Impact of Spa Therapy on Symptoms and Quality of Life in Post-COVID-19 Patients with Chronic Conditions
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population and Study Design
2.2. Anti-SARS-CoV-2 Vaccination Status
2.3. Post-COVID-19 Condition
2.4. Symptom and QoL Assessment
2.5. Statistical Analysis
3. Results
3.1. Characteristics at Enrollment
3.2. Effects of Spa Therapy on Post-COVID-19 and Disease-Specific Symptoms
3.3. QoL Improvement in Post-COVID-19 Patients
3.4. Satisfaction of Spa Treatment
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Symptoms (N, %) | Total N = 78 N (%) | Females N = 56 N (%) | Males N = 22 N (%) | p Value | VAS Score | p Value | Δ% | |
---|---|---|---|---|---|---|---|---|
Before | After | |||||||
Chronic fatigue | 52 (67) | 39 (70) | 13 (59) | 0.374 | 3.2 ± 0.8 | 1.7 ± 1.1 | 0.001 | −47% |
Muscle pain | 37 (47) | 29 (52) | 8 (36) | 0.220 | 3.1 ± 0.9 | 1.6 ± 1.1 | 0.001 | −48% |
Joint pain | 32 (41) | 23 (41) | 9 (41) | 0.990 | 2.0 ± 0.8 | 1.6 ± 1.0 | 0.001 | −20% |
Brain fog | 28 (36) | 22 (39) | 6 (27) | 0.320 | 2.9 ± 1.0 | 1.7 ± 1.0 | 0.001 | −41% |
Persistent cough | 24 (31) | 16 (29) | 8 (36) | 0.502 | 2.8 ± 1.2 | 0.9 ± 1.1 | 0.001 | −68% |
Headache | 23 (29) | 17 (30) | 6 (27) | 0.788 | 2.8 ± 1.0 | 1.1 ± 1.0 | 0.001 | −61% |
Chest pain | 14 (18) | 8 (14) | 6 (27) | 0.179 | 2.3 ± 0.9 | 0.7 ± 0.9 | 0.001 | −70% |
Dyspnea | 13 (17) | 9 (16) | 4 (18) | 0.822 | 2.3 ± 1.3 | 0.8 ± 0.8 | 0.003 | −65% |
Taste disorders | 13 (17) | 9 (16) | 4 (18) | 0.822 | 2.8 ± 0.9 | 1.2 ± 1.3 | 0.001 | −57% |
Pseudo freezing hands and feet | 13 (17) | 8 (14) | 5 (23) | 0.368 | 2.4 ± 1.3 | 1.0 ± 1.1 | 0.001 | −58% |
Tinnitus | 13 (17) | 8 (14) | 5 (23) | 0.368 | 2.9 ± 1.0 | 1.8 ± 1.0 | 0.01 | −38% |
Gastroesophageal reflux | 11 (14) | 8 (14) | 3 (14) | 0.941 | 2.8 ± 0.9 | 1.0 ± 0.8 | 0.001 | −64% |
Sore throat | 10 (13) | 7 (13) | 3 (14) | 0.893 | 2.8 ± 1.1 | 0.3 ± 0.7 | 0.001 | −89% |
Persistent loss of smell | 10 (13) | 7 (13) | 3 (14) | 0.893 | 3.3 ± 1.1 | 1.0 ± 1.3 | 0.001 | −70% |
Burning sensation of the skin | 9 (12) | 7 (13) | 2 (9) | 0.672 | 2.9 ± 0.6 | 1.0 ± 1.1 | 0.001 | −66% |
Hair loss | 9 (12) | 9 (16) | 0 (0) | 0.046 | 2.4 ± 1.2 | 1.1 ± 0.6 | 0.01 | −54% |
Dysphony | 8 (10) | 6 (11) | 2 (9) | 0.832 | 1.8 ± 1.0 | 0.1 ± 0.4 | 0.01 | −94% |
