- Annals of Surgical Oncology
- Annals of Surgery
- Arab Journal of Gastroenterology
- Current Oncology
- Clinical Journal of the American Society of Nephrology 
- Endoscopy International Open
- International Journal of Pediatric Otorhinolaryngology
- International Journal of Surgery
- Irish Journal of Psychological Medicine
- Journal of Crohn's and Colitis
- Journal of the American College of Cardiology
- Nature
- Open Research Europe
- Psychiatry Research
- The Journal of Bone and Joint Surgery
- The Lancet
- World Journal for Pediatric and Congenital Heart Surgery

Changes to COVID-19 Patient Comorbidity Treatment and Communication References by Journal

- Restructuring Structural Heart Disease Practice During the COVID-19 Pandemic
- COVID-19: Crisis Management in Congenital Heart Surgery

Changes to Treatment and Communication Related to Cardiovascular Diseases in the COVID-19 Era

- General Cancer and Radiological Treatment
- Surgical Oncology Treatment Changes

Changes to Treatment and Communication Related to Cancer in the COVID-19 Era

- New Endoscopic Practices Due to COVID-19
- Endoscopy in inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period
- Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery

Changes to Treatment and Communication Related to Digestive Diseases in the COVID-19 Era

- Mitigating Risk of COVID-19 in Dialysis Facilities
- The impact of COVID-19 on kidney transplantation

Changes to Treatment and Communication Related to Renal Diseases in the COVID-19 Era

- Liver transplantation in the era of COVID-19

Changes to COVID-19 Patient Comorbidity Treatment and Communication Related to Liver Diseases in the COVID-19 Era

The procedures covered under this node are those treat a pre-existing comorbidity, such as knee or hip problems, which may be fixed by an elective surgery or procedure.

- Resuming Elective Orthopaedic Surgery During the COVID-19 Pandemic
- Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic
- Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1

Changes to COVID-19 Patient Comorbidity Treatment and Communication Related to Elective Surgeries in the COVID-19 Era

The COVID-19 pandemic significantly disrupted standard treatment and communication protocols for patients with pre-existing psychological disorders. Healthcare providers were required to rapidly adapt their services, often transitioning to telemedicine, to ensure the continued care and management of psychiatric comorbidities and substance addictions.

Impact of COVID-19 on Psychological Disorder Treatment and Communication

During the COVID-19 pandemic, the routine treatment of and communication regarding pre-existing patient comorbidities were significantly disrupted. To ensure continuity of care, healthcare providers implemented new clinical guidelines and safety precautions, largely utilizing telehealth and virtual communication platforms. While these new communication and treatment policies share broad similarities across medical fields, specific protocols vary based on the unique management needs of each comorbidity.

Ohio State University, Columbus

University of Michigan - Ann Arbor

Google

- Areas of care administered via telehealth
- Postpandemic recovery
- COVID-19 Related Telehealth Programs 
- Limitations of telehealth infrastructure
- Benefits to telehealth infrastructure
- Telehealth modalities
- Strategies to increase telehealth uptake
- Safeguarding telehealth services
- Opportunities of telehealth infrastructure
- Stay-at-home outpatient care
- Initial COVID-19 hospital surge
- Patient satisfaction
- Telehealth in surgery 
- Restructuring the Healthcare System using Telemedicine

Focuses of telehealth and telemedicine during the COVID-19 pandemic

COVID-19 comorbidities are high risk conditions that put patients at greater risk for infection and negative outcomes. Some COVID-19 comorbidities have been found to be: 
- Cancer 
- Cardiovascular Disease
- Diabetes
- Digestive Diseases
- HIV
- Hypertension
- Immunological Disease
- Liver Injury
- Obesity
- Renal disease
- Respiratory System Disease

COVID-19 Patient Comorbidities

- As per NIH, chronic diseases usually last for ≥3 months and can be progressive.
- As per CDC, the deadliest chronic diseases in the US (from most to least deadly) are heart disease, cancer, CLRD, stroke, Alzheimer's disease, and diabetes.
- People with chronic diseases are more likely to experience severe complications of COVID-19 if they get infected.

