Post-acute COVID-19 syndrome

Nature Medicine, Journal Year: 2021, Volume and Issue: 27(4), P. 601 - 615

Published: March 22, 2021

Language: Английский

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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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Risk factors for severe and critically ill COVID‐19 patients: A review

Allergy, Journal Year: 2020, Volume and Issue: 76(2), P. 428 - 455

Published: Nov. 13, 2020

The pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome 2 (SARS-CoV-2), has an unprecedented global social and economic impact, high numbers deaths. Many risk factors have been identified in progression COVID-19 into a critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver kidney tumors, clinically apparent immunodeficiencies, local early type I interferon secretion capacity, pregnancy. Possible complications include injury, coagulation disorders, thoromboembolism. development lymphopenia eosinopenia are laboratory indicators COVID-19. Laboratory parameters to monitor lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, proinflammatory cytokines interleukin (IL)-6, IL-1β, Krebs von den Lungen-6 (KL-6), ferritin. cytokine storm extensive chest computed tomography imaging patterns disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day initiation treatment, quality health care reported influence individual outcomes. this review, we highlight scientific evidence on severity

Language: Английский

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The signal pathways and treatment of cytokine storm in COVID-19

Signal Transduction and Targeted Therapy, Journal Year: 2021, Volume and Issue: 6(1)

Published: July 7, 2021

Abstract The Coronavirus Disease 2019 (COVID-19) pandemic has become a global crisis and is more devastating than any other previous infectious disease. It affected significant proportion of the population both physically mentally, destroyed businesses societies. Current evidence suggested that immunopathology may be responsible for COVID-19 pathogenesis, including lymphopenia, neutrophilia, dysregulation monocytes macrophages, reduced or delayed type I interferon (IFN-I) response, antibody-dependent enhancement, especially, cytokine storm (CS). CS characterized by hyperproduction an array pro-inflammatory cytokines closely associated with poor prognosis. These excessively secreted initiate different inflammatory signaling pathways via their receptors on immune tissue cells, resulting in complicated medical symptoms fever, capillary leak syndrome, disseminated intravascular coagulation, acute respiratory distress multiorgan failure, ultimately leading to death most severe cases. Therefore, it clinically important understand initiation develop effective treatment strategies COVID-19. Herein, we discuss latest developments immunopathological characteristics focus current research status involved. We also induction, function, downstream signaling, existing potential interventions targeting these related signal pathways. believe comprehensive understanding will help better effectively control this disease diseases.

Language: Английский

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Umbilical cord mesenchymal stem cells for COVID-19 acute respiratory distress syndrome: A double-blind, phase 1/2a, randomized controlled trial

Stem Cells Translational Medicine, Journal Year: 2021, Volume and Issue: 10(5), P. 660 - 673

Published: Jan. 5, 2021

Acute respiratory distress syndrome (ARDS) in COVID-19 is associated with high mortality. Mesenchymal stem cells are known to exert immunomodulatory and anti-inflammatory effects could yield beneficial ARDS. The objective of this study was determine safety explore efficacy umbilical cord mesenchymal cell (UC-MSC) infusions subjects A double-blind, phase 1/2a, randomized, controlled trial performed. Randomization stratification by ARDS severity used foster balance among groups. All were analyzed under intention treat design. Twenty-four randomized 1:1 either UC-MSC treatment (n = 12) or the control group 12). Subjects received two intravenous (at day 0 3) 100 ± 20 × 10

Language: Английский

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Systemic and organ-specific immune-related manifestations of COVID-19

Nature Reviews Rheumatology, Journal Year: 2021, Volume and Issue: 17(6), P. 315 - 332

Published: April 26, 2021

Immune-related manifestations are increasingly recognized conditions in patients with COVID-19, around 3,000 cases reported worldwide comprising more than 70 different systemic and organ-specific disorders. Although the inflammation caused by SARS-CoV-2 infection is predominantly centred on respiratory system, some can develop an abnormal inflammatory reaction involving extrapulmonary tissues. The signs symptoms associated this excessive immune response very diverse resemble autoimmune or diseases, clinical phenotype that seemingly influenced epidemiological factors such as age, sex ethnicity. severity of also varied, ranging from benign self-limiting features to life-threatening syndromes. Little known about pathogenesis these manifestations, tend emerge within first 2 weeks infection, whereas others appear a late post-infectious stage even asymptomatic patients. As body evidence comprises case series uncontrolled studies, diagnostic therapeutic decision-making unsurprisingly often based scarcely experience expert opinion. Additional studies required learn mechanisms involved development apply knowledge achieve early diagnosis most suitable therapy.

