Long covid—mechanisms, risk factors, and management

BMJ, Journal Year: 2021, Volume and Issue: unknown, P. n1648 - n1648

Published: July 26, 2021

Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives health of people around globe. As 4 July 2021, more than 183 million confirmed cases been recorded worldwide, 3.97 deaths. Recent evidence shown that range persistent symptoms can remain long after acute SARS-CoV-2 infection, this condition is now coined covid by recognized research institutes. Studies have affect whole spectrum with covid-19, from those very mild disease to most severe forms. Like involve multiple organs many systems including, but not limited to, respiratory, cardiovascular, neurological, gastrointestinal, musculoskeletal systems. The include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, post-traumatic stress disorder, muscle pain, concentration problems, headache. This review summarizes studies term effects hospitalized non-hospitalized patients describes they endure. Risk factors for possible therapeutic options are also discussed.

Language: Английский

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Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Infectious Diseases, Journal Year: 2021, Volume and Issue: 53(10), P. 737 - 754

Published: May 22, 2021

Long COVID or post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific medical communities. This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity, even younger adults, children, those not hospitalized. While the precise definition long may be lacking, most common symptoms reported many studies are fatigue dyspnoea that last for months after acute COVID-19. Other persistent include cognitive mental impairments, chest joint pains, palpitations, myalgia, smell taste dysfunctions, cough, headache, gastrointestinal cardiac issues. Presently, there limited literature discussing possible pathophysiology, risk factors, treatments COVID, which current review aims to address. In brief, driven by long-term tissue damage (e.g. lung, brain, heart) pathological inflammation from viral persistence, immune dysregulation, autoimmunity). The associated factors female sex, more than five early symptoms, dyspnoea, prior psychiatric disorders, specific biomarkers D-dimer, CRP, lymphocyte count), although research required substantiate such factors. preliminary evidence suggests personalized rehabilitation training help certain cases, therapeutic drugs repurposed other similar conditions, myalgic encephalomyelitis chronic syndrome, postural orthostatic tachycardia mast cell activation also hold potential. sum, this hopes provide understanding what known about COVID.

Language: Английский

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Global Prevalence of Post-Coronavirus Disease 2019 (COVID-19) Condition or Long COVID: A Meta-Analysis and Systematic Review

The Journal of Infectious Diseases, Journal Year: 2022, Volume and Issue: 226(9), P. 1593 - 1607

Published: April 14, 2022

Abstract Background This study aims to examine the worldwide prevalence of post-coronavirus disease 2019 (COVID-19) condition, through a systematic review and meta-analysis. Methods PubMed, Embase, iSearch were searched on July 5, 2021 with verification extending March 13, 2022. Using random-effects framework DerSimonian-Laird estimator, we meta-analyzed post-COVID-19 condition at 28+ days from infection. Results Fifty studies included, 41 meta-analyzed. Global estimated pooled was 0.43 (95% confidence interval [CI], .39–.46). Hospitalized nonhospitalized patients had estimates 0.54 CI, .44–.63) 0.34 .25–.46), respectively. Regional Asia (0.51; 95% .37–.65), Europe (0.44; .32–.56), United States America (0.31; .21–.43). for 30, 60, 90, 120 after infection be 0.37 .26–.49), 0.25 .15–.38), 0.32 .14–.57), 0.49 .40–.59), Fatigue most common symptom reported 0.23 .17–.30), followed by memory problems (0.14; .10–.19). Conclusions finds is substantial; health effects COVID-19 seem prolonged can exert stress healthcare system.

Language: Английский

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Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19

PLoS Medicine, Journal Year: 2021, Volume and Issue: 18(9), P. e1003773 - e1003773

Published: Sept. 28, 2021

Background Long-COVID refers to a variety of symptoms affecting different organs reported by people following Coronavirus Disease 2019 (COVID-19) infection. To date, there have been no robust estimates the incidence and co-occurrence long-COVID features, their relationship age, sex, or severity infection, extent which they are specific COVID-19. The aim this study is address these issues. Methods findings We conducted retrospective cohort based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. within 6 months in 3 after diagnosis were calculated for 9 core features (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other cognitive anxiety/depression). Their network was also analyzed. Comparison with propensity score–matched diagnosed influenza during same time period achieved using Kaplan–Meier analysis Cox proportional hazard model. atopic dermatitis used as negative control. Among survivors (mean [SD] age: 46.3 [19.8], 55.6% female), 57.00% had one more feature recorded whole 6-month (i.e., acute phase), 36.55% between months. each was: abnormal breathing (18.71% 1- 180-day period; 7.94% 90- to180-day period), fatigue/malaise (12.82%; 5.87%), pain (12.60%; 5.71%), headache (8.67%; 4.63%), (11.60%; 7.19%), (15.58%; 8.29%), myalgia (3.24%; 1.54%), (7.88%; 3.95%), anxiety/depression (22.82%; 15.49%). All frequently than (with an overall excess 16.60% ratios 1.44 2.04, all p < 0.001), co-occurred commonly, formed interconnected network. Significant differences associated illness severity. Besides limitations inherent EHR data, include that (i) do not generalize who but diagnosed, nor seek receive medical attention when experiencing long-COVID; (ii) say nothing about persistence clinical features; (iii) difference cohorts might be affected seeking receiving symptoms. Conclusions occurred showed some specificity COVID-19, though observed influenza. Different profiles demographics

