News from the Visegrád Countries - Czech Republic, Poland, Slovakia and Hungary

Wyva · May 20, 2024

Context: basically you can't read anything about long covid in Hungarian media anymore (government or independent media, it really doesn't matter which one). I mean you can find a few articles sometimes that are translated from some foreign source about some LC research that made some waves abroad (like the Wüst paper), but even that is rare. There are basically zero original Hungarian articles about LC anymore (there weren't many to begin with).

Btw, a few people from my group (the ones with LC mostly) have tried to approach journalists but they weren't interested. They also tried to send them the stories of pwME from my group that we also sent to the Ministry a few months ago to show how bad the situation in healthcare is (that no one knows or understands the disease, no one can diagnose it etc). Not a beep came back.

So anyway, after this introduction even a short, not too well-informed article like this is newsworthy here.

ChatGPT translation:

Gábor Kemenesi: After the Pandemic, a Cure for Long Covid Must Be Found Urgently

Covid is a very new virus, so scientists are only now beginning to understand the long-term changes it causes in the body, said the virologist.

According to a British survey conducted between November 2023 and March 2024, 71.1% of respondents said they had been suffering from Long Covid for at least a year, 51.3% for two years, and 30.6% reported post-Covid symptoms from three years ago. According to the UK's Office for National Statistics, this amounts to 1.5 million British patients, of whom 381,000 are in particularly poor condition.

"It is well known that some symptoms remain after the acute phase of other viral infections, but Long Covid is unique," said virologist Gábor Kemenesi on InfoRádió.

"What sets it apart is that Covid was a completely new virus, and it quickly swept across the globe, causing a sudden surge of infections. We still do not fully understand how, during its course of infection, it leaves behind various symptoms, inflammation sites, sleep disturbances, and other issues whose biological backgrounds are not yet understood," said the virologist, indicating that recognizing and treating Long Covid is difficult for this reason.

Initially, information about the disease comes from so-called correlation data, such as when someone notes that their sleep worsened after having Covid, and this is recorded by science. Then they examine whether there is a biological basis for this, and if they find actual organ changes or cellular processes, they can potentially look for a cure.

"So far, the concept of Long Covid is still very vague.

What is certain is that it exists and is known in other viral infections, but the Covid pandemic was caused by a very new virus. Scientists need to understand it now and find cures for it," said Gábor Kemenesi, recalling a previous statement that the Covid pandemic is evolving into the problem of Long Covid, its understanding, and its medical treatment. He emphasized that Long Covid is a significant factor in the world today, and science is rushing to understand and find treatments for it.

Simon Williams, a researcher at Swansea University, told The Guardian that the survey results proving the spread of Long Covid in the UK indicate a chronic public health crisis.

Gábor Kemenesi is a young virologist/researcher who is a somewhat well-known face in the media. He doesn't seem to be super well-informed about ME/CFS but he is still someone actually talking about long covid, unlike basically anyone else, including doctors. Edina, my group moderator, who also happens to be the moderator of a big LC Facebook group, told me that Kemenesi is actually a member of their group and even liked some of her posts there. So now she is planning to approach him, with the hope of making him an ally.

Wyva · Jun 12, 2024

Some conference abstracts from The 30th National Scientific Assembly of the Hungarian Psychological Society from 2023 (book of abstracts here). There was a whole section titled "Affective and cognitive neuropsychological functions in post-COVID syndrome, and specifically developed psychological interventions for these symptoms".

These abstracts are mostly about psychological research into post-covid syndrome funded by the Hungarian Academy of Sciences. These papers have yet to be published but they used art therapy and virtual reality-based therapy. Apart from the main authors, you can see involvement from Veronika Müller, who is actually a pulmonologist and seems to have a special interest in long covid as she also gave lectures on long covid at the two symposiums of the Academy earlier.

Some of you may remember her as someone not very familiar with ME/CFS and post-viral syndromes at all, to the point that one of the papers on long covid she contributed to said previous sars infections didn't have such lingering symptoms, which is very easy to disprove. I don't know if her knowledge is more up-to-date now. She is also pushing cardiopulmonary rehabilitation for long covid as far as I know but again, long covid to her may be lung-related long covid, people she sees at the pulmonary clinic.

Anyway, here are the abstracts about the upcoming studies, translated by ChatGPT:

Introduction:

Affective and cognitive neuropsychological functions in post-COVID syndrome, and specifically developed psychological interventions for these symptoms

Chair: Renáta Cserjési – Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology
Opponent: Csaba Borbély – National Institute of Mental Neurology and Neurosurgery

Post-COVID syndrome, also known as long COVID, refers to a set of symptoms that persist for weeks or even months after the resolution of a COVID-19 infection. In addition to significantly increased fatigue, neurocognitive symptoms such as memory and executive function impairments, attention disorders, psychomotor coordination disturbances, and language difficulties may be characteristic. Additionally, depressive and anxiety symptoms can also emerge or intensify.