Language: Английский

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Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity

Nutrients, Journal Year: 2020, Volume and Issue: 12(11), P. 3361 - 3361

Published: Oct. 31, 2020

Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin are features severe COVID disease. Of these, only is modifiable. Through its interactions a multitude cells, may have several ways to reduce risk acute respiratory tract infections COVID-19: reducing survival replication viruses, inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin concentrations inversely correlated incidence or severity The date generally satisfies Hill’s criteria for causality biological system, namely, strength association, consistency, temporality, gradient, plausibility (e.g., mechanisms), coherence, although experimental verification lacking. Thus, seems strong enough people physicians can use recommend supplements prevent treat COVID-19 light their safety wide therapeutic window. In view public health policy, however, results large-scale randomized controlled trials required currently progress.

Language: Английский

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Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19

Frontiers in Immunology, Journal Year: 2021, Volume and Issue: 12

Published: June 30, 2021

More than one year since its emergence, corona virus disease 2019 (COVID-19) is still looming large with a paucity of treatment options. To add to this burden, sizeable subset patients who have recovered from acute COVID-19 infection reported lingering symptoms, leading significant disability and impairment their daily life activities. These are considered suffer what has been termed as “chronic” or “long” form post-acute sequelae COVID-19, experiencing syndrome long-haulers. Despite recovery infection, the persistence atypical chronic including extreme fatigue, shortness breath, joint pains, brain fogs, anxiety depression, that could last for months implies an underlying pathology persist beyond presentation disease. As opposed direct effects itself, immune response severe respiratory coronavirus 2 (SARS-CoV-2) believed be largely responsible appearance these lasting possibly through facilitating ongoing inflammatory process. In review, we hypothesize potential immunological mechanisms persistent prolonged effects, describe multi-organ long-term manifestations COVID-19.

Language: Английский

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Tissue-Specific Immunopathology in Fatal COVID-19

American Journal of Respiratory and Critical Care Medicine, Journal Year: 2020, Volume and Issue: 203(2), P. 192 - 201

Published: Nov. 20, 2020

In life-threatening coronavirus disease (COVID-19), corticosteroids reduce mortality, suggesting that immune responses have a causal role in death. Whether this deleterious inflammation is primarily direct reaction to the presence of severe acute respiratory syndrome 2 (SARS-CoV-2) or an independent immunopathologic process unknown.

Language: Английский

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Management of hospitalised adults with coronavirus disease 2019 (COVID-19): a European Respiratory Society living guideline

European Respiratory Journal, Journal Year: 2021, Volume and Issue: 57(4), P. 2100048 - 2100048

Published: March 10, 2021

Hospitalised patients with coronavirus disease 2019 (COVID-19) as a result of SARS-CoV-2 infection have high mortality rate and frequently require noninvasive respiratory support or invasive ventilation. Optimising standardising management through evidence-based guidelines may improve quality care therefore patient outcomes.A task force from the European Respiratory Society endorsed by Chinese Thoracic identified priority interventions (pharmacological non-pharmacological) for initial version this "living guideline" using PICO (population, intervention, comparator, outcome) format. The GRADE approach was used assessing evidence strength recommendations. Systematic literature reviews were performed, data pooled meta-analysis where possible. Evidence tables presented to decision frameworks formulate recommendations.Based on available at time guideline development (20 February, 2021), panel makes strong recommendation in favour use systemic corticosteroids requiring supplementary oxygen ventilatory support, anticoagulation hospitalised patients. conditional interleukin (IL)-6 receptor antagonist monoclonal antibody treatment high-flow nasal continuous positive airway pressure hypoxaemic failure. make recommendations against hydroxychloroquine lopinavir-ritonavir. Conditional are made azithromycin, combined colchicine, remdesivir, latter case specifically mechanical No remdesivir supplemental oxygen. Further research made.The base COVID-19 now supports specific interventions. These will be regularly updated further becomes available.

Language: Английский

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