Long COVID: major findings, mechanisms and recommendations

Nature Reviews Microbiology, Journal Year: 2023, Volume and Issue: 21(3), P. 133 - 146

Published: Jan. 13, 2023

Language: Английский

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The neurobiology of long COVID

Neuron, Journal Year: 2022, Volume and Issue: 110(21), P. 3484 - 3496

Published: Oct. 7, 2022

Persistent neurological and neuropsychiatric symptoms affect a substantial fraction of people after COVID-19 represent major component the post-acute syndrome, also known as long COVID. Here, we review what is understood about pathobiology impact on CNS discuss possible neurobiological underpinnings cognitive affecting survivors. We propose chief mechanisms that may contribute to this emerging health crisis.

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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Proteomics of fibrin amyloid microclots in long COVID/post-acute sequelae of COVID-19 (PASC) shows many entrapped pro-inflammatory molecules that may also contribute to a failed fibrinolytic system

Cardiovascular Diabetology, Journal Year: 2022, Volume and Issue: 21(1)

Published: Sept. 21, 2022

Post-acute sequelae of COVID-19 (PASC), also now known as long COVID, has become a major global health and economic burden. Previously, we provided evidence that there is significant insoluble fibrin amyloid microclot load in the circulation individuals with these microclots entrap substantial number inflammatory molecules, including those might prevent clot breakdown. Scientifically, most challenging aspect this debilitating condition traditional pathology tests such serum CRP (C-reactive protein) may not show any abnormal markers, albeit measure only soluble molecules. Elevated, or biomarkers IL-6, D-Dimer fibrinogen indicate an increased risk for thrombosis host immune response COVID-19. The absence standard tests, result amount confusion patients clinicians, are extremely sick even bed-ridden but no regular identifiable reason their disease. Biomarkers currently available cannot detect molecules present identified therefore unable to confirm presence mechanisms drive formation.

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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Why we need a deeper understanding of the pathophysiology of long COVID

The Lancet Infectious Diseases, Journal Year: 2023, Volume and Issue: 23(4), P. 393 - 395

Published: Feb. 15, 2023

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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Long COVID: a review and proposed visualization of the complexity of long COVID

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

Published: April 20, 2023

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2) infection, or Long COVID, is a prevailing second pandemic with nearly 100 million affected individuals globally and counting. We propose visual description the complexity COVID its pathogenesis that can be used by researchers, clinicians, public health officials to guide global effort toward an improved understanding eventual mechanism-based provision care afflicted patients. The proposed visualization framework for should evidence-based, dynamic, modular, systems-level approach condition. Furthermore, further research such could establish strength relationships between pre-existing conditions (or risk factors), biological mechanisms, resulting clinical phenotypes outcomes COVID. Notwithstanding significant contribution disparities in access social determinants have on disease course long our model focuses primarily mechanisms. Accordingly, sets out scientific, clinical, efforts better understand abrogate burden imposed

Language: Английский

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

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

Published: July 25, 2023

Language: Английский

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Therapeutic trials for long COVID-19: A call to action from the interventions taskforce of the RECOVER initiative

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

Published: March 9, 2023

Although most individuals recover from acute SARS-CoV-2 infection, a significant number continue to suffer Post-Acute Sequelae of (PASC), including the unexplained symptoms that are frequently referred as long COVID, which could last for weeks, months, or even years after phase illness. The National Institutes Health is currently funding large multi-center research programs part its Researching COVID Enhance Recover (RECOVER) initiative understand why some do not fully COVID-19. Several ongoing pathobiology studies have provided clues potential mechanisms contributing this condition. These include persistence antigen and/or genetic material, immune dysregulation, reactivation other latent viral infections, microvascular dysfunction, and gut dysbiosis, among others. our understanding causes remains incomplete, these early pathophysiologic suggest biological pathways be targeted in therapeutic trials aim ameliorate symptoms. Repurposed medicines novel therapeutics deserve formal testing clinical trial settings prior adoption. While we endorse trials, especially those prioritize inclusion diverse populations affected by COVID-19 discourage off-label experimentation uncontrolled unsupervised settings. Here, review ongoing, planned, future interventions based on current pathobiological processes underlying We focus clinical, pharmacological, feasibility data, with goal informing interventional studies.

Language: Английский

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