The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID

Signal Transduction and Targeted Therapy, Journal Year: 2023, Volume and Issue: 8(1)

Published: Nov. 1, 2023

Abstract There have been hundreds of millions cases coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome 2 (SARS-CoV-2). With the growing population recovered patients, it crucial to understand long-term consequences and management strategies. Although COVID-19 was initially considered an illness, recent evidence suggests that manifestations including but not limited those cardiovascular, respiratory, neuropsychiatric, gastrointestinal, reproductive, musculoskeletal systems may persist long after phase. These persistent manifestations, also referred as COVID, could impact all patients with across full spectrum illness severity. Herein, we comprehensively review current literature on highlighting its epidemiological understanding, vaccinations, organ-specific sequelae, pathophysiological mechanisms, multidisciplinary In addition, psychological psychosomatic factors underscored. Despite these findings diagnostic therapeutic strategies based previous experience pilot studies remain inadequate, well-designed clinical trials should be prioritized validate existing hypotheses. Thus, propose primary challenges concerning biological knowledge gaps efficient remedies well discuss corresponding recommendations.

Language: Английский

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Effectiveness of Functional or Aerobic Exercise Combined With Breathing Techniques in Telerehabilitation for Patients With Long COVID: A Randomized Controlled Trial

Physical Therapy, Journal Year: 2023, Volume and Issue: 103(11)

Published: Sept. 2, 2023

The aim of this study was to compare the short-term clinical effects 2 telerehabilitation programs, functional versus aerobic exercises (AEs), both combined with breathing techniques, regarding improvement long coronavirus disease 2019 (COVID-19) symptoms.A randomized controlled trial conducted. participants were assigned randomly either exercise (FE) group or AE group, including techniques. interventions lasted for 8 weeks 3 sessions per week, and they conducted through Fisiotrack mobile phone application. Assessments performed at baseline after treatment, testing fatigue (Fatigue Assessment Scale), dyspnea (London Chest Activity Daily Living performance (30 Seconds Standing Test), perceived stress (Perceived Stress anxiety depression (Hospital Anxiety Depression Questionnaire), quality life (European Quality Life Scale). change treatment (Patient Global Impression Change usability application (System Usability adherence also examined treatment.In total, 43 (FE n = 21; 22; mean age 42.4 [SD 6.5] years) completed study. In intragroup comparison, FE showed improved (-6.7 points; 95% CI -11.9 -1.3), capacity (2.6 repetitions; 0.3 4.9), (-4.9 -9.1 0.8), while (-6.2 -10.3 -2.1). No significant differences in intergroup effect identified studied variables. Significant observed Patient Scale favor compared reached minimal clinically important difference groups. ease use tool rated excellent groups.Both modalities are effective improving symptoms patients COVID-19. For performance, shows more promising results.FE may be recommended depending on patients' symptoms, improve Telerehabilitation an optimal intervention modality prescription physical

Language: Английский

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Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 infection: A systematic diagnostic approach

European Journal of Neurology, Journal Year: 2023, Volume and Issue: 30(9), P. 2713 - 2725

Published: June 12, 2023

Abstract Background and purpose Following increasing demands of patients with suspected neurological symptoms after infection severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2), the Department Neurology at Medical University Vienna established a new outpatient clinic to systematically assess, diagnose, document complaints potentially associated prior SARS‐CoV‐2 infection. Methods The data presented here include prospectively collected 156 outpatients from May 2021 April 2022. Patients underwent semistandardized interviewing about reported onset infection, examination, comprehensive diagnostic workup. Results Reported included fatigue (77.6%), subjective cognitive impairment (72.4%), headache (47.7%), loss smell and/or taste (43.2%), sleep disturbances (42.2%). Most had mild disease (COVID‐19) course (84%) comorbidities (71%), which most frequent were psychiatric disorders (34%). Frequency was not age, sex, or severity COVID‐19 course. A workup revealed no abnormalities in clinical electrophysiological imaging assessments majority ( n = 143, 91.7%). Neuropsychological assessment subgroup 28, 17.9%) showed that impairments executive functions attention, anxiety, depression, somatization highly common. Conclusions In this systematic registry, we identified fatigue, impairment, as frequently persisting Structural findings rare. We also suspect link between growing burden pandemic on personal lives increase complaints.

Language: Английский

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Measuring objective fatigability and autonomic dysfunction in clinical populations: How and why?

Frontiers in Sports and Active Living, Journal Year: 2023, Volume and Issue: 5

Published: March 30, 2023

Fatigue is a major symptom in many diseases, often among the most common and severe ones may last for an extremely long period. Chronic fatigue impacts quality of life, reduces capacity to perform activities daily living, has socioeconomical consequences such as impairing return work. Despite high prevalence deleterious fatigue, little known about its etiology. Numerous causes have been proposed explain chronic fatigue. They encompass psychosocial behavioral aspects (e.g., sleep disorders) biological inflammation), hematological anemia) well physiological origins. Among potential role altered acute resistance, i.e. increased fatigability given exercise, that related physical deconditioning. For instance, we others recently evidenced relationships between objective fatigability, defined abnormal deterioration functional (maximal force or power), provided appropriately measured. Indeed, studies field measured during single-joint, isometric exercises. While those are valuable from fundamental science point view, they do not allow test patients ecological situations when purpose search link with As complementary measure evaluation neuromuscular function (i.e., fatigability), studying dysfunction autonomic nervous system (ANS) also great interest context The challenge evaluating ANS (i.e.,. how?) will be discussed first part present article. New tools developed muscle presented. In second paper, discuss measuring (i.e. why?). beneficial effects activity attenuating demonstrated, better etiology personalize training intervention. We believe this key order account complex, multifactorial nature

