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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Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: A population-based, nested case-control study

PLoS Medicine, Journal Year: 2025, Volume and Issue: 22(1), P. e1004511 - e1004511

Published: Jan. 23, 2025

Background Self-reported health problems following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are common and often include relatively non-specific complaints such as fatigue, exertional dyspnoea, concentration or memory disturbance sleep problems. The long-term prognosis of post-acute sequelae COVID-19/post-COVID-19 (PCS) is unknown, data finding correlating organ dysfunction pathology with self-reported symptoms in patients non-recovery from PCS scarce. We wanted to describe clinical characteristics diagnostic findings among persisting for >1 year assessed risk factors persistence versus improvement. Methods This nested population-based case-control study included subjects aged 18–65 years ( n = 982) age- sex-matched control without 576) according an earlier questionnaire (6–12 months after infection, phase 1) consenting provide follow-up information undergo comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, laboratory testing four university centres southwestern Germany (phase 2, another 8.5 [median, range 3–14 months] 1). mean age the participants was 48 years, 65% were female. At 67.6% at 1 developed persistent PCS, whereas 78.5% recovered remained free related PCS. Improvement associated mild index previous full-time employment, educational status, no specialist consultation not attending a rehabilitation programme. development new initially intercurrent secondary SARS-CoV-2 status. Patients less frequently never smokers (61.2% 75.7%), more obese (30.2% 12.4%) higher values body mass (BMI) fat, had lower status (university entrance qualification 38.7% 61.5%) than continued recovery. Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness anxiety/depression/sleep predominant symptom clusters. Exercise intolerance post-exertional malaise (PEM) >14 h compatible myalgic encephalomyelitis/chronic fatigue reported by 35.6% 11.6% patients, respectively. In analyses adjusted sex-age class combinations, centre qualification, significant differences between those recovery observed performance three different tests, scores perceived stress, subjective cognitive disturbances, dysautonomia, depression anxiety, quality, quality life. handgrip strength (40.2 [95% confidence interval (CI) [39.4, 41.1]] 42.5 CI [41.5, 43.6]] kg), maximal oxygen consumption (27.9 [27.3, 28.4]] 31.0 [30.3, 31.6]] ml/min/kg weight) ventilatory efficiency (minute ventilation/carbon dioxide production slope, 28.8 [28.3, 29.2]] 27.1 [26.6, 27.7]]) significantly reduced relative group adjustment centre, education, BMI, smoking use beta blocking agents. There measures systolic diastolic cardiac function rest, level N-terminal brain natriuretic peptide blood levels other measurements (including complement activity, markers Epstein–Barr virus [EBV] reactivation, inflammatory coagulation markers, serum cortisol, adrenocorticotropic hormone dehydroepiandrosterone sulfate). Screening viral (PCR stool samples spike antigen plasma) subgroup negative. Sensitivity (pre-existing illness/comorbidity, obesity, medical care infection) revealed similar findings. PEM pain worse results almost all tests. A limitation that we objective on exercise capacity cognition before infection. addition, did unable attend clinic whatever reason illness, immobility social deprivation exclusion. Conclusions this study, majority working recover second their illness. Patterns essentially similar, dominated complaints. Despite signs deficits capacity, there major investigations, our do support persistence, EBV adrenal insufficiency increased turnover pathophysiologically relevant history disease might help stratify cases severity.

Language: Английский

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A systematic review of post COVID-19 condition in children and adolescents: Gap in evidence from low-and -middle-income countries and the impact of SARS-COV-2 variants

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0315815 - e0315815

Published: March 3, 2025

The long-term health consequences following COVID-19 have largely been reported in adult populations living high-income countries. We therefore did a systematic review of post condition symptoms children and adolescents (<18 years), aiming to identify include publications from low- or middle-income countries (LMICs). From EMBASE, Medline, Pubmed until the 30th October 2023, we searched all studies reporting original complete data outcomes at least 20 under 18 years age with history confirmed acute infection. excluded non-English publications, pre-prints, unreviewed articles, grey literature, inaccessible full text, those limited specific population. Risk Bias was assessed using STROBE guidelines for observational studies. used descriptive narrative analysis summarize findings. Forty 825,849 adolescents; median persistent consistently adolescent range but not included young (<5 years). Only one study, 58 participants aged 6-17 years, population LMIC. Studies relied on symptom rather than objective measures organ dysfunction. definition varied; most duration two three months more. However, since onset specified, it difficult which study is truly consistent WHO's condition. Prevalence ranged 1.8% 70% marked heterogeneity between criteria including severity COVID presentation. Most were undertaken when Alpha variant predominant strain. prevalence 6.7% variant-, 23% 61.9% Delta-, 17% 34.6% Omicron-, 3.7% 34% Other-variant predominated fatigue (70%), headache (37.5%) respiratory (35%); subgroups. half control group. variations population, methods, reliance alone lack groups make challenging determine impact adolescents. LMIC especially infants major gap.

