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

---

Effects of Multidisciplinary Rehabilitation Program in Patients with Long COVID-19: Post-COVID-19 Rehabilitation (PCR SIRIO 8) Study

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(2), P. 420 - 420

Published: Jan. 4, 2023

Up to 80% of COVID-19 survivors experience prolonged symptoms known as long COVID-19. The aim this study was evaluate the effects a multidisciplinary rehabilitation program in patients with composed physical training (aerobic, resistance, and breathing exercises), education, group psychotherapy. After 6 weeks 97 COVID-19, body composition analysis revealed significant decrease abdominal fatty tissue (from 2.75 kg 2.5 kg; p = 0.0086) concomitant increase skeletal muscle mass 23.2 24.2 0.0104). Almost participants reported dyspnea improvement assessed modified Medical Research Council scale. Patients’ capacity Minute Walking Test increased from 320 382.5 m (p < 0.0001), number repetitions 30 s Chair Stand improved 13 16 well fitness Short Physical Performance Battery 14 0.0001). impact fatigue on everyday functioning reduced Modified Fatigue Impact Scale 37 27 Cardiopulmonary exercise test did not show any change. has composition, dyspnea, patients.

Language: Английский

---

The knowns and unknowns of long COVID-19: from mechanisms to therapeutical approaches

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: March 4, 2024

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been defined as the greatest global health and socioeconomic crisis of modern times. While most people recover after being infected with virus, a significant proportion them continue to experience issues weeks, months even years acute infection SARS-CoV-2. This persistence clinical symptoms in individuals for at least three onset or emergence new lasting more than two months, without any other explanation alternative diagnosis have named long COVID, long-haul post-COVID-19 conditions, chronic post-acute sequelae (PASC). Long COVID characterized constellation disorders that vary widely their manifestations. Further, mechanisms underlying are not fully understood, which hamper efficient treatment options. review describes predictors common related COVID's effects on central peripheral nervous system organs tissues. Furthermore, transcriptional markers, molecular signaling pathways risk factors such sex, age, pre-existing condition, hospitalization during phase COVID-19, vaccination, lifestyle presented. Finally, recommendations patient rehabilitation management, well therapeutical approaches discussed. Understanding complexity this disease, its across multiple organ systems overlapping pathologies possible paramount developing diagnostic tools treatments.

Language: Английский

---

Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal

Sports Medicine - Open, Journal Year: 2024, Volume and Issue: 10(1)

Published: April 24, 2024

Abstract People with long COVID may suffer from a wide range of ongoing symptoms including fatigue, exertional dyspnea, reduced exercise performance, and others. In particular, impaired performance is condition that can be recovered in many people through an individualized physical training program. However, clinical experience has shown the presence post-exertional malaise (PEM) significant barrier to COVID. Currently, there no guideline or consensus available on how apply this cohort. Therefore, we conducted literature review PubMed library using following search terms: “COVID”, “post-COVID”, “long COVID” “exercise” searching for studies January 2020 2024. Data 46 trials were included. Exercise regimes very heterogeneous none these reported management PEM context Based feedback additional survey was answered by 14 international experts field COVID, combined authors´ own extensive practical experience, best practice proposal recommendations been developed. This differentiates procedures according no, mild/moderate severe These guide allied healthcare professionals worldwide initiating adjusting programs stratified severity PEM.

Language: Английский

---

First results from post-COVID inpatient rehabilitation

Frontiers in Rehabilitation Sciences, Journal Year: 2023, Volume and Issue: 3

Published: Jan. 23, 2023

Background COVID-19 is associated with various symptoms and psychological involvement in the long term. In view of multifactorial triggering maintenance post-COVID syndrome, a multimodal therapy somatomedical psychotherapeutic content expedient. This paper compares stress patients their course rehabilitation to psychosomatic psychocardiological patients. Method Observational study control-groups clinical, standardized examination: testing (BDI-II, HELATH-49), 6-MWT as somatic parameter, two measurement points (admission, discharge). Sample characteristics, including work related parameters, general symptom-load during are evaluated. Results At admission all measures were significantly affected, but less pronounced than or (BDI-II = 19.29 ± 9.03, BDI-II 28.93 12.66, psychocardiology 24.47 10.02). During rehabilitation, complaint domains sub-groups, symptom severity was reduced (effect sizes ranging from d .34 1.22). Medium positive effects seen on self-efficacy ( .69) large activity participation 1.06) 6-MWT, walking distance improved by an average 76.43 63.58 meters Not single patient deteriorated distance, which would have been possible sign post exercise malaise (PEM). Conclusion Post-COVID slighter burden Although not curative, benefit interventions there no signs PEM.

Language: Английский

---

Functionality, physical activity, fatigue and quality of life in patients with acute COVID-19 and Long COVID infection

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: Nov. 14, 2023

A prominent feature of COVID-19, both in the short and long term, is reduction quality life (QoL) due to low functionality scores presence fatigue, which can hinder daily activities. The main objective this study compare functional status, level physical activity, QoL patients with Long COVID other COVID-19 who did not develop persistent illness, determine whether there a relationship between these variables QoL. cross-sectional was conducted 170 participants had been infected or developed COVID. studied were functionality, measured using PostCOVID-19 Functional Status Scale (PCFS), International Physical Activity Questionnaire (IPAQ), Short Form 12 (SF-12), Fatigue Severity (FSS). findings show significant (p < 0.001) reduced lower activity levels, increased fatigue severity, poorer patients. Furthermore, are also related worse QoL, but only status predicts it. In conclusion, our results have shown highly correlations group regarding fatigue.

