized anxiety disorder by asking how frequent participants have been bothered by symptoms of anxiety.
Time frame: 6-month follow-up
Depressive symptoms
Patient-Health Questionnaire (PHQ-9): assesses the nine symptoms of a major depressive episode.
Time frame: Baseline
Depressive symptoms
Patient-Health Questionnaire (PHQ-9): assesses the nine symptoms of a major depressive episode.
Time frame: 3-month follow-up
Depressive symptoms
Patient-Health Questionnaire (PHQ-9): assesses the nine symptoms of a major depressive episode.
Time frame: 6-month follow-up
Fatigue
Fatigue Severity Scale (FSS): measures the severity of fatigue and its effect on a person's activities and lifestyle
Time frame: Baseline
Fatigue
Fatigue Severity Scale (FSS): measures the severity of fatigue and its effect on a person's activities and lifestyle
Time frame: 3-month follow-up
Fatigue
Fatigue Severity Scale (FSS): measures the severity of fatigue and its effect on a person's activities and lifestyle
Time frame: 6-month follow-up
Self-reported cognitive function
Patient Reported Outcomes Measurement Information System (PROMIS): the PROMIS Short Form v2.0 - Cognitive Function measures perceived changes in cognitive function.
Time frame: Baseline
Self-reported cognitive function
Patient Reported Outcomes Measurement Information System (PROMIS): the PROMIS Short Form v2.0 - Cognitive Function measures perceived changes in cognitive function.
Time frame: 3-month follow-up
Self-reported cognitive function
Patient Reported Outcomes Measurement Information System (PROMIS): the PROMIS Short Form v2.0 - Cognitive Function measures perceived changes in cognitive function.
Time frame: 6-month follow-up
Persistent symptoms
Newcastle post-COVID syndrome Follow Up Screening Questionnaire: identifies individuals who are experiencing residuals COVID-19 related symptoms and for who multi-disciplinary management or specialist support may be beneficial.
Time frame: Baseline (long COVID group only)
Persistent symptoms
Newcastle post-COVID syndrome Follow Up Screening Questionnaire: identifies individuals who are experiencing residuals COVID-19 related symptoms and for who multi-disciplinary management or specialist support may be beneficial.
Time frame: 3-month follow-up (long COVID group only)
Persistent symptoms
Newcastle post-COVID syndrome Follow Up Screening Questionnaire: identifies individuals who are experiencing residuals COVID-19 related symptoms and for who multi-disciplinary management or specialist support may be beneficial.
Time frame: 6-month follow-up (long COVID group only)
Cognitive function - MoCA
MoCA: assesses short term memory, visuospatial abilities, executive functions, attention, concentration and working memory, language and orientation in time and place.
Time frame: Baseline
Cognitive function - MoCA
MoCA: assesses short term memory, visuospatial abilities, executive functions, attention, concentration and working memory, language and orientation in time and place.
Time frame: 3-month follow-up
Cognitive function - MoCA
MoCA: assesses short term memory, visuospatial abilities, executive functions, attention, concentration and working memory, language and orientation in time and place.
Time frame: 6-month follow-up
Cognitive function - auditory attention and working memory
Digit Span subtest of the WAIS-IV battery (including forward and Backward tasks): assesses auditory attention and working memory.
Time frame: Baseline
Cognitive function - auditory attention and working memory
Digit Span subtest of the WAIS-IV battery (including forward and Backward tasks): assesses auditory attention and working memory.
Time frame: 3-month follow-up
Cognitive function - auditory attention and working memory
Digit Span subtest of the WAIS-IV battery (including forward and Backward tasks): assesses auditory attention and working memory.
Time frame: 6-month follow-up
Cognitive function - information processing and executive functioning
Trail Making Test: assesses speed of information processing and executive functioning.
Time frame: Baseline
Cognitive function - information processing and executive functioning
Trail Making Test: assesses speed of information processing and executive functioning.
Time frame: 3-month follow-up
Cognitive function - information processing and executive functioning
Trail Making Test: assesses speed of information processing and executive functioning.
Time frame: 6-month follow-up
Grip strength
Grip Strength: Grip strength of both hands will be measured using a handgrip dynamometer. Grip strength is associated with concurrent overall strength, upper limb function and quality of life. Three trials will be performed, and the maximum strength reached will be used in the subsequent analysis.
Time frame: Baseline
Grip strength
Grip Strength: Grip strength of both hands will be measured using a handgrip dynamometer. Grip strength is associated with concurrent overall strength, upper limb function and quality of life. Three trials will be performed, and the maximum strength reached will be used in the subsequent analysis.
Time frame: 3-month follow-up
Grip strength
Grip Strength: Grip strength of both hands will be measured using a handgrip dynamometer. Grip strength is associated with concurrent overall strength, upper limb function and quality of life. Three trials will be performed, and the maximum strength reached will be used in the subsequent analysis.
Time frame: 6-month follow-up
Lower extremity function (including balance, gait speed and lower extremity strength)
Short performance physical battery (SPPB): The SPPB is a short (5-10 min) test to measure lower extremity function using tasks that mimic daily activities. It examines 3 areas of lower extremity function, including static standing balance (3 timed standing positions), gait speed (time to complete 4m walk), and getting in and out of a chair (time to complete 5x sit to stand).
