Long COVID in pediatrics—epidemiology, diagnosis, and management

European Journal of Pediatrics, Год журнала: 2024, Номер 183(4), С. 1543 - 1553

Опубликована: Янв. 27, 2024

Abstract This review summarizes current knowledge on post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children adolescents. A literature was performed to synthesize information from clinical studies, expert opinions, guidelines. PASC also termed Long COVID — at any age comprise a plethora unspecific symptoms present later than 4 weeks after confirmed or probable infection with severe respiratory syndrome corona virus type 2 (SARS-CoV-2), without another medical explanation. PCC adolescents defined by the WHO as occurring within 3 months acute coronavirus disease 2019 (COVID-19), lasting least months, limiting daily activities. Pediatric mostly manifest mild courses majority cases remit few months. However, can last for more 1 year may result significant disability. Frequent include fatigue, exertion intolerance, anxiety. Some patients postural tachycardia (PoTS), small number fulfill criteria myalgic encephalomyelitis/chronic fatigue (ME/CFS). To date, no diagnostic marker has been established, differential diagnostics remains challenging. Therapeutic approaches appropriate self-management well palliation non-pharmaceutical pharmaceutical strategies. Conclusion : pediatrics heterogenous severity duration. stepped, interdisciplinary, individualized approach is essential management. Current health care structures have be adapted, research extended meet psychosocial needs young people similar conditions. What Known: • Post-acute (COVID-19) lead activity limitation reduced quality life. belongs large group syndromes (PAIS). Specific biomarkers causal treatment options are not yet available. New: In February 2023, case definition post provided World Health Organization (WHO), indicating duration Interdisciplinary collaborations necessary established worldwide offer harmonized, multimodal diagnosis management PASC/PCC

Язык: Английский

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Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial

Psychological Medicine, Год журнала: 2023, Номер 54(6), С. 1122 - 1132

Опубликована: Окт. 16, 2023

Abstract Background The post-COVID-19 condition describes the persistence or onset of somatic symptoms (e.g. fatigue) after acute COVID-19. Based on an existing cognitive-behavioral treatment protocol, we developed a specialized group intervention for individuals with condition. present study examines feasibility, acceptance, and effectiveness program inpatients in neurological rehabilitation setting. Methods comprises eight sessions includes psychoeducational experience-based interventions common psychophysiological mechanisms persistent symptoms. A feasibility trial was conducted using one-group design naturalistic N = 64 history mild COVID-19 that fulfilled WHO criteria were enrolled. After each session, evaluation forms completed psychometric questionnaires psychopathological symptom burden collected pre- post-intervention. Results well received by participants therapists. Each session rated as comprehensible overall satisfaction high. Pre-post effect sizes (of standard incl. new program; intention-to-treat) showed significantly reduced subjective fatigue ( p < 0.05, d av 0.33) improved disease coping ps 0.33–0.49). Conclusions Our results support acceptance newly Yet, findings have to be interpreted cautiously due lack control follow-up measurement, small sample size, relatively high drop-out rate.

Язык: Английский

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Characteristic functional connectome related to Post-COVID-19 syndrome

Scientific Reports, Год журнала: 2024, Номер 14(1)

Опубликована: Фев. 29, 2024

Abstract Post-COVID-19 syndrome is a serious complication following SARS-CoV-2 infection, characterized primarily by fatigue and cognitive complaints. Although first metabolic structural imaging alterations in have been identified, their functional consequences remain unknown. Thus, we explored the impact of on connectome brain providing deeper understanding pathophysiological mechanisms. In cross-sectional observational study, resting-state magnetic resonance data 66 patients with after mild infection (mean age 42.3 years, 57 female) healthy controls 42.1 38 mean time seven months acute COVID-19 were analysed using graph theoretical approach. Network features quantified measures including distance, nodal degree, betweenness Katz centrality, compared between both groups. Graph correlated clinical quantifying fatigue, function, affective symptoms sleep disturbances. Alterations mainly found brainstem, olfactory cortex, cingulate thalamus cerebellum average infection. Additionally, strong correlations severity, functioning daytime sleepiness from scales observed. Our study confirms relevance changes as mediating factors for persistent improves our understanding.

