Treatable traits for long COVID

Respirology, Год журнала: 2023, Номер 28(11), С. 1005 - 1022

Опубликована: Сен. 16, 2023

Long COVID, or post-acute COVID-19 sequelae, is experienced by an estimated one in eight adults following acute COVID-19. COVID a new and complex chronic health condition that typically includes multiple symptoms cross organ systems fluctuate over time; one-size-fits-all approach is, therefore, not likely to be appropriate nor relevant for long treatment. 'Treatable Traits' personalized medicine approach, purpose-built address the complexity heterogeneity of conditions. This comprehensive review aimed understand how treatable traits could applied first identifying most prevalent then available evidence strategies target these traits. An umbrella 22 systematic reviews identified 34 complications common with grouped into trait clusters: neurological, chest, psychological, pain, fatigue, sleep impairment, functional impairment other. A randomized control trials 18 studies explored different intervention approaches prevention (k = 4) management 14). While single study reported metformin as effective prevention, findings need replicated consensus required around define clinical trial endpoint. For management, current supports exercise training respiratory muscle chest limitation clusters. there are exploring interventions targeting other traits, further high-quality RCTs needed, particularly clusters pain impairment.

Язык: Английский

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Higher COVID-19 Vaccination Rates Are Associated with Lower COVID-19 Mortality: A Global Analysis

Vaccines, Год журнала: 2022, Номер 11(1), С. 74 - 74

Опубликована: Дек. 28, 2022

Mass vaccination initiatives are underway worldwide, and a considerable percentage of the world's population is now vaccinated. This study examined association COVID-19 deaths per 1000 cases with fully vaccinated population. The global median were 15.68 (IQR 9.84, 25.87) after 6 months vaccinations 11.96 6.08, 20.63) 12 months. Across 164 countries, we found significant variations in levels populations, booster doses, mortality, higher vaccine coverage lower mortality high-income countries. Several regression models performed to test between mortality. Control variables used account for confounding variables. A 10-percentage-point increase was associated an 18.1% decrease (95%CI, 7.4-28.8%) 16.8% 6.9-26.7%). rates 33.1% 16.0-50.2%). relationship present most analyses by country income groups effect size. Efforts needed reduce hesitancy while ensuring suitable infrastructure supply enable all countries their rates.

Язык: Английский

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Predictive Attributes for Developing Long COVID—A Study Using Machine Learning and Real-World Data from Primary Care Physicians in Germany

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(10), С. 3511 - 3511

Опубликована: Май 17, 2023

(1) In the present study, we used data comprising patient medical histories from a panel of primary care practices in Germany to predict post-COVID-19 conditions patients after COVID-19 diagnosis and evaluate relevant factors associated with these using machine learning methods. (2) Methods: Data retrieved IQVIATM Disease Analyzer database were used. Patients at least one between January 2020 July 2022 selected for inclusion study. Age, sex, complete history diagnoses prescription before infection respective practice extracted each patient. A gradient boosting classifier (LGBM) was deployed. The prepared design matrix randomly divided into train (80%) test (20%). After optimizing hyperparameters LGBM by maximizing F2 score, model performance evaluated several metrics. We calculated SHAP values importance individual features, but more importantly, direction influence feature our dataset, i.e., whether it is positively or negatively long COVID. (3) Results: both sets, showed high recall (sensitivity) 81% 72% specificity 80% 80%; this offset, however, moderate precision 8% 7% an F2-score 0.28 0.25. most common predictive features identified included variant, physician practice, age, distinct number therapies, sick days ratio, vaccination rate, somatoform disorders, migraine, back pain, asthma, malaise fatigue, as well cough preparations. (4) Conclusions: exploratory study describes initial investigation prediction potential increasing risk developing COVID electronic records learning. Notably, development demographics their histories.