Language: Английский

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Symptoms and risk factors for long COVID in non-hospitalized adults

Nature Medicine, Journal Year: 2022, Volume and Issue: 28(8), P. 1706 - 1714

Published: July 25, 2022

Abstract Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook retrospective matched cohort study using UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine that are confirmed SARS-CoV-2 beyond 12 weeks in non-hospitalized adults and the risk factors developing symptoms. selected 486,149 1,944,580 propensity score-matched no recorded evidence infection. Outcomes included 115 individual symptoms, well COVID, defined composite outcome 33 by World Health Organization clinical case definition. Cox proportional hazards models were used estimate adjusted hazard ratios (aHRs) for outcomes. A total 62 significantly after weeks. The largest aHRs anosmia (aHR 6.49, 95% CI 5.02–8.39), hair loss (3.99, 3.63–4.39), sneezing (2.77, 1.40–5.50), ejaculation difficulty (2.63, 1.61–4.28) reduced libido (2.36, 1.61–3.47). Among patients infected SARS-CoV-2, COVID female sex, belonging an ethnic minority, socioeconomic deprivation, smoking, obesity wide comorbidities. was also found be increased along gradient decreasing age. plethora sociodemographic factors.

Language: Английский

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Characterising long COVID: a living systematic review

BMJ Global Health, Journal Year: 2021, Volume and Issue: 6(9), P. e005427 - e005427

Published: Sept. 1, 2021

While it is now apparent clinical sequelae (long COVID) may persist after acute COVID-19, their nature, frequency and aetiology are poorly characterised. This study aims to regularly synthesise evidence on long COVID characteristics, help inform management, rehabilitation strategies interventional studies improve long-term outcomes.A living systematic review. Medline, CINAHL (EBSCO), Global Health (Ovid), WHO Research COVID-19 database, LitCovid Google Scholar were searched till 17 March 2021. Studies including at least 100 people with confirmed or clinically suspected 12 weeks more post onset included. Risk of bias was assessed using the tool produced by Hoy et al. Results analysed descriptive statistics meta-analyses estimate prevalence.A total 39 included: 32 cohort, 6 cross-sectional 1 case-control. Most showed high moderate risk bias. None set in low-income countries few included children. reported 10 951 (48% female) countries. previously hospitalised (78%, 8520/10 951). The longest mean follow-up time 221.7 (SD: 10.9) days onset. Over 60 physical psychological signs symptoms wide prevalence reported, most commonly weakness (41%; 95% CI 25% 59%), general malaise (33%; 15% 57%), fatigue (31%; 24% 39%), concentration impairment (26%; 21% 32%) breathlessness (25%; 18% 34%). 37% (95% 60%) patients reduced quality life; 26% (10/39) presented pulmonary function.Long a complex condition prolonged heterogeneous symptoms. nature precludes precise case definition evaluation. There an urgent need for prospective, robust, standardised, controlled into aetiology, factors biomarkers characterise different at-risk populations settings.CRD42020211131.

Language: Английский

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Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection

Nature Immunology, Journal Year: 2022, Volume and Issue: 23(2), P. 210 - 216

Published: Jan. 13, 2022

Language: Английский

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Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021

JAMA, Journal Year: 2022, Volume and Issue: 328(16), P. 1604 - 1604

Published: Oct. 10, 2022

Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID).To estimate the proportion of males and females with COVID-19, younger or older than 20 years age, who had COVID in 2020 2021 their symptom duration.Bayesian meta-regression pooling 54 studies 2 medical record databases data for 1.2 million (from 22 countries) infection. Of studies, 44 were published 10 collaborating cohorts (conducted Austria, Faroe Islands, Germany, Iran, Italy, Netherlands, Russia, Sweden, Switzerland, US). The participant derived from (10 501 hospitalized 42 891 nonhospitalized individuals), cohort 526 1906), US electronic (250 928 846 046). Data collection spanned March January 2022.Symptomatic infection.Proportion at least 1 3 self-reported clusters (persistent fatigue bodily pain mood swings; cognitive problems; ongoing respiratory problems) months 2021, estimated separately aged by sex both sexes age.A total included (mean 4-66 years; males, 26%-88%). In modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) experienced including 3.2% UI, 0.6%-10.0%) swings, 3.7% 0.9%-9.6%) problems, 2.2% 0.3%-7.6%) problems adjusting health status before comprising an 51.0% 16.9%-92.4%), 60.4% 18.9%-89.1%), 35.4% 9.4%-75.1%), respectively, cases. more common women (10.6% [95% 4.3%-22.2%]) men (5.4% 2.2%-11.7%]). Both age be affected 2.8% 0.9%-7.0%) infections. mean cluster duration was 9.0 7.0-12.0 months) among 4.0 3.6-4.6 individuals. Among infection, 15.1% 10.3%-21.1%) continued 12 months.This study presents estimates

Language: Английский

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Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis

Journal of the Neurological Sciences, Journal Year: 2022, Volume and Issue: 434, P. 120162 - 120162

Published: Jan. 28, 2022

Language: Английский

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The Lancet Commission on lessons for the future from the COVID-19 pandemic

The Lancet, Journal Year: 2022, Volume and Issue: 400(10359), P. 1224 - 1280

Published: Sept. 14, 2022

Language: Английский

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