COVID-19-Associated Multisystem Inflammatory Syndrome in Children and Cardiovascular Autonomic Control: A Prospective Cohort Study Nine Months after SARS-CoV-2 Infection DOI Open Access
Paolo Castiglioni, Susanna Rampichini, Carla Corti

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(14), P. 4163 - 4163

Published: July 16, 2024

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) has emerged as a severe pediatric complication during the SARS-CoV-2 pandemic, with potential long-term cardiovascular repercussions. We hypothesized that heart rate and blood pressure control at rest postural maneuvers MIS-C patients, months after remission of inflammatory syndrome, may reveal autonomic dysfunctions. Methods: assessed 17 patients (13 males; 11.9 ± 2.6 years, m SD) 9 acute infection 18 age- (12.5 2.1 years) sex- males) matched controls. Heart variability, baroreflex function, hemodynamic parameters were analyzed supine standing postures. Results: exhibited reduced particularly parasympathetic (pNN50+: 6.1 6.4% controls, 2.5 3.9% MIS-C; RMSSD: 34 19 ms 21 14 MIS-C, p < 0.05), no interaction between case posture. Blood variability sensitivity did not differ groups except for high-frequency power systolic (3.3 1.2 mmHg2 1.8 0.05). The group also showed lower diastolic pressure–time indices (DPTI) (SPTI), (DPTI: 36.2 9.4 mmHg·s 29.4 6.2 SPTI: 26.5 4.3 23.9 2.4 Conclusions: Altered persist with, however, compensatory mechanisms help maintain homeostasis light challenges, such maneuvers. These results highlight importance assessing children to possibly identify residual risks inform targeted interventions rehabilitation protocols.

Language: Английский

Long COVID: a clinical update DOI
Trisha Greenhalgh, Manoj Sivan,

Alice Perlowski

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 404(10453), P. 707 - 724

Published: July 31, 2024

Language: Английский

Citations

78
What is quality in long covid care? Lessons from a national quality improvement collaborative and multi-site ethnography DOI Creative Commons
Trisha Greenhalgh, Julie Darbyshire, Cassie Lee

et al.

BMC Medicine, Journal Year: 2024, Volume and Issue: 22(1)

Published: April 15, 2024

Abstract Background Long covid (post covid-19 condition) is a complex condition with diverse manifestations, uncertain prognosis and wide variation in current approaches to management. There have been calls for formal quality standards reduce so-called “postcode lottery” of care. The original aim this study—to examine the nature long care unwarranted services—evolved focus on examining reasons why standardizing was so challenging condition. Methods In 2021–2023, we ran improvement collaborative across 10 UK sites. dataset reported here mostly but not entirely qualitative. It included data origins context each clinic, interviews staff patients, ethnographic observations at 13 clinics (50 consultations) 45 multidisciplinary team (MDT) meetings (244 patient cases). Data collection analysis were informed by relevant lenses from clinical (e.g. evidence-based guidelines), science cycles) philosophy knowledge. Results Participating made progress towards assessment management some topics; remained could usually be explained. Clinics had different histories path dependencies, occupied place their healthcare ecosystem served varied caseload including high proportion patients comorbidities. A key mechanism achieving high-quality when local MDTs deliberated unusual, or cases which guidelines provided no easy answers. such cases, collective learning occurred through idiographic (case-based) reasoning , practitioners build lessons particular general. This contrasts nomothetic implicit guidelines, assumed go general findings trials) (management individual patients). Conclusion Not all services unwarranted. Largely because covid’s manifestations are comorbidities common, generic “evidence-based” require much adaptation. condition, resources may productively spent supporting optimise case-based interdisciplinary discussion. Quality service should include review sample assess how interpreted personalized meet patients’ unique needs. Study registration NCT05057260, ISRCTN15022307.

Language: Английский

Citations

11
Long COVID DOI
Neda Hasan,

Rachael Rogers,

Emma Tucker

et al.

Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Citations

0
Adult Long Coronavirus Disease 2019 DOI
Ivette F. Emery, Clifford J. Rosen

Infectious Disease Clinics of North America, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

0
Identifying commonalities and differences between EHR representations of PASC and ME/CFS in the RECOVER EHR cohort DOI Creative Commons
John Powers, Tomas J. McIntee, Abhishek Bhatia

et al.

Communications Medicine, Journal Year: 2025, Volume and Issue: 5(1)

Published: April 11, 2025

Shared symptoms and biological abnormalities between post-acute sequelae of SARS-CoV-2 infection (PASC) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) could suggest common pathophysiological bases would support coordinated treatment efforts. Empirical studies comparing these syndromes are needed to better understand their commonalities differences. We analyzed electronic health record data from 6.5 million adult patients the National COVID Cohort Collaborative. PASC ME/CFS diagnostic groups were defined based on recorded diagnoses, other conditions within two used train separate machine learning-driven computable phenotypes (CPs). The most predictive for each CP examined compared, overlap labeled by was examined. Condition records also statistically derive condition clusters. Rates subphenotypes clusters compared groups. Approximately half one other. Dyspnea, fatigue, cognitive impairment most-predictive shared both CPs, whereas specific CP. Recorded into cardiopulmonary, neurological, comorbidity clusters, with cardiopulmonary cluster showing partial specificity Data-driven approaches indicate substantial in associated diagnoses. Nevertheless, somewhat more commonly diagnosis, conditions, such as pain sleep disturbances, diagnosis. These findings that symptom management illnesses overlap.

