The immunology of long COVID

Nature reviews. Immunology, Journal Year: 2023, Volume and Issue: 23(10), P. 618 - 634

Published: July 11, 2023

Language: Английский

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ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

Frontiers in Medicine, Journal Year: 2023, Volume and Issue: 10

Published: June 2, 2023

Some patients remain unwell for months after "recovering" from acute COVID-19. They develop persistent fatigue, cognitive problems, headaches, disrupted sleep, myalgias and arthralgias, post-exertional malaise, orthostatic intolerance other symptoms that greatly interfere with their ability to function can leave some people housebound disabled. The illness (Long COVID) is similar myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well persisting illnesses follow a wide variety of infectious agents following major traumatic injury. Together, these are projected cost the U.S. trillions dollars. In this review, we first compare ME/CFS Long COVID, noting considerable similarities few differences. We then in extensive detail underlying pathophysiology two conditions, focusing on abnormalities central autonomic nervous system, lungs, heart, vasculature, immune gut microbiome, energy metabolism redox balance. This comparison highlights how strong evidence each abnormality, illness, helps set priorities future investigation. review provides current road map literature biology both illnesses.

Language: Английский

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Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long-COVID symptoms

European Respiratory Journal, Journal Year: 2022, Volume and Issue: unknown, P. 2200970 - 2200970

Published: Sept. 22, 2022

Background Autoimmunity has been reported in patients with severe COVID-19. We investigated whether antinuclear/extractable-nuclear antibodies (ANAs) were present up to a year after infection, and if they associated the development of clinically relevant Post-Acute Sequalae COVID-19 (PASC) symptoms. Methods A rapid assessment line immunoassay was used measure circulating levels ANA/ENAs 106 convalescent varying acute phase severities at 3, 6, 12 months post-recovery. Patient-reported fatigue, cough, dyspnea recorded each timepoint. Multivariable logistic regression model receiver-operating curves (ROC) test association autoantibodies patient-reported outcomes pro-inflammatory cytokines. Results Compared age- sex-matched healthy controls (n=22) those who had other respiratory infections (n=34), higher detectable ANAs 3 post-recovery (p<0.001). The mean number ANA autoreactivities per individual decreased from (3.99 1.55) persistent positive titers dyspnea, cough severity. Antibodies U1-snRNP anti-SS-B/La both positively symptoms fatigue (p<0.028, AUC=0.86) (p<0.003, AUC=0.81). Pro-inflammatory cytokines such as tumour necrosis factor alpha (TNFα) C-reactive protein predicted elevated months. TNFα, D-dimer, IL-1β strongest Regression analysis showed TNFα (β=4.65, p=0.004) general symptomaticity (β=2.40, p=0.03) Interpretation Persistently post-COVID are persisting inflammation subset survivors. This finding indicates need for further investigation into role autoimmunity PASC.

Language: Английский

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Efficacy of first dose of covid-19 vaccine versus no vaccination on symptoms of patients with long covid: target trial emulation based on ComPaRe e-cohort

BMJ Medicine, Journal Year: 2023, Volume and Issue: 2(1), P. e000229 - e000229

Published: Feb. 1, 2023

To evaluate the effect of covid-19 vaccination on severity symptoms in patients with long covid. Target trial emulation based ComPaRe e-cohort. covid cohort, a nationwide e-cohort (ie, cohort where recruitment and follow-up are performed online) covid, France. Adult (aged ≥18 years) enrolled before 1 May 2021 were included study if they reported confirmed or suspected SARS-CoV-2 infection, persistent for >3 weeks after onset, at least one symptom attributable to baseline. Patients who received first vaccine injection matched an unvaccinated control group 1:1 ratio according their propensity scores. Number symptoms, rate complete remission proportion reporting unacceptable state 120 days recorded. 910 analyses (455 vaccinated 455 group). By days, had reduced number (mean 13.0 (standard deviation 9.4) v 14.8 (9.8) group; mean difference -1.8, 95% confidence interval -3.0 -0.5) doubled (16.6% 7.5%, hazard 1.93, 1.18 3.14). Vaccination patients' lives score impact tool 24.3 16.7) 27.6 (16.7); -3.3, -5.7 -1.0) (38.9% 46.4%, risk -7.4%, -14.5% -0.3%). In group, two (0.4%) serious adverse events requiring admission hospital. this study, social, professional, family those infection.