Язык: Английский

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Precision management of post‐COVID pain: An evidence and clinical‐based approach

European Journal of Pain, Год журнала: 2023, Номер 27(9), С. 1107 - 1125

Опубликована: Фев. 28, 2023

Abstract Background Pain after a SARS‐CoV‐2 acute infection (post‐COVID pain) is becoming new healthcare emergency but remains underestimated and most likely undertreated due to lack of recognition the phenomenon knowledge underlying pain mechanisms. Evidence supporting any particular treatment approach for management post‐COVID lacking. Large variability in patient response standard treatments clinically observed, which has led calls personalized, tailored treating patients with chronic (i.e. ‘precision medicine’). Applying global concerted action towards precision medicine could help guide clinical decision‐making aid more effective treatments. Methods The current position paper discusses factors be considered by clinicians managing ranging from identification phenotype genetic consideration. Results ability into nociceptive, neuropathic, nociplastic or mixed type suggested as first step better planification programme. Further, consideration other factors, such gender, comorbidities, received at phase onset‐associated COVID‐19 symptoms, during hospitalization presence emotional disturbances should implemented Conclusions Accordingly, considering these include multimodal pharmacological non‐pharmacological modalities targeting emotional/cognitive aspects psychological and/or coping strategies), central sensitization‐associated mechanisms neuroscience education), exercise programmes well lifestyle interventions (e.g. nutritional support sleep management). Significance This presents an evidence‐based reasoning pain.

Язык: Английский

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Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID)

BMC Medicine, Год журнала: 2024, Номер 22(1)

Опубликована: Фев. 1, 2024

Abstract Background Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood studies with control groups exposed to other infections lacking. This study aimed investigate the incidence of post-COVID-19 condition (PCC) incomplete recovery CYP hospital discharge compare between different SARS-CoV-2 variants non-SARS-CoV-2 infections. Methods A prospective exposure-stratified cohort individuals under 18 years old Moscow, Russia. Exposed cohorts were paediatric patients admitted laboratory-confirmed April 2 December 11, 2020 (Wuhan variant cohort) January 12 February 19, 2022 (Omicron cohort). respiratory intestinal infections, but negative lateral flow rapid diagnostic test PCR-test results for SARS-CoV-2, 2022, served as unexposed reference cohort. Comparison ‘exposed cohorts’ ‘reference cohort’ was conducted using 1:1 matching by age sex. Follow-up data collected via telephone interviews parents, utilising long COVID protocol survey developed International Severe Acute Respiratory Emerging Infection Consortium (ISARIC). The WHO case definition used categorise PCC. Results Of 2595 confirmed COVID-19, 1707 (65.7%) participated follow-up interviews, 1183/1707 (69%) included final ‘matched’ analysis. median time post-discharge 6.7 months. PCC significantly higher Wuhan (89.7 cases per 1000 person-months, 95% CI 64.3–120.3) compared post-infection sequalae (12.2 4.9–21.9), whereas difference Omicron significant. had rates dermatological, fatigue, gastrointestinal, sensory, sleep manifestations, behavioural emotional problems than only significant decreased school attendance. When comparing cohorts, event physical activity, deterioration relationships observed. rate also both cohorts. Conclusions exhibited a propensity inducing broad spectrum symptoms changes, suggesting pronounced impact on long-term outcomes. Conversely, resulted fewer effects no from common seasonal viral illnesses. may mean that subsequent might lead same level consequences earlier variants.

Язык: Английский

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Translating insights into therapies for Long Covid

Science Translational Medicine, Год журнала: 2024, Номер 16(773)

Опубликована: Ноя. 13, 2024

Long Covid is defined by a wide range of symptoms that persist after the acute phase severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Commonly reported include fatigue, weakness, postexertional malaise, and cognitive dysfunction, with many other reported. Symptom range, duration, severity are highly variable partially overlap myalgic encephalomyelitis/chronic fatigue post-acute infectious syndromes, highlighting opportunities to define shared mechanisms pathogenesis. Potential diverse, including persistence viral reservoirs, dysregulated immune responses, direct damage tissues targeted SARS-CoV-2, inflammation driven reactivation latent infections, vascular endothelium activation or subsequent thromboinflammation, autoimmunity, metabolic derangements, microglial activation, microbiota dysbiosis. The heterogeneity baseline characteristics people Covid, as well varying states immunity therapies given at time infection, have made etiologies difficult determine. Here, we examine progress on preclinical models for review being in clinical trials, need large human studies further development better understand Covid. Such will inform trials treatments benefit those living this condition.

