Long COVID: Clinical characteristics, proposed pathogenesis and potential therapeutic targets

Frontiers in Molecular Biosciences, Год журнала: 2023, Номер 10

Опубликована: Апрель 26, 2023

The emergence of persistent ill-health in the aftermath SARS-CoV-2 infection has presented significant challenges to patients, healthcare workers and researchers. Termed long COVID, or post-acute sequelae COVID-19 (PASC), symptoms this condition are highly variable span multiple body systems. underlying pathophysiology remains poorly understood, with no therapeutic agents proven be effective. This narrative review describes predominant clinical features phenotypes COVID alongside data supporting potential pathogenesis these including ongoing immune dysregulation, viral persistence, endotheliopathy, gastrointestinal microbiome disturbance, autoimmunity, dysautonomia. Finally, we describe current therapies under investigation, as well future options based on proposed research.

Язык: Английский

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Post COVID-19 condition after Wildtype, Delta, and Omicron SARS-CoV-2 infection and prior vaccination: Pooled analysis of two population-based cohorts

PLoS ONE, Год журнала: 2023, Номер 18(2), С. e0281429 - e0281429

Опубликована: Фев. 22, 2023

Background Post COVID-19 condition (PCC) is an important complication of SARS-CoV-2 infection, affecting millions worldwide. This study aimed to evaluate the prevalence and severity post with novel variants after prior vaccination. Methods We used pooled data from 1350 SARS-CoV-2-infected individuals two representative population-based cohorts in Switzerland, diagnosed between Aug 5, 2020, Feb 25, 2022. descriptively analysed PCC, defined as presence frequency PCC-related symptoms six months among vaccinated non-vaccinated infected Wildtype, Delta, Omicron SARS-CoV-2. multivariable logistic regression models assess association estimate risk reduction PCC infection newer further assessed associations using multinomial regression. To identify groups similar symptom patterns differences presentation across variants, we performed exploratory hierarchical cluster analyses. Results found strong evidence that had reduced odds developing compared Wildtype-infected (odds ratio 0.42, 95% confidence interval 0.24–0.68). The were Delta or Wildtype no respect number received vaccine doses timing last vaccinated, Omicron-infected was lower levels. In analyses, identified four clusters diverse systemic, neurocognitive, cardiorespiratory, musculoskeletal symptoms, variants. Conclusion appears be lowered by variant crucial guide future public health measures vaccination strategies.

Язык: Английский

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Immunological profiling in long COVID: overall low grade inflammation and T-lymphocyte senescence and increased monocyte activation correlating with increasing fatigue severity

Frontiers in Immunology, Год журнала: 2023, Номер 14

Опубликована: Окт. 10, 2023

Many patients with SARS-CoV-2 infection develop long COVID fatigue as one of the most disabling symptoms. We performed clinical and immune profiling fatigued non-fatigued age- sex-matched healthy controls (HCs).Long symptoms were assessed using patient-reported outcome measures, including assessment scale (FAS, scores ≥22 denote fatigue), followed up to year after hospital discharge. inflammation-related genes in circulating monocytes, serum levels inflammation-regulating cytokines, leukocyte lymphocyte subsets, major monocyte subsets senescent T-lymphocytes, at 3-6 months post-discharge.We included 37 36 42 HCs. Fatigued represented a more severe profile than patients, many concurrent (median 9 [IQR 5.0-10.0] vs 3 [1.0-5.0] symptoms, p<0.001), signs cognitive failure (41%) depression (>24%). Immune abnormalities that found entire group low grade inflammation (increased inflammatory gene expression increased pro-inflammatory cytokines) T-lymphocyte senescence exhausted CD8+ TEMRA-lymphocytes). profiles did not significantly differ between groups. However, severity (total FAS score) correlated increases intermediate non-classical upregulated CCL2, CCL7, SERPINB2 Galectin-9, higher counts.Long is associated persistent lasting hospitalization. Increased stronger activation potentially point direction monocyte-endothelial interaction. These present against background common patients.

