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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A review of cytokine-based pathophysiology of Long COVID symptoms

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

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Post-COVID dysautonomias: what we know and (mainly) what we don’t know

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

Published: Jan. 11, 2024

Language: Английский

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Immunosenescence and Cytomegalovirus: Exploring Their Connection in the Context of Aging, Health, and Disease

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(2), P. 753 - 753

Published: Jan. 6, 2024

Aging induces numerous physiological alterations, with immunosenescence emerging as a pivotal factor. This phenomenon has attracted both researchers and clinicians, prompting profound questions about its implications for health disease. Among the contributing factors, one intriguing actor in this complex interplay is human cytomegalovirus (CMV), member of herpesvirus family. Latent CMV infection exerts influence on aging immune system, potentially to age-related diseases. review delves into intricate relationship between CMV, revealing how chronic viral impacts landscape. We explore mechanisms through which can impact composition functionality cell populations induce shifts inflammatory profiles aging. Moreover, we examine potential role pathologies such cardiovascular diseases, cancer, neurodegenerative disorders, COVID-19, Long COVID. underlines importance understanding CMV. It offers insights pathophysiology age-associated well COVID-19 outcomes among elderly. By unraveling connections gain deeper aging’s remarkable journey that infections play transforming system.

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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COVID-19 annual update: a narrative review

Human Genomics, Journal Year: 2023, Volume and Issue: 17(1)

Published: July 24, 2023

Abstract Three and a half years after the pandemic outbreak, now that WHO has formally declared emergency is over, COVID-19 still significant global issue. Here, we focus on recent developments in genetic genomic research COVID-19, give an outlook state-of-the-art therapeutical approaches, as gradually transitioning to endemic situation. The sequencing characterization of rare alleles different populations made it possible identify numerous genes affect either susceptibility or severity disease. These findings provide beginning new avenues pan-ethnic therapeutic well potential screening protocols. causative virus, SARS-CoV-2, spotlight, but novel threatening virus could appear anywhere at any time. Therefore, continued vigilance further warranted. We also note emphatically prevent future pandemics other world-wide health crises, imperative capitalize what have learnt from COVID-19: specifically, regarding its origins, world’s response, insufficient preparedness. This requires unprecedented international collaboration timely data sharing for coordination effective response rapid implementation containment measures.

Language: Английский

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From aging to long COVID: exploring the convergence of immunosenescence, inflammaging, and autoimmunity

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: Oct. 24, 2023

The process of aging is accompanied by a dynamic restructuring the immune response, phenomenon known as immunosenescence. This mini-review navigates through complex landscape age-associated changes, chronic inflammation, age-related autoimmune tendencies, and their potential links with immunopathology Long COVID. Immunosenescence serves an introductory departure point, elucidating alterations in cell profiles functional dynamics, changes T-cell receptor signaling, cytokine network dysregulation, compromised regulatory function. Subsequent scrutiny or “inflammaging,” highlights its roles susceptibilities mediator perturbations observed COVID patients. introduction epigenetic facets further amplifies interconnections. In this compact review, we consider interactions between immunosenescence, autoimmunity. We aim to explore multifaceted relationships that link these processes shed light on underlying mechanisms drive interconnectedness. With focus understanding immunological context aging, seek provide insights into how immunosenescence inflammation contribute emergence progression disorders elderly may serve for disturbances.

Language: Английский

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Aged brain and neuroimmune responses to COVID-19: post-acute sequelae and modulatory effects of behavioral and nutritional interventions

Immunity & Ageing, Journal Year: 2023, Volume and Issue: 20(1)

Published: April 12, 2023

Advanced age is one of the significant risk determinants for coronavirus disease 2019 (COVID-19)-related mortality and long COVID complications. The contributing factors may include age-related dynamical remodeling immune system, known as immunosenescence chronic low-grade systemic inflammation. Both these induce an inflammatory milieu in aged brain drive changes microenvironment neurons microglia, which are characterized by a general condition inflammation, so-called neuroinflammation. Emerging evidence reveals that privilege aging be compromised. Resident cells, such astrocytes, neurons, oligodendrocytes but also infiltrating monocytes, T cells macrophages participate complex intercellular networks multiple reciprocal interactions. Especially microglia playing regulatory role contribute to disturbing homeostasis impairments neuroimmune responses. Neuroinflammation trigger structural damage, diminish regeneration, neuronal cell death, modulate synaptic this manner negatively interfere with functions.In review article, we give insights into interactions highlight impact COVID-19 on functional systems already modulated We discuss potential ways severe acute respiratory syndrome 2 (SARS-CoV-2) proposed mechanisms biological development persisting conditions. summarize responsible COVID, including autoimmunity, direct virus-mediated cytotoxicity, hypercoagulation, mitochondrial failure, dysbiosis, reactivation other viruses, Cytomegalovirus (CMV). Finally, effects various interventional options can decrease propagation biological, physiological, psychosocial stressors activation inhibit triggering unbalanced modulatory bioactive nutritional compounds along multimodal benefits behavioral interventions moderate exercise, applied postinfectious order improve health.

Language: Английский

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Exercise intolerance associated with impaired oxygen extraction in patients with long COVID

Respiratory Physiology & Neurobiology, Journal Year: 2023, Volume and Issue: 313, P. 104062 - 104062

Published: April 17, 2023

Language: Английский

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Developing effective strategies to optimize physical activity and cardiorespiratory fitness in the long Covid population- The need for caution and objective assessment

Progress in Cardiovascular Diseases, Journal Year: 2024, Volume and Issue: 83, P. 62 - 70

Published: March 1, 2024

The Post Covid-19 Condition (commonly known as Long Covid) has been defined by the World Health Organisation occurring in individuals with a history of probable or confirmed SARS CoV 2 infection, usually within 3 months from onset acute infection symptoms that last for at least two which cannot be explained an alternative diagnosis. Covid is associated over hundred recognised and affects tens millions people worldwide. Widely reported reductions quality life(QoL) functional status are caused extremely sensitive cyclical symptom profiles augmented following exposure to physical, emotional, orthostatic, cognitive stimuli. This manifestation prevents engaging routine activities daily living (ADLs) important health well-being, social economic impacts. Post-exertional exacerbation (PESE) (also post-exertional malaise) severity fatigue other orthostatic tasks. Typically, this will occur 24–72 h after "over-exertion" can persist several days even weeks. It hallmark prevalence 86%. debilitating nature PESE patients physical activity impacts QoL. In review, authors present update literature relating make case evidence-based guidelines support design implementation safe rehabilitation approaches Covid. review also considers role objective monitoring quantify patient's response external stimuli used management inform decisions engagement any could prompt symptoms.

Language: Английский

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