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Chirumbolo S, Franzini M, Tirelli U. Does PI-ME/CFS recall post-COVID (PASC) syndrome? Virus Res 2024; 345:199393. [PMID: 38735438 DOI: 10.1016/j.virusres.2024.199393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/14/2024]
Affiliation(s)
| | - Marianno Franzini
- Italian Scientific Society of Oxygen-Ozone Therapy (SIOOT)-High Master School of Oxygen Ozone Therapy, University of Pavia, Italy
| | - Umberto Tirelli
- Tirelli Medical Group, Pordenone and Former Director Oncology, Aviano Cancer Center, Aviano (PN), Italy
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Liira H, Garner P, Malmivaara A, Kanerva M, Kvarnström K, Sainio M, Varonen M, Venäläinen M, Vuokko A, Arokoski J. Prognosis of patients with post-Covid-19 condition: Prospective cohort cluster analysis at one year. J Psychosom Res 2024; 182:111808. [PMID: 38781803 DOI: 10.1016/j.jpsychores.2024.111808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE We aimed to identify clinically relevant clusters among patients with post-Covid-19 condition (PCC) and assess prognosis overall and within clusters. METHODS Prospective cohort study of patients with PCC attending a rehabilitation clinic. We monitored patient reported outcome measures (PROMs): EuroHIS quality of life and symptoms. Unsupervised hierarchical cluster analyses were performed to identify clusters of patients with different quantity of symptoms, and symptoms presenting together. Preliminary findings on symptom prevalence and quality of life at 12 months are reported. RESULTS Among 409 patients, 70.4% were women, with an average baseline of 20.3 (SD 6.8) symptoms. Three clusters emerged based on symptom quantity, labelled by the average number of symptoms at baseline: Cluster-11 (17% of all patients), Cluster-17 (35%), and Cluster-25 (48%). Multinomial logistic regression showed female sex, multiple comorbidities predicting more symptoms. Four symptom-based clusters were defined: fatigue and cognitive complaints; pain, trouble sleeping, palpitations and other symptoms; gastrointestinal symptoms; and emotion-related symptoms. Linear regression models showed that female sex, multiple comorbidities, anxiety, use of antidepressants, BMI and smoking were among the determinants of symptom clusters. In 12-month follow-up, symptom count decreased, and quality of life improved across all clusters, with 9% having good quality of life at baseline and 33% at 12 months. CONCLUSION Four patient clusters based on symptoms were identified in the PCC cohort. Prognosis was favorable across all clusters, with symptom reduction and improved quality of life observed. Female sex, comorbidities, BMI, and mental-health related variables predicted higher symptom burden, suggesting multifactorial origins of PCC.
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Affiliation(s)
- Helena Liira
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland.
