Post-COVID syndrome: Current challenge in the work of the general practitioner DOI Creative Commons
Irena Pušica,

Ana Lončar

Opsta medicina, Journal Year: 2024, Volume and Issue: 30(3-4), P. 67 - 85

Published: Jan. 1, 2024

Introduction. Post-COVID syndrome is characterized by a wide range of clinical symptoms that persist for more than three months after the initial SARS-CoV-2 infection. Objective. Our objective was to confirm and explore long-term effects post-COVID syndrome, prevalence individual symptoms, factors may influence their occurrence. Method. In our study, we conducted cross-sectional analysis on patients who had previously been infected with SARS-CoV-2. Participants were requested complete questionnaire during latter part 2023. The data examined using descriptive statistics, Kruskal-Wallis test, Bonferroni test multiple pair comparisons SPSS 26. A p-value <0.05 considered statistically significant. Results. Out total 90 participants, 15.6% did not experience symptoms. However, 24.4% experienced persisted longer six months. most common reported rapid fatigue (60%), chronic (53.3%), difficulty concentrating (45.6%). There significant difference in occurrence tachycardia, sweating, constipation among different age groups (p<0.05). Additionally, presence cough, chest pain, constipation, sexual disorders showed differences relation body mass index, Furthermore, nightmares, headaches, anxiety, abdominal diarrhea noticed cigarette smoking status Lastly, comorbidities, there hair loss Conclusion. holistic approach necessary treating patient post-COVID. Therefore, role general practitioner (GP) crucial.

Language: Английский

The Immunopathogenesis of a Cytokine Storm: The Key Mechanisms Underlying Severe COVID-19 DOI Creative Commons

Luka Hiti,

Tijana Markovič,

Mitja Lainščak

et al.

Cytokine & Growth Factor Reviews, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

A cytokine storm is marked by excessive pro-inflammatory release, and has emerged as a key factor in severe COVID-19 cases - making it critical therapeutic target. However, its pathophysiology was poorly understood, which hindered effective treatment. SARS-CoV-2 initially disrupts angiotensin signalling, promoting inflammation through ACE-2 downregulation. Some patients' immune systems then fail to shift from innate adaptive immunity, suppressing interferon responses leading pyroptosis neutrophil activation. This amplifies tissue damage inflammation, creating loop. The result the disruption of Th1/Th2 Th17/Treg balances, lymphocyte exhaustion, extensive blood clotting. Cytokine treatments include glucocorticoids suppress system, monoclonal antibodies neutralize specific cytokines, JAK inhibitors block receptor signalling. most treatment options for mitigating infection remain vaccines preventive measure antiviral drugs early stages infection. article synthesizes insights into dysregulation COVID-19, offering framework better understand storms improve monitoring, biomarker discovery, strategies other conditions involving storms.

Language: Английский

Citations

6
Animal Models for Long COVID: Current Advances, Limitations, and Future Directions DOI
Yu Zhang, Huan Chen, Yumeng Li

et al.

Journal of Medical Virology, Journal Year: 2025, Volume and Issue: 97(2)

Published: Feb. 1, 2025

ABSTRACT Long COVID (LC) represents a chronic, systemic, and often disabling condition that poses significant ongoing threat to public health. Foundational scientific studies are needed unravel the underlying mechanisms, with ultimate goal of developing effective preventative therapeutic strategies. Therefore, there is an urgent demand for animal models can accurately replicate clinical features LC. This review integrates epidemiological data summarize pathological changes in extrapulmonary systems involved Additionally, it critically examines capacity existing models, including nonhuman primates, genetically modified mice, Syrian hamsters, exhibit enduring postinfection symptoms align human manifestations, identifies key areas requiring further development. The objective offer insights will aid development next‐generation thereby accelerating our understanding how acute respiratory viral infections transition into chronic conditions, ensuring preparedness future pandemics.

Language: Английский

Citations

0
Risk of Post-Acute Sequelae of COVID-19 and Oral Antivirals in Adults Aged Over 60 years: A Nationwide Retrospective Cohort Study DOI Creative Commons
Hye Jin Joo, Eunji Kim, Kyungmin Huh

et al.

