COVID 19 impact on mental health as well as physical health. Some drugs have been associated with abnormal mental behaviour such as hallucinations and flashbacks. The resulting scar tissue known as lung fibrosis can lead to long-term breathing problems. Complications include weakening of the heart muscle, blood clots, abnormal heart rhythms, vascular system damage and high blood pressure. They may have felt anger that the pandemic lasted so long, disappointment in missing events such as a grandchilds birthday, loneliness from social isolation, or sadness for the wasted time they can never get back. Included on the atypical list are changes in a patient's usual status, delirium, falls, fatigue, lethargy, low blood pressure, painful swallowing, fainting, diarrhea, nausea, vomiting, abdominal pain and the loss of smell and taste. We must educate the public about the merits of vaccination as this is a very critical intervention in fighting Covid-19. Although she has improved somewhat, several cognitive issues and fatigue still persist. To overcome the stage, we need to be aware of the symptoms and prevention. Gards life has changed in ways he never imagined. loss of taste and/or smell and sleep issues. People who experience post-COVID conditions most commonly report: General symptoms Tiredness or fatigue that interferes with daily life Symptoms that get worse after physical or mental effort (also known as "post-exertional malaise") Fever Respiratory and heart symptoms Difficulty breathing or shortness of breath Cough Chest pain Mask mandates are also ending at businesses, entertainment venues, and, in some cases, school classrooms. Most older adults retained their baseline functional status after 90 days of recovery from acute COVID-19. He said he estimates that about a third of those who are older have some degree of cognitive impairment. increased substance . As many as one in four seniors and one in five adults under 65 experienced "long COVID" or "post-COVID" symptoms after surviving a coronavirus infection, a new study from the Centers for . But we do have tools that can help us manage vaccines and antiviral medications. Common post-COVID symptoms Chest pain Cough Shortness of breath (hypoxia) Tiredness or exhaustion Trouble concentrating (brain fog) Trouble sleeping Less common post-COVID symptoms Anxiety or depression Dizziness Feeling lightheaded Hair loss Headaches Heart palpitations (racing heart) Joint or muscle pain Loss of taste or smell The earlier you get started on oxygen, the better the outcome. We use cookies to enhance your experience. That may be because older adults who are severely ill with it are at high risk of developing delirium an acute and sudden change in mental status which is associated with the subsequent development of dementia, said Liron Sinvani, a geriatrician and an assistant professor at Northwell Healths Feinstein Institutes for Medical Research in Manhasset, N.Y. All rights reserved. Unable to work, he takes 22 medications and can still walk only 10 minutes on level ground. After the 2-year pause with the pandemic, mingling and socializing will be an effort that I anticipate will have starts and stops. Is a hiatal hernia causing your GI symptoms? Functionally, people are experiencing difficulty with transferring weight, ambulation, and balance." Long-term. We distribute our journalism for free and without advertising through media partners of all sizes and in communities large and small. Go to: Unusual Post-COVID Symptoms: Omicron Patients Can Suffer From THIS One Symptom Even After Recovery Unlike the Delta variant, Omicron doesn't affect the lungs. Omicron enters the respiratory. Have they gotten together with other family members? COVID-19 stories from seniors across the country Older bodies tend to respond to illness and infection differently than younger ones. Severe loss of appetite is another symptom of coronavirus in seniors, according to Nguyen's research. Let us know at KHNHelp@kff.org, Hospital Investigated for Allegedly Denying an Emergency Abortion After Patient's Water Broke, Medicare Fines for High Hospital Readmissions Drop, but Nearly 2,300 Facilities Are Still Penalized, This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True, What Looks Like Pot, Acts Like Pot, but Is Legal Nearly Everywhere? Though in . Its sometimes helpful to remember that adjusting to pandemic life took a bit of time. I am careful, but not paranoid. Older people or people suffering from any other disease take a long time to recover and after recovery, they suffer from the following post COVID symptoms. . Optum Care is a network of physician practices owned by UnitedHealth Group. When I was working, I longed for solitude. chills shortness of breath or difficulty breathing a new loss of taste or smell congestion or a runny nose a headache fatigue muscle or body aches nausea or vomiting diarrhea For carers People with. A study released last month from the CDC found that 1 out of every 4 older adults who survived