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Comellas AP, Fain SB. Lung MRI identifies potentially treatable subtypes of long COVID. Eur Respir J 2024; 63:2400381. [PMID: 38548274 DOI: 10.1183/13993003.00381-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Alejandro P Comellas
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Sean B Fain
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Leung JM, Wu MJ, Kheradpour P, Chen C, Drake KA, Tong G, Ridaura VK, Zisser HC, Conrad WA, Hudson N, Allen J, Welberry C, Parsy-Kowalska C, Macdonald I, Tapson VF, Moy JN, deFilippi CR, Rosas IO, Basit M, Krishnan JA, Parthasarathy S, Prabhakar BS, Salvatore M, Kim CC. Early immune factors associated with the development of post-acute sequelae of SARS-CoV-2 infection in hospitalized and non-hospitalized individuals. Front Immunol 2024; 15:1348041. [PMID: 38318183 PMCID: PMC10838987 DOI: 10.3389/fimmu.2024.1348041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024] Open
Abstract
Background Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to post-acute sequelae of SARS-CoV-2 (PASC) that can persist for weeks to years following initial viral infection. Clinical manifestations of PASC are heterogeneous and often involve multiple organs. While many hypotheses have been made on the mechanisms of PASC and its associated symptoms, the acute biological drivers of PASC are still unknown. Methods We enrolled 494 patients with COVID-19 at their initial presentation to a hospital or clinic and followed them longitudinally to determine their development of PASC. From 341 patients, we conducted multi-omic profiling on peripheral blood samples collected shortly after study enrollment to investigate early immune signatures associated with the development of PASC. Results During the first week of COVID-19, we observed a large number of differences in the immune profile of individuals who were hospitalized for COVID-19 compared to those individuals with COVID-19 who were not hospitalized. Differences between individuals who did or did not later develop PASC were, in comparison, more limited, but included significant differences in autoantibodies and in epigenetic and transcriptional signatures in double-negative 1 B cells, in particular. Conclusions We found that early immune indicators of incident PASC were nuanced, with significant molecular signals manifesting predominantly in double-negative B cells, compared with the robust differences associated with hospitalization during acute COVID-19. The emerging acute differences in B cell phenotypes, especially in double-negative 1 B cells, in PASC patients highlight a potentially important role of these cells in the development of PASC.
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Affiliation(s)
| | - Michelle J. Wu
- Verily Life Sciences, South San Francisco, CA, United States
| | | | - Chen Chen
- Verily Life Sciences, South San Francisco, CA, United States
| | | | - Gary Tong
- Verily Life Sciences, South San Francisco, CA, United States
| | | | | | - William A. Conrad
- Providence Little Company of Mary Medical Center Torrance, Torrance, CA, United States
| | | | - Jared Allen
- Oncimmune Limited, Nottingham, United Kingdom
| | | | | | | | - Victor F. Tapson
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - James N. Moy
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | | | - Ivan O. Rosas
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Mujeeb Basit
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jerry A. Krishnan
- Breathe Chicago Center, University of Illinois Chicago, Chicago, IL, United States
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona, Tucson, AZ, United States
| | - Bellur S. Prabhakar
- Department of Microbiology and Immunology, University of Illinois - College of Medicine, Chicago, IL, United States
| | - Mirella Salvatore
- Department of Medicine and Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Charles C. Kim
- Verily Life Sciences, South San Francisco, CA, United States
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Kantele A, Paajanen J, Pietilä JP, Vapalahti O, Pakkanen SH, Lääveri T. Long COVID-associated symptoms prevalent in both SARS-CoV-2 positive and negative individuals: A prospective follow-up study. New Microbes New Infect 2024; 56:101209. [PMID: 38174103 PMCID: PMC10761764 DOI: 10.1016/j.nmni.2023.101209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/03/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Background Research into persistent symptoms among SARS-CoV-2-positive i.e. CoV(+) patients mostly focuses on hospitalized individuals. Our prospective follow-up study compares long COVID-associated symptoms among laboratory-confirmed CoV(+) and SARS-CoV-2 negative [CoV(-)] individuals. Methods SARS-CoV-2 RT-PCR-tested volunteers were recruited into four cohorts: 1) CoV(+) outpatients, 2) CoV(-) outpatients, 3) CoV(+) intensive care unit (ICU) inpatients, and 4) CoV(+) non-ICU inpatients. Neutralizing antibodies were assessed and questionnaires filled in at enrolment and days 90-120, 121-180, 181-270, 271-365, and 365-533. Results Of the 1326 participants, 1191 were CoV(+): 46 ICU, 123 non-ICU, and 1022 outpatients; 135 were CoV(-) outpatient controls. Both CoV(+) outpatients and CoV(-) controls showed high overall symptom rates at all time points. More prevalent among CoV(+) than CoV(-) outpatients were only impaired olfaction and taste; many others proved more frequent for CoV(-) participants. At ≥181 days, fatigue, dyspnoea, various neuropsychological symptoms and several others were recorded more often for CoV(+) inpatients than outpatients. Conclusions Long COVID-associated symptoms were more frequent among hospitalized than non-hospitalized CoV(+) participants. As for outpatients, only impaired olfaction and taste showed higher rates in the CoV(+) group; some symptoms proved even more common among those CoV(-). Besides suggesting low long COVID prevalences for outpatients, our results highlight the weight of negative controls.
