BMJ Open Respiratory Research,
Год журнала:
2024,
Номер
11(1), С. e002111 - e002111
Опубликована: Фев. 1, 2024
Background
Multiple
prolonged
symptoms
observed
in
patients
who
recovered
from
COVID-19
are
defined
as
long
COVID.
Although
diverse
phenotypic
combinations
possible,
they
remain
unclear.
This
study
aimed
to
perform
a
cluster
analysis
of
COVID
Japan
and
clarify
the
association
between
its
characteristics
background
factors
quality
life
(QOL).
Methods
multicentre
prospective
cohort
collected
various
QOL
after
January
2020
February
2021.
included
935
aged
≥18
years
with
at
26
participating
medical
facilities.
Hierarchical
was
performed
using
24
symptom
3
months
diagnosis.
Results
Participants
were
divided
into
following
five
clusters:
numerous
across
multiple
organs
(cluster
1,
n=54);
no
or
minor
2,
n=546);
taste
olfactory
disorders
3,
n=76);
fatigue,
psychoneurotic
dyspnoea
(low
prevalence
cough
sputum)
4,
n=207)
fatigue
(high
5,
n=52).
Cluster
1
elderly
severe
symptoms,
while
young
female
mild
symptoms.
No
significant
differences
comorbidities.
showed
most
impaired
QOL,
followed
by
clusters
4
5;
these
changes
well
composition
over
year.
Conclusions
We
identified
clusters.
Future
different
pathologies
could
result
individualised
treatment
Trial
registration
number
The
protocol
is
registered
UMIN
clinical
trials
registry
(UMIN000042299).
Nature Medicine,
Год журнала:
2022,
Номер
29(1), С. 226 - 235
Опубликована: Дек. 1, 2022
Abstract
The
post-acute
sequelae
of
SARS-CoV-2
infection
(PASC)
refers
to
a
broad
spectrum
symptoms
and
signs
that
are
persistent,
exacerbated
or
newly
incident
in
the
period
after
acute
infection.
Most
studies
have
examined
these
conditions
individually
without
providing
evidence
on
co-occurring
conditions.
In
this
study,
we
leveraged
electronic
health
record
data
two
large
cohorts,
INSIGHT
OneFlorida+,
from
national
Patient-Centered
Clinical
Research
Network.
We
created
development
cohort
validation
OneFlorida+
including
20,881
13,724
patients,
respectively,
who
were
infected,
investigated
their
diagnoses
30–180
days
documented
Through
machine
learning
analysis
over
137
conditions,
identified
four
reproducible
PASC
subphenotypes,
dominated
by
cardiac
renal
(including
33.75%
25.43%
patients
cohorts);
respiratory,
sleep
anxiety
(32.75%
38.48%);
musculoskeletal
nervous
system
(23.37%
23.35%);
digestive
respiratory
(10.14%
12.74%)
sequelae.
These
subphenotypes
associated
with
distinct
patient
demographics,
underlying
before
phase
severity.
Our
study
provides
insights
into
heterogeneity
may
inform
stratified
decision-making
management
EBioMedicine,
Год журнала:
2022,
Номер
87, С. 104413 - 104413
Опубликована: Дек. 21, 2022
Stratification
of
patients
with
post-acute
sequelae
SARS-CoV-2
infection
(PASC,
or
long
COVID)
would
allow
precision
clinical
management
strategies.
However,
COVID
is
incompletely
understood
and
characterised
by
a
wide
range
manifestations
that
are
difficult
to
analyse
computationally.
Additionally,
the
generalisability
machine
learning
classification
COVID-19
outcomes
has
rarely
been
tested.
Journal of Clinical Investigation,
Год журнала:
2022,
Номер
132(15)
Опубликована: Июль 31, 2022
SARS-CoV-2–infected
individuals
may
suffer
a
multi–organ
system
disorder
known
as
"long
COVID"
or
post-acute
sequelae
of
SARS-CoV-2
infection
(PASC).
There
are
no
standard
treatments,
the
pathophysiology
is
unknown,
and
incidence
varies
by
clinical
phenotype.
Acute
COVID-19
correlates
with
biomarkers
systemic
inflammation,
hypercoagulability,
comorbidities
that
less
prominent
in
PASC.
Macrovessel
thrombosis,
hallmark
acute
COVID-19,
frequent
Female
sex
at
birth
associated
reduced
risk
for
progression,
but
increased
Persistent
microvascular
endotheliopathy
cryptic
tissue
reservoirs
has
been
implicated
PASC
pathology.
Autoantibodies,
localized
reactivation
latent
pathogens
also
be
involved,
potentially
leading
to
documented
multiple
tissues.
Diagnostic
assays
illuminating
possible
therapeutic
targets
discussed.
