Associate Professor and Head of Development Division
School of Chinese Medicine,
The Chinese University of Hong Kong
Presenter/Author:
Vincent CH CHUNG (1)
Other Author:
HO Fai Fai (2), XU Shanshan (3), KWONG Ming Hong Talos (3), LI Siu Cheong Angus (3), HA Eun Hae (2), HUA Heyu (2), LIONG Ching (2), LEUNG Kwan Chi (2), LEUNG Ting Hung (2), LIN Zhixiu (2), WONG Yeung Shan Samuel (3), Faming PAN (4)
Author Affiliation:
1. The Jockey Club School of Public Health and Primary Care / School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
2. School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
3. The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
4. Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University
Keywords:
Long COVID; Chinese Medicine; Telemedicine
Abstract:
Introduction: The emergence and persistence of symptoms after acute COVID-19 can become a major burden on the healthcare system although there is limited information on the prevalence, patterns, and clinical severity of different symptoms and functional disability in post-COVID-19 Syndrome (Long COVID). We assessed the features of the Long COVID burden in a cohort of COVID-19 patients after the fifth COVID-19 major wave in Hong Kong.
Method: A cross-sectional study of 135 patients with confirmed COVID-19 from Feb to Apr 2022 who utilized Chinese medicine telemedicine services at the School of Chinese Medicine, The Chinese University of Hong Kong was conducted. Consistent with the WHO definition of Long COVID, COVID-19 Yorkshire Rehabilitation Scale was administered via an online survey 12 weeks after the acute infection. Each symptom or functional difficulty was scored on a 0–10 Likert scale and was also compared with those before infection. Prevalence of symptom severity and functional disability were analysed to identify burden and patterns. The correlation between symptom severity, functional disability, patient characteristics, and overall health was explored.
Results: The mean age was 46.8 years, with 46 (34.1%) males. Symptoms, functional difficulties, and overall health worsened significantly when compared to the status prior to the infection. More than 50% reported the following sequelae 12 weeks after the acute infection: breathlessness, laryngeal / airway complications, fatigue, weakness, sleep, cognition and anxiety. The presence of a single symptom or functional difficulty was significantly correlated with at least 7 other problems positively, except for pain. Symptoms and functional difficulties were significantly more severe compared to pre-COVID-19 status in the following subgroups: poorer mobility among those who received 0-2 doses of COVID-19 vaccines; higher pain and cognition impairment among chronic disease patients; lower personal care capability among those with secondary education or below; lower social functions among females and finally more severe swallowing, depression, personal care, and social function problems among those who were > 50 years.
Conclusion: Long COVID is a significant healthcare burden in Hong Kong with complex needs for symptoms and functional limitation management. The severity of the disease burden tends to be higher among vulnerable groups including those who are chronic disease patients, older, less well educated, or have incomplete COVID-19 vaccination. Designing relevant health and rehabilitation services tailored to the needs of these patients is warranted.
Reference:
N/A
Funding Source:
N/A
Conflict of Interests:
The author reports no conflicts of interest related to this study.
Dr. Vincent CH Chung is a registered Chinese medicine practitioner with training in both evidence based healthcare and public health. As a Jockey Club Scholar he received Bachelor of Chinese Medicine and Bachelor of Biomedical Science (First Class) from Hong Kong Baptist University. With support from the Li Po Chun Charitable Trust Fund – Overseas Postgraduate Study and Professional Training Scholarship, he completed his MSc in Evidence based Healthcare in Oxford University. He studied his PhD in Public Health at The Chinese University of Hong Kong, focusing on health services research.
He is one of the few scholars with research spanning across clinical, public health, and policy aspects of Integrative Medicine. He envisions evidence-based integration of conventional and complementary healthcare by promoting rigorous research, policy advocacy, and quality education locally, nationally, and internationally. He has published more than 133 articles in international peer-reviewed academic journals including the Canadian Medical Association Journal (IF: 8.26), Cochrane Database of Systematic Reviews (IF: 9.28), Annals of the Rheumatic Diseases (IF:19.1), Obesity Reviews (IF: 9.21), Perspectives in Public Health (Top 10% journal in the Public, Environmental & Occupational Health Category, IF: 4.94), Journal of Ethnopharmacology and Chinese Medicine (Top journals in the Integrative and Complementary Medicine Category, IF: 4.36 and 5.45 respectively).
He ranked at the top 1.84% amongst all researchers in the category of Complementary & Alternative Medicine globally, according to the updated science-wide author databases of standardized citation indicators (PloS Biology 18.10 (2020): e3000918). He served as a consultant for the WHO Western Pacific Regional Office in formulating strategy for using traditional and complementary medicine for promoting healthy aging, as well as an observer in the development process of WHO Traditional Medicine Strategy. Consultancy reports are published in British Medical Bulletin 137.1 (2021): 70-81 and Integrative Medicine Research 10.1 (2021): 100469.
He was the Principal Investigator of 10 external competitive research grants (5 from the Health and Medical Research Fund, 2 from Chinese Medicine Development Fund, 3 from commissioned research grants and research contracts). He has supervised / co-supervised 3 PhD students to completion and has contributed to 3 book chapters. He is Associate Editor of BMC Trials (Since 2019), BMC Complementary Medicine and Therapies (Since 2011) and Complementary Therapies in Medicine (2017-2020), and serves as editorial board member of European Journal of Integrative Medicine (Since 2013) and Scientific Reports (2017-2019).
He serves as External Examiner of the BSc Chinese Medicine program for the International Medical University, Malaysia (2021-2023). He has been an External Assessor (for promotion and substantiation) in Public Health for University Technology Sydney, and in Chinese Medicine for Western Sydney University, Australia. He reviewed grants for both international and local research funding bodies including EU / MSCA-Cofund doctoral program of the Swiss School of Public Health (SSPH+), Research and Development Administration Office of the University of Macau, and the Hong Kong Research Grants Council. He was appointed as External Examiner for PhD candidates at Western Sydney University.
On public and government services, he serves as a member of the Hong Kong SAR Government Chinese Medicine Development Committee (2018-2023), as well as the Patient Experience Sub-committee of the Chinese Medicine Hospital Planning Office. He was also a member of the Registration Committee, Chinese Medicine Practitioner Board, Chinese Medicine Council of Hong Kong (2018-2021).