The remaining psychological and neurocognitive symptoms can have a significant impact on patients' quality of life and health status, making the study of this phenomenon and the exploration of potential intervention options of paramount importance. This symposium presents the research conducted by the EMIND Integrative Neuropsychology Research Group at the ELTE Institute of Psychology, in cooperation with the Semmelweis University Pulmonology Clinic and the University of Pannonia.

In the introduction of the symposium, Renáta Cserjési, head of the EMIND lab, will outline the structure and objectives of the post-COVID studies. The first presentation will compare the affective and cognitive neuropsychological functions of individuals who have recovered from COVID-19 with those who have not been infected (presentation by Fanni Forsthoffer, BA student). The second presentation will showcase a virtual reality-based cognitive intervention focused on post-COVID symptoms and its impact on the health status of the participants (presentation by Sarolta Imre, MA student).

The third presentation will present the results of an art therapy protocol specifically developed for post-COVID, through qualitative and quantitative analyses (presentation by Zsuzsanna Valachiné Geréb, clinical psychologist and art therapist). The final presentation will discuss the effects of these interventions on affective and cognitive neuropsychological functions (presentation by Kinga Nedda Pete, PhD student). The research is supported by the high-risk grant from the Hungarian Academy of Sciences (MTA) aimed at studying post-COVID phenomena.
Click to expand...

The Impact of COVID-19 on Executive Functions in a Hungarian Sample

Fanni Forsthoffer¹, Kinga Nedda Pete², Zsuzsanna Valachiné Geréb², Renáta Cserjési³, Sarolta Imre¹, Orsolya Gőbel⁴, Cecília Sik-Lányi⁵, János Tamás Varga⁴, Veronika Müller⁴
¹Student at Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology
²Eötvös Loránd University, Faculty of Education and Psychology, Doctoral School of Psychology
³Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology
⁴Semmelweis University, Pulmonology Clinic
⁵University of Pannonia, Faculty of Information Technology

The coronavirus pandemic, which has been part of our lives for nearly three years, poses both physical and mental health challenges to our society. COVID-19 complicates our lives not only during the infection period but also afterward with certain residual symptoms. The altered living conditions, the novelty of the disease, and its unknown long-term effects pose significant mental and neuropsychological threats. Depression and anxiety alone have a substantial negative impact on cognitive abilities, but increasing research supports that COVID-19, like other infectious viruses, can induce changes in the central nervous system.

These studies typically focus on Western societies and often examine cognitive functions in general. The aim of the current research is to gather information on a more specific area of cognitive functions, namely executive functions, after coronavirus infection, with a focus on a Hungarian sample. Alongside measuring executive functions, we also assessed the levels of depression and anxiety to exclude the possibility that our results could be attributed to factors other than the coronavirus. Consistent with previous studies, we predicted that our sample would also show better results in the control group, i.e., those who had not been infected with the virus.

Despite this, a significant difference was detected only in the results of the Frontal Assessment Battery's prehensile behavior subtest, where the group that had contracted COVID-19 performed significantly worse than the control group that had not been infected. Surprisingly, in the other tests, the group that had contracted the disease performed better. Further research is warranted to determine whether this finding is significant and, if so, what might be the cause for the significant difference observed only in prehensile behavior in a smaller sample.
Click to expand...

Rehabilitation of Neuropsychological Functions in Post-COVID Patients Using Virtual Reality (VR) Methods

Sarolta Imre¹, Kinga Nedda Pete², Zsuzsanna Valachiné Geréb², Renata Cserjési³, Fanni Forsthoffer¹, Orsolya Gőbel⁴, Cecília Sik-Lányi⁵, János Tamás Varga⁴, Veronika Müller⁴
¹Student at Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology
²Eötvös Loránd University, Faculty of Education and Psychology, Doctoral School of Psychology
³Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology
⁴Semmelweis University, Pulmonology Clinic
⁵University of Pannonia, Faculty of Information Technology

Patients suffering from post-COVID syndrome may experience impairments lasting for weeks, months, or even years, significantly reducing their quality of life. Among the most common symptoms is cognitive impairment, for which there is currently no well-established and effective method to compensate for the impairment or restore normal functioning. Among the new techniques for cognitive rehabilitation, virtual reality (VR) has shown promising results in patients who have had a stroke and those with mild cognitive impairment.

Therefore, the main aim of the present research is to confirm the effectiveness of VR techniques in patients with post-COVID syndrome. Only individuals who were at least 18 years old and had contracted COVID-19, and who subjectively perceived themselves as having cognitive deficits, were allowed to participate in the research. Exclusion criteria included prior psychiatric or neurological disorders. To test our hypotheses, we used a test battery consisting of neuropsychological tests, including assessments of memory, attention, and executive functions.

