Long COVID or Post-COVID-19 Condition: Past, Present and Future Research Directions

Microorganisms, Год журнала: 2023, Номер 11(12), С. 2959 - 2959

Опубликована: Дек. 11, 2023

The presence of symptoms after an acute SARS-CoV-2 infection (long-COVID) has become a worldwide healthcare emergency but remains underestimated and undertreated due to lack recognition the condition knowledge underlying mechanisms. In fact, prevalence post-COVID ranges from 50% during first months up 20% two-years after. This perspective review aimed map existing literature on identify gaps in guide global effort toward improved understanding long-COVID suggest future research directions. There is plethora symptomatology that can be COVID-19; however, today, there no clear classification definition this condition, termed or post-COVID-19 condition. heterogeneity led groups/clusters patients, which could exhibit different risk factors Viral persistence, long-lasting inflammation, immune dysregulation, autoimmune reactions, reactivation latent infections, endothelial dysfunction alteration gut microbiota have been proposed as potential mechanisms explaining complexity long-COVID. such equation, viral biology (e.g., re-infections, variants), host genetics, epigenetics) external vaccination) should also considered. These various will discussed current directions suggested.

Язык: Английский

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Musculoskeletal involvement: COVID-19 and post COVID 19

Turkish Journal of Physical Medicine and Rehabilitation, Год журнала: 2023, Номер 1(1), С. 1 - 7

Опубликована: Фев. 28, 2023

The worldwide pandemic of coronavirus disease 2019 (COVID-19) was known to predominantly affect the lungs, but it realized that COVID-19 had a large variety clinical involvement. Cardiovascular, gastrointestinal, neurological, and musculoskeletal systems are involved by direct or indirect mechanisms with various manifestations. involvement can manifest during infection, due medications used for treatment COVID-19, in post/long syndrome. major symptoms fatigue, myalgia/arthralgia, back pain, low chest pain. During last two years, increased, no clear consensus obtained about pathogenesis. However, there is valuable data supports hypothesis angiotensinconverting enzyme 2, inflammation, hypoxia, muscle catabolism. Additionally, were also have adverse effects, such as corticosteroid-induced myopathy osteoporosis. Therefore, while deciding drugs, priorities benefits should be taken into consideration. Symptoms begin three months from onset continue at least months, cannot explained another diagnosis accepted Prior may persist fluctuate, new manifest. In addition, must one symptom infection. Most common myalgia, arthralgia, weakness, sarcopenia, impaired exercise capacity, physical performance. female sex, obesity, elderly patients, hospitalization, prolonged immobility, having mechanical ventilation, not vaccination, comorbid disorders predictors Musculoskeletal pain problem tends chronic form. There on mechanism, inflammation angiotensin-converting 2 seem play an important role. Localized generalized occur after general localized An accurate allows physicians initiate management proper rehabilitation programs.

Язык: Английский

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Cerebral microstructural alterations in Post-COVID-condition are related to cognitive impairment, olfactory dysfunction and fatigue

Nature Communications, Год журнала: 2024, Номер 15(1)

Опубликована: Май 18, 2024

Abstract After contracting COVID-19, a substantial number of individuals develop Post-COVID-Condition, marked by neurologic symptoms such as cognitive deficits, olfactory dysfunction, and fatigue. Despite this, biomarkers pathophysiological understandings this condition remain limited. Employing magnetic resonance imaging, we conduct comparative analysis cerebral microstructure among patients with healthy controls, that contracted COVID-19 without long-term symptoms. We reveal widespread alterations in microstructure, attributed to shift volume from neuronal compartments free fluid, associated the severity initial infection. Correlating these cognition, olfaction, fatigue unveils distinct affected networks, which are close anatomical-functional relationship respective

Язык: Английский

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Functional and Morphological Differences of Muscle Mitochondria in Chronic Fatigue Syndrome and Post-COVID Syndrome

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(3), С. 1675 - 1675

Опубликована: Янв. 30, 2024

Patients suffering from chronic fatigue syndrome (CFS) or post-COVID (PCS) exhibit a reduced physiological performance capability. Impaired mitochondrial function and morphology may play pivotal role. Thus, we aimed to measure the muscle oxidative phosphorylation (OXPHOS) capacity assess in CFS PCS patients comparison healthy controls (HCs). Mitochondrial OXPHOS was measured permeabilized fibers using high-resolution respirometry. (subsarcolemmal/intermyofibrillar form/cristae/diameter/circumference/area) content (number proportion/cell) were assessed via electron microscopy. Analyses included differences between HC, CFS, PCS, whereas comparisons morphology/content made for vs. PCS. of complex I, which compared HC. While subsarcolemmal area, volume/cell, diameter, perimeter higher no difference observed these variables intermyofibrillar mitochondria. Both cristae integrity CFS. increased impaired function, but progressed pathological morphological changes suggest structural due prolonged inactivity unknown molecular causes. Instead, significantly lower I activity suggests probably direct virus-induced alterations.