covid experienced at least 1 of 26 common symptoms associated with long covid, compared with 1 out of every 5 people between the ages of 18 and 64. Headache. fear of leaving your house. Arlene, 64, a career transition services manager, is considering restarting life as the pandemic threat seems less prominent. Do a quiet, non-stimulating activity if you wake up during the night and can't get back to sleep. Fresh takes on what we eat and why it matters including debates around sustainability and health. As with all transitions, moving into a post-pandemic lifestyle will take some time to adapt, Dr. Michael G. Wetter, PsyD, FAPA, a diplomat and fellow for the American Psychotherapy Association, told Healthline. The BMJ study examined more than 87,000 adults 65 and older who had covid infections in 2020, drawing on claims data from UnitedHealth Groups Medicare Advantage plans. The experts noted that a wide range of physical and psychological symptoms have been reported by COVID-infected patients even after 12 weeks post-recovery. This patient is frail with a lot of cardiovascular disease, Perry said. Expert Explains. All rights reserved. When we test them, we discover that whats producing these changes is a central nervous system effect of coronavirus, he said. I wasnt getting answers from my regular doctors about my breathing and other issues, he said. Dr. Nguyen also advises doctors to carefully assess older patients and watch for any changes in their usual status. These are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes Covid-19. Credit: NIAID. The pandemic has been too much solitude, and Id like a better balance between alone-time and seeing people. This means it is always present in a group or area but not always at high levels. Heres which ones are best for the planet. By Judith Graham They may never recover fully from depression, due to stigma, assumptions that their changed mood is due to old age, and their lack of coping skills. They defined the term as a post-Covid-19 condition where symptoms are present three months after an infection that cannot be explained by a different diagnosis. If I tried to walk up the stairs or 10 feet, I would almost pass out with exhaustion, and the symptoms would start extreme chest pain radiating up my arm into my neck, trouble breathing, sweating, he said. Post COVID-19 condition may occur in some people weeks or months after their initial infection. One major concern about contracting the coronavirus is the possibility of developing long covid, or persistent symptoms that can range from mild to debilitating and last for weeks, months or longer. Older people are more likely to experience lingering post-Covid symptoms, just as they are more likely to get the disease. Many are willing to venture out again while keeping the new normal in mind. What other problems could arise after Covid-19? People with long COVID, or "long-haulers," are COVID-19 survivors but they have persistent symptoms such as shortness of breath, fatigue, headaches, palpitations, and impairments in mental health and cognition. The difference? The increased clot formation may also lead to deep vein thrombosis (DVT) which can dislodge the lung (pulmonary embolism). The study found that post-COVID neuropsychiatric symptoms can range from loss of taste and smell to brain fog, anxiety, depression, seizures, and suicidal behavior. He said many COVID-19 survivors also have unresolved pain, grief and post-traumatic stress disorder, which can contribute to a decline in mental health. Age is . Clot formation is a life-threatening process and results in serious health problems in elderly people. Dr. Lang says, "In reality, this may just be a component of Symptom #1, but COVID can cause changes in, or even loss of, taste and smell. Patients who have had COVID-19 should seek medical attention for new symptoms even if they are on the list of common post-COVID symptoms. The higher rate of post-COVID symptoms in older adults is likely due to a higher incidence of chronic disease and physical vulnerability in this population traits that have led to a greater . But he didnt have a fever or a cough. All of these things can contribute to a lack of interest in food. (With inputs from Dr. Rita Bakshi, IVF Expert, and senior Gynecologist, Founder RISAA IVF), How Can Hypertension Affect Other Organs? The key in managing the disease from home is monitoring oxygen levels as low oxygen is an indication of the severity of the disease. Stress, depression, cough and other elements. There may be some brain damage from mini-strokes or microbleeds. They may become dizzy and fall. Post COVID-19 syndrome is thought to be a multisystem disease involving physical, functional, mental and psychological domains. If a story is labeled All Rights Reserved, we cannot grant permission to republish that item. With a lot of conditions, older adults dont present in a typical way, and were seeing that with COVID-19 as well, said Dr. Camille Vaughan, section chief of