| | - Paul Garner
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Antti Malmivaara
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Mari Kanerva
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Kvarnström
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Markku Sainio
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Mikko Varonen
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Mikko Venäläinen
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Aki Vuokko
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
| | - Jari Arokoski
- Clinic for Persistent Somatic Symptoms, Helsinki University Hospital, Helsinki, Finland
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3
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Appel KS, Nürnberger C, Bahmer T, Förster C, Polidori MC, Kohls M, Kraus T, Hettich-Damm N, Petersen J, Blaschke S, Bröhl I, Butzmann J, Dashti H, Deckert J, Dreher M, Fiedler K, Finke C, Geisler R, Hanses F, Hopff SM, Jensen BEO, Konik M, Lehnert K, de Miranda SMN, Mitrov L, Miljukov O, Reese JP, Rohde G, Scherer M, Tausche K, Tebbe JJ, Vehreschild JJ, Voit F, Wagner P, Weigl M, Lemhöfer C. Definition of the Post-COVID syndrome using a symptom-based Post-COVID score in a prospective, multi-center, cross-sectoral cohort of the German National Pandemic Cohort Network (NAPKON). Infection 2024:10.1007/s15010-024-02226-9. [PMID: 38587752 DOI: 10.1007/s15010-024-02226-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/25/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE The objective examination of the Post-COVID syndrome (PCS) remains difficult due to heterogeneous definitions and clinical phenotypes. The aim of the study was to verify the functionality and correlates of a recently developed PCS score. METHODS The PCS score was applied to the prospective, multi-center cross-sectoral cohort (in- and outpatients with SARS-CoV-2 infection) of the "National Pandemic Cohort Network (NAPKON, Germany)". Symptom assessment and patient-reported outcome measure questionnaires were analyzed at 3 and 12 months (3/12MFU) after diagnosis. Scores indicative of PCS severity were compared and correlated to demographic and clinical characteristics as well as quality of life (QoL, EQ-5D-5L). RESULTS Six hundred three patients (mean 54.0 years, 60.6% male, 82.0% hospitalized) were included. Among those, 35.7% (215) had no and 64.3% (388) had mild, moderate, or severe PCS. PCS severity groups differed considering sex and pre-existing respiratory diseases. 3MFU PCS worsened with clinical severity of acute infection (p = .011), and number of comorbidities (p = .004). PCS severity was associated with poor QoL at the 3MFU and 12MFU (p < .001). CONCLUSION The PCS score correlated with patients' QoL and demonstrated to be instructive for clinical characterization and stratification across health care settings. Further studies should critically address the high prevalence, clinical relevance, and the role of comorbidities. TRAIL REGISTRATION NUMBER The cohort is registered at www. CLINICALTRIALS gov under NCT04768998.
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Affiliation(s)
- Katharina S Appel
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany.
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Carolin Nürnberger
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Bahmer
- Internal Medicine Department I, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), Grosshansdorf, Germany
| | - Christian Förster
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Maria Cristina Polidori
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Mirjam Kohls
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Tanja Kraus
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Nora Hettich-Damm
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Julia Petersen
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Sabine Blaschke
- Emergency Department, University Medical Center Göttingen, Göttingen, Germany
| | - Isabel Bröhl
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Jana Butzmann
- Medical Faculty, Institute of Medical Microbiology and Hospital Hygiene, University Hospital Magdeburg, Otto-Von-Guericke University Magdeburg, Magdeburg, Germany
| | - Hiwa Dashti
- Practice for General Medicine Dashti, Eberswalde, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Karin Fiedler
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Carsten Finke
- Department of Neurology, Charité Berlin, Berlin, Germany
| | - Ramsia Geisler
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Frank Hanses
- Emergency Department and Department for Infection Control an Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Sina M Hopff
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Björn-Erik O Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Düsseldorf University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Margarethe Konik
- Department of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen, University Duisburg-Essen, Essen, Germany
| | - Kristin Lehnert
- DZHK (German Center for Cardiovascular Research), University Medicine Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Susana M Nunes de Miranda
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Lazar Mitrov
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Olga Miljukov
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Jens-Peter Reese
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Gernot Rohde
- Department of Respiratory Medicine, Goethe University Frankfurt, University Hospital, Medical Clinic I, Frankfurt/Main, Germany
| | - Margarete Scherer
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Kristin Tausche
