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Sakurada Y, Matsuda Y, Motohashi K, Hasegawa T, Otsuka Y, Nakano Y, Tokumasu K, Yamamoto K, Sunada N, Honda H, Hagiya H, Ueda K, Otsuka F. Clinical characteristics of female long COVID patients with menstrual symptoms: a retrospective study from a Japanese outpatient clinic. J Psychosom Obstet Gynaecol 2024; 45:2305899. [PMID: 38270210 DOI: 10.1080/0167482x.2024.2305899] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
PURPOSE To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated. METHODS Symptoms of long COVID, QOL, mental health, and related endocrine data were compared between two groups with and without menstrual disturbances. RESULTS Of 349 female patients who visited our clinic between February 2021 and March 2023, 223 patients with long COVID (aged 18-50 years) were included. Forty-four (19.7%) of the patients had menstrual symptoms associated with long COVID. The patients with menstrual symptoms were older than those without menstrual symptoms (42.5 vs. 38 years). The percentage of patients with menstrual symptoms was higher during the Omicron phase (24%) than during the Preceding (13%) and Delta (12%) phases. Cycle irregularity was the most frequent (in 63.6% of the patients), followed by severe pain (25%), heavy bleeding (20.5%), perimenopausal symptoms (18.2%), and premenstrual syndrome (15.9%). Fatigue and depression were the most frequent complications. Scores for fatigue and for QOL were significantly worse in long COVID patients with menstrual symptoms. Results of endocrine examinations showed significantly increased cortisol levels in patients with menstrual complaints. CONCLUSION Long COVID has an impact on menstrual conditions and on QOL related to menstrual conditions.
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Affiliation(s)
- Yasue Sakurada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yui Matsuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kanon Motohashi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toru Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideharu Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan
| | - Keigo Ueda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan
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Huth D, Bräscher AK, Tholl S, Fiess J, Birke G, Herrmann C, Jöbges M, Mier D, Witthöft M. Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial. Psychol Med 2024; 54:1122-1132. [PMID: 37842765 DOI: 10.1017/s0033291723002921] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND The post-COVID-19 condition describes the persistence or onset of somatic symptoms (e.g. fatigue) after acute COVID-19. Based on an existing cognitive-behavioral treatment protocol, we developed a specialized group intervention for individuals with post-COVID-19 condition. The present study examines the feasibility, acceptance, and effectiveness of the program for inpatients in a neurological rehabilitation setting. METHODS The treatment program comprises eight sessions and includes psychoeducational and experience-based interventions on common psychophysiological mechanisms of persistent somatic symptoms. A feasibility trial was conducted using a one-group design in a naturalistic setting. N = 64 inpatients with a history of mild COVID-19 that fulfilled WHO criteria for post-COVID-19 condition were enrolled. After each session, evaluation forms were completed and psychometric questionnaires on somatic and psychopathological symptom burden were collected pre- and post-intervention. RESULTS The treatment program was well received by participants and therapists. Each session was rated as comprehensible and overall satisfaction with the sessions was high. Pre-post effect sizes (of standard rehabilitation incl. new treatment program; intention-to-treat) showed significantly reduced subjective fatigue (p < 0.05, dav = 0.33) and improved disease coping (ps < 0.05, dav = 0.33-0.49). CONCLUSIONS Our results support the feasibility and acceptance of the newly developed cognitive-behavioral group intervention for individuals with post-COVID-19 condition. Yet, findings have to be interpreted cautiously due to the lack of a control group and follow-up measurement, the small sample size, and a relatively high drop-out rate.
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Affiliation(s)
- Daniel Huth
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sarah Tholl
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Johanna Fiess
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Gunnar Birke
- Kliniken Schmieder Gailingen, Gailingen, Germany
| | | | | | - Daniela Mier
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
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Cárdenas-Rodríguez N, Ignacio-Mejía I, Correa-Basurto J, Carrasco-Vargas H, Vargas-Hernández MA, Albores-Méndez EM, Mayen-Quinto RD, De La Paz-Valente R, Bandala C. Possible Role of Cannabis in the Management of Neuroinflammation in Patients with Post-COVID Condition. Int J Mol Sci 2024; 25:3805. [PMID: 38612615 PMCID: PMC11012123 DOI: 10.3390/ijms25073805] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 04/14/2024] Open
Abstract
The post-COVID condition (PCC) is a pathology stemming from COVID-19, and studying its pathophysiology, diagnosis, and treatment is crucial. Neuroinflammation causes the most common manifestations of this disease including headaches, fatigue, insomnia, depression, anxiety, among others. Currently, there are no specific management proposals; however, given that the inflammatory component involves cytokines and free radicals, these conditions must be treated to reduce the current symptoms and provide neuroprotection to reduce the risk of a long-term neurodegenerative disease. It has been shown that cannabis has compounds with immunomodulatory and antioxidant functions in other pathologies. Therefore, exploring this approach could provide a viable therapeutic option for PCC, which is the purpose of this review. This review involved an exhaustive search in specialized databases including PubMed, PubChem, ProQuest, EBSCO, Scopus, Science Direct, Web of Science, and Clinical Trials. Phytocannabinoids, including cannabidiol (CBD), cannabigerol (CBG), and Delta-9-tetrahydrocannabinol (THC), exhibit significant antioxidative and anti-inflammatory properties and have been shown to be an effective treatment for neuroinflammatory conditions. These compounds could be promising adjuvants for PCC alone or in combination with other antioxidants or therapies. PCC presents significant challenges to neurological health, and neuroinflammation and oxidative stress play central roles in its pathogenesis. Antioxidant therapy and cannabinoid-based approaches represent promising areas of research and treatment for mitigating adverse effects, but further studies are needed.
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Affiliation(s)
| | - Iván Ignacio-Mejía
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados de Sanidad, UDEFA, Mexico City 11200, Mexico;
| | - Jose Correa-Basurto
- Laboratorio de Diseño y Desarrollo de Nuevos Fármacos e Innovación Biotecnológica, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | | | - Marco Antonio Vargas-Hernández
- Subdirección de Investigación, Escuela Militar de Graduados en Sanidad, UDEFA, Mexico City 11200, Mexico; (M.A.V.-H.); (E.M.A.-M.)
| | - Exal Manuel Albores-Méndez
- Subdirección de Investigación, Escuela Militar de Graduados en Sanidad, UDEFA, Mexico City 11200, Mexico; (M.A.V.-H.); (E.M.A.-M.)
| | | | - Reynita De La Paz-Valente
- Laboratorio de Medicina Traslacional Aplicada a Neurociencias, Enfermedades Crónicas y Emergentes, Escuela superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
| | - Cindy Bandala
- Laboratorio de Medicina Traslacional Aplicada a Neurociencias, Enfermedades Crónicas y Emergentes, Escuela superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico;
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Sivan M, Smith AB, Osborne T, Goodwin M, Lawrence RR, Baley S, Williams P, Lee C, Davies H, Balasundaram K, Greenwood DC. Long COVID Clinical Severity Types Based on Symptoms and Functional Disability: A Longitudinal Evaluation. J Clin Med 2024; 13:1908. [PMID: 38610673 PMCID: PMC11012375 DOI: 10.3390/jcm13071908] [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: 02/26/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Long COVID (LC) is a multisystem clinical syndrome with functional disability and compromised overall health. Information on LC clinical severity types is emerging in cross-sectional studies. This study explored the pattern and consistency of long COVID (LC) clinical severity types over time in a prospective sample. Methods: Participants with LC completed the condition-specific outcome measure C19-YRSm (Yorkshire Rehabilitation Scale modified version) at two assessment time points. A cluster analysis for clinical severity types was undertaken at both time points using the k-means partition method. Results: The study included cross-sectional data for 759 patients with a mean age of 46.8 years (SD = 12.7), 69.4% females, and a duration of symptoms of 360 days (IQR 217 to 703 days). The cluster analysis at first assessment revealed three distinct clinical severity type clusters: mild (n = 96), moderate (n = 422), and severe (n = 241). Longitudinal data on 356 patients revealed that the pattern of three clinical severity types remained consistent over time between the two assessments, with 51% of patients switching clinical severity types between the assessments. Conclusions: This study is the first of its kind to demonstrate that the pattern of three clinical severity types is consistent over time, with patients also switching between severity types, indicating the fluctuating nature of LC.
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Affiliation(s)
- Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
- COVID Rehabilitation Service, Leeds Community Healthcare NHS Trust, Leeds LS11 0DL, UK
- National Demonstration Centre of Rehabilitation Medicine, Leeds Teaching Hospitals NHS Trust, Leeds LS7 4SA, UK
| | - Adam B. Smith
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.B.S.); (D.C.G.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
| | - Thomas Osborne
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
| | - Madeline Goodwin
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
| | - Román Rocha Lawrence
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK; (T.O.); (M.G.); (R.R.L.)
- ELAROS 24/7 Digital Company, Sheffield S1 2BJ, UK
| | - Sareeta Baley
- Birmingham Community Healthcare NHS Trust, Birmingham B7 4BN, UK;
| | - Paul Williams
- Hertfordshire Community NHS Trust, Welwyn AL6 9PW, UK;
| | - Cassie Lee
- Imperial College Healthcare NHS Trust, London W2 1NY, UK;
| | - Helen Davies
- Cardiff and Vale University Hospitals NHS Trust, Cardiff CF14 4XW, UK;
| | - Kumaran Balasundaram
- NIHR Leicester Biomedical Research Centre—Respiratory & Infection Theme, Glenfield Hospital, Leicester LE3 9QP, UK;
| | - Darren C. Greenwood
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.B.S.); (D.C.G.)
- Leeds Institute for Data Analytics, University of Leeds, Leeds LS2 9JT, UK
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Funk A, Florin TA, Kuppermann N, Finkelstein Y, Kazakoff A, Baldovsky M, Tancredi DJ, Breslin K, Bergmann KR, Gardiner M, Pruitt CM, Liu DR, Neuman MI, Wilkinson M, Ambroggio L, Pang XL, Cauchemez S, Malley R, Klassen TP, Lee BE, Payne DC, Mahmud SM, Freedman SB. Household Transmission Dynamics of Asymptomatic SARS-CoV-2-Infected Children: A Multinational, Controlled Case-Ascertained Prospective Study. Clin Infect Dis 2024:ciae069. [PMID: 38530249 DOI: 10.1093/cid/ciae069] [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: 11/01/2023] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Asymptomatic SARS-CoV-2 infection in children is highly prevalent but its acute and chronic implications have been minimally described. METHODS In this controlled case-ascertained household transmission study, we recruited asymptomatic children <18 years with SARS-CoV-2 nucleic acid testing performed at 12 tertiary care pediatric institutions in Canada and the United States. We attempted to recruit all test-positive children and 1 to 3 test-negative, site-matched controls. After 14 days' follow-up we assessed the clinical (ie, symptomatic) and combined (ie, test-positive, or symptomatic) secondary attack rates (SARs) among household contacts. Additionally, post-COVID-19 condition (PCC) was assessed in SARS-CoV-2-positive participating children after 90 days' follow-up. RESULTS A total of 111 test-positive and 256 SARS-CoV-2 test-negative asymptomatic children were enrolled between January 2021 and April 2022. After 14 days, excluding households with co-primary cases, the clinical SAR among household contacts of SARS-CoV-2-positive and -negative index children was 10.6% (19/179; 95% CI: 6.5%-16.1%) and 2.0% (13/663; 95% CI: 1.0%-3.3%), respectively (relative risk = 5.4; 95% CI: 2.7-10.7). In households with a SARS-CoV-2-positive index child, age <5 years, being pre-symptomatic (ie, developed symptoms after test), and testing positive during Omicron and Delta circulation periods (vs earlier) were associated with increased clinical and combined SARs among household contacts. Among 77 asymptomatic SARS-CoV-2-infected children with 90-day follow-up, 6 (7.8%; 95% CI: 2.9%-16.2%) reported PCC. CONCLUSIONS Asymptomatic SARS-CoV-2-infected children, especially those <5 years, are important contributors to household transmission, with 1 in 10 exposed household contacts developing symptomatic illness within 14 days. Asymptomatic SARS-CoV-2-infected children may develop PCC.