International Journal of Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown, P. 107850 - 107850

Published: Feb. 1, 2025

To investigate the association between oral antiviral administration and post-acute sequelae of COVID-19 (PASC) risk in Korea. This retrospective cohort study used data from Korea Disease Control Prevention Agency Health Insurance Review Assessment Service. We analyzed patients aged > 60 years January to December 2022. The primary outcome was occurrence 27 PASCs within 30-120 days after diagnosis. hazard ratio calculated using Cox proportional hazards model. Nirmatrelvir/ritonavir significantly reduced cardiovascular diseases, including heart failure cardiomyopathies (aHR, 0.86), cardiac dysrhythmias 0.83), ischemic stroke 0.88). Moreover, it also lowered hospitalization due respiratory diseases chronic obstructive pulmonary disease 0.92) decreased renal disorders dialysis needs 0.57) acute 0.85). Molnupiravir 0.84) other cerebrovascular 0.84). Respiratory conditions by approximately 13-14% 0.87 0.86, respectively). molnupiravir ambulatory were associated with PASC risk; thus, antivirals may mitigate indirect SARS-CoV-2 infection effects.

Language: Английский

Citations

0
Factors affecting the impact of COVID-19 vaccination on post COVID-19 conditions among adults: A systematic literature review DOI Creative Commons
Abby E. Rudolph,

Nadine Al Akoury,

Natalija Bogdanenko

et al.

Human Vaccines & Immunotherapeutics, Journal Year: 2025, Volume and Issue: 21(1)

Published: March 13, 2025

This systematic literature review summarizes the evidence across 56 publications and pre-prints (January 2020–July 2023) with low-risk of bias based on JBI critical appraisal, that report adjusted estimates for relationship between COVID-19 vaccination Post-COVID-19 Condition (PCC) by timing relative to infection or PCC-onset. Comparisons vaccine effectiveness (aVE) against ≥1 PCC (vs. unvaccinated) study characteristics known impact burden VE other endpoints were possible 31 studies where preceded infection. Seventy-seven percent pre-infection aVE statistically significant (range: 7%–95%). Statistically slightly higher mRNA 14%–84%) than non-mRNA vaccines 16%–38%) ranges before during Omicron overlapped. Our findings suggest SARS-CoV-2 reduces risk regardless type, number doses received, definition, predominant variant, severity acute infections included.

Language: Английский

Citations

0
Shifting the Focus in Acute SARS-CoV-2 Management to Include Prevention of Long COVID DOI
Lao‐Tzu Allan‐Blitz, Jeffrey D. Klausner

Clinical Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown

Published: March 26, 2025

Language: Английский

Citations

0
The Omicron Variant Is Associated with a Reduced Risk of the Post COVID-19 Condition and Its Main Phenotypes Compared to the Wild-Type Virus: Results from the EuCARE-POSTCOVID-19 Study DOI Creative Commons
Francesca Bai, Andrea Santoro, Pontus Hedberg

et al.

Viruses, Journal Year: 2024, Volume and Issue: 16(9), P. 1500 - 1500

Published: Sept. 23, 2024

Post COVID-19 condition (PCC) is defined as ongoing symptoms at ≥1 month after acute COVID-19. We investigated the risk of PCC in an international cohort according to viral variants. included 7699 hospitalized patients six centers (January 2020-June 2023); a subset participants with visit over year clinical recovery were analyzed. Variants observed or estimated using Global Data Science Initiative (GISAID) data. Because returning for post may have higher risk, and because variant could be associated probability returning, we used weighted logistic regressions. proportion effect wild-type (WT) virus vs. Omicron on PCC, which was mediated by Intensive Care Unit (ICU) admission, through mediation analysis. In total, 1317 returned COVID median 2.6 (IQR 1.84-3.97) months recovery. WT present 69.6% participants, followed Alpha (14.4%), Delta (8.9%), Gamma (3.9%) strains (3.3%). Among most common manifestations fatigue (51.7%), brain fog (32.7%) respiratory (37.2%). reduced clusters; conversely, variants WT. 42% appeared ICU admission. A infection, suggesting possible reduction burden time. non-negligible seems increased disease severity during disease.