- Department of Internal Medicine I, University Hospital Carl Gustav Carus TU Dresden, Dresden, Germany
| | - Johannes J Tebbe
- Department of Gastroenterology and Infectious Diseases, Klinikum Lippe, Lippe, Germany
| | - Jörg Janne Vehreschild
- Center for Internal Medicine, Medical Department 2 (Hematology/Oncology and Infectious Diseases), Goethe University Frankfurt, University Hospital, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Florian Voit
- Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Patricia Wagner
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Martin Weigl
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany
| | - Christina Lemhöfer
- Institute of Physical and Rehabilitation Medicine, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
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Sun YK, Wang C, Lin PQ, Hu L, Ye J, Gao ZG, Lin R, Li HM, Shu Q, Huang LS, Tan LH. Severe pediatric COVID-19: a review from the clinical and immunopathophysiological perspectives. World J Pediatr 2024; 20:307-324. [PMID: 38321331 PMCID: PMC11052880 DOI: 10.1007/s12519-023-00790-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) tends to have mild presentations in children. However, severe and critical cases do arise in the pediatric population with debilitating systemic impacts and can be fatal at times, meriting further attention from clinicians. Meanwhile, the intricate interactions between the pathogen virulence factors and host defense mechanisms are believed to play indispensable roles in severe COVID-19 pathophysiology but remain incompletely understood. DATA SOURCES A comprehensive literature review was conducted for pertinent publications by reviewers independently using the PubMed, Embase, and Wanfang databases. Searched keywords included "COVID-19 in children", "severe pediatric COVID-19", and "critical illness in children with COVID-19". RESULTS Risks of developing severe COVID-19 in children escalate with increasing numbers of co-morbidities and an unvaccinated status. Acute respiratory distress stress and necrotizing pneumonia are prominent pulmonary manifestations, while various forms of cardiovascular and neurological involvement may also be seen. Multiple immunological processes are implicated in the host response to COVID-19 including the type I interferon and inflammasome pathways, whose dysregulation in severe and critical diseases translates into adverse clinical manifestations. Multisystem inflammatory syndrome in children (MIS-C), a potentially life-threatening immune-mediated condition chronologically associated with COVID-19 exposure, denotes another scientific and clinical conundrum that exemplifies the complexity of pediatric immunity. Despite the considerable dissimilarities between the pediatric and adult immune systems, clinical trials dedicated to children are lacking and current management recommendations are largely adapted from adult guidelines. CONCLUSIONS Severe pediatric COVID-19 can affect multiple organ systems. The dysregulated immune pathways in severe COVID-19 shape the disease course, epitomize the vast functional diversity of the pediatric immune system and highlight the immunophenotypical differences between children and adults. Consequently, further research may be warranted to adequately address them in pediatric-specific clinical practice guidelines.
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Affiliation(s)
- Yi-Kan Sun
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310030, China
| | - Can Wang
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Pei-Quan Lin
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Lei Hu
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Jing Ye
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Zhi-Gang Gao
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Ru Lin
- Department of Cardiopulmonary and Extracorporeal Life Support, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Hao-Min Li
- Clinical Data Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Qiang Shu
- Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
- National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Li-Su Huang
- National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
| | - Lin-Hua Tan
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
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5
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Hua Y, Ma P, Li C, Gao N, Ding Z. Association between COVID 19 exposure and expression of malignant pathological features in oral squamous cell carcinoma: A retrospective cohort study. Oral Oncol 2024; 151:106740. [PMID: 38489898 DOI: 10.1016/j.oraloncology.2024.106740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES To analyze the relationship between the clinical and pathological characters of OSCC and COVID 19 exposure. MATERIALS AND METHODS A retrospective cohort study in patients with OSCC with or without COVID 19 was performed. A total of 200 OSCC patients treated with surgery from 2019 to 2023 were included. Clinical and pathological features were analysed between two groups. Characters with statistical difference were further analysed by performing univariate analysis and logistic regression analysis. RESULTS The expression of Ki67 (n = 57, 71.3 %, P < 0.001) and CyclinD1 (n = 64, 80 %, P < 0.001) in OSCC with the exposure history of COVID 19 is higher than that in patients never exposed to COVID 19. COVID 19 exposure history is an independent influencing factor for higher expression of Ki67 (OR = 4.04, 95 % CI: 1.87-8.72, P < 0.001) and CyclinD1 (OR = 5.45, 95 % CI: 2.56-11.60, P < 0.001). CONCLUSION COVID 19 may suggest more invasive malignant biological behavior of cancer cells in OSCC.