Язык: Английский

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Systemic inflammation relates to neuroaxonal damage associated with long-term cognitive dysfunction in COVID-19 patients

Brain Behavior and Immunity, Год журнала: 2024, Номер 117, С. 510 - 520

Опубликована: Фев. 7, 2024

Cognitive deficits are increasingly recognized as a long-term sequela of severe COVID-19. The underlying processes and molecular signatures associated with these neurological sequalae COVID-19 remain largely unclear, but may be related to systemic inflammation-induced effects on the brain. We studied inflammation-brain interplay its relation development cognitive impairment in patients who survived Trajectories inflammation neuroaxonal damage blood biomarkers during ICU admission were analyzed outcomes. Prospective longitudinal cohort study surviving admission. During admission, was sampled consecutively assess levels inflammatory cytokines neurofilament light chain (NfL) using an ultrasensitive multiplex Luminex assay single molecule array technique (Simoa). functioning evaluated comprehensive neuropsychological assessment six months after ICU-discharge. Ninety-six (median [IQR] age 61 [55–69] years) enrolled from March 2020 June 2021 divided into two cohorts: those received no COVID-19-related immunotherapy (n = 28) treated either dexamethasone or tocilizumab 68). Plasma NfL concentrations increased 95 % their stay, median 23 [18–38] pg/mL at 250 [160–271] 28 days, p < 0.001. Besides age, glomerular filtration rate, immunomodulatory treatment, C-reactive protein, more specific markers day 14 (i.e., interleukin (IL)-8, tumour necrosis factor, IL-1 receptor antagonist) significant predictors (R2 44 %, 0.001), illustrating association between sustained damage. Twenty-six (27 %) exhibited discharge ICU. showed pronounced increase that developed (p 0.03). Higher predicted poorer outcome information processing speed (Trail Making Test A, r −0.26, 0.01; Letter Digit Substitution Test, −0.24, 0.02). Prolonged critically ill is subsequent impairment. Moreover, our findings suggest plasma stay possess prognostic value predicting future

Язык: Английский

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Employment outcomes of people with Long Covid symptoms: community-based cohort study

European Journal of Public Health, Год журнала: 2024, Номер 34(3), С. 489 - 496

Опубликована: Фев. 29, 2024

Abstract Background Evidence on the long-term employment consequences of SARS-CoV-2 infection is lacking. We used data from a large, community-based sample in UK to estimate associations between Long Covid and outcomes. Methods This was an observational, longitudinal study using pre–post design. included survey participants 3 February 2021 30 September 2022 when they were aged 16–64 years not education. Using conditional logit modelling, we explored time-varying relationship status ≥12 weeks after first test-confirmed (reference: pre-infection) labour market inactivity (neither working nor looking for work) or workplace absence lasting ≥4 weeks. Results Of 206 299 (mean age 45 years, 54% female, 92% white), 15% ever inactive 10% absent during follow-up. Compared with pre-infection, higher reporting &lt;40 [adjusted odds ratio (aOR): 1.45; 95% CI: 1.17–1.81] 40 &lt;52 (aOR: 1.34; 1.05–1.72) post-infection. Combining official statistics prevalence, assuming correct statistical model, our estimates translate 27 000 (95% 6000–47 000) working-age adults being because July 2022. Conclusions likely have contributed reduced participation market, though it unlikely be sole driver. Further research required quantify contribution other factors, such as indirect health effects pandemic.

Язык: Английский

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Cortical thickness alterations and systemic inflammation define long-COVID patients with cognitive impairment