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Affiliation(s)
- Anu Kantele
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Biomedicum 1, Haartmaninkatu 8, Helsinki University Hospital and University of Helsinki, 00290, Helsinki, Finland
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
- Human Microbiome Research Program, Faculty of Medicine, Haartmaninkatu 4, 00014, University of Helsinki, Helsinki, Finland
| | - Juuso Paajanen
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Finland
| | - Jukka-Pekka Pietilä
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Biomedicum 1, Haartmaninkatu 8, Helsinki University Hospital and University of Helsinki, 00290, Helsinki, Finland
- Human Microbiome Research Program, Faculty of Medicine, Haartmaninkatu 4, 00014, University of Helsinki, Helsinki, Finland
| | - Olli Vapalahti
- Viral Zoonoses Research Unit, Departments of Virology and Veterinary Biosciences, Faculties of Medicine and Veterinary Medicine, 00014, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital Diagnostic Center, HUSLAB, Clinical Microbiology, Topeliuksenkatu 32, 00290, Helsinki, Finland
| | - Sari H. Pakkanen
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Biomedicum 1, Haartmaninkatu 8, Helsinki University Hospital and University of Helsinki, 00290, Helsinki, Finland
- Human Microbiome Research Program, Faculty of Medicine, Haartmaninkatu 4, 00014, University of Helsinki, Helsinki, Finland
| | - Tinja Lääveri
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Biomedicum 1, Haartmaninkatu 8, Helsinki University Hospital and University of Helsinki, 00290, Helsinki, Finland
- Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
- Human Microbiome Research Program, Faculty of Medicine, Haartmaninkatu 4, 00014, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital Diagnostic Center, HUSLAB, Clinical Microbiology, Topeliuksenkatu 32, 00290, Helsinki, Finland
- Department of Computer Science, Aalto University, PO Box 15400, FI-00076, AALTO, Finland
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Gupta V, Kariotis S, Rajab MD, Errington N, Alhathli E, Jammeh E, Brook M, Meardon N, Collini P, Cole J, Wild JM, Hershman S, Javed A, Thompson AAR, de Silva T, Ashley EA, Wang D, Lawrie A. Unsupervised machine learning to investigate trajectory patterns of COVID-19 symptoms and physical activity measured via the MyHeart Counts App and smart devices. NPJ Digit Med 2023; 6:239. [PMID: 38135699 PMCID: PMC10746711 DOI: 10.1038/s41746-023-00974-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Previous studies have associated COVID-19 symptoms severity with levels of physical activity. We therefore investigated longitudinal trajectories of COVID-19 symptoms in a cohort of healthcare workers (HCWs) with non-hospitalised COVID-19 and their real-world physical activity. 121 HCWs with a history of COVID-19 infection who had symptoms monitored through at least two research clinic visits, and via smartphone were examined. HCWs with a compatible smartphone were provided with an Apple Watch Series 4 and were asked to install the MyHeart Counts Study App to collect COVID-19 symptom data and multiple physical activity parameters. Unsupervised classification analysis of symptoms identified two trajectory patterns of long and short symptom duration. The prevalence for longitudinal persistence of any COVID-19 symptom was 36% with fatigue and loss of smell being the two most prevalent individual symptom trajectories (24.8% and 21.5%, respectively). 8 physical activity features obtained via the MyHeart Counts App identified two groups of trajectories for high and low activity. Of these 8 parameters only 'distance moved walking or running' was associated with COVID-19 symptom trajectories. We report a high prevalence of long-term symptoms of COVID-19 in a non-hospitalised cohort of HCWs, a method to identify physical activity trends, and investigate their association. These data highlight the importance of tracking symptoms from onset to recovery even in non-hospitalised COVID-19 individuals. The increasing ease in collecting real-world physical activity data non-invasively from wearable devices provides opportunity to investigate the association of physical activity to symptoms of COVID-19 and other cardio-respiratory diseases.