Язык: Английский

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Long-COVID syndrome: physical–mental interplay in the spotlight

Inflammopharmacology, Год журнала: 2023, Номер 31(2), С. 559 - 564

Опубликована: Март 9, 2023

Patients suffering from Long-COVID syndrome experience a variety of different symptoms on physical, but also psychological and social level. Previous psychiatric conditions such as depression anxiety have been identified separate risk factors for developing syndrome. This suggests complex interplay physical mental rather than simple cause-effect relationship specific biological pathogenic process. The biopsychosocial model provides foundation understanding these interactions integrating them into broader perspective the patient disease instead individual symptoms, pointing towards need treatment options well level besides targets. leads to our conclusion, that should be underlying philosophy understanding, diagnosing treating patients syndrome, moving away strictly biomedical suspected by many patients, treaters media while reducing stigma still associated with suggestion physical-mental interplay.

Язык: Английский

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Multi-target drugs for the treatment of cognitive impairment and fatigue in post-COVID syndrome: focus on Ginkgo biloba and Rhodiola rosea

Journal of Neural Transmission, Год журнала: 2024, Номер 131(3), С. 203 - 212

Опубликована: Фев. 12, 2024

Abstract Cognitive impairment, depression and (mental) fatigue represent the most frequent neuropsychiatric symptoms of post-COVID syndrome. Neuroinflammation, oxidative stress mitochondrial dysfunction have been identified as common pathophysiological mechanisms underlying these symptoms. Attempts to treat post-COVID-associated cognitive impairment with different drugs available for other diseases not yet successful. One probable explanation could be that work by one specific mechanism action only in a broad multi-target way. Therefore, they will address spectrum possibly responsible Notably, nearly all currently under investigation syndrome are rather addressing single target instead several pathomechanisms this condition. Contrary approach, herbal often consist many ingredients pharmacological properties targets. might promising approach treatment symptomatic presentation following SARS-CoV-2 infection. Of drugs, extracts Ginkgo biloba Rhodiola rosea probably best investigated candidates. Their vitro vivo includes anti-oxidative, anti-inflammatory, antidepressant well reducing fatigue. In studies, both showed positive effects on physical mental impaired cognition. Moreover, depressive were also reduced some studies. However, even if results promising, data still preliminary require additional proof further

Язык: Английский

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Cardiopulmonary Long-Term Sequelae in Patients after Severe COVID-19 Disease

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(4), С. 1536 - 1536

Опубликована: Фев. 15, 2023

We aimed to identify cardiopulmonary long-term effects after severe COVID-19 disease as well predictors of Long-COVID in a prospective registry. A total 150 consecutive, hospitalized patients (February 2020 and April 2021) were included six months post hospital discharge for clinical follow-up. Among them, 49% experienced fatigue, 38% exertional dyspnea 75% fulfilled criteria Long-COVID. Echocardiography detected reduced global longitudinal strain (GLS) 11% diastolic dysfunction 4%. Magnetic resonance imaging revealed traces pericardial effusion 18% signs former pericarditis or myocarditis Pulmonary function was impaired 11%. Chest computed tomography identified post-infectious residues 22%. Whereas fatigue did not correlate with abnormalities, associated pulmonary (OR 3.6 [95% CI: 1.2-11], p = 0.026), GLS 5.2 1.6-16.7], 0.003) and/or left ventricular 4.2 1.03-17], 0.04). Predictors length in-hospital stay (OR: 1.15 1.05-1.26], 0.004), admission intensive care unit cannot be computed, 0.001) higher NT-proBNP 1.5 1.05-2.14], 0.026). Even 6 discharge, majority While no associations between abnormalities found, correlated function, dysfunction.