Nausea | 7 (9) | 5(9) | 2 (9) | 0.982 | 3.0 ± 0.6 | 0.4 ± 0.5 | 0.001 | −87% |
Itching | 7 (9) | 4 (7) | 3 (14) | 0.367 | 2.9 ± 1.3 | 0.9 ± 0.9 | 0.001 | −69% |
Earache | 6 (8) | 6 (11) | 0 (0) | 0.110 | 2.8 ± 0.4 | 1.5 ± 1.0 | 0.03 | −46% |
Dysphagia | 4 (5) | 2 (3.6) | 2 (9) | 0.320 | 2.3 ± 1.0 | 0.3 ± 0.5 | 0.04 | −87% |
Vomiting | 3 (4) | 2 (3.6) | 1 (4.5) | 0.840 | 3.3 ± 0.6 | 0.3 ± 0.6 | 0.04 | −91% |
Nasal congestion | 2 (3) | 1 (1.8) | 1 (4.5) | 0.488 | 2.5 ± 0.7 | 0.5 ± 0.7 | 0.3 | −80% |
Irritability | 2 (3) | 1 (1.8) | 1 (4.5) | 0.488 | 2.5 ± 0.7 | 1.5 ± 0.7 | 0.707 | −40% |
Symptoms | Females with Post-COVID-19 N = 56 | Males with Post-COVID-19 N = 22 | ||||||
---|---|---|---|---|---|---|---|---|
Before | After | Δ% | p Value | Before | After | Δ% | p Value | |
Chronic fatigue | 3.2 ± 0.8 | 1.7 ± 1.1 | −47% | 0.001 | 3.0 ± 0.8 | 1.5 ± 1.3 | −53% | 0.001 |
Muscle pain | 3.1 ± 0.9 | 1.7 ± 1.1 | −45% | 0.001 | 3.1 ± 0.8 | 1.4 ± 1.1 | −55% | 0.006 |
Joint pain | 2.9 ± 0.9 | 1.6 ± 1.1 | −45% | 0.001 | 3.2 ± 0.7 | 1.7 ± 0.9 | −47% | 0.002 |
Brain fog | 2.9 ± 1.0 | 1.7 ± 0.9 | −41% | 0.001 | 2.7 ± 1.4 | 1.5 ± 1.4 | −44% | 0.03 |
Persistent cough | 2.8 ± 1.2 | 0.8 ± 1.1 | −71% | 0.001 | 3.0 ± 1.2 | 1.1 ± 1.2 | −66% | 0.01 |
Headache | 2.9 ± 1.0 | 1.4 ± 1.0 | −52% | 0.001 | 2.5 ± 1.0 | 0.5 ± 0.8 | −80% | 0.001 |
Taste disorders | 2.6 ± 1.0 | 1.1 ± 1.3 | −58% | 0.003 | 3.3 ± 0.5 | 1.3 ± 1.5 | −67% | 0.12 |
Pseudo freezing hands and feet | 2.1 ± 1.2 | 0.8 ± 0.9 | −62% | 0.004 | 2.8 ± 1.3 | 1.4 ± 1.5 | −50% | 0.11 |
Tinnitus | 3.0 ± 1.1 | 1.8 ± 1.0 | −40% | 0.03 | 2.8 ± 0.8 | 2.0 ± 1.0 | −29% | 0.1 |
Sore throat | 2.6 ± 1.1 | 0.4 ± 0.8 | −85% | 0.003 | 3.3 ± 1.2 | 0.0 ± 0.0 | −100% | 0.04 |
Chest pain | 2.5 ± 0.9 | 1.0 ± 0.9 | −60% | 0.01 | 2.0 ± 0.9 | 0.3 ± 0.8 | −85% | 0.02 |
Persistent loss of smell | 3.1 ± 1.2 | 1.6 ± 1.1 | −48% | 0.01 | 3.7 ± 0.6 | 1.0 ± 1.7 | −73% | 0.09 |
Dysphony | 1.7 ± 1.0 | 0.2 ± 0.4 | −88% | 0.03 | 2.0 ± 1.4 | 0.0 ± 0.0 | −100% | 0.3 |
Gastroesophageal reflux | 2.8 ± 1.0 | 1.0 ± 0.8 | −64% | 0.001 | 3.0 ± 0.0 | 1.0 ± 1.0 | −67% | 0.07 |
Nausea | 2.8 ± 0.4 | 0.6 ± 0.5 | −79% | 0.001 | 3.5 ± 0.7 | 0.0 ± 0.0 | −100% | 0.09 |
Itching | 2.3 ± 1.5 | 0.8 ± 1.0 | −65% | 0.01 | 3.7 ± 0.6 | 1.0 ± 1.0 | −73% | 0.02 |
Hair loss | 2.4 ± 1.2 | 1.1 ± 0.6 | −54% | 0.01 | - | - | - | - |