Language: Английский

Citations

0
Long COVID in 2025: a clinical viewpoint DOI
Andrew Schamess, Markus Velten,

Aaron Friedberg

et al.

Life Sciences, Journal Year: 2025, Volume and Issue: unknown, P. 123633 - 123633

Published: April 1, 2025

Language: Английский

Citations

0
Orthostatic Intolerance in Children With Long COVID Utilizing a 10-Minute Passive Standing Test DOI
Amanda K. Morrow,

Cindy Villatoro,

Christina Kokorelis

et al.

Clinical Pediatrics, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 9, 2024

Despite there being a wide variety of symptoms reported in pediatric long COVID, one condition that has become increasingly recognized is orthostatic intolerance (OI), which can cause significant morbidity, limiting activities daily living. This study examines rates OI 92 children with COVID who underwent bedside passive standing test post-COVID-19 rehabilitation clinic. Seventy-one percent met criteria for an condition, including postural tachycardia syndrome (POTS), (OT), classic hypotension (OH), delayed OH, and hypertension. Our findings suggest common necessitating appropriate clinical screening treatment.

Language: Английский

Citations

2
Improving quality in adult long covid services: Findings from the LOCOMOTION quality improvement collaborative DOI Creative Commons
Julie Darbyshire, Trisha Greenhalgh, Nawar Diar Bakerly

et al.

Clinical Medicine, Journal Year: 2024, Volume and Issue: 24(5), P. 100237 - 100237

Published: Aug. 23, 2024

The protracted form of COVID-19 known as 'long covid' was first described in 2020. Its symptoms, course and prognosis vary widely; some patients have a multi-system, disabling prolonged illness. In 2021, ring-fenced funding provided to establish 90 long covid clinics England; were also established Scotland Wales. NIHR-funded LOCOMOTION project implemented UK-wide quality improvement collaborative involving ten these clinics, which ran from 2021 2023. At regular online meetings held approximately 8-weekly, participants prioritized topics, discussed research evidence guidelines, presented exemplar case histories clinic audits. A patient advisory group priority-setting exercise, participated undertook service evaluation audit. goal successive cycles aimed at changing practice align with sometimes hard achieve because definitive did not yet exist this new condition; many had comorbidities; practically constrained various ways. Nevertheless, much progress made series 'best practice' guides produced, covering general assessment management; breathing difficulties; orthostatic tachycardia other autonomic symptoms; fatigue cognitive impairment; vocational rehabilitation. This paper summarises key findings the front-line clinician mind.

Language: Английский

Citations

2
Postacute Sequelae of COVID (PASC or Long COVID): An Evidenced-Based Approach DOI Creative Commons
Daniel O. Griffin

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(9)

Published: Aug. 27, 2024

Abstract While the acute manifestations of infectious diseases are well known, in some individuals, symptoms can either persist or appear after period. Postviral fatigue syndromes recognized with other viral infections and described coronavirus disease 2019 (COVID-19). We have a growing number individuals that for weeks, months, years. Here, we share evidence regarding abnormalities associated postacute sequelae COVID-19 (PASC) therapeutics. describe physiological biochemical seen reporting PASC. several evidence-based interventions to offer patients. It is expected this understanding mechanisms driving PASC benefits certain therapeutics may not only lead better outcomes those but also potential treating postinfectious sequelae.

Language: Английский

Citations

2
COVID-19-Associated Multisystem Inflammatory Syndrome in Children and Cardiovascular Autonomic Control: A Prospective Cohort Study Nine Months after SARS-CoV-2 Infection DOI Open Access
Paolo Castiglioni, Susanna Rampichini, Carla Corti

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(14), P. 4163 - 4163

Published: July 16, 2024

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) has emerged as a severe pediatric complication during the SARS-CoV-2 pandemic, with potential long-term cardiovascular repercussions. We hypothesized that heart rate and blood pressure control at rest postural maneuvers MIS-C patients, months after remission of inflammatory syndrome, may reveal autonomic dysfunctions. Methods: assessed 17 patients (13 males; 11.9 ± 2.6 years, m SD) 9 acute infection 18 age- (12.5 2.1 years) sex- males) matched controls. Heart variability, baroreflex function, hemodynamic parameters were analyzed supine standing postures. Results: exhibited reduced particularly parasympathetic (pNN50+: 6.1 6.4% controls, 2.5 3.9% MIS-C; RMSSD: 34 19 ms 21 14 MIS-C, p < 0.05), no interaction between case posture. Blood variability sensitivity did not differ groups except for high-frequency power systolic (3.3 1.2 mmHg2 1.8 0.05). The group also showed lower diastolic pressure–time indices (DPTI) (SPTI), (DPTI: 36.2 9.4 mmHg·s 29.4 6.2 SPTI: 26.5 4.3 23.9 2.4 Conclusions: Altered persist with, however, compensatory mechanisms help maintain homeostasis light challenges, such maneuvers. These results highlight importance assessing children to possibly identify residual risks inform targeted interventions rehabilitation protocols.

Language: Английский

Citations

0