Neurologic Manifestations of Long COVID Disproportionately Affect Young and Middle‐Age Adults

Annals of Neurology, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 22, 2024

Objective To investigate neurologic manifestations of post‐acute sequelae SARS‐CoV‐2 infection (Neuro‐PASC) in post‐hospitalization Neuro‐PASC (PNP) and non‐hospitalized (NNP) patients across the adult lifespan. Methods Cross‐sectional study first consecutive 200 PNP 1,100 NNP evaluated at a Neuro‐coronavirus disease 2019 (COVID‐19) clinic between May 2020 March 2023. Patients were divided into younger (18–44 years), middle‐age (45–64 older (65+ years) age groups. Results Younger individuals accounted for 142 (71%) 995 1100 (90.5%) patients. Significant age‐related differences frequencies comorbidities abnormal findings demonstrated higher prevalence Conversely, 10 months from COVID‐19 onset, we found significant symptoms indicating lower prevalence, therefore, symptom burden, individuals. Moreover, there subjective impression fatigue (median [interquartile range (IQR)] patient‐reported outcomes measurement information system [PROMIS] score: 64 [57–69], 63 [57–68], 60.5 [50.8–68.3]; p = 0.04) sleep disturbance [IQR] PROMIS 57 [51–63], 56 [53–63], 54 [46.8–58]; 0.002) group, commensurate with impairment quality life (QoL) among Finally, objective executive function National Institutes Health [NIH] toolbox 48 [35–63], 49 [38–63], 54.5 [45–66.3]; 0.01), working memory NIH 47 [40–53], 50 [44–57], [43–58]; 0.0002) patients, worst performance coming group. Interpretation are disproportionally affected by regardless acute severity. Although people more frequently have comorbidities, suffer burden cognitive dysfunction contributing to decreased QoL. principally affects adults their prime, profound public health socioeconomic impacts warranting dedicated resources prevention, diagnosis interventions. ANN NEUROL 2024

Язык: Английский

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2024 Update of the RECOVER-Adult Long COVID Research Index

JAMA, Год журнала: 2024, Номер unknown

Опубликована: Дек. 18, 2024

Importance Classification of persons with long COVID (LC) or post–COVID-19 condition must encompass the complexity and heterogeneity condition. Iterative refinement classification index for research is needed to incorporate newly available data as field rapidly evolves. Objective To update 2023 adults LC using additional participant from Researching Enhance Recovery (RECOVER-Adult) study an expanded symptom list based on input patient communities. Design, Setting, Participants Prospective, observational cohort including 18 years older without known prior SARS-CoV-2 infection who were enrolled at 83 sites in US Puerto Rico. Included participants had least 1 visit taking place 4.5 months after first later, not within 30 days a reinfection. The visits took between October 2021 March 2024. Exposure infection. Main Outcomes Measures Presence participant-reported symptoms. Results A total 13 647 (11 743 1904 infection; median age, 45 [IQR, 34-69 years]; 73% female) included. Using absolute shrinkage selection operator analysis regression approach model, symptoms contributing updated 2024 included postexertional malaise, fatigue, brain fog, dizziness, palpitations, change smell taste, thirst, chronic cough, chest pain, shortness breath, sleep apnea. For index, optimal threshold identify highly symptomatic was score 11 greater. classified 20% 4% those having likely (vs 21% 5%, respectively, index) 39% possible LC, which new category model. Cluster identified 5 subtypes that tracked quality-of-life measures. Conclusions Relevance builds help researchers classify its subtypes. Continued future will be understanding

Язык: Английский

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Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) and the Urgent Need to Identify Diagnostic Biomarkers and Risk Factors

Medical Science Monitor, Год журнала: 2024, Номер 30

Опубликована: Сен. 18, 2024

Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), also known as post-COVID-19 condition post-COVID syndrome, can affect anyone infected with SARS-CoV-2, regardless age the severity initial symptoms COVID-19. COVID/PASC is continuation development new after three months from infection, which lasts for at least two and has no other identifiable cause. occurs in 10-20% patients SARS-CoV-2. The most common include fatigue, cognitive impairment (brain fog), shortness breath. However, more than 200 have been reported. No phenotypic diagnostic biomarkers identified developing long COVID/PASC, a multisystem disorder that present isolated combined respiratory, hematological, immunological, cardiovascular, neuropsychiatric symptoms. There cure. Therefore, individualized patient management requires multidisciplinary clinical approach. Because millions people had continue to COVID-19, even era vaccination antiviral therapies, now will increasingly become health economic burden world must prepare for. Almost five years beginning COVID-19 pandemic, this article aims review what currently about anticipated increasing global burden, why there still an urgent need identify risk factors improve prevention treatment.

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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Long-term mitochondrial and metabolic impairment in lymphocytes of subjects who recovered after severe COVID-19

Cell Biology and Toxicology, Год журнала: 2025, Номер 41(1)

Опубликована: Янв. 10, 2025

The underlying mechanisms explaining the differential course of SARS-CoV-2 infection and potential clinical consequences after COVID-19 resolution have not been fully elucidated. As a dysregulated mitochondrial activity could impair immune response, we explored long-lasting changes in functionality, circulating cytokine levels, metabolomic profiles infected individuals symptoms resolution, to evaluate whether complete recovery be achieved. Results this pilot study evidenced that different parameters aerobic respiration lymphocytes recuperated from severe lagged behind those shown upon mild recovery, basal conditions simulated reinfection, they also showed altered glycolytic capacity. groups trends enhanced superoxide production parallel lower OPA1-S levels. Unbalance pivotal fusion (MFN2, OPA1) fission (DRP1, FIS1) proteins was detected, suggesting disruption dynamics, as well lack structural integrity electron transport chain. In serum, levels IL-1β, IFN-α2, IL-27 persisted long growing amounts latter correlated with maximal respiration, ATP production, Finally, trend for higher 3-hydroxybutyrate found recovered compared course. summary, acute infection, metabolic seem differ situation full versus one evolving infection.