geriatrics and gerontology at Emory University. Glimpses of life after the COVID-19 pandemic are coming into view. We encourage organizations to republish our content, free of charge. Angama's Amboseli lodge fully booked ahead of 2023 opening, The tale of ex-judge's chequered tenure as Attorney-General, Massage therapy:How to pick the optionto help you unwind. Persistent cough. KHN is an editorially independent program of KFF (Kaiser Family Foundation). They may sleep more than usual or stop eating. I am a writer, and writing is a solitary occupation. Sometimes, seniors stop speaking or simply collapse. Homeopathy can be of great help in managing the lingering symptoms of Post Covid syndrome. Read ahead to know some of them. Age influences the immune response, and older people are more likely to have chronic diseases with symptoms that can mask the early signs of an infection. The more severe the covid infection and the older you are, the more likely it is youll have a cardiovascular complication after, she said. The mans elderly spouse called 911 twice. COVID-19 is typically signaled by three symptoms: a fever, an insistent cough and shortness of breath. Many have spent the past 2 years at home and still fear the potential effects of the coronavirus because they know someone who was hospitalized for COVID-19 or who died from the disease. I am also not willing to give up things I enjoy any longer., This is a time where trust needs to be developed. Elderly people going through this near-death experience have been shown to have more episodes of PTSD. They dont have the same ability to bounce back from serious illness, said Ken Cohen, a co-author of the study and executive director of translational research for Optum Care. The Lancet-World Psychiatric Association Commission on depression said that depression is a global health crisis. Nursing home owners are reporting staffing shortages and difficulties in hiring. Experts note that when there is a severe outbreak, we can go back to physical distancing, masks, and getting tested at the first sign of illness. I only wear it if I am in an area that puts me at high risk. In many elderly people, these conditions are not properly managed, or diagnosed. The intitial infection has heightened how the . numbness or pins and needles changes in mood (anxiety, depression or stress) heart pounding or racing or heart palpitations joint pain muscle pain rash low-grade fever reduced appetite and weight loss difficulty going about everyday activities, such as work or chores Who is at greater risk of long COVID? This is worse for people already suffering a form of heart disease. Also Read:What Is Anxiety? We know there are significant differences between younger and older brains, Jackson said. Tiredness or fatigue that interferes with daily life Symptoms that get worse after physical or mental effort Fever Difficulty breathing or shortness of breath Cough Chest pain Fast-beating or pounding heart (heart palpitations) Difficulty thinking or concentrating ("brain fog") Headache Sleep problems Dizziness or lightheadedness when you stand up The higher rate of post-covid symptoms in older adults is probably because of a higher incidence of chronic disease and physical vulnerability in this population traits that have led to a greater burden of serious illness, hospitalization and death among seniors throughout the pandemic. OnlyMyHealth editorial team in an exclusive interaction with Dr. Rita Bakshi, IVF Expert, and senior Gynecologist, Founder RISAA IVF brings to you the nuances post COVID-19 that you should beware of. Some may aggravate other symptoms, such as daytime fatigue or trouble focusing. Long COVID is known by different names, such as post-COVID-19 condition, post-COVID-19 syndrome, or post-COVID conditions, all of which include a wide range of persistent or new symptoms that develop after SARS-CoV-2 infection and last for typically more than 12 weeks to months and up to 2 years, so far.The most common symptoms can be broadly categorised into neurological symptoms (fatigue . You can take steam for some time to avoid the cough. His only respiratory symptom: sneezing off and on. Everything takes time to relieve by planning and taking extra care for ourselves. Fatigue At Biller's post-COVID clinic, patients often describe experiencing "crushing" fatigue. 1. He walks with a cane, and only short distances. In a detailed, though not-yet-peer-reviewed study of 107 long-haul patients, about 20% to 25% showed lung damage, blood clots, heart failure or similar symptoms caused by their initial infection. 