Long COVID science, research and policy

Nature Medicine, Год журнала: 2024, Номер 30(8), С. 2148 - 2164

Опубликована: Авг. 1, 2024

Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system be severely disabling. The cumulative global incidence long around 400 million individuals, which estimated to have an annual economic impact approximately $1 trillion-equivalent about 1% economy. Several mechanistic pathways are implicated in COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement endothelial inflammation microbiome dysbiosis. devastating impacts on individual lives and, due its complexity prevalence, also has major ramifications for systems economies, even threatening progress toward achieving Sustainable Development Goals. Addressing challenge requires ambitious coordinated-but so far absent-global research policy response strategy. In this interdisciplinary review, we provide synthesis state scientific evidence assess human health, systems, economy metrics, forward-looking roadmap.

Язык: Английский

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Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID

Infection and Chemotherapy, Год журнала: 2024, Номер 56(1), С. 122 - 122

Опубликована: Янв. 1, 2024

"Long COVID" is a term used to describe condition when the symptoms and signs associated with coronavirus disease 2019 (COVID-19) persist for more than three months among patients infected COVID-19; this has been reported globally poses serious public health issue. Long COVID can manifest in various forms, highlighting need appropriate evaluation management by experts from fields. However, due lack of clear clinical definitions, knowledge pathophysiology, diagnostic methods, treatment protocols, it necessary develop best standard guidelines based on scientific evidence date. We developed guideline diagnosing treating long analyzing latest research data collected start COVID-19 pandemic until June 2023, along consensus expert opinions. This provides recommendations diagnosis that be applied practice, total 32 key questions related COVID. The should comprehensive, including medical history, physical examination, blood tests, imaging studies, functional tests. To reduce risk developing COVID, vaccination antiviral during acute phase are recommended. will revised there reasonable updates availability new

Язык: Английский

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Navigating neurologic post-COVID-19 conditions in adults: Management strategies for cognitive dysfunction, headaches and neuropathies

Life Sciences, Год журнала: 2025, Номер 362, С. 123374 - 123374

Опубликована: Янв. 5, 2025

Язык: Английский

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A practical framework for Long COVID treatment in primary care

Life Sciences, Год журнала: 2024, Номер 354, С. 122977 - 122977

Опубликована: Авг. 12, 2024

Язык: Английский

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Identification of a multi-omics factor predictive of long COVID in the IMPACC study

bioRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Фев. 14, 2025

Following SARS-CoV-2 infection, ∼10-35% of COVID-19 patients experience long COVID (LC), in which often debilitating symptoms persist for at least three months. Elucidating the biologic underpinnings LC could identify therapeutic opportunities. We utilized machine learning methods on analytes and patient reported outcome surveys provided over 12 months after hospital discharge from >500 hospitalized IMPACC cohort to a multi-omics "recovery factor". participants who experienced had lower recovery factor scores compared without LC. Biologic characterization revealed increased levels plasma proteins associated with inflammation, elevated transcriptional signatures heme metabolism, decreased androgenic steroids patients. The was also altered circulating immune cell frequencies. Notably, were predictive occurrence as early admission, irrespective acute disease severity. Thus, identifies risk infection reveals biomarkers potential treatment targets.

Язык: Английский

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Analysis of 977 Long COVID Patients Reveals Prevalent Neuropathy and Association with Anti-Ganglioside Antibodies

