Pathophysiology and mechanism of long COVID: a comprehensive review

Annals of Medicine, Journal Year: 2022, Volume and Issue: 54(1), P. 1473 - 1487

Published: May 20, 2022

After almost 2 years of fighting against SARS-CoV-2 pandemic, the number patients enduring persistent symptoms long after acute infection is a matter concern. This set was referred to as "long COVID", and it defined more recently "Post COVID-19 condition" by World health Organization (WHO). Although studies have revealed that COVID can manifest whatever severity inaugural illness, underlying pathophysiology still enigmatic.To conduct comprehensive review address putative persisting COVID.We searched 11 bibliographic databases (Cochrane Library, JBI EBP Database, Medline, Embase, PsycInfo, CINHAL, Ovid Nursing Journals@Ovid, SciLit, EuropePMC, CoronaCentral). We selected put forward hypotheses on pathophysiology, well those encompassed in their research investigation.A total 98 articles were included systematic review, 54 which exclusively addressed while 44 involved patients. Studies displayed heterogeneity with respect initial timing analysis, or presence control group. likely results from long-term organ damage due acute-phase infection, specific mechanisms following illness could contribute later possibly affecting many organs. As such, autonomic nervous system account for without clear evidence damage. Immune dysregulation, auto-immunity, endothelial dysfunction, occult viral persistence, coagulation activation are main pathophysiological so far.Evidence why occur limited, available heterogeneous. Apart damage, hints suggest be symptoms. KEY MESSAGESLong-COVID multisystem disease develops regardless severity. Its clinical spectrum comprises wide range symptoms.The its unclear. phase accounts symptoms, long-lasting inflammatory been proposed, well.Existing involving Long-COVID highly heterogeneous, they include various levels different time frame well.

Language: Английский

---

Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis

Brain Communications, Journal Year: 2021, Volume and Issue: 4(1)

Published: Dec. 15, 2021

The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined prevalence survivors COVID-19. For this pre-registered systematic review meta-analysis (PROSPERO ID CRD42021239750), searched MEDLINE, EMBASE, CINAHL PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting at post-acute or later time-points infection control groups where available. each study, a minimum two authors extracted summary data. symptom, calculated pooled using generalized linear mixed models. Heterogeneity was measured with I2. Subgroup analyses were conducted for hospitalization, severity duration follow-up. From 2844 unique titles, 51 (n = 18 917 patients). mean follow-up 77 days (range 14-182 days). Study quality most commonly moderate. prevalent symptom sleep disturbance [pooled 27.4% (95% confidence interval 21.4-34.4%)], followed by fatigue [24.4% (17.5-32.9%)], objective cognitive impairment [20.2% (10.3-35.7%)], anxiety [19.1% (13.3-26.8%)] post-traumatic stress [15.7% (9.9-24.1%)]. Only reported groups, both higher frequencies versus controls. Between-study heterogeneity high (I2 79.6-98.6%). There little no evidence differential based on hospitalization status, duration. Neuropsychiatric common from literature longer-term consequences is still maturing but indicates particularly insomnia, fatigue, disorders first 6 months infection.

Language: Английский

---

Long COVID and its Management

International Journal of Biological Sciences, Journal Year: 2022, Volume and Issue: 18(12), P. 4768 - 4780

Published: Jan. 1, 2022

The pandemic of COVID-19 is the biggest public health crisis in 21

Language: Английский

---

Post-COVID Syndrome: An Insight on Its Pathogenesis

Vaccines, Journal Year: 2021, Volume and Issue: 9(5), P. 497 - 497

Published: May 12, 2021

Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after diagnosis COVID-19 characterize post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates high 85% have been reported among patients with history hospitalization. Currently, there no consensus on classification We reviewed published information syndrome, putting emphasis its pathogenesis. The pathogenesis multi-factorial and one mechanism may be implicated several manifestations. Prolonged inflammation has key role account some neurological complications, cognitive dysfunction, other symptoms. A multisystem inflammatory adults (MIS-A) all ages also described recently, similarly children (MIS-C). post-infectious pathogenetic MIS-A supported by fact that established through serology up third cases. Other mechanisms are include immune-mediated vascular thromboembolism, nervous system dysfunction. Although current data indicating overwhelming majority good prognosis, registries actively follow them needed order define full spectrum long-term outcome. consensus-based essential guide clinical, diagnostic, therapeutic management. Further research imperative elucidate

Language: Английский

---

Long COVID-19 Syndrome: A Comprehensive Review of Its Effect on Various Organ Systems and Recommendation on Rehabilitation Plans

Biomedicines, Journal Year: 2021, Volume and Issue: 9(8), P. 966 - 966

Published: Aug. 5, 2021

The majority of people infected with SARS-CoV-2 fully recovered within a few weeks. However, considerable number patients different ages still suffer from long-lasting problems similar to the multi-organ damage in its acute phase infection, or experience symptoms continuously for longer term after recovery. severity primary infection seems not be associated possibility and long-term symptoms. Various unresolved have been reported COVID-19 survivors months hospital discharge. Long Syndrome refers 4 initial onset. It is important understand systemic effects Syndrome, presentations, need rehabilitations restore functional recovery survivors. Government, healthcare workers, survivor groups should collaborate establish self-sustaining system facilitate follow-up rehabilitations, prioritization resources more severely This review looks into various aspects: respiratory, cardiovascular, hematological, renal, gastrointestinal, neurological, metabolic Syndromes. Recommendations details explored cope tremendous patients.

