Pharmacological evaluation of vitamin D in COVID-19 and long COVID-19: recent studies confirm clinical validation and highlight metformin to improve VDR sensitivity and efficacy

Inflammopharmacology, Journal Year: 2023, Volume and Issue: 32(1), P. 249 - 271

Published: Nov. 13, 2023

Abstract Nearly four years after its first appearance, and having gone from pandemic to endemic, the SARS-CoV-2 remains out of control globally. The purpose this study was evaluate clinical efficacy vitamin D (VD) in COVID-19 long COVID-19, explain discrepancy outcomes highlight potential impact metformin on VD recent articles. Articles January 2022 August 2023 were selected for review. objective achieved by reviewing, analyzing, discussing articles demonstrating (1) mechanism action (2) observational or randomized trials (RCTs) that support not beneficial effects COVID. (3) genetic non-genetic reasons variation VD. collected electronic databases such as PubMed, Scopus, MEDLINE, Google Scholar, Egyptian Knowledge Bank, Science Direct, Cochrane Database Systematic Reviews. Twenty three studies conducted vitro animal models indicated may act through protecting respiratory system antimicrobial peptide cathelicidins, reducing lung inflammation, regulating innate adaptive immune functions up regulation autophagy gene activity. Our review identified 58 met criteria. number publications supporting a activity treating 49 (86%), including 12 meta-analyses. Although total patients included all 14,071,273, role 14,029,411 (99.7%). Collectively, extensive decisive relationship between low levels severity mortality outcomes. Importantly, evidence intervention has demonstrated effectiveness supplements COVID-19. Furthermore, results 4 supported alleviating symptoms disease. However, eight RCTs one meta-analysis contain low-grade against Twenty-five have addressed association VDR DBP polymorphisms treatment failure Impaired signaling underlie variability mechanisms. Interestingly, studies, therapeutic possibly improving AMPK enhancing In conclusion, been significantly strengthened over past 18 months, with several meta-analyses reporting conclusive supplementation highlighting improve sensitivity

Language: Английский

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Why does malaise/fatigue occur? Underlying mechanisms and potential relevance to treatments in rheumatoid arthritis

Expert Review of Clinical Immunology, Journal Year: 2024, Volume and Issue: 20(5), P. 485 - 499

Published: Jan. 15, 2024

Introduction Fatigue and malaise are commonly associated with a wide range of medical conditions, including rheumatoid arthritis (RA). Evidence suggests that fatigue can be overwhelming for patients, yet these symptoms remain inadequately-managed, largely due to an incomplete elucidation the underlying causes.

Language: Английский

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Potential Beneficial Effects of Naringin and Naringenin on Long COVID—A Review of the Literature

Microorganisms, Journal Year: 2024, Volume and Issue: 12(2), P. 332 - 332

Published: Feb. 4, 2024

Coronavirus disease 2019 (COVID-19) caused a severe epidemic due to acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Recent studies have found that patients do not completely recover from infections, but instead, suffer variety of post-acute sequelae SARS-CoV-2 infection, known as long COVID. The effects COVID can be far-reaching, with duration up six months and range symptoms such cognitive dysfunction, immune dysregulation, microbiota dysbiosis, myalgic encephalomyelitis/chronic fatigue syndrome, myocarditis, pulmonary fibrosis, cough, diabetes, pain, reproductive thrombus formation. However, recent shown naringenin naringin palliative on various COVID-19 sequelae. Flavonoids naringenin, commonly in fruits vegetables, positive effects, including reducing inflammation, preventing viral providing antioxidants. This article discusses the molecular mechanisms clinical treating above diseases. It proposes them potential drugs for treatment COVID, it inferred exhibit extended medications, future likely serving nutraceuticals or supplements comprehensive alleviation manifestations complications.

Language: Английский

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Advances in researches on long coronavirus disease in children: a narrative review

Translational Pediatrics, Journal Year: 2024, Volume and Issue: 13(2), P. 318 - 328

Published: Feb. 1, 2024

In the context of global pandemic coronavirus disease 2019 (COVID-19), more than 700 million infections and millions deaths have occurred in countries around world. Currently, two main sequelae this are considered to occur children, namely, multi-system inflammatory syndrome children long COVID. Among these two, incidence COVID is higher its impact on population extensive, which focus us. However, due lack relevant studies limitations most studies, COVID-19 infection lag behind those adults, but they begun attract attention some clinicians researchers. We aim summarize current knowledge helping pediatricians researchers better understand providing guidance research clinical treatment it.