Following this, a group of post-COVID patients participated in a 6-week VR intervention using the Enhance VR program. To assess the long-term effects of the intervention, we repeated the administration of the neuropsychological test battery twice: first, 9 weeks after the initial test administration, and then again 12 weeks after the second test administration. The practical benefit of the research is significant and timely; however, its limitations include the small number of participants due to the nature of the procedure.
Click to expand...

Art Towards Health - A Short Art Therapy Program in the Rehabilitation of Post-COVID Patients

Renáta Cserjési¹, Zsuzsanna Valachiné Geréb², Kinga Nedda Pete², Orsolya Gőbel³, Cecília Sik-Lányi⁴, Veronika Müller³

¹Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology
²Eötvös Loránd University, Faculty of Education and Psychology, Doctoral School of Psychology
³Semmelweis University, Pulmonology Clinic
⁴University of Pannonia, Faculty of Information Technology

The cognitive and affective psychological problems caused by COVID-19 can manifest during the virus's acute phase and may persist after the infection, significantly impacting patients' daily lives and work capacity. In our presentation, we will theoretically and practically present an art therapy protocol aimed at assisting in the rehabilitation of post-COVID patients. Our goal is to examine the effects of the interventions on changes in neuropsychological functions and quality of life in individuals with post-COVID symptoms.

Art therapy has been shown to promote neuroplasticity and has a positive impact on attention, executive functions, spatial-visual abilities, and memory, contributing to increased well-being and reduced depression and anxiety. It changes behavioral and thinking patterns and biologically reduces anxiety by normalizing heart rate, blood pressure, and cortisol levels. Art therapy provides access to emotions and autobiographical memories, helps integrate somatosensory experiences, increases functional connectivity in the default mode network, which serves not only cognitive development but also enhances psychological resilience. The effects of art therapy have proven effective on neuropsychological components as well. Art therapy rehabilitation aims to enhance both neuropsychological development and emotional improvement.

The art therapy protocol consists of 6 sessions with the following themes: (1) presenting ourselves and our experiences; (2) body image and imagination about the functioning immune system; (3) restoring safety; (4) following the rhythm of breathing and releasing tension with directed drawing techniques; (5) gratitude sculpture for resources and survival; (6) foresight image of the process and comfort box. The technical background of the sessions is compiled from protocols of positive art therapy, healthcare art therapy, and art therapy practices for life-threatening illnesses. We conducted state assessments before and after each session.

The impact assessment consists of pre-post questionnaires. The sessions have a circular structure: check-in circle, relaxation with breathing, short directed imaginative creative art creation, and sharing. Participants report emotional improvements after the sessions. Longitudinal effects and neuropsychological follow-up examinations are ongoing. In my presentation, I would like to provide insight into the qualitative aspects of the research. The embodied experiences and internal resources presented externally in the participants' images and narratives.
Click to expand...

Effects of Virtual Reality-Based Cognitive Intervention Program and Art Therapy on Affective and Cognitive Neuropsychological Functions in Post-COVID Syndrome

Pete Kinga Nedda1, Valachiné Geréb Zsuzsanna1, Imre Sarolta2, Forsthoffer Fanni1,
Gőbel Orsolya1, Sik-Lányi Cecília4, Varga János Tamás3, Müller Veronika3, Cserjési Renáta2

1Eötvös Loránd University, Faculty of Education and Psychology, Doctoral School of Psychology

2Eötvös Loránd University, Faculty of Education and Psychology, Institute of Psychology, student

4Semmelweis University, Pulmonology Clinic

5University of Pannonia, Faculty of Engineering, Department of Information Technology

Longitudinal studies indicate long-term neurocognitive impairments in post-COVID patients, such as deficits in executive functions, memory impairments, attentional and language difficulties, as well as psychomotor disorders. Additionally, depressive and anxiety symptoms may appear or exacerbate. The remaining neurocognitive and psychological problems significantly impact patients' daily lives, quality of life, and perceived health status. Therefore, investigating post-COVID symptoms and exploring possible intervention opportunities are of paramount importance.

The presentation will discuss a virtual reality-based cognitive intervention developed for post-COVID symptoms, as well as an art therapy program focusing on post-COVID, and their effects on affective and cognitive neuropsychological functions. It is expected that both intervention programs will significantly improve problematic neurocognitive functions and reduce affective disorders, thereby improving patients' quality of life and perceived health status. The first group (1) underwent a virtual reality-based cognitive intervention (n=16, 11 females and 5 males), while the second group (2) was developed with art therapy (n=13 females) over a period of 6 weeks.

