Long COVID: mechanisms, risk factors and recovery

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

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Long COVID: pathophysiological factors and abnormalities of coagulation

Trends in Endocrinology and Metabolism, Journal Year: 2023, Volume and Issue: 34(6), P. 321 - 344

Published: April 19, 2023

Acute COVID-19 infection is followed by prolonged symptoms in approximately one ten cases: known as Long COVID. The disease affects ~65 million individuals worldwide. Many pathophysiological processes appear to underlie COVID, including viral factors (persistence, reactivation, and bacteriophagic action of SARS CoV-2); host (chronic inflammation, metabolic endocrine dysregulation, immune autoimmunity); downstream impacts (tissue damage from the initial infection, tissue hypoxia, dysbiosis, autonomic nervous system dysfunction). These mechanisms culminate long-term persistence disorder characterized a thrombotic endothelialitis, endothelial hyperactivated platelets, fibrinaloid microclots. abnormalities blood vessels coagulation affect every organ represent unifying pathway for various

Language: Английский

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Data-driven identification of post-acute SARS-CoV-2 infection subphenotypes

Nature Medicine, Journal Year: 2022, Volume and Issue: 29(1), P. 226 - 235

Published: Dec. 1, 2022

Abstract The post-acute sequelae of SARS-CoV-2 infection (PASC) refers to a broad spectrum symptoms and signs that are persistent, exacerbated or newly incident in the period after acute infection. Most studies have examined these conditions individually without providing evidence on co-occurring conditions. In this study, we leveraged electronic health record data two large cohorts, INSIGHT OneFlorida+, from national Patient-Centered Clinical Research Network. We created development cohort validation OneFlorida+ including 20,881 13,724 patients, respectively, who were infected, investigated their diagnoses 30–180 days documented Through machine learning analysis over 137 conditions, identified four reproducible PASC subphenotypes, dominated by cardiac renal (including 33.75% 25.43% patients cohorts); respiratory, sleep anxiety (32.75% 38.48%); musculoskeletal nervous system (23.37% 23.35%); digestive respiratory (10.14% 12.74%) sequelae. These subphenotypes associated with distinct patient demographics, underlying before phase severity. Our study provides insights into heterogeneity may inform stratified decision-making management

Language: Английский

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Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations

The Lancet Respiratory Medicine, Journal Year: 2023, Volume and Issue: 11(8), P. 739 - 754

Published: July 17, 2023

Individuals with SARS-CoV-2 infection can develop symptoms that persist well beyond the acute phase of COVID-19 or emerge after phase, lasting for weeks months initial illness. The post-acute sequelae COVID-19, which include physical, cognitive, and mental health impairments, are known collectively as long COVID post-COVID-19 condition. substantial burden this multisystem condition is felt at individual, health-care system, socioeconomic levels, on an unprecedented scale. Survivors COVID-19-related critical illness risk respiratory distress syndrome, sepsis, chronic illness, these multidimensional morbidities might be difficult to differentiate from specific effects COVID-19. We provide overview manifestations in adults. explore various organ systems, describe potential pathophysiological mechanisms, consider challenges providing clinical care support survivors manifestations. Research needed reduce incidence optimise therapeutic rehabilitative patients.

Language: Английский

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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

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

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