Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

eLife, Journal Year: 2023, Volume and Issue: 12

Published: March 22, 2023

COVID-19, with persistent and new onset of symptoms such as fatigue, post-exertional malaise, cognitive dysfunction that last for months impact everyday functioning, is referred to Long COVID under the general category post-acute sequelae SARS-CoV-2 infection (PASC). PASC highly heterogenous may be associated multisystem tissue damage/dysfunction including acute encephalitis, cardiopulmonary syndromes, fibrosis, hepatobiliary damages, gastrointestinal dysregulation, myocardial infarction, neuromuscular neuropsychiatric disorders, pulmonary damage, renal failure, stroke, vascular endothelial dysregulation. A better understanding pathophysiologic mechanisms underlying essential guide prevention treatment. This review addresses potential hypotheses connect long-term health consequences. Comparisons between other virus-initiated chronic syndromes myalgic encephalomyelitis/chronic fatigue syndrome postural orthostatic tachycardia will addressed. Aligning identifying potentially regulated common underlining pathways necessary true nature PASC. The discussed contributors include from injury one or more organs, reservoirs replicating virus its remnants in several tissues, re-activation latent pathogens Epstein-Barr herpes viruses COVID-19 immune-dysregulated environment, interactions host microbiome/virome communities, clotting/coagulation dysfunctional brainstem/vagus nerve signaling, dysautonomia autonomic dysfunction, ongoing activity primed immune cells, autoimmunity due molecular mimicry pathogen proteins. individualized suggests different therapeutic approaches required best manage specific patients.

Language: Английский

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COVID-19 and its long-term sequelae: what do we know in 2023?

Polskie Archiwum Medycyny Wewnętrznej, Journal Year: 2023, Volume and Issue: unknown

Published: Jan. 9, 2023

Post‑viral syndrome is a well‑known medical condition characterized by different levels of physical, cognitive, and emotional impairment that may persist with fluctuating severity after recovering from an acute viral infection. Unsurprisingly, COVID‑19 also be accompanied medium- long‑term clinical sequelae SARS‑CoV‑2 Although many definitions have been provided, "long‑COVID" can defined as occurring in patients history infection, developing 3 months the symptoms onset, persisting for at least 2 months, not explained alternative diagnoses. According to recent global analyses, cumulative prevalence long‑COVID seems range between 9% 63%, up 6‑fold higher than similar postviral infection conditions. Long‑COVID primarily encompasses presence 1 symptom, such fatigue, dyspnea, cognitive / brain fog, postexertional malaise, memory issues, musculoskeletal pain spasms, cough, sleep disturbances, tachycardia palpitations, altered smell taste perception, headache, chest pain, depression. The most important demographic predictors date are female sex, older age, cigarette smoking, pre‑existing conditions, lack vaccination, pre‑Omicron variants, number phase symptoms, load, severe critical illness, well invasive mechanical ventilation. Concerning care patients, greatest challenge fact this cannot considered single entity, thus it needs integrated multidisciplinary management, specifically tailored type symptoms.

Language: Английский

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Long COVID prevalence and impact on quality of life 2 years after acute COVID-19

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

Published: July 11, 2023

There has been an increasing interest in the long-term impact of long COVID. However, only a few studies have investigated clinical manifestations COVID after 24 months acute infection. In this study, prospective online surveys were conducted adults previously diagnosed with coronavirus disease 2019 (COVID-19) South Korea between February 13 and March 13, 2020, at 6, 12, COVID-19. We self-reported symptoms EuroQol-5-dimension index. Among 900 individuals enrolled initially, 150 completed all 3 surveys. After excluding cases COVID-19 reinfection, 132 included final analysis. participants, 94 (71.2%) experienced The most frequently reported fatigue (34.8%), amnesia (30.3%), concentration difficulties (24.2%), insomnia (20.5%), depression (19.7%). Notably, no significant differences noted incidence terms number vaccinations received. Although neuropsychiatric quality life improved over time, it continued to affect 32.7% participants. Symptoms COVID, particularly symptoms, tend persist vaccination or received may not significantly

Language: Английский

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Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study

Clinical Infectious Diseases, Journal Year: 2023, Volume and Issue: 77(2), P. 194 - 202

Published: March 11, 2023

Disentangling the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and vaccination on occurrence post-acute sequelae SARS-CoV-2 (PASC) is crucial to estimate reduce burden PASC.We performed a cross-sectional analysis (May/June 2022) within prospective multicenter healthcare worker (HCW) cohort in north-eastern Switzerland. HCWs were stratified by viral variant status at time their first positive nasopharyngeal swab. without swab with negative serology served as controls. The sum 18 self-reported PASC symptoms was modeled univariable multivariable negative-binomial regression analyze association mean symptom number status.Among 2912 participants (median age: 44 years; 81.3% female), significantly more frequent after wild-type infection (estimated number: 1.12; P < .001; median since infection: 18.3 months), Alpha/Delta (0.67 symptoms; 6.5 Omicron BA.1 infections (0.52 = .005; 3.1 months) versus uninfected controls (0.39 symptoms). After infection, estimated 0.36 for unvaccinated individuals 0.71 1-2 vaccinations (P .028) 0.49 ≥3 prior .30). Adjusting confounders, only (adjusted rate ratio [aRR]: 2.81; 95% confidence interval [CI]: 2.08-3.83) (aRR: 1.93; CI: 1.10-3.46) associated outcome.Previous pre-Omicron strongest risk factor among our HCWs. Vaccination before not clear protective effect against this population.