Language: Английский

---

Biomarkers in long COVID-19: A systematic review

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

Published: Jan. 20, 2023

Purpose Long COVID, also known as post-acute sequelae of COVID-19, refers to the constellation long-term symptoms experienced by people suffering persistent for one or more months after SARS-CoV-2 infection. Blood biomarkers can be altered in long COVID patients; however, associated with and their roles disease progression remain undetermined. This study aims systematically evaluate blood that may act indicators therapeutic targets COVID. Methods A systematic literature review PubMed, Embase, CINAHL was performed on 18 August 2022. The search keywords COVID-19 were used filter out eligible studies, which then carefully evaluated. Results Identified from 28 studies representing six biological classifications, 113 significantly COVID: (1) Cytokine/Chemokine (38, 33.6%); (2) Biochemical markers (24, 21.2%); (3) Vascular (20, 17.7%); (4) Neurological (6, 5.3%); (5) Acute phase protein (5, 4.4%); (6) Others 17.7%). Compared healthy control recovered patients without symptoms, 79 increased, 29 decreased, 5 required further determination patients. Of these, up-regulated Interleukin 6, C-reactive protein, tumor necrosis factor alpha might serve potential diagnostic Moreover, neurological exhibited higher levels neurofilament light chain glial fibrillary acidic whereas those pulmonary a level transforming growth beta. Conclusion present elevated inflammatory initial Our found significant associations between specific symptoms. Further investigations are warranted identify core set diagnose manage clinical practice.

Language: Английский

---

SARS-CoV-2 Spike protein induces TLR4-mediated long-term cognitive dysfunction recapitulating post-COVID-19 syndrome in mice

Cell Reports, Journal Year: 2023, Volume and Issue: 42(3), P. 112189 - 112189

Published: Feb. 17, 2023

Cognitive dysfunction is often reported in patients with post-coronavirus disease 2019 (COVID-19) syndrome, but its underlying mechanisms are not completely understood. Evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike protein or fragments released from cells during infection, reaching different tissues, including the CNS, irrespective of presence viral RNA. Here, we demonstrate brain infusion mice has a late impact on cognitive function, recapitulating post-COVID-19 syndrome. We also show neuroinflammation and hippocampal microgliosis mediate Spike-induced memory via complement-dependent engulfment synapses. Genetic pharmacological blockage Toll-like receptor 4 (TLR4) signaling protects animals against synapse elimination induced by infusion. Accordingly, cohort 86 who recovered mild COVID-19, genotype GG TLR4-2604G>A (rs10759931) associated poor outcome. These results identify TLR4 as key target to investigate long-term after COVID-19 infection humans rodents.

Language: Английский

---

Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches

Journal of Clinical Investigation, Journal Year: 2022, Volume and Issue: 132(15)

Published: July 31, 2022

SARS-CoV-2–infected individuals may suffer a multi–organ system disorder known as "long COVID" or post-acute sequelae of SARS-CoV-2 infection (PASC). There are no standard treatments, the pathophysiology is unknown, and incidence varies by clinical phenotype. Acute COVID-19 correlates with biomarkers systemic inflammation, hypercoagulability, comorbidities that less prominent in PASC. Macrovessel thrombosis, hallmark acute COVID-19, frequent Female sex at birth associated reduced risk for progression, but increased Persistent microvascular endotheliopathy cryptic tissue reservoirs has been implicated PASC pathology. Autoantibodies, localized reactivation latent pathogens also be involved, potentially leading to documented multiple tissues. Diagnostic assays illuminating possible therapeutic targets discussed.

Language: Английский

---

SARS‐CoV‐2 and Mitochondrial Proteins in Neural‐Derived Exosomes of COVID‐19

Annals of Neurology, Journal Year: 2022, Volume and Issue: 91(6), P. 772 - 781

Published: March 14, 2022

As SARS-CoV-2 is known to invade neural cell mitochondria, a plasma system for quantifying central nervous proteins in living humans was used investigate neuropathogenic mechanisms of long-COVID-19.

Language: Английский

---

Neuropsychiatric aspects of long COVID: A comprehensive review

Psychiatry and Clinical Neurosciences, Journal Year: 2022, Volume and Issue: 77(2), P. 84 - 93

Published: Nov. 17, 2022

Although some patients have persistent symptoms or develop new following coronavirus disease 2019 (COVID-19) infection, neuropsychiatric aspects of long COVID are not well known. This review summarizes and provides an update on the dimensions COVID. Its manifestations commonly include fatigue, cognitive impairment, sleep disorders, depression, anxiety, post-traumatic stress disorder. There no specific tests for COVID, but characteristic findings such as hypometabolism positron emission tomography been reported. The possible mechanisms inflammation, ischemic effects, direct viral invasion, social environmental changes. Some patient characteristics severity complications acute COVID-19 infection may be associated with increased risk symptoms. Long resolve spontaneously persist, depending type established treatments lacking, various psychological pharmacological attempted. Vaccination against plays a key role in prevention disease. With differences among SARS-CoV-2 variants, including omicron variant, likely to change future. Further studies clarifying effective warranted.

Language: Английский

---