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Affiliation(s)
- Anna Funk
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Todd A Florin
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital Chicago, Chicago, Illinois, USA
| | - Nathan Kuppermann
- Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, California, USA
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California, USA
| | - Yaron Finkelstein
- Divisions of Emergency Medicine and Clinical Pharmacology and Toxicology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Alissa Kazakoff
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Michael Baldovsky
- Division of Pediatric Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Daniel J Tancredi
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California, USA
| | - Kristen Breslin
- Division of Emergency Medicine, Children's National Hospital, Washington, D.C., USA
| | - Kelly R Bergmann
- Department of Pediatric Emergency Medicine, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Michael Gardiner
- Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, California, USA
- Division of Emergency Medicine, Rady Children's Hospital, San Diego, California, USA
| | - Christopher M Pruitt
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Deborah R Liu
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Keck USC School of Medicine, Los Angeles, California, USA
| | - Mark I Neuman
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Matthew Wilkinson
- Department of Pediatrics, University of Texas at Austin, Dell Medical School, Austin, Texas, USA
| | - Lilliam Ambroggio
- Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
- Section of Emergency Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Université Paris Cité, CNRS UMR 2000, Paris, France
| | - Richard Malley
- Division of Infectious Diseases, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Terry P Klassen
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Bonita E Lee
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Daniel C Payne
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Salaheddin M Mahmud
- Dept of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephen B Freedman
- Section of Pediatric Emergency Medicine, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Section of Gastroenterology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Iversen A, Blomberg B, Haug K, Kittang B, Özgümüs T, Cox RJ, Langeland N. Symptom trajectories of post-COVID sequelae in patients with acute Delta or Omicron infection in Bergen, Norway. Front Public Health 2024; 12:1320059. [PMID: 38504678 PMCID: PMC10948556 DOI: 10.3389/fpubh.2024.1320059] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction A substantial proportion of the over 700 million COVID-19 cases world-wide experience long-term symptoms. The objectives of this study were to compare symptom trajectories and risk factors for post-COVID-19 condition after Delta and Omicron infection. Methods This study consecutively recruited patients with SARS-CoV-2 infection from November 2021 to March 2022. We recorded demographics, comorbidities, vaccination status, sick leave, and 18 symptoms during acute infection and after 4 months. The primary outcome measures were symptoms during acute infection and after 4 months. Secondary outcome measures were work and school absenteeism. Results We followed a cohort of 1,374 non-hospitalized COVID-19 patients in Bergen, Norway, at three time points. The median age was 39.8 years and 11% were children <16 years. Common acute upper respiratory symptoms waned during follow-up. Fatigue remained common from acute infection (40%) until after 4 months (37%). Four months post-infection, patients reported increased frequencies of dyspnea (from 15% during acute illness to 25% at 4 months, p < 0.001), cognitive symptoms (from 9 to 32%, p < 0.001) and depression (from 1 to 17%, p < 0.001). Patients infected with Omicron reported less dyspnea (22% versus 27%, p = 0.046) and smell/taste problems (5% versus 19%, p < 0.001) at 4 months follow-up than those with Delta infection. Comorbidities and female sex were risk factors for persistent dyspnea and cognitive symptoms. Ten percent reported sick leave after acute illness, and vaccination reduced the risk of absenteeism (adjusted risk ratio: 0.36, 95% confidence interval: 0.15, 0.72, p = 0.008). Conclusion At 4 months, home-isolated patients infected with Omicron reported overall comparable symptom burden, but less dyspnea and smell/taste problems than Delta infected patients. Several acute symptoms waned during follow-up. It is worrying that dyspnea, neurocognitive symptoms, and particularly depression, increased significantly during the first 4 months after acute infection. Previous vaccination was protective against prolonged sick leave.
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Affiliation(s)
- Arild Iversen
- Chief Municipal Doctor’s Office, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kjell Haug
- Chief Municipal Doctor’s Office, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bård Kittang
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Nursing Home Medicine, Bergen Municipality, Bergen, Norway
| | - Türküler Özgümüs
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rebecca Jane Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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MacCallum-Bridges CL, Hirschtick JL, Allgood KL, Ryu S, Orellana RC, Fleischer NL. Cross-sectional population-based estimates of a rural-urban disparity in prevalence of long COVID among Michigan adults with polymerase chain reaction-confirmed COVID-19, 2020-2022. J Rural Health 2024; 40:303-313. [PMID: 37974389 DOI: 10.1111/jrh.12807] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/25/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To (1) assess whether residential rurality/urbanicity was associated with the prevalence of 30- or 90-day long COVID, and (2) evaluate whether differences in long COVID risk factors might explain this potential disparity. METHODS We used data from the Michigan COVID-19 Recovery Surveillance Study, a population-based probability sample of adults with COVID-19 (n = 4,937). We measured residential rurality/urbanicity using dichotomized Rural-Urban Commuting Area codes (metropolitan, nonmetropolitan). We considered outcomes of 30-day long COVID (illness duration ≥30 days) and 90-day long COVID (illness duration ≥90 days). Using Poisson regression, we estimated unadjusted prevalence ratios (PRs) to compare 30- and 90-day long COVID between metropolitan and nonmetropolitan respondents. Then, we adjusted our model to account for differences between groups in long COVID risk factors (age, sex, acute COVID-19 severity, vaccination status, race and ethnicity, socioeconomic status, health care access, SARS-CoV-2 variant, and pre-existing conditions). We estimated associations for the full study period (Jan 1, 2020-May 31, 2022), the pre-vaccine era (before April 5, 2021), and the vaccine era (after April 5, 2021). FINDINGS Compared to metropolitan adults, the prevalence of 30-day long COVID was 15% higher (PR = 1.15 [95% CI: 1.03, 1.29]), and the prevalence of 90-day long COVID was 27% higher (PR = 1.27 [95% CI: 1.09, 1.49]) among nonmetropolitan adults. Adjusting for long COVID risk factors did not reduce disparity estimates in the pre-vaccine era but halved estimates in the vaccine era. CONCLUSIONS Our findings provide evidence of a rural-urban disparity in long COVID and suggest that the factors contributing to this disparity changed over time as the sociopolitical context of the pandemic evolved and COVID-19 vaccines were introduced.
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Affiliation(s)
| | - Jana L Hirschtick
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kristi L Allgood
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, Texas, USA
| | - Soomin Ryu
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert C Orellana
- CDC Foundation, Atlanta, Georgia, USA
- Michigan Department of Health and Human Services, Lansing, Michigan, USA
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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8
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Bileviciute-Ljungar I, Norrefalk JR, Borg K. Improved Functioning and Activity According to the International Classification of Functioning and Disability after Multidisciplinary Telerehabilitation for Post-COVID-19 Condition-A Randomized Control Study. J Clin Med 2024; 13:970. [PMID: 38398284 PMCID: PMC10889504 DOI: 10.3390/jcm13040970] [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: 12/28/2023] [Revised: 01/24/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
This study investigates the outcomes and feasibility concerning the functioning and activity of multidisciplinary group telerehabilitation for a post-COVID-19 condition. Recruitment for the group rehabilitation was announced three times during 2021 and 2022 through the COVID-19 patient organization in Sweden. The key inclusion criteria were remaining symptoms and functional impairments beyond 12 weeks after SARS-CoV-2 infection; medical assessment and treatment regarding comorbidities or new postinfection symptoms; the ability to use the Internet. Participants were randomized into a rehabilitation group or onto a waiting list using an Internet program. Multiple outcomes included self-scored questionnaires and physical tests before and after eight weeks, and at six months follow-up. Here, we present the self-scored outcomes on the International Classification of Functioning and Disability questionnaire (ICF, 22 body functions and 16 activity/participation categories) and breathing scales. Of the 164 participants who registered for the study, 67 (mean age 43, 78% women) participated in an eight-week group rehabilitation compared to 42 who served as waiting list controls (mean age 47, 88% women). At six months follow-up, 60 participants from the rehabilitation group and 21 from the waiting list completed the data. The results indicate that a larger number of ICF body functions and activity/participation categories had improved in the rehabilitation group after eight weeks and six months. Overall credibility, as assessed by the Credibility Expectancy Questionnaire, was high, and the attrition rate in rehabilitation was low. The results indicate beneficial outcomes for multidisciplinary telerehabilitation in people suffering from a post-COVID-19 condition. Therefore, rehabilitation interventions should be further developed and implemented in clinical practice.
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Affiliation(s)
- Indre Bileviciute-Ljungar
- Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, 18288 Stockholm, Sweden; (J.-R.N.); (K.B.)
- Multidisciplinary Pain Clinic, Capio St. Göran Hospital, 11219 Stockholm, Sweden
- Department of Physical and Rehabilitation Medicine, Danderyd University Hospital, 18288 Stockholm, Sweden
| | - Jan-Rickard Norrefalk
- Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, 18288 Stockholm, Sweden; (J.-R.N.); (K.B.)
| | - Kristian Borg
- Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, 18288 Stockholm, Sweden; (J.-R.N.); (K.B.)
- Multidisciplinary Pain Clinic, Capio St. Göran Hospital, 11219 Stockholm, Sweden
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9
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Lammers N, Beese F, Hoebel J, Poethko-Müller C, Wachtler B. Social Inequalities in Long-Term Health Effects After COVID-19-A Scoping Review. Int J Public Health 2024; 69:1606739. [PMID: 38384747 PMCID: PMC10878999 DOI: 10.3389/ijph.2024.1606739] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
Objectives: We aimed to map and synthesize evidence about social inequalities in long-term health effects after COVID-19 (LTHE), often referred to as "long COVID" or "post-COVID-19 conditions." Methods: We conducted a scoping review of peer-reviewed articles by searching the databases Embase and Scopus. According to predefined inclusion criteria, titles/abstracts and full texts were screened for eligibility. Additionally, reference lists of all included studies were hand-searched for eligible studies. This study followed the PRISMA guidelines for scoping reviews. Results: Nineteen articles were included. LTHE were analysed according to ethnicity, education, income, employment and deprivation indices. The studies varied significantly in their definitions of LTHE. Eighty-two analyses showed no statistically significant associations. At least 12 studies had a high risk of type II errors. Only studies associating deprivation indices and long COVID tended to show a higher prevalence of LTHE in deprived areas. Conclusion: Although some studies indicated social inequalities in LTHE, evidence was generally weak and inconclusive. Further studies with larger sample sizes specifically designed to detect social inequalities regarding LTHE are needed to inform future healthcare planning and public health policies.
