Long Covid (LC) is a debilitating, multisystemic disease that has emerged as the largest mass-disabling event in recent history. Due to the episodic disability and stigma associated with the condition, people with LC (PwLC) often experience social isolation. Mobile telemanipulator robots (MTRs) have the potential to support remote social inclusion for PwLC. However, nuanced MTR design is necessary to accommodate PwLC's fluctuating symptoms and avoid exacerbating them due to the complexities of teleoperation. In this work, we conducted participatory research with eight PwLC to explore how MTRs can be designed to support their needs. Through online, semi-structured interviews, we found that all participants recognized the potential of MTRs to enhance social inclusion across various settings. Our findings highlight the importance of providing PwLC with adaptive, autonomous support during teleoperation to meet their pacing needs and minimize exertion. Many PwLC preferred MTRs with adjustable autonomy, as they would offer greater agency over the robot's actions in social spaces. Due to concerns about stigma, participants also wanted MTRs to provide flexible control over the visibility of their disability, allowing them to manage how others perceive them according to their preferences and context. Based on these findings, we present key design considerations, grounded in critical disability studies and critical access studies, for designing MTRs that support remote social inclusion for PwLC while safeguarding their well-being. This work serves as a basis for developing accessible MTR systems that promote inclusivity for PwLC and other chronic conditions.

Long COVID is a chronic and often disabling illness with long-term consequences. Although progress has been made in the clinical characterization of long COVID, no approved treatments exist and disconnects between patients and researchers threaten to hinder future progress. Incorporating patients as active collaborators in long COVID research can bridge the gap and accelerate progress toward treatments and cures.

Long Covid (LC) is a debilitating disease impacting over 65 million people worldwide. The heterogeneity, severity, and unpredictability of LC symptoms cause episodic disability, leading to widespread social isolation among People with Long Covid (PwLC). Mobile Telemanipulator Robots (MTRs) offer the potential to support the social inclusion of PwLC. However, nuanced MTR design is needed to accommodate PwLC's fluctuating needs and avoid perpetuating stigma. In this work, we engaged PwLC in a participatory design process to explore how MTRs can be designed to support them. We present design considerations, grounded in the lenses of critical disability studies and critical access studies, for accessible MTR systems to support PwLC. We plan to expand on this to develop new shared control algorithms and explore the social and ethical implications of autonomous behaviors in such MTR systems.

Long COVID, or complications arising from COVID-19 weeks after infection, has become a central concern for public health experts. The United States National Institutes of Health founded the RECOVER initiative to better understand long COVID. We used electronic health records available through the National COVID Cohort Collaborative to characterize the association between SARS-CoV-2 vaccination and long COVID diagnosis. Among patients with a COVID-19 infection between August 1, 2021 and January 31, 2022, we defined two cohorts using distinct definitions of long COVID-a clinical diagnosis (n=47,404) or a previously described computational phenotype (n=198,514)-to compare unvaccinated individuals to those with a complete vaccine series prior to infection. Evidence of long COVID was monitored through June or July of 2022, depending on patients' data availability. We found that vaccination was consistently associated with lower odds and rates of long COVID clinical diagnosis and high-confidence computationally derived diagnosis after adjusting for sex, demographics, and medical history. The extent to which COVID-19 vaccination protects against long COVID is not well understood. Here, the authors use electronic health record data from the United States and find that, for people who received their vaccination prior to infection, vaccination was associated with lower incidence of long COVID.

Most public health and medicine did not have answers when people started experiencing prolonged symptoms after COVID-19, so patients decided to advocate for, care for, and research themselves. Over the last several years, while care and research for Long COVID have expanded, patients have encountered a lack of support from providers and researchers who do not believe, validate, and value their experience. In this chapter, members of the Patient-Led Research Collaborative detail patient advocacy to date, including how patients helped to name, define, and secure funding for Long COVID; how providers can be better partners in care; and how researchers can better incorporate patients and the patient experience in their studies. Patients, providers, and researchers can improve outcomes for people with Long COVID, but only if they do so together.

Many people infected with COVID-19 have found that they still experience health effects months and even years afterward, with the pandemic representing one of the largest mass-disabling events in modern history, affecting people from all demographics. It is proposed here that modern robotics methods have the potential to substantially improve the quality of life for long COVID patients and to help them recover more quickly. This paper describes what long COVID is and what its symptoms are, presents requirements for robotic capabilities to assist patients, and considers patient feedback on the possible challenges associated with developing and implementing such a solution.

BACKGROUND:A significant number of patients with COVID-19 experience prolonged symptoms, known as Long COVID. Few systematic studies have investigated this population, particularly in outpatient settings. Hence, relatively little is known about symptom makeup and severity, expected clinical course, impact on daily functioning, and return to baseline health.METHODS:We conducted an online survey of people with suspected and confirmed COVID-19, distributed via COVID-19 support groups (e.g. Body Politic, Long COVID Support Group, Long Haul COVID Fighters) and social media (e.g. Twitter, Facebook). Data were collected from September 6, 2020 to November 25, 2020. We analyzed responses from 3762 participants with confirmed (diagnostic/antibody positive; 1020) or suspected (diagnostic/antibody negative or untested; 2742) COVID-19, from 56 countries, with illness lasting over 28 days and onset prior to June 2020. We estimated the prevalence of 203 symptoms in 10 organ systems and traced 66 symptoms over seven months. We measured the impact on life, work, and return to baseline health.FINDINGS:For the majority of respondents (>91%), the time to recovery exceeded 35 weeks. During their illness, participants experienced an average of 55.9+/- 25.5 (mean+/-STD) symptoms, across an average of 9.1 organ systems. The most frequent symptoms after month 6 were fatigue, post-exertional malaise, and cognitive dysfunction. Symptoms varied in their prevalence over time, and we identified three symptom clusters, each with a characteristic temporal profile. 85.9% of participants (95% CI, 84.8% to 87.0%) experienced relapses, primarily triggered by exercise, physical or mental activity, and stress. 86.7% (85.6% to 92.5%) of unrecovered respondents were experiencing fatigue at the time of survey, compared to 44.7% (38.5% to 50.5%) of recovered respondents. 1700 respondents (45.2%) required a reduced work schedule compared to pre-illness, and an additional 839 (22.3%) were not working at the time of survey due to illness. Cognitive dysfunction or memory issues were common across all age groups (~88%). Except for loss of smell and taste, the prevalence and trajectory of all symptoms were similar between groups with confirmed and suspected COVID-19.INTERPRETATION:Patients with Long COVID report prolonged, multisystem involvement and significant disability. By seven months, many patients have not yet recovered (mainly from systemic and neurological/cognitive symptoms), have not returned to previous levels of work, and continue to experience significant symptom burden.FUNDING:All authors contributed to this work in a voluntary capacity. The cost of survey hosting (on Qualtrics) and publication fee was covered by AA's research grant (Wellcome Trust/Gatsby Charity via Sainsbury Wellcome center, UCL).