Language: Английский

Citations

1
Inclusion of racial and ethnic groups in clinical trials for COVID-19 and post-acute COVID-19 syndrome: An analysis of studies registered on ClinicalTrials.gov DOI Creative Commons

Aasiya Chaka,

Daniel Pan,

Mohannad Irshad

et al.

Journal of Infection, Journal Year: 2024, Volume and Issue: 89(2), P. 106207 - 106207

Published: June 20, 2024

We read with interest the study by Juan and colleagues, who found in a network systematic review meta-analysis of nine observational studies, that early use oral antiviral drugs could protect against developing post-acute COVID-19 syndrome (PASC).1Jiang J. Li Y. Jiang Q. Qin H. Early risk post covid-19 syndrome: A meta-analysis.Journal Infection. June 2024; (Published online)106190https://doi.org/10.1016/j.jinf.2024.106190Abstract Full Text PDF Scopus (0) Google Scholar The race ethnicity reporting is critical for assessing equity, especially relating to COVID-19, where those from ethnic minority groups suffered disproportionately worse clinical outcomes than majority groups.2Sze S. Pan D. Nevill C.R. et al.Ethnicity COVID-19: meta-analysis.EClinicalMedicine. 2020; 29-30100630https://doi.org/10.1016/j.eclinm.2020.100630Abstract (438) Scholar, 3Irizar P. Kapadia al.Ethnic inequalities infection, hospitalisation, intensive care admission, Death: global over 200 million participants.eClinicalMedicine. 2023; 57101877https://doi.org/10.1016/j.eclinm.2023.101877Abstract PubMed (26) 4Irizar Taylor al.Disproportionate hospitalisation death indigenous peoples: An application Priority Public Health Conditions Analytical Framework.eClinicalMedicine. 68102360https://doi.org/10.1016/j.eclinm.2023.102360Abstract previous UK randomised controlled trials conducted up May 2022 no screened inclusion effectiveness data ethnicity.5Murali M. Gumber L. Jethwa representation trials: Systematic Review meta-analysis.BMC Medicine. 21https://doi.org/10.1186/s12916-023-02809-7Crossref (12) recent vaccine Black adults other racial or minorities were underrepresented, highlighting importance considering these trial inception.6Herieka Babalis Tzala E. Budhathoki Johnson N.A. How inclusive UK-based vaccines? investigating enrolment adult minorities.Trials. 25: 255https://doi.org/10.1186/s13063-024-08054-4Crossref searched ClinicalTrials.gov either (PASC). total 8,940 registered between 1st December 2019 20th April 2023 when we 'COVID-19'. Trials fewer participants excluded as preliminary showed too small determine whether adequately represented. Ten investigators reviewed titles extracted registries. examined documents attached 'Study Details' section registry intended (1) report demographic on ethnicity, (2) consider effect (3) recruit proportions representative their population. If results published 'Results Posted' registry, recorded ethnicity. Race are not equivalent nor concordant there complexities around how they defined research. As per ClinicalTrials.gov, referred 'Black, Asian White' 'Hispanic' 'Non-Hispanic'. 1,289 including 9,927,605 reviewed; 1,230 (95%) studied 59 (5%) PASC across 83 countries. 204 (16%) multinational 213 (17%) USA. Around third (n=407, 32%) had been peer journals. 157 (12%) (Fig. 1a). Of these, 109 (69%) mentioned intention collect 58 (37%) outcomes. Three studies recruiting population, detailed descriptions provided Supplementary 1. 