{"id":18531,"date":"2024-04-23T08:00:33","date_gmt":"2024-04-23T05:00:33","guid":{"rendered":"https:\/\/blogit.lab.fi\/labfocus\/?p=18531"},"modified":"2024-04-23T08:00:34","modified_gmt":"2024-04-23T05:00:34","slug":"korona-aika-ei-ole-ohi","status":"publish","type":"post","link":"https:\/\/blogit.lab.fi\/labfocus\/korona-aika-ei-ole-ohi\/","title":{"rendered":"Korona-aika ei ole ohi"},"content":{"rendered":"\n

Vuonna 2019 SARS-CoV-2-virus alkoi levit\u00e4 aiheuttaen maailmanlaajuisen COVID-19-pandemian, johon on kuollut t\u00e4h\u00e4n p\u00e4iv\u00e4\u00e4n menness\u00e4 yli 7 miljoonaa ihmist\u00e4. Kaiken kaikkiaan vahvistettuja COVID-19-tartuntoja on raportoitu noin 775 miljoonaa kappaletta. (WHO 2024.) Akuutin taudin vakavuudesta riippumatta 10\u201320 %:lle kehittyy pitk\u00e4kestoisia COVID-oireita, jotka vaikuttavat merkitt\u00e4v\u00e4sti toimintakykyyn sek\u00e4 el\u00e4m\u00e4nlaatuun (WHO 2022).<\/p>\n\n\n\n

Pitk\u00e4kestoinen COVID-19 on multisysteeminen elimellinen sairaus, josta on tehty satoja biol\u00e4\u00e4ketieteellisi\u00e4 l\u00f6yd\u00f6ksi\u00e4 (Davis ym. 2023), ja erilaisia oireita on raportoitu yli 200 (WHO 2022). Tyypillisimpi\u00e4 oireita ovat voimakas uupumus, hengenahdistus, aivosumu, syd\u00e4mentykytykset, korkea syke sek\u00e4 erilaiset neurologiset ja kognitiiviset oireet (CDC 2022).<\/p>\n\n\n\n

\"\"
Kuva 1. Koronavirus voi vaikuttaa l\u00e4hes kaikkiin elimiin ja elinj\u00e4rjestelmiin. (fernandozhiminaicela 2020)<\/figcaption><\/figure>\n\n\n\n

Pitk\u00e4kestoista COVID-19:\u00e4\u00e4 sairastavat heitteill\u00e4<\/h2>\n\n\n\n

Suomessa ei ole olemassa kansallisia hoito- ja kuntoutussuosituksia pitk\u00e4kestoista COVID-19:\u00e4\u00e4 sairastaville, vaikka kansainv\u00e4lisi\u00e4 suosituksia on julkaistu yli 30. MOT:n tekem\u00e4n selvityksen mukaan pitk\u00e4kestoiseen COVID-19:\u00e4\u00e4n sairastuneet saavat monenkirjavaa hoitoa ja tukea, koska sairaus jakaa asiantuntijoiden mielipiteit\u00e4 voimakkaasti (Karppinen 2022). L\u00e4\u00e4k\u00e4rit ovat erimielisi\u00e4 siit\u00e4, onko kyseess\u00e4 elimellinen, toiminnallinen vai psyykkinen sairaus, vaikka tutkimukset (Davis ym. 2023) ovat osoittaneet, ett\u00e4 sairauden taustalla ovat biologiset mekanismit.<\/p>\n\n\n\n

Pitk\u00e4kestoisessa COVID-19:ss\u00e4 on poikkeavia piirteit\u00e4, jolloin tavanomaiset kuntoutusmenetelm\u00e4t voivat olla jopa terveytt\u00e4 heikent\u00e4vi\u00e4 tai vaarallisia. T\u00e4rkein huomioitava asia on PEM\/PESE-oire. PEM\/PESE tarkoittaa mink\u00e4 tahansa aktiivisuuden j\u00e4lkeist\u00e4 suhteetonta voinnin huononemista tai oireiden pahenemista (Stussmann ym. 2020). T\u00e4ll\u00f6in perinteinen nousujohteinen terapeuttinen harjoittelu voi pahimmillaan romahduttaa sairastuneen voinnin pysyv\u00e4sti (World Physiotherapy 2021, 7).<\/p>\n\n\n\n