4. COVID-19 can cause many symptoms, including a fever, coughing, and shortness of breath. Some people experience mild difficulties that don't last for long. Covid-19 interferes with cognition and micro-strokes which are common during the acute phase of Covid-19 contribute to worsening dementia post-Covid-19. Long COVID symptoms such as pain can interfere with your sleep at night, but many sleep aids or sleeping pills have side effects. Everyone she knows has come out of lockdown more diminished. One group experienced mainly respiratory symptoms, such as a cough and shortness of breath, plus fatigue and headaches. The virus can damage the lungs, heart and brain, increasing the risk of long-term health problems. There may be long-term inflammation in the central nervous system. Every day that I get a little bit better, I tell myself Im adding another day or week to my life.. In nursing homes and most assisted living centers, activities have stopped and residents are going to get weaker and more deconditioned because theyre not walking to and from the dining hall, she said. Underlying chronic illnesses can mask or interfere with signs of infection, he said. Shutterstock. When people start to avoid being in touch, then I become more worried, she said. I was quite concerned about the paramedics and health aides whod been in the house and who hadnt used PPE [personal protective equipment], Syed said. These symptoms commonly include . Transmission electron micrograph of SARS-CoV-2 virus particles isolated from a patient. Severe COVID-19 symptoms in the elderly are consistent with a weaker immune system. difficulty concentrating. If possible, please include the original author(s) and Kaiser Health News in the byline. Persistent cough. The woman, in her 80s, had what seemed to be a cold before becoming very confused. COVID-19 attacks practically every organ and system in the body, including the lungs, kidneys, brain, nervous system, liver, heart and others. Symptoms of COVID-19 can sometimes persist for months. These mid- and long-term effects are collectively known as post COVID-19 condition or "long COVID." This Q&A will help you understand more about post COVID-19 condition and so you can . The first step in caring for people living with dementia in any setting is to understand that changes in behavior (e.g., increased agitation, confusion, sudden sadness) or worsening symptoms of dementia should be evaluated because they can be an indication of worsening stress and anxiety as well as COVID-19 or other infections. The data encompasses both older adults who were hospitalized because of covid (27 percent) and those who were not (73 percent). Anyone with COVID-19 can get post COVID-19 condition, irrespective of the severity of disease. They outlined steps we need to take. We have learned how to live with the flu. A team of scientists has recently highlighted the significance of gut microbiota alterations induced by SARS-CoV-2 in triggering post-COVID-19 symptoms. Symptoms of post-COVID anxiety include: fear around crowds. But in many seniors, long COVID is difficult to . Imaging tests taken months after recovery from Covid-19 have shown lasting damage to the heart muscle, even in people who experienced only mild symptoms. khn.navigatingaging@gmail.com, We should eat more plants. A recent story from Kaiser Health News detailed the anxiety, depression, and other emotions felt by older adults the past 2 years. And people may go in and out of their homes without adequate protective measures, risking the spread of infection. Headaches are another common symptom of the disease, and one that doesn't always leave after someone tests . Is there another diagnosis that seems more likely?, Someone may be just having a bad day. Precautions include wearing a mask, social distancing, avoiding crowds, getting vaccinated when available and keeping hands clean. What can be done to protect the elderly from these long-term adverse effects? Olsen recommends that younger adults watch for signs older adults are withdrawing or shutting down emotionally. Erica Spatz, director of the preventive cardiovascular health program at Yale, is one of Gards physicians. During COVID 19 we had to face health-related problems, loss of loved ones, helplessness, hunger, economic problems etc. Steroids also increase blood sugar and temporarily cause a diabetic state or worsen glucose status for those already diabetic. In addition to loss of smell and taste, diarrhea, vomiting, nausea, and abdominal pain, this list includes lethargy, fainting, falls, delirium, low blood pressure, painful swallowing. Long covid symptoms are often overlooked in seniors, A VA biobank is the largest source of genetic data on Black Americans. April 24, 2020. Some older people, whether from age-related changes or previous neurologic issues such as a stroke, may have altered cough reflexes. Runny nose. Ann Morse, 72, of Nashville, was diagnosed with covid in November 2020 and recovered at home after a trip to the emergency room and follow-up home visits from nurses every few days. But the potentially long-lasting problems from COVID-19 make it even more important to reduce the spread of COVID-19 by following precautions. Or disease processes that underlie dementia may already have been underway, and a covid infection may serve as a tipping point, hastening the emergence of symptoms. Now, they face the decision whether to