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Affiliation(s)
- Varsha Gupta
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Republic of Singapore
- Bioinformatics Institute, Agency for Science Technology and Research (A*STAR), Singapore, Republic of Singapore
| | - Sokratis Kariotis
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Republic of Singapore
- Department of Neuroscience, University of Sheffield, Sheffield, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Mohammed D Rajab
- Department of Computer Science, University of Sheffield, Sheffield, UK
| | - Niamh Errington
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Elham Alhathli
- Department of Neuroscience, University of Sheffield, Sheffield, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Department of Nursing, Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Emmanuel Jammeh
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Martin Brook
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for in-silico Medicine, University of Sheffield, Sheffield, UK
| | - Naomi Meardon
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Paul Collini
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Joby Cole
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jim M Wild
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute for in-silico Medicine, University of Sheffield, Sheffield, UK
| | - Steven Hershman
- Department of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Ali Javed
- Department of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - A A Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Thushan de Silva
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Euan A Ashley
- Department of Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Dennis Wang
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Republic of Singapore
- Bioinformatics Institute, Agency for Science Technology and Research (A*STAR), Singapore, Republic of Singapore
- Department of Computer Science, University of Sheffield, Sheffield, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Allan Lawrie
- National Heart and Lung Institute, Imperial College London, London, UK.
- Insigneo Institute for in-silico Medicine, University of Sheffield, Sheffield, UK.
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De Lorenzo R, Di Filippo L, Scelfo S, Merolla A, Giustina A, Conte C, Rovere-Querini P. Longitudinal Changes in Physical Function and Their Impact on Health Outcomes in COVID-19 Patients. Nutrients 2023; 15:4474. [PMID: 37892549 PMCID: PMC10610243 DOI: 10.3390/nu15204474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) is correlated with a variety of long-term sequelae that affect different aspects of health, including physical function. This study investigated the longitudinal changes in handgrip strength (HGS) over six months post-hospital discharge in COVID-19 patients and explores the associations between HGS, health-related quality of life, dyspnoea, exercise capacity, and body mass index (BMI). METHODS Adult COVID-19 patients were followed up at one, three, and six months after hospital discharge. HGS, BMI, exercise capacity, and health-related quality of life were assessed. Data from patients with HGS measurements at all three time points were analysed. RESULTS Low HGS was prevalent one month post-discharge (35%). Participants with low HGS exhibited more severe disease (30.5% vs. 5.9% were admitted to the intensive care unit, p < 0.01), longer hospital stays (median [IQR] 21 [10.0; 40.5] vs. 12.0 [8.0; 20.0] days, p < 0.01), greater weight loss (-5.7 [-9.1; -0.6] vs. -3.2 [-5.7; -0.0] kg, p = 0.004), and reduced exercise capacity (6 min walking test [6 MWT], 95.7 [84.0; 102.0] vs. 100.0 [92.9; 105.0]% predicted, p = 0.007). Those with persistently low HGS (40% of the initial low HGS group) had worse exercise capacity (6-MWT 93.3 [78.3; 101.0] vs. 101.0 [95.0; 107.0]% predicted, p < 0.001), more dyspnoea (29.0% vs. 2.0% of participants, p < 0.001), poorer quality of life (visual analogue scale score, 75 [50; 75] vs. 85 [75; 95], p < 0.001), and higher rates of problems in various health dimensions. HGS at 1 month was the only significant predictor of HGS improvement from 1 month to 6 months (odds ratio [95% CI] 1.11 [1.03; 1.20], p = 0.008). CONCLUSIONS This study highlights the prevalence of reduced physical function among COVID-19 survivors and emphasises the importance of early identification and intervention to optimise their long-term health. Monitoring HGS, a simple and reliable tool, can provide valuable insights into patients' overall physical function, aiding in tailored care and improved outcomes.
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Affiliation(s)
- Rebecca De Lorenzo
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
| | - Luigi Di Filippo
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS Hospital, 20132 Milan, Italy
| | - Sabrina Scelfo
- Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Aurora Merolla
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
| | - Andrea Giustina
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
- Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS Hospital, 20132 Milan, Italy
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy
| | - Patrizia Rovere-Querini
- School of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy; (R.D.L.); (L.D.F.); (A.M.); (A.G.); (P.R.-Q.)
- Innate Immunity and Tissue Remodeling Unit, Division of Immunology, Transplantation, and Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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