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Affiliation(s)
| | | | | | | | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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10
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Havdal LB, Selvakumar J, Lund Berven L, Stiansen-Sonerud T, Zetterberg H, Blennow K, Holmøy T, Wyller VBB. Neurological involvement among non-hospitalized adolescents and young adults 6 months after acute COVID-19. Front Neurol 2024; 15:1345787. [PMID: 38385031 PMCID: PMC10879600 DOI: 10.3389/fneur.2024.1345787] [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: 12/21/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction The post-COVID-19 condition (PCC) is characterized by debilitating persistent symptoms, including symptoms suggesting neurological aberrations such as concentration difficulties, impaired memory, pain, and sleep disturbances. The underlying mechanisms remain elusive. This study aimed to investigate brain injury biomarkers, neurocognitive test performance, and self-reported neurological and neuropsychological symptoms in young people with PCC. Methods A total of 404 non-hospitalized adolescents and young adults aged 12-25 years who tested positive for SARS-CoV-2, along with 105 matched SARS-CoV-2 negative individuals, were prospectively enrolled and followed-up for 6 months (Clinical Trials ID: NCT04686734). All participants underwent comprehensive assessment encompassing clinical examinations, questionnaires, neurocognitive testing and blood sampling. Serum samples were immunoassayed for the brain injury biomarkers neurofilament light chain (Nfl) and glial fibrillary acidic protein (GFAp). At 6 months, cross-sectional analyses of serum Nfl/GFAp, neurocognitive test results and symptom scores were performed across groups based on adherence to PCC criteria as well as initial SARS-CoV-2 test results. Also, associations between Nfl/GFAp, neurocognitive test results, and symptom scores were explored. Results A total of 381 SARS-CoV-2 positive and 85 SARS-CoV-2 negative were included in the final analysis at 6 months, of whom 48% and 47%, respectively, adhered to the PCC criteria. Serum levels of Nfl and GFAp were almost equal across groups and did not differ from reference values in healthy populations. Also, neurocognitive test results were not different across groups, whereas symptom scores were significantly higher in patients fulfilling PCC criteria (independent of initial SARS-CoV-2 status). No significant associations between Nfl/GFAp, neurocognitive test results, and symptom scores were found. Conclusion Normal brain injury biomarkers and neurocognitive performance 6 months after mild COVID-19 implies that the persistent symptoms associated with PCC are not concurrent with ongoing central nervous system damage or permanent disruption of cognitive functions. This finding contradicts the notion of neuroinflammation as a likely explanation for the persistent symptoms.
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Affiliation(s)
- Lise Beier Havdal
- Department of Paediatrics and Adolescent Health, Akershus University Hospital, Lørenskog, Norway
| | - Joel Selvakumar
- Department of Paediatrics and Adolescent Health, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lise Lund Berven
- Department of Paediatrics and Adolescent Health, Akershus University Hospital, Lørenskog, Norway
| | - Tonje Stiansen-Sonerud
- Department of Paediatrics and Adolescent Health, Akershus University Hospital, Lørenskog, Norway
- Department of Clinical Molecular Biology (EpiGen), University of Oslo and Akershus University Hospital, Lørenskog, Norway
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UCL Institute of Neurology, Department of Neurodegenerative Disease, Queen Square, London, United Kingdom
- UK Dementia Research Institute, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Kowloon, Hong Kong SAR, China
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Trygve Holmøy
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Vegard Bruun Bratholm Wyller
- Department of Paediatrics and Adolescent Health, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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11
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Tan S, Pryor AJG, Melville GW, Fischer O, Hewitt L, Davis KJ. The lingering symptoms of post-COVID-19 condition (long-COVID): a prospective cohort study. Intern Med J 2024; 54:224-233. [PMID: 38008902 DOI: 10.1111/imj.16251] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/15/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Longer-term symptoms (long COVID) may be present in seemingly recovered patients for several months and can be debilitating. AIM To investigate the prevalence and type of symptoms in those with a prior COVID-19 diagnosis. METHODS This prospective, longitudinal observational study commenced in July 2020 investigating the longer-term health impacts of COVID-19. Participants were recruited via public health units and media publicity. Surveys were completed upon enrolment, and at 1, 3, 6 and 12 months. Outcome measures included incidence of activity limitations and symptoms against health and vaccination status, age and gender. RESULTS Overall, 339 participants were recruited. At 3 months after COVID-19, 66.8% reported symptoms, and 44.8% were still experiencing symptoms at 12 months. Fatigue was most common at every point (between 53.1% and 33.1%). Pain symptoms increased in relative prevalence over time, whereas respiratory/pulmonary-type symptoms decreased substantially after 3 months. Females and younger people were more likely to experience symptoms in the early stages of long COVID (P < 0.01) and those with more comorbidities in the latter stages (P < 0.001). Vaccination showed a statistically significant protective effect against symptoms (P < 0.01-0.001). CONCLUSION Long-term COVID-19 symptoms exist among recovered patients up to 12 months after contracting the virus. Fatigue is a primary contributor, while chronic pain became more problematic after 6 months. Vaccination was a factor in preventing long-term symptoms and aiding faster recovery from symptoms. Further work exploring additional contributors to symptom prevalence would assist in developing appropriate follow-up care.
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Affiliation(s)
- Stuart Tan
- Physician in Trauma and Rehabilitation Medicine, Illawarra Shoalhaven Local Health District, New South Wales, Australia
- Senior Staff Specialist, Wollongong Hospital, Wollongong, New South Wales, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anna J G Pryor
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Geoffrey W Melville
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Olivia Fischer
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Lyndel Hewitt
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kimberley J Davis
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
- Research Central, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
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12
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Ansone L, Rovite V, Brīvība M, Jagare L, Pelcmane L, Borisova D, Thews A, Leiminger R, Kloviņš J. Longitudinal NMR-Based Metabolomics Study Reveals How Hospitalized COVID-19 Patients Recover: Evidence of Dyslipidemia and Energy Metabolism Dysregulation. Int J Mol Sci 2024; 25:1523. [PMID: 38338803 PMCID: PMC10855192 DOI: 10.3390/ijms25031523] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), can manifest as long-term symptoms in multiple organ systems, including respiratory, cardiovascular, neurological, and metabolic systems. In patients with severe COVID-19, immune dysregulation is significant, and the relationship between metabolic regulation and immune response is of great interest in determining the pathophysiological mechanisms. We aimed to characterize the metabolomic footprint of recovering severe COVID-19 patients at three consecutive timepoints and compare metabolite levels to controls. Our findings add proof of dysregulated amino acid metabolism in the acute phase and dyslipidemia, glycoprotein level alterations, and energy metabolism disturbances in severe COVID-19 patients 3-4 months post-hospitalization.
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Affiliation(s)
- Laura Ansone
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
| | - Vita Rovite
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
| | - Monta Brīvība
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
| | - Lauma Jagare
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
| | - Līva Pelcmane
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
| | - Daniella Borisova
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
| | - Anne Thews
- Bruker BioSpin GmbH & Co., Rudolf-Plank-Straße 23, 76275 Ettlingen, Germany; (A.T.); (R.L.)
| | - Roland Leiminger
- Bruker BioSpin GmbH & Co., Rudolf-Plank-Straße 23, 76275 Ettlingen, Germany; (A.T.); (R.L.)
| | - Jānis Kloviņš
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia; (V.R.); (M.B.); (L.J.); (L.P.); (D.B.)
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Važgėlienė D, Kubilius R, Bileviciute-Ljungar I. The Impact of Previous Comorbidities on New Comorbidities and Medications after a Mild SARS-CoV-2 Infection in a Lithuanian Cohort. J Clin Med 2024; 13:623. [PMID: 38276129 PMCID: PMC10816360 DOI: 10.3390/jcm13020623] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
This cross-sectional study investigates new comorbidities and new medications after a mild SARS-CoV-2 infection. Data were collected after an acute SARS-CoV-2 infection by online survey in a Lithuanian cohort. Sociodemographic data, SARS-CoV-2-related symptoms, previous and new comorbidities, and medications were analysed. The results of 895 participants (mean age: 44 years) show that 91% were women, 58% had higher education, and 84% were working. Among those, 473 (52.8%) answered being "healthy" before infection; 823 (92%) indicated being positive on diagnostic tests; and 841 (94%) were non-hospitalized. Asymptomatic infection was reported by 17 participants (1.9%). Participants reporting any comorbidity before a SARS-CoV-2 infection reported more frequently having remaining symptoms compared to those who were "healthy", particularly in relation to neurological symptoms. Thirteen percent of participants reported new comorbidities, and thirty-five percent started new medication. Among new medications, an intake of vitamins/supplements (21%) and anti-inflammatory drugs (4%) was more often reported by "unhealthy" participants. Regression analysis revealed that new cardiovascular and pulmonary diagnoses predicted each other. Participants reporting prior neurological disorders tended to have an increased risk of intaking new vitamins/supplements and anti-inflammatory drugs after infection. The results indicate a significantly increased consumption of medication, particularly unprescribed substances, after SARS-CoV-2, indicating a need of more research in this area.
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Affiliation(s)
- Dovilė Važgėlienė
- Department of Physical Rehabilitation Medicine, Kaunas Clinic of the Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania (R.K.)
- Department of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Raimondas Kubilius
- Department of Physical Rehabilitation Medicine, Kaunas Clinic of the Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania (R.K.)
- Department of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Indre Bileviciute-Ljungar
- Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, 182 57 Stockholm, Sweden
- Multidisciplinary Pain Clinic, Capio St. Göran Hospital, 112 19 Stockholm, Sweden
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14
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Boyarchuk O, Volianska L. Autoimmunity and long COVID in children. Reumatologia 2024; 61:492-501. [PMID: 38322108 PMCID: PMC10839920 DOI: 10.5114/reum/176464] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/06/2023] [Indexed: 02/08/2024] Open
Abstract
Numerous hypotheses regarding the pathogenetic mechanisms of long COVID have been proposed. Immune dysregulation and autoimmunity are among the leading hypotheses. In this article, we present two clinical cases of long COVID. The first case demonstrates the phenotype of long COVID with pain and musculoskeletal symptoms, which is often associated with autoimmunity and mimics systemic connective tissue diseases. In the second case, a high titer of antinuclear antibodies was observed after SARS-CoV-2 infection, but the clinical symptoms were limited to fever and headache. Only a comprehensive evaluation of clinical symptoms and thorough objective examination can confirm or exclude autoimmune diseases after a previous SARS-CoV-2 infection. A systematic search in the PubMed Medline database was carried out for studies focusing on immune dysregulation, autoimmunity, and its association with the clinical phenotype of long COVID. The question of the role of autoimmunity in the development of long COVID and the management approaches are discussed.
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Affiliation(s)
- Oksana Boyarchuk
- Department of Children's Diseases and Pediatric Surgery, I. Horbachevsky Ternopil National Medical University, Ukraine
| | - Liubov Volianska
- Department of Children's Diseases and Pediatric Surgery, I. Horbachevsky Ternopil National Medical University, Ukraine
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15
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Punj M, Schwartz M, Morris A, Cheung J, Munipalli B. A Survey of Sleep Quality From a Post-COVID Clinic. J Prim Care Community Health 2024; 15:21501319241233205. [PMID: 38369723 PMCID: PMC10878031 DOI: 10.1177/21501319241233205] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 02/20/2024] Open
Abstract
OBJECTIVES To assess the prevalence of sleep disturbance among patients evaluated at a clinic for patients afflicted with Post-acute sequelae of COVID-19 (PASC). METHODS Sleep disturbance was assessed with the Patient-Reported Outcomes Measurement Information System-Sleep Disturbance (PROMIS-SD) framework among adult patients of the PASC clinic. RESULTS Among 312 patients, the mean age was 46.2 years, and 70.2% were women. About 41.0% of patients had no sleep disturbance; sleep disturbance was mild to moderate in 51.3% and severe in 7.7%. PROMIS-SD score was negatively correlated with the time from the initial positive COVID-19 test to the initial consultation in the PASC clinic (Pearson r = -.094; r2 = .0088). CONCLUSIONS The PROMIS-Sleep Disturbance framework can serve as a tool to assess the burden of sleep disturbances in PASC patients.