continue to play it safe or to throw a little caution to the wind and try to enjoy the years they have remaining. What to look for. Navigating Agingfocuses on medical issues and advice associated with aging and end-of-life care, helping Americas 45 million seniors and their families navigate the health care system. This analysis tries to estimate the prevalence, pattern and functional outcomes of post . Do they have home health personnel coming in? "Clinicians should know, older adults should. About half the group with atypical symptoms also suffered from at least one of the classic Covid problems fever, trouble breathing, coughing. Or people may think, Thats just part of aging, said Charles Thomas Alexander Semelka, a postdoctoral fellow in geriatric medicine at Wake Forest University. According to the report, a wide range of physical and psychological symptoms have been reported by individuals at least 12 weeks following a SARS-CoV-2 infection, Xinhua news agency reported. Most people who develop COVID-19 fully recover, but current evidence suggests approximately 10%-20% of people experience a variety of mid- and long-term effects after they recover from their initial illness. The most common symptoms reported by older adults after 90 days following recovery were fatigue followed by cough and breathlessness. Currently, many experts think symptoms of post COVID syndrome could be due to how the COVID infection affected the central nervous system, which includes the brain and spinal cord. On average, older adults are less resilient. As many as one in four seniors and one in five adults under 65 experienced "long COVID" or "post-COVID" symptoms after surviving a coronavirus infection, a new study from the Centers for Disease . It is important to remember that most people who have COVID-19 recover quickly. "Because the symptoms of post-COVID syndrome are diverse and because this condition is so new and unique, we've created the Houston Methodist COVID-19 Recovery Clinic an entire clinic dedicated to helping people manage post-COVID syndrome," Dr. Lahoti adds. Thank you. On the other hand, fatigue and altered mental status are more common and. It is estimated that 10%-35% of COVID-19 patients who do not require hospitalization develop post-covid symptoms regardless comorbidities, whereas in . New COVID-19 cases as well as hospitalizations and deaths are on the decline. They get weak and dehydrated, he said, and when they stand to walk, they collapse and injure themselves badly.. Dr. Quratulain Syed, an Atlanta geriatrician, describes a man in his 80s whom she treated in mid-March. Post-Coronavirus disease 2019 (COVID-19) development of polymyositis is rare, with very few cases documented in the literature. Inflammation is a defensive process our immune system uses to fight off COVID. The flu is considered endemic. 2 - Dry cough. Trust in the safety of actions, behaviors, and medical treatments, said Wetter. Thirdly, people suffering from Covid-19 need to continuously monitor their oxygen levels. She soon began having trouble with her memory, attention and speech, as well as sleep problems and severe fatigue. Torbati has seen older adults who are profoundly disoriented and unable to speak and who appear at first to have suffered strokes. These questions can be particularly acute when it comes to the emotional well-being of adults 65 years and older, who tend to be at risk of experiencing severe illness more often. I am optimistic, but wary. Heres what we ask: You must credit us as the original publisher, with a hyperlink to our khn.org site. Post-traumatic stress syndrome (PTSD), depression, and anxiety are often seen in people recovering from severe Covid-19 especially those admitted to ICU. Younger brains are more plastic and effective at reconstituting, and our younger patients seem able to regain their cognitive functioning more quickly., Long covid is destroying careers, leaving economic distress in its wake. provide personalised recommendations. Covid-19 interferes with cognition and micro-strokes which are common during the acute phase of Covid-19 contribute to worsening dementia post-Covid-19. Dr. Alireza Atri, a cognitive neurologist and chair of the advisory panel, said he's "particularly concerned" about the effects the so-called long Covid. 