As a control, a third group (3) did not participate in any intervention (n=20, 10 females and 10 males). The measurement tools included the Montreal Cognitive Assessment (MoCA), the D2-R test, the forward and backward digit span tests, the verbal fluency test, the Trail Making Test (TMT), the Stroop test, the Frontal Assessment Battery (FAB), the Perceived Deficits Questionnaire (PDQ), the Post-COVID-19 Functional Scale (PCFS), EQ-VAS, the State-Trait Anxiety Inventory (STAI), the Patient Health Questionnaire (PHQ-9), and the Satisfaction with Life Scale (SWLS), which were assessed both before and after the intervention. The time between the two assessments was 9 weeks for both the intervention groups and the control group. The ongoing research is supported by the Hungarian Academy of Sciences (MTA) high-risk grant for research on post-COVID phenomena.
Click to expand...

Wyva · Jun 12, 2024

This is my favourite part, from the art therapy abstract:

"The art therapy protocol consists of 6 sessions with the following themes: (1) presenting ourselves and our experiences; (2) body image and imagination about the functioning immune system; (3) restoring safety; (4) following the rhythm of breathing and releasing tension with directed drawing techniques; (5) gratitude sculpture for resources and survival; (6) foresight image of the process and comfort box. The technical background of the sessions is compiled from protocols of positive art therapy, healthcare art therapy, and art therapy practices for life-threatening illnesses. We conducted state assessments before and after each session."

I guess I'll just start imagining that my immune system works just fine, maybe paint some weird Dalí-style artwork inspired by it and wait for my brainfog to eventually go away!

In all honesty, it sounds like it was mostly designed for people who almost died at the ICU though.

Hutan · Jun 12, 2024

Thanks @Wyva, so we have a whole batch of papers on poorly conceived studies to look forward to.

The Impact of COVID-19 on Executive Functions in a Hungarian Sample
Despite this, a significant difference was detected only in the results of the Frontal Assessment Battery's prehensile behavior subtest, where the group that had contracted COVID-19 performed significantly worse than the control group that had not been infected. Surprisingly, in the other tests, the group that had contracted the disease performed better. Further research is warranted to determine whether this finding is significant and, if so, what might be the cause for the significant difference observed only in prehensile behavior in a smaller sample.
Click to expand...

When no cognitive dysfunction shows up, I often wonder about the selection of the participants. I think we might have expected some worse performance on more of the named tests e.g. the trail making test which is joining numbered dots together with a line as quickly as possible.

The people with Long Covid who make it to research studies are, I think, often well-resourced, well-educated and probably, pre-illness, would have scored high on tests of cognitive ability. They are probably also relatively mildly affected. They will often be medical staff such as doctors and nurses or the family of doctors and nurses, because recruitment notices are often circulated in the facility where the study is done. Pairing these people with controls of convenience, (and especially if controls were paid for their participation - no idea if that is the case here), is likely to mask any reduced cognitive function in the Long Covid cohort. Cognitive tests in adults tend to be highly positively correlated with years of education and negatively correlated with age.

I was intrigued to know what prehensile behaviour might be. I think it is this, a measure of environmental autonomy:

The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample
(instructions translated from Italian, from the supplementary materials)

6. Prehensile behaviour
The [examiner] is sitting in front of the [subject]. Put the hands of the subject with the palms up, resting on his knees. Without saying anything and without looking at the subject, the examiner brings his hands close to those of the subject and touches the palms, at the same time from both sides, observing if the subject spontaneously grasps them. If the subject grabs them, the examiner tries again after telling him, “Don't take my hands.”

Attribution of the score: 3=the subject does not grab the hands of the examiner; 2=the subject hesitates and asks what he has to do; 1=the subject grabs hands without hesitation; 0=the subject grabs the hands of the examiner even after he has been asked not to do so.
Click to expand...

So, that's weird. I wonder about sample sizes and also about any bias in the examiner as they perform the assessment.

Kitty · Jun 12, 2024

Attribution of the score: 3=the subject does not grab the hands of the examiner; 2=the subject hesitates and asks what he has to do; 1=the subject grabs hands without hesitation; 0=the subject grabs the hands of the examiner even after he has been asked not to do so.
Click to expand...

What about when the subject moves their hands back so as not to make contact? That would be my instinctive reaction!

Log in or Sign up

News from the Visegrád Countries - Czech Republic, Poland, Slovakia and Hungary

Wyva Senior Member (Voting Rights)

Wyva Senior Member (Voting Rights)

Wyva Senior Member (Voting Rights)

Hutan Moderator Staff Member

Kitty Senior Member (Voting Rights)

Share This Page

Log in or Sign up

News from the Visegrád Countries - Czech Republic, Poland, Slovakia and Hungary

Wyva Senior Member (Voting Rights)

Wyva Senior Member (Voting Rights)

Wyva Senior Member (Voting Rights)

Hutan Moderator Staff Member

Kitty Senior Member (Voting Rights)

Share This Page

Useful Searches