Terveydenhuollon ammattilaiset tarvitsevat yhdenmukaisia ohjeita<\/h2>\n\n\n\n

LAB-ammattikorkeakoulussa kehitettiin fysioterapeuteille suunnattu opas pitk\u00e4kestoista COVID-19:\u00e4\u00e4 sairastavien toimintakyvyn arviointiin, jota ohjaa ICF-luokitus. Arvioinnissa hy\u00f6dynnet\u00e4\u00e4n oirekyselyit\u00e4 sek\u00e4 mittareita. Opas tehtiin yhteisty\u00f6ss\u00e4 ME\/CFS- ja long covid -ammattilaisten verkoston <\/a>kanssa, ja se perustuu kansainv\u00e4lisiin hoito- ja kuntoutussuosituksiin (HIQA 2022; NICE 2024; WHO 2023). Oppaasta voi olla hy\u00f6ty\u00e4 my\u00f6s muille terveydenhuollon ammattilaisille.<\/p>\n\n\n\n

\"[Alt-teksti:
Kuva 2. Sairastunutta tulisi arvioida yksil\u00f6llisesti eri osa-alueilla (Kaapro & Mukala 2024, 13).<\/figcaption><\/figure>\n\n\n\n

Koska pitk\u00e4kestoinen COVID-19 aiheuttaa merkitt\u00e4v\u00e4\u00e4 ty\u00f6- ja toimintakyvyn sek\u00e4 el\u00e4m\u00e4nlaadun laskua (Davis ym. 2021; O\u2019Mahony ym. 2022; Tak 2023), tulisi pitk\u00e4kestoisia oireita kokevien toimintakyky selvitt\u00e4\u00e4 mahdollisimman nopeasti. Toimintakyvyn arvioinnissa huomioidaan kyky suorittaa normaalit p\u00e4ivitt\u00e4iset toiminnot, perustarpeiden t\u00e4yttyminen sek\u00e4 terveyden ja hyvinvoinnin yll\u00e4pit\u00e4minen ja henkil\u00f6lle itselleen merkitykselliset asiat (Sarap ym. 2022). Toimintakyvyn arviointi ei saa lis\u00e4t\u00e4 oireita, vaan se tulee suhteuttaa sairauden vaikeusasteeseen (CDC 2024). Arvioinnin pohjana k\u00e4ytet\u00e4\u00e4n ICF-mallia, jossa huomioidaan henkil\u00f6 yksil\u00f6n\u00e4 toimintaymp\u00e4rist\u00f6ss\u00e4\u00e4n.<\/p>\n\n\n\n

\n
\n

Kirjoittajat<\/p>\n\n\n\n

Saara Kaapro<\/strong>\u202fon LAB-ammattikorkeakoulun Lahden kampuksen fysioterapiaopiskelija, joka valmistuu kes\u00e4ll\u00e4 2024. Kaaprolla on omakohtaista kokemusta pitk\u00e4kestoisesta COVID-19:st\u00e4 ja h\u00e4n on k\u00e4ynyt ME\/CFS- ja Long COVID -ammattilaisten verkoston j\u00e4rjest\u00e4miss\u00e4 koulutuksissa aiheeseen liittyen.<\/p>\n\n\n\n

Anu Kaksonen<\/strong>\u202fty\u00f6skentelee lehtorina LAB-ammattikorkeakoulun hyvinvointiyksik\u00f6ss\u00e4 ja OMT-fysioterapeuttina omassa yrityksess\u00e4\u00e4n, jossa kohtaa pitk\u00e4kestoisista covid-oireista k\u00e4rsivi\u00e4 asiakkaita.<\/p>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n