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Affiliation(s)
- Mantavya Punj
- Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
- Kadlec Regional Medical Center, Richland, WA, USA
| | - Michael Schwartz
- Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
- University at Buffalo, Buffalo, NY, USA
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16
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Pagen DME, Van Herck M, van Bilsen CJA, Brinkhues S, Konings K, den Heijer CDJ, Spruit MA, Hoebe CJPA, Dukers-Muijrers NHTM. High proportions of post-exertional malaise and orthostatic intolerance in people living with post-COVID-19 condition: the PRIME post-COVID study. Front Med (Lausanne) 2023; 10:1292446. [PMID: 38162880 PMCID: PMC10757844 DOI: 10.3389/fmed.2023.1292446] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024] Open
Abstract
Background Exercise-based treatments can worsen/exacerbate symptoms in people who were SARS-CoV-2 positive and living with post-COVID-19 condition (PL-PCC) and who have post-exertional malaise (PEM) or orthostatic intolerance (OI). Nevertheless, PEM and OI are not routinely assessed by clinicians. We estimated PEM and OI proportions in PL-PCC, as well as in people not living with PCC (PnL-PCC) and negatives (i.e., never reported a SARS-CoV-2 positive test), and identified associated factors. Methods Participants from the Prevalence, Risk factors, and Impact Evaluation (PRIME) post-COVID-19 condition study were included. PEM and OI were assessed using validated questionnaires. PCC was defined as feeling unrecovered after SARS-CoV-2 infection. Multivariable regression analyses to study PEM and OI were stratified for sex. Results Data from 3,783 participants were analyzed. In PL-PCC, the proportion of PEM was 48.1% and 41.2%, and the proportion of OI was 29.3% and 27.9% in women and men, respectively. Proportions were higher in PL-PCC than negatives, for PEM in women OR=4.38 [95%CI:3.01-6.38]; in men OR = 4.78 [95%CI:3.13-7.29]; for OI in women 3.06 [95%CI:1.97-4.76]; in men 2.71 [95%CI:1.75-4.21]. Associated factors were age ≤ 60 years, ≥1 comorbidities, and living alone. Conclusion High proportions of PEM and OI are observed in PL-PCC. Standard screening for PEM and OI is recommended in PL-PCC to promote appropriate therapies.
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Affiliation(s)
- Demi M. E. Pagen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Maarten Van Herck
- Department of Research and Education, Ciro, Horn, Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
- Faculty of Rehabilitation Sciences, The Rehabilitation Research Center (REVAL), BIOMED–Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Céline J. A. van Bilsen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge and Innovation, South Limburg Public Health Service, Heerlen, Netherlands
| | - Kevin Konings
- Department of Process and Information Management, Communication and Automation, South Limburg Public Health Service, Heerlen, Netherlands
| | - Casper D. J. den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Martijn A. Spruit
- Department of Research and Education, Ciro, Horn, Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
| | - Christian J. P. A. Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
| | - Nicole H. T. M. Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Tebeka S, Carcaillon-Bentata L, Decio V, Alleaume C, Beltzer N, Gallay A, Lemogne C, Pignon B, Makovski TT, Coste J. Complex association between post-COVID-19 condition and anxiety and depression symptoms. Eur Psychiatry 2023; 67:e1. [PMID: 38088068 DOI: 10.1192/j.eurpsy.2023.2473] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND To assess the associations between anxiety and depressive symptoms and post-COVID-19 condition (PCC) by exploring the direction of these associations and their relevance in the definition of PCC. METHODS Nationwide survey among French adults, recruited between March and April, 2022, using a quota method to capture a representative sample of the general population with regard to sex, age, socioeconomic status, size of the place of residence, and region. We included all participants who met the World Health Organization (WHO) definition of PCC in addition to a random sample of participants infected with SARS-COV-2 for at least 3 months but without PCC. Self-reported anxiety and depressive symptoms, chronic anxiety and depression (for more than 3 years), and anxiety and depression were measured using the GAD-2 and PHQ-2 questionnaires, respectively. RESULTS In a sample of 1,095 participants with PCC and 1,021 participants infected with SARS-COV-2 without PCC, 21% had self-reported anxiety and 18% self-reported depression, whereas 33% and 20% had current measured symptoms of anxiety and depression, respectively. The high prevalence of these symptoms cannot only be explained by the characterization of PCC, as only 13.4% of anxiety symptoms and 7.6% of depressive symptoms met the WHO criteria for PCC. Only one participant met the WHO criteria based on self-reported anxiety or depressive symptoms alone, as these were always combined with other symptoms in patients with PCC. Chronic symptoms were associated with PCC (aOR 1.27; 95% CI: 1.00-1.61). In addition, measured anxiety was associated with PCC (aOR = 1.29; 95% CI: 1.02-1.62). CONCLUSIONS Pre-COVID-19 chronic anxiety and depression may play a role in the development of PCC or share vulnerability factors with it. Our results challenge the inclusion of anxiety and depression in the definition of PCC.
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Affiliation(s)
- Sarah Tebeka
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
- Institute of Psychiatry and Neurosciences, Team 1, Université Paris Cité, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Laure Carcaillon-Bentata
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Valentina Decio
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Caroline Alleaume
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Nathalie Beltzer
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Cédric Lemogne
- Center for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Paris, France
- Service de Psychiatrie de l'Adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
| | - Baptiste Pignon
- DMU IMPACT, INSERM U955, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Université Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires "H. Mondor", Creteil, France
| | - Tatjana T Makovski
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Joël Coste
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, The National Public Health Agency, Saint-Maurice, France
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Pan JQ, Tian ZM, Xue LB. Hyperbaric Oxygen Treatment for Long COVID: From Molecular Mechanism to Clinical Practice. Curr Med Sci 2023; 43:1061-1065. [PMID: 37924387 DOI: 10.1007/s11596-023-2799-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/20/2023] [Indexed: 11/06/2023]
Abstract
Long COVID symptoms typically occur within 3 months of an initial COVID-19 infection, last for more than 2 months, and cannot be explained by other diagnoses. The most common symptoms include fatigue, dyspnea, coughing, and cognitive impairment. The mechanisms of long COVID are not fully understood, but several hypotheses have been put forth. These include coagulation and fibrosis pathway activation, inflammatory and autoimmune manifestations, persistent virus presence, and Epstein-Barr virus reactivation. Hyperbaric oxygen therapy (HBOT) is a therapeutic method in which a person inhales 100% oxygen under pressure greater than that of the atmosphere. HBOT has some therapeutic effects, including improvement of microcirculation, inhibition of cytokine release leading to a reduction in inflammatory responses, inhibition of autoimmune responses, and promotion of neurological repair. Several clinical trials have been carried out using HBOT to treat long COVID. The results suggest that HBOT helps to improve symptom severity, reduce symptom duration, and enhance patients' quality of life. It is believed that HBOT is an effective option for patients with long COVID, which is worth actively promoting.
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Affiliation(s)
- Jian-Qing Pan
- Department of Hyperbaric Oxygen, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, China.
| | | | - Lian-Bi Xue
- Department of Hyperbaric Oxygen, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, China
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19
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Rach S, Kühne L, Zeeb H, Ahrens W, Haug U, Pohlabeln H. Mild COVID-19 infection associated with post-COVID-19 condition after 3 months - a questionnaire survey. Ann Med 2023; 55:2226907. [PMID: 37337723 DOI: 10.1080/07853890.2023.2226907] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19), caused by infection with SARS-CoV-2, can lead to post-COVID-19 condition, a secondary syndrome of persistent and new post-acute symptoms, but evidence on this syndrome is still scarce. METHODS In a questionnaire survey, residents of the city of Bremen (Germany) with verified SARS-CoV-2 infection were invited to answer questions (online questionnaire or interview) concerning symptoms experienced at the time of infection and at the time of questionnaire completion at least three months later. Main outcome of the analysis was the presence of a post-COVID-19 condition at the time of the interview, defined as the presence of at least two of three leading symptoms: fatigue, breathing difficulties, or cognitive problems. RESULTS A post-COVID-19 condition was more likely to be reported if respondents had, at the time of infection, suffered from fatigue (OR 1.75; 95% CI: 1.00, 3.06), breathing difficulties (OR 4.02; 95% CI: 2.80, 5.77), cognitive symptoms (OR 2.98; 95% CI: 1.48, 6.02), or head- & bone aches (OR 2.06; 95% CI: 1.25, 3.42). The odds of developing a post-COVID-19 condition increased with the number of symptoms at infection. Females were more likely to report a post-COVID-19 condition (OR 1.54; 95% CI: 1.05, 2.24). Analyzing only non-hospitalized respondents changed results only slightly. CONCLUSION Our study adds to growing evidence that even a mild course of COVID-19 poses a risk for developing a post-COVID-19 condition. Females and those with initial symptoms including fatigue, breathing difficulties, and cognitive symptoms seem more likely to also experience post COVID-19 symptoms several months after infection.KEY MESSAGESEven a mild course of COVID-19 poses a risk for developing a post-COVID-19 condition.Females seem more likely to develop a post-COVID-19 condition.Those with initial symptoms including fatigue, breathing difficulties, and cognitive symptoms seem more likely to develop a post-COVID-19 condition.
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Affiliation(s)
- Stefan Rach
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Lisa Kühne
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Ulrike Haug
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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20
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Fontana JM, Alito A, Piterà P, Verme F, Cattaldo S, Cornacchia M, Mai S, Brunani A, Capodaglio P. Whole-Body Cryostimulation in Post-COVID Rehabilitation for Patients with Obesity: A Multidisciplinary Feasibility Study. Biomedicines 2023; 11:3092. [PMID: 38002092 PMCID: PMC10669700 DOI: 10.3390/biomedicines11113092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/23/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND A post-COVID condition can reduce activity and quality of life, resulting in a significant socioeconomic and health burden. Understanding its impact on patients' health is important for the development of personalized rehabilitation interventions. An independent association between obesity and post-COVID condition was found because of complications and comorbidities. METHODS Sixteen patients with obesity and post-COVID symptoms (i.e., dyspnea, pain, poor sleep quality, muscle fatigue), admitted to the Istituto Auxologico Italiano, Piancavallo (VB), Italy, were recruited for a four-week rehabilitation program including conventional exercise therapy, nutritional intervention, psychological support and whole-body cryostimulation (WBC). RESULTS All participants attended all sessions of the program. Anthropometric data showed statistically significant changes in weight, waist circumference and body mass index. Biochemical analyses showed significant reductions in lipid and inflammatory profiles. There was a significant improvement in physical performance, reduction in pain and improvement in psychological well-being. CONCLUSION A multidisciplinary rehabilitation protocol including WBC, designed for patients with obesity and a post-COVID condition, is safe and feasible. The overall improvements demonstrate that multidisciplinary rehabilitation was effective on post COVID patients and suggest that the use of WBC is safe and could play a role as a booster in rehabilitation programs.
