Long COVID: mechanisms, risk factors and recovery

Experimental Physiology, Год журнала: 2022, Номер 108(1), С. 12 - 27

Опубликована: Ноя. 22, 2022

Abstract Long COVID, the prolonged illness and fatigue suffered by a small proportion of those infected with SARS‐CoV‐2, is placing an increasing burden on individuals society. A Physiological Society virtual meeting in February 2022 brought clinicians researchers together to discuss current understanding long COVID mechanisms, risk factors recovery. This review highlights themes arising from that meeting. It considers nature exploring its links other post‐viral illnesses such as myalgic encephalomyelitis/chronic syndrome, how research can help us better support suffering all syndromes. started particularly swiftly populations routinely monitoring their physical performance – namely military elite athletes. The high degree diagnosis, intervention success these active suggest management strategies for wider population. We then consider key component populations, cardiopulmonary exercise training, has revealed COVID‐related changes physiology including alterations peripheral muscle function, ventilatory inefficiency autonomic dysfunction. impact dysautonomia are further discussed relation postural orthostatic tachycardia treatment aim combat sympathetic overactivation stimulating vagus nerve. interrogate mechanisms underlie symptoms, focus impaired oxygen delivery due micro‐clotting disruption cellular energy metabolism, before considering indirectly or directly tackle mechanisms. These include remote inspiratory training integrated care pathways combine rehabilitation drug interventions into healthcare access across different populations. Overall, this showcases physiological reveals occur therapeutic being developed tested condition.

Язык: Английский

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Dysautonomia following COVID-19 is not associated with subjective limitations or symptoms but is associated with objective functional limitations

Heart Rhythm, Год журнала: 2021, Номер 19(4), С. 613 - 620

Опубликована: Дек. 9, 2021

Язык: Английский

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Post-COVID-19 Condition: Where Are We Now?

Life, Год журнала: 2022, Номер 12(4), С. 517 - 517

Опубликована: Март 31, 2022

COVID-19 is currently considered a systemic infection involving multiple systems and causing chronic complications. Compared to other post-viral fatigue syndromes, these complications are wider more intense. The most frequent symptoms profound fatigue, dyspnea, sleep difficulties, anxiety or depression, reduced lung capacity, memory/cognitive impairment, hyposmia/anosmia. Risk factors for this condition severity of illness, than five in the first week disease, female sex, older age, presence comorbidities, weak anti-SARS-CoV-2 antibody response. Different lines research have attempted explain protracted symptoms; persistent inflammation, autonomic nervous system disruption, hypometabolism, autoimmunity may play role. Due thyroid high ACE expression, key molecular complex SARS-CoV-2 uses infect host cells, be target coronavirus infection. Thyroid dysfunction after combination numerous mechanisms, its role long-COVID manifestations not yet established. proposed mechanisms direct effect on an indirect inflammatory immune response, hypothalamic-pituitary-thyroid (HPT) axis leading decreased serum TSH. Only few studies reported gland status post-COVID-19 condition. post-COVID deserves recognition as cause syndrome. It important recognize affected individuals at early stage so we can offer them adequate treatments, helping thrive through uncertainty their

Язык: Английский

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Cardiovascular autonomic dysfunction in “Long COVID”: pathophysiology, heart rate variability, and inflammatory markers

Frontiers in Cardiovascular Medicine, Год журнала: 2023, Номер 10

Опубликована: Сен. 1, 2023

Long COVID is characterized by persistent signs and symptoms that continue or develop for more than 4 weeks after acute COVID-19 infection. Patients with experience a cardiovascular autonomic imbalance known as dysautonomia. However, the underlying pathophysiological mechanisms behind this remain unclear. Current hypotheses include neurotropism, cytokine storms, inflammatory persistence. Certain immunological factors indicate autoimmune dysfunction, which can be used to identify patients at higher risk of COVID. Heart rate variability imbalances in individuals suffering from COVID, measurement non-invasive low-cost method assessing modulation. Additionally, biochemical markers are diagnosing monitoring These improve understanding driving response its effects on sympathetic parasympathetic pathways nervous system. Autonomic may result lower heart variability, impaired vagal activity, substantial sympathovagal imbalance. New research subject must encouraged enhance long-term risks cause

Язык: Английский

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Long-Term Impact of COVID-19 on Heart Rate Variability: A Systematic Review of Observational Studies

Healthcare, Год журнала: 2023, Номер 11(8), С. 1095 - 1095

Опубликована: Апрель 11, 2023

Coronavirus disease 2019 (COVID-19) sequelae (or long COVID) has become a clinically significant concern. Several studies have reported the relationship between heart rate variability (HRV) parameters and COVID-19. This review investigates long-term association COVID-19 HRV parameters. Four electronic databases were searched up to 29 July 2022. We included observational comparing (measurement durations: 1 min or more) in participants with without history of used assessment tools developed by National Heart, Lung, Blood Institute group evaluate methodological quality studies. Eleven cross-sectional compared individuals who recovered from acute infection controls (n = 2197). Most standard deviation normal-to-normal intervals (SDNN) root mean square successive differences. The was not optimal. generally found decreased SDNN parasympathetic activity post-COVID-19 individuals. Compared controls, decreases observed had COVID. emphasized inhibition conditions. Due limitations measuring parameters, findings should be further validated robust prospective longitudinal

