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

In order to understand the current status of terminal care for cancer patients and to investigate the significance of palliative care units (PCUs), we reviewed 414 cancer patients who died at our hospital during the 2-year period since October 2013 (PCU: 219 patients, general wards: 195 patients) based on their history of anticancer therapy and use of palliative care. Compared with PCU patients, those in the general wards were older, the diagnosis was delayed, and disease progression was more rapid. It was suggested that these factors had a negative impact on the opportunity to receive standard anticancer therapy and palliative care. Among the patients who received chemotherapy, the median interval from the final treatment to death was 110 days for those in the PCU while it was significantly shorter (55 days) for those in the general wards. Chemotherapy was administered within 1 month before death to 2% of patients in the PCU versus 32% of patients in the general wards, so the rate was much higher among the latter patients. In order to provide appropriate terminal care for cancer patients, the PCU seems to be important. Irrespective of the timing of cancer diagnosis and progression, it is important to increase general social awareness of palliative care and advanced care planning in order to promote the use of palliative care strategies.

In order to study the physical fitness of rural children in Gifu prefecture, a total of 128 rural boys and girls aged 8-14 years old in the Tokuyama-Elementary School and-Middle School, which are in a far rural district from busy civilized urban distriet, were measured for the developmental status, i. e, physique, examination of physical fitness, maximum working capacity, cardiorespiratory function and urinary excretion in summer, 1962, and the comparison was made on the results obtained there with those of the average Japanese children of the same age.
The results obtained were as follows:
1) Little or no difference was found between physical development of rural children and that of average Japanese boys and girls ; i. e, the physique of rural children was not superior nor inferior to the value of the average Japanese children.
2) The record of sprint games, such as 50m-sprint-run, broad jumping, ball throwing, Sargent-jump, grip strength and back strength of rural children was lower than that of the Japanese average. Whereas, the endurance ability measured with a long-distance running (1500m for boys and 1000m for girls) was tended to be higher in the rural children, especially in the girls, than the average Japanese value. However, no significant difference was presented in the flexibility test (forward bending of the upper-body in standing posture) between rural and average Japanese values.
3) The examination of cardiopulmonary function : i.e. E.C.G., blood pressure, heart rate, vital capacity and maximum expiratony flow rate exhibited no abnormal sign. The systolic and diastolic blood pressure tended to increase with age, but the heart rate tended to decrease. The examination of the urinary glucose, protein and occult-blood remained normal, and most of the urine pH of the girls were within the range between 6 and 7, whereas, those of boys were between 5 and 6.
4) The maximum working capacity (maximum oxygen intake, vital capacity) showeda linear increase proportional to age and physique (body height, body weigmt, body surface, etc, ) over the range of the age tested. Sexual difference appeared after 12 years of age.
5) The possibility was suggested that the maximum O₂ intake could be predicted from the vital capacity of the same individual regardless of age, sex and physique, and a theoretical background for that was discussed.