Burning sensation of the skin | 3.0 ± 0.6 | 1.0 ± 1.2 | −67% | 0.01 | 2.5 ± 0.7 | 1.0 ± 1.4 | −60% | 0.2 |
Nasal congestion | 3 | 0 | −100% | - | 2 | 1 | −50% | - |
Dysphagia | 2.0 ± 1.4 | 0.0 ± 0.0 | −100% | 0.3 | 2.5 ± 0.7 | 0.5 ± 0.7 | −80% | 0.3 |
Earache | 2.8 ± 0.4 | 1.5 ± 1.0 | −46% | 0.03 | - | - | - | - |
Irritability | 2 | 1 | −50% | - | 3 | 2 | −33% | - |
Vomiting | 3.0 ± 0.0 | 0.5 ± 0.7 | −83% | 0.1 | 4 | 0 | −100% | - |
Dyspnea | 2.4 ± 1.3 | 0.8 ± 0.7 | −67% | 0.02 | 2.0 ± 1.4 | 0.8 ± 1.0 | −60% | 0.08 |
Symptoms (N, %) | Total N = 43 N (%) | VAS Score | p Value | Females N = 32 | Males N = 11 | |||||
---|---|---|---|---|---|---|---|---|---|---|
Before | After | Before | After | p Value | Before | After | p Value | |||
Spontaneous pain | 23 (53) | 2.8 ± 1.0 | 1.5 ± 1.4 | 0.01 | 2.7 ± 0.9 | 1.5 ± 1.3 | 0.01 | 3.0 ± 0.8 | 1.3 ± 1.9 | 0.07 |
Functional pain | 28 (65) | 3.3 ± 0.5 | 2.4 ± 0.9 | 0.01 | 3.4 ± 0.5 | 2.5 ± 0.7 | 0.01 | 3.2 ± 0.4 | 1.8 ± 1.3 | 0.03 |
Morning stiffness | 22 (51) | 3.1 ± 0.9 | 2.0 ± 1.4 | 0.01 | 3.1 ± 0.9 | 1.9 ± 1.3 | 0.01 | 3.5 ± 0.7 | 3.0 ± 1.4 | 0.5 |
Paresthesia | 18 (462) | 2.7 ± 0.8 | 1.1 ± 1.2 | 0.01 | 2.4 ± 0.8 | 1.1 ± 1.2 | 0.01 | 2.7 ± 0.6 | 1.0 ± 1.7 | 0.2 |
Nasal obstruction | 6 (14) | 3.3 ± 0.5 | 2.5 ± 0.5 | 0.01 | 3.5 ± 0.6 | 2.5 ± 0.6 | 0.01 | 3.0 ± 0.0 | 2.5 ± 0.7 | 0.5 |
Sneezing | 6 (14) | 2.2 ± 1.0 | 1.2 ± 1.0 | 0.01 | 2.3 ± 1.2 | 1.3 ± 1.2 | 0.01 | 2.0 ± 1.0 | 1.0 ± 1.0 | 0.23 |
Nasal itching | 3 (7) | 2.7 ± 0.6 | 1.7 ± 1.2 | 0.2 | 3 | 3 | - | 2.5 ± 0.7 | 1.0 ± 0.0 | 0.2 |
Headache | 4 (9) | 2.3 ± 1.0 | 1.1 ± 1.2 | 0.02 | 2.7 ± 0.6 | 1.3 ± 1.2 | 0.06 | 1 | 0 | - |
Cough | 3 (7) | 2.7 ± 0.6 | 1.7 ± 1.5 | 0.4 | 3.0 ± 0.0 | 1.5 ± 2.1 | 0.5 | 2 | 2 | - |
SF-36 Items | Subjects with Post-COVID-19 N = 78 | Never-Infected Subjects N = 38 | p Value * | p Value # | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Before | After | Δ% | p Value | Before | After | Δ% | p Value | |||
PF | 71 ± 23 | 84 ± 16 | +18% | <0.0001 | 82 ± 18 | 87 ± 17 | +6% | 0.0022 | 0.2052 | 0.4831 |
RLP | 46 ± 40 | 79 ± 33 | +72% | <0.0001 | 60 ± 42 | 85 ± 27 | +42% | 0.0003 | 0.3950 | 0.2664 |
P | 48± 26 | 68 ± 22 | +42% | <0.0001 | 55± 21 | 76 ± 17 | +38% | <0.0001 | 0.8427 | 0.0547 |
GH | 50 ± 20 | 60 ± 18 | +20% | <0.0001 | 52 ± 15 | 63 ± 13 | +21% | <0.0001 | 0.9889 | 0.3541 |