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Affiliation(s)
- Yufei Hua
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Pingchuan Ma
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Chunjie Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Ning Gao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Zhangfan Ding
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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Lemogne C, Gouraud C, Ouazana Vedrines C, Pritschkat C, Rotenberg L, Horn M, Cathébras P, Kachaner A, Scherlinger M, de Broucker T, Pignon B, Chauvet-Gelinier JC, Günther S, Gocko X, Pitron V, Ranque B. National committee statement as a missed opportunity to acknowledge the relevance of a biopsychosocial approach in understanding long COVID. J Psychosom Res 2024:111596. [PMID: 38272788 DOI: 10.1016/j.jpsychores.2024.111596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Clément Gouraud
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Charles Ouazana Vedrines
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Caroline Pritschkat
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Léa Rotenberg
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Mathilde Horn
- Université de Lille, INSERM, CHU de Lille, U1172, Lille Neuroscience & Cognition, Lille 59000, France.
| | - Pascal Cathébras
- Service de Médecine interne, CHU de Saint-Étienne, hôpital Nord, Saint-Étienne 42055, France.
| | - Alexandra Kachaner
- Université Paris Cité, Paris Saclay University, UVSQ, INSERM, UMS 011 « Population-based Cohorts Unit », Paris, France; Service de Médecine interne, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France.
| | - Marc Scherlinger
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, Strasbourg 67098, France.
| | - Thomas de Broucker
- Service de Neurologie, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, Saint-Denis 93200, France.
| | - Baptiste Pignon
- Université Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Créteil, France.
| | - Jean-Christophe Chauvet-Gelinier
- Service de Psychiatrie Adultes, CHU de Dijon, Dijon, France; INSERM U-1231, Center for Translational and Molecular medicine, University of Burgundy, Dijon, France.
| | - Sven Günther
- Unité d'Explorations Fonctionnelles Respiratoires et du Sommeil, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France; Université Paris Cité, Innovative Therapies in Haemostasis, INSERM UMR_S1140, Paris 75006, France.
| | - Xavier Gocko
- Department of general practice, Faculty of medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France; INSERM UMR 1059, Sainbiose DVH, University of Lyon, Saint-Etienne 42000, France; INSERM CIC-EC 1408, University of Lyon, Saint-Etienne 42000, France.
| | - Victor Pitron
- Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris 75004, France; Centre du Sommeil et de la Vigilance-Pathologie Professionnelle, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
| | - Brigitte Ranque
- Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris 75004, France; Service de Médecine interne, AP-HP, Hôpital Européen Georges-Pompidou, Paris 75015, France; Unité CASPer, AP-HP, Hôpital Hôtel-Dieu, Paris 75004, France.
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7
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Righi E, Dalla Vecchia I, Auerbach N, Morra M, Górska A, Sciammarella C, Lambertenghi L, Gentilotti E, Mirandola M, Tacconelli E, Sartor A. Gut Microbiome Disruption Following SARS-CoV-2: A Review. Microorganisms 2024; 12:131. [PMID: 38257958 PMCID: PMC10820238 DOI: 10.3390/microorganisms12010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
COVID-19 has been associated with having a negative impact on patients' gut microbiome during both active disease and in the post-acute phase. In acute COVID-19, rapid alteration of the gut microbiome composition was observed, showing on one side a reduction in beneficial symbionts (e.g., Roseburia, Lachnospiraceae) and on the other side an increase in opportunistic pathogens such as Enterococcus and Proteobacteria. Alpha diversity tends to decrease, especially initially with symptom onset and hospital admission. Although clinical recovery appears to align with improved gut homeostasis, this process could take several weeks, even in mild infections. Moreover, patients with COVID-19 post-acute syndrome showed changes in gut microbiome composition, with specific signatures associated with decreased respiratory function up to 12 months following acute disease. Potential treatments, especially probiotic-based therapy, are under investigation. Open questions remain on the possibility to use gut microbiome data to predict disease progression and on potential confounders that may impair result interpretation (e.g., concomitant therapies in the acute phase; reinfection, vaccines, and occurrence of novel conditions or diseases in the post-acute syndrome). Understanding the relationships between gut microbiome dynamics and disease progression may contribute to better understanding post-COVID syndrome pathogenesis or inform personalized treatment that can affect specific targets or microbiome markers.