Language: Английский

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Long COVID syndrome: An unfolding enigma

The Indian Journal of Medical Research, Journal Year: 2024, Volume and Issue: 159, P. 585 - 600

Published: Sept. 7, 2024

Post-acute sequelae of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19), called as long COVID syndrome, is a major global public health issue after recovery from COVID-19. The occurs in symptomatic patients irrespective illness severity. symptoms continue four wk and persist beyond three months. Risk factors for include older age, female gender, multiple co-morbidities including diabetes mellitus, prior chronic illnesses, hospitalized with disease, especially receiving assisted ventilation, high viral load, reactivation Epstein Barr (EB) virus human herpes 6 (HH6), circulating auto antibodies against various organs type I interferon. prevalence varies 10 to 20 per cent, most data have been reported high-income countries. Any system can get involved COVID. fatigue, cognition impairment, cough dyspnoea, anosmia, hair loss diarrhoea, among others. While there are no laboratory tests confirmation diagnosis, reduced complement C7 complexes at six months, two-gene biomarker FYN SARS-CoV-2 antisense ribonucleic acid (RNA) emerging potentially useful biomarkers There should be alternative explain symptoms. Vaccination early use oral antiviral nirmatrelvir within the first five days mild having risk progression help preventing Several clinical trials underway treatment results these eagerly awaited. Physical mental rehabilitation home, community level or hospital setting appropriate essential

Language: Английский

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Therapeutic Approaches to Dysautonomia in Childhood, with a Special Focus on Long COVID

Children, Journal Year: 2023, Volume and Issue: 10(2), P. 316 - 316

Published: Feb. 7, 2023

Dysautonomia seems to be important for the pathophysiology of psychosomatic diseases and, more recently, long COVID. This concept may explain clinical symptoms and could help open new therapeutic approaches.We compared our data from an analysis heart rate variability (HRV) in active standing test 28 adolescents who had developed inappropriate sinus tachycardia (IST, n = 13) or postural orthostatic syndrome (POTS, 15) after contracting COVID-19 disease and/or vaccination with 64 database dysautonomia due prior pandemic. We prove effects treatment: omega-3 fatty acid supplementation (O3-FA, 18) addition propranolol (low dose, up 20-20-0 mg, 32) ivabradine 5-5-0 mg (n 17) on regulation (HRV).The HRV were not different between SARS-CoV-2-related disorders The increases children POTS while significantly lower low-dose (27.2 ± 17.4 bpm***), (23.6 8.12 bpm*), O-3-FA (25.6 8.4 bpm*). IST lying/standing was (81.6 10.1 bpm**/101.8 18.8***), (84.2 bpm***/105.4 14.6**), (88.6 7.9 bpm*/112.1/14.9*).The disease/vaccination are a historical control Low-dose > acids decrease elevated rates patients beneficial these dysautonomia.

Language: Английский

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Health Resort Treatment Mitigates Neuropsychiatric Symptoms in Long COVID Patients: A Retrospective Study

Healthcare, Journal Year: 2025, Volume and Issue: 13(2), P. 196 - 196

Published: Jan. 19, 2025

Background/Objectives: Among the neuropsychiatric symptoms of long COVID, following may be listed: sleep disturbances, headaches, anxiety, depression, dizziness, numbness, memory loss, and concentration difficulties. Various therapies have been implemented to mitigate these symptoms; however, health resort treatments that utilize a wide range modalities stimulating multidirectional biological reactions also effective. The aim this study was assess severity in COVID patients who qualified for treatment, evaluate effectiveness treatment group patients, effect balneological factors course. Methods: A retrospective analysis medical records 120 people with (69 women 51 men) aged 42–79 underwent 2021 performed. People were eligible at lowland based on valid referral from doctor. included therapies, physical medicine modalities, exercise programs, education, psychological support. Patients assessed persistent 0–10 point scale before after treatment. Results: After greatest improvement noted disorders (2.47 ± 2.23 points vs. 0.86 1.25 points, p < 0.00001) dizziness (1.39 1.94 0.34 0.76 0.00001). lowest observed (2.68 2.5 1 1.4 Conclusions: reported mild symptoms. Health mitigates symptoms, as it is complex approach. Treatment includes improves greater extent. This method should integrated into standard COVID.

Language: Английский

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Balneotherapy for the treatment of post-COVID syndrome: a randomized controlled trial

BMC Complementary Medicine and Therapies, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 4, 2025