Язык: Английский

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Chinese herbal medicine for dyspnea and persistent symptoms of long COVID: a systematic review and meta-analysis of randomized controlled trials

Journal of Integrative Medicine, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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Tracking Survivors With Long COVID: Method, Implementation, and Results of an Observational Study

Research in Nursing & Health, Год журнала: 2025, Номер unknown

Опубликована: Янв. 7, 2025

While the coronavirus disease 2019 (COVID-19) pandemic has declined, many survivors continue to suffer debilitating symptoms, such as fatigue, pain, and foggy thoughts. Sustained COVID-19 or Long COVID, challenge health care resources economic recovery. This article describes methodology, implementation, results of an observational study investigating how time since diagnosis may affect lingering symptoms among adult population. The descriptive distribution overall experience by individuals' characteristics were examined. Random samples from two patient cohorts (n = 147 in 2020-2021 n 137 2021-2022) recruited a registry mid-Michigan. Samples drawn pool patients ≥ 3 months following their diagnosis. Overall (number, severity, interference) was self-reported using comprehensive symptom inventory. findings showed that 66% cohort 47% 2021-2022 reported 1 with average 11.2 (±3.0) 8.9 (±3.3) months, respectively, after Females significantly more (p 0.018), higher severity 0.008) interference 0.007) compared males. Compared admitted emergency departments, outpatients lower 0.020) less 0.018). Our analyses moderate proportion (43%) adults remained symptomatic nearly year infection did not either cohort. Female sex admission setting are important factors consider for managing studying COVID.

Язык: Английский

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Effects of sleep quality on the risk of various long COVID symptoms among older adults following infection: an observational study

BMC Geriatrics, Год журнала: 2025, Номер 25(1)

Опубликована: Янв. 9, 2025

The long-term sequelae of coronavirus disease 2019 (COVID-19) and its recovery have becoming significant public health concerns. Therefore, this study aimed to enhance the limited evidence regarding relationship between sleep quality on long COVID among older population aged 60 years or old. Our included 4,781 COVID-19 patients enrolled from April May 2023, based Peking University Health Cohort. Sleep was assessed using Pittsburgh Quality Index (PSQI) scale. Long evaluated by well-trained professionals through patients' self-reported symptoms. Binary logistic regression models were employed calculate odds ratios (OR) 95% confidence intervals (95% CI). prevalence adults 57.4% (2,743/4,781). Specifically, general symptoms, cardiovascular respiratory gastrointestinal neurological psychiatric symptoms 47.7% (2,282/4,781), 3.4% (163/4,781), 35.2% (1683/4,781), 8.7% (416/4,781) 5.8% (279/4,781), respectively. For each one-point increase in PSQI scores, risk COVID, increased 3% CI: 1.01, 1.06), 7% 1.13), 11% 1.07, 1.15), 20% 1.15, 1.25), In multivariate models, compared with good sleepers, poor exhibited an (aOR = 1.17; 1.03, 1.33), 1.50; 1.06, 2.14), 2.03; 1.61, 2.54), 2.57; CI 1.96, 3.37). findings indicate that is related various manifestations populations. A comprehensive assessment multidisciplinary management may be essential ensure healthy aging future.

Язык: Английский

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Self-Reported Long COVID and Its Impact on COVID-19-Related Worries and Behaviors After Lifting the COVID-19 Restrictions in China

Healthcare, Год журнала: 2025, Номер 13(3), С. 262 - 262

Опубликована: Янв. 29, 2025

Objective: Since the lifting of COVID-19 restrictions in China November 2022, there has been a notable surge infection rate. Little is known about prevalence long COVID among general adult population and its impact on COVID-19-related worries behaviors after policy change. Methods: This cross-sectional study recruited 1530 adults with prior Guangzhou from February to March 2023. Logistic regression analyses trend were performed investigate associations between COVID- preventive behaviors. Results: The estimated was 18.0% (95% confidence interval: 16.1% 20.0%). Common symptoms included cough (60.7%), fatigue (47.6%), dyspnea (34.5%), palpitation (26.2%), insomnia (25.1%). Adjusted for background variables, individuals exhibited higher level compared those who had fully recovered (reference: without COVID; adjusted odds ratios ranged 1.87 2.55, all p values < 0.001). Participants primarily expressed regarding potential reinfection, pandemic daily life, increasing number cases deaths, capacity healthcare system. While did not statistically significantly affect their Conclusions: Long prevalent restrictions, it significant worries. highlights importance monitoring mental health developing targeted intervention strategies improve adherence measures.

Язык: Английский

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