Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis

Brain Behavior and Immunity, Год журнала: 2021, Номер 101, С. 93 - 135

Опубликована: Дек. 29, 2021

Язык: Английский

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Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection

JAMA Network Open, Год журнала: 2021, Номер 4(10), С. e2128568 - e2128568

Опубликована: Окт. 13, 2021

Importance

Short-term and long-term persistent postacute sequelae of COVID-19 (PASC) have not been systematically evaluated. The incidence evolution PASC are dependent on time from infection, organ systems tissue affected, vaccination status, variant the virus, geographic region.

Objective

To estimate system–specific frequency PASC.

Evidence Review

PubMed (MEDLINE), Scopus, World Health Organization Global Literature Coronavirus Disease, CoronaCentral databases were searched December 2019 through March 2021. A total 2100 studies identified cited references. Studies providing data in children adults included. Preferred Reporting Items for Systematic Reviews Meta-analyses (PRISMA) guidelines abstracting followed performed independently by 2 reviewers. Quality was assessed using Newcastle-Ottawa Scale cohort studies. main outcome diagnosed (1) laboratory investigation, (2) radiologic pathology, (3) clinical signs symptoms. classified system, ie, neurologic; cardiovascular; respiratory; digestive; dermatologic; ear, nose, throat as well mental health, constitutional symptoms, functional mobility.

Findings

From a identified, 57 with 250 351 survivors met inclusion criteria. mean (SD) age 54.4 (8.9) years, 140 196 (56%) male, 197 777 (79%) hospitalized during acute COVID-19. High-income countries contributed 45 (79%). median (IQR) proportion experiencing at least 1 54.0% (45.0%-69.0%; 13 studies) month (short-term), 55.0% (34.8%-65.5%; 38 to 5 months (intermediate-term), (31.0%-67.0%; 9 6 or more (long-term). Most prevalent pulmonary sequelae, neurologic disorders, health mobility impairments, general symptoms chest imaging abnormality (median [IQR], 62.2% [45.8%-76.5%]), difficulty concentrating 23.8% [20.4%-25.9%]), generalized anxiety disorder 29.6% [14.0%-44.0%]), impairments 44.0% [23.4%-62.6%]), fatigue muscle weakness 37.5% [25.4%-54.5%]), respectively. Other frequently reported included cardiac, dermatologic, digestive, disorders.

Conclusions Relevance

In this systematic review, than half experienced after recovery. most common involved abnormalities, These effects occur scale that could overwhelm existing care capacity, particularly low- middle-income countries.

Язык: Английский

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Pathophysiology and mechanism of long COVID: a comprehensive review

Annals of Medicine, Год журнала: 2022, Номер 54(1), С. 1473 - 1487

Опубликована: Май 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.

Язык: Английский

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Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)—A Systemic Review and Comparison of Clinical Presentation and Symptomatology

Medicina, Год журнала: 2021, Номер 57(5), С. 418 - 418

Опубликована: Апрель 26, 2021

Background and Objectives: Long COVID defines a series of chronic symptoms that patients may experience after resolution acute COVID-19. Early reports from studies with long suggests constellation similarities to another medical illness—myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A review study comparing contrasting ME/CFS reported yield mutualistic insight into the characterization management both conditions. Materials Methods: systemic literature search was conducted in MEDLINE PsycInfo through 31 January 2021 for related symptomatology. The accordance PRISMA methodology. Results: Twenty-one were included qualitative analysis. by compared list compiled multiple case definitions. Twenty-five out 29 known at least one selected study. Conclusions: symptomatology suggest many overlaps clinical presentation ME/CFS. need monitoring treatment post-COVID is evident. Advancements standardization research methodologies would improve quality future research, allow further investigations differences between

Язык: Английский

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Accelerated biological aging in COVID-19 patients

Nature Communications, Год журнала: 2022, Номер 13(1)

Опубликована: Апрель 19, 2022

Abstract Chronological age is a risk factor for SARS-CoV-2 infection and severe COVID-19. Previous findings indicate that epigenetic could be altered in viral infection. However, the aging COVID-19 has not been well studied. In this study, DNA methylation of blood samples from 232 healthy individuals 413 patients profiled using EPIC array. Epigenetic ages each individual are determined by applying clocks telomere length estimator to profile individual. acceleration calculated compared between groups. We observe strong correlations individual’s chronological ( r > 0.8, p < 0.0001). also find increasing attrition sequential infected developing non-severe addition, longitudinal profiling analysis accumulation syndrome partly reversed at late clinic phases some patients. conclusion, accelerated associated with may contribute post-COVID-19 among survivors.