Язык: Английский

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Five cluster classifications of long COVID and their background factors: A cross-sectional study in Japan

Clinical and Experimental Medicine, Год журнала: 2023, Номер 23(7), С. 3663 - 3670

Опубликована: Апрель 7, 2023

Язык: Английский

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Post-Acute COVID-19 Joint Pain and New Onset of Rheumatic Musculoskeletal Diseases: A Systematic Review

Diagnostics, Год журнала: 2023, Номер 13(11), С. 1850 - 1850

Опубликована: Май 25, 2023

As the number of reports post-acute COVID-19 musculoskeletal manifestations is rapidly rising, it important to summarize current available literature in order shed light on this new and not fully understood phenomenon. Therefore, we conducted a systematic review provide an updated picture potential rheumatological interest, with particular focus joint pain, onset rheumatic diseases presence autoantibodies related inflammatory arthritis such as rheumatoid factor anti-citrullinated protein antibodies. We included 54 original papers our review. The prevalence arthralgia was found range from 2% 65% within time frame varying 4 weeks 12 months after acute SARS-CoV-2 infection. Inflammatory also reported various clinical phenotypes symmetrical polyarthritis RA-like pattern similar other prototypical viral arthritis, polymyalgia-like symptoms, or monoarthritis oligoarthritis large joints resembling reactive arthritis. Moreover, high figures post-COVID-19 patients fulfilling classification criteria for fibromyalgia were found, ranging 31% 40%. Finally, about antibodies largely inconsistent. In conclusion, interest new-onset are frequently COVID-19, highlighting role trigger development autoimmune conditions diseases.

Язык: Английский

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Characterisation, symptom pattern and symptom clusters from a retrospective cohort of Long COVID patients in primary care in Catalonia

BMC Infectious Diseases, Год журнала: 2024, Номер 24(1)

Опубликована: Янв. 15, 2024

Abstract Background Around 10% of people infected by SARS-COV-2 report symptoms that persist longer than 3 months. Little has been reported about sex differences in and clustering over time non-hospitalised patients primary care settings. Methods This is a descriptive study cohort mainly non-hospitalized with persistence months from the clinical onset co-creation Long Covid Catalan affected group using an online survey. Recruitment was March 2020 to June 2021. Exclusion criteria were being admitted ICU, < 18 years age not living Catalonia. We focused on 117 gathered groups performed cluster analysis first 21 days infection, at 22–60 days, ≥ Results analysed responses 905 participants (80.3% women). Median between symptom questionnaire response date 8.7 General (as fatigue) most prevalent no sex, age, or wave although its frequency decreased (from 91.8 78.3%). Dermatological (52.1% women, 28.5% men), olfactory (34.9% 20.9% men) neurocognitive (70.1% 55.8% showed greatest sex. Cluster five clusters predominance Taste & smell (24.9%) Multisystemic (26.5%) baseline _Multisystemic (34.59%) Heterogeneous (24.0%) ≥3 The more men. Menstrual stable time, while transitions occurred . Conclusions both sexes three-time cut-off points. Major observed dermatological, symptoms. increase might suggest adaptation non-specific evolution condition which can hinder detection medical appointments. A carefully collection patients’ participation research may generate useful knowledge presentation

Язык: Английский

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Interventions for the management of long covid (post-covid condition): living systematic review

