We are now entering the second year of the COVID-19 pandemic caused by one of the SARS coronaviruses, SARS-CoV-2. As of 30 March 2021, more than 127 million cases have been confirmed, with more than 2.79 million deaths attributed to COVID-19, making it one of the deadliest pandemics in history.

The symptoms can vary from none, to life threatening illness predominantly affecting the respiratory system. Spread is mainly airborne and may also spread via contaminated surfaces, and people can be contagious for up to 2 weeks even if they are not displaying any symptoms.

There have been more than 4.3 million confirmed cases of coronavirus in the UK and over 126,000 people have died. As lockdown restrictions ease, figures are at a low with 4,560 people with coronavirus in hospital across the UK. PHE figures for 28th March show that no deaths have been reported in London due to Covid-19 for the second time this year, and there were 56 deaths across the UK within 28 days of a positive test for coronavirus reported on 30 March 2021.

The vaccine programme which was the first in the world starting on 8th December 2020 has now resulted in an incredible 30,444,829 people being given a first dose by the end of 28 March 2021 which accounts for half of the UK’s adult population, and more than three million people have had a second dose. At Preventicum, 100% of our medical team have been vaccinated.

The majority of people who have SARS-CoV-2 either have no or mild symptoms. If they get symptoms these usually appear within 2-14 days of being infected and last for a couple of weeks. Around 1% of people will die from SARS-CoV-2, but as treatments for the disease improves, survival rates are also going up. The majority of people make a full recovery within 12 weeks. However, what we are also seeing is that some people have prolonged symptoms which have been called “Long Covid” or “Post-COVID-19 syndrome”.

At present there is no long-term evidence base to determine how long the ongoing effects seen after an infection will last and the term “post COVID-19 syndrome” reflects the acute phase of the illness has ended, not that the person has recovered.

 

There are two stages to what is commonly known as Long COVID:

  • Ongoing symptomatic COVID-19 – symptoms that last 4-12 weeks
  • Post-COVID-19 syndrome – symptoms that last for more than 12 weeks and cannot be explained by another diagnosis

Older people and people with underlying medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection.

Other long-term signs and symptoms may include:

  • Brain fog
  • Insomnia
  • Dizziness
  • Palpitations
  • Mood changes
  • Tinnitus and ear pain
  • Nausea, diarrhoea and a reduction in appetite
  • Changes to sense of smell or taste
  • Rashes or hair loss

Everyone experiences the symptoms differently and they are not always constant.

At the start of the illness severe COVID-19 can cause significant lung problems including pneumonia and respiratory failure, which can result in permanent damage and scarring to the lungs, and so is seen as a disease that primarily affects the lungs. But it can damage many other organs including the heart and brain as well and this organ damage may increase the risk of long-term health problems. COVID-19 can also make blood cells more likely to clump up and form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused by COVID-19 is believed to come from very small clots that block tiny blood vessels (capillaries) in the heart muscle. Other parts of the body affected by blood clots include the lungs, legs, liver and kidneys.  It can also cause heart muscle inflammation and heart rhythm disturbances.

The British Lung Foundation and Asthma UK’s post-COVID survey of over 1000 patients, of which over 800 had not been admitted to hospital, found that:

“…many people who had mild – moderate COVID are now on a long road to recovery, affecting both their physical and mental health” and

“When asked what symptoms most affect them, the top five were: breathing problems (90%), extreme tiredness (64%), sleep problems (22%), cough (22%) and changes in mood, or anxiety or depression (22%). The majority of people had not experienced these symptoms before having COVID.”

Potential explanations for long Covid include this may be the result of a persistent immune response that is triggered by the virus which causes inflammation and damage to other parts of body, it could be due to tissue damage done during the acute part of the illness and the virus could also hide in the body as we had seen with other viruses e.g. EBV and herpes before reactivating. There have also been a number of comparisons between long Covid and chronic fatigue syndrome/ME which is also linked to viral infections.

Currently the only treatment available are those that manage the symptoms, optimise overall health and boost immune function through supportive therapy and lifestyle factors including diet and exercise.

Unfortunately we cannot predict how long recovery from long Covid will take, this is not unique to this illness as other viral illnesses can also have lasting effect. When looking at the data from other viruses this suggests that the majority of symptoms will resolve within 3 months, although tiredness may persist for longer, but this may not apply to everyone. There does not seem to be a direct correlation between the seriousness of COVID-19 and the long-term illness.

