Neurological post‐acute sequelae of SARS‐CoV‐2 infection DOI Creative Commons
Masaki Takao, Masayuki Ohira

Psychiatry and Clinical Neurosciences, Journal Year: 2022, Volume and Issue: 77(2), P. 72 - 83

Published: Sept. 23, 2022

The novel coronavirus disease 19 (COVID‐19), caused by severe acute respiratory syndrome 2 (SARS‐CoV‐2), can have two phases: (generally 4 weeks after onset) and chronic (>4 onset). Both phases include a wide variety of signs symptoms including neurological psychiatric symptoms. that are considered sequelae COVID‐19 termed post‐COVID condition, long COVID‐19, post‐acute SARS‐CoV‐2 infection (PASC). PASC fatigue, dyspnea, palpitation, dysosmia, subfever, hypertension, alopecia, sleep problems, loss concentration, amnesia, numbness, pain, gastrointestinal symptoms, depression, anxiety. Because the specific pathophysiology has not yet been clarified, there no definite criteria hence World Health Organization's definition is quite broad. Consequently, it difficult to correctly diagnose PASC. Approximately 50% patients may show at least one symptom up 12 months infection; however, exact prevalence determined. Despite extensive research in progress worldwide, currently clear diagnostic methodologies or treatments for In this review, we discuss available information on highlight infection. Furthermore, provide clinical suggestions diagnosing caring with based our outpatient clinic experience.

Language: Английский

ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature DOI Creative Commons
Anthony L. Komaroff, W. Ian Lipkin

Frontiers in Medicine, Journal Year: 2023, Volume and Issue: 10

Published: June 2, 2023

Some patients remain unwell for months after "recovering" from acute COVID-19. They develop persistent fatigue, cognitive problems, headaches, disrupted sleep, myalgias and arthralgias, post-exertional malaise, orthostatic intolerance other symptoms that greatly interfere with their ability to function can leave some people housebound disabled. The illness (Long COVID) is similar myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well persisting illnesses follow a wide variety of infectious agents following major traumatic injury. Together, these are projected cost the U.S. trillions dollars. In this review, we first compare ME/CFS Long COVID, noting considerable similarities few differences. We then in extensive detail underlying pathophysiology two conditions, focusing on abnormalities central autonomic nervous system, lungs, heart, vasculature, immune gut microbiome, energy metabolism redox balance. This comparison highlights how strong evidence each abnormality, illness, helps set priorities future investigation. review provides current road map literature biology both illnesses.

Language: Английский

Citations

183
Long COVID: mechanisms, risk factors and recovery DOI Creative Commons
Rónan Astin, Amitava Banerjee, Mark R. Baker

et al.

Experimental Physiology, Journal Year: 2022, Volume and Issue: 108(1), P. 12 - 27

Published: Nov. 22, 2022

Abstract Long COVID, the prolonged illness and fatigue suffered by a small proportion of those infected with SARS‐CoV‐2, is placing an increasing burden on individuals society. A Physiological Society virtual meeting in February 2022 brought clinicians researchers together to discuss current understanding long COVID mechanisms, risk factors recovery. This review highlights themes arising from that meeting. It considers nature exploring its links other post‐viral illnesses such as myalgic encephalomyelitis/chronic syndrome, how research can help us better support suffering all syndromes. started particularly swiftly populations routinely monitoring their physical performance – namely military elite athletes. The high degree diagnosis, intervention success these active suggest management strategies for wider population. We then consider key component populations, cardiopulmonary exercise training, has revealed COVID‐related changes physiology including alterations peripheral muscle function, ventilatory inefficiency autonomic dysfunction. impact dysautonomia are further discussed relation postural orthostatic tachycardia treatment aim combat sympathetic overactivation stimulating vagus nerve. interrogate mechanisms underlie symptoms, focus impaired oxygen delivery due micro‐clotting disruption cellular energy metabolism, before considering indirectly or directly tackle mechanisms. These include remote inspiratory training integrated care pathways combine rehabilitation drug interventions into healthcare access across different populations. Overall, this showcases physiological reveals occur therapeutic being developed tested condition.