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Affiliation(s)
- Elda Righi
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Ilaria Dalla Vecchia
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Nina Auerbach
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Matteo Morra
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Anna Górska
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Concetta Sciammarella
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Lorenza Lambertenghi
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Elisa Gentilotti
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Massimo Mirandola
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Evelina Tacconelli
- IMID Laboratory, Department of Diagnostics and Public Health, Infectious Diseases Division, University of Verona, 37134 Verona, Italy (A.G.); (C.S.); (E.T.)
| | - Assunta Sartor
- Microbiology Unit, Udine University Hospital, 33100 Udine, Italy;
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Schwendinger F, Looser V, Gerber M, Schmidt-Trucksäss A. Autonomic dysfunction and exercise intolerance in post-COVID-19 - An as yet underestimated organ system? Int J Clin Health Psychol 2024; 24:100429. [PMID: 38348143 PMCID: PMC10859561 DOI: 10.1016/j.ijchp.2023.100429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 02/15/2024] Open
Abstract
Individuals recovering from COVID-19 often present with persistent symptoms, particularly exercise intolerance and low cardiorespiratory fitness. Put simply, the Wasserman gear system describes the interdependence of heart, lungs, and musculature as determinants of cardiorespiratory fitness. Based on this system, recent findings indicate a contribution of peripheral, cardiovascular, and lung diffusion limitations to persistent symptoms of exercise intolerance and low cardiorespiratory fitness. The autonomic nervous system as an organ system involved in the pathophysiology of exercise intolerance and low cardiorespiratory fitness, has received only little attention as of yet. Hence, our article discusses contribution of the autonomic nervous system through four potential pathways, namely alterations in (1) cerebral hemodynamics, (2) afferent and efferent signaling, (3) central hypersensitivity, and (4) appraisal and engagement in physical activity. These pathways are summarized in a psycho-pathophysiological model. Consequently, this article encourages a shift in perspective by examining the state of the pulmonary and cardiovascular system, the periphery, and auxiliary, the autonomic nervous system as potential underlying mechanisms for exercise intolerance and low cardiorespiratory fitness in patients with post-COVID-19.
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Affiliation(s)
- F. Schwendinger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - V.N. Looser
- Division of Sports Science, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - M. Gerber
- Division of Sports Science, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - A. Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, University of Basel, Schanzenstrasse 55, 4056 Basel, Switzerland
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9
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Dellacasa C, Ortali M, Rossi E, Abu Attieh H, Osmo T, Puskaric M, Rinaldi E, Prasser F, Stellmach C, Cataudella S, Agarwal B, Mata Naranjo J, Scipione G. An innovative technological infrastructure for managing SARS-CoV-2 data across different cohorts in compliance with General Data Protection Regulation. Digit Health 2024; 10:20552076241248922. [PMID: 38766364 PMCID: PMC11100396 DOI: 10.1177/20552076241248922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 04/04/2024] [Indexed: 05/22/2024] Open
Abstract
Background The ORCHESTRA project, funded by the European Commission, aims to create a pan-European cohort built on existing and new large-scale population cohorts to help rapidly advance the knowledge related to the prevention of the SARS-CoV-2 infection and the management of COVID-19 and its long-term sequelae. The integration and analysis of the very heterogeneous health data pose the challenge of building an innovative technological infrastructure as the foundation of a dedicated framework for data management that should address the regulatory requirements such as the General Data Protection Regulation (GDPR). Methods The three participating Supercomputing European Centres (CINECA - Italy, CINES - France and HLRS - Germany) designed and deployed a dedicated infrastructure to fulfil the functional requirements for data management to ensure sensitive biomedical data confidentiality/privacy, integrity, and security. Besides the technological issues, many methodological aspects have been