Frontiers in Immunology,
Год журнала:
2023,
Номер
14
Опубликована: Апрель 20, 2023
Post-Acute
Sequelae
of
Severe
Acute
Respiratory
Syndrome
Coronavirus
-
2
(SARS-CoV-2)
infection,
or
Long
COVID,
is
a
prevailing
second
pandemic
with
nearly
100
million
affected
individuals
globally
and
counting.
We
propose
visual
description
the
complexity
COVID
its
pathogenesis
that
can
be
used
by
researchers,
clinicians,
public
health
officials
to
guide
global
effort
toward
an
improved
understanding
eventual
mechanism-based
provision
care
afflicted
patients.
The
proposed
visualization
framework
for
should
evidence-based,
dynamic,
modular,
systems-level
approach
condition.
Furthermore,
further
research
such
could
establish
strength
relationships
between
pre-existing
conditions
(or
risk
factors),
biological
mechanisms,
resulting
clinical
phenotypes
outcomes
COVID.
Notwithstanding
significant
contribution
disparities
in
access
social
determinants
have
on
disease
course
long
our
model
focuses
primarily
mechanisms.
Accordingly,
sets
out
scientific,
clinical,
efforts
better
understand
abrogate
burden
imposed
The Lancet Regional Health - Europe,
Год журнала:
2023,
Номер
33, С. 100724 - 100724
Опубликована: Сен. 5, 2023
At
least
5-10%
of
subjects
surviving
COVID-19
develop
the
post-COVID-19
condition
(PCC)
or
"Long
COVID".
The
clinical
presentation
PCC
is
heterogeneous,
its
pathogenesis
being
deciphered,
and
objective,
validated
biomarkers
are
lacking.
It
unknown
if
a
single
entity
heterogeneous
syndrome
with
overlapping
pathophysiological
basis.
large
US
RECOVER
study
identified
four
clusters
according
to
their
presenting
symptoms.
However,
long-term
implications
remain
unknown.We
conducted
2-year
prospective
cohort
COVID-19,
including
individuals
fulfilling
WHO
definition
full
recovery.
We
systematically
collected
symptoms
using
prespecified
questionnaires
performed
additional
diagnostic
imaging
tests
when
needed.
Factors
associated
were
modelled
logistic
regression.
Unsupervised
clustering
analysis
was
used
group
recovery
direct
acyclic
graph
approach.The
included
548
individuals,
341
PCC,
followed
for
median
23
months
(IQR
16.5-23.5),
207
fully
recovered.
In
model
best
fit,
who
male
had
tertiary
studies
less
likely
whereas
history
headache,
presence
tachycardia,
fatigue,
neurocognitive
neurosensitive
complaints
dyspnea
at
diagnosis
predicted
development
PCC.
cluster
revealed
three
symptom
an
additive
number
Only
26
(7.6%)
recovered
from
during
follow-up;
almost
all
them
(n
=
24)
belonged
symptomatic
A,
dominated
mainly
by
fatigue.
Recovery
more
in
male,
required
ICU
admission,
cardiovascular
comorbidities,
hyporexia
and/or
smell/taste
alterations
acute
COVID-19.
Subjects
muscle
pain,
impaired
attention,
dyspnea,
conversely,
recover
PCC.Preexisting
medical
socioeconomic
factors,
as
well
symptoms,
extremely
rare
first
2
years,
posing
major
challenge
healthcare
systems.Fundació
Lluita
contra
les
Infeccions.
International Journal of Infectious Diseases,
Год журнала:
2023,
Номер
134, С. 1 - 7
Опубликована: Май 6, 2023
ObjectivesThe
objective
of
this
study
was
to
characterize
post-COVID
condition
symptoms
and
symptom
clusters,
their
duration,
prevalence.MethodsWe
conducted
a
systematic
review
random-effects
meta-analysis
studies
reporting
post-COVID-19
respectively.
We
searched
MEDLINE
(via
PubMed),
Scopus,
Web
Science,
Science
Direct,
Google
Scholar,
EBSCOhost,
EMBASE,
PsycINFO,
Cochrane
Library,
Mednar
for
literature
on
the
up
August
2022.ResultsIn
76
included
studies,
we
found
that
although
most
were
reported
less
frequently
7-12
months
after
infection
compared
earlier,
over
20%
patients
at
least
one
condition-compatible
symptom.
In
seven
neurological
clustering
consistently
identified,
followed
by
cardiorespiratory
systemic/inflammatory.ConclusionPost-COVID
provides
direction
research
into
etiology,
diagnosis,
management
conditions.
Studies
clusters
remain
rare
due
focus
individual
reporting.
should
replace
accelerate
our
understanding
emerging
public
health
issue.