Role of Endothelium in Cardiovascular Sequelae of Long COVID DOI Creative Commons
L. Santoro, Vincenzo Zaccone, Lorenzo Falsetti

et al.

Biomedicines, Journal Year: 2023, Volume and Issue: 11(8), P. 2239 - 2239

Published: Aug. 9, 2023

The global action against coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 infection, shed light on endothelial dysfunction. Although primarily affects the pulmonary system, multiple studies have documented pan-vascular involvement in COVID-19. virus is able to penetrate barrier, damaging it directly or indirectly and causing endotheliitis multi-organ injury. Several mechanisms cooperate development of dysfunction, including cell injury pyroptosis, hyperinflammation cytokine storm syndrome, oxidative stress reduced nitric oxide bioavailability, glycocalyx disruption, hypercoagulability, thrombosis. After acute-phase some patients reported signs symptoms a systemic disorder known as long COVID, which broad range cardiovascular (CV) disorders emerged. To date, exact pathophysiology COVID remains unclear: addition persistence infection mechanisms, specific pathways CV damage been postulated, such persistent viral reservoirs heart an autoimmune response cardiac antigens through molecular mimicry. aim this review provide overview main patterns enduring activation following offer latest summary complications COVID.

Language: Английский

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC) DOI Creative Commons
Zaki A. Sherif, Christian R. Gómez, Thomas J. Connors

et al.

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

Citations

152
Long COVID: pathophysiological factors and abnormalities of coagulation DOI Creative Commons
Simone Turner, Asad Khan, David Putrino

et al.

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

Citations

148
COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): Similarities and differences DOI Creative Commons
Felix Scholkmann,

Christian-Albrecht May

Pathology - Research and Practice, Journal Year: 2023, Volume and Issue: 246, P. 154497 - 154497

Published: May 3, 2023

Worldwide there have been over 760 million confirmed coronavirus disease 2019 (COVID-19) cases, and 13 billion COVID-19 vaccine doses administered as of April 2023, according to the World Health Organization. An infection with severe acute respiratory syndrome 2 (SARS-CoV-2) can lead an disease, i.e. COVID-19, but also a post-acute (PACS, "long COVID"). Currently, side effects vaccines are increasingly being noted studied. Here, we summarise currently available indications discuss our conclusions that (i) these specific similarities differences PACS, (ii) new term should be used refer (post-COVID-19 vaccination syndrome, PCVS, colloquially "post-COVIDvac-syndrome"), (iii) is need distinguish between (ACVS) (PACVS) - in analogy PACS ("long Moreover, address mixed forms caused by natural SARS-CoV-2 vaccination. We explain why it important for medical diagnosis, care research use terms (PCVS, ACVS PACVS) order avoid confusion misinterpretation underlying causes enable optimal therapy. do not recommend "Post-Vac-Syndrome" imprecise. The article serves current problem "medical gaslighting" relation PCVS raising awareness among professionals supplying appropriate terminology disease.

Language: Английский

Citations

87
Inflammatory and vascular biomarkers in post‐COVID‐19 syndrome: A systematic review and meta‐analysis of over 20 biomarkers DOI
Shin Jie Yong, Alice Halim, Michael Halim

et al.

Reviews in Medical Virology, Journal Year: 2023, Volume and Issue: 33(2)

Published: Jan. 27, 2023

Abstract Severe acute respiratory syndrome coronavirus 2 may inflict a post‐viral condition known as post‐COVID‐19 (PCS) or long‐COVID. Studies measuring levels of inflammatory and vascular biomarkers in blood, serum, plasma COVID‐19 survivors with PCS versus non‐PCS controls have produced mixed findings. Our review sought to meta‐analyse those studies. A systematic literature search was performed across five databases until 25 June 2022, an updated on 1 November 2022. Data analyses were Review Manager R Studio statistical software. Twenty‐four from 23 studies meta‐analysed. Higher C‐reactive protein (Standardized mean difference (SMD) = 0.20; 95% CI: 0.02–0.39), D‐dimer (SMD 0.27; 0.09–0.46), lactate dehydrogenase 0.30; 0.05–0.54), leukocytes 0.34; 0.02–0.66) found than without PCS. After sensitivity analyses, lymphocytes 0.12–0.48) interleukin‐6 0.12–0.49) also significantly higher cases. No significant differences noted the remaining investigated (e.g., ferritin, platelets, troponin, fibrinogen). Subgroup suggested biomarker changes mainly driven by cases diagnosed via manifestation organ abnormalities rather symptomatic persistence, well duration <6 ≥6 months. In conclusion, our pinpointed certain associated PCS, which shed light potential new approaches understanding, diagnosing, treating

Language: Английский

Citations

82
Epidemiology, clinical presentation, pathophysiology, and management of long COVID: an update DOI

Sizhen Su,

Yi‐Miao Zhao, Na Zeng

et al.