considered: Berlin Institute of Health (BIH), Charité provided its expertise both for data protection, information security, and data harmonisation/standardisation. Results The resulting infrastructure is based on a multi-layer approach that integrates several security measures to ensure data protection. A centralised Data Collection Platform has been established in the Italian National Hub while, for the use cases in which data sharing is not possible due to privacy restrictions, a distributed approach for Federated Analysis has been considered. A Data Portal is available as a centralised point of access for non-sensitive data and results, according to findability, accessibility, interoperability, and reusability (FAIR) data principles. This technological infrastructure has been used to support significative data exchange between population cohorts and to publish important scientific results related to SARS-CoV-2. Conclusions Considering the increasing demand for data usage in accordance with the requirements of the GDPR regulations, the experience gained in the project and the infrastructure released for the ORCHESTRA project can act as a model to manage future public health threats. Other projects could benefit from the results achieved by ORCHESTRA by building upon the available standardisation of variables, design of the architecture, and process used for GDPR compliance.
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Affiliation(s)
- Chiara Dellacasa
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | - Maurizio Ortali
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | - Elisa Rossi
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
| | - Hammam Abu Attieh
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Osmo
- Département Archivage et Services aux Données (DASD), Centre Informatique National de l'Enseignement Supérieur (CINES), Montpellier, France
| | - Miroslav Puskaric
- High Performance Computing Center Stuttgart (HLRS), University of Stuttgart, Stuttgart, Germany
| | - Eugenia Rinaldi
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Prasser
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Caroline Stellmach
- Berlin Institute of Health (BIH), Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Bhaskar Agarwal
- HPC Department, CINECA Consorzio Interuniversitario,
Bologna, Italy
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10
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Shenoy PU, Udupa H, KS J, Babu S, K N, Jain N, Das R, Upadhyai P. The impact of COVID-19 on pulmonary, neurological, and cardiac outcomes: evidence from a Mendelian randomization study. Front Public Health 2023; 11:1303183. [PMID: 38155884 PMCID: PMC10752946 DOI: 10.3389/fpubh.2023.1303183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Background Long COVID is a clinical entity characterized by persistent health problems or development of new diseases, without an alternative diagnosis, following SARS-CoV-2 infection that affects a significant proportion of individuals globally. It can manifest with a wide range of symptoms due to dysfunction of multiple organ systems including but not limited to cardiovascular, hematologic, neurological, gastrointestinal, and renal organs, revealed by observational studies. However, a causal association between the genetic predisposition to COVID-19 and many post-infective abnormalities in long COVID remain unclear. Methods Here we employed Mendelian randomization (MR), a robust genetic epidemiological approach, to investigate the potential causal associations between genetic predisposition to COVID-19 and long COVID symptoms, namely pulmonary (pneumonia and airway infections including bronchitis, emphysema, asthma, and rhinitis), neurological (headache, depression, and Parkinson's disease), cardiac (heart failure and chest pain) diseases, and chronic fatigue. Using two-sample MR, we leveraged genetic data from a large COVID-19 genome-wide association study and various disorder-specific datasets. Results This analysis revealed that a genetic predisposition to COVID-19 was significantly causally linked to an increased risk of developing pneumonia, airway infections, headache, and heart failure. It also showed a strong positive correlation with chronic fatigue, a frequently observed symptom in long COVID patients. However, our findings on Parkinson's disease, depression, and chest pain were inconclusive. Conclusion Overall, these findings provide valuable insights into the genetic underpinnings of long COVID and its diverse range of symptoms. Understanding these causal associations may aid in better management and treatment of long COVID patients, thereby alleviating the substantial burden it poses on global health and socioeconomic systems.