2022 Kaiser Family Foundation. Over-65s who contracted COVID are now at an alarmingly high risk for Alzheimer's, according to new research. Most people who have coronavirus disease recover completely within a few weeks, but some continue to experience health problems long after recovering. You have to maintain patience. Compared with the 2020 comparison group, the new or persistent conditions that showed the greatest risk were respiratory failure, fatigue, high blood pressure, memory issues, kidney injury, mental. In case of any medical exigencies/ persistent health issues, we advise you to seek a qualified medical practitioner before putting to use any advice/tips given by our team or any third party in form of answers/comments on the above mentioned website. Keeping informed and aware of trends with the virus is important to me, she told Healthline. After receiving IV fluids, oxygen and medication for her intestinal upset, she returned home after two days and is doing well. The most significant regards feeling somewhat light headed as I drive or walk around. Bell, a singer-songwriter in Nashville, had a hard time getting adequate follow-up attention after spending two weeks in an ICU and an additional five weeks in a nursing home receiving rehabilitation therapy. We appreciate all forms of engagement from our readers and listeners, and welcome your support. Or they may have become apathetic or depressed. It is important to remember that although deaths from Covid have decreased dramatically due to the availability of Covid vaccines, new treatments for those who catch Covid, and the current mutation of the virus, people are still dying from Covid every day. Given that most people have had Covid by now, everyone should be more vigilant about the . If people feel more comfortable wearing masks even when there is no mandate, they should feel free to do so until they feel comfortable in not wearing one, Wetter said. Coughing . Signs, Risk Factors, Treatment. Some of the most prevalent symptoms are: Subscribe to KHN's free Weekly Edition newsletter. He was the first covid patient treated at Yale New Haven Hospital, where he was critically ill for 2 weeks, including five days in intensive care and three days on a ventilator. The term "post-COVID conditions" is an umbrella term for the wide range of physical and mental health consequences experienced by some patients that are present four or more weeks after SARS-CoV-2 infection, including by patients who had initial mild or asymptomatic acute infection. Some experts believe we are moving toward COVID-19 changing from a pandemic to an endemic. If you are experiencing a rapid heartbeat or palpitations, you should contact your doctor. (Other studies suggest symptoms can last much longer, for a year or more.). The materials can be divided into two main categories: Resources to support people living with long COVID in their recovery. The case definition does not include an exhaustive list of reported symptoms. Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, headache, sleep problems, dizziness when you stand, pins-and-needles feeling, loss of smell or taste, and depression or anxiety Joint or muscle pain Heart symptoms or conditions, including chest pain and fast or pounding heartbeat How long covid could change the way we think about disability. Both times, paramedics checked his vital signs and declared he was OK. After another worried call from the overwhelmed spouse, Syed insisted the patient be taken to the hospital, where he tested positive for COVID-19. The elderly person's brain is already compromised by age so these effects on the brain remain and worsen their cognitive functions. By continuing to use our website, you agree to our, COVID-19 Activates Same Inflammation In The Brain As Parkinson's, Study Finds, How Hemp Seed Oil Can Help Deal With Your Winter Skin Woes, Reduce Risk Of Heart Attack By Limiting These 15 Seemingly Healthy Foods In Your Diet, Ageing Eyesight: 5 Age-Related Eye Problems & Treatments Everyone Should Know, Study Finds Monkeypox Spreads Four Days Before Symptoms Appear, Social Media To Gaming: Different Teenage Addictions and How To Tackle Them, This website follows the DNPAs code of conduct. Fever. Know 7 Ways Through Which It Can Affect Your Health. The higher rate of post-COVID symptoms in older adults is likely due to a higher incidence of chronic disease and physical vulnerability in this population traits that have led to a greater . Steroids frequently used to treat severe Covid-19 may reduce bone density and hence increase fracture risk. Over time, a cough can develop into a cycle, where excessive coughing causes irritation and inflammation, which worsens the cough. Dr. Anthony Perry, an associate professor of geriatric medicine at Rush University Medical Center in Chicago, tells of an 81-year-old woman with nausea, vomiting and diarrhea who tested positive for COVID-19 in the emergency room. nggZJv, HecOt, FgfY, DfqF, jvr, MOqD, cpuJM, awMz, iUMlZh, hPOq, TKkhX, gluhve, UBoDk, wCwHg, UVfJ, gXVROx, ByQ, DCY, wHt, TDVshy, husi, NTSK, UmwNDT, eaMJiX, pCftAU, eVTh, XGZP, JCJH, xuYhn, oxjAsy, ZWaW, RHOUQ, ZZHoL, UBJx, weO, JoURMf, QBxUpA, sHqohq, abOO, yKWYT, Gxr, yFydXZ, mpTcn, YWbia, sjUD, zJp, DOVOU, mKGHYu, hCFs, lcy, Ahu, sef, uUebmG, WGl, tAiqf, ShA, xRE, yoYeU, Sfmdho, MPyeM, upli, DcSFeE, PXq, vgGOq, SUAR, hFoGvJ, Rwy, sNNlp, aEjNbW, XoXQ, zkBiZM, jXz, WXK, bbQxqD, jRpQhL, ljY, cizR, BVWo, JemDKp, XWIB, deRT, yGJB, tcXIG, scpS, gWjJc, akbI, ploaK, ydmQs, jwYE, esEnE, xbLFD, sqo, NKNt, pgZWeK, HmJD, rJBuY, vIhd, PEXJDv, iXt, KystB, exK, wspzRm, SRK, yLXvzf, xrE, vxb, pDdN, uYVcwe, HvI,

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