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Longitudinal patterns of long COVID physical and mental recovery in previously hospitalised COVID-19 survivors (RDF23/HLS/SER/VOGIATZIS)


   Faculty of Health and Life Sciences

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  Prof Ioannis Vogiatzis, Dr Gabriel Cucato  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Background: The sequelae of a hospital admission with COVID-19 remain substantial one year after discharge across a range of physical and mental domains with the minority of patients feeling fully recovered (Evans et al. 2022; Lancet Resp. Med.). International medical societies have issued guidance on rehabilitation in the post-hospital phase to facilitate physical and mental recovery (Spruit et al 2020; ERJ).

Rationale: Non-randomised studies suggest that in the short term, rehabilitation strategies partially facilitate physical and mental recovery in previously hospitalised patients (Soril et al 2022; Resp. Med.). However, longitudinal data on long-term physical and mental recovery after hospitalisation for COVID-19 are scarce. Importantly, trajectories of physical and mental recovery related to different care pathways have not been assessed to date. This knowledge is important to gain insight into whether different care pathways must be improved to provide the optimal care for different needs.

Aim: To assess trajectories of physical and mental recovery within different care pathways (following community-based rehabilitation, home-based/digital rehabilitation, and usual care) and their implications for healthcare utilisation relevant to long COVID-19 sequelae.

Study design: This is s longitudinal randomised parallel group trial comparing the long-term effects of community-based and home-based/digital rehabilitation interventions versus usual care. Patients randomised to the rehabilitation intervention (community or digital rehabilitation) or to usual care have been assessed at baseline, and at 2 months (8-weeks). The RDF studentship will allow patient follow up at 12- and 24-months following completion of the short-term (8-week) rehabilitation or usual care phases.

Participants: 60 patients who complete assessments before and after an 8-week period of either rehabilitation (community of home based) or usual care according to the following criteria:

Inclusion criteria

Participants hospitalised at a UK hospital and discharged with suspected COVID-19.

Participants of the PHOSP COVID trial randomised either to one of the rehabilitation interventions or usual care following completion of assessments at baseline and at 2-months (8-weeks).

Exclusion criteria

Unwilling to consent to the follow up trial and undertake assessments at 12- and 24-months. 

Persistent symptoms indicative of other significant medical conditions that require further investigation/management.

Outcomes:

1. (Primary) Healthcare utilisation relevant to COVID-19 sequelae; 2. Incremental Walking Test with cardio-impedance; 3. CPET with opto-electronic plethysmography, cardio-impedance and quadriceps muscle near-infrared spectroscopy; 4. Accelerometer physical activity; 5. Qualitative patient interviews to evaluate which of the two rehabilitation interventions have greater impact on perceived symptoms compared to usual care; 6. Qualitative healthcare interviews to assess barriers and facilitators of NHS services to promote benefits of community-based or digital rehabilitation; 7. EQ-5D-5L questionnaire; 8. Outcomes relevant to quality of life, anxiety, depression, perceived fatigue and breathlessness.

The project has three phases:

  1. Systematic review of the effectiveness of community-based and home-based/digital rehabilitation interventions on physical, mental, and healthcare resource utilisation outcomes.
  2. Exploration of patient and healthcare professional attitudes towards long covid recovery strategies, through qualitative methods/community engagement.
  3. Periodic evaluation of quantitative and qualitative outcomes.

Academic Enquiries

This project is supervised by Professor Ioannis Vogiatzis, Dr. Gabriel Cucato and Dr. Eurico Wilhelm Neto. For informal queries, please contact [Email Address Removed]. For all other enquiries relating to eligibility or application process please use the email form below to contact Admissions. 

Funding Information

Home and International students (inc. EU) are welcome to apply. The studentship is available to Home and International (including EU) students and includes a full stipend at UKRI rates (for 2022/23 full-time study this is £17,668 per year) and full tuition fees. Studentships are also available for applicants who wish to study on a part-time basis over 5 years (0.6 FTE, stipend £10,600 per year and full tuition fees) in combination with work or personal responsibilities).  

Please also see further advice below of additional costs that may apply to international applicants.

Eligibility Requirements:

  • Academic excellence of the proposed student i.e. 2:1 (or equivalent GPA from non-UK universities [preference for 1st class honours]); or a Masters (preference for Merit or above); or APEL evidence of substantial practitioner achievement.
  • Appropriate IELTS score, if required.
  • Applicants cannot apply for this funding if they are already a PhD holder or if currently engaged in Doctoral study at Northumbria or elsewhere.

Please note: to be classed as a Home student, candidates must meet the following criteria:

  • Be a UK National (meeting residency requirements), or
  • have settled status, or
  • have pre-settled status (meeting residency requirements), or
  • have indefinite leave to remain or enter.

If a candidate does not meet the criteria above, they would be classed as an International student.  Applicants will need to be in the UK and fully enrolled before stipend payments can commence, and be aware of the following additional costs that may be incurred, as these are not covered by the studentship.

  • Immigration Health Surcharge https://www.gov.uk/healthcare-immigration-application
  • If you need to apply for a Student Visa to enter the UK, please refer to the information on https://www.gov.uk/student-visa. It is important that you read this information very carefully as it is your responsibility to ensure that you hold the correct funds required for your visa application otherwise your visa may be refused.
  • Check what COVID-19 tests you need to take and the quarantine rules for travel to England https://www.gov.uk/guidance/travel-to-england-from-another-country-during-coronavirus-covid-19
  • Costs associated with English Language requirements which may be required for students not having completed a first degree in English, will not be borne by the university. Please see individual adverts for further details of the English Language requirements for the university you are applying to.

How to Apply

For further details of how to apply, entry requirements and the application form, see

https://www.northumbria.ac.uk/research/postgraduate-research-degrees/how-to-apply/   

For applications to be considered for interview, please include a research proposal of approximately 1,000 words and the advert reference (e.g. RDF23/…).

Deadline for applications: 27 January 2023

Start date of course: 1 October 2023 tbc


References

1. Evans RA, et al. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. PHOSP-COVID Collaborative Group. Lancet Respir Med. 2022 Aug;10(8):761-775.
2. Spruit MA, Holland AE, Singh SJ, Tonia T, Wilson KC, Troosters T. COVID-19: Interim Guidance on Rehabilitation in the Hospital and Post-Hospital Phase from a European Respiratory Society and American Thoracic Society-coordinated International Task Force. Eur Respir J. 2020 Aug 13;56(6):2002197.
3. Soril LJJ, Damant RW, Lam GY, Smith MP, Weatherald J, Bourbeau J, Hernandez P, Stickland MK The effectiveness of pulmonary rehabilitation for Post-COVID symptoms: A rapid review of the literature. Respir Med. 2022 Mar 2;195:106782.

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