Usability and Satisfaction of Augmented Reality During Pediatric Anesthesia Induction: A Pilot Study.

Months after an acute infection with SARS-CoV-2, a substantial number of patients continue to experience persistent symptoms, a condition frequently referred to as “Long COVID” []. The patient-developed term ‘Long COVID’ corresponds to the World Health Organization’s (WHO) “post-COVID-19 condition”. In its definition, the WHO emphasizes its significant impact on quality of life (QoL) and overall functioning. In this article, we use the term ‘Long COVID,’ because it is more frequently used in clinical practice and by patients themselves. Impaired QoL among patients with Long COVID has been extensively documented, along with its associated factors [–]. A systematic review and meta-analysis identified fatigue and history of Intensive Care Unit (ICU) admission as key contributors to poorer QoL []. Other studies found several other factors associated with impaired QoL such as the number of persistent symptoms, specific symptoms (including sleep disturbances, cognitive complaints, or anxiety and depressive symptoms), and low levels of physical activity [–]. Conversely, positive associations with QoL were found in relation to professional activity, perceived self-efficacy, and patient activation [,]. Long COVID is a challenging condition for both clinicians and researchers. Despite extensive investigations into potential pathophysiological pathways, replicated findings remain scarce and no single hypothesis fully explains the heterogeneity of this condition []. Long COVID encompasses a diverse array of non-specific symptoms, whose profound impact on patients’ lives often contrasts with the lack of abnormalities identified by physical examination or routine diagnostic tests [–]. After careful assessment, many patients with Long COVID meet the criteria for a “functional somatic disorder” (FSD) []. This diagnosis is based on both positive arguments (i.e., the presence of cognitive and behavioral mechanisms such as classical conditioning, symptom avoidance, focused attention on bodily functioning, catastrophizing and intolerance to uncertainty) [,,] and negative arguments (i.e., the absence of clinical findings or test results that fully explain the symptoms) [,]. This clinically useful categorization differs from the former DSM-IV classification of “somatoform disorders,” which primarily relied on negative diagnostic criteria (i.e., the absence of clinical or paraclinical explanations for the symptoms). It also differs from more recent classifications, such as the DSM-5 somatic symptom disorder or the ICD-11 bodily distress disorder, which focus exclusively on positive criteria (i.e., the presence of excessive thoughts, emotions, and behaviors related to the symptoms). The diagnosis of functional somatic disorders (FSD) involves an approach that combines both positive and negative criteria at the time of assessment. Furthermore, the contribution of cognitive and behavioral mechanisms to symptom persistence does not preclude the involvement of other mechanisms, but widens the scope of therapeutic perspectives within a biopsychosocial approach [,,,], including cognitive and behavioral therapy, which has shown promise in helping patients with long COVID [–]. Unfortunately, although it might be well accepted when carefully explained through individual consultation [], the diagnosis of FSD is frequently perceived as stigmatizing [] and may be misinterpreted as a dismissal of the significant QoL impairment experienced by patients [,]. Evidence suggests that physicians and patients often diverge in their perceptions of Long COVID’s severity, potentially due to the lack of identifiable physiological abnormalities. Nevertheless, research consistently demonstrates that FSD are associated with substantial QoL impairments, comparable to – or even greater than – those observed in other medical conditions [–]. Therefore, the main objective of this study was to investigate factors associated with QoL among patients seeking care for long COVID, with a particular focus on the relationship between QoL and a diagnosis of FSD.