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Март 5, 2025

Abstract Background Long COVID (LC) is a novel condition that characterized by persistent symptoms last from months to years following SARS-CoV-2 infection. While LC vary widely, neuropathy one of the most prevalent and drastically affects patients’ quality life. However, underlying pathophysiology remains poorly understood. Here, we investigated prevalence potential mechanisms in largest cohort date. Methods We conducted an observational study 977 adults with at Dell Medical School. Participants underwent clinical assessments, skin punch biopsy, comprehensive metabolic, endocrine immunological profiling. A subset patients received treatment intravenous immunoglobulin (IVIG). Findings Neuropathic were reported 55% (534/977) participants, biopsy confirming small fiber 56.5% (48/85) cases, affecting both epidermal autonomic nerve fibers. Common risk factors for neuropathy, including metabolic disorders, did not fully explain neuropathic symptoms. general markers (lymphocyte, T cell, B cell count C reactive protein unremarkable, unexpectedly, detected anti-ganglioside antibodies (AGAs) 25% comparable rate other AGA-associated neuropathies. Longitudinal testing revealed AGA positivity, multiple elevated AGAs patients. In pilot eight patients, IVIG resulted improvement patient Interpretation Our findings reveal high LC, evidence suggesting autoimmune mechanism involving four The therapeutic response further supports pathophysiology, benefits immunomodulation

Язык: Английский

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Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic

Annals of Clinical and Translational Neurology, Год журнала: 2025, Номер unknown

Опубликована: Апрель 8, 2025

ABSTRACT Objective To report Long COVID characteristics and longitudinal courses of patients evaluated between 4/14/21–4/14/22 at the University Pennsylvania Neurological Clinic (PNCC), including clinical symptoms, neurological examination findings, neurocognitive screening tests from a standardized PNCC evaluation approach. Methods This is retrospective cross‐sectional study in single‐center tertiary care academic center. Participants include 240 with documented evidence positive SARS‐CoV‐2 PCR or antibody test who underwent initial 182 follow‐up. Main outcomes are patient demographics, duration illness prior to self‐reported improvement, cognitive testing results—including Montreal Cognitive Assessment (version 8.2) (MoCA) Oral Trail Making Test‐B (OTMT‐B). Results The majority (73%) did not require hospitalization for their acute COVID‐19 symptoms. Frequent complaints included headache (60%), dizziness/vertigo (40%), disturbance taste/smell (40%). Almost all (94%) reported over 30% had abnormal scores on testing. Severe infection, fewer years education level, non‐White race were found be statistically associated an increased likelihood having Neuroimaging laboratory largely informative care. Sixty‐two percent follow‐up visits improvement primary complaint within 1 year evaluation. Interpretation Performance may consistent frequently patients. most common trajectory was symptom.

Язык: Английский

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Compassion fatigue, work engagement, and psychological distress in health care workers treating patients with long COVID

PM&R, Год журнала: 2025, Номер unknown

Опубликована: Апрель 18, 2025

Abstract Background Health care workers (HCWs) caring for patients with chronic disease are more likely to experience compassion fatigue. The impacts on HCWs a new complex disease, long COVID, unknown. Objective To measure fatigue, work engagement, and psychological distress in COVID investigate associations personal history of demographic occupational characteristics. Design Cross‐sectional survey study assessing characteristics, Compassion Fatigue‐Short Scale (CF‐SS), Utrecht Work Engagement Scale‐3 (UWES‐3), Screening Tool Psychological Distress (STOP‐D) COVID. Setting Online from March–June 2023. Participants 116 Interventions Not applicable. Main Outcome Measures CF‐SS, UWES‐3, STOP‐D scores factors. Results had worse all outcome measures compared those without Effects were moderate (UWES‐3: η 2 = −0.09, p .01; STOP‐D: 0.06, .02; CF‐SS: 0.07, .02). comparable between physical medicine rehabilitation physicians other ( > .05). CF‐SS showed small positive correlation r s 0.19, n 112, .04) the percentage provider's patient population Mean differed career‐level groups medium large effects 0.13, 0.06). engagement was early career late <.01). middle fatigue Conclusions Among mean primary outcomes without. Early this less engaged greater whereas distress.

