Vagus nerve inflammation contributes to dysautonomia in COVID-19

Acta Neuropathologica, Год журнала: 2023, Номер 146(3), С. 387 - 394

Опубликована: Июль 15, 2023

Abstract Dysautonomia has substantially impacted acute COVID-19 severity as well symptom burden after recovery from (long COVID), yet the underlying causes remain unknown. Here, we hypothesized that vagus nerves are affected in which might contribute to autonomic dysfunction. We performed a histopathological characterization of postmortem patients and controls, detected SARS-CoV-2 RNA together with inflammatory cell infiltration composed primarily monocytes. Furthermore, sequencing revealed strong response neurons, endothelial cells, Schwann cells correlated load. Lastly, screened clinical cohort 323 detect phenotype nerve affection found decreased respiratory rate non-survivors critical COVID-19. Our data suggest induces inflammation followed by dysfunction contributes disease courses dysautonomia observed long COVID.

Язык: Английский

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Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID

Infection and Chemotherapy, Год журнала: 2024, Номер 56(1), С. 122 - 122

Опубликована: Янв. 1, 2024

"Long COVID" is a term used to describe condition when the symptoms and signs associated with coronavirus disease 2019 (COVID-19) persist for more than three months among patients infected COVID-19; this has been reported globally poses serious public health issue. Long COVID can manifest in various forms, highlighting need appropriate evaluation management by experts from fields. However, due lack of clear clinical definitions, knowledge pathophysiology, diagnostic methods, treatment protocols, it necessary develop best standard guidelines based on scientific evidence date. We developed guideline diagnosing treating long analyzing latest research data collected start COVID-19 pandemic until June 2023, along consensus expert opinions. This provides recommendations diagnosis that be applied practice, total 32 key questions related COVID. The should comprehensive, including medical history, physical examination, blood tests, imaging studies, functional tests. To reduce risk developing COVID, vaccination antiviral during acute phase are recommended. will revised there reasonable updates availability new

Язык: Английский

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Neurological post‐acute sequelae of SARS‐CoV‐2 infection

Psychiatry and Clinical Neurosciences, Год журнала: 2022, Номер 77(2), С. 72 - 83

Опубликована: Сен. 23, 2022

The novel coronavirus disease 19 (COVID‐19), caused by severe acute respiratory syndrome 2 (SARS‐CoV‐2), can have two phases: (generally 4 weeks after onset) and chronic (>4 onset). Both phases include a wide variety of signs symptoms including neurological psychiatric symptoms. that are considered sequelae COVID‐19 termed post‐COVID condition, long COVID‐19, post‐acute SARS‐CoV‐2 infection (PASC). PASC fatigue, dyspnea, palpitation, dysosmia, subfever, hypertension, alopecia, sleep problems, loss concentration, amnesia, numbness, pain, gastrointestinal symptoms, depression, anxiety. Because the specific pathophysiology has not yet been clarified, there no definite criteria hence World Health Organization's definition is quite broad. Consequently, it difficult to correctly diagnose PASC. Approximately 50% patients may show at least one symptom up 12 months infection; however, exact prevalence determined. Despite extensive research in progress worldwide, currently clear diagnostic methodologies or treatments for In this review, we discuss available information on highlight infection. Furthermore, provide clinical suggestions diagnosing caring with based our outpatient clinic experience.

Язык: Английский

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Post-COVID Syndrome in Adults—An Overview

Viruses, Год журнала: 2023, Номер 15(3), С. 675 - 675

Опубликована: Март 4, 2023

This article provides an overview of various aspects related to post-COVID syndrome. Apart from its prevalence, symptoms and sequelae, risk determinants, psychosocial implications, the pathogenesis condition is discussed in more detail. A focus on thrombo-inflammation SARS-CoV-2 infection, role neutrophil extracellular traps, prevalence venous thromboembolism made. Moreover, COVID-19 syndrome immunocompromising conditions, impact vaccination prevention treatment are reviewed. Autoimmunity a hallmark syndrome, and, therefore, another this article. Thus, misdirected cellular humoral immune responses can enhance latent autoimmunity Facing high cases worldwide, it be assumed that autoimmune disorders will increase globally over next few years. Recent advances identifying genetically determined variants may open avenue for better understanding susceptibility severity infection

