The Greifswald Post COVID Rehabilitation Study and Research (PoCoRe)–Study Design, Characteristics and Evaluation Tools

(1) Background: COVID-19 is often associated with significant long-term symptoms and disability, i.e., the long/post-COVID syndrome (PCS). Even after presumably mild COVID-19 infections, an increasing number of patients seek medical help for these long-term sequelae, which can affect various organ systems. The pathogenesis of PCS is not yet understood. Therapy has so far been limited to symptomatic treatment. The Greifswald Post COVID Rehabilitation Study (PoCoRe) aims to follow and deeply phenotype outpatients with PCS in the long term, taking a holistic and comprehensive approach to the analysis of their symptoms, signs and biomarkers. (2) Methods: Post-COVID outpatients are screened for symptoms in different organ systems with a standardized medical history, clinical examination, various questionnaires as well as physical and cardiopulmonary function tests. In addition, biomaterials are collected for the analysis of immunomodulators, cytokines, chemokines, proteome patterns as well as specific (auto)antibodies. Patients are treated according to their individual needs, adhering to the current standard of care. PoCoRe’s overall aim is to optimize diagnostics and therapy in PCS patients.

[1]  E. Bendstrup,et al.  A new paradigm is needed to explain long COVID. , 2023, The Lancet. Respiratory medicine.

[2]  L. Wieler,et al.  Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany , 2022, PLoS medicine.

[3]  J. Steinacker,et al.  Post-acute sequelae of covid-19 six to 12 months after infection: population based study , 2022, BMJ.

[4]  J. Rosmalen,et al.  Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study , 2022, The Lancet.

[5]  G. Gkoutos,et al.  Symptoms and risk factors for long COVID in non-hospitalized adults , 2022, Nature Medicine.

[6]  M. Soleimani,et al.  Post‐COVID‐19 functional limitations in hospitalized patients and associated risk factors: A 3‐month follow‐up study , 2022, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[7]  S. Saydah,et al.  Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021 , 2022, Morbidity and Mortality Weekly Report.

[8]  S. Riley,et al.  Persistent COVID-19 symptoms in a community study of 606,434 people in England , 2022, Nature Communications.

[9]  D. Antonenko,et al.  Neuromodulation through brain stimulation-assisted cognitive training in patients with post-COVID-19 cognitive impairment (Neuromod-COV): study protocol for a PROBE phase IIb trial , 2022, BMJ Open.

[10]  M. Rietschel,et al.  The assessment of childhood maltreatment and its associations with affective symptoms in adulthood: Results of the German National Cohort (NAKO). , 2022, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[11]  M. Puhan,et al.  Long COVID Through a Public Health Lens: An Umbrella Review , 2022, Public Health Reviews.

[12]  T. Georges,et al.  Evaluation of the Post-COVID-19 Functional Status (PCFS) Scale in a cohort of patients recovering from hypoxemic SARS-CoV-2 pneumonia , 2022, BMJ Open Respiratory Research.

[13]  OUP accepted manuscript , 2022, The Journal of Infectious Diseases.

[14]  E. Wan,et al.  Long-term complications of COVID-19 , 2021, American journal of physiology. Cell physiology.

[15]  C. Giurgi-Oncu,et al.  Cardiovascular Abnormalities and Mental Health Difficulties Result in a Reduced Quality of Life in the Post-Acute COVID-19 Syndrome , 2021, Brain sciences.

[16]  C. E. Ventura-Alfaro,et al.  Validation of the Post-Covid-19 Functional Status Scale into Mexican-Spanish , 2021, Journal of rehabilitation medicine clinical communications.

[17]  S. McGill,et al.  An Overview of Post–COVID-19 Condition (Long COVID) , 2021, Canadian Journal of Health Technologies.

[18]  Ryan J. Low,et al.  Characterizing long COVID in an international cohort: 7 months of symptoms and their impact , 2021, EClinicalMedicine.

[19]  U. Merle,et al.  Persistent Symptoms in Adult Patients 1 Year After Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study , 2021, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  P. Hyland,et al.  The international trauma questionnaire (ITQ) measures reliable and clinically significant treatment-related change in PTSD and complex PTSD , 2021, European journal of psychotraumatology.

[21]  T. Kohlmann,et al.  Translation and adaptation of the German version of the Veterans Rand—36/12 Item Health Survey , 2021, Health and Quality of Life Outcomes.

[22]  L. Bairy,et al.  LONG TERM COMPLICATIONS OF COVID-19 , 2021, International Journal of Medical and Biomedical Studies.