Chronic Diseases

With decreased emergency department visits due to the pandemic, the potential for increased complications due to the neglected complications is very high. This deficit can be characterized as "care debt" to the healthcare systems.
Developing a telehealth infrastructure can allow healthcare systems to manage and track complications with patients while maintaining data security and confidentiality.

Postpandemic recovery

- Emergency Telemedicine Consultation System
- Federal Communications Commission COVID-19 Telehealth Program
- Federal Communications Commission Rural Health Care Program

COVID-19 Related Telehealth Programs

- patient-centered
- protects patients, clinicians, and community from exposure
- allows 24/7 communication between patients and clinicians
- reduces staffing issue
- preserves personal protective equipment (PPE)
- maintains patient-provider relationships during quarantine 
- protects the elderly as well as those who live in very rural settings, are medically vulnerable, or experience limited mobility 


Benefits to telehealth infrastructure

- limitations to clinician-to-clinician communications
- limitations of remote patient monitoring
- limitations of video visits
- limitations to telephone visits
- limitations to patient initiated communication
- limitations to training clinicians in using telemedicine devices
- geographic region (in the U.S.)
- payment and reimbursement
- Interstate/ intrastate regulatory protocol and telehealth
- social barriers to telehealth implementation

Limitations of telehealth infrastructure 

- synchronous
- asynchronous
- remote patient monitoring

Telehealth modalities

The types of care administered via telehealth include acute, chronic, primary, and specialty care

Areas of care administered via telehealth

- Include options for language interpretation
- Communicate with insurers and payers to determine the availability of covered telehealth and nurse advice line services
- Provide outreach to patients with limited connectivity and technology access, and provide flexibility in platforms to include video and non-video options


Strategies to increase telehealth uptake

In order to safeguard telehealth services, healthcare systems should consider
- Compliance with federal and state regulations, directives, and expiration dates
- Awareness of announcements on HIPAA and COVID-19 by the Office of Civil Rights (OCR)
- Training of staff and healthcare providers in telehealth protocol 

Safeguarding telehealth services

- Opportunities of E-consult: clinician-to-clinician communications
- Opportunities for Remote patient monitoring
- Opportunities for Patient-initiated messaging
- Opportunities for Telephone visit
- Opportunities for Video visit

Opportunities of telehealth infrastructure

This is the first phase of delivering care to patients during the pandemic and transforming the current system to provide care while minimizing infection.
To optimize care, telephone visits and video visits take up a big portion of out-patient care as telephone visits increased 3000% and video visits increasing 1000% between the period of March 16th to April 9th.

Stay-at-home outpatient care

COVID-19 is different from a normal disaster due to the virulence of the virus. Because of this, the demand for telehealth applications increases to manage the standard of care needed to treat patients all while allowing professionals to work remotely during the initial surge of the virus. 

Initial COVID-19 hospital surge

- Patient satisfaction is associated with modality of Telehealth.
- Comparable with in-person visits

Patient satisfaction

- Video conferences or photos can be used for follow-ups after surgery for post-operative complications without patients needing to physically go to the hospitals. 
- Before engaging in a telehealth follow-up program, patients are asked if they prefer to visit clinicals in person. 
- Many elective surgeries have been postponed to the future by the American College of Surgeons. However, preoperative evaluations should still be conducted utilizing imaging, labs, medical history, risks, benefits, and imaging. This information should be discussed with the patient and their family members.
- Videoconferencing can also be used for emergency situations so that patients can potentially avoid entering the ER and being in danger of COVID-19. 


Telehealth in Surgery (COVID-19)

Changes to COVID-19 Patient Comorbidity Treatment and Communication

The COVID-19 infection has shown increased death rates among older patients. Relatedly, the majority of healthcare workers, across the world, are over the age of 50 and are at higher risk of getting infected due to interactions with infected patients. In order to safeguard those in the healthcare profession who are at a higher risk of mortality, a restructuring of the healthcare system is necessary, and telehealth is at the forefront of said restructuring. 

Restructuring the Healthcare System using Telemedicine

COVID-19 may be worse in patients with comorbidities, and this can cause damage to the heart, liver, kidneys, and blood and immune systems. Many patients have had multiple organ failure that started with pneumonia, and became worse when therapeutic effects were unsatisfactory. Comorbidities can cause a patient's deterioration, leading to multiple organ failure. Organ function should be closely monitored and protective measures such as mechanical ventilation, glucocorticoids, antivirals, symptomatic treatments, and anti-shock therapy should be administered if necessary. 