Language: Английский

Citations

172
Long COVID and the cardiovascular system—elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies: a joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial and Pericardial Diseases DOI Creative Commons
Mariann Gyöngyösi, Pilar Alcaide, Folkert W. Asselbergs

et al.

Cardiovascular Research, Journal Year: 2022, Volume and Issue: 119(2), P. 336 - 356

Published: July 25, 2022

Abstract Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available cardiovascular manifestations of long COVID. In addition chronic fatigue, which is common symptom COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, newly developed supraventricular ventricular arrhythmias. Imaging heart vessels provided evidence chronic, post-infectious perimyocarditis consequent left right failure, arterial wall inflammation, microthrombosis in certain patient populations. Better understanding underlying cellular molecular mechanisms will aid development effective treatment strategies its manifestations. A number have been proposed, including those involving direct effects on myocardium, microthrombotic damage endothelium, persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, inflammatory markers, are not highly predictive either presence outcome when measured 3 infection. Further studies needed understand mechanisms, identify specific guide future preventive treatments address sequelae.

Language: Английский

Citations

127
Post-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know? DOI Creative Commons
Giandomenico Bisaccia, Fabrizio Ricci,

Vittoria Recce

et al.

Journal of Cardiovascular Development and Disease, Journal Year: 2021, Volume and Issue: 8(11), P. 156 - 156

Published: Nov. 15, 2021

Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID syndrome, is emerging as a major health issue in patients with previous infection. Symptoms commonly experienced by include fatigue, palpitations, chest pain, dyspnea, reduced exercise tolerance, and "brain fog". Additionally, symptoms orthostatic intolerance syncope suggest the involvement autonomic nervous system. Signs cardiovascular dysfunction appear to be common PASC are similar those observed postural tachycardia syndrome inappropriate sinus tachycardia. In this review, we report on epidemiology PASC, discuss current evidence possible mechanisms underpinning dysregulation system, nonpharmacological pharmacological interventions treat relieve PASC-associated dysautonomia.

Language: Английский

Citations

111
Psychiatric and neurological complications of long COVID DOI Creative Commons
Jolanta B. Zawilska, K Kuçzyńska

Journal of Psychiatric Research, Journal Year: 2022, Volume and Issue: 156, P. 349 - 360

Published: Oct. 20, 2022

Language: Английский

Citations

109
A review of cytokine-based pathophysiology of Long COVID symptoms DOI Creative Commons

Russell N. Low,

Ryan Low, Athena Akrami

et al.

Frontiers in Medicine, Journal Year: 2023, Volume and Issue: 10

Published: March 31, 2023

The Long COVID/Post Acute Sequelae of COVID-19 (PASC) group includes patients with initial mild-to-moderate symptoms during the acute phase illness, in whom recovery is prolonged, or new are developed over months. Here, we propose a description pathophysiology COVID presentation based on inflammatory cytokine cascades and p38 MAP kinase signaling pathways that regulate production. In this model, SARS-CoV-2 viral infection hypothesized to trigger dysregulated peripheral immune system activation subsequent release. Chronic low-grade inflammation leads brain microglia an exaggerated release central cytokines, producing neuroinflammation. Immunothrombosis linked chronic microclot formation decreased tissue perfusion ischemia. Intermittent fatigue, Post Exertional Malaise (PEM), CNS "brain fog," arthralgias, paresthesias, dysautonomia, GI ophthalmic problems can consequently arise as result elevated cytokines. There abundant similarities between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). DNA polymorphisms viral-induced epigenetic changes gene expression may lead patients, predisposing some develop autoimmunity, which be gateway ME/CFS.

Language: Английский

Citations

103
Cerebral hypoperfusion in post-COVID-19 cognitively impaired subjects revealed by arterial spin labeling MRI DOI Creative Commons
Miloš Ajčević,

Katerina Iscra,

Giovanni Furlanis

et al.