L\u00e4hteet<\/h2>\n\n\n\n

CDC. 2022. Long COVID or Post-COVID Conditions. Centers for Disease Control and Prevention. Viitattu 27.2.2024. Saatavissa https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/long-term-effects\/index.html<\/a><\/p>\n\n\n\n

CDC. 2024. Managing Post-Exertional Malaise (PEM) in ME\/CFS. Centers for Disease Control and Prevention. Viitattu 27.2.2024. Saatavissa https:\/\/www.cdc.gov\/me-cfs\/pdfs\/interagency\/Managing-PEM_508.pdf<\/a><\/p>\n\n\n\n

Davis, H., Assaf, G., McCorkell, L., Wei, H., Low, R., Re’em, Y., Redfield, S., Austin, P & Akrami, A. 2021. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. National Library of Medicine. Viitattu 10.4.2024. Saatavissa https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8280690\/<\/a><\/p>\n\n\n\n

Davis, H., McCorkell, L., Vogel, J & Topol, E. 2023. Long COVID: major findings, mechanisms, and recommendations. Nature.com. Viitattu 27.2.2024. Saatavissa https:\/\/www.nature.com\/articles\/s41579-022-00846-2<\/a><\/p>\n\n\n\n

fernandozhiminaicela. 2020. Zhiminaicela, F. Koeputkeen, covid-19. Pixabay. Viitattu 10.4.2024. Saatavissa https:\/\/pixabay.com\/fi\/photos\/koeputkeen-covid-19-naamio-5065426\/<\/a><\/p>\n\n\n\n

HIQA. 2022. International review of clinical guidelines and models of care for long COVID. Health Information and Quality Authority. Viitattu 10.4.2024. Saatavissa https:\/\/www.hiqa.ie\/sites\/default\/files\/2022-12\/Long-COVID-guidelines.pdf<\/a><\/p>\n\n\n\n

Kaapro, S. & Mukala, E. 2024. Pitk\u00e4kestoista COVID-19:\u00e4\u00e4 sairastavan toimintakyvyn arviointi – Opas oirekyselyist\u00e4 ja mittareista fysioterapeuteille. Opinn\u00e4ytety\u00f6 AMK. LAB-ammattikorkeakoulu, sosiaali- ja terveysala, fysioterapia. Viitattu 10.4.2024. Saatavissa https:\/\/www.theseus.fi\/bitstream\/handle\/10024\/820547\/Kaapro_Mukala.pdf?sequence=2&isAllowed=y<\/a><\/p>\n\n\n\n

Karppinen, K. 2022. Jo yli 21 000 suomalaista on saanut long covid -diagnoosin \u2013 moni pitk\u00e4kestoiseen koronaan sairastunut j\u00e4\u00e4 vaille riitt\u00e4v\u00e4\u00e4 tukea ja hoitoa. Yle. Viitattu 27.2.2024. Saatavissa https:\/\/yle.fi\/a\/74-20007043<\/a><\/p>\n\n\n\n

NICE. 2024. COVID-19 rapid guideline: managing the long-term effects of COVID-19. National Institute of Health and Care Excellence. Viitattu 10.4.2024. Saatavissa https:\/\/www.nice.org.uk\/guidance\/ng188<\/a><\/p>\n\n\n\n

O\u00b4Mahony, L., Buwalda, T., Blair, M., Forde, B., Lunjani, N., Ambikan, A., Neogi, U., Barret, B., Geary, E., O\u00b4Connor, N., Dineen, J., Clarce, G., Kelleher, E., Horgan, M., Jackson, A & Sadlier, C. 2022. Impact of Long COVID on health and quality of life. Viitattu 27.2.2024. Saatavissa https:\/\/hrbopenresearch.org\/articles\/5-31#ref-35<\/a><\/p>\n\n\n\n

