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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COVID-19 in the Initiation and Progression of Atherosclerosis

JACC Advances, Год журнала: 2024, Номер 3(8), С. 101107 - 101107

Опубликована: Июль 17, 2024

The incidence of atherosclerotic cardiovascular disease is increasing globally, especially in low- and middle-income countries, despite significant efforts to reduce traditional risk factors. Premature subclinical atherosclerosis has been documented association with several viral infections. magnitude the recent COVID-19 pandemic highlighted need understand between SARS-CoV-2 atherosclerosis. This review examines various pathophysiological mechanisms, including endothelial dysfunction, platelet activation, inflammatory immune hyperactivation triggered by infection, specific attention on their roles initiating promoting progression lesions. Additionally, it addresses pathogenic mechanisms which post-acute phase may contribute development vascular disease. Understanding overlap these syndromes enable novel therapeutic strategies. We further explore for guidelines closer follow-up often-overlooked evidence among patients COVID-19, particularly those cardiometabolic

Язык: Английский

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Shifts in Metabolic Biomarkers Related to Cardiovascular Disease and Diabetes from 2013 to 2023: A Decade of Change, Including the COVID-19 Era

Research Square (Research Square), Год журнала: 2025, Номер unknown

Опубликована: Янв. 2, 2025

IMPORTANCE Understanding trends in cardiovascular and diabetes-related metabolic biomarkers across populations, especially during the COVID-19 pandemic, is essential for informing public health strategies targeting prevention management of diseases (CVD) diabetes. This study aimed to assess among U.S. adults from 2013-2014 2021-2023. DESIGN, SETTING, AND PARTICIPANTS analyzed five cycles cross-sectional data National Health Nutrition Examination Survey (NHANES) spanning The sample was weighted reflect noninstitutionalized civilian population aged 18 older. Data analysis conducted August October 2024. EXPOSURES Calendar year sociodemographic subgroups, including age, gender, race, educational level, family poverty-to-income ratio. MAIN OUTCOMES MEASURES Primary outcomes included body mass index (BMI), waist circumference, fat percentage, systolic blood pressure (SBP), diastolic (DBP), pulse rate, estimated wave velocity (ePWV), fasting glucose, glycohemoglobin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), insulin, insulin resistance index. Trends were using survey-weighted linear regression models. RESULTS A 10,337 participants included. BMI, percentage showed significant increases (all P trend < 0.05). Specifically, BMI increased 28.54 kg/m² (95% CI: 28.18-28.91) 29.43 28.85-30.01); circumference rose 97.63 cm 96.86-98.40) 100.11 98.77-101.44); 33.59% 31.11-34.07%) 35.68% 34.90-36.46%). Significant interactions these observed various education income subgroups. DBP (P 0.0001) ePWV also increased, with rising 68.01 mmHg 67.42-68.60) 74.17 73.29-76.06) 7.89 m/s 7.75-8.02) 8.41 8.27-8.55), while rate declined 72.27 bpm 71.17-73.37) 70.59 69.96-71.23) 0.0001). Although SBP did not show an overall trend, men (from 121.06 [95% 119.87-122.25] 123.27 122.41-124.12], = 0.005) individuals less than a high school 117.56 115.77-119.34] 124.55 121.81-127.30], Pfor No found HDL-C. Fasting glucose glycohemoglobin upward (P 0.001 0.027, respectively), notable Mexican Americans (fasting glucose: 5.90 mmol/L 5.81-6.00] 6.64 6.26-7.01], 0.0001; glycohemoglobin: 5.59% 5.51-5.68] 6.06% 5.84-6.28], 0.001). CONCLUSIONS RELEVANCE Analysis NHANES indicates that most significantly 2021-2023, differences demographic groups. These findings can help shape targeted strategies, addressing needs diverse populations.

