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

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Investigating the possible mechanisms of autonomic dysfunction post-COVID-19

Autonomic Neuroscience, Journal Year: 2022, Volume and Issue: 245, P. 103071 - 103071

Published: Dec. 24, 2022

Language: Английский

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Beyond Acute COVID-19: A Review of Long-term Cardiovascular Outcomes

Canadian Journal of Cardiology, Journal Year: 2023, Volume and Issue: 39(6), P. 726 - 740

Published: Feb. 6, 2023

Statistics Canada estimated that approximately 1.4 million Canadians suffer from long COVID. Although cardiovascular changes during acute SARS-CoV-2 infection are well documented, long-term sequelae less understood. In this review, we sought to characterize adult outcomes in the months after COVID-19 illness. our search identified reports of including cardiac dysautonomia, myocarditis, ischemic injuries, and ventricular dysfunction. Even patients without overt outcomes, subclinical have been observed. Cardiovascular can stem exacerbation preexisting conditions, ongoing inflammation, or as a result damage occurred infection. For example, myocardial fibrosis has reported hospital admission for illness, might be consequence myocarditis injury disease. turn, contribute further dysrhythmias heart failure. Severity risk factor consequences, however, also young, healthy individuals who had asymptomatic mild evolving evidence suggests previous disease, there is heterogeneity existing evidence, some studies marred by measured unmeasured confounders. Many investigations limited relatively short follow-up. Future should focus on longer term (beyond 1 year) identifying prevalence different populations basis COVID disease severity.

Language: Английский

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Consistency of inconsistency in long‐COVID‐19 pain symptoms persistency: A systematic review and meta‐analysis

Pain Practice, Journal Year: 2023, Volume and Issue: 24(1), P. 120 - 159

Published: July 21, 2023

Abstract Introduction Individuals recovering from acute COVID‐19 episodes may continue to suffer various ongoing symptoms, collectively referred as Long‐COVID. Long‐term pain symptoms are amongst the most common and clinically significant be reported for this post‐COVID‐19 syndrome. Objectives This systematic review meta‐analysis aimed evaluate proportions of persisting experienced by individuals past phase identify their associated functional consequences inflammatory correlates. Methods Two online databases were systematically searched inception until 31 March 2022. We primary research articles in English, which evaluated after laboratory‐confirmed resolution specifically on and/or outcomes. Results Of 611 identified articles, 26 included, used data extraction, assessed methodological quality risk bias two independent reviewers. Pain grouped under one six major domains, serving our co‐outcomes. Proportional meta‐analyses pooled logit‐transformed values single performed using random‐effects‐restricted maximum‐likelihood model. An estimated 8%, 6%, 18%, 17%, 12% continued report persistence chest, gastrointestinal, musculoskeletal joint, muscle, general body, nervous system‐related respectively, up year COVID‐19. Considerable levels heterogeneity demonstrated across all results. Functional quality‐of‐life impairments some biomarker elevations with long‐COVID symptoms. Conclusion study's findings suggest that although not well characterized, being non‐negligible those episodes, thus highlighting importance future efforts focus aspect.

Language: Английский

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ApoE4 associated with severe COVID-19 outcomes via downregulation of ACE2 and imbalanced RAS pathway

Journal of Translational Medicine, Journal Year: 2023, Volume and Issue: 21(1)

Published: Feb. 9, 2023

Recent numerous epidemiology and clinical association studies reported that ApoE polymorphism might be associated with the risk severity of coronavirus disease 2019 (COVID-19), yielded inconsistent results. Severe acute respiratory syndrome 2 (SARS-CoV-2) infection relies on its spike protein binding to angiotensin-converting enzyme (ACE2) receptor expressed host cell membranes.A meta-analysis was conducted clarify between COVID-19. Multiple interaction assays were utilized investigate potential molecular link SARS-CoV-2 primary ACE2, protein. Immunoblotting immunofluorescence staining methods used access regulatory effect different isoform ACE2 expression.ApoE gene (ε4 carrier genotypes VS non-ε4 genotypes) is increased (P = 0.0003, OR 1.44, 95% CI 1.18-1.76) progression < 0.00001, 1.85, 1.50-2.28) interacts both but did not show isoform-dependent effects. ApoE4 significantly downregulates expression in vitro vivo subsequently decreases conversion Ang II 1-7.ApoE4 increases infectivity a manner may depend differential interactions or ACE2. Instead, dysregulation renin-angiotensin system (RAS) provide explanation by which exacerbates COVID-19 disease.