Язык: Английский

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The neurobiology of SARS-CoV-2 infection

Nature reviews. Neuroscience, Год журнала: 2023, Номер 25(1), С. 30 - 42

Опубликована: Дек. 4, 2023

Язык: Английский

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Long COVID: Complications, Underlying Mechanisms, and Treatment Strategies

Archives of Microbiology & Immunology, Год журнала: 2023, Номер 07(02)

Опубликована: Янв. 1, 2023

Long Covid is one of the most prevalent and puzzling conditions that arose with pandemic. Covid-19 infection generally resolves within several weeks but some experience new or lingering symptoms. Though there no formal definition for such symptoms CDC boadly describes long as persons having a wide range new, recurring sustained health issues four more after first being infected SARS-CoV2. The WHO defines manifestation from "probable confirmed" start approximately 3 months onset acute last than 2 months. Numerous studies have looked at implications on various organs. Many specific mechanisms been proposed changes. In this article, we provide an overview main by which induces end-organ damage in recent research studies. We also review treatment options, current clinical trials, other potential therapeutic avenues to control followed information about effect vaccination Covid. Lastly, discuss questions knowledge gaps present understanding believe effects has quality life, future life expectancy are required better understand eventually prevent treat disease. acknowledge not limited those article it may affect offspring therefore, deem important identify prognostic targets condition.

Язык: Английский

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Autonomic cardiac function in children and adolescents with long COVID: a case-controlled study

European Journal of Pediatrics, Год журнала: 2024, Номер 183(5), С. 2375 - 2382

Опубликована: Март 6, 2024

Although the mechanisms underlying pathophysiology of long COVID condition are still debated, there is growing evidence that autonomic dysfunction may play a role in long-term complications or persisting symptoms observed significant proportion patients after SARS-CoV-2 infection. However, studies focused on have primarily been conducted adults, while function has not yet investigated pediatric subjects. In this study, for first time, we assessed whether with present abnormalities cardiac function. Fifty-six (mean age 10.3 ± 3.8 y) and 27 age-, sex-, body surface area-matched healthy controls 10.4 4.5y) underwent standard 12-lead electrocardiography (ECG) 24-h ECG Holter monitoring. Autonomic was by time-domain frequency-domain heart rate variability parameters. A comprehensive echocardiographic study also obtained two-dimensional echocardiography tissue Doppler imaging. Data analysis showed had changes HRV variables compared to controls: significantly lower r-MSSD (root mean square successive RR interval differences, 47.4 16.9 versus 60.4 29.1, p = 0.02), higher values VLF (very low frequency, 2077.8 1023.3 494.3 1015.5 ms, 0.000), LF (low 1340.3 635.6 354.6 816.8 HF (high 895.7 575.8 278.9 616.7 0.000). No differences were between two groups both systolic diastolic parameters echocardiography. Conclusion: These findings suggest an imbalance toward relative predominance parasympathetic tone, as already reported adult COVID. Further needed clarify clinical significance demonstrate its pathophysiological mechanism COVID, paving way effective therapeutic preventive strategies. What Known: • Long Covid children described globally, but mostly collecting temporal evolution symptoms. New: Cardiac tone children, adults.