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Affiliation(s)
- Pooja U. Shenoy
- Division of Data Analytics, Bioinformatics and Structural Biology, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, India
| | - Hrushikesh Udupa
- Department of Community Medicine, Yenepoya Medical College and Hospital, Yenepoya (Deemed to be University), Mangalore, India
| | - Jyothika KS
- Department of Statistics, Yenepoya (Deemed to be University), Mangalore, India
| | - Sangeetha Babu
- Department of Statistics, Yenepoya (Deemed to be University), Mangalore, India
| | - Nikshita K
- Department of Statistics, Yenepoya (Deemed to be University), Mangalore, India
| | - Neha Jain
- Department of Statistics, Yenepoya (Deemed to be University), Mangalore, India
| | - Ranajit Das
- Division of Data Analytics, Bioinformatics and Structural Biology, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, India
| | - Priyanka Upadhyai
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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11
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Peppercorn K, Edgar CD, Kleffmann T, Tate WP. A pilot study on the immune cell proteome of long COVID patients shows changes to physiological pathways similar to those in myalgic encephalomyelitis/chronic fatigue syndrome. Sci Rep 2023; 13:22068. [PMID: 38086949 PMCID: PMC10716514 DOI: 10.1038/s41598-023-49402-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Of those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ~ 10% develop the chronic post-viral debilitating condition, long COVID (LC). Although LC is a heterogeneous condition, about half of cases have typical post-viral fatigue with onset and symptoms that are very similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). A key question is whether these conditions are closely related. ME/CFS is a post-stressor fatigue condition that arises from multiple triggers. To investigate the pathophysiology of LC, a pilot study of patients (n = 6) and healthy controls (n = 5) has used quantitative proteomics to discover changes in peripheral blood mononuclear cell (PBMC) proteins. A principal component analysis separated all long COVID patients from healthy controls. Analysis of 3131 proteins identified 162 proteins differentially regulated, of which 37 were related to immune functions, and 21 to mitochondrial functions. Markov cluster analysis identified clusters involved in immune system processes, and two aspects of gene expression-spliceosome and transcription. These results were compared with an earlier dataset of 346 differentially regulated proteins in PBMC's from ME/CFS patients (n = 9) analysed by the same methodology. There were overlapping protein clusters and enriched molecular pathways particularly in immune functions, suggesting the two conditions have similar immune pathophysiology as a prominent feature, and mitochondrial functions involved in energy production were affected in both conditions.
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Affiliation(s)
- Katie Peppercorn
- Division of Health Sciences, Department of Biochemistry, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand
| | - Christina D Edgar
- Division of Health Sciences, Department of Biochemistry, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand
| | - Torsten Kleffmann
- Division of Health Sciences, Department of Biochemistry, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand
| | - Warren P Tate
- Division of Health Sciences, Department of Biochemistry, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand.