Язык: Английский

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Testosterone Replacement Therapy and Risk of COVID-19 and Effect of COVID-19 on Testosterone's Treatment Effect

Journal of the Endocrine Society, Год журнала: 2025, Номер 9(3)

Опубликована: Янв. 7, 2025

Abstract Context Whether circulating testosterone, dihydrotestosterone, and estradiol levels or testosterone replacement therapy (TRT) affects the risk of COVID-19 whether response to TRT remains unknown. Objective The study evaluated baseline are associated with developing treatment TRT. Methods Among 5204 men, aged 45 80 years, hypogonadism in TRAVERSE trial, 379 developed COVID-19. We compared on-treatment hormone levels, safety efficacy participants without diagnosis. Results Neither nor estradiol, dihydrotestosterone prior differed significantly between men Incidence was similar randomized placebo groups (3-year Kaplan-Meier incidence 8.0% 8.6% group, P = .823). Incidences COVID-19-related hospitalizations (38.5% vs 32.8%, .222) deaths (12.8% 8.9%, .247) were groups. Changes hypogonadal symptoms, libido, energy, hemoglobin/hematocrit attenuated testosterone-treated who major adverse cardiovascular events, venous thromboembolism, acute kidney injury those diagnosis without. Conclusion In disease (CVD) increased CVD, pre-COVID-19 did not. not affect

Язык: Английский

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Impact of Delta SARS-CoV-2 Infection on Glucose Metabolism: Insights on Host Metabolism and Virus Crosstalk in a Feline Model

Viruses, Год журнала: 2024, Номер 16(2), С. 295 - 295

Опубликована: Фев. 15, 2024

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes enhanced mortality in people with metabolic and cardiovascular diseases. Other highly infectious RNA viruses have demonstrated dependence on glucose transport utilization, so we hypothesized that SARS-CoV-2 infection could lead to alterations cellular whole-body metabolism. Twenty-four healthy domestic cats were intratracheally inoculated B.1.617.2 (delta) samples collected at 4- 12-days post-inoculation (dpi). Blood circulating cortisol concentrations elevated 4 12 dpi. Serum insulin concentration was statistically significantly decreased, while angiotensin detected the pancreas skeletal muscle low levels; however, no change number of insulin-producing cells or proinflammatory cytokines observed infected through increased GLUT protein expression both heart lungs, correlating AMPK expression. In brief, blood cardio-pulmonary an AMPK-dependent mechanism, without affecting pancreas, suggesting induces reprogramming host A better understanding cell metabolism virus crosstalk discovery novel therapeutic targets for patients affected by COVID-19.

Язык: Английский

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Risk factors associated with 30‐day mortality following COVID‐19 infection in patients receiving kidney replacement therapy in Australian and New Zealand

Internal Medicine Journal, Год журнала: 2025, Номер unknown

Опубликована: Янв. 11, 2025

The COVID-19 pandemic impacted greatest among patients with pre-existing chronic health conditions, including kidney disease. This retrospective cohort study aimed to investigate the 30-day mortality of receiving replacement therapy (KRT) after infection COVID-19, living in Australia and New Zealand between 2020 2022, on haemodialysis (HD), peritoneal dialysis (PD) renal transplant (KT) recipients. is a using data from Australian Dialysis Transplant Registry (ANZDATA). Patients were included if they tested positive for while KRT first reported January end November 2022. Multivariable logistic regression was used assess relationship modality following infection, all potential confounders included. A total 9828 requiring within crude rate by 3.0% HD, 3.8% PD 2.4% KT. In adjusted model, there significant increase odds increasing age, diabetes, peripheral vascular disease, having ever smoked received ≥5 years. Relative KT recipients had increased death 2021 2022 but not 2020. significantly higher than general population, several risk factors identified associated rates.