Multiple Organ Injuries in COVID- 19 Patients with Comorbidities

- Hypertension and COVID-19 by Geographic Location
- Hypertension and COVID-19 by Topic

Hypertension as a Comorbidity of COVID-19

- Respiratory System Disease in COVID-19 Patients by Geographic Location 
- Asthma as a Comorbidity of COVID-19

Respiratory System Disease as a Comorbidity of COVID-19

Human Immunodeficiency Virus (HIV) and COVID-19 can interact synergistically as a syndemic. While HIV itself may not directly increase the risk of contracting SARS-CoV-2, people living with HIV frequently have other pre-existing conditions—such as diabetes, hypertension, and cardiovascular diseases—that heighten the severity and lethality of a COVID-19 coinfection.

HIV as a Comorbidity of COVID-19

- By country
- Liver Transplantation
- Chronic Liver Disease

Liver Injuries as a Comorbidity of COVID-19 

- This node acts as a general summary of the comorbidity of cancer and COVID-19 from a paper that analyzed many other papers detailing the same thing at its time of release.
- Via a pooled meta-analysis of studies from around the globe analyzing the prevalence of cancer in COVID-19 patients, it was found that the prevalence of cancer in COVID-19 patients is about 2%, which is higher than the overall prevalence of cancer in the population (I think).
- This leads to a hypothesized conclusion that while there is not a lot of data for COVID-19 infection and cancer patients, there is an elevated risk for these patients. However, due to inconclusive and generally lacking data on this topic, this conclusion is not concrete.
- Many major cancer centers worldwide have taken extra precaution when it comes to the treatment of these patients as many cancer treatments (e.g., chemotherapy) weaken the immune system as a side effect.
- There has currently been no order to withhold chemotherapy, radiotherapy, immunotherapy, or delaying adjuvant therapy to treat cancer patients, however extra care must be taken by patients and physicians alike to not allow these high-risk patients to become infected.

Cancer as a Comorbidity of COVID-19 

Patients with digestive diseases like inflammatory bowel disease (IBD) or gastrointestinal cancer are at a higher risk to experience more severe symptoms of COVID-19. Autopsy studies are important in understanding how COVID-19 affects the digestive system. More data needs to be collected to determine the exact relationship between digestive diseases and COVID-19. 

Digestive Diseases as a Comorbidity of COVID-19

- Prevalence of pathophysiology, prognosis, and practical considerations
- Knowledge in progress
- The link between diabetes and ACE2
- Diabetes in COVID-19 patients by geographic location 
- Degree of Hyperglycemia on COVID-19 mortality
- Diabetes Medication on COVID-19 mortality
- COVID-19 and endocrine diseases. A statement from the European Society of Endocrinology

Diabetes as a Comorbidity of COVID-19

Cardiovascular disease is a risk factor for severe COVID-19, and COVID-19 causes cardiovascular complications. 

Cardiovascular Disease and COVID-19

- A retrospective multi-center experience of renal transplants from India during COVID-19 pandemic

Renal Diseases as a Comorbidity of COVID-19

Immunological diseases are high-risk comorbid conditions that put patients at greater risk for severe COVID-19 infections and negative health outcomes. These comorbidities, which include common variable immunodeficiency, severe combined immunodeficiency, and secondary haemophagocytic lymphohistiocytosis, can significantly impair the body's immune defenses or trigger extreme, uncontrolled inflammatory responses such as cytokine storms when responding to a SARS-CoV-2 infection.

Immunological Diseases as a Comorbidity of COVID-19

This node categorizes references and research papers related to COVID-19 patient comorbidities by their publishing journal.

COVID-19 Comorbidities References by Journal

Obesity is a significant comorbidity for COVID-19, affecting the severity of symptoms, length of hospital stays, and overall clinical outcomes. In obese patients, a higher baseline level of proinflammatory cytokines increases the risk of experiencing a severe cytokine storm. The clinical impact of this comorbidity also varies depending on factors such as geographic location and patient age.