2 shows breakdowns all recruited 3 USA relation proportion group US population based census estimates, results.7United States Census Bureau . U.S QuickFacts: United States. U.S. Department Commerce; n.d. [Accessed 04 Sept 2023]. Available from: https://www.census.gov/quickfacts/fact/table/US/PST045222Google Although absolute number different (only 1% recorded), roughly US. Fig. 1b 117 (9%) reported registry. protocols but did (Supplementary 1). trials, 112 (96%) four part Adaptive Treatment (ACTT) (Table noted ACTT-1, Hispanic Latinx have significantly shorter time recovery Remdesivir compared placebo; both Clinicaltrials.gov within final manuscript.8ClinicalTrials .gov. Trial (ACTT). ID: NCT04280705. National Library Medicine; Accessed 12 Feb 2024 https://clinicaltrials.gov/study/NCT04280705?cond=NCT04280705&rank=1&tab=resultsGoogle 9Beigel J.H. Tomashek K.M. Dodd L.E. al.Remdesivir treatment — report.New England Journal 383: 1813-1826https://doi.org/10.1056/nejmoa2007764Crossref In ACTT-2, 4, received plus another immunomodulatory intervention. consistently three although differences formally assessed statistically.10Kalil A.C. Patterson T.F. Mehta A.K. al.Baricitinib Plus remdesivir hospitalized covid-19.New 2021; 384: 795-807https://doi.org/10.1056/nejmoa2031994Crossref 11Kalil al.Efficacy interferon beta-1a alone hospitalised covid-19: double-blind, randomised, placebo-controlled, phase trial.The Lancet Respiratory 9: 1365-1376https://doi.org/10.1016/s2213-2600(21)00384-2Abstract 12Wolfe versus dexamethasone (ACTT-4): double placebo-controlled 2022; 10: 888-899https://doi.org/10.1016/s2213-2600(22)00088-1Abstract This suggest differing immune responses groups.Table 1Clinical presented (ACCT-1, 2, 4).ACCT-1Time (days)PlaceboRemdesivirAsian12 (9-15)11 (9-15)Black/African-American15 (10-21)10 (7-16)White15 (12-19)9 (8-12)Other24 (15-N/A)9 (6-14)Time Ethnicity (days)Not Hispanic/Latinx15 (13-18)*10 (8-12)*Hispanic/Latinx12.5 (9-22)10.0 (7-14)ACTT-2Time RaceRemdesevir placeboRemdesevir BarcitinibAsian10 (9-13)10 (7-13)Black/African-American6 (5-8)7 (5-8)White7 (6-9)7 (5-8)Other8 (6-11)7 (6-8)Time EthnicityNot Hispanic/Latinx9 (7-10)7 (6-8)Hispanic/Latinx7 (6-8)ACCT-3Time (days)Remdesivir placeboRemdesivir beta-1aAsian8 (6-12)8 (6-9)Black/African-American4 (4-5)4 (4-5)White5 (4-5)Other5 (4-6)6 (5-7)Time Hispanic/Latinx5 (4-5)5 (4-5)Hispanic/Latinx5 (N/A)6 (5-7)ACCT-4Proportion meeting criteria death, invasive mechanical ventilation ECMO 30 days BaricitinibRemdesivir DexamethasoneAsian0.76 (0.58-0.87)0.88 (0.71-0.95)Black/African-American0.91 (0.83-0.96)0.86 (0.77-0.92)White0.87 (0.82-0.90)0.88 (0.83-0.91)Other0.87 (0.78-0.93)0.89 (0.80-0.94)Proportion Hispanic/Latinx0.87 (0.82-0.90)0.87 (0.83-0.91)Hispanic/Latinx0.88 (0.82-0.92)0.87 (0.81-0.92)Significant highlighted *. Open table new tab Significant Our has some limitations. searches only database many updated results. Nevertheless, updating best practice. summary, globally considered design publication By 2023, after height pandemic, (0.3% 3% outcomes) which unacceptable given well documented disparities COVID-19.2Sze Furthermore, acute (not SARS-CoV-2 prophylaxis, PASC), significant Hispanic/Latinx non-Hispanic/Latinx groups, potential overall treatment. recommend prospective include manner inception publication. Additionally, journals should strongly relevant. authors declare conflicts interest. Download .docx (.02 MB) Help docx files material

Language: Английский

Citations

0
In adults with postacute sequelae of COVID-19, nirmatrelvir–ritonavir did not improve symptoms at 10 wk DOI
Dennis G. Maki

Annals of Internal Medicine, Journal Year: 2024, Volume and Issue: 177(10), P. JC118 - JC118

Published: Sept. 30, 2024

Geng LN, Bonilla H, Hedlin et al.