Post-Acute COVID Syndrome (PACS) is a complex disorder that currently lacks effective evidenced-based therapies to manage it. This randomized controlled trial aims evaluate the effects of balneotherapy (BT) on PACS symptomatology. Ninety-eight adults with visited at Hospital del Mar Research Institute, Barcelona (Spain) were included study. Participants in intervention group (n = 51) allocated 12 sessions BT and aquatic exercises delivered one month while control 47) did not. The primary outcome was absolute change questionnaire scores between baseline two follow-up points: immediately after (or one-month post-baseline for group) 2 months post-baseline. following scales/questionnaires employed: Post-COVID-19 functional status scale, mMRC dyspnea Scale, SF-36, Pittsburgh Sleep Quality Index (PSQI), Anxiety Depression Scale (HADS), Memory failures everyday life severe head injury, Visual Analogic (VAS). Forty-seven patients 43 completed majority participants middle-aged women (> 84%; mean age 48 years), most prevalent symptoms fatigue, musculoskeletal pain, neurocognitive impairment 88%). Noteworthy, vast not undergo infection (ICU admissions < 3%). After BT, significant improvement detected vs. various SF-36 domains, PSQI total score (Beta-coefficient [95%CI] 2.641 [1.15;4.12]; p -value 0.003), HAD's anxiety subscale 1.72 [0.40;3.03;p-value 0.023), VAS 1.625 [0.32;2.96]; p-value 0.026). Among these, SF-36's energy/fatigue pain subscales exhibited prominent changes Beta-coefficient -17.45 [-24.23;-10.66] − 21.634 [-30.48;-12.78], respectively (p-value 0.0001). No adverse reported during although seventeen mild transient worsening preexisting symptoms, particularly fatigue/post-exertional malaise mainly first BT. Balneotherapy comprise an therapeutic modality can alleviate several characterize PACS, fatigue. However, sustainability these over time remains uncertain, as evidenced by loss some between-group differences follow-up. ClinicalTrials.gov NCT05765591 (13/03/2023).

Language: Английский

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A multidisciplinary review of long COVID to address the challenges in diagnosis and updated management guidelines

Annals of Medicine and Surgery, Journal Year: 2025, Volume and Issue: 87(4), P. 2105 - 2117

Published: Feb. 27, 2025

Long COVID has emerged as a significant challenge since the COVID-19 pandemic, which was declared an outbreak in March 2020, marked by diverse symptoms and prolonged duration of disease. Defined WHO persisting or emerging for at least two months post-SARS-CoV-2 infection without alternative cause, its prevalence varies globally, with estimates 10–20% Europe, 7.3% USA, 3.0% UK. The condition’s etiology remains unclear, involving factors, such renin–angiotensin system overactivation, persistent viral reservoirs, immune dysregulation, autoantibodies. Reactivated viruses, like EBV HSV-6, alongside epigenetic alterations, exacerbate mitochondrial dysfunction energy imbalance. Emerging evidence links SARS-CoV-2 to chromatin gut microbiome changes, further influencing long-term health impacts. Diagnosis long requires detailed systemic evaluation through medical history physical examination. Management is highly individualized, focusing mainly on patient’s affected systems. A multidisciplinary approach essential, integrating perspectives address manifestations, underlying mechanisms, therapeutic strategies. Enhanced understanding COVID’s pathophysiology clinical features critical improving patient outcomes quality life. With growing number cases expected advancing research disseminating knowledge remain vital developing effective diagnostic management frameworks, ultimately supporting better care individuals.

Language: Английский

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Donepezil for Fatigue and Psychological Symptoms in Post–COVID-19 Condition

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(3), P. e250728 - e250728

Published: March 17, 2025

Importance Fatigue is the most commonly reported symptom of post–COVID-19 condition (also known as long COVID) and impairs various functions. One underlying mechanisms may be intracerebral inflammation due to decreases in acetylcholine levels. Objective To examine effects donepezil hydrochloride, an acetylcholinesterase inhibitor, on fatigue psychological symptoms. Design, Setting, Participants A multicenter, double-blind randomized clinical trial was performed Japan. Between December 14, 2022, March 31, 2024, adult patients within 52 weeks onset COVID-19 with a global binary score 4 or greater Chalder Scale were into placebo group. Exposure The intervention conducted during 3-week period, hydrochloride being administered at dosage 3 mg/d for first week then 5 2 weeks. Main Outcomes Measures primary outcome change absolute after initiation treatment. Other outcomes 8 weeks, such symptoms quality life, evaluated secondary outcomes. Results total 120 eligible enrolled 10 withdrew lost follow-up; therefore, 110 (55 each group) included efficacy analysis (64 [58%] female; mean [SD] age, 43 [12] years). No significant differences observed baseline characteristics between groups. baseline-adjusted estimating treatment effect donepezil, measured difference scores 0.34 (95% CI, −2.23 2.91), showing no ( P = .79). Scores Hospital Anxiety Depression Scale, Impact Event Scale–Revised, EuroQol 5-Dimension 5-Level Version, Patient Health Questionnaire, Daily Status similar. serious adverse events occurred either Conclusions Relevance In this treat condition, not confirmed general population. development effective therapeutics needed, more trials should future. Trial Registration Japan Registry Clinical Trials Identifier: jRCT 2031220510

Language: Английский

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