Language: Английский

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Presence of SARS‐CoV‐2 RNA in COVID‐19 survivors with post‐COVID symptoms 2 years after hospitalization: The VIPER study

Journal of Medical Virology, Journal Year: 2024, Volume and Issue: 96(5)

Published: May 1, 2024

Abstract The SARS‐CoV‐2 VIrus PERsistence (VIPER) study investigated the presence of long‐lasting RNA in plasma, stool, urine, and nasopharyngeal samples COVID‐19 survivors. reverse transcription polymerase chain reactions (RT‐PCR) were analyzed within swab survivors with post‐COVID symptoms a comparison group without matched by age, sex, body mass index vaccination status. Participants self‐reported any symptom (defined as that started no later than 3 months after initial infection). Fifty‐seven (57.9% women, age: 51.1, standard deviation [SD]: 10.4 years) previously hospitalized 55 (56.4% 50.0, SD: 12.8 individuals who had past infection evaluated 27 (SD 7.5) 26 8.7) hospital discharge, respectively. was identified three patients (5.2%) but not or urine samples. Thus, sample symptoms. most prevalent consisted fatigue (93%), dyspnea, pain (both, 87.7%). This did find samples, 2 years infection. A prevalence 5.2% suggesting potential active recent reinfection, found These results do support association between symptomatology recruited population.

Language: Английский

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Translating insights into therapies for Long Covid

Science Translational Medicine, Journal Year: 2024, Volume and Issue: 16(773)

Published: Nov. 13, 2024

Long Covid is defined by a wide range of symptoms that persist after the acute phase severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Commonly reported include fatigue, weakness, postexertional malaise, and cognitive dysfunction, with many other reported. Symptom range, duration, severity are highly variable partially overlap myalgic encephalomyelitis/chronic fatigue post-acute infectious syndromes, highlighting opportunities to define shared mechanisms pathogenesis. Potential diverse, including persistence viral reservoirs, dysregulated immune responses, direct damage tissues targeted SARS-CoV-2, inflammation driven reactivation latent infections, vascular endothelium activation or subsequent thromboinflammation, autoimmunity, metabolic derangements, microglial activation, microbiota dysbiosis. The heterogeneity baseline characteristics people Covid, as well varying states immunity therapies given at time infection, have made etiologies difficult determine. Here, we examine progress on preclinical models for review being in clinical trials, need large human studies further development better understand Covid. Such will inform trials treatments benefit those living this condition.

Language: Английский

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Neuropsychiatric Manifestations of Long COVID-19: A Narrative Review of Clinical Aspects and Therapeutic Approaches

Life, Journal Year: 2025, Volume and Issue: 15(3), P. 439 - 439

Published: March 11, 2025

The COVID-19 (C-19) pandemic has highlighted the significance of understanding long-term effects this disease on quality life those infected. Long (L-C19) presents as persistent symptoms that continue beyond main illness period, usually lasting weeks to years. One lesser-known but significant aspects L-C19 is its impact neuropsychiatric manifestations, which can have a profound effect an individual’s life. Research shows creates issues such mental fog, emotional problems, and brain symptoms, along with sleep changes, extreme fatigue, severe head pain, tremors seizures, pain in nerves. People cognitive problems plus fatigue mood disorders experience great difficulty handling everyday activities, personal hygiene, social interactions. Neuropsychiatric make people withdraw from activity hurt relationships, thus causing feelings loneliness. unpredictable state generates heavy psychological pressure through suffering, including depression anxiety. changes impairment, swings it hard for work or study effectively, decreases their output at school lowers job contentment. purpose narrative review summarize clinical data present literature regarding manifestations L-C19, identify current methods diagnosis treatment lead correct management condition, highlight these patients’

Language: Английский

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Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: population-based, nested case-control study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 22, 2024