Язык: Английский

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HEART Rate Variability Biofeedback for LOng COVID Dysautonomia (HEARTLOC): Results of a Feasibility Study

Advances in Rehabilitation Science and Practice, Год журнала: 2024, Номер 13

Опубликована: Янв. 1, 2024

Introduction: Post-COVID-19 syndrome, or Long Covid (LC) refers to symptoms persisting 12 weeks after the COVID-19 infection. LC comprises a wide range of dysautonomia symptoms, including fatigue, breathlessness, palpitations, dizziness, pain and brain fog. This study tested feasibility estimated efficacy, Heart Rate Variability Biofeedback (HRV-B) programme via standardised slow diaphragmatic breathing technique in individuals with LC. Methods: patients underwent 4-week HRV-B intervention for 10 minutes twice daily 4 using Polar H10 ECG (Electrocardiogram) chest strap Elite HRV phone application. Outcome measures C19-YRSm (Yorkshire Rehabilitation Scale modified), Composite Autonomic Symptom Score (COMPASS-31), WHO Disability Assessment Schedule (WHODAS), EQ5D-5L (EuroQol 5 Dimensions) Root Mean Square Successive Differences between heartbeats (RMSSD) Fitbit device were recorded before intervention. The was pre-registered at clinicaltrials.gov NCT05228665. Results: A total 13 participants (54% female, 46% male) completed high levels independent use technology, data completeness adherence. There statistically significant improvement C19YRS-m ( P = .001), COMPASS-31 .007), RMSSD .047), WHODAS .02) EQ5D Global Health .009). Qualitative feedback suggested could it independently, satisfied reported beneficial effects from Conclusion: is feasible small sample size limits generalisability. warrants further exploration larger randomised controlled study.

Язык: Английский

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Possible Role of Fibrinaloid Microclots in Postural Orthostatic Tachycardia Syndrome (POTS): Focus on Long COVID

Journal of Personalized Medicine, Год журнала: 2024, Номер 14(2), С. 170 - 170

Опубликована: Янв. 31, 2024

Postural orthostatic tachycardia syndrome (POTS) is a common accompaniment of variety chronic, inflammatory diseases, including long COVID, as are small, insoluble, 'fibrinaloid' microclots. We here develop the argument, with accompanying evidence, that fibrinaloid microclots, through their ability to block flow blood microcapillaries and thus cause tissue hypoxia, not simply correlated but in fact, by preceding it, may be chief intermediary POTS, which body's exaggerated 'physiological' response hypoxia. Similar reasoning accounts for symptoms bundled under term 'fatigue'. Amyloids known membrane disruptors, when targets nerve membranes, this can explain neurotoxicity hence autonomic nervous system dysfunction contributes POTS. Taken together view, we indicate microclots serve link POTS fatigue COVID manner at once both mechanistic explanatory. This has clear implications treatment such diseases.

Язык: Английский

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Post-COVID postural orthostatic tachycardia syndrome (POTS): a new phenomenon

Frontiers in Neurology, Год журнала: 2024, Номер 15

Опубликована: Март 22, 2024

Background The impact of COVID-19 has been far-reaching, and the field neurology is no exception. Due to long-hauler effect, a variety chronic health consequences have occurred for some post-COVID patients. A subset these patients experienced symptoms autonomic dysfunction tested positive postural orthostatic tachycardia syndrome (POTS) via testing. Methods We conducted chart review convenience sample from seen by neurologists at our tertiary care center suspicion POTS. Patients included in study had clearly defined POTS based on clinical criteria tilt table test, were 81.25% female, an average age approximately 36. Out 16 patients, 12 confirmed COVID test result, with remaining 4 having strong infection. Our analysis examined most bothersome 3 affecting each patient per neurologist’s note their initial visit POTS, presentation, comorbidities, neurological exam findings, testing results, COMPASS-31 questionnaire PROMIS fatigue survey results. Results Palpitations (68.75%) (62.5%) common impactful reported Cleveland Clinic visit. frequent comorbidities migraines (37.5%), irritable bowel (IBS) (18.75%), Raynaud’s (18.75%). Neurological findings results other than yielded variable without clear trends. Survey showed substantial symptom burden (COMPASS-31 score 44.45) high levels (PROMIS 64.64) Conclusion are similar diagnosed general population including Fatigue was identified as debilitating symptom. hope that will be early step toward further investigation focus trends this review.

Язык: Английский

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