Language: Английский

Citations

0
Factors affecting the impact of COVID-19 vaccination on post COVID-19 conditions among adults: A Systematic Literature Review DOI
Abby E. Rudolph,

Nadine Al Akoury,

Natalija Bogdanenko

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 4, 2024

Abstract Importance Existing systematic literature reviews (SLRs) on COVID-19 vaccine effectiveness (VE) against post-COVID-19 conditions (PCC) document high heterogeneity across studies, but have not compared VE design features known to impact PCC burden or other endpoints. Objective This SLR summarizes the evidence studies among predominately adults that report an adjusted measure of association for relationship between vaccination and PCC, by timing relative infection PCC-onset different study characteristics. Evidence review A comprehensive search strategy was developed within OVID platform EMBASE, MEDLINE® Evidence-Based Medicine reviews, supplemented with WHO COVID library Google Scholar® searches, collate published posted as pre-prints January 1 st , 2020 July 18 th 2023. JBI Critical Appraisal Checklists were used assess each study’s risk bias. Findings included 97 synthesized results from 56 low bias reported measures PCC. Overall, 77% pre-infection (aVE) estimates (vs. unvaccinated) statistically significant (range: 7%–95%), 80% reflecting a mix those vaccinated before after 62%–73%), one five onset (aVE=41%), 43% post-infection (two protective [range: 28%–40%] [aVE=-47%]), 46% specifying (23 29%–75%] [aVE=-132%]). Statistically aVE slightly higher mRNA 14%–84%) than non-mRNA vaccines 16%–38%) ranges during (4 studies; range: 10%–70%) Omicron predominance (10 7%–50%) overlapped. Pre-infection regardless type, number doses received, definition, predominant variant, severity acute infections included. Conclusions Relevance Collectively our findings suggest received prior SARS-CoV-2 reduces subsequent developing variant circulating. Key points Question Do vary onset, type disease severity? appeared reduce unvaccinated). Compared types, seemed offer greater protection, dose response observed vaccines. Meaning Despite reduced ≥1 proportion sample hospitalized, definition.

Language: Английский

Citations

0
Post-COVID syndrome: Current challenge in the work of the general practitioner DOI Creative Commons
Irena Pušica,

Ana Lončar

Opsta medicina, Journal Year: 2024, Volume and Issue: 30(3-4), P. 67 - 85

Published: Jan. 1, 2024

Introduction. Post-COVID syndrome is characterized by a wide range of clinical symptoms that persist for more than three months after the initial SARS-CoV-2 infection. Objective. Our objective was to confirm and explore long-term effects post-COVID syndrome, prevalence individual symptoms, factors may influence their occurrence. Method. In our study, we conducted cross-sectional analysis on patients who had previously been infected with SARS-CoV-2. Participants were requested complete questionnaire during latter part 2023. The data examined using descriptive statistics, Kruskal-Wallis test, Bonferroni test multiple pair comparisons SPSS 26. A p-value <0.05 considered statistically significant. Results. Out total 90 participants, 15.6% did not experience symptoms. However, 24.4% experienced persisted longer six months. most common reported rapid fatigue (60%), chronic (53.3%), difficulty concentrating (45.6%). There significant difference in occurrence tachycardia, sweating, constipation among different age groups (p<0.05). Additionally, presence cough, chest pain, constipation, sexual disorders showed differences relation body mass index, Furthermore, nightmares, headaches, anxiety, abdominal diarrhea noticed cigarette smoking status Lastly, comorbidities, there hair loss Conclusion. holistic approach necessary treating patient post-COVID. Therefore, role general practitioner (GP) crucial.

Language: Английский

Citations

0