In October 2020 NHS England and NHS Improvement announced a £10 million investment to help local services in every part of the country bring together the right professionals. These professionals will provide physical, cognitive and psychological assessments of those experiencing suspected post-COVID syndrome, so that they are put onto the right clinical pathway to treat their symptoms.

If you have persistent symptoms following COVID-19 infection please do follow up with your GP who can arrange further investigations which might include blood tests, observations like blood pressure and heart rate and a chest x-ray. There are a number of excellent private services and specialists who also offer a multidisciplinary approach to managing long covid symptoms.

It is important to remember that most people who have COVID-19 recover quickly. But the potentially long-lasting problems make it even more important to reduce the spread of the disease by following precautions such as wearing masks, social distancing, hand hygiene and following the government guidelines.

Sources:

https://www.nhs.uk/conditions/coronavirus-covid-19/long-term-effects-of-coronavirus-long-covid/

https://www.yourcovidrecovery.nhs.uk/

https://www.nice.org.uk/guidance/ng188/documents/final-scope

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/11/C0840-national-guidance-for-post-covid-syndrome-assesment-clinics-111220.pdf

https://en.wikipedia.org/wiki/COVID-19_pandemic

 

CANCER 30 GENE PANEL

Overview

All of us have a 1 in 2 lifetime risk of cancer, but some common cancers – breast, melanoma, pancreatic, prostate and ovarian – are known to occur more frequently in families, passing from one generation to the next. This is because certain gene mutations can be inherited.

Perhaps the most commonly talked about are the BRCA 1 and BRCA 2 genes, where mutations can indicate increased risk of developing breast, melanoma, pancreatic, prostate and ovarian cancers.

The 30-gene Pan Cancer Panel test from Everything Genetic, examines BRCA1 and BRCA2 and an additional 28 genes which can also indicate risk in the areas of uterine, colorectal (bowel) and stomach cancer.

Why have this test?

Knowing you have a genetic mutation enables you to make sure you have the appropriate regular screening and investigations. Many mutations are known to be hereditary; if you have a mutation, there is a 50% chance that your siblings and children will have it too.

What genes are tested?

Genes APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4*, CDKN2A(p14ARF), CDKN2A(p16INK4a), CHEK2, EPCAM*, GREM1*, MITF*, MLH1, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2*, POLD1*, POLE*, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53.

What does the test involve?

This test is a simple saliva test that you can do in the clinic on the day of your assessment, or in your own home of you prefer – we do not need a blood sample. If you choose to add this test after your health assessment, you will receive a kit in the post with clear instructions on taking your sample, together with all the paperwork you need to sign and post to Everything Genetic.

How long does reporting take?

Once your sample is received at the US laboratory, it will be sequenced, and your genes analysed. A report is then generated, usually within 5 weeks of the laboratory receiving your sample.

How will I get my results?

Your Preventicum doctor will explain the process in your consultation, and you will also have a counselling session with a consultant (usually the day after your Preventicum assessment) so you understand this fully before consenting for the test.

Once your genes have been analysed, you will be sent your results from Preventicum. If there are any positive findings you will also be contacted by a Consultant Geneticist to discuss these, the implications, and next steps. If the results are negative but you still wish to discuss these further, a consultation can be arranged at no extra charge.

Discussing your results with a geneticist and Preventicum doctor will help you to:

  • Understand your risks
  • Monitor your health
  • Consider your lifestyle or diet
  • Protect your family

MUSCULOSKELETAL MOVEMENT SCREEN AND STRENGTH & CONDITIONING COACHING

Overview

Preventicum have partnered with Pure Sports Medicine (PSM), world-class sport and exercise medicine specialists to offer a musculoskeletal movement screen together with strength and conditioning coaching. PSM’s team will work with you to prevent, diagnose, treat and manage any injuries, bringing a multi-disciplinary, team-based approach to your health management.

Why have this test?

  • If you have an existing injury such as back or joint pain.
  • You want to improve or start a new exercise regime.
  • You are trying to improve your lifestyle.

What are the benefits of this screen?

  • Helps you to prevent injury and become injury resistant
  • Improve your ability to resist ailments
  • Improve and optimise your performance in your chosen sport

What can I expect?

