Predictors of Recovery and the App-Facilitated Tele-Rehabilitation (AFTER) Program for COVID Survivors

康复预测因素以及针对新冠肺炎幸存者的应用程序辅助远程康复 (AFTER) 计划

• 批准号: 10169066
• 负责人: Kristine Mace Erlandson
• 金额: $ 52.35万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10169066
• 关键词: 2019-nCoV; Accounting; Acute; Address; Adult; Adult Respiratory Distress Syndrome; Age; Aging; C-reactive protein; COVID-19; Caring; Cessation of life; Characteristics; Cognition; Complex; Computerized Medical Record; Critical Illness; Data; Development; Disease; Disease Surveillance; Dyspnea; Elderly; Enrollment; Equipment; Exposure to; Face; Fatigue; Funding; Health; Health Services Accessibility; Home environment; Hospital Personnel; Hospitalization; Hospitals; Hour; Impairment; Individual; Inflammation; Inflammatory Response; Injury; Intensive Care Units; Intervention; Learning Module; Marble; Measures; Mechanical ventilation; Medical; Moods; Morbidity - disease rate; Myalgia; National Heart, Lung, and Blood Institute; Neuropsychology; Outcome; Outcome Measure; Participant; Patients; Persons; Physical Function; Population; Prone Position; Provider; Quarantine; Recovery; Rehabilitation therapy; Resources; Risk Factors; Sedation procedure; Smell Perception; Software Tools; Standardization; Stress; Subgroup; Survivors; Symptoms; Taste Perception; Testing; Time; Translating; Uncertainty; Work; aged; base; biobehavior; comorbidity; coronavirus disease; cost; disability; exercise program; experience; high risk; human old age (65+); improved; innovation; middle age; mortality; multiple chronic conditions; novel; pandemic disease; post-traumatic symptoms; prevent; programs; prospective; recruit; rehabilitation service; rehabilitative care; telehealth; telerehabilitation; virtual

PROJECT SUMMARY/ABSTRACT Older adults and adults with comorbidities or disability are at highest risk for morbidity and mortality from COVID-19, although many healthy middle-aged adults without underlying risk factors also experience severe disease, likely driven by a profound and exaggerated inflammatory response. Those who develop severe COVID-19 with acute respiratory distress syndrome often require prolonged mechanical ventilation and have limited contact with hospital personnel, including rehabilitation providers, due to infectivity and shortages of adequate personal protective equipment. Even patients with less severe COVID-19 who do not require intensive care unit (ICU) care often experience prolonged fatigue, myalgias, and activity-limiting dyspnea. While the long-term consequences of COVID-19 are not yet known, the combination of immobility, limited in- hospital interventions, and heightened inflammation may have detrimental effects on physical function lasting well beyond that seen with other critical illness. The overarching hypothesis is that both older adults with multimorbidity and healthy middle-aged adults who experience the `accelerated aging' effects of profound inflammation associated with COVID-19 will experience significant ongoing physical and neuropsychological impairment. Novel, scalable interventions that can overcome many of the barriers imposed by COVID-19 are urgently needed to reverse physical and neuropsychological impairments and prevent the long-term functional consequences. Aim 1 will determine predictors of improved post-hospitalization recovery of adults recently hospitalized with COVID-19. Aim 2 will investigate the feasibility and initial efficacy of a multicomponent tele- rehabilitation program during COVID-19 recovery. This study will enroll 300 adults recently hospitalized due to COVID-19 and follow these individuals for 16 weeks post-discharge using telehealth; Aim 2 will enroll a subset of 40 individuals from Aim 1 who required ICU care for at least 24 hours, who will be compared to similar controls in Aim 1. Significance of the proposed work is based on the great need to identify predictors of multisystem recovery and long-term health in survivors of COVID-19, and to deliver safe and effective rehabilitative care to medically complex patients even, and especially, when they face post-hospitalization barriers to in-person care. This work will directly translate to other medically complex populations who will benefit from innovative tele-rehabilitation, which has not yet been applied to medically complex patients. This study will contribute immediately to our knowledge of the course of recovery for survivors of COVID-19 and predictors for prolonged impairment during COVID-19 recovery. Furthermore, it will advance the feasibility of tele-rehabilitation as a more generally useful intervention in medically complex patients lacking access (distance, availability, mobility) to standard rehabilitative services. Developing safe and effective tele- rehabilitation programs as alternatives to in-person rehabilitation for medically complex populations could transform post-hospital care for medically complex patients including, but not limited to, those with COVID-19.