Language: Английский

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Headache in long COVID as disabling condition: A clinical approach

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

Published: March 23, 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can exacerbate previous headache disorders or change the type of pain experienced from headaches. This study aimed to investigate clinical features Long COVID headaches.This was a cross-sectional, descriptive, and analytical observational that included 102 patients (with headache, n = 50; without 52) with long complaints. The Migraine Disability Assessment Test Visual Analog Pain Scale were used collect participants' data according standardized protocol.The in this who reported experiencing headaches before COVID-19 had longer duration phase than pre-long (p 0.031), exhibited partial improvement symptoms analgesics 0.045), <1 year 0.030). Patients moderate severe disability those classified as having highly likely develop chronic Hospital admission [odds ratio (OR) 3.0082; 95% confidence interval (95% CI): 1.10-8.26], back (OR 4.0017; CI: 1.13-14.17), insomnia 3.1339; 1.39-7.06), paraesthesia 2.7600; 1.20-6.33) associated these patients.Headache is disabling condition COVID-19, exacerbating conditions prior contracting COVID-19.

Language: Английский

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Long COVID and its association with neurodegenerative diseases: pathogenesis, neuroimaging, and treatment

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

Published: April 4, 2024

Corona Virus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has presented unprecedented challenges to world. Changes after COVID-19 have had a significant impact on patients with neurodegenerative diseases. This study aims explore mechanism of diseases examining main pathways central nervous system infection SARS-CoV-2. Research indicated that chronic inflammation and abnormal immune response are primary factors leading neuronal damage long-term consequences COVID-19. In some patients, concurrent inflammatory leads increased release pro-inflammatory cytokines, which may significantly prognosis. Molecular imaging can accurately assess severity in phase. Furthermore, use FDG-PET is advocated quantify relationship between neuroinflammation psychiatric cognitive symptoms who recovered from Future development should focus aggressive post-infection control targeted therapies target ACE2 receptors, ERK1/2, Ca 2+ .

Language: Английский

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SARS‐CoV‐2, aging, and Post‐COVID‐19 neurodegeneration

Journal of Neurochemistry, Journal Year: 2022, Volume and Issue: 165(2), P. 115 - 130

Published: Dec. 2, 2022

Abstract As the world continues to experience effects of SARS‐CoV‐2, there is evidence suggest that sequelae viral infection (the post‐COVID‐19 condition; PCC) at both an individual and population level will be significant long‐lasting. The history pandemics or epidemics in last 100 years caused by members RNA virus family, which coronaviruses are a member, provides ample acute neurological effects. However, except for H1N1 influenza pandemic 1918/1919 Spanish flu) with its associated encephalitis lethargica, little information on long‐term sequelae. COVID‐19 first has occurred setting aging population, especially several high‐income countries. Its survivors greatest risk developing neurodegenerative conditions as they age, rendering current unique paradigm not previously witnessed. SARS‐CoV‐2 virus, among largest viruses, single‐stranded encodes 29 proteins include spike protein contains key domains required ACE2 binding, complex array nonstructural (NSPs) accessory ensure escape from innate immune response, allowing efficient replication, translation, exocytosis fully functional virion. Increasingly, these also recognized potentially contributing biochemical molecular processes underlying neurodegeneration. In addition directly being taken up brain endothelium, constituents can transported neurons, astrocytes, microglia extracellular vesicles accelerate pathological fibril formation. nucleocapsid intrinsically disordered participate liquid condensate formation, including heteropolymers disease‐associated RNA‐binding such TDP‐43, FUS, hnRNP1A. mutate under pressure exerted highly efficacious vaccines, it evolving into greater transmissibility but less severity compared original strain. potential lingering impact nervous system thus represent ongoing legacy even global health challenge than infection. image

Language: Английский

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COVID-19 promotes endothelial dysfunction and thrombogenicity: role of proinflammatory cytokines/SGLT2 prooxidant pathway

Journal of Thrombosis and Haemostasis, Journal Year: 2023, Volume and Issue: 22(1), P. 286 - 299

Published: Oct. 4, 2023

Language: Английский

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Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems

Infectious Disease Reports, Journal Year: 2023, Volume and Issue: 15(6), P. 806 - 830

Published: Dec. 15, 2023

The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as 'long- COVID-19' (or simply COVID'), emerges substantial subset of patients, manifesting with constellation over 200 reported symptoms that span multiple organ systems. This also 'post-acute sequelae SARS-CoV-2 infection' (PASC), presents perplexing clinical picture far-reaching implications, often persisting long after acute phase. While initial research focused on immediate pulmonary impact virus, recognition COVID-19 multiorgan disruptor has unveiled gamut protracted and severe health issues. review summarizes primary effects COVID respiratory, cardiovascular, nervous It delves mechanisms underlying these impacts underscores critical need for comprehensive understanding COVID's pathogenesis.

Language: Английский

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