Language: Английский

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COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): Similarities and differences

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

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The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID

Signal Transduction and Targeted Therapy, Journal Year: 2023, Volume and Issue: 8(1)

Published: Nov. 1, 2023

Abstract There have been hundreds of millions cases coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome 2 (SARS-CoV-2). With the growing population recovered patients, it crucial to understand long-term consequences and management strategies. Although COVID-19 was initially considered an illness, recent evidence suggests that manifestations including but not limited those cardiovascular, respiratory, neuropsychiatric, gastrointestinal, reproductive, musculoskeletal systems may persist long after phase. These persistent manifestations, also referred as COVID, could impact all patients with across full spectrum illness severity. Herein, we comprehensively review current literature on highlighting its epidemiological understanding, vaccinations, organ-specific sequelae, pathophysiological mechanisms, multidisciplinary In addition, psychological psychosomatic factors underscored. Despite these findings diagnostic therapeutic strategies based previous experience pilot studies remain inadequate, well-designed clinical trials should be prioritized validate existing hypotheses. Thus, propose primary challenges concerning biological knowledge gaps efficient remedies well discuss corresponding recommendations.

Language: Английский

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Long-term symptom severity and clinical biomarkers in post-COVID-19/chronic fatigue syndrome: results from a prospective observational cohort

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 63, P. 102146 - 102146

Published: Aug. 19, 2023

Post-COVID-19 syndrome (PCS) is characterised by a wide range of symptoms, primarily fatigue and exertion intolerance. While disease courses in the early months post-infection have been well-described, long-term health consequences for patients with PCS disabling remain unclear.In this prospective observational cohort study, we evaluated symptom severity various biomarkers, including hand grip strength (HGS), cardiovascular function, laboratory parameters, 106 moderate to severe intolerance at three time points after infection (3-8, 9-16, 17-20 months). The study was conducted Charité's Fatigue Centre outpatient clinic neuroimmunology Berlin, Germany from July 16, 2020, February 18, 2022. A subset (PCS-ME/CFS) met diagnostic criteria myalgic encephalomyelitis/chronic according Canadian Consensus Criteria (CCC). aim determine differences course between two patient groups (i.e., vs PCS-ME/CFS) identify correlating biomarkers.Patients PCS-ME/CFS reported persistently high most symptoms up 20 infection, while showed overall improvement. Although post-exertional malaise (PEM), hallmarks post-infectious syndromes, were still evident both groups, they remained more pronounced PCS-ME/CFS. Inflammatory biomarkers decreased but not antinuclear antibodies. Lower HGS onset correlated persistence, particularly PCS-ME/CFS.Our findings suggest that can persist beyond encompass full scope ME/CFS as defined CCC. Sub-classifying based on CCC assist management monitoring due their higher severity.C. S. supported grant Weidenhammer-Zoebele Foundation. F. K. Volkswagen

Language: Английский

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Long COVID manifests with T cell dysregulation, inflammation, and an uncoordinated adaptive immune response to SARS-CoV-2

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

Published: Feb. 10, 2023

Long COVID (LC), a type of post-acute sequelae SARS-CoV-2 infection (PASC), occurs after at least 10% infections, yet its etiology remains poorly understood. Here, we used multiple "omics" assays (CyTOF, RNAseq/scRNAseq, Olink) and serology to deeply characterize both global SARS-CoV-2-specific immunity from blood individuals with clear LC non-LC clinical trajectories, 8 months following prior receipt any vaccine. Our analysis focused on deep phenotyping T cells, which play important roles in against may also contribute COVID-19 pathogenesis. findings demonstrate that exhibit systemic inflammation immune dysregulation. This is evidenced by differences cell subset distribution ways imply ongoing responses, as well sex-specific perturbations cytolytic subsets. Individuals harbored increased frequencies CD4+ cells poised migrate inflamed tissues, exhausted CD8+ cells. They significantly higher levels antibodies, contrast individuals, exhibited mis-coordination between their B responses. RNAseq/scRNAseq Olink analyses similarly revealed dysregulatory mechanisms, along non-immune associated perturbations, LC. Collectively, our data suggest proper crosstalk the humoral cellular arms adaptive has broken down LC, this, perhaps context persistent virus, leads dysregulation, inflammation, symptoms this debilitating condition.

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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