Time frame: Baseline
Lower extremity function (including balance, gait speed and lower extremity strength)
Short performance physical battery (SPPB): The SPPB is a short (5-10 min) test to measure lower extremity function using tasks that mimic daily activities. It examines 3 areas of lower extremity function, including static standing balance (3 timed standing positions), gait speed (time to complete 4m walk), and getting in and out of a chair (time to complete 5x sit to stand).
Time frame: 3-month follow-up
Lower extremity function (including balance, gait speed and lower extremity strength)
Short performance physical battery (SPPB): The SPPB is a short (5-10 min) test to measure lower extremity function using tasks that mimic daily activities. It examines 3 areas of lower extremity function, including static standing balance (3 timed standing positions), gait speed (time to complete 4m walk), and getting in and out of a chair (time to complete 5x sit to stand).
Time frame: 6-month follow-up
Gait endurance
6-minute walk test (6MWT): The 6MWT will be performed in a 15 to 20-meter corridor and the distance covered will be measured with a measuring wheel.
Time frame: Baseline
Gait endurance
6-minute walk test (6MWT): The 6MWT will be performed in a 15 to 20-meter corridor and the distance covered will be measured with a measuring wheel.
Time frame: 3-month follow-up
Gait endurance
6-minute walk test (6MWT): The 6MWT will be performed in a 15 to 20-meter corridor and the distance covered will be measured with a measuring wheel.
Time frame: 6-month follow-up
Oxygen consumption (VO2)
Oxygen consumption (VO2) will be measured during the 6WMT using indirect calorimetry collected by a portable gas analysis system (Metamax® 3b).
Time frame: Baseline
Oxygen consumption (VO2)
Oxygen consumption (VO2) will be measured during the 6WMT using indirect calorimetry collected by a portable gas analysis system (Metamax® 3b).
Time frame: 3-month follow-up
Oxygen consumption (VO2)
Oxygen consumption (VO2) will be measured during the 6WMT using indirect calorimetry collected by a portable gas analysis system (Metamax® 3b).
Time frame: 6-month follow-up
Metabolic cost of walking
Metabolic cost of walking will be measured during the 6WMT using indirect calorimetry collected by a portable gas analysis system (Metamax® 3b).
Time frame: Baseline
Metabolic cost of walking
Metabolic cost of walking will be measured during the 6WMT using indirect calorimetry collected by a portable gas analysis system (Metamax® 3b).
Time frame: 3-month follow-up
Metabolic cost of walking
Metabolic cost of walking will be measured during the 6WMT using indirect calorimetry collected by a portable gas analysis system (Metamax® 3b).
Time frame: 6-month follow-up
Frailty
Clinical Frailty Scale (CFS): The CFS is a scale used to grade frailty and thus, identify participants who are at a higher risk of poor outcomes.
Time frame: Baseline
Frailty
Clinical Frailty Scale (CFS): The CFS is a scale used to grade frailty and thus, identify participants who are at a higher risk of poor outcomes.
Time frame: 3-month follow-up
Frailty
Clinical Frailty Scale (CFS): The CFS is a scale used to grade frailty and thus, identify participants who are at a higher risk of poor outcomes.
Time frame: 6-month follow-up
Physical activity - Number of steps in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The average daily number of steps will be retrieved
Time frame: Baseline
Physical activity - Number of steps in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The average daily number of steps will be retrieved
Time frame: 3-month follow-up
Physical activity - Number of steps in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The average daily number of steps will be retrieved
Time frame: 6-month follow-up
Physical activity - Weekly number of minutes of moderate and intense activity in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations.The weekly number of minutes of moderate and intense activity will be retrieved
Time frame: Baseline
Physical activity - Weekly number of minutes of moderate and intense activity inreal-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations.The weekly number of minutes of moderate and intense activity will be retrieved
Time frame: 3-month follow-up
Physical activity - Weekly number of minutes of moderate and intense activity in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations.The weekly number of minutes of moderate and intense activity will be retrieved
Time frame: 6-month follow-up
Sleep: Sleep time in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The sleep time will be retrieved from the fitness tracker watch
Time frame: Baseline
Sleep: Sleep time in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The sleep time will be retrieved from the fitness tracker watch
Time frame: 3-month follow-up
Sleep: Sleep time in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The sleep time will be retrieved from the fitness tracker watch
Time frame: 6-month follow-up
Sleep: Sleep efficiency in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The sleep efficiency will be retrieved from the fitness tracker watch
Time frame: Baseline
Sleep: Sleep efficiency in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The sleep efficiency will be retrieved from the fitness tracker watch
Time frame: 3-month follow-up
Sleep: Sleep efficiency in real-life environment
Participants will be asked to wear a fitness tracker watch (Garmin Forerunner 35) 24 hrs/day for 7 consecutive days after each of the three physical evaluations. The sleep efficiency will be retrieved from the fitness tracker watch
Time frame: 6-month follow-up
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