Language: Английский

---

Evaluation of Exercise Rehabilitation Programs to Improve Cardiac and Respiratory Health in COVID-19 Patients: A Systematic Review of Randomized Controlled Trials

Global Journal of Medical Pharmaceutical and Biomedical Update, Journal Year: 2025, Volume and Issue: 20, P. 1 - 1

Published: Jan. 31, 2025

Introduction: Coronavirus disease 2019 (COVID-19) survivors have suffered from long-term impacts of the disease. Many are experiencing persistent cardiac and respiratory complications. Some studies shown that exercise-based rehabilitation plays a critical role in recovery post-COVID-19 patients order to minimize complications such as dyspnea, breathlessness, heart failure. Objective: The objective this study was evaluate effectiveness programs improve functions COVID-19 patients. Methodology: An extensive search literature conducted on PubMed, Cochrane Central Register Controlled Trials, TRIP databases using following keywords Boolean operators: High intensity interval training (HIIT) OR exercise AND long COVID. Randomized controlled trials (RCTs) published English language 2020 2024 were included study. Full-text articles reviewed Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines implemented during systematic review. Patients who had pre-existing excluded Results: This review 5 RCTs involving 291 participants. (intervention) groups showed notable improvements VO2 peak with pooled data (ES = 0.765, SE 0.193, 95% confidence [CI] 0.391, 1.139). mean difference (MD) 2.42, maximum, rate (HR max) increased (MD 5.33), left ventricular mass by MD 6.8 (95% CI: 0.8; 12.8 g; P 0.029) indicating enhanced cardiovascular conditioning function. Maximum voluntary ventilation 5.3) improved endurance along an stability FEV1 FVC. In addition, drastic improvement ventilatory efficiency breathing patterns noted, thus reducing perceived dyspnea. HIIT intervention: Two participants reduction their predicted residual volume % (8%) total lung capacity. comparison, control group no significant improvement. Conclusion: Exercise-based decreasing symptoms palpitations, By integrating into post-COVID care, can be significantly improved.

Language: Английский

---

Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis and Management

Viruses, Journal Year: 2023, Volume and Issue: 15(2), P. 533 - 533

Published: Feb. 14, 2023

The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. majority of the patients survived developed Post-COVID-19 Syndrome (PC19S) varying severity. Currently, diagnosis PC19S is achieved through history symptomatology that cannot be explained by an alternative diagnosis. However, heavy reliance on subjective reporting prone to errors. Besides, there no unified diagnostic assessment tool classify clinical severity patients. This leads significant difficulties when managing terms public resource utilization, progression monitorization rehabilitation plan formulation. narrative review aims current evidence based triple assessment: symptomatology, biochemical analysis imaging evidence. Further tools can monitor patient’s progression, prognosis intervals monitoring. It also highlights high-risk features for closer earlier Rehabilitation programs related trials are evaluated; however, most them focus cardiorespiratory fitness psychiatric presentations such as anxiety depression. research required establish objective comprehensive facilitate management plans.

Language: Английский

---

“There is no one who helps you with it”: experiences of people with long COVID regarding medical care, therapeutic measures, and barriers in the German healthcare system: results of a qualitative study with four focus groups

BMC Health Services Research, Journal Year: 2023, Volume and Issue: 23(1)

Published: Oct. 26, 2023

Many people experience long-term symptoms such as fatigue, cognitive problems, or shortness of breath after an acute infection with COVID-19. This emerging syndrome, known long COVID, is new and complex in many aspects. study aims to collect the experiences COVID ambulatory healthcare structures.Four focus groups were conducted a total 23 adults June July 2022. These discussions audio-recorded, subsequently transcribed, analyzed using qualitative content analysis Mayring Kuckartz.Fourteen out 19 participants who had primary care encounter regarding their did not perceive it helpful. respondents reported that general practitioners take seriously refer them specialists made therapeutic recommendations. However, some they prescribed non-pharmaceutical therapies (e.g., group meetings supported by psychotherapists, occupational therapy, etc.) improved condition. 14 perceived barriers providers' lack awareness poor access specialists, specialized clinics), high bureaucratic hurdles for specific services. To improve medical care, suggested campaigns raise among providers population, increase research government investments development treatment structures expanding existing services, establishing one-stop shops integrated specialist COVID.Several implications professionals policymakers can be derived from this study: (1) should seriously, assume coordinating role, make referrals, establish contact clinics; (2) planners on developing interprofessional evidence-based approaches COVID; (3) outpatient clinics expanded. The overarching goal must develop consistent guidelines diagnosis, treatment.The registered German register clinical trials (DRKS00026007, first registration 09/09/2021).

Language: Английский

---

Effects of Pulmonary Rehabilitation on Respiratory Function and Thickness of the Diaphragm in Patients with Post-COVID-19 Syndrome: A Randomized Clinical Trial

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(2), P. 425 - 425

Published: Jan. 12, 2024

Rehabilitation is an effective method for improving the overall health of patients who have experienced long-term effects COVID-19.

Language: Английский

---