Язык: Английский

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Subjective and Objective Cognitive Deficits in Patients with Post-COVID Syndrome

Zeitschrift für Neuropsychologie, Год журнала: 2023, Номер 34(2), С. 99 - 110

Опубликована: Май 24, 2023

Abstract: Cognitive impairment is a prominent symptom of the post-COVID syndrome (PCS). However, correspondence between subjective cognitive complaints (SCC) and objective results inconsistent. Here, we investigated this discrepancy. This longitudinal study included N = 42 individuals who reported SCC as PCS after mild infection at inclusion. Data collection comprised questionnaires neuropsychological assessment baseline follow-up (FU). At FU – on average 15 months acute COVID-19 88 % patients persisting SCC. There was an approx. 40 discrepancy report test both visits. Patients with indicated elevated fatigue reduced quality life compared to without FU. A growing number anticipated request assessments even infections.

Язык: Английский

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Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Frontiers in Pharmacology, Год журнала: 2024, Номер 15

Опубликована: Апрель 22, 2024

Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking. Methods: A systematic literature search evaluating the diagnosis and treatment of associated PCS was conducted. Practical PCS-associated care summarized, based on an evaluation pharmacological plausibility clinical applications. Results: Currently, pathology remains unclear no high-quality data to support targeted interventions. Existing approaches directed towards symptom relief where counseling chronicity disease regular reassessments at 4- 8-week intervals considered reasonable. Patients should be informed encouraged adopt a healthy lifestyle that centers around balanced nutrition physical activities. They may also benefit from intake vitamins, micronutrients, probiotics. The administration Ginkgo biloba extract could offer safe potentially beneficial option. Other non-pharmacological measures include physiotherapy, digitally supported training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, when new occur, specialized diagnostic such as comprehensive neurocognitive testing neuroimaging initiated. Very few patients would require inpatient rehabilitation. Conclusion: debilitating condition affect daily functioning reduce work productivity. Management multidisciplinary approach, centering physical, cognitive, therapies.

Язык: Английский

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How are Long-Covid, Post-Sepsis-Syndrome and Post-Intensive-Care-Syndrome related? A conceptional approach based on the current research literature

Critical Care, Год журнала: 2024, Номер 28(1)

Опубликована: Авг. 29, 2024

Long-Covid (LC), Post-Sepsis-Syndrome (PSS) and Post-Intensive-Care-Syndrome (PICS) show remarkable overlaps in their clinical presentation. Nevertheless, it is unclear if they are distinct syndromes, which may co-occur the same patient, or three different labels to describe similar symptoms, assigned on basis patient history professional perspective of treating physician. Therefore, we reviewed current literature relation between LC, PSS PICS. To date, syndromes cannot reliably be distinguished due similarities presentation as share cognitive, psychological physical impairments with only probabilities occurrence a heterogeneity individual expression. The diagnosis furthermore hindered by lack specific diagnostic tools. It can concluded that survivors after COVID-19 sepsis likely have more frequent severe consequences than patients milder courses, some COVID-19-specific sequelae, e.g. an increased risk for venous thromboembolism 30 days acute disease, occur less often other causes. Patients profit from leveraging synergies PICS, LC treatment well experiences gained infection-associated chronic conditions general. Disentangling molecular pathomechanisms enable future targeted therapies go beyond symptomatic treatment.

Язык: Английский

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What We Know About Neurocognitive Outcomes in Long-/Post-COVID-19 Adults

Zeitschrift für Neuropsychologie, Год журнала: 2024, Номер 35(2), С. 63 - 76

Опубликована: Май 1, 2024

Abstract: This review assesses neurocognitive studies on long-/post-COVID-19 adult patients, highlighting the research gaps. We categorize populations by infection severity, demographics, inclusion of controls, and psychological/biological factors. Methodologically, we analyzed 73 (95,600 subjects) from December 2019 to October 2022 using PRISMA-ScR guidelines PICO framework. Our findings revealed that most lacked control groups (88 %) reported unclear overall cognitive outcomes (73 %). While frequently assessed executive functions (86 attention (85 %), there were few longitudinal studies. Varied reporting sample sizes further complicated analysis. The identified gaps encompass convenience sampling, limited studies, inadequate use test batteries, leading a discrepancy between expected outcomes. absence standardized comparisons inconsistent statistical methods exacerbated these

Язык: Английский

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