[23]  F. Pitta,et al.  Construct validity of the Post-COVID-19 Functional Status Scale in adult subjects with COVID-19 , 2021, Health and Quality of Life Outcomes.

[24]  OUP accepted manuscript , 2021, European Heart Journal.

[25]  Sally J. Singh,et al.  COPD assessment test for the evaluation of COVID-19 symptoms , 2020, Thorax.

[26]  I. Alobid,et al.  Ethyl alcohol threshold test: a fast, reliable and affordable olfactory Assessment tool for COVID-19 patients , 2020, European Archives of Oto-Rhino-Laryngology.

[27]  M. Endres,et al.  The Post-COVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19 , 2020, European Respiratory Journal.

[28]  P. Prandoni,et al.  Measuring functional limitations after venous thromboembolism: Optimization of the Post-VTE Functional Status (PVFS) Scale. , 2020, Thrombosis research.

[29]  A. Petersmann,et al.  The Integrated Research Biobank of the University Medicine Greifswald , 2020 .

[30]  T. Luck,et al.  Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample. , 2017, Journal of affective disorders.

[31]  K. Spindler,et al.  Responsiveness Comparison of the EQ-5D, PROMIS Global Health, and VR-12 Questionnaires in Knee Arthroscopy , 2016, Orthopaedic journal of sports medicine.

[32]  H. Grabe,et al.  [The childhood trauma screener (CTS) - development and validation of cut-off-scores for classificatory diagnostics]. , 2013, Psychiatrische Praxis.

[33]  C. Beierlein,et al.  Short Scale for Measuring General Self-efficacy Beliefs (ASKU) Kurzskala zur Erfassung allgemeiner Selbstwirksamkeits- erwartungen (ASKU) , 2013 .

[34]  U. John,et al.  [A brief instrument for the assessment of childhood abuse and neglect: the childhood trauma screener (CTS)]. , 2012, Psychiatrische Praxis.

[35]  P. Jones,et al.  Development and first validation of the COPD Assessment Test , 2009, European Respiratory Journal.

[36]  E. Brähler,et al.  Fragebogen zur sozialen Unterstützung (F-SozU): Normierung der Kurzform (K-14) , 2009 .

[37]  J. Richards,et al.  Factor structure of the PHQ-9 screen for depression across time since injury among persons with spinal cord injury. , 2008 .

[38]  B. Löwe,et al.  Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population , 2008, Medical care.

[39]  Jürgen Hoyer,et al.  Die deutsche Version des Life-Orientation-Tests (LOT-R) zum dispositionellen Optimismus und Pessimismus , 2008 .

[40]  R. Spitzer,et al.  The PHQ-9 , 2001, Journal of General Internal Medicine.

[41]  O. Decker,et al.  Alexithymia in the German general population , 2007, Social Psychiatry and Psychiatric Epidemiology.

[42]  B. Löwe,et al.  A brief measure for assessing generalized anxiety disorder: the GAD-7. , 2006, Archives of internal medicine.

[43]  J. Cummings,et al.  The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment , 2005, Journal of the American Geriatrics Society.

[44]  Anthony F Jorm The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): a review , 2004, International Psychogeriatrics.

[45]  R. Bagby,et al.  The 20-Item Toronto Alexithymia Scale: IV. Reliability and factorial validity in different languages and cultures , 2003 .

[46]  G. V. van Heck,et al.  Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale. , 2003, Journal of psychosomatic research.

[47]  S. Sahadevan,et al.  Prevalence of cognitive impairment amongst Singapore's elderly Chinese: a community‐based study using the ECAQ and the IQCODE , 2003, International journal of geriatric psychiatry.

[48]  R. Spitzer,et al.  The PHQ-9: A new depression diagnostic and severity measure , 2002 .

[49]  K. Trzesniewski,et al.  Measuring Global Self-Esteem: Construct Validation of a Single-Item Measure and the Rosenberg Self-Esteem Scale , 2001 .

[50]  R. Spitzer,et al.  The PHQ-9: validity of a brief depression severity measure. , 2001, Journal of general internal medicine.

[51]  E. Brähler,et al.  [The Antonovsky Sense of Coherence Scale. Test statistical evaluation of a representative population sample and construction of a brief scale]. , 2000, Psychotherapie, Psychosomatik, medizinische Psychologie.

[52]  R. Spitzer,et al.  Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. , 1999, JAMA.

[53]  E. Brähler,et al.  Fragebogen zur Sozialen Unterstützung (F-SozU): Normierung an einer repräsentativen Stichprobe , 1999 .

[54]  R. Bagby,et al.  The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. , 1994, Journal of psychosomatic research.