项目摘要/摘要 合并症或残疾的老年人和成年人的发病率和死亡率最高 COVID-19，尽管许多没有潜在危险因素的健康中年成年人也经历了严重 疾病可能是由深刻而夸张的炎症反应驱动的。那些发展严重的人 与急性呼吸遇险综合症的共同19-19通常需要长时间的机械通气，并具有 由于感染力和短缺，与医院人员的接触有限 足够的个人防护设备。即使是不需要不需要的covid的患者也不需要 重症监护病房（ICU）护理通常会经历长时间的疲劳，肌痛和限制活动呼吸困难。 尽管Covid-19的长期后果尚不清楚，但固定性的组合有限，IN- 医院干预措施和炎症增强可能对持久的身体机能有害 远远超出了其他重症疾病。总体假设是两个老年人 多种疾病和健康的中年成年人，他们经历了深刻的“加速衰老”影响 与Covid-19相关的炎症将经历重要的持续的身体和神经心理学 损害。可以克服COVID-19所施加的许多障碍的新型，可扩展的干预措施是 迫切需要扭转身体和神经心理学障碍并防止长期功能 结果。 AIM 1将确定改善成年人院后恢复后改善的预测指标 19岁住院。 AIM 2将调查多组分远程的可行性和初始功效 Covid-19恢复期间的康复计划。这项研究将招募300名最近因 COVID-19，并使用远程医疗后16周关注这些人。 AIM 2将注册一个子集 在AIM 1的40个人中，需要ICU护理至少24小时，他们将与类似 目标1中的控制。拟议工作的重要性是基于确定预测因素的巨大需求 Covid-19的幸存者的多系统恢复和长期健康，并提供安全有效 康复护理至关重要的患者，尤其是当他们面对院后的治疗 面对面护理的障碍。这项工作将直接转化为其他医学复杂的人群 受益于创新的远程康复，尚未应用于医学复杂的患者。这 研究将立即为我们对Covid-19和Covid-19和 预测在19009恢复期间长时间损伤的预测因素。此外，它将提高 电信理化是对缺乏访问的医学复杂患者的更普遍有用的干预措施 （距离，可用性，流动性）到标准康复服务。开发安全有效的电信 康复计划是医学上复杂人群的面对面康复的替代方案 为医学复杂的患者改造院后护理，包括但不限于19岁的患者。

项目成果

Assessing the sensibility and utility of a short-form version of the HIV Disability Questionnaire in clinical practice settings in Canada, Ireland and the USA: a mixed methods study.

评估简短版艾滋病毒残疾问卷在加拿大、爱尔兰和美国临床实践环境中的敏感性和实用性：一项混合方法研究。

• DOI: 10.1136/bmjopen-2022-062008
• 发表时间: 2022-09-29
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: O'Brien, Kelly K.;Solomon, Patricia;Carusone, Soo Chan;Erlandson, Kristine M.;Bergin, Colm;Bayoumi, Ahmed M.;Hanna, Steven E.;Harding, Richard;Brown, Darren A.;Vera, Jaime H.;Boffito, Marta;Murray, Carolann;Aubry, Rachel;O'Shea, Noreen;St Clair-Sullivan, Natalie;Boyd, Mallory;Swinton, Marilyn;Torres, Brittany;Davis, Aileen M.
• 通讯作者: Davis, Aileen M.

Association of Phenotypic Aging Marker with comorbidities, frailty and inflammatory markers in people living with HIV.

• DOI: 10.1186/s12877-022-03720-1
• 发表时间: 2022-12-31
• 期刊: BMC GERIATRICS
• 影响因子: 4.1
• 作者: Han, Win Min;Apornpong, Tanakorn;Gatechompol, Sivaporn;Ubolyam, Sasiwimol;Chattranukulchai, Pairoj;Wattanachanya, Lalita;Siwamogsatham, Sarawut;Kerr, Stephen J.;Erlandson, Kristine M.;Avihingsanon, Anchalee
• 通讯作者: Avihingsanon, Anchalee

Inference following multiple imputation for generalized additive models: an investigation of the median p-value rule with applications to the Pulmonary Hypertension Association Registry and Colorado COVID-19 hospitalization data.

• DOI: 10.1186/s12874-022-01613-w
• 发表时间: 2022-05-21
• 期刊: BMC medical research methodology
• 影响因子: 4
• 作者: Bolt MA;MaWhinney S;Pattee JW;Erlandson KM;Badesch DB;Peterson RA
• 通讯作者: Peterson RA

Frailty and HIV: Moving from Characterization to Intervention.

• DOI: 10.1007/s11904-021-00554-1
• 发表时间: 2021-06
• 期刊: Current HIV/AIDS reports
• 影响因子: 4.6
• 作者: Erlandson KM;Piggott DA
• 通讯作者: Piggott DA

Episodic Disability Questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States.

突发性残疾问卷 (EDQ) 测量加拿大、爱尔兰、英国和美国艾滋病毒感染者的特征。

• DOI: 10.21203/rs.3.rs-2758163/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: O'Brien,KellyK;Erlandson,KristineM;Brown,DarrenA;Carusone,SooChan;Vera,JaimeH;Bergin,Colm;Avery,Lisa;Bayoumi,AhmedM;Hanna,StevenE;Harding,Richard;Solomon,Patricia;StClair-Sullivan,Natalie;O'Shea,Noreen;Murray,Carolann;B
• 通讯作者: B