Язык: Английский

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Autonomic Dysfunction during Acute SARS-CoV-2 Infection: A Systematic Review

Journal of Clinical Medicine, Год журнала: 2022, Номер 11(13), С. 3883 - 3883

Опубликована: Июль 4, 2022

Although autonomic dysfunction (AD) after the recovery from Coronavirus disease 2019 (COVID-19) has been thoroughly described, few data are available regarding involvement of nervous system (ANS) during acute phase SARS-CoV-2 infection. The primary aim this review was to summarize current knowledge AD occurring COVID-19. Secondarily, we aimed clarify prognostic value ANS and role parameters in predicting According PRISMA guidelines, performed a systematic across Scopus PubMed databases, resulting 1585 records. records check analysis included reports’ references allowed us include 22 articles. studies were widely heterogeneous for study population, dysautonomia assessment, COVID-19 severity. Heart rate variability tool most frequently chosen analyze parameters, followed by automated pupillometry. Most found COVID-19, often related worse outcome. Further needed evidence emerging suggests that complex imbalance is prominent feature leading poor prognosis.

Язык: Английский

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Neural dysregulation in post-COVID fatigue

Brain Communications, Год журнала: 2023, Номер 5(3)

Опубликована: Янв. 1, 2023

Abstract Following infection with SARS-CoV-2, a substantial minority of people develop lingering after-effects known as ‘long COVID’. Fatigue is common complaint impact on daily life, but the neural mechanisms behind post-COVID fatigue remain unclear. We recruited 37 volunteers self-reported after mild COVID and carried out battery behavioural neurophysiological tests assessing central, peripheral autonomic nervous systems. In comparison age- sex-matched without (n = 52), we show underactivity in specific cortical circuits, dysregulation function myopathic change skeletal muscle. Cluster analysis revealed no subgroupings, suggesting single entity individual variation, rather than small number distinct syndromes. Based our analysis, were also able to exclude sensory feedback circuits descending neuromodulatory control. These abnormalities objective may aid development novel approaches for disease monitoring.

Язык: Английский

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Heart rate variability is reduced in COVID‐19 survivors and associated with physical activity and fatigue

Physiological Reports, Год журнала: 2024, Номер 12(2)

Опубликована: Янв. 1, 2024

Abstract Reduced heart rate variability (HRV) and fatigue are common after COVID‐19 infection both potentially influenced by physical activity (PA). We compared resting HRV, PA from accelerometers questionnaires, self‐reported in 41 survivors (~8 months postinfection, 38 ± 17 years) with matched controls. Differences HRV were observed on acceleration capacity ( p = 0.041), deceleration 0.032), high‐frequency peak frequency 0.019), absolute low‐frequency power 0.042), relative very 0.012), SD2 (from Poincare plot; 0.047), DFA2 (slope of long‐term detrended fluctuation analysis; 0.004). Fatigue was greater < 0.001) no differences PA. Moderate‐vigorous (MVPA) (Standardized Beta −0.427, 0.003) steps per day −0.402, 0.007) associated controlling for age, sex, body fat percentage. correlated to less MVPA (Spearman's rho 0.342, 0.031) fewer (rho 0.329, 0.038) survivors, indirectly linked through these mediators (Estimate −0.20; 0.040). present a model showing the complex relations between PA, that provides foundation strategies improve outcomes rehabilitation infection.

Язык: Английский

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Wearable Devices, Smartphones, and Interpretable Artificial Intelligence in Combating COVID-19

Sensors, Год журнала: 2021, Номер 21(24), С. 8424 - 8424

Опубликована: Дек. 17, 2021

Physiological measures, such as heart rate variability (HRV) and beats per minute (BPM), can be powerful health indicators of respiratory infections. HRV BPM acquired through widely available wrist-worn biometric wearables smartphones. Successive abnormal changes in these could potentially an early sign infections COVID-19. Thus, smartphones should play a significant role combating COVID-19 the detection supported by other contextual data artificial intelligence (AI) techniques. In this paper, we investigate measurements (i.e., BPM) collected from demonstrating onsets inflammatory response to The AI framework consists two blocks: interpretable prediction model classify status (as normal or affected inflammation) recurrent neural network (RNN) analyze users’ daily textual logs mobile application). Both classification decisions are integrated generate final decision either “potentially infected” “no evident signs infection”. We used publicly dataset, which comprises 186 patients with more than 3200 readings numerous user logs. first evaluation approach showed accuracy 83.34 ± 1.68% 0.91, 0.88, 0.89 precision, recall, F1-Score, respectively, predicting infection days before onset symptoms interpretation using local model-agnostic explanations (LIME).

Язык: Английский

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COVID-19 and the long-term cardio-respiratory and metabolic health complications

Reviews in Cardiovascular Medicine, Год журнала: 2022, Номер 23(2)

Опубликована: Фев. 9, 2022

Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2) transmission continues to impact people globally. Whilst the symptoms and management strategies are well documented, millions of globally experiencing a prolonged debilitating symptom profile that is reported last months even years. COVID-19 multi-system disease however magnitude effects its associated legacy presently not understood. Early reports indicate multidisciplinary approaches between clinical non-clinical entities needed provide effective rehabilitative patient support pathways restore pre-COVID-19 quality life functional status. Accordingly, this review provides summary on cardiovascular, inflammatory, respiratory, musculoskeletal function following an infection along with long-COVID.

Язык: Английский

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