BMJ, Год журнала: 2024, Номер unknown, С. e081318 - e081318

Опубликована: Ноя. 27, 2024

Abstract Objective To compare the effectiveness of interventions for management long covid (post-covid condition). Design Living systematic review. Data sources Medline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, Cochrane Central Register Controlled Trials from inception to December 2023. Eligibility criteria that randomised adults (≥18 years) with drug or non-drug interventions, placebo sham, usual care. Results 24 trials 3695 patients were eligible. Four (n=708 patients) investigated eight (n=985) physical activity rehabilitation, three (n=314) behavioural, four (n=794) dietary, (n=309) medical devices technologies, one (n=585) a combination exercise mental health rehabilitation. Moderate certainty evidence suggested that, compared care, an online programme cognitive behavioural therapy (CBT) probably reduces fatigue (mean difference −8.4, 95% confidence interval (CI) −13.11 −3.69; Checklist Individual Strength subscale; range 8-56, higher scores indicate greater impairment) improves concentration −5.2, −7.97 −2.43; problems 4-28; impairment). online, supervised, combined rehabilitation leads improvement in overall health, estimated 161 more per 1000 (95% CI 61 292 more) experiencing meaningful recovery, symptoms depression −1.50, −2.41 −0.59; Hospital Anxiety Depression Scale 0-21; impairment), quality life (0.04, 0.00 0.08; Patient-Reported Outcomes Measurement Information System 29+2 Profile; −0.022-1; less intermittent aerobic 3-5 times weekly 4-6 weeks function continuous 3.8, 1.12 6.48; SF-36 component summary score; 0-100; No compelling was found support other including, among others, vortioxetine, leronlimab, probiotics-prebiotics, coenzyme Q10, amygdala insula retraining, L-arginine vitamin C, inspiratory muscle training, transcranial direct current stimulation, hyperbaric oxygen, mobile application providing education on covid. Conclusion suggests CBT improve Systematic review registration Open Science Framework https://osf.io/9h7zm/ . Readers’ note This article is living will be updated reflect emerging evidence. Updates may occur up two years date original publication.

Язык: Английский

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Differences in Long COVID severity by duration of illness, symptom evolution, and vaccination: a longitudinal cohort study from the INSPIRE group

The Lancet Regional Health - Americas, Год журнала: 2025, Номер 44, С. 101026 - 101026

Опубликована: Фев. 14, 2025

Язык: Английский

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Long COVID Classification: Findings from a Clustering Analysis in the Predi-COVID Cohort Study

International Journal of Environmental Research and Public Health, Год журнала: 2022, Номер 19(23), С. 16018 - 16018

Опубликована: Ноя. 30, 2022

The increasing number of people living with Long COVID requires the development more personalized care; currently, limited treatment options and rehabilitation programs adapted to variety presentations are available. Our objective was design an easy-to-use classification help stratify COVID. Individual characteristics a detailed set 62 self-reported persisting symptoms together quality life indexes 12 months after initial COVID-19 infection were collected in cohort SARS-CoV-2 infected Luxembourg. A hierarchical ascendant (HAC) used identify clusters people. We identified three patterns gradient disease severity. Cluster-Mild encompassed almost 50% study population composed participants less severe infection, fewer comorbidities, (mean = 2.9). Cluster-Moderate characterized by mean 11 poor sleep respiratory life. Compared other clusters, Cluster-Severe higher proportion women smokers symptoms, particular vascular, urinary, skin symptoms. evidenced that can be stratified into subcategories terms If replicated populations, this simple will clinicians improve care

Язык: Английский

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Clustering Analysis Identified Three Long COVID Phenotypes and Their Association with General Health Status and Working Ability

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(11), С. 3617 - 3617

Опубликована: Май 23, 2023

Background/aim: This study aimed to distinguish different phenotypes of long COVID through the post-COVID syndrome (PCS) score based on long-term persistent symptoms following COVID-19 and evaluate whether these affect general health work ability. In addition, identified predictors for severe COVID. Method: cluster analysis included cross-sectional data from three cohorts patients after COVID-19: non-hospitalized (n = 401), hospitalized 98) those enrolled at outpatient’s clinic 85). All subjects responded survey sociodemographic clinical factors. K-Means ordinal logistic regression were used create PCS scores that patients’ phenotypes. Results: 506 with complete divided into distinct phenotypes: none/mild (59%), moderate (22%) (19%). The phenotype, predominating fatigue, cognitive impairment depression, had most reduced status Smoking, snuff, body mass index (BMI), diabetes, chronic pain symptom severity onset factors predicting phenotype. Conclusion: suggested COVID, where was associated highest impact working knowledge could be by clinicians support their medical decisions regarding prioritizing more detailed follow-up some patient groups.

Язык: Английский

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