EF | 45 ± 22 | 63 ± 15 | +40% | <0.0001 | 60 ± 18 | 72 ± 15 | +20% | 0.0002 | 0.0215 | 0.0514 |
RLE | 50 ± 44 | 83 ± 27 | +66% | <0.0001 | 68 ± 41 | 89 ± 26 | +31% | 0.0057 | 0.0659 | 0.7487 |
SF | 58 ± 27 | 73 ± 22 | +26% | <0.0001 | 68 ± 23 | 79 ± 19 | +16% | 0.0121 | 0.4064 | 0.5917 |
EWB | 55 ± 21 | 70 ± 15 | +27% | <0.0001 | 69 ± 18 | 76 ± 19 | +10% | 0.0190 | 0.0134 | 0.2359 |
SF-36 Items | Males with Post-COVID-19 N = 22 | Females with Post-COVID-19 N = 56 | p Value * | p Value # | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Before | After | Δ% | p Value | Before | After | Δ% | p Value | |||
PF | 76 ± 21 | 87 ± 14 | +14% | 0.0074 | 64 ± 24 | 84 ± 17 | +24% | <0.0001 | 0.1540 | 0.3663 |
RLP | 50 ± 37 | 82 ± 36 | +64% | 0.0026 | 45 ± 41 | 77 ± 33 | +71% | <0.0001 | 0.5094 | 0.3594 |
P | 53± 29 | 67 ± 26 | +26% | 0.0426 | 46 ± 25 | 68 ± 21 | +48% | <0.0001 | 0.3582 | 0.9222 |
GH | 53 ± 17 | 62 ± 22 | +17% | 0.0153 | 49 ± 21 | 59 ± 17 | +20% | <0.0001 | 0.5589 | 0.6435 |
EF | 48 ± 21 | 61 ± 20 | +27% | 0.0072 | 44 ± 22 | 64 ± 13 | +45% | <0.0001 | 0.5225 | 0.9845 |
RLE | 55 ± 46 | 82 ± 29 | +49% | 0.0083 | 48 ± 44 | 83 ± 27 | +73% | <0.0001 | 0.5714 | 0.7400 |
SF | 61 ± 25 | 73 ± 25 | +20% | 0.0229 | 57 ± 28 | 73 ± 20 | +28% | <0.0001 | 0.5804 | 0.6325 |
EWB | 57 ± 19 | 67 ± 17 | +18% | 0.0639 | 55 ± 22 | 71 ± 15 | +29% | <0.0001 | 0.5938 | 0.5120 |
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Costantino, M.; Giudice, V.; Farroni, M.; Marongiu, F.; De Caro, F.; Filippelli, A. Impact of Spa Therapy on Symptoms and Quality of Life in Post-COVID-19 Patients with Chronic Conditions. J. Clin. Med. 2024, 13, 5091. https://doi.org/10.3390/jcm13175091
Costantino M, Giudice V, Farroni M, Marongiu F, De Caro F, Filippelli A. Impact of Spa Therapy on Symptoms and Quality of Life in Post-COVID-19 Patients with Chronic Conditions. Journal of Clinical Medicine. 2024; 13(17):5091. https://doi.org/10.3390/jcm13175091
Chicago/Turabian StyleCostantino, Maria, Valentina Giudice, Mario Farroni, Francesco Marongiu, Francesco De Caro, and Amelia Filippelli. 2024. "Impact of Spa Therapy on Symptoms and Quality of Life in Post-COVID-19 Patients with Chronic Conditions" Journal of Clinical Medicine 13, no. 17: 5091. https://doi.org/10.3390/jcm13175091