Brain Behavior and Immunity, Год журнала: 2023, Номер 116, С. 175 - 184

Опубликована: Ноя. 28, 2023

As the heterogeneity of symptoms is increasingly recognized among long-COVID patients, it appears highly relevant to study potential pathophysiological differences along different subtypes. Preliminary evidence suggests distinct alterations in brain structure and systemic inflammatory patterns specific groups patients. To this end, we analyzed cortical thickness peripheral immune signature between clinical subgroups based on 3 T-MRI scans markers n = 120 participants comprising healthy never-infected controls (n 30), COVID-19 survivors 29), patients with 26) without 35) cognitive impairment according screening Montreal Cognitive Assessment. Whole-brain comparison 4 was conducted by surface-based morphometry. We identified areas showing a progressive increase across groups, starting from individuals who had never been infected COVID-19, followed survivors, deficits (MoCA ≥ 26), finally, exhibiting significant < 26). These findings highlight continuum associated more pronounced changes observed experiencing (p 0.05, FWE-corrected). Affected regions covered prefrontal temporal gyri, insula, posterior cingulate, parahippocampal gyrus, parietal areas. Additionally, discovered immunophenotype, elevated levels IL-10, IFNγ, sTREM2 especially group suffering impairment. demonstrate lingering immunological impaired survivors. This implies complex underlying pathomechanism emphasizes necessity investigate whole spectrum post-COVID biology determine targeted treatment strategies targeting sub-groups.

Язык: Английский

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Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(12), С. 3966 - 3966

Опубликована: Июнь 10, 2023

Post-COVID-19 syndrome (PCS) has been described as 'the pandemic after the pandemic' with more than 65 million people worldwide being affected. The enormous range of symptoms makes both diagnosis complex and treatment difficult. In a post-COVID rehabilitation outpatient clinic, 184 patients, mostly non-hospitalized, received comprehensive, interdisciplinary diagnostic assessment fixed follow-up appointments. At baseline, three in four patients reported 10 symptoms, most frequent were fatigue (84.9%), decreased physical capacity (83.0%), tiredness (81.1%), poor concentration (73.6%), sleeping problems (66.7%) shortness breath (67.3%). Abnormalities found mean values scores for (FAS = 34.3), cognition (MoCA 25.5), psychological alterations (anxiety, depression, post-traumatic stress disorder), limitation lung function (CAT) severity PCS (PCFS, MCRS). Clinical abnormalities elevated heart rate, breathing rate at rest, blood pressure NT-proBNP levels. As frequency decreases only slowly but often significantly over course, it is important to monitor longer period time. Many them suffer from an immense symptom burden, without pre-existing clinical correlates. Our results show clear association objectifiable assessments tests well pronounced symptoms.

Язык: Английский

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Post COVID-19 symptoms are common, also among young adults in the general population

Scientific Reports, Год журнала: 2023, Номер 13(1)

Опубликована: Июль 12, 2023

Post coronavirus disease-19 (post COVID-19) is mainly studied in clinical populations and less known about post COVID-19 a young general population. The aim of the study to investigate prevalence symptoms its potential risk factors adults. Participants from Swedish population-based birth cohort BAMSE were included (n = 2022, mean age 26.5 years). was assessed through questionnaire defined as after confirmed (registry-based or self-reported positive test) lasting for ≥ 2 months. In total, 681 participants had COVID-19. Among them, 112 (16.5%) fulfilled definition (17.8% females, 14.5% males, p 0.26). most common altered smell taste (68.8%), dyspnea (33.7%) fatigue (30.4%). Overall, no major identified except being bedbound during However, asthma rhinitis associated with symptom dyspnea, migraine taste, lower self-rated health fatigue. conclusion, are common, also among adults Although not life-threatening, it could have considerable impact on public due high long-term symptoms.

Язык: Английский

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Divergent adaptive immune responses define two types of long COVID

Frontiers in Immunology, Год журнала: 2023, Номер 14

Опубликована: Июль 20, 2023

Background The role of adaptive immune responses in long COVID remains poorly understood, with contrasting hypotheses suggesting either an insufficient antiviral response or excessive associated inflammatory damage. To address this issue, we set to characterize humoral and CD4+ T cell patients prior SARS-CoV-2 vaccination. Methods Long who were seropositive (LC+, n=28) seronegative (LC-, n=23) by spike ELISA assay recruited based on (i) initial infection documented PCR the conjunction three major signs COVID-19 (ii) persistence resurgence at least 3 symptoms for over months. They compared resolved (RE, n=29) uninfected control individuals (HD, n=29). Results spectrum persistent proved similar both groups, a trend higher number group (median=6 vs 4.5; P=0.01). use highly sensitive S-flow enabled detection low levels spike-specific IgG 22.7% ELISA-seronegative (LC-) patients. In contrast, uniformly high LC+ RE groups. Multiplexed antibody analyses 30 different viral antigens showed that LC- had defective all proteins tested but most cases preserved other viruses. A primary line revealed detectable SARS-CoV-2-specific CD4 39.1% patients, while frequencies Correlation overall strong associations between cellular responses, exceptions group. Conclusions These findings provide evidence two types COVID. Seropositive coordinated as those recovered specific cells and/or antibodies close half (52.2%). divergent sharing comparable raise possibility multiple etiologies

Язык: Английский

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