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12
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Lundberg-Morris L, Leach S, Xu Y, Martikainen J, Santosa A, Gisslén M, Li H, Nyberg F, Bygdell M. Covid-19 vaccine effectiveness against post-covid-19 condition among 589 722 individuals in Sweden: population based cohort study. BMJ 2023; 383:e076990. [PMID: 37993131 PMCID: PMC10666099 DOI: 10.1136/bmj-2023-076990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To investigate the effectiveness of primary covid-19 vaccination (first two doses and first booster dose within the recommended schedule) against post-covid-19 condition (PCC). DESIGN Population based cohort study. SETTING Swedish Covid-19 Investigation for Future Insights-a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) project, a register based cohort study in Sweden. PARTICIPANTS All adults (≥18 years) with covid-19 first registered between 27 December 2020 and 9 February 2022 (n=589 722) in the two largest regions of Sweden. Individuals were followed from a first infection until death, emigration, vaccination, reinfection, a PCC diagnosis (ICD-10 diagnosis code U09.9), or end of follow-up (30 November 2022), whichever came first. Individuals who had received at least one dose of a covid-19 vaccine before infection were considered vaccinated. MAIN OUTCOME MEASURE The primary outcome was a clinical diagnosis of PCC. Vaccine effectiveness against PCC was estimated using Cox regressions adjusted for age, sex, comorbidities (diabetes and cardiovascular, respiratory, and psychiatric disease), number of healthcare contacts during 2019, socioeconomic factors, and dominant virus variant at time of infection. RESULTS Of 299 692 vaccinated individuals with covid-19, 1201 (0.4%) had a diagnosis of PCC during follow-up, compared with 4118 (1.4%) of 290 030 unvaccinated individuals. Covid-19 vaccination with any number of doses before infection was associated with a reduced risk of PCC (adjusted hazard ratio 0.42, 95% confidence interval 0.38 to 0.46), with a vaccine effectiveness of 58%. Of the vaccinated individuals, 21 111 received one dose only, 205 650 received two doses, and 72 931 received three or more doses. Vaccine effectiveness against PCC for one dose, two doses, and three or more doses was 21%, 59%, and 73%, respectively. CONCLUSIONS The results of this study suggest a strong association between covid-19 vaccination before infection and reduced risk of receiving a diagnosis of PCC. The findings highlight the importance of primary vaccination against covid-19 to reduce the population burden of PCC.
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Affiliation(s)
- Lisa Lundberg-Morris
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Pharmacology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Susannah Leach
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- AstraZeneca, Mölndal, Sweden
| | - Yiyi Xu
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jari Martikainen
- Bioinformatics and Data Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Gisslén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Bygdell
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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13
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Kostka K, Roel E, Trinh NTH, Mercadé-Besora N, Delmestri A, Mateu L, Paredes R, Duarte-Salles T, Prieto-Alhambra D, Català M, Jödicke AM. "The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis". Nat Commun 2023; 14:7449. [PMID: 37978296 PMCID: PMC10656441 DOI: 10.1038/s41467-023-42726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
Persistent symptoms following the acute phase of COVID-19 present a major burden to both the affected and the wider community. We conducted a cohort study including over 856,840 first COVID-19 cases, 72,422 re-infections and more than 3.1 million first negative-test controls from primary care electronic health records from Spain and the UK (Sept 2020 to Jan 2022 (UK)/March 2022 (Spain)). We characterised post-acute COVID-19 symptoms and identified key symptoms associated with persistent disease. We estimated incidence rates of persisting symptoms in the general population and among COVID-19 patients over time. Subsequently, we investigated which WHO-listed symptoms were particularly differential by comparing their frequency in COVID-19 cases vs. matched test-negative controls. Lastly, we compared persistent symptoms after first infections vs. reinfections.Our study shows that the proportion of COVID-19 cases affected by persistent post-acute COVID-19 symptoms declined over the study period. Risk for altered smell/taste was consistently higher in patients with COVID-19 vs test-negative controls. Persistent symptoms were more common after reinfection than following a first infection. More research is needed into the definition of long COVID, and the effect of interventions to minimise the risk and impact of persistent symptoms.
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Affiliation(s)
- Kristin Kostka
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Elena Roel
- I Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Núria Mercadé-Besora
- I Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Antonella Delmestri
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Lourdes Mateu
- Department of Infectious Diseases, Hospital Germans Trias i Pujol, Badalona, Spain
- Fundació Lluita contra les Infeccions, Badalona, Spain
| | - Roger Paredes
- Department of Infectious Diseases, Hospital Germans Trias i Pujol, Badalona, Spain
- Fundació Lluita contra les Infeccions, Badalona, Spain
- irsiCaixa AIDS Research Institute, Badalona, Spain
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Talita Duarte-Salles
- I Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Daniel Prieto-Alhambra
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom.
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Martí Català
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Annika M Jödicke
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
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