Abstract Objective To assess risk factors for persistence vs improvement and to describe clinical characteristics diagnostic evaluation of subjects with post-acute sequelae COVID-19/post-COVID-19 syndrome (PCS) persisting more than one year. Design Nested population-based case-control study. Setting Comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, laboratory testing in four university health centres southwestern Germany (2022). Participants PCS cases aged 18 65 years (n=982) age sex-matched controls without (n=576) according an earlier questionnaire study (six 12 months after acute infection, phase 1) consenting provide follow-up information undergo assessment (phase 2, another 8.5 [median] 1). Main outcome measures Relative frequencies symptoms problems distribution symptom scores test results between persistent controls. Additional analysis included predictors changing case or control status over time adjustments potentially confounding variables. Results At the examination 2), 67.6% initial remained cases, whereas 78.5% continued report no related PCS. In adjusted analyses, among were mild index previous full-time employment, educational status, specialist consultation not attending a rehabilitation programme. Among controls, new worsening development intercurrent secondary SARS-CoV-2 infection status. less frequently never smokers, had higher values BMI body fat, lower Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness anxiety/depression/sleep predominant clusters, exercise intolerance post-exertional malaise >14 h (PEM) compatible ME/CFS (according Canadian consensus criteria) reported by 35.6% 11.6% respectively. significant differences stable (at 2) observed performances, perceived stress subjective cognitive disturbances, indicating dysautonomia, depression anxiety, sleep quality, fatigue, quality life. handgrip strength, maximal oxygen consumption, ventilator efficiency significantly reduced. However, there systolic diastolic cardiac function, level pro-BNP blood levels other measurements (including complement activity, serological markers EBV reactivation, inflammatory coagulation markers, cortisol, ACTH DHEA-S serum levels). Screening viral (based on PCR stool samples spike antigen plasma subgroup cases) was negative. Sensitivity analyses (pre-existing illness/comorbidity, obesity, PEM, medical care infection) revealed similar findings showed that PEM pain worse almost all tests. Conclusions This nested demonstrates majority do recover second year their illness, patterns remaining essentially similar, nonspecific dominated complaints. We found objective signs deficits reduced capacity likely be unrelated primary pulmonary dysfunction some but major pathology investigations. A history which associated severe as well disease may pragmatic means stratify severity. What is already known this topic Self-reported following have commonly been described persist months. They typically include relatively non-specific complaints such exertional dyspnoea, concentration memory disturbance problems. The incidence post-COVID-19 varying sociodemographic variables, pre-existing comorbidities, severity factors. long-term prognosis unknown differ different clusters. Evidence measurable single multiple organ correlation self-reported patients non-recovery from described. adds describes (need for) programme (the latter probably due reverse causation) PCS, changes clusters After comprehensive correlated symptoms, detected often longer lasting malaise, both physical (diminished consumption ventilatory efficiency), performances while investigations adjustment possible confounders.

Language: Английский

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Does PI-ME/CFS recall post-COVID (PASC) syndrome?

Virus Research, Journal Year: 2024, Volume and Issue: 345, P. 199393 - 199393

Published: May 18, 2024

Language: Английский

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The Association Between Self-Reported Long COVID Symptoms and COVID-19 Conspiracy Theories in Jordan, Kuwait, among Other Arab Countries

Published: Aug. 8, 2024

Long COVID comprises persistent symptoms which extend beyond four weeks post-SARS-CoV-2 infection. The potential association between long and the endorsement of COVID-19 conspiracy theories has not been explored, particularly in Arab countries where high these reported. This study aimed to explore endorsing prevalence self-reported among adults Jordan Kuwait addition other countries. employed a cross-sectional design using an electronic self-administered survey Arabic language. Recruitment utilized snowball sampling via social media was distributed July 2024. instrument included sections on demographic information, history infection, vaccination status. manifestations were assessed score reflecting frequency intensity ten recognized with subsequent categorization into three categories: low, middle, high. beliefs measured 5-point Likert scale across five items. final sample comprised 756 respondents, majority whom confirmed diagnosis at least once (n = 493, 65.2%). results indicated neutral average attitude towards (mean 15.18±4.64 out 30.00). Participants scores significantly more likely report (aOR 6.85, 95% CI: 2.90–16.13, p &amp;lt; 0.001) middle 2.82, 1.32–6.06, 0.008) compared those lower scores. Additional predictors higher reporting female sex household income. Frequent infections hospitalizations also associated symptom reporting. revealed significant correlation magnitude findings highlighted influence sociodemographic factors infection reporting, suggests that public health strategies should address mitigate challenges effectively.

Language: Английский

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The Association between Self-Reported Long COVID Symptoms and COVID-19 Conspiracy Theories in Jordan and Kuwait

COVID, Journal Year: 2024, Volume and Issue: 4(9), P. 1440 - 1462

Published: Sept. 12, 2024

Long COVID comprises persistent symptoms that extend beyond four weeks post-SARS-CoV-2 infection. The potential association between long and the endorsement of COVID-19 conspiracy theories has not been explored, particularly in Arab countries, where high these reported. This study aimed to explore endorsing prevalence self-reported among adults Jordan Kuwait addition other countries. employed a cross-sectional design using Computer-Assisted Web Interviewing (CAWI), conducted Arabic. Recruitment utilized convenience-based snowball sampling via social media survey was distributed July 2024. manifestations were assessed across ten recognized symptoms, belief measured five-point Likert scale five items. final sample comprised 755 respondents, majority whom history confirmed diagnosis at least once (n = 493, 65.2%). results indicated neutral average attitude towards (mean score 15.18 ± 4.64 out 30.00). Participants with scores more likely report (aOR 6.85, p < 0.001) or middle 2.82, 0.008) compared those lower scores. Additional predictors higher reporting included female sex, household income, frequent infections, hospitalizations. revealed significant correlation frequency magnitude symptom reporting. findings also highlighted influence sociodemographic factors infection on reporting, which suggests public health strategies should address mitigate challenges effectively.

Language: Английский

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