BACKGROUND: The long-term impact of symptom classification on quality of life (QOL) and economic outcomes among individuals with long coronavirus disease (COVID) remains poorly understood. This study aimed to clarify the situation of long COVID in Japan by analyzing patients using cluster classification. METHODS: This multicenter, retrospective cohort study enrolled 515 patients with COVID-19 and followed up for 36 months via standardized questionnaires. Patients were classified based on: 1) symptom trajectory over time and 2) symptom cluster profiles at 3 months. RESULTS: While the number of symptoms decreased, fatigue and dyspnea frequently persisted, whereas anosmia and dysgeusia declined. Cough and sputum decreased gradually. The proportion of patients with 5-9 symptoms increased. The mean (interquartile range) presenteeism scores were lower in the continuous (60 [50-80]) and relapse groups (65 [48-80]) than in the recovered group (70 [50-80]). The multiple symptoms cluster had the worst SF-36, presenteeism, and absenteeism scores (47.2 [44.7-49.8], 48.8 [27.5-72.5], and 10.9 [0.0-11.0], respectively). CONCLUSIONS Patients with continuous and multiple symptoms experienced persistently lower QOL and greater economic burden up to 36 months after COVID-19 diagnosis. The long-term effects of long COVID are not only physical but also mental and economical. Thus, further research is needed to clarify the economical and physiological impact of long COVID.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; COVID-19/complications* ; Japan/epidemiology* ; Post-Acute COVID-19 Syndrome/psychology* ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; East Asian People

Background : Since 2002, Keio University Hospital's Kampo Clinic has promoted itself actively through the media, public presentations, faculty outreach and an internet home page. However, the relative value of these promotions is unknown. Additionally, the range and prevalence of presenting concerns, and the ages and the gender ratio of the patients served at Keio is unknown.Objective and Methods : To better understand and better serve the patients, the medical charts of every new patient who presented to Keio University Hospital's Kampo Clinic from November 2004 to November 2005 (n=791) were retrospectively analyzed for 1) referral source, 2) age, 3) gender, and, 4) disease category.Results : The internet webpage was by far the best source of new patient referrals. The out-of-hospital referral rate to the clinic was remarkably low. Women exceeded men by a 3 : 1 ratio. Most women were in their thirties but male patients were fairly evenly distributed across the age spectrum. Patients under 16 and over 70 were gender-balanced. The vast majority of patients presented with general medicine/pediatric, dermatological or gynecological problems.Conclusion : A patient-oriented internet home page provides a good source of new patient referrals. Given the low rate of referrals from outside hospitals and physicians, additional outreach directed at internal medicine, dermatology or obstetrics/gynecology physicians appears warranted.
Clinic ; Hospitals ; Medicine, Kampo ; seconds ; Universities

The aim of this study was to develop a new method for the determination of NO2 levels encountered in clinical settings as well as in environmental studies, using a bi−component atmospheric pressure ionization mass spectrometry(APIMS). Hydrogen (1%) diluted in pure argon was ionized by corona discharge in the first ionization component. Fifty ml of the analyte diluted in 250ml of composite air or carbon dioxide (CO2) was introduced into the second ionization component and analyzed. When composite air was used as the sample carrier gas, NO in the analyte was oxygenated and there was an increase in the NO2 content from that in the original analyte. However, when CO2 was used as the sample carrier gas, the level of NO2 in the analyte could be determined because CO2 did not change the NO2 content from that in the original analyte. A calibration curve with good linearity was obtained using the UG−410 APIMS system, with a regression equation of Y(%)=5.513*10-2 X(ppb) and a detection limit of 0.9ppb. Since APIMS detects NO2 directly within its system, the concentration of NO does not need to be measured. This system may be of great help in the accurate detection and determination of the concentration of low levels of NO2 during inhaled NO therapy
Carbon Dioxide ; ionization ; Spectrum Analysis, Mass ; Direct type of resin cement ; Adjudication

It has been experienced that Kampo, with its philosophy that every disease is psychosomatic in origin and that herbs affect both the psyche and the soma, sometimes has a dramatic effect on somatoform disorders, though there has been no study examining the effects of Kampo on somatoform disorders. In this preliminary study, the morbidity of somatoform disorders among patients who visited the Keio Kampo Clinic and the patients' psychological well-being were examined.
One hundred patients (17 males and 83 females; mean age [±SD], 39±16) who sought Kampo treatment for the first time at Keio University Hospital participated in this study. A Japanese checklist derived from the somatoform disorders schedule (version 1.1) was used to check the somatoform symptoms. To assess psychological well-being, the subjective well-being inventory (SUBI) was performed. The subjects' clinical records were examined afterwards to rule out symptoms which could be medically explained.
Somatoform patients and medically ill (non-somatoform) patients were 65% and 26% of the total respectively. The somatoform patients showed significantly lower SUBI positive scores than the non-somatoform patients (p=0.042), while SUBI negative scores were significantly higher (p=0.001). Among the somatoform patients, there was a negative correlation between numbers of somatoform symptoms and SUBI positive scores (r=0.267; p=0.032), and a positive correlation between numbers of somatoform symptoms and SUBI negative scores (r=0.337; p=0.006).
Following the SUBI scores through treatment courses may lead to a better understanding of the pathology of somatoform disorders and to more effective use of Kampo.