This hour-long session starts with a specialist musculoskeletal physiotherapist consultation to determine injuries, exercise history and video gait analysis. All sessions are tailored to the individual and look at relevant lifestyle factors with a clinical assessment of any injuries.

Following this, you will meet a strength and conditioning coach for a full body movement screen and in-depth strength assessment, using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

You will leave with a management plan including any recommendations for further treatment and a letter from your physiotherapist, detailing your findings from the day will be included in your Preventicum final report.

ESSENTIAL

Consultation with a Preventicum doctor
Lasting up to 50 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have.

Detailed physical examination with a Preventicum doctor
An examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure

Over 45 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function in women, HbA1c (diabetes test), vitamin D, and PSA on men over 50 years.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

Echocardiogram
A non-invasive ultrasound examination using high-frequency sound waves to create detailed pictures of your heart. We look at the structure and function of your heart including the valves and can record dynamic changes within this moving organ to see how the heart is managing blood flow around the body.

Resting electrocardiogram (ECG)
ECG is used in diagnosing many electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Body Composition Analysis
The InBody 720 provides a detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Tonometry (glaucoma/eye test)

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 20-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.

ELITE

Consultation and physical examination with a Preventicum doctor
Lasting up to 60 minutes, you will have the opportunity to discuss your current health, medical and family history and any concerns you may have. Your doctor will also carry out a physical examination of the eyes, ears, mouth, throat, heart, lungs, musculoskeletal system, nervous system, gastrointestinal system and skin. In men we examine the groin, testes and prostate* (over 50) and in women we perform a breast examination and gynaecological examination and smear if required.*
*With consent and chaperone if requested.

Vital observations
Height, weight, BMI, resting heart rate, blood pressure.

Over 50 blood tests and urine analysis
Including a full blood count, comprehensive cholesterol profile, liver and kidney function tests, bone profile, iron studies, inflammatory markers, thyroid function, HbA1c (diabetes test), vitamin and mineral profile including vitamin D, and PSA on men over 50 years.

Magnetic Resonance Imaging (MRI)
MRI scans of your brain, heart, central arteries and organs of the abdomen and the pelvis as well as a whole spinal scan including your cervical, thoracic and lumber spine. Our two, state-of-the-art MRI scanners are equipped with ‘in-bore’ technology, ambient lighting and a choice of music or film to create an immersive audio video visual experience.

Ultrasound examinations
We scan the carotid arteries, abdominal aorta, liver, gallbladder, biliary tree, pancreas, kidneys, spleen, bladder, uterus and ovaries in women and the prostate in men.

VO2max*
Cardiopulmonary exercise testing, also known as VO2max, is a measure of aerobic, cardiac fitness and endurance capacity.
*Please note that during COVID-19 restrictions, this aerosol generating test is not being offered. You may book to return for this at a later date, or we will refund you the cost for this test.

Resting electrocardiogram (ECG)
ECG is used to diagnose electrical heart abnormalities and can help to show if there is the possibility of significant coronary artery disease.

Spirometry (lung function test)
Spirometry is used to determine lung function and to help to detect lung disease.

Pure Sports musculoskeletal movement screen and strength & conditioning coaching
A consultation and movement screen with a specialist musculoskeletal physiotherapist at Pure Sports (on-site) to determine injuries, exercise history and gait analysis. A sports coach will then take you through an in-depth strength assessment using a mix of gym equipment, clinical tests, and hand-held strength testing for specific muscle groups.

Body Composition Analysis
A detailed, highly accurate map of body composition, including visceral fat, using 30 impedance measurements.

Audiometry (hearing test)
This test measures the sensitivity of your hearing across a range of different frequencies.

Tonometry (glaucoma/eye test)

Radiologist consultation
A results consultation with one of our highly experienced consultant radiologists. A virtual tour viewing hundreds of your MRI scan images, including a video of your beating heart and you will be given a USB of your images to take away on the day.

Results consultation
The opportunity to go through your results from the day with your Preventicum doctor and discuss further management and referrals as needed. Please note that some of the results take slightly longer to analyse and will be available in your final report.

Preventicum Lifestyle Prescription
A bespoke lifestyle prescription covering the key areas of nutrition, sleep, exercise, relaxation and environment, to help you optimise your health and wellbeing.

Follow-on consultation
This 30-minute virtual follow-on consultation will take place 6 months after your assessment or at a time of your specification.

For more information, please see our brochure.