Language: Английский

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Understanding Fatigue

Published: Jan. 1, 2025

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Effect of Post-COVID-19 on Brain Volume and Glucose Metabolism: Influence of Time Since Infection and Fatigue Status

Brain Sciences, Journal Year: 2023, Volume and Issue: 13(4), P. 675 - 675

Published: April 18, 2023

Post-COVID-19 syndrome (PCS) fatigue is typically most severe <6 months post-infection. Combining magnetic resonance imaging (MRI) and positron emission tomography (PET) with the glucose analog [18F]-Fluorodeoxyglucose (FDG) provides a comprehensive overview of effects PCS on regional brain volumes metabolism, respectively. The primary purpose this exploratory study was to investigate differences in MRI/PET outcomes between people < 6 (N = 18, 11 female) > 15, after COVID-19. secondary assess if any were associated symptoms. Subjects showed smaller putamen, pallidum, thalamus compared subjects months. In months, fatigued had frontal areas non-fatigued subjects. Moreover, worse several results revealed no metabolism However, both groups exhibited hypo- hypermetabolism normative database. These suggest that may alter but not particularly those experiencing

Language: Английский

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The challenges of post-COVID-19 fatigue research

Frontiers in Psychology, Journal Year: 2023, Volume and Issue: 14

Published: March 27, 2023

OPINION article Front. Psychol., 27 March 2023Sec. Psychology for Clinical Settings Volume 14 - 2023 | https://doi.org/10.3389/fpsyg.2023.1120928

Language: Английский

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Decoding Post-Viral Fatigue: The Basal Ganglia’s Complex Role in Long-COVID

Neurology International, Journal Year: 2024, Volume and Issue: 16(2), P. 380 - 393

Published: March 28, 2024

Long-COVID afflicts millions with relentless fatigue, disrupting daily life. The objective of this narrative review is to synthesize current evidence on the role basal ganglia in long-COVID discuss potential mechanisms, and highlight promising therapeutic interventions. A comprehensive literature search was conducted using PubMed, Scopus, Web Science databases. Mounting from PET, MRI, functional connectivity data reveals disturbances exhaustion, including inflammation, metabolic disruption, volume changes, network alterations focused striatal dopamine circuitry regulating motivation. Theories suggest inflammation-induced signaling could impede effort/reward valuation, disrupt cortical–subcortical motivational pathways, or diminish excitatory input arousal centers, attenuating drive initiation. Recent pilots targeting abnormalities show provisional efficacy. However, heterogeneous outcomes, inconsistent metrics, perceived versus fatigue discrepancies temper insights. Despite growing research, gaps remain understanding precise pathways linking dysfunction validating treatment Further research needed advance ganglia’s contribution neurological sequelae offer hope for improving function across expanding affected population.

Language: Английский

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Amantadine and/or transcranial magnetic stimulation for fatigue associated with multiple sclerosis (FETEM): study protocol for a phase 3 randomised, double-blind, cross-over, controlled clinical trial

BMJ Open, Journal Year: 2024, Volume and Issue: 14(1), P. e078661 - e078661

Published: Jan. 1, 2024

Introduction Fatigue is one of the most disabling symptoms multiple sclerosis (MS), and effective treatments are lacking. Amantadine used treatments, although its efficacy under debate. Transcranial magnetic stimulation (TMS) a promising intervention that has shown positive effects in some preliminary investigations. We aim to investigate effect 6 weeks amantadine and/or TMS fatigue due MS. Methods analysis The study national, multicentre, phase 3, randomised, double-blind, cross-over, placebo-controlled sham-controlled clinical trial. Adult patients with relapsing-remitting MS, Expanded Disability Status Scale score 1.5–4.5 Severity Score>4 eligible for Participants will be randomised sequences study. Each sequence consists four periods treatment three washout 12–18 weeks. All receive all combinations therapies. primary outcome Modified Impact Scale. secondary outcomes Symbol Digit Modalities Test (cognition), Beck Depression Inventory-II (depressive symptoms) Short-Survey 12 (quality life). Safety cost-effectiveness also evaluated. An exploratory substudy including MRI blood biomarkers conducted. Ethics dissemination approved by Committee Hospital Clinico San Carlos Spanish Agency Medications Medical Devices. findings published scientific peer-reviewed journals presented at relevant conferences. Trial registration number EudraCT 2021-004868-95; NCT05809414 .

Language: Английский

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Somatosensory processing in long COVID fatigue and its relations with physiological and psychological factors

Experimental Physiology, Journal Year: 2024, Volume and Issue: 109(10), P. 1637 - 1649

Published: Aug. 6, 2024

Fatigue is prevalent amongst people with long COVID, but poorly understood. The sensory attenuation framework proposes that impairments in processing lead to heightened perception of effort, driving fatigue. This study aims investigate the role somatosensory COVID fatigue and quantify how relates other prominent symptoms including autonomic dysfunction, mood illness beliefs experience We will recruit 44 individuals neither nor (controls). Our primary objective compare baseline between controls. Additionally, we explore associations processing, fatigability level induced by cognitive physical exertion. Due complex nature fatigue, also state perceived mood, beliefs, nervous system function interact predict trait comprehensive investigation elucidate impact

Language: Английский

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