Язык: Английский

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Evolution of long COVID over two years in hospitalised and non-hospitalised survivors in Bangladesh: a longitudinal cohort study

Journal of Global Health, Год журнала: 2025, Номер 15

Опубликована: Март 14, 2025

In developing settings, comparative data on COVID hospitalised survivors (HS) and non-hospitalised (NHS) is scarce. We determined burdens, incidence, evolution, associated factors of long COVID-19 over two years among these groups. conducted a longitudinal cohort study in Dhaka, Bangladesh, recruited confirmed from December 2020 to May 2021 (previously reported). 346 underwent in-person follow-ups at five, nine, 18 months post-infection. The assessment included symptoms, cardiorespiratory function, neuropsychiatric conditions, quality life, laboratory tests. outcomes one or more symptoms and/or signs indicative COVID, aligning closely with the World Health Organization definition post-COVID-19 condition. Of participants, we 326 analysis. 78% HS (n/N = 171/219) 62% NHS 55/89) reported least sequela symptom. had higher odds palpitations, headaches, dizziness, sleeping difficulties, brain fog, muscle weakness, joint pain, hypertension, insulin requirement, poor prolonged corrected QT intervals electrocardiogram compared (95% confidence interval (CI)>1). Regarding sequelae-symptoms, neurological outcomes, restrictive spirometry findings, abnormalities remained unchanged, although psychiatric sequelae, exercise capacity improved both Hospital readmission rates significantly increased (P < 0.05). incidence cough, hypertension were CI>1). Two vaccine doses decreased risk respiratory (adjusted ratio (aRR) 0.76; 95% CI 0.63-0.91) sequelae (aRR 0.78; 0.66-0.92) than no doses. survivors, particularly HS, experienced burden persistent health issues after infection. However, vaccination reduced outcomes. These findings highlight importance ongoing programs need for targeted rehabilitation services low-resource settings.

Язык: Английский

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Imidazole propionate is increased in severe COVID-19 and correlates with cardiac involvement

Journal of Infection, Год журнала: 2025, Номер unknown, С. 106494 - 106494

Опубликована: Апрель 1, 2025

Язык: Английский

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Impact of COVID-19 and Non-COVID-19 Hospitalized Pneumonia on Longer-Term Cardiovascular Mortality in People With Type 2 Diabetes: A Nationwide Prospective Cohort Study From Scotland

Diabetes Care, Год журнала: 2024, Номер 47(8), С. 1342 - 1349

Опубликована: Июнь 18, 2024

In this study we examine whether hospitalized coronavirus disease 2019 (COVID-19) pneumonia increases long-term cardiovascular mortality more than other pneumonias in people with type 2 diabetes and aim to quantify the relative (CVD) risks associated COVID-19 versus non-COVID-19 pneumonia.

Язык: Английский

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Increased risk of arrhythmias, heart failure, and thrombosis in SARS-CoV-2 positive individuals persists at one year post-infection

Computational and Structural Biotechnology Journal, Год журнала: 2024, Номер 24, С. 476 - 483

Опубликована: Июнь 20, 2024

Risk of cardiovascular events is increased after COVID-19. However, information on risk trends COVID-19 infection lacking and estimates by sex are inconsistent. Our aim was to examine outcomes mortality in a large cohort (164,346 participants) SARS-CoV-2 positive individuals compared non-positive individuals, stratified sex. Data were obtained from the Spanish Health System's electronic medical records. Selected ≥45 years old with/without test period March-May 2020. Follow-up until January 31, 2021, for (angina/myocardial infarction, arrhythmias, bypass/revascularization, heart failure, peripheral artery disease, stroke/transient ischemic attack, thrombosis), March mortality. Individuals matched propensity score. Incidence with accelerated failure time models. The effect matching severity assessed sensitivity analyses. In first 3 months follow-up, had higher all events. From 4-12 months, there overall, females (HR= 1.26 [1.11-1.42]), arrhythmias thrombosis males 1.29 [1.14-1.47] HR= 1.35 [1.03-1.77], respectively). When patients admitted ICU excluded, incidence similar regardless positive/non-positive status. full year observed males, respectively.

Язык: Английский

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