Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study

BMJ, Journal Year: 2022, Volume and Issue: unknown, P. e069676 - e069676

Published: May 18, 2022

Abstract Objective To estimate associations between covid-19 vaccination and long covid symptoms in adults with SARS-CoV-2 infection before vaccination. Design Observational cohort study. Setting Community dwelling population, UK. Participants 28 356 participants the Office for National Statistics COVID-19 Infection Survey aged 18-69 years who received at least one dose of an adenovirus vector or mRNA vaccine after testing positive infection. Main outcome measure Presence 12 weeks over follow-up period 3 February to 5 September 2021. Results Mean age was 46 years, 55.6% (n=15 760) were women, 88.7% (n=25 141) white ethnicity. Median 141 days from first (among all participants) 67 second (83.8% participants). 6729 (23.7%) reported any severity once during follow-up. A associated initial 12.8% decrease (95% confidence interval −18.6% −6.6%, P<0.001) odds covid, subsequent data compatible both increases decreases trajectory (0.3% per week, 95% −0.6% 1.2% P=0.51). 8.8% −14.1% −3.1%, P=0.003) a by 0.8% week (−1.2% −0.4% P<0.001). Heterogeneity not found sociodemographic characteristics, health status, hospital admission acute covid-19, type (adenovirus mRNA), duration Conclusions The likelihood observed evidence suggested sustained improvement dose, median days. Vaccination may contribute reduction population burden although longer is needed.

Language: Английский

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Postacute COVID-19 is Characterized by Gut Viral Antigen Persistence in Inflammatory Bowel Diseases

Gastroenterology, Journal Year: 2022, Volume and Issue: 163(2), P. 495 - 506.e8

Published: May 1, 2022

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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Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment

Nature Neuroscience, Journal Year: 2024, Volume and Issue: 27(3), P. 421 - 432

Published: Feb. 22, 2024

Abstract Vascular disruption has been implicated in coronavirus disease 2019 (COVID-19) pathogenesis and may predispose to the neurological sequelae associated with long COVID, yet it is unclear how blood–brain barrier (BBB) function affected these conditions. Here we show that BBB evident during acute infection patients COVID cognitive impairment, commonly referred as brain fog. Using dynamic contrast-enhanced magnetic resonance imaging, COVID-associated Transcriptomic analysis of peripheral blood mononuclear cells revealed dysregulation coagulation system a dampened adaptive immune response individuals Accordingly, showed increased adhesion human endothelial vitro, while exposure serum from induced expression inflammatory markers. Together, our data suggest sustained systemic inflammation persistent localized dysfunction key feature

Language: Английский

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Long COVID: pathophysiological factors and abnormalities of coagulation

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

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Viral persistence, reactivation, and mechanisms of long COVID

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

Published: May 4, 2023

The COVID-19 global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has infected hundreds of millions individuals. Following infection, a subset can develop wide range chronic symptoms affecting diverse organ systems referred to as post-acute sequelae SARS-CoV-2 (PASC), also known long COVID. A National Institutes Health-sponsored initiative, RECOVER: Researching COVID Enhance Recovery, sought understand basis in large cohort. Given that occur COVID, mechanisms may underlie these be diverse. In this review, we focus on emerging literature supporting role(s) viral persistence or reactivation viruses play PASC. Persistence RNA antigens is reported some organs, yet mechanism which they do so and how associated with pathogenic immune responses unclear. Understanding RNA, antigen other reactivated relate specific inflammatory drive PASC provide rationale for treatment.

Language: Английский

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Pathogenesis Underlying Neurological Manifestations of Long COVID Syndrome and Potential Therapeutics

Cells, Journal Year: 2023, Volume and Issue: 12(5), P. 816 - 816

Published: March 6, 2023

The development of long-term symptoms coronavirus disease 2019 (COVID-19) more than four weeks after primary infection, termed "long COVID" or post-acute sequela COVID-19 (PASC), can implicate persistent neurological complications in up to one third patients and present as fatigue, "brain fog", headaches, cognitive impairment, dysautonomia, neuropsychiatric symptoms, anosmia, hypogeusia, peripheral neuropathy. Pathogenic mechanisms these long COVID remain largely unclear; however, several hypotheses both nervous system systemic pathogenic such SARS-CoV2 viral persistence neuroinvasion, abnormal immunological response, autoimmunity, coagulopathies, endotheliopathy. Outside the CNS, SARS-CoV-2 invade support stem cells olfactory epithelium leading alterations function. infection may induce abnormalities innate adaptive immunity including monocyte expansion, T-cell exhaustion, prolonged cytokine release, which cause neuroinflammatory responses microglia activation, white matter abnormalities, microvascular changes. Additionally, clot formation occlude capillaries endotheliopathy, due protease activity complement contribute hypoxic neuronal injury blood-brain barrier dysfunction, respectively. Current therapeutics target pathological by employing antivirals, decreasing inflammation, promoting regeneration. Thus, from laboratory evidence clinical trials literature, we sought synthesize pathophysiological pathways underlying potential therapeutics.

Language: Английский

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Why has the epidemiology of RSV changed during the COVID-19 pandemic?

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 61, P. 102089 - 102089

Published: July 1, 2023

The coronavirus disease 2019 (COVID-19) pandemic has drastically perturbed the epidemiology of Respiratory Syncytial Virus (RSV) respiratory tract infections in children. reasons for this are not clear. In article, we review current literature and critically discuss different theories to explain why RSV changed during COVID-19 pandemic. Proposed mechanisms include decreased viral immunity vulnerable age groups caused by prolonged lack circulation early pandemic, potential Severe Acute Syndrome Corona 2 (SARS-CoV-2)-induced immune dysregulation, interactions between SARS-CoV-2 RSV, modifications health-seeking behaviors as well heath systems factors. Research genomics phylogeny, more robust immunology research is needed guide prevention health care resource planning.

Language: Английский

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Remodeling of T Cell Dynamics During Long COVID Is Dependent on Severity of SARS-CoV-2 Infection

Frontiers in Immunology, Journal Year: 2022, Volume and Issue: 13

Published: June 10, 2022

Several COVID-19 convalescents suffer from the post-acute COVID-syndrome (PACS)/long COVID, with symptoms that include fatigue, dyspnea, pulmonary fibrosis, cognitive dysfunctions or even stroke. Given scale of worldwide infections, long-term recovery and integrative health-care in nearest future, it is critical to understand cellular molecular mechanisms as well possible predictors longitudinal post-COVID-19 responses convalescent individuals. The immune system T cell alterations are proposed drivers COVID syndrome. However, despite number studies on COVID-19, many them addressed only severe short-term responses. Here, we performed mild, moderate COVID-19-convalescent patients, at two time points (3 6 months infection), assess dynamics cells landscape, integrated patients-reported symptoms. We show among subsets exhibit different, severity- time-dependent dynamics, result a polarization towards an exhausted/senescent state CD4+ CD8+ perturbances Tregs. In particular, high proportion CD57+ terminal effector cells, together significant decrease naïve population, augmented granzyme B IFN-γ production unresolved inflammation after infection. Mild showed increased naïve, decreased central memory Treg subsets. Patients all severity groups can be predisposed long symptoms, fatigue not necessarily related dysfunctions, was found convalescents. conclusion, functional remodeling could seen two-step process, leading distinct states Our data imply attenuation blocking might influence post-COVID either search for any treatment prevent PACS further complications mandatory patients SARS-CoV-2 infection, those suffering COVID-19.

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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