A State-of-the-Art Review on the Recent Advances of Mesenchymal Stem Cell Therapeutic Application in Systematic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease with an unknown etiology that has widespread clinical and immunological manifestations. Despite the increase in knowledge about the pathogenesis process and the increase in treatment options, however, the treatments fail in half of the cases. Therefore, there is still a need for research on new therapies. Mesenchymal stem cells (MSCs) are powerful regulators of the immune system and can reduce the symptoms of systemic lupus erythematosus. This study aimed to review the mechanisms of immune system modulation by MSCs and the role of these cells in the treatment of SLE. MSCs suppress T lymphocytes through various mechanisms, including the production of transforming growth factor-beta (TGF-B), prostaglandin E2 (PGE2), nitric oxide (NO), and indolamine 2 and 3-oxygenase (IDO). In addition, MSCs inhibit the production of their autoantibodies by inhibiting the differentiation of lymphocytes. The production of autoantibodies against nuclear antigens is an important feature of SLE. On the other hand, MSCs inhibit antigen delivery by antigen-presenting cells (APCs) to T lymphocytes. Studies in animal models have shown the effectiveness of these cells in treating SLE. However, few studies have been performed on the effectiveness of this treatment in humans. It can be expected that new treatment strategies for SLE will be introduced in the future, given the promising results of MSCs application.

Recent advances in the detection of glioblastoma, from imaging-based methods to proteomics and biosensors: A narrative review.

Glioblastoma (GBM) is an aggressive type of cancer that originates in the cells called astrocytes, which support the functioning of nerve cells. It can develop in either the brain or the spinal cord and is also known as glioblastoma multiform. GBM is a highly aggressive cancer that can occur in either the brain or spinal cord. The detection of GBM in biofluids offers potential advantages over current methods for diagnosing and treatment monitoring of glial tumors. Biofluid-based detection of GBM focuses on identifying tumor-specific biomarkers in blood and cerebrospinal fluid. To date, different methods have been used to detect biomarkers of GBM, ranging from various imaging techniques to molecular approaches. Each method has its own strengths and weaknesses. The present review aims to scrutinize multiple diagnostic methods for GBM, with a focus on proteomics methods and biosensors. In other words, this study aims to provide an overview of the most significant research findings based on proteomics and biosensors for the diagnosis of GBM.

Tailored design and preparation of magnetic nanocomposite particles for the isolation of exosomes.

Here, we prepared a magnetic nanocomposite system composed of a cluster of magnetite nanoparticles coated with silica shell (MSNPs) with an average diameter of 140 ± 20 nm and conjugated with CD9 antibody (AntiCD9) using different strategies including adsorption or chemical conjugation of antibody molecules to either aminated MSNPs (AMSNPs) or carboxylated MSNPs (CMSNPs). Then, MSNPs were employed to isolate exosomes from ultracentrifuge-enriched solution, PC3 cell-culture medium, or exosome-spiked simulated plasma samples. Quantitative tests using nanoparticle-tracking analysis confirmed antibody-covalently conjugated MSNPs, i.e. the AntiCD9-AMSNPs and AntiCD9-CMSNPs enabled >90% recovery of exosomes. Additionally, the exosomes isolated with AntiCD9-CMSNPs showed higher recovery efficiency compared to the AntiCD9-AMSNPs. For both nanoadsorbents, lower protein impurities amounts were obtained as compared to that of exosomes isolated by ultracentrifugation and Exocib kit. The mean diameter assessment of the isolated exosomes indicates that particles isolated by using AntiCD9-AMSNPs and AntiCD9-CMSNPs have smaller sizes (136 ± 2.64 nm and 113 ± 11.53 nm, respectively) than those obtained by UC-enriched exosomes (140.9 ± 1.6 nm) and Exocib kit (167 ± 10.53 nm). Such promising results obtained in the isolation of exosomes recommend magnetic nanocomposite as an efficient tool for the simple and fast isolation of exosomes for diagnosis applications.

Simultaneous removal of cationic and anionic dyes from simulated industrial effluents using a nature-inspired adsorbent.

Alginate-grafted polyaniline (Alg-g-PANI) microparticles were synthesized through the grafting of aniline onto functionalized Alg followed by double crosslinking by glutaraldehyde and calcium chloride. The performance of the developed microparticles as adsorbent in simultaneous removal of malachite green (MG) and congo red (CR) dyes were examined by the batch method. Experimental parameters, including adsorbent amount, pH, initial dyes concentrations, and contact time were optimized. Langmuir and Freundlich adsorption models were employed to explore the equilibrium isotherm. As the Langmuir model results, the maximum adsorption capacities (Qm) of microparticles for the MG and CR dyes were obtained as 578.3 and 409.6 mgg-1, respectively. Adsorption kinetics for both dyes were well-fitted with the pseudo-second-order model that confirm the rate-limiting step might be the chemical adsorption. The adsorbent was regenerated via desorption process and was reusable five times without a substantial decrease in its adsorption efficacy in first three cycles. Adsorbent-dyes interactions were computationally evaluated using Gromacs package, and it was found that both MG and CR are able to interact strongly with the adsorbent. In accordance with experimental results, simulation data revealed that MG can be removed more efficiently than those of the CR. As the experimental results, we could conclude that the synthesized Alg-g-PANI microparticles can be used as a nature-inspired adsorbent for simultaneous removals of CR and MG dyes.

Status of Iranian schools' psycho-social environment: cultural adaptation and validation of the Persian version of the W.H.O profile to create Child-Friendly Schools.

BACKGROUND: Creating an environment for emotional and social well-being is an important responsibility of Health-Promoting and Child-Friendly Schools. Thus, the present study aimed to assess cultural adaptation and validation of the Persian version of the Psycho-Social Environment (PSE) Profile. The second purpose of this study was to survey the psycho-social environment of schools among a local sample of Iranian school staff. METHODS: This study was conducted in two phases, including cultural adaptation and validation of a culturally adapted scale. The cultural adaptation process followed the procedure suggested by Beaton et al. Then, the culturally adapted scale was administered to a local sample of Iranian school staff including managers (21.9%), teachers (57.4%), support staff (4%), and other school staff (16.7%) in a cross-sectional study. The participants' mean age was 39.98 ± 8.11 years and they were mostly female (62.8%). The psychometric properties of the culturally adapted version of the questionnaire were tested using a confirmatory factor analysis (n = 265), and a test of internal consistency. Finally, the status of schools' psycho-social environment was assessed using descriptive and analytical statistics. RESULTS: Confirmatory factor analysis indicated an overall good fit for the 7-factor profile (χ2/df: 1.906, PNFI: 0.62, TLI: 0.78, CFI: 0.79, RMSE: 0.059). The test of internal consistency showed an acceptable reliability (α = 0. 98). CONCLUSIONS: The Persian version of the PSE profile was culturally adapted for use in Iranian schools. Certainly, this culturally adapted version of PSE profile could be useful to determine the school psycho-social environment and to make any changes that can promote a friendly school climate for all participants, and to enhance learning and development.

Efficacy of the Synbiotic Supplementation on the Metabolic Factors in Patients with Metabolic Syndrome: A Randomized, Triple-Blind, Placebo-Controlled Trial.

Background: Metabolic syndrome is overwhelmingly increasing and is a significant risk factor for cardiovascular disorder, so effective treatment strategies are considered high priority. This study aimed to determine the effects of synbiotic supplementation on metabolic factors in patients with metabolic syndrome. Methods: In this triple-blind, randomized, placebo-controlled, clinical trial, 108 participants were divided into two groups to receive synbiotic supplementation or placebo for 12 weeks. All participants were also educated about maintaining a healthy lifestyle and consuming low-calorie nutritious meals, along with dietary intake and physical activity monitoring. Anthropometric measures, blood pressure, glycemic indices, lipid profile, hepatic enzymes, and hs-CRP were evaluated at the baseline and end of the trial. Results: Synbiotic supplementation significantly reduces fasting blood glucose (FBG) levels in the intervention group versus placebo group [-14.69 ± 15.11 mg/dl vs. -8.23 ± 7.90 mg/dl; p=0.007], but there was no difference between groups in other metabolic factors. Conclusions: These findings suggest that synbiotic supplementation while following a healthy lifestyle and nutrition improved FBG in patients with metabolic syndrome.

The Historical Epidemiology of Human Monkeypox: A Review of Evidence from the 1970 Emergence to the 2022 Outbreak.

Human Monkeypox (HMPX) outbreak in the year 2022 occurs in many countries outside of the African regions, a common location of such outbreaks, with a considerable rate of human-to-human transmission, which was an uncommon route of infection before. The epidemiological reports also represent a sharping pace of infection spreading between communities rather than in previous outbreaks as the following pace of afflictions is unpredictable. Also, the cautions regarding the sexually transmitted infection of the such virus have been raised in this outbreak. Further, the main reservoirs of the recent outbreaks are yet to be revealed. As a consequence, the World Health Organization (WHO) has declared the 2022 HMPX outbreak as an "Atypical" phenomenon compared to its previous characteristics. To better recognize the properties of this outbreak, herein we systematically described and compared the historical evidence of monkeypox virus outbreaks in the aspects of epidemiological, clinical, and molecular evolutions since its emergence, as well as an explanation of the previous investigations and considerations of WHO and other international health societies over time. The history of human and monkeypox virus interaction during the past 64 years provides viewpoints on preventing strategies and assessing the present and potential future hazards of health implications.

Nitrogen-rich silicon quantum dots: facile synthesis and application as a fluorescent 'on-off-on' probe for sensitive detection of Hg2+ and cyanide ions.

The sensitive and reliable detection of Hg2+ and CN- as harsh environmental contaminants are of great importance. In view of this, a novel 'on-off-on' fluorescent probe based on nitrogen-rich silicon quantum dots (NR-SiQDs) has been designed for sensitive detection of Hg2+ and CN- ions in aqueous medium. NR-SiQDs were synthesized using a facile, one-step, and environment friendly procedure in the presence of 3-aminopropyl trimethoxysilane (APTMS) and ascorbic acid (AA) as precursors, with l-asparagine as a nitrogen source for surface modification. The NR-SiQDs exhibited strong fluorescence emission at 450 nm with 42.34% quantum yield, satisfactory salt tolerance, and superior photostability and pH stability. The fluorescence emission was effectively quenched using Hg2+ (turn-off) due to the formation of a nonfluorescent stable NR-SiQDs/Hg2+ complex, whereas after the addition of cyanide ions (CN- ), Hg2+ ions could be leached from the surface of the NR-SiQDs and the fluorescence emission intensity of the quenched NR-SiQDs fully recovered (turn-on) due to the formation of highly stable [Hg(CN)4 ]2- species. After optimizing the response conditions, the obtained limits of detection were found to be 53 nM and 0.46 µM for Hg2+ and CN- , respectively. Finally, the NR-SiQD-based fluorescence probe was utilized to detect Hg2+ and CN- ions in water samples and satisfactory results were obtained, suggesting its potential application for environmental monitoring.

Determination of cyanide based on a dual-emission ratiometric nanoprobe using silver sulfide quantum dots and silicon nanoparticles.

A novel ratiometric fluorescent nanoprobe was designed for the sensitive determination of cyanide anion (CN-) by the electrostatic attraction between positively charged silicon nanoparticles (Si NPs) and negatively charged silver sulfide quantum dots (Ag2S QDs). The nanoprobe exhibited two well-resolved emission peaks at 446 nm and 540 nm under a single excitation wavelength (360 nm). In the presence of CN-, the fluorescence of Ag2S QDs at 540 nm was remarkably quenched, while the fluorescence of the Si NPs at 446 nm remained constant, establishing the desired conditions for ratiometric fluorescence detection. Under optimal conditions, the ratiometric fluorescence assay showed good linearity (R2 = 0.9921) within the range 0.05-15 µM, and the limit of detection was calculated to be 56 nM (at an S/N ratio of 3). The proposed Ag2S QD/Si NP nanoprobe has been successfully used to determine CN- in water and sprouting potato samples with satisfactory recoveries in the range 97-110.5%.

The Effect of Balance Training on Functional Outcomes in Patients with Knee Osteoarthritis: A Systematic Review.

Background: Knee osteoarthritis (OA) is a common musculoskeletal disorder that is associated with balance impairment. Recent studies have used balance exercises for improvement of balance and functional performance among knee OA patients. The purpose of this study was analyzing the effects of balance training in patients with knee OA. Methods: This review included clinical trials in which the effect of balance training on functional measures was assessed compared to other physiotherapy interventions or control groups in patients with knee OA. To this aim, Electronic databases (PubMed, SCOPUS, EMBASE, PEDro, CINAHL, and WOS) were searched from 1 January 1990 to 30 June 2021. Two independent reviewers selected the studies, extracted the data, and assessed the quality of the studies. Results: Fifteen articles of clinical trials were eligible to include in this review. Most studies used patient-reported outcome measures, and some studies used performance-based functional outcome measures for the evaluation of functional outcomes. The findings of studies showed that physical function in knee OA patients could have clinical improvements significantly after receiving balance training. However, studies assessing the effect of balance training on muscle strength of the quadriceps and the hamstring had conflicting results. Also, the finding of studies showed that more significant improvement in postural stability and balance in the balance training group rather than the control group. Conclusion: The results of the current systematic review demonstrate balance exercises significantly improve balance and functionality in knee OA patients. However, the effect of balance training on muscle strength was not clearly revealed due to few studies.

Prevalence and Clinical Outcomes of Vitamin D Deficiency in COVID-19 Hospitalized Patients: A Retrospective Single-Center Analysis.

Vitamin D attenuates inflammatory responses to viral respiratory infections. Hence, vitamin D deficiency may be a highly significant prognostic factor for severity and mortality in COVID-19 patients. To evaluate the complications and mortality in different vitamin D status groups in COVID-19 hospitalized patients, we conducted this retrospective study on 646 laboratory-confirmed COVID-19 patients who were hospitalized in Shahid Modarres Hospital, Tehran, Iran from 16th March 2020 until 25th February 2021. Overall, patients with vitamin D deficiency, insufficiency and sufficiency were 16.9%, 43.6% and 39.5%, respectively. The presence of comorbidity, length of hospitalization, ICU admission, and invasive mechanical ventilation requirement and overall complications were significantly more in patients with vitamin D deficiency (p-value < 0.001). 46.8% (51/109) of vitamin D deficient patients died due to the disease, whilst the mortality rate among insufficient and sufficient vitamin D groups was 29.4% (83/282) and 5.5% (14/255), respectively. In univariate analysis, age > 60 years (odds ratio (OR) = 6.1), presence of comorbidity (OR = 10.7), insufficient vitamin D status (OR = 7.2), and deficient vitamin D status (OR = 15.1) were associated with increase in COVID-19 mortality (p-value < 0.001). Finally, the multivariate analysis adjusted for age, sex, and comorbidities indicated vitamin D deficiency as an independent risk factor for mortality (OR = 3.3, p-value = 0.002). Vitamin D deficiency is a strong risk factor for mortality and severity of SARS-CoV-2 infection. Vitamin D supplementation may be able to prevent or improve the prognosis of COVID-19 during this pandemic.

Evaluation of the Incidence of Chronic Thromboembolic Pulmonary Hypertension 1 Year After First Episode of Acute Pulmonary Embolism: A Cohort Study.

PURPOSE: Chronic thromboembolic pulmonary hypertension (CTEPH) is an important complication after acute pulmonary embolism (PE) with considerable morbidity and mortality. The aim of this study was to estimate the CTEPH incidence in a cohort after the first occurrence of PE. METHODS: We conducted a 1-year follow-up cohort study between 2015 and 2018 to assess the incidence of CTEPH in 474 patients with their first acute episode of PE. For the diagnosis of CTEPH, patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography, right heart catheterization, ventilation-perfusion lung scanning, and CT pulmonary angiography. RESULTS: Overall, 317 patients were included in the study. The mean age of the patients was 56.5 ± 16 years. One hundred and three patients (32%) had exertional dyspnea at the 1-year follow-up. Patients with evidence of pulmonary hypertension (PH) on echocardiography underwent right heart catheterization. Eleven patients (18%) had no PH (mPAP < 25 mmHg); 47 patients (81%) had mPAP > 25 mmHg. Fifteen patients had PAWP > 15 mmHg, including those with underlying left heart problems or valvular diseases. There were 32 patients with PAH (mPAP > 25 mmHg and PVR > 3 WU) undergoing CTEPH studies; 22 patients (6.9%) had multiple segmental defects suggesting CTEPH on a perfusion scan. CONCLUSION: The incidence of CTEPH observed in this study 1 year after the first episode of acute PE was approximately 6.9%. This incidence seems to be high in our population, and diagnostic and therapeutic strategies for the early identification of CTEPH are needed.

Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran.

The Coronavirus Disease 2019 (COVID-19) pandemic has killed many people worldwide since December 2019, and Iran has been among the most affected countries. In this retrospective study, we aimed to determine the prognostic factors associated with mortality in COVID-19 patients by analyzing 396 survived and 63 non-survived patients in Shahid Modarres Hospital, Tehran, Iran, from January 30th until April 5th, 2020. As the results, the BMI > 35 (p = 0.0003), lung cancer (p = 0.007), chronic kidney disease (p = 0.002), Immunocompromised condition (p = 0.003), and diabetes (p = 0.018) were more frequently observed in the expired group. The history of statins use was more common in the discharged group (p = 0.002), while there was no significant difference in the drug history of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, aspirin, and/or steroids, and in the past-year influenza vaccination. Multivariable regression demonstrated rising odds of in-hospital death related with age (odds ratio (OR) = 1.055, p = 0.002), levels of C-reactive protein (CRP) (OR = 2.915, p < 0.001), creatinine (OR = 1.740, p = 0.023), lymphocyte count (OR = 0.999, p = 0.008), and magnesium level (OR = 0.032, p < 0.001) on admission. In conclusion, the patients with older age and higher BMI with lymphopenia, hypomagnesemia, elevated CRP and/or raised creatinine on admission are at higher risk of mortality due to the COVID-19 infection, which requires the physicians to use timely and strong therapeutic measures for such patients.

Lecithin soybean phospholipid nano-transfersomes as potential carriers for transdermal delivery of the human growth hormone.

Pharmaceutical molecules such as peptides and proteins are usually injected into the body. Numerous efforts have been made to find new noninvasive ways to administer these peptides. In this study, highly flexible vesicles (transfersomes [TFs]) were designed as a new modern transdermal drug delivery system for systemic drug administration through the skin, which had also been evaluated in vitro. In this study, two growth hormone-loaded TF formulations were prepared, using soybean lecithin and two different surfactants; F1 _sodium deoxycholate and F 2 _sodium lauryl sulfate. Thereafter, the amount of skin penetration by the two formulas was assessed using the Franz diffusion cell system. TF formulations were evaluated for size, zeta potential and in vitro skin penetration across the rat skin. Results indicated that vesicle formulations were stable for 4 weeks and their mean sizes were 241.33 ± 17 and 171 ± 12.12 nm in the F 1 and F 2 formulation, respectively. After application to rat skin, transport of the human growth hormone (hGH) released from the TF formulations was found to be higher than that of the hGH alone. Maximum amounts of transdermal hormone delivery were estimated to be 489.54 ± 8.301 and 248.46 ± 4.019 ng·cm-2 , for F 1 and F 2 , respectively. The results demonstrate the capability of the TF-containing growth hormone in transdermal delivery and superiority of the F 1 to F 2 TFs.