Molecular Psychiatry, Journal Year: 2023, Volume and Issue: 28(10), P. 4056 - 4069

Published: July 25, 2023

Language: Английский

Citations

62
Thromboinflammation in long COVID—the elusive key to postinfection sequelae? DOI Creative Commons
Leo Nicolai, Rainer Kaiser, Konstantin Stark

et al.

Journal of Thrombosis and Haemostasis, Journal Year: 2023, Volume and Issue: 21(8), P. 2020 - 2031

Published: May 11, 2023

Language: Английский

Citations

52
Mechanisms of long COVID and the path toward therapeutics DOI Creative Commons

Michael J. Peluso,

Steven G. Deeks

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

Published: Sept. 1, 2024

Language: Английский

Citations

33
The knowns and unknowns of long COVID-19: from mechanisms to therapeutical approaches DOI Creative Commons
Roxana Gheorghiţă, Iuliana Șoldănescu, Andrei Lobiuc

et al.

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: March 4, 2024

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been defined as the greatest global health and socioeconomic crisis of modern times. While most people recover after being infected with virus, a significant proportion them continue to experience issues weeks, months even years acute infection SARS-CoV-2. This persistence clinical symptoms in individuals for at least three onset or emergence new lasting more than two months, without any other explanation alternative diagnosis have named long COVID, long-haul post-COVID-19 conditions, chronic post-acute sequelae (PASC). Long COVID characterized constellation disorders that vary widely their manifestations. Further, mechanisms underlying are not fully understood, which hamper efficient treatment options. review describes predictors common related COVID's effects on central peripheral nervous system organs tissues. Furthermore, transcriptional markers, molecular signaling pathways risk factors such sex, age, pre-existing condition, hospitalization during phase COVID-19, vaccination, lifestyle presented. Finally, recommendations patient rehabilitation management, well therapeutical approaches discussed. Understanding complexity this disease, its across multiple organ systems overlapping pathologies possible paramount developing diagnostic tools treatments.

Language: Английский

Citations

23
Mechanisms of endothelial activation, hypercoagulation and thrombosis in COVID-19: a link with diabetes mellitus DOI Creative Commons
Inés Valencia, Jairo Lumpuy‐Castillo, Giselle Santos Magalhães

et al.

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Feb. 20, 2024

Abstract Early since the onset of COVID-19 pandemic, medical and scientific community were aware extra respiratory actions SARS-CoV-2 infection. Endothelitis, hypercoagulation, hypofibrinolysis identified in patients as subsequent responses endothelial dysfunction. Activation barrier may increase severity disease contribute to long-COVID syndrome post-COVID sequelae. Besides, it cause alterations primary, secondary, tertiary hemostasis. Importantly, these have been highly decisive evolution infected also diagnosed with diabetes mellitus (DM), who showed previous In this review, we provide an overview potential triggers activation related under diabetic milieu. Several mechanisms are induced by both viral particle itself immune-defensive response (i.e., NF-κB/NLRP3 inflammasome pathway, vasoactive peptides, cytokine storm, NETosis, complement system). Alterations coagulation mediators such factor VIII, fibrin, tissue factor, von Willebrand factor: ADAMST-13 ratio, kallikrein-kinin or plasminogen-plasmin systems reported. Moreover, imbalance thrombotic thrombolytic (tPA, PAI-I, fibrinogen) factors favors hypercoagulation hypofibrinolysis. context DM, can be exacerbated leading higher loss However, a series therapeutic strategies targeting activated endothelium specific antibodies inhibitors against thrombin, key cytokines, X, system, system might represent new opportunities address hypercoagulable state present DM. Antidiabetics ameliorate dysfunction, inflammation, platelet aggregation. By improving microvascular pathology subjects, associated comorbidities risk mortality could reduced.

Language: Английский

Citations

20
Pathophysiological, immunological, and inflammatory features of long COVID DOI Creative Commons
Karen Böhmwald, Benjamín Diethelm‐Varela,

Linmar Rodríguez-Guilarte

et al.

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: Feb. 28, 2024

The COVID-19 pandemic continues to cause severe global disruption, resulting in significant excess mortality, overwhelming healthcare systems, and imposing substantial social economic burdens on nations. While most of the attention therapeutic efforts have concentrated acute phase disease, a notable proportion survivors experience persistent symptoms post-infection clearance. This diverse set symptoms, loosely categorized as long COVID, presents potential additional public health crisis. It is estimated that 1 5 exhibit clinical manifestations consistent with COVID. Despite this prevalence, mechanisms pathophysiology COVID remain poorly understood. Alarmingly, evidence suggests cases within condition develop debilitating or disabling symptoms. Hence, urgent priority should be given further studies equip systems for its management. review provides an overview available information emerging condition, focusing affected individuals’ epidemiology, pathophysiological mechanisms, immunological inflammatory profiles.

Language: Английский

Citations

20