Язык: Английский

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SARS-CoV-2 drives JAK1/2-dependent local complement hyperactivation

Science Immunology, Год журнала: 2021, Номер 6(58)

Опубликована: Апрель 2, 2021

Patients with coronavirus disease 2019 (COVID-19) present a wide range of acute clinical manifestations affecting the lungs, liver, kidneys and gut. Angiotensin converting enzyme (ACE) 2, best-characterized entry receptor for disease-causing virus SARS-CoV-2, is highly expressed in aforementioned tissues. However, pathways that underlie are still poorly understood. Here, we unexpectedly found complement system was one intracellular most induced by SARS-CoV-2 infection lung epithelial cells. Infection respiratory cells generated activated component C3a could be blocked cell-permeable inhibitor factor B (CFBi), indicating presence an inducible cell-intrinsic C3 convertase Within bronchoalveolar lavage patients, distinct signatures activation myeloid, lymphoid tracked severity. Genes drugs normalize these genes both implicated interferon-JAK1/2-STAT1 signaling NF-κB as main drivers their expression. Ruxolitinib, JAK1/2 inhibitor, normalized interferon signature all gene transcripts cell lines, but did not affect NF-κB-regulated genes. alone or combination antiviral remdesivir, inhibited protein produced infected Together, postulate therapy JAK inhibitors NF-κB-signaling potentially have application severe COVID-19.

Язык: Английский

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Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

eLife, Год журнала: 2023, Номер 12

Опубликована: Март 22, 2023

COVID-19, with persistent and new onset of symptoms such as fatigue, post-exertional malaise, cognitive dysfunction that last for months impact everyday functioning, is referred to Long COVID under the general category post-acute sequelae SARS-CoV-2 infection (PASC). PASC highly heterogenous may be associated multisystem tissue damage/dysfunction including acute encephalitis, cardiopulmonary syndromes, fibrosis, hepatobiliary damages, gastrointestinal dysregulation, myocardial infarction, neuromuscular neuropsychiatric disorders, pulmonary damage, renal failure, stroke, vascular endothelial dysregulation. A better understanding pathophysiologic mechanisms underlying essential guide prevention treatment. This review addresses potential hypotheses connect long-term health consequences. Comparisons between other virus-initiated chronic syndromes myalgic encephalomyelitis/chronic fatigue syndrome postural orthostatic tachycardia will addressed. Aligning identifying potentially regulated common underlining pathways necessary true nature PASC. The discussed contributors include from injury one or more organs, reservoirs replicating virus its remnants in several tissues, re-activation latent pathogens Epstein-Barr herpes viruses COVID-19 immune-dysregulated environment, interactions host microbiome/virome communities, clotting/coagulation dysfunctional brainstem/vagus nerve signaling, dysautonomia autonomic dysfunction, ongoing activity primed immune cells, autoimmunity due molecular mimicry pathogen proteins. individualized suggests different therapeutic approaches required best manage specific patients.

Язык: Английский

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A Systematic Review of Persistent Symptoms and Residual Abnormal Functioning following Acute COVID-19: Ongoing Symptomatic Phase vs. Post-COVID-19 Syndrome

Journal of Clinical Medicine, Год журнала: 2021, Номер 10(24), С. 5913 - 5913

Опубликована: Дек. 16, 2021

To compare the two phases of long COVID, namely ongoing symptomatic COVID-19 (OSC; signs and symptoms from 4 to 12 weeks initial infection) post-COVID-19 syndrome (PCS; beyond weeks) with respect symptomatology, abnormal functioning, psychological burden, quality life.

Язык: Английский

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Long COVID and the cardiovascular system—elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies: a joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial and Pericardial Diseases

Cardiovascular Research, Год журнала: 2022, Номер 119(2), С. 336 - 356

Опубликована: Июль 25, 2022

Abstract Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available cardiovascular manifestations of long COVID. In addition chronic fatigue, which is common symptom COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, newly developed supraventricular ventricular arrhythmias. Imaging heart vessels provided evidence chronic, post-infectious perimyocarditis consequent left right failure, arterial wall inflammation, microthrombosis in certain patient populations. Better understanding underlying cellular molecular mechanisms will aid development effective treatment strategies its manifestations. A number have been proposed, including those involving direct effects on myocardium, microthrombotic damage endothelium, persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, inflammatory markers, are not highly predictive either presence outcome when measured 3 infection. Further studies needed understand mechanisms, identify specific guide future preventive treatments address sequelae.

Язык: Английский

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Challenges in defining Long COVID: Striking differences across literature, Electronic Health Records, and patient-reported information

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2021, Номер unknown

Опубликована: Март 26, 2021

Since late 2019, the novel coronavirus SARS-CoV-2 has introduced a wide array of health challenges globally. In addition to complex acute presentation that can affect multiple organ systems, increasing evidence points long-term sequelae being common and impactful. The worldwide scientific community is forging ahead characterize range outcomes associated with infection; however underlying assumptions in these studies have varied so widely resulting data are difficult compareFormal definitions needed order design robust consistent Long COVID consistently capture variation outcomes. Even condition itself goes by three terms, most "Long COVID", but also "COVID-19 syndrome (PACS)" or, "post-acute infection (PASC)". present study, we investigate used literature published date compare them against available from electronic records patient-reported information collected via surveys. holds potential produce second public crisis on heels pandemic itself. Proactive efforts identify characteristics this heterogeneous imperative for rigorous effort mitigate threat.

Язык: Английский

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