Prevalence of Work-Related Musculoskeletal Disorders in Iranian Physical Therapists: A Cross-sectional Study.

OBJECTIVE: The purpose of this study was to determine the prevalence of musculoskeletal disorders among Iranian physical therapists. METHODS: A cross-sectional study was carried out. An online survey was completed by Iranian physiotherapists from June 2017 to August 2017. A total of 333 online questionnaires were sent, and 319 questionnaires were fully completed and used for data analysis. The Persian version of the Nordic Questionnaire was the main outcome measurement. This questionnaire identified work-related pain or discomfort in 9 parts of the body, including: (1) neck, (2) shoulder, (3) elbow, (4) wrists, (5) upper back, (6) lumbar, (7) thighs, (8) knee, and (9) ankle. RESULTS: The findings of this study showed the prevalence of musculoskeletal disorders was 94% in Iranian physiotherapists. Lumbar (65%), neck (57.4%), shoulder (50.2%), upper back (49%), and knee (45.5%) were the most prevalent regions of these disorders. While ankle (19.7%) and elbow (21.6%) disorders showed the lowest prevalence. CONCLUSION: The prevalence of work-related musculoskeletal disorders was high in Iranian physiotherapists, especially in the lumbar, neck, shoulder, and upper back regions.

Evaluation of Caspase 3 Enzyme and TNF-alpha as Biomarkers in Ureteropelvic Junction Obstruction in Children- a preliminary report.

OBJECTIVE: To determine the applicability of urinary caspase 3 enzyme and TNF-α as biomarkers in children with ureteropelvic junction obstruction (UPJO). METHODS: In this study, 31 unilateral UPJO patients and 33 age- and sex-matched healthy childrens were enrolled. The patients with UPJO consisted of 11 female and 20 male children between the ages of 2 to 62 months old. All participants were evaluated regarding anterior-posterior(AP) diameter and cortical thickness of affected kidney by ultrasonography. Technetium DTPA renal scan and voiding cystourethrogram(to assess vesicoureteral reflux) were performed, pre-operatively. Also, urinary levels of TNF-α and caspase 3 enzyme were checked. Follow-ups included measurement of aforementioned indices in patients: AP diameter and cortical thickness of the affected kidney, as well as TNF-α and caspase 3 levels in urine, three and six months after pyeloplasty. RESULTS: The results showed highly significant decrease in urinary TNF-α and caspase 3 enzyme (P values < 0.01), approaching the level measured in children without UPJO after six months. Significant decrease in AP diameter and increase in cortical thickness were also noticed (P values < 0.01). CONCLUSION: The results of this study strongly support that TNF-α and caspase 3 levels in urine can be used for improvement monitoring in follow-up of UPJO patients after pyeloplasty and can also be potentially used as determining indices for surgical plan but more studies, especially in patients who are not surgical candidates are needed to confirm our observaitons.

Curcumin-Loaded Amine-Functionalized Mesoporous Silica Nanoparticles Inhibit α-Synuclein Fibrillation and Reduce Its Cytotoxicity-Associated Effects.

This study aimed to develop a drug carrier based on amine-functionalized mesoporous silica nanoparticles (AAS-MSNPs) for a poorly water-soluble drug, curcumin (CUR), and to study its effects on α-synuclein (α-Syn) fibrillation and cytotoxicity. Here, we show that AAS-MSNPs possess high values of loading efficiency and capacity (33.5% and 0.45 mg drug/mg MSNPs, respectively) for CUR. It is also revealed that α-Syn species interact strongly with the CUR-loaded AAS-MSNPs, leading to a significant inhibition of the fibrillation process. Furthermore, these samples reduce the toxic effects of CUR. However, drug-loaded AAS-MSNPs do not affect the cytotoxic properties of the formed fibrils considerably. In addition, CUR loaded onto AAS-MSNPs shows enhanced stability in comparison with that of the free drug. These remarkable properties introduce AAS-MSNPs as a promising tool for the formulation of poorly water-soluble drugs such as CUR.

Advances in three-dimensional electrochemical degradation: A comprehensive review on pharmaceutical pollutants removal from aqueous solution.

Water pollution, stemming from various contaminants including organic and pharmaceutical pollutants, poses a significant global challenge. Amidst the array of methods available for pollutant mitigation, the three-dimensional electrochemical approach emerges as a standout solution due to its environmental compatibility, cost-effectiveness, and rapid efficiency. This study delves into the efficacy of three-dimensional electrochemical processes in purging organic and pharmaceutical pollutants from aqueous media. Existing research indicates that the three-dimensional electrochemical process, particularly when employing particle electrodes, exhibits notable success in degrading organic and pharmaceutical pollutants. This achievement is largely attributed to the ample specific surface area of particle electrodes and the shortened mass transfer distance, which collectively enhance efficiency in comparison to traditional two-dimensional electrochemical methods. Moreover, this approach is lauded for its environmental friendliness and cost-effectiveness. However, it is imperative to note that the efficacy of the process is subject to various factors including temperature, pH levels, and current intensity. While the addition of oxidants can augment process efficiency, it also carries the risk of generating intermediate compounds that impede the reaction. In conclusion, the three-dimensional electrochemical method proves to be a viable and practical approach, provided that process conditions are meticulously considered and adhered to. Offering advantages from both environmental and economic perspectives, this method presents a promising alternative to conventional water and wastewater treatment techniques.

Post-COVID-19 physical and cognitive impairments and associations with quality of life: a cross-sectional study.

Background and objective: This study aimed to compare physical and cognitive functions between post-coronavirus disease 2019 (COVID-19) participants and healthy matched controls and investigate associations between physical and cognitive impairments with quality of life. Methods: Twenty-three post-COVID-19 participants and 23 age and sex-matched healthy people without a history of COVID-19 were included. Physical function was assessed using the Medical Research Council Sum Score (MRC-SS), 2 min Step Test, Modified Borg Scale, and Short Physical Performance Battery (SPPB) Test. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), and Stroop test, and the quality of life was evaluated using the Euro Quality of Life-5 Dimensions-3 Levels (EQ-5D-3l) questionnaire. Assessments were performed by a physical therapist in one session. Results: Mann-Whitney U test showed that in the post-COVID-19 group, compared to the control group, the number of steps in the 2 min Step Test (p < 0.001, ES = 0.57) and the scores of the SPPB (p = 0.03, ES = 0.32), MoCA (p = 0.003, ES = 0.44), Stroop test (p < 0.001, ES = 0.75), and the EQ-5D-3l visual analog scale (p = 0.027, ES = 0.32) were significantly lower. In addition, the Modified Borg Scale score (p < 0.001, ES = 0.6), TMT-A (p = 0.013, ES = 0.36) and TMT-B (p = 0.016, ES = 0.35) times, and the Stroop time (p < 0.001, ES = 0.61) were significantly higher in the post-COVID-19 group. There were no significant between-group differences in the MRC-SS score (p = 0.055, ES = 0.28). Furthermore, there were significant moderate to high associations between physical and cognitive functions and the quality of life in post-COVID-19 participants. Conclusions: On average 4 months after symptomatic COVID-19, post-COVID-19 participants had significant impairments in physical and cognitive functions compared to healthy matched controls that were significantly correlated with the quality of life. These findings highlight the need for a comprehensive assessment to plan appropriate management strategies.