Язык: Английский

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The 2024 National Academies of Sciences, Engineering, and Medicine Long COVID Definition: What Clinicians Need to Know

Journal of General Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Март 10, 2025

Abstract Millions of Americans affected by Long COVID (LC) report difficulty accessing care and support. One barrier is obtaining a diagnosis. In response, US federal agencies commissioned National Academies Sciences, Engineering, Medicine (NASEM) committee to re-examine the existing definitions for LC. The Committee concluded that LC “an infection-associated chronic condition (IACC) occurring after SARS-CoV-2 infection present at least 3 months as continuous, relapsing remitting, or progressive disease state can singular multiple symptoms and/or diagnosable conditions.” full was released in June 2024. We briefly highlight features aspects definition may help clinicians identify those who remain undiagnosed improve all patients.

Язык: Английский

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Health outcomes one year after Omicron infection among 12,789 adults: a community-based cross-sectional study

The Lancet Regional Health - Western Pacific, Год журнала: 2025, Номер unknown, С. 101507 - 101507

Опубликована: Март 1, 2025

Characterizing the paradigm and impact of long COVID is crucial for addressing this worldwide health challenge. This study aimed to investigate prevalence one year after primary Omicron infection characterize differences in long-term consequence between participants with persistent those who fully recovered. a community-based cross-sectional conducted from December 2023 March 2024 at China-Japan Friendship Hospital 16 administrative districts Beijing. 12,789 infected 2022 January were recruited through stratified multistage random sampling included final analysis. Of them, 376 229 without matched further physical examinations. The outcome was infection. Secondary outcomes muscle strength, exercise capacity, health-related quality life (HRQoL), mental health, work status, laboratory tests, Among (media [IQR] age, 48.4 [37.3 61.4] years; 7817 females [61.1%]), 995 them (7.8%) experienced within year, 651 (5.1%) having symptoms. Fatigue (598/995 [60.1%]) post-exertional malaise (367/995 [36.9%]) most common Brain fog had lowest resolution proportion as 4.2% year. odds increased reinfections (odds ratios reinfection 2.592 [95% CI: 2.188 3.061]; two or more: 6.171 [3.227 11.557]; all p < 0.001). Participants markedly lower strength (upper-limb: 26.9 ± 12.4 vs. 29.1 14.5 Kg; lower-limb: 40.0 [27.0 62.0] 43.0 [28.0 59.0] s), worse capacity poorer HRQoL, meaningful difference tests results compared COVID. They also exhibited significantly higher proportions abnormal lung function (FEV1 %pred<80%: 13.0% 2.0%; DLco 32.7% 19.9%) imaging abnormalities (23.5% 13.6%). considerable burden progression neurological symptoms following warrant close monitoring. Utilizing professional questionnaires developing reliable diagnostic tools are necessary improving diagnosis treatment supported by Beijing Research Center Respiratory Infectious Diseases (BJRID2024-012), Chinese Academy Medical Sciences Innovation Fund (2022-I2M-CoV19-005/CIFMS 2021-I2M-1-048), National Natural Science Foundation China (82241056/82200114/82200009), New Cornerstone Foundation.

Язык: Английский

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Leukocyte telomere length and telomerase activity in Long COVID patients from Rio de Janeiro, Brazil

Memórias do Instituto Oswaldo Cruz, Год журнала: 2025, Номер 120

Опубликована: Янв. 1, 2025

Coronavirus disease 2019 (COVID-19) is caused by the new coronavirus 2 (severe acute respiratory syndrome - SARS-CoV-2). Long COVID a condition associated with persistent COVID-19 symptoms and/or emerging symptoms. Telomeres are specialised structures for genome protection at end of chromosomes and telomerase enzyme that synthesises telomere DNA. Patients were recruited Pedro Ernesto University Hospital (HUPE) in Rio de Janeiro, Brazil, main purpose investigating association between length COVID. Leukocyte (LTL) was determined quantitative real-time polymerase chain reaction (qPCR) 34 patients compared to control group (n = 122). Telomerase activity qPCR assays using commercial kit from ScienCell. A questionnaire on symptoms, vaccine doses blood count completed. The found have an increase LTL. also examined smaller number be reactivated blood. It will necessary conduct further studies monitor determine if future health issues could linked elongated telomeres.

Язык: Английский

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ORCHESTRA Delphi consensus: diagnostic and therapeutic management of Post-COVID-19 condition in vulnerable populations

Clinical Microbiology and Infection, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Язык: Английский

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Long COVID across SARS‐CoV‐2 variants: Clinical features, pathogenesis, and future directions

MedComm – Future Medicine, Год журнала: 2024, Номер 3(4)

Опубликована: Дек. 1, 2024

Abstract Long coronavirus disease (COVID) is characterized by persistent symptoms following severe acute respiratory syndrome 2 (SARS‐CoV‐2) infection and has emerged as a significant health concern. As SARS‐CoV‐2 evolved from the wild‐type strain to Alpha, Beta, Delta, Omicron variants, there may be variant‐specific influence on long COVID akin disease. This review aims summarize our current knowledge of influences in incidence, symptom profile well mechanisms pathogenesis. We highlight that incidence lower with variants. The also show some dependence different reduction cardiopulmonary more recent heterogeneity related differences affecting immune system, viral persistence, autoimmunity. However, emerging data suggest vaccinations play big role shaping presentation COVID. ongoing work profiles populations infected only will beneficial toward useful definitions development effective diagnostic therapeutic strategies.

Язык: Английский

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