Sarap, R., Shinde, M., Mahajan, P & Saini, V. 2022. Evaluation of Quality of Life, Fatigue Severity and Functional Status in Post Covid-19 Patients – Cross-Over Longitudinal Study. International Journal of Health Sciences and Research. Viitattu 27.2.2024. Saatavissa https:\/\/www.ijhsr.org\/IJHSR_Vol.12_Issue.9_Sep2022\/IJHSR07.pdf<\/a><\/p>\n\n\n\n

Stussmann, B., Williams, A., Snow, J., Gavin, A., Scott, R., Nath, A & Walitt, B. 2020. Characterization of Post\u2013exertional Malaise in Patients With Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome. National Library of Medicine. National Center for Biotechnology Information. Viitattu 23.2.2023. Saatavissa https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7530890\/<\/a><\/p>\n\n\n\n

Tak, C. 2023. The health impact of long COVID: a cross-sectional examination of healthrelated quality of life, disability, and health status among individuals with self-reported postacute sequelae of SARS CoV-2 infection at various points of recovery. SpringerOpen. Viitattu 27.2.2024. Saatavissa https:\/\/jpro.springeropen.com\/articles\/10.1186\/s41687-023-00572-0<\/a><\/p>\n\n\n\n

WHO. 2022. Post COVID-19 condition (Long COVID). Viitattu 27.2.2024. Saatavissa https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/post-covid-19-condition<\/a><\/p>\n\n\n\n

WHO. 2023. Clinical management of COVID-19: Living guideline. 18 August 2023. Viitattu 10.4.2024. Saatavissa https:\/\/iris.who.int\/bitstream\/handle\/10665\/372288\/WHO-2019-nCoV-clinical-2023.2-eng.pdf?sequence=1<\/a><\/p>\n\n\n\n

WHO. 2024. WHO COVID-19 dashboard. Viitattu 27.2.2024. Saatavissa https:\/\/data.who.int\/dashboards\/covid19\/deaths?n=c<\/a><\/p>\n\n\n\n

World Physiotherapy. 2021. World Physiotherapy Response to COVID-19. Briefing Paper 9. Safe rehabilitation approaches for people living with long COVID: Physical activity and exercise. Viitattu 27.2.2024. Saatavissa https:\/\/world.physio\/sites\/default\/files\/2021-06\/Briefing-Paper-9-Long-Covid-FINAL.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Vuonna 2019 SARS-CoV-2-virus alkoi levit\u00e4 aiheuttaen maailmanlaajuisen COVID-19-pandemian, johon on kuollut t\u00e4h\u00e4n p\u00e4iv\u00e4\u00e4n menness\u00e4 yli 7 miljoonaa ihmist\u00e4. Kaiken kaikkiaan vahvistettuja COVID-19-tartuntoja on raportoitu noin 775 miljoonaa kappaletta. (WHO 2024.) Akuutin taudin vakavuudesta riippumatta 10\u201320 %:lle kehittyy pitk\u00e4kestoisia COVID-oireita, jotka vaikuttavat merkitt\u00e4v\u00e4sti toimintakykyyn sek\u00e4 el\u00e4m\u00e4nlaatuun (WHO 2022). Pitk\u00e4kestoinen COVID-19 on multisysteeminen elimellinen sairaus, josta on […]<\/p>\n","protected":false},"author":17,"featured_media":18533,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15,119],"tags":[29,816,4194,1891,9172,5445],"class_list":{"0":"post-18531","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health_fi","8":"category-osallisuuden-edistaminen-ja-turvallinen-arki","9":"tag-artikkeli-e1","10":"tag-covid-19","11":"tag-icf","12":"tag-koronavirus","13":"tag-long-covid","14":"tag-tyokyky-fi","15":"czr-hentry"},"yoast_head":"\nKorona-aika ei ole ohi - LAB Focus<\/title>\n<meta name=\"description\" content=\"Valmistui opas pitk\u00e4kestoista covidia sairastavien henkil\u00f6iden toimintakyvyn arviointiin. 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