Язык: Английский

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Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement

PM&R, Год журнала: 2025, Номер unknown

Опубликована: Апрель 22, 2025

Abstract Background In 2021, the American Academy of Physical Medicine and Rehabilitation established Multi‐Disciplinary Post‐Acute Sequelae SARS‐CoV‐2 Infection Collaborative to provide guidance from Long COVID clinics for evaluation management COVID. The collaborative previously published eight consensus statements using a primarily symptom‐based approach. However, symptoms most often do not occur in isolation. Aims This compendium aims equip clinicians with an efficient, up‐to‐date clinical resource evaluating managing adults experiencing symptoms. primary intended audience includes physiatrists, care physicians, other who first‐line assessment symptoms, especially settings where subspecialty is readily available. provides holistic framework management, symptom‐specific considerations, updates on prevalence, health equity, disability pathophysiology, emerging evidence regarding treatments under investigation. Because closely resembles infection‐associated chronic conditions (IACCs) such as myalgic encephalomyelitis/chronic fatigue syndrome, this may also be helpful these related conditions. Methods Guidance was developed by collaborative's modified Delphi multidisciplinary group whose members include pulmonologists, cardiologists, psychiatrists, neuropsychologists, neurologists, occupational therapists, physical speech language pathologists, patients, government representatives. Over 40 centers are represented collaborative. Results defined National Academies Sciences, Engineering, “an IACC that occurs after infection present at least 3 months continuous, relapsing remitting, or progressive disease state affects one more organ systems.” current global prevalence estimated 6%. Higher has been identified among female gender, certain racial ethnic groups, individuals live nonurban areas. anyone can develop being infected virus. wide variety symptom clusters. common exaggerated diminished energy windows, postexertional malaise (PEM)/postexertional exacerbation (PESE), cognitive impairment (brain fog), dysautonomia, pain/myalgias, smell taste alterations. Holistic should traditional history, examination, additional diagnostic testing, indicated. A positive COVID‐19 test during acute required diagnose COVID, currently, there no single laboratory finding definitively confirming ruling out diagnosis basic recommended all patients possible consideration labs procedures guided patient's specific Current strategies focus supportive care. Critical considerations conservation addressing comorbidities modifiable risk factors. Additionally, (1) it essential validate experience reassurance their taken seriously because many have had dismissed loved ones clinicians; (2) activity recommendations must carefully tailored tolerance overly intense trigger PEM/PESE worsened muscle damage; (3) treatment delivered humility persistent unknowns To date, limited data guide medication specifically context As such, use generally follows standard practice indications dosing, extra attention prioritize patient preference via shared decision‐making cautious medications improve some (eg, cognitive/attention impairment) but worsen PEM/PESE). Numerous trials investigating treatments. return‐to‐work process challenging fluctuate, vary nature, affect multiple functional areas cognitive), manifest “invisible disability” acknowledged employers coworkers. Clinicians help return work identifying suitable workplace accommodations resources, providing necessary documentation, recommending vocational therapy when needed. If efforts unsuccessful significantly worsens impedes recovery, applying warranted. recognized potential Americans Disabilities Act. Conclusion contribute overall well‐being manner acknowledges challenges faced uncertainties field. For detailed information readers reference statements.

Язык: Английский

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Dissecting clinical features of COVID-19 in a cohort of 21,312 acute care patients

Communications Medicine, Год журнала: 2025, Номер 5(1)

Опубликована: Апрель 25, 2025

Although, COVID-19 has resulted in over 7 million deaths globally, many questions still remain about the risk factors for disease severity and effects of variants vaccinations course pandemic. To address this gap, we conducted a retrospective analysis electronic health records from patients 2.5 years pandemic to identify associated clinical features. We analyze cohort 21,312 acute-care year period define six trajectory groups (TGs) with demographics, diagnoses, vitals, labs, imaging, consultations, medications. show that proportion mild increased time, particularly during Omicron waves. Additionally, while fatal had differences age, age did not distinguish severe versus critical disease. Furthermore, find both male sex Hispanic/Latino ethnicity are more severe/critical TGs. More also have higher rate neuropsychiatric diagnoses along an immunological signature high neutrophils immature granulocytes, low lymphocytes monocytes. Interestingly, albumin is one best lab predictors association malnutrition patients, raising concern nutritional insufficiency influencing outcomes. Despite this, only small fraction labs checked (e.g. Vitamin D, thiamine, B vitamins) or received vitamin supplementation. Our findings expand on COVID-19, highlight interaction between severity, status, complications acute care enable identification at

Язык: Английский

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