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: April 10, 2023

Cognitive impairment is one of the most prevalent symptoms post Severe Acute Respiratory Syndrome COronaVirus 2 (SARS-CoV-2) state, which known as Long COVID. Advanced neuroimaging techniques may contribute to a better understanding pathophysiological brain changes and underlying mechanisms in post-COVID-19 subjects. We aimed at investigating regional cerebral perfusion alterations subjects who reported subjective cognitive after mild SARS-CoV-2 infection, using non-invasive Arterial Spin Labeling (ASL) MRI technique analysis. Using MRI-ASL image processing, we investigated 24 patients (53.0 ± 14.5 years, 15F/9M) with persistent complaints COVID-19 period. Voxelwise region-of-interest analyses were performed identify statistically significant differences blood flow (CBF) maps between patients, age sex matched healthy controls (54.8 9.1 13F/9M). The results showed hypoperfusion widespread network group, predominantly affecting frontal cortex, well parietal temporal identified by non-parametric permutation testing (p < 0.05, FWE-corrected TFCE). areas right hemisphere regions more extensive. These findings support hypothesis large dysfunction post-COVID complaints. nature ASL-MRI method play an important role monitoring prognosis

Language: Английский

Citations

62
Post-COVID dysautonomias: what we know and (mainly) what we don’t know DOI
David S. Goldstein

Nature Reviews Neurology, Journal Year: 2024, Volume and Issue: 20(2), P. 99 - 113

Published: Jan. 11, 2024

Language: Английский

Citations

20
Post-acute sequela of COVID-19 infection in individuals with multiple sclerosis DOI Creative Commons
Amber Salter, Samantha Lancia, Gary Cutter

et al.

Multiple Sclerosis Journal, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 3, 2025

Background: Many common symptoms in post-acute sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) overlap with those of multiple sclerosis (MS). We examined and performance the PASC score, developed general population, MS based on history. Methods: surveyed North American Research Committee Multiple Sclerosis (NARCOMS) registry participants regarding infections categorized Symptoms experienced before, during, after were used to identify persistent new symptoms. was defined as a score ⩾ 12 National Institutes Health (NIH) study RECOVER. Results: Of 4787 surveyed, 2927 included: 294 (10%) having recent COVID-19; 853 (29.1%) non-COVID-19 infection; 246 (8.4%) COVID-19 1534 (52.4%) uninfected, never nor any within past 6 months. Compared groups reported at least two-fold increase fever, cough, loss smell/taste, shortness breath. Based symptoms, identified only 1.5% COVID-19. Conclusion: Our suggests lower than expected prevalence complex association between development infections. The similar proportions classified across shows that are complicate assessment MS.

Language: Английский

Citations

2
Long COVID-19 and Postural Orthostatic Tachycardia Syndrome- Is Dysautonomia to Be Blamed? DOI Creative Commons
Karan R. Chadda,

Ellen E. Blakey,

Christopher Huang

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2022, Volume and Issue: 9

Published: March 9, 2022

While the increased arrhythmic tendency during acute COVID-19 infection is recognised, long-term cardiac electrophysiological complications are less well known. There a high number of patients reporting ongoing symptoms post-infection, termed long COVID. A recent hypothesis that COVID could be attributed to dysautonomia, defined as malfunction autonomic nervous system (ANS). The most prevalent cardiovascular dysautonomia amongst young people postural orthostatic tachycardia syndrome (POTS). Numerous reports have described development POTS part Possible underlying mechanisms, although not mutually exclusive or exhaustive, include hypovolaemia, neurotropism, inflammation and autoimmunity. Treatment options for other currently limited. Future research studies should aim elucidate mechanisms enable targeted therapies. Furthermore, it important educate healthcare professionals recognise conditions arising from COVID-19, such POTS, allow prompt diagnosis access early treatment.

Language: Английский

Citations

70