Obesity as a Comorbidity of COVID-19

- Cancer is a term that refers to a collection of diseases in which some of the body's cells divide uncontrollably and invade surrounding tissues. 
- Cancer can metastasize, i.e., spread to other parts of the body. Metastatic cancer is hard to treat and tends to be fatal. Most cancer deaths are caused by metastasis.

This node should be a relation node, but I can't delete it since it's a root node of the "cancer" tree and it has two upvotes.


Cancer

- According to the WHO, "Cardiovascular disease is the name for the group of disorders of heart and blood vessels."  
- As per WHO, cardiovascular disease includes hypertension, coronary heart disease, cerebrovascular disease,  peripheral vascular disease, heart failure, rheumatic heart disease, congenital heart disease, and cardiomyopathies. 
- Cardiovascular disease is a risk factor for severe COVID-19, and COVID-19 causes cardiovascular complications. 

Cardiovascular disease 

Previous lung disease is a risk factor for mortality in patients with COVID-19. Older age, male gender, home oxygen therapy, and respiratory failure on admission were associated with an increased mortality. 

lung disease

- CKD, also known as chronic renal disease,  is a chronic, non-communicable, irreversible condition where kidney function gradually declines over time.
- However, CKD progression can be slowed down dramatically or even stopped.
- The earlier stages of CKD are usually asymptomatic.
- Diabetes and high blood pressure cause almost two-thirds of CKD cases.
- Source: https://www.kidney.org/atoz/content/about-chronic-kidney-disease

Chronic Kidney Disease

Diabetes is a collection of diseases in which blood glucose levels (i.e., blood sugar) is too high. The most common types of diabetes are type II diabetes, type I diabetes, gestational diabetes, and prediabetes.



Diabetes

- Alzheimer's disease is a progressive chronic disease. It's "a type of dementia that affects memory, thinking and behavior"; over time, these symptoms progressively interfere with daily tasks.
- It's the 6th leading cause of death. Current treatments can alleviate the symptoms but can't stop the progression of Alzheimer's.

Alzheimer's Disease

Neurodegenerative diseases are a group of neurological conditions characterized by the progressive deterioration or death of neurons. These diseases are driven by factors such as protein aggregation, protein misfolding, apoptosis, and mitochondrial dysfunction.

Neurodegenerative Diseases

Since mindfulness meditation can alleviate symptoms of distress, pain, and chronic disease, it can be used to treat hallucinations and delusions experienced by schizophrenic patients. 

What Symptoms Mindfulness Meditation can help Treat in Patients with Severe Schizophrenia

- Cystic fibrosis
- Diabetes
- Multiple sclerosis
- Cancers
- AIDS
- Hemophilia
- Epilepsy
- Hepatitis
- Hyperhidrosis
- Musculoskeletal Disorders
- Cardiovascular Diseases
- Long COVID

List of Medical Disabilities

Abnormally excessive sweating that is often unrelated to body temperature nor exercise. Known as the silent disorder, this is a widespread condition that affects almost 3% of the population. Currently, solutions to alleviate the condition either serve as temporary solutions or cause many other side effects.

Hyperhidrosis

"Chronic pain management" or "pain management" typically refers to the practice of employing pain killing medicines, psychological therapy/ practices, and/ or managing/ controlling the environment of the patient/ sufferer in order to lessen or mitigate the pain they feel or else make the pain in question more manageable.

Chronic Pain Management

Chronic pain is often a symptom of chronic conditions/ disabilities, though not always. In the medical sphere, "chronic pain" is defined as pain that may be constant in some sense of come and go. Or, in the case of conditions that may have a cure or may "heal", chronic pain is defined as pain that lasts longer than three to six months.

Chronic Pain

Chronic illness increases the likelihood of comorbid conditions such as mental illness and other physical conditions, a lower quality of life, increased cost of healthcare, and complications from a failure to manage the condition(s) properly. 

Mental Health Issues in Children and Adolescents with Chronic Illness

Psychological factors significantly influence the onset, progression, and management of chronic diseases. For instance, motivation, goal setting, and problem-solving strategies are essential for overcoming barriers to positive lifestyle changes. Additionally, emotional management plays a critical role in coping with the demands of chronic illnesses, making these psychological elements central to patient health outcomes.

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