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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Chronic inflammation, neutrophil activity, and autoreactivity splits long COVID

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Июль 14, 2023

While immunologic correlates of COVID-19 have been widely reported, their associations with post-acute sequelae (PASC) remain less clear. Due to the wide array PASC presentations, understanding if specific disease features associate discrete immune processes and therapeutic opportunities is important. Here we profile patients in recovery phase via proteomics screening machine learning find signatures ongoing antiviral B cell development, immune-mediated fibrosis, markers death but not controls uncomplicated recovery. Plasma profiling further allow stratification into inflammatory non-inflammatory types. Inflammatory PASC, identifiable through a refined set 12 blood markers, displays evidence neutrophil activity, memory alterations, building autoreactivity more than year post COVID-19. Our work thus helps refine categorization aid both targeting epidemiological investigation PASC.

Язык: Английский

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Solving the puzzle of Long Covid

Science, Год журнала: 2024, Номер 383(6685), С. 830 - 832

Опубликована: Фев. 22, 2024

Long Covid provides an opportunity to understand how acute infections cause chronic disease

Язык: Английский

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SARS-CoV-2 Reinfections and Long COVID in the Post-Omicron Phase of the Pandemic

International Journal of Molecular Sciences, Год журнала: 2023, Номер 24(16), С. 12962 - 12962

Опубликована: Авг. 19, 2023

We are reviewing the current state of knowledge on virological and immunological correlates long COVID, focusing recent evidence for possible association between increasing number SARS-CoV-2 reinfections parallel pandemic COVID. The severity largely depends initial episode; in turn, this is determined both by a combination genetic factors, particularly related to innate immune response, pathogenicity specific variant, especially its ability infect induce syncytia formation at lower respiratory tract. cumulative risk COVID as well various cardiac, pulmonary, or neurological complications increases proportionally infections, primarily elderly. Therefore, cases expected remain high future. Reinfections apparently increase likelihood but less so if they mild asymptomatic children adolescents. Strategies prevent urgently needed, among older adults who have higher burden comorbidities. Follow-up studies using an established case definition precise diagnostic criteria people with without reinfection may further elucidate contribution burden. Although accumulating supports vaccination, before after infection, preventive strategy reduce more robust comparative observational studies, including randomized trials, needed provide conclusive effectiveness vaccination preventing mitigating all age groups. Thankfully, answers not only prevention, also treatment options rates recovery from gradually starting emerge.

Язык: Английский

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Mechanisms of long COVID and the path toward therapeutics

Cell, Год журнала: 2024, Номер unknown

Опубликована: Сен. 1, 2024

Язык: Английский

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Mechanisms of endothelial activation, hypercoagulation and thrombosis in COVID-19: a link with diabetes mellitus

Cardiovascular Diabetology, Год журнала: 2024, Номер 23(1)

Опубликована: Фев. 20, 2024

Abstract Early since the onset of COVID-19 pandemic, medical and scientific community were aware extra respiratory actions SARS-CoV-2 infection. Endothelitis, hypercoagulation, hypofibrinolysis identified in patients as subsequent responses endothelial dysfunction. Activation barrier may increase severity disease contribute to long-COVID syndrome post-COVID sequelae. Besides, it cause alterations primary, secondary, tertiary hemostasis. Importantly, these have been highly decisive evolution infected also diagnosed with diabetes mellitus (DM), who showed previous In this review, we provide an overview potential triggers activation related under diabetic milieu. Several mechanisms are induced by both viral particle itself immune-defensive response (i.e., NF-κB/NLRP3 inflammasome pathway, vasoactive peptides, cytokine storm, NETosis, complement system). Alterations coagulation mediators such factor VIII, fibrin, tissue factor, von Willebrand factor: ADAMST-13 ratio, kallikrein-kinin or plasminogen-plasmin systems reported. Moreover, imbalance thrombotic thrombolytic (tPA, PAI-I, fibrinogen) factors favors hypercoagulation hypofibrinolysis. context DM, can be exacerbated leading higher loss However, a series therapeutic strategies targeting activated endothelium specific antibodies inhibitors against thrombin, key cytokines, X, system, system might represent new opportunities address hypercoagulable state present DM. Antidiabetics ameliorate dysfunction, inflammation, platelet aggregation. By improving microvascular pathology subjects, associated comorbidities risk mortality could reduced.

Язык: Английский

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Metformin: Therapeutic profile in the treatment of type 2 diabetes

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(S3), С. 3 - 19

Опубликована: Май 24, 2024

Metformin (dimethyl-biguanide) can claim its origins in the use of Galega officinalis as a plant treatment for symptoms ascribed to diabetes. Since first clinical metformin glucose-lowering agent 1957, this medicine has emerged first-line pharmacological option support lifestyle interventions management type 2 diabetes (T2D). It acts through multiple cellular pathways, principally gut, liver and muscle, counter insulin resistance lower blood glucose without weight gain or risk overt hypoglycaemia. Other effects include improvements lipid metabolism, decreased inflammation long-term cardiovascular risk. is conveniently combined with other medications, be prescribed prediabetes reduce progression T2D, used some regions assist glycaemic control pregnancy. Consistent diversity actions, established safety profile cost-effectiveness, being assessed further possible applications. The requires adequate renal function drug elimination, may cause initial gastrointestinal side effects, which moderated by taking meals using an extended-release formulation. Thus, serves valuable therapeutic resource throughout natural history T2D.

Язык: Английский

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Cardiovascular disease as part of Long COVID: a systematic review

European Journal of Preventive Cardiology, Год журнала: 2024, Номер unknown

Опубликована: Фев. 20, 2024

Long COVID syndrome has had a major impact on million patients' lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed narrative review order to identify the extent manifestations syndrome.

Язык: Английский

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Clinical course and management of COVID-19 in the era of widespread population immunity

Nature Reviews Microbiology, Год журнала: 2023, Номер 22(2), С. 75 - 88

Опубликована: Дек. 19, 2023

Язык: Английский

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Drug Therapies for Diabetes

International Journal of Molecular Sciences, Год журнала: 2023, Номер 24(24), С. 17147 - 17147

Опубликована: Дек. 5, 2023

The treatment of type 2 diabetes (T2D) necessitates a multifaceted approach that combines behavioral and pharmacological interventions to mitigate complications sustain high quality life. Treatment encompasses the management glucose levels, weight, cardiovascular risk factors, comorbidities, associated through medication lifestyle adjustments. Metformin, standard in management, continues serve as primary, first-line oral across all age groups due its efficacy, versatility combination therapy, cost-effectiveness. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for HbA1c weight reduction, with significant benefits. Sodium-glucose cotransporter inhibitors (SGLT-2i) lower levels independently insulin while conferring cardiovascular, renal, heart-failure outcomes. Combined therapies emphasizing early sustained glycemic control are promising options management. As therapy remains pivotal, metformin non-insulin agents such GLP-1 RA SGLT-2i compelling options. Notably, exciting novel treatments like dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist show promise substantially reducing glycated hemoglobin body weight. This comprehensive review highlights evolving landscape pharmacotherapy diabetes, drugs currently available treating their effectiveness impact on target organs, side effects. work also provides insights can support customization strategies.

Язык: Английский

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