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Affiliation(s)
- Jacopo Maria Fontana
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy; (P.P.); (F.V.); (A.B.); (P.C.)
| | - Angelo Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy;
| | - Paolo Piterà
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy; (P.P.); (F.V.); (A.B.); (P.C.)
| | - Federica Verme
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy; (P.P.); (F.V.); (A.B.); (P.C.)
| | - Stefania Cattaldo
- Laboratory of Clinical Neurobiology, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy;
| | - Mauro Cornacchia
- Pulmonary Rehabilitation Department, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy;
| | - Stefania Mai
- Laboratory of Metabolic Research, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy;
| | - Amelia Brunani
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy; (P.P.); (F.V.); (A.B.); (P.C.)
| | - Paolo Capodaglio
- Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, 28824 Piancavallo, Italy; (P.P.); (F.V.); (A.B.); (P.C.)
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Torino, 10121 Torino, Italy
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21
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Thi Khanh HN, Cornelissen L, Castanares-Zapatero D, De Pauw R, Van Cauteren D, Demarest S, Drieskens S, Devleesschauwer B, De Ridder K, Charafeddine R, Smith P. Association between SARS-CoV-2 variants and post COVID-19 condition: findings from a longitudinal cohort study in the Belgian adult population. BMC Infect Dis 2023; 23:774. [PMID: 37940843 PMCID: PMC10634063 DOI: 10.1186/s12879-023-08787-8] [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: 04/01/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND While many studies on the determinants of post-COVID-19 conditions (PCC) have been conducted, little is known about the relationship between SARS-CoV-2 variants and PCC. This study aimed to assess the association between different SARS-CoV-2 variants and the probability of having PCC three months after the infection. METHODS This study was a longitudinal cohort study conducted between April 2021 and September 2022 in Belgium. In total, 8,238 adults with a confirmed SARS-CoV-2 infection were followed up between the time of their infection and three months later. The primary outcomes were the PCC status three months post infection and seven PCC symptoms categories (neurocognitive, autonomic, gastrointestinal, respiratory, musculoskeletal, anosmia and/or dysgeusia, and other manifestations). The main exposure variable was the type of SARS-CoV-2 variants (i.e. Alpha, Delta, and Omicron), extracted from national surveillance data. The association between the different SARS-CoV-2 variants and PCC as well as PCC symptoms categories was assessed using multivariable logistic regression. RESULTS The proportion of PCC among participants infected during the Alpha, Delta, and Omicron-dominant periods was significantly different and respectively 50%, 50%, and 37%. Participants infected during the Alpha- and Delta-dominant periods had a significantly higher odds of having PCC than those infected during the Omicron-dominant period (OR = 1.61, 95% confidence interval [CI] = 1.33-1.96 and OR = 1.73, 95%CI = 1.54-1.93, respectively). Participants infected during the Alpha and Delta-dominant periods were more likely to report neurocognitive, respiratory, and anosmia/dysgeusia symptoms of PCC. CONCLUSIONS People infected during the Alpha- and Delta-dominant periods had a higher probability of having PCC three months after infection than those infected during the Omicron-dominant period. The lower probability of PCC with the Omicron variant must also be interpreted in absolute figures. Indeed, the number of infections with the Omicron variant being higher than with the Alpha and Delta variants, it is possible that the overall prevalence of PCC in the population increases, even if the probability of having a PCC decreases.
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Affiliation(s)
- Huyen Nguyen Thi Khanh
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium.
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Laura Cornelissen
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | | | - Robby De Pauw
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Stefaan Demarest
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Sabine Drieskens
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Ghent, Belgium
| | - Karin De Ridder
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - Pierre Smith
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
- Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
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22
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Engelmann P, Büchel C, Frommhold J, Klose HFE, Lohse AW, Maehder K, Nestoriuc Y, Scherer M, Suling A, Toussaint A, Weigel A, Zapf A, Löwe B. Psychological risk factors for Long COVID and their modification: study protocol of a three-arm, randomised controlled trial (SOMA.COV). BJPsych Open 2023; 9:e207. [PMID: 37920139 PMCID: PMC10753953 DOI: 10.1192/bjo.2023.591] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/25/2023] [Accepted: 09/21/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Growing evidence suggests that in addition to pathophysiological, there are psychological risk factors involved in the development of Long COVID. Illness-related anxiety and dysfunctional symptom expectations seem to contribute to symptom persistence. AIMS With regard to the development of effective therapies, our primary aim is to investigate whether symptoms of Long COVID can be improved by a targeted modification of illness-related anxiety and dysfunctional symptom expectations. Second, we aim to identify additional psychosocial risk factors that contribute to the persistence of Long COVID, and compare them with risk factors for symptom persistence in other clinical conditions. METHOD We will conduct an observer-blinded, three-arm, randomised controlled trial. A total of 258 patients with Long COVID will be randomised into three groups of equal size: targeted expectation management in addition to treatment as usual (TAU), non-specific supportive treatment plus TAU, or TAU only. Both active intervention groups will comprise three individual online video consultation sessions and a booster session after 3 months. The primary outcome is baseline to post-interventional change in overall somatic symptom severity. CONCLUSIONS The study will shed light onto the action mechanisms of a targeted expectation management intervention for Long COVID, which, if proven effective, can be used stand-alone or in the context of broader therapeutic approaches. Further, the study will enable a better understanding of symptom persistence in Long COVID by identifying additional psychological risk factors.
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Affiliation(s)
- Petra Engelmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Christian Büchel
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Hans F. E. Klose
- II. Medical Clinic and Polyclinic, University Medical Center Hamburg-Eppendorf, Germany
| | - Ansgar W. Lohse
- I. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Germany
| | - Kerstin Maehder
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Yvonne Nestoriuc
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany; and Department of Psychology, Helmut Schmidt University, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Germany
| | - Anna Suling
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Angelika Weigel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Antonia Zapf
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
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23
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Liu TH, Huang PY, Wu JY, Chuang MH, Hsu WH, Tsai YW, Tsai MH, Lai CC. Real-world data analysis of post-COVID-19 condition risk in older patients. Age Ageing 2023; 52:afad204. [PMID: 37962418 DOI: 10.1093/ageing/afad204] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Indexed: 11/15/2023] Open
Abstract
This study investigated the risk of post-COVID-19 conditions in older patients with COVID-19 compared to those with influenza, and how age impacts this relationship. Patients aged ≥65 years with COVID-19 or influenza were identified using the TriNetX network. The risk of post-COVID-19 conditions was compared between survivors of COVID-19 and influenza, followed by a comparison of post-COVID-19 conditions risk between patients aged 65-74 years and those aged over 75 years. Compared with influenza survivors, post-COVID-19 conditions were significantly more prevalent in patients with COVID-19 (hazard ratio [HR], 1.534; 95% confidence interval [CI]: 1.405-1.675). Specifically, COVID-19 survivors have a significantly higher risk of experiencing abnormal breathing (HR, 2.052; 95% CI: 1.757-2.397), fatigue (HR, 1.587; 95% CI: 1.322-1.905), anxiety/depression (HR, 1.587; 95% CI: 1.322-1.905), cognitive symptoms (HR, 1.667; 95% CI: 1.295-2.146) and cough (HR, 1.250; 95% CI: 1.006-1.553) compared with the influenza group. Contrastingly, no significant difference was observed in the risk of any post-COVID-19 condition between COVID-19 survivors aged 65-74 years and those aged over 75 years (HR, 0.994; 95% CI: 0.920-1.073). However, a lower incidence of cognitive symptoms was observed in patients aged 65-74 years compared to those aged ≥75 years (HR, 0.543; 95% CI: 0.445-0.661). In conclusion, compared with influenza, older patients have a higher risk of developing post-COVID-19 conditions after SARS-CoV-2 infection, and those aged over ≥75 years may have an increased risk of developing cognitive symptoms compared to those aged 65-74 years.
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Affiliation(s)
- Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Min-Hsiang Chuang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Wan-Hsuan Hsu
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ya-Wen Tsai
- Center for Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Meng-Hsiu Tsai
- Department of Geriatrics and Gerontology, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
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24
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Njøten KL, Espehaug B, Magnussen LH, Jürgensen M, Kvale G, Søfteland E, Aarli BB, Frisk B. Relationship between exercise capacity and fatigue, dyspnea, and lung function in non-hospitalized patients with long COVID. Physiol Rep 2023; 11:e15850. [PMID: 37984816 PMCID: PMC10659919 DOI: 10.14814/phy2.15850] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
Long COVID is a global health problem that impairs patients' functional status. More than 200 reported symptoms have been identified where fatigue, dyspnea, and exercise impairment are most common. This study aimed to describe exercise capacity, fatigue, dyspnea, and lung function in previously non-hospitalized patients with long COVID, and examine the relationship between exercise capacity and fatigue, dyspnea, and lung function. Sixty-five patients, 54 women (83%), mean age of 39 standard deviation (12) years, were included and completed spirometry, cardiopulmonary exercise test, stair climbing test (SCT), 30 second sit-to-stand test (30STST), and questionnaires regarding fatigue and dyspnea. Fatigue was reported by 95% of the participants, whereas 65% reported severe fatigue, and 66% reported dyspnea. Mean exercise capacity measured with peak oxygen uptake (V̇O2peak % pred.) was ≥85% in 65% of the participants. Mean forced expiratory volume in 1 s. and forced vital capacity were 96.6 (10.7)% and 100.8 (10.9)%, respectively, while reduced diffusion capacity for carbon monoxide (DLCO ) was found in eight participants (13%). Reduced V̇O2peak kg-1 and increased time on SCT were significantly associated with increased dyspnea and reduced DLCO but not with fatigue, while 30STST was associated with increased fatigue and dyspnea in previously non-hospitalized patients with long COVID.
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Affiliation(s)
- Kiri Lovise Njøten
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
- Helse i HardangerØysteseNorway
| | - Birgitte Espehaug
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
| | - Liv Heide Magnussen
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
| | - Marte Jürgensen
- Helse i HardangerØysteseNorway
- Division of PsychiatryHaukeland University HospitalBergenNorway
| | - Gerd Kvale
- Helse i HardangerØysteseNorway
- Division of PsychiatryHaukeland University HospitalBergenNorway
- Department of Clinical PsychologyUniversity of BergenBergenNorway
| | - Eirik Søfteland
- Helse i HardangerØysteseNorway
- Department of MedicineHaukeland University HospitalBergenNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | - Bernt Bøgvald Aarli
- Helse i HardangerØysteseNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Department of Thoracic MedicineHaukeland University HospitalBergenNorway
| | - Bente Frisk
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
- Helse i HardangerØysteseNorway
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25
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Fedorowski A, Olsén MF, Nikesjö F, Janson C, Bruchfeld J, Lerm M, Hedman K. Cardiorespiratory dysautonomia in post-COVID-19 condition: Manifestations, mechanisms and management. J Intern Med 2023; 294:548-562. [PMID: 37183186 DOI: 10.1111/joim.13652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
A significant proportion of COVID-19 patients experience debilitating symptoms for months after the acute infection. According to recent estimates, approximately 1 out of 10 COVID-19 convalescents reports persistent health issues more than 3 months after initial recovery. This 'post-COVID-19 condition' may include a large variety of symptoms from almost all domains and organs, and for some patients it may mean prolonged sick-leave, homestay and strongly limited activities of daily life. In this narrative review, we focus on the symptoms and signs of post-COVID-19 condition in adults - particularly those associated with cardiovascular and respiratory systems, such as postural orthostatic tachycardia syndrome or airway disorders - and explore the evidence for chronic autonomic dysfunction as a potential underlying mechanism. The most plausible hypotheses regarding cellular and molecular mechanisms behind the wide spectrum of observed symptoms - such as lingering viruses, persistent inflammation, impairment in oxygen sensing systems and circulating antibodies directed to blood pressure regulatory components - are discussed. In addition, an overview of currently available pharmacological and non-pharmacological treatment options is presented.