Language: Английский

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Tissue-based T cell activation and viral RNA persist for up to 2 years after SARS-CoV-2 infection

Science Translational Medicine, Journal Year: 2024, Volume and Issue: 16(754)

Published: July 3, 2024

The mechanisms of postacute medical conditions and unexplained symptoms after SARS-CoV-2 infection [Long Covid (LC)] are incompletely understood. There is growing evidence that viral persistence, immune dysregulation, T cell dysfunction may play major roles. We performed whole-body positron emission tomography imaging in a well-characterized cohort 24 participants at time points ranging from 27 to 910 days acute using the radiopharmaceutical agent [

Language: Английский

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Mechanisms of long COVID and the path toward therapeutics

Cell, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 1, 2024

Language: Английский

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Characteristics of long COVID and the impact of COVID-19 vaccination on long COVID 2 years following COVID-19 infection: prospective cohort study

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 9, 2024

Abstract This prospective cohort study aimed to identify characteristics of long COVID and any potential mitigating effects COVID-19 vaccinations in patients 24 months following infection. Adult diagnosed with between February 17, 2020, March 24, were scheduled visit the hospital four times (6, 12, 18, after infection) assess their symptoms, quality life, mental health. Among 235 patients, 121 (51.5%) completed visits. Of these, 59.5% female, a median age 52 years. Mild moderate disease severity identified 101 (83.4%) patients. A total 75 participants (62.0%) still experiencing symptoms acute Fatigue, amnesia, difficulty concentrating, insomnia most common symptoms. The frequency neuropsychiatric did not differ based on vaccination status or number doses received. Quality life improved over time for participants, but 32.2% respondents reported anxiety/depression at end study. Overall, our demonstrates that can persist up infection, affecting health life.

Language: Английский

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Multimodal Molecular Imaging Reveals Tissue-Based T Cell Activation and Viral RNA Persistence for Up to 2 Years Following COVID-19

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: July 31, 2023

ABSTRACT The etiologic mechanisms of post-acute medical morbidities and unexplained symptoms (Long COVID) following SARS-CoV-2 infection are incompletely understood. There is growing evidence that viral persistence immune dysregulation may play a major role. We performed whole-body positron emission tomography (PET) imaging in cohort 24 participants at time points ranging from 27 to 910 days acute using novel radiopharmaceutical agent, [ 18 F]F-AraG, highly selective tracer allows for anatomical quantitation activated T lymphocytes. Tracer uptake the COVID group, which included those with without Long symptoms, was significantly higher compared pre-pandemic controls many regions, including brain stem, spinal cord, bone marrow, nasopharyngeal hilar lymphoid tissue, cardiopulmonary tissues, gut wall. Although cell activation tended be imaged closer illness, increased up 2.5 years infection. observed cord wall associated presence symptoms. In addition, lung tissue persistent pulmonary Notably, these tissues also individuals COVID. Given high F]F-AraG detected gut, we obtained colorectal situ hybridization RNA immunohistochemical studies subset identified cellular rectosigmoid lamina propria all participants, 158 676 initial COVID-19 suggesting could long-term immunological perturbations.

Language: Английский

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Long COVID-19 Pathophysiology: What Do We Know So Far?

Microorganisms, Journal Year: 2023, Volume and Issue: 11(10), P. 2458 - 2458

Published: Sept. 30, 2023

Long COVID-19 is a recognized entity that affects millions of people worldwide. Its broad clinical symptoms include thrombotic events, brain fog, myocarditis, shortness breath, fatigue, muscle pains, and others. Due to the binding virus with ACE-2 receptors, expressed in many organs, it can potentially affect any system; however, most often cardiovascular, central nervous, respiratory, immune systems. Age, high body mass index, female sex, previous hospitalization, smoking are some its risk factors. Despite great efforts define pathophysiology, gaps remain be explained. The main mechanisms described literature involve viral persistence, hypercoagulopathy, dysregulation, autoimmunity, hyperinflammation, or combination these. exact may differ from system system, but share same pathways. This review aims describe prevalent pathophysiological pathways explaining this syndrome.

Language: Английский

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Long COVID in the United States

PLoS ONE, Journal Year: 2023, Volume and Issue: 18(11), P. e0292672 - e0292672

Published: Nov. 2, 2023

Although yet to be clearly identified as a clinical condition, there is immense concern at the health and wellbeing consequences of long COVID. Using data collected from nearly half million Americans in period June 2022-December 2022 US Census Bureau's Household Pulse Survey (HPS), we find 14 percent reported suffering COVID some point, whom it time survey. Its incidence varies markedly across United States-from 11 Hawaii 18 West Virginia-and higher for women than men, among Whites compared with Blacks Asians, declines rising education income. It its highest midlife same way negative affect. Ever having had strongly associated affect (anxiety, depression, worry lack interest things), correlation being strongest those who currently report COVID, especially if they severe symptoms. In contrast, short never Long also physical mobility problems, problems dressing bathing. mental indicated by recall understanding difficulties. Again, associations are while said have fewer Vaccination lower affect, including

Language: Английский

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