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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Differentiation of Prior SARS-CoV-2 Infection and Postacute Sequelae by Standard Clinical Laboratory Measurements in the RECOVER Cohort

Annals of Internal Medicine, Journal Year: 2024, Volume and Issue: 177(9), P. 1209 - 1221

Published: Aug. 12, 2024

There are currently no validated clinical biomarkers of postacute sequelae SARS-CoV-2 infection (PASC).

Language: Английский

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Blood Biomarkers of Long COVID: A Systematic Review

Molecular Diagnosis & Therapy, Journal Year: 2024, Volume and Issue: 28(5), P. 537 - 574

Published: Aug. 5, 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: 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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sTREM-1 as a Predictive Biomarker for Disease Severity and Prognosis in COVID-19 Patients

Journal of Inflammation Research, Journal Year: 2024, Volume and Issue: Volume 17, P. 3879 - 3891

Published: June 1, 2024

Background: Research on biomarkers associated with the severity and adverse prognosis of COVID-19 can be beneficial for improving patient outcomes. However, there is limited research role soluble TREM-1 (sTREM-1) in predicting patients. Methods: A total 115 patients admitted to emergency department Beijing Youan Hospital from February May 2023 were included study. Demographic information, laboratory measurements, blood samples sTREM-1 levels collected upon admission. Results: Our study found that plasma increased disease (moderate vs mild, p=0.0013; severe moderate, p=0.0195). had good predictive value 28-day mortality (area under ROC curve was 0.762 0.805, respectively). also exhibited significant correlations age, body temperature, respiratory rate, PaO 2 /FiO , PCT, CRP, CAR. Ultimately, through multivariate logistic regression analysis, we determined (OR 1.008, 95% CI: 1.002– 1.013, p=0.005), HGB 0.966, 0.935– 0.998, p=0.036), D-dimer 1.001, 1.000– p=0.009), CAR 1.761, 1.154– 2.688, p=0.009) independent predictors The combination these four markers yielded a strong cases an AUC 0.919 (95% 0.857 − 0.981). Conclusion: demonstrated mortality, serving as prognostic factor In future, anticipate conducting large-scale multicenter studies validate our findings. Keywords: COVID-19, sTREM-1, inflammation-related markers, severity,

Language: Английский

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A Significance of Endothelial Dysfunction in Long COVID-19 for The Possible Future Pandemic of Chronic Kidney Disease and Cardiovascular Disease

Published: June 21, 2024

Various symptoms have been reported to persist beyond acute phase of severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which is referred as long disease 19 (long COVID-19). Over 65 million individuals suffer from COVID-19. However, the causes COVID-19 largely unknown. Since are observed throughout body, vascular endothelial dysfunction may be a strong candidate induce The angioten-sin-converting enzyme (ACE2), entry receptor SARS-CoV-2, ubiquitously expressed in cells. We previously found that risk factors for athero-sclerotic cardiovascular (ASCVD) and history ASCVD can COVID-19, suggesting contribution pre-existing Here, we show significant association with development biomarkers patients also crucial players ASCVD. consider influence on chronic kidney (CKD) Furthermore, suggest therapeutic interventions by considering treatment tar-gets Such prevent pandemic CKD post era.

Language: Английский

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The Significance of Endothelial Dysfunction in Long COVID-19 for the Possible Future Pandemic of Chronic Kidney Disease and Cardiovascular Disease

Biomolecules, Journal Year: 2024, Volume and Issue: 14(8), P. 965 - 965

Published: Aug. 8, 2024

Various symptoms have been reported to persist beyond the acute phase of severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which is referred as long disease 19 (long COVID-19). Over 65 million individuals suffer from COVID-19. However, causes COVID-19 are largely unknown. Since observed throughout body, vascular endothelial dysfunction a strong candidate explaining induction The angiotensin-converting enzyme (ACE2), entry receptor for SARS-CoV-2, ubiquitously expressed in cells. We previously found that risk factors atherosclerotic cardiovascular (ASCVD) and history ASCVD raise COVID-19, suggesting contribution pre-existing Here, we show significant association with development biomarkers patients also crucial players ASCVD. consider influence on chronic kidney (CKD) Future assessments outcomes resulting therapeutic interventions improve function may imply significance

Language: Английский

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ЕНДОТЕЛІАЛЬНА ДИСФУНКЦІЯ І СИСТЕМА ГЕМОСТАЗУ У ПОСТКОВІДНОМУ ПЕРІОДІ

Здобутки клінічної і експериментальної медицини, Journal Year: 2024, Volume and Issue: 4, P. 157 - 166

Published: Dec. 23, 2024

РЕЗЮМЕ. Вплив ендотеліальної дисфункції на тяжкість перебігу коронавірусної хвороби не викликає сумнівів. Коморбідна патологія (артеріальна гіпертензія, серцево-судинна та цукровий діабет), в патогенезі якої значну роль відіграє порушення нормального функціонування ендотелію судин, визнана фактором ризику, який асоціювався з тяжким перебігом COVID-19 летальним наслідком. Незважаючи інтенсивні дослідження, зумовлені пандемією SARS-CoV-2, питання ролі запалення низької інтенсивності у ускладнень відновного періоду після перенесеного захворювання все ще залишаються недостатньо дослідженими. Це особливо важливо й тому, що вхідні ворота для вірусу – рецептори АПФ2 експресовані ендотелії різко зростають ризик частота розвитку тромботичних ускладнень. Мета роботи оцінити зміни біомаркерів дисфункції, які регулюють систему гемостазу, пацієнтів постковідному періоді. Матеріал і методи. До дослідження був залучений 191 пацієнт період 1–90 днів останнього негативного ПЛР-тесту, них 58 (30,37 %) чоловіків 133 (69,63 жінки віком від 18 до 80 років. Середній вік склав (49,76± 13,38) Залежно тяжкості перенесеної було поділено наступним чином: група із легким (HQM), хворі середньої (HMO), киснезалежні пацієнти (HSV) критичні (HCR). Для обстеження застосовували загальноклінічні методи аналіз доступної медичної документації. За допомогою імуноензимного аналізу використанням стандартних наборів ELISA визначали рівні фактора фон Віллебранда (vWF), інгібітора активатора плазміногену-1 (PAI-1), тканинного плазміногену (tPA) високочутливого С-реактивного білка СРБ (hsCRP) залучених пацієнтів. Результати. Було залучено груп HQM n=79 або 41,4 %; HMO n=74 38,7 HSV n=25 13,1 критичних хворих HCR n=13 6,8 %. обстежених достовірно різнився наймолодшими були групі (43,84±13,08 років, кількість старших 65 років 5 79). Зі зростанням зростала Після отриманих даних усіх поділили групи високого (HRG, n=163) низького ризику (NRG, n=28). Результати проведеного нами вказують, протягом трьох місяців реконвалесцентного зберігаються глибокі розлади системи регуляції судинного тонусу ознаки хронічного запального процесу. Про це свідчить стійке підвищення біомаркерів, засвідчують протромботичні зміни. Рівні tPA, vWF PAI-1 тяжких чітко корелювали тяжкістю наявністю коморбідної патології надмірної маси тіла ожиріння, артеріальної гіпертензії серцево-судинної патології, незалежно статі. Також одужання залишався підвищеним рівень hsCRP. Висновки. Достовірні відхилення показників зміни, 90 ПЛР-тесту. Пригнічення антикоагулянтних властивостей ендотелію, призводить протромботичного стану, найбільше вираженим тяжчим хвороби.

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