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Affiliation(s)
- Artur Fedorowski
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Karolinska University Hospital, Solna, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Monika Fagevik Olsén
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Frida Nikesjö
- Department of Respiratory Medicine in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Judith Bruchfeld
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Maria Lerm
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linköping University, Linköping, Sweden
| | - Kristofer Hedman
- Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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26
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Zamli AH, Misnan NA, Lim SY, Zohdi WNWM, Baharum N, Andiappan K. Post-COVID-19 Condition Characterization: Insights From a Cross-Sectional Study in a Malaysian Rehabilitation Center. Asia Pac J Public Health 2023; 35:516-523. [PMID: 37798930 DOI: 10.1177/10105395231203118] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Although post-COVID-19 condition (PCC) is a major public health concern, studies on PCC in Southeast Asia are lacking. This study aimed to describe PCC symptoms and its functional impact among COVID-19 survivors undergoing outpatient rehabilitation in Malaysia. We evaluated 3037 patients with confirmed COVID-19, referred between November 2020 and September 2022, 3 to 6 months after infection. PCC was diagnosed in 71.1%. Fatigue and dyspnea were the most common symptoms. The PCC patients had reduced respiratory, ambulatory, and musculoskeletal function, and higher fatigue and pain scores, and were less likely to return to work (odds ratio [OR] = 0.55) compared with non-PCC patients. Recognition of PCC symptoms and its functional impact can guide early, tailored, rehabilitation interventions.
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Affiliation(s)
- Akmal Hafizah Zamli
- Department of Rehabilitation Medicine, Sungai Buloh Hospital, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nor Arisah Misnan
- Infectious Disease Department, Sungai Buloh Hospital, Ministry of Health Malaysia, Selangor, Malaysia
| | - Su-Yin Lim
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, Selangor, Malaysia
| | - Wan Najwa Wan Mohd Zohdi
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
| | - Nurakmal Baharum
- Centre for Coordination of Clinical Research Network, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Kavitha Andiappan
- Department of Rehabilitation Medicine, Sungai Buloh Hospital, Ministry of Health Malaysia, Selangor, Malaysia
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27
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Udeh R, Utrero-Rico A, Dolja-Gore X, Rahmati M, McEVoy M, Kenna T. Lactate dehydrogenase contribution to symptom persistence in long COVID: A pooled analysis. Rev Med Virol 2023; 33:e2477. [PMID: 37706263 DOI: 10.1002/rmv.2477] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 09/15/2023]
Abstract
There's critical need for risk predictors in long COVID. This meta-analysis evaluates the evidence for an association between plasma lactate dehydrogenase (LDH) and long COVID and explores the contribution of LDH to symptoms persistent across the distinct post-acute sequelae of COVID-19 (PASC) domains. PubMed, EMBASE, Web of Science, and Google Scholar were searched for articles published up to 20 March 2023 for studies that reported data on LDH levels in COVID-19 survivors with and without PASC. Random-effect meta-analysis was employed to estimate the standardized mean difference (SMD) with corresponding 95% confidence interval of each outcome. There were a total of 8289 study participants (3338 PASC vs. 4951 controls) from 46 studies. Our meta-analysis compared to the controls showed a significant association between LDH elevation and Resp-PASC [SMD = 1.07, 95%CI = 0.72, 1.41, p = 0.01] but not Cardio-PASC [SMD = 1.79, 95%CI = -0.02, 3.61, p = 0.05], Neuro-PASC [SMD = 0.19, 95%CI = -0.24, 0.61, p = 0.40], and Gastrointestinal-PASC [SMD = 0.45, 95%CI = -1.08, 1.98, p = 0.56]. This meta-analysis suggests elevated LDH can be used for predicting Resp-PASC, but not Cardio-PASC, Neuro-PASC or gastrointestinal-PASC. Thus, elevated plasma LDH following COVID infection may be considered as a disease biomarker.
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Affiliation(s)
- Raphael Udeh
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, New South Wales, Australia
| | | | - Xenia Dolja-Gore
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Mark McEVoy
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC, Australia
| | - Tony Kenna
- Centre for Immunology & Infection Control, Queensland University of Technology, Bendigo, Queensland, Australia
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Shmueli E, Bar-On O, Amir B, Mei-Zahav M, Stafler P, Levine H, Steuer G, Rothschild B, Tsviban L, Amitai N, Dotan M, Chodick G, Prais D, Ashkenazi-Hoffnung L. Pulmonary Evaluation in Children with Post-COVID-19 Condition Respiratory Symptoms: A Prospective Cohort Study. J Clin Med 2023; 12:6891. [PMID: 37959356 PMCID: PMC10648595 DOI: 10.3390/jcm12216891] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/22/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Background: Studies on post-COVID-19 condition (PCC) in adults have shown deterioration in pulmonary function tests (PFTs), mainly a diffusion limitation. Among the pediatric population, data are scarce. Aim: To characterize PFTs in children with PCC, including changes over time. Methods: A prospective longitudinal study of children with defined PCC and respiratory complaints who were referred to a designated multidisciplinary clinic from 11/2020 to 12/2022. Results: Altogether, 184 children with a mean age of 12.4 years (SD 4.06) were included. A mild obstructive pattern was demonstrated in 19/170 (11%) at presentation, as indicated by spirometry and/or positive exercise challenge test and/or reversibility post bronchodilators, only three had a previous diagnosis of asthma. Lung volumes and diffusion were normal in all but one patient (1/134, 0.7%). Exhaled nitric oxide levels were elevated in 32/144 (22%). A total of 33 children who had repeated PFTs had normal or near-normal PFTs on follow-up testing, including seven (21.2%) who had mild obstructive PFTs at presentation. Multivariate analysis identified older age [OR 1.36 (95% CI:1.07-1.75)], specific imaging findings (prominent bronchovascular markings (OR 43.28 (95% CI: 4.50-416.49)), and hyperinflation (OR 28.42, 95% CI: 2.18-370.84)] as significant predictors of an obstructive pattern on PFTs. Conclusions: In children with PCC and respiratory symptoms, the most common impairment was a mild obstructive pattern; most were without a history of asthma. Improvement was witnessed in long-term follow-up. In contrast to the adult population, no diffusion limitation was found. Empirical periodic inhaler therapy may be considered in children with factors associated with PFT abnormalities.
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Affiliation(s)
- Einat Shmueli
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Ophir Bar-On
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
| | - Ben Amir
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Meir Mei-Zahav
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Patrick Stafler
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Hagit Levine
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Guy Steuer
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
| | - Benjamin Rothschild
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
| | - Lior Tsviban
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
| | - Nofar Amitai
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Miri Dotan
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Gabriel Chodick
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Dario Prais
- Pulmonology Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petach Tikva 49202, Israel; (O.B.-O.); (M.M.-Z.); (P.S.); (H.L.); (G.S.); (B.R.); (L.T.); (N.A.); (M.D.); (D.P.)
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
| | - Liat Ashkenazi-Hoffnung
- Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (B.A.); (G.C.); (L.A.-H.)
- Department of Day Hospitalization, Schneider Children’s Medical Center of Israel, Petach Tikva 49202, Israel
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Yang J, Lim KH, Lim KT, Woods JT, Mohabbat AB, Wahner-Roedler DL, Ganesh R, Bauer BA. Complementary and alternative medicine for long COVID: a systematic review of randomized controlled trials. Ther Adv Chronic Dis 2023; 14:20406223231204727. [PMID: 37841213 PMCID: PMC10571674 DOI: 10.1177/20406223231204727] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Background Complementary and alternative medicine (CAM) interventions are growing in popularity as possible treatments for long COVID symptoms. However, comprehensive analysis of current evidence in this setting is still lacking. Objective This study aims to review existing published studies on the use of CAM interventions for patients experiencing long COVID through a systematic review. Design Systematic review of randomized controlled trials (RCTs). Methods A comprehensive electronic literature search was performed in multiple databases and clinical trial registries from September 2019 to January 2023. RCTs evaluating efficacy and safety of CAM for long COVID were included. Methodological quality of each included trial was appraised with the Cochrane 'risk of bias' tool. A qualitative analysis was conducted due to heterogeneity of included studies. Results A total of 14 RCTs with 1195 participants were included in this review. Study findings demonstrated that CAM interventions could benefit patients with long COVID, especially those suffering from neuropsychiatric disorders, olfactory dysfunction, cognitive impairment, fatigue, breathlessness, and mild-to-moderate lung fibrosis. The main interventions reported were self-administered transcutaneous auricular vagus nerve stimulation, neuro-meditation, dietary supplements, olfactory training, aromatherapy, inspiratory muscle training, concurrent training, and an online breathing and well-being program. Conclusion CAM interventions may be effective, safe, and acceptable to patients with symptoms of long COVID. However, the findings from this systematic review should be interpreted with caution due to various methodological limitations. More rigorous trials focused on CAM for long COVID are warranted in the future.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kia Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kia Teng Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Arya B. Mohabbat
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Ravindra Ganesh
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A. Bauer
- Division of General Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
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Jacobs LMC, Wintjens MSJN, Nagy M, Willems L, ten Cate H, Spronk HMH, van Kuijk SMJ, Ghossein-Doha C, Netea MG, Groh LA, van Petersen AS, Warlé MC. Biomarkers of sustained systemic inflammation and microvascular dysfunction associated with post-COVID-19 condition symptoms at 24 months after SARS-CoV-2-infection. Front Immunol 2023; 14:1182182. [PMID: 37868959 PMCID: PMC10586198 DOI: 10.3389/fimmu.2023.1182182] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Comprehensive studies investigating sustained hypercoagulability, endothelial function, and/or inflammation in relation to post-COVID-19 (PCC) symptoms with a prolonged follow-up are currently lacking. Therefore, the aim of this single-centre cohort study was to investigate serum biomarkers of coagulation activation, microvascular dysfunction, and inflammation in relation to persisting symptoms two years after acute COVID-19. Methods Patients diagnosed with acute SARS-CoV-2 infection between February and June 2020 were recruited. Outcome measures included the CORona Follow-Up (CORFU) questionnaire, which is based on an internationally developed and partially validated basic questionnaire on persistent PCC symptoms. Additionally, plasma biomarkers reflecting coagulation activation, endothelial dysfunction and systemic inflammation were measured. Results 167 individuals were approached of which 148 (89%) completed the CORFU questionnaire. At 24 months after acute infection, fatigue was the most prevalent PCC symptom (84.5%). Over 50% of the patients experienced symptoms related to breathing, cognition, sleep or mobility; 30.3% still experienced at least one severe or extreme (4 or 5 on a 5-point scale) PCC symptom. Multiple correlations were found between several PCC symptoms and markers of endothelial dysfunction (endothelin-1 and von Willebrand factor) and systemic inflammation (Interleukin-1 Receptor antagonist). No positive correlations were found between PCC symptoms and coagulation complexes. Discussion In conclusion, this study shows that at 24 months after acute COVID-19 infection patients experience a high prevalence of PCC symptoms which correlate with inflammatory cytokine IL-1Ra and markers of endothelial dysfunction, especially endothelin-1. Our data may provide a rationale for the selection of treatment strategies for further clinical studies. Trial registration This study was performed in collaboration with the CORona Follow-Up (CORFU) study (NCT05240742, https://clinicaltrials.gov/ct2/show/ NCT05240742).
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Affiliation(s)
- Lotte M. C. Jacobs
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marieke S. J. N. Wintjens
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
- Department of Intensive Care Medicine, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
| | - Magdolna Nagy
- Department of Biochemistry, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Loes Willems
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Hugo ten Cate
- Department of Biochemistry, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
- Center for Thrombosis and Haemostasis, Gutenberg University Medical Center, Mainz, Germany
| | - Henri M. H. Spronk
- Department of Biochemistry, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
| | - Sander M. J. van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
| | - Chahinda Ghossein-Doha
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Department of Cardiology, Maastricht University Medical Center+ (UMC+), Maastricht, Netherlands
| | - Mihai G. Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Immunology and Metabolism, Life & Medical Sciences Institute, University of Bonn, Bonn, Germany
| | - Laszlo A. Groh
- Department of Molecular Cell Biology and Immunology, Amsterdam Cardiovascular Sciences, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Institute for Infection and Immunity, Cancer Centre Amsterdam, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Michiel C. Warlé
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
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Bartczak KT, Miłkowska-Dymanowska J, Pietrusińska M, Kumor-Kisielewska A, Stańczyk A, Majewski S, Piotrowski WJ, Lipiński C, Wawrocki S, Białas AJ. Is Pulmonary Involvement a Distinct Phenotype of Post-COVID-19? Biomedicines 2023; 11:2694. [PMID: 37893068 PMCID: PMC10604471 DOI: 10.3390/biomedicines11102694] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: COVID-19 infection often provokes symptoms lasting many months: most commonly fatigue, dyspnea, myalgia and mental distress symptoms. In this study, we searched for clinical features of post-COVID-19 condition (PCC) and differences between patients with and without pulmonary involvement. (2) Methods: A total of 282 patients with a mean age of 57 years (SD +/- 12 years) underwent assessment up to 12 weeks after COVID-19 recovery. The course of acute disease, past medical history and clinical symptoms were gathered; pulmonary function tests were performed; radiographic studies were assessed and follow-up examinations were conducted. Patients with and without detectable pulmonary lesions were divided into separate groups. (3) Results: Patients within the pulmonary group were more often older (59 vs. 51 y.o.; p < 0.001) males (p = 0.002) that underwent COVID-19-related hospitalization (p < 0.001) and were either ex- or active smokers with the median of 20 pack-years. We also managed to find correlations with hypertension (p = 0.01), liver failure (p = 0.03), clinical symptoms such as dyspnea (p < 0.001), myalgia (p = 0.04), headache (p = 0.009), sleeplessness (p = 0.046), pulmonary function tests (such as FVC, TLCO, RV and TLC; p < 0.001) and several basic laboratory tests (D-dimer, cardiac troponin, WBC, creatinine and others). (4) Conclusions: Our results indicate that initial pulmonary involvement alters the PCC, and it can be used to individualize clinical approaches.
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Affiliation(s)
- Krystian T. Bartczak
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
| | - Joanna Miłkowska-Dymanowska
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
| | - Małgorzata Pietrusińska
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
| | - Anna Kumor-Kisielewska
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
| | - Adam Stańczyk
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland;
| | - Sebastian Majewski
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
| | - Wojciech J. Piotrowski
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
| | - Cezary Lipiński
- The Center for Innovation and Technology Transfer, Medical University of Lodz, 92-215 Lodz, Poland (S.W.)
| | - Sebastian Wawrocki
- The Center for Innovation and Technology Transfer, Medical University of Lodz, 92-215 Lodz, Poland (S.W.)
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos, Switzerland
| | - Adam J. Białas
- Department of Pneumology, Medical University of Lodz, 90-153 Lodz, Poland; (J.M.-D.); (A.K.-K.); (S.M.); (W.J.P.); (A.J.B.)
- Department of Pulmonary Rehabilitation, Center for Lung Diseases and Rehabilitation, Blessed Rafal Chylinski Memorial Hospital for Lung Diseases, 91-520 Lodz, Poland
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Štěpánek L, Nakládalová M, Sovová E, Štěpánek L, Boriková A, Sovová M, Moravcová K, Ožana J, Jelínek L. COVID-19 reduces cardiorespiratory fitness even months after a mild to moderate acute phase: a retrospective cohort study. Infect Dis (Lond) 2023; 55:684-693. [PMID: 37395125 DOI: 10.1080/23744235.2023.2228408] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/05/2023] [Accepted: 06/18/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND COVID-19 survivors may experience long-term health problems, including deterioration of cardiorespiratory fitness (CRF), as demonstrated by several cross-sectional studies that compared the results of cardiopulmonary exercise tests (CPET) performed only after COVID-19 with predicted values. This study aimed to analyze a change in CRF between repeated CPETs in response to suffered COVID-19. METHODS A total of 127 healthcare workers (HCWs; mean age 55.7 years) underwent two CPETs with a mean interval of 762 days. Forty HCWs suffered from COVID-19 (mild to moderate severity) in the interim (321 days before the second CPET), and 87 HCWs formed a control group. Mixed-effects regression with multiple adjustment and interaction terms was used for two response variables - maximum oxygen uptake (VO2 max) and power output. RESULTS Between both CPETs, mean VO2 max decreased statistically significantly in the COVID-19 subgroup (by 3.12 mL/kg/min, p = .034) and insignificantly in controls (by 0.56 mL/kg/min, p = .412). The proportion of HCWs achieving predicted VO2 max decreased from 75.9% to 59.5% (p = .161) in COVID-19 survivors, while it increased from 73.8% to 81% (p = .274) in controls. COVID-19 (β = -0.66, p = .014) and body mass index (β = -0.49, p < .001) were independent negative predictors of VO2 max change. COVID-19 was not associated with a change in power output. CONCLUSIONS On the basis of repeated CPETs, COVID-19 significantly, albeit rather modestly, reduces CRF almost one year after infection. The reduction persists even after the acute phase with mild or moderate severity.
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Affiliation(s)
- Ladislav Štěpánek
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Marie Nakládalová
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Eliška Sovová
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Lubomír Štěpánek
- Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alena Boriková
- Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Markéta Sovová
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Katarína Moravcová
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jaromír Ožana
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Libor Jelínek
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
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Pagen DME, van Bilsen CJA, Brinkhues S, Van Herck M, Konings K, den Heijer CDJ, ter Waarbeek HLG, Spruit MA, Hoebe CJPA, Dukers-Muijrers NHTM. Prevalence of Long-term Symptoms Varies When Using Different Post-COVID-19 Definitions in Positively and Negatively Tested Adults: The PRIME Post-COVID Study. Open Forum Infect Dis 2023; 10:ofad471. [PMID: 37885796 PMCID: PMC10599319 DOI: 10.1093/ofid/ofad471] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/14/2023] [Indexed: 10/28/2023] Open
Abstract
Background Long-term symptoms after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (ie, post-coronavirus disease 2019 [COVID-19] condition or long COVID) constitute a substantial public health problem. Yet, the prevalence remains currently unclear as different case definitions are used, and negatively tested controls are lacking. We aimed to estimate post-COVID-19 condition prevalence using 6 definitions. Methods The Prevalence, Risk factors, and Impact Evaluation (PRIME) post-COVID-19 condition study is a population-based sample of COVID-19-tested adults. In 2021, 61 655 adults were invited to complete an online questionnaire, including 44 symptoms plus a severity score (0-10) per symptom. Prevalence was calculated in both positively and negatively tested adults, stratified by time since their COVID-19 test (3-5, 6-11, or ≥12 months ago). Results In positive individuals (n = 7405, 75.6%), the prevalence of long-term symptoms was between 26.9% and 64.1% using the 6 definitions, while in negative individuals (n = 2392, 24.4%), the prevalence varied between 11.4% and 32.5%. The prevalence of long-term symptoms potentially attributable to COVID-19 ranged from 17.9% to 26.3%. Conclusions There is a (substantial) variation in prevalence estimates when using different post-COVID-19 condition definitions, as is current practice; there is limited overlap between definitions, indicating that the essential post-COVID-19 condition criteria are still unclear. Including negatives is important to determine long-term symptoms attributable to COVID-19. Trial registration ClinicalTrials.gov Identifier: NCT05128695.
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Affiliation(s)
- Demi M E Pagen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Social Medicine, Maastricht University, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Céline J A van Bilsen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Social Medicine, Maastricht University, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Stephanie Brinkhues
- Department of Knowledge & Innovation, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Maarten Van Herck
- Department of Research and Education, Ciro, Horn, the Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, the Netherlands
- REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kevin Konings
- Department of Process & Information Management, Communication & Automation, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Casper D J den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Social Medicine, Maastricht University, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
| | - Henriëtte L G ter Waarbeek
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
| | - Martijn A Spruit
- Department of Research and Education, Ciro, Horn, the Netherlands
- Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine, and Life Sciences, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Social Medicine, Maastricht University, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht, the Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health, South Limburg Public Health Service, Heerlen, the Netherlands
- Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Garcia-Gasalla M, Berman-Riu M, Rodriguez A, Iglesias A, Fraile-Ribot PA, Toledo-Pons N, Pol-Pol E, Ferré-Beltrán A, Artigues-Serra F, Martin-Pena ML, Pons J, Murillas J, Oliver A, Riera M, Ferrer JM. Elevated complement C3 and increased CD8 and type 1 helper lymphocyte T populations in patients with post-COVID-19 condition. Cytokine 2023; 169:156295. [PMID: 37453328 DOI: 10.1016/j.cyto.2023.156295] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/28/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Biological markers associated to post-COVID-19 condition (PCC) have not been clearly identified. METHODS Eighty-two patients attending our post-COVID-19 outpatient clinic were recruited and classified as fully recovered (40.2%) or presenting with PCC (59.8%). Clinical and radiological data, laboratory markers, cytokines, and lymphocyte populations were analyzed. RESULTS Median number of days after hospitalization was 78.5 [p25-p75: 60-93] days. PCC was significantly more frequent in women, in patients with a previously critical COVID-19, and in those with two or more comorbidities. No differences were found in lymphocyte counts, ferritin, C-reactive protein, D-dimer or sCD25, IL-1β, IL-1Ra, IL-6, CXCL8, IL-17A, IL-18, IL-22, IFN-γ, TNF-α, and IL-10 cytokines levels. PCC patients showed significantly higher levels of complement factor C3 than fully recovered patients: median C3 128 mg/dL [p25-p75:107-135] vs 111 mg/dL [p25-p75: 100-125] (p =.005), respectively. In the flow cytometry assessment of peripheral blood lymphocyte subpopulations, PCC patients showed significantly increased CD8 populations compared to fully recovered patients: median CD8: 529 [p25-p75: 384-683] vs 370/mm3 [p25-p75:280-523], p =.007. When type 1, 2, 17/22, and 17.1 helper and follicular T lymphocyte subpopulations were analyzed, the frequency of Th1 was significantly higher in PCC patients compared to fully recovered patients (30% vs 38.5%, p =.028). CONCLUSION Patients with a post-COVID-19 condition showed significantly increased immunological parameters of inflammation (complement factor C3 and CD8 and Th1 T lymphocyte populations) compared to fully recovered patients. These parameters could be used as biological markers of this condition.
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Affiliation(s)
- Mercedes Garcia-Gasalla
- Department of Internal Medicine, Hospital Universitari Son Espases, Palma, Spain; Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Universitat de les Illes Balears. Palma de Mallorca, Illes Balears, Spain.
| | - Maria Berman-Riu
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Universitat de les Illes Balears. Palma de Mallorca, Illes Balears, Spain
| | - Adrian Rodriguez
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Department of Internal Medicine, Hospital Universitari Son Llàtzer, Palma, Spain
| | - Amanda Iglesias
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Centro de Investigación Biomedica en Red (CIBER) de Enfermedades Respiratorias, Hospital Universitari Son Espases, Palma, Spain
| | - Pablo A Fraile-Ribot
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Department of Microbiology, Hospital Universitari Son Espases, Palma, Spain
| | - Nuria Toledo-Pons
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Department of Pneumology, Hospital Universitari Son Espases, Palma, Spain
| | - Elisabet Pol-Pol
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Department of Immunology, Hospital Universitari Son Espases, Palma, Spain
| | - Adrian Ferré-Beltrán
- Department of Internal Medicine, Hospital Universitari Son Espases, Palma, Spain
| | | | - M Luisa Martin-Pena
- Department of Internal Medicine, Hospital Universitari Son Espases, Palma, Spain; Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Jaime Pons
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Centro de Investigación Biomedica en Red (CIBER) de Enfermedades Respiratorias, Hospital Universitari Son Espases, Palma, Spain; Department of Immunology, Hospital Universitari Son Espases, Palma, Spain
| | - Javier Murillas
- Department of Internal Medicine, Hospital Universitari Son Espases, Palma, Spain; Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Universitat de les Illes Balears. Palma de Mallorca, Illes Balears, Spain
| | - Antonio Oliver
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Department of Microbiology, Hospital Universitari Son Espases, Palma, Spain; Universitat de les Illes Balears. Palma de Mallorca, Illes Balears, Spain
| | - Melchor Riera
- Department of Internal Medicine, Hospital Universitari Son Espases, Palma, Spain; Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Universitat de les Illes Balears. Palma de Mallorca, Illes Balears, Spain
| | - Joana M Ferrer
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain; Department of Immunology, Hospital Universitari Son Espases, Palma, Spain; Universitat de les Illes Balears. Palma de Mallorca, Illes Balears, Spain
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Menichetti F. The Potential Role of Hypothalamic Phospholipid Liposomes in the Supportive Therapy of Some Manifestations of Post-COVID-19 Condition: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Brain Fog. J Clin Med 2023; 12:5478. [PMID: 37685544 PMCID: PMC10488182 DOI: 10.3390/jcm12175478] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Post-COVID-19 condition (commonly known as Long COVID) is a heterogeneous clinical condition in which Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and brain fog stand out among the different clinical symptoms and syndromes. Cerebral metabolic alterations and neuroendocrine disorders seem to constitute an important part of the pathophysiology of Post-COVID-19 condition (PCC). Given the substantial lack of specific drugs and effective therapeutic strategies, hypothalamic phospholipid liposomes, which have been on the market for several years as adjuvant therapy for cerebral metabolic alterations resulting from neuroendocrine disorders, might represent a potential option in an overall therapeutic strategy that aims to control PCC-associated symptoms and syndromes. Their pharmacological mechanisms and clinical effects strongly support their potential effectiveness in PCC. Our initial clinical experience seems to corroborate this rationale. Further controlled clinical research is warranted in order to verify this hypothesis.
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Pinto Pereira SM, Nugawela MD, McOwat K, Dalrymple E, Xu L, Ladhani SN, Simmons R, Chalder T, Swann O, Ford T, Heyman I, Segal T, Semple MG, Rojas NK, Consortium CL, Shafran R, Stephenson T. Symptom Profiles of Children and Young People 12 Months after SARS-CoV-2 Testing: A National Matched Cohort Study (The CLoCk Study). Children (Basel) 2023; 10:1227. [PMID: 37508724 PMCID: PMC10377812 DOI: 10.3390/children10071227] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Although 99% of children and young people have been exposed to SARS-CoV-2, the long-term prevalence of post-COVID-19 symptoms in young people is unclear. The aim of this study is to describe symptom profiles 12 months after SARS-CoV-2 testing. METHOD A matched cohort study of a national sample of 20,202 children and young people who took a SARS-CoV-2 PCR test between September 2020 and March 2021. RESULTS 12 months post-index-test, there was a difference in the number of symptoms reported by initial negatives who never tested positive (NN) compared to the other three groups who had at least one positive test (p < 0.001). Similarly, 10.2% of the NN group described five-plus symptoms at 12 months compared to 15.9-24.0% in the other three groups who had at least one positive test. The most common symptoms were tiredness, sleeping difficulties, shortness of breath, and headaches for all four groups. For all these symptoms, the initial test positives with subsequent reports of re-infection had higher prevalences than other positive groups (p < 0.001). Symptom profiles, mental health, well-being, fatigue, and quality of life did not vary by vaccination status. CONCLUSIONS Following the pandemic, many young people, particularly those that have had multiple SARS-CoV-2 positive tests, experience a range of symptoms that warrant consideration and potential investigation and intervention.
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Affiliation(s)
- Snehal M. Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK
| | - Manjula D. Nugawela
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Kelsey McOwat
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Emma Dalrymple
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Laila Xu
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Shamez N. Ladhani
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
- Paediatric Infectious Diseases Research Group, St. George’s University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Ruth Simmons
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Olivia Swann
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh EH16 4TL, UK
| | - Tamsin Ford
- Department of Psychiatry, Hershel Smith Building Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Terry Segal
- University College London Hospitals NHS Foundation Trust, London NW1 2PG, UK
| | - Malcolm G. Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L69 3BX, UK
- Respiratory Medicine, Alder Hey Children’s Hospital, Liverpool L12 2AP, UK
| | - Natalia K. Rojas
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6BT, UK
| | | | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Terence Stephenson
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
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García Cena CE, Silva L, Diaz Palencia FH, Moríñigo MI, Santos CP, Pazmiño RS, Benito-León J, Gómez-Andrés D. Internet of medical things. Measurement of respiratory dynamics using wearable sensors in post-COVID-19 patients. Enfoque UTE 2023; 14:36-48. [PMID: 37521501 PMCID: PMC10375539 DOI: 10.29019/enfoqueute.972] [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] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Nowadays, the measurement of respiratory dynamics is underrated at clinical setting and in the daily life of a subject and it still represents a challenge from a technical and medical point of view. In this article we propose a concept to measure some of its parameters, such as the respiratory rate (RR), using four inertial sensors. Two different experiments were performed to validate the concept. We analyzed the most suitable placement of each sensor to assess those features and we studied the reliability of the system to measure abnormal parameters of respiration (tachypnea, bradypnea and breath holding). Finally, we measured post-COVID-19 patients, some of them with breath alterations after more than a year of the diagnosis. Experimental results showed that the proposed system could be potentially used to measure the respiratory dynamics at clinical setting. Moreover, while RR can be easily calculated by any sensor, other parameters need to be measured with a sensor in a particular position.
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Affiliation(s)
- Cecilia E García Cena
- ETSIDI-Centre for Automation and Robotics from Universidad Politecnica de Madrid. Spain. C. Ronda de Valencia 3, 28012. Madrid. Spain
| | - Luís Silva
- Industrial Electronics Department, University of Minho, Guimarães, Portugal
| | | | - María Islán Moríñigo
- ETSIDI-Centre for Automation and Robotics from Universidad Politecnica de Madrid. Spain. C. Ronda de Valencia 3, 28012. Madrid. Spain
| | - Cristina P Santos
- Industrial Electronics Department, University of Minho, Guimarães, Portugal
| | - Roque Saltarén Pazmiño
- ETSIDI-Centre for Automation and Robotics from Universidad Politecnica de Madrid. Spain. C. Ronda de Valencia 3, 28012. Madrid. Spain
| | - Julian Benito-León
- Department of Neurology,University Hospital "12 de Octubre", Madrid,Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED),Spain; Department of Medicine, 5 Complutense University, Madrid, Spain
| | - David Gómez-Andrés
- Child Neurology Unit. Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Euro-NMD & ERN-RND, Barcelona, Spain
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Gunnarsson DV, Miskowiak KW, Pedersen JK, Hansen H, Podlekareva D, Johnsen S, Dall CH. Physical Function and Association with Cognitive Function in Patients in a Post-COVID-19 Clinic-A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:ijerph20105866. [PMID: 37239592 DOI: 10.3390/ijerph20105866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023]
Abstract
Patients with long-term health sequelae of COVID-19 (post-COVID-19 condition) experience both physical and cognitive manifestations. However, there is still uncertainty about the prevalence of physical impairment in these patients and whether there is a link between physical and cognitive function. The aim was to assess the prevalence of physical impairment and investigate the association with cognition in patients assessed in a post-COVID-19 clinic. In this cross-sectional study, patients referred to an outpatient clinic ≥ 3 months after acute infection underwent screening of their physical and cognitive function as part of a comprehensive multidisciplinary assessment. Physical function was assessed with the 6-Minute Walk Test, the 30 s Sit-to-Stand Test and by measuring handgrip strength. Cognitive function was assessed with the Screen for Cognitive Impairment in Psychiatry and the Trail Making Test-Part B. Physical impairment was tested by comparing the patients' performance to normative and expected values. Association with cognition was investigated using correlation analyses and the possible explanatory variables regarding physical function were assessed using regression analyses. In total, we included 292 patients, the mean age was 52 (±15) years, 56% were women and 50% had been hospitalised during an acute COVID-19 infection. The prevalence of physical impairment ranged from 23% in functional exercise capacity to 59% in lower extremity muscle strength and function. There was no greater risk of physical impairment in previously hospitalised compared with the non-hospitalised patients. There was a weak to moderate association between physical and cognitive function. The cognitive test scores had statistically significant prediction value for all three outcomes of physical function. In conclusion, physical impairments were prevalent amongst patients assessed for post-COVID-19 condition regardless of their hospitalisation status and these were associated with more cognitive dysfunction.
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Affiliation(s)
- Durita Viderø Gunnarsson
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Department of Psychology, University of Copenhagen-Mental Health Services, Capital Region of Denmark, 1172 Copenhagen, Denmark
| | - Johanna Kølle Pedersen
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Department of Psychology, University of Copenhagen-Mental Health Services, Capital Region of Denmark, 1172 Copenhagen, Denmark
| | - Henrik Hansen
- Respiratory Research Unit and Department of Respiratory Medicine, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, 2610 Antwerp, Belgium
| | - Daria Podlekareva
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
| | - Stine Johnsen
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
| | - Christian Have Dall
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital-Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
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Enax-Krumova E, Forsting J, Rohm M, Schwenkreis P, Tegenthoff M, Meyer-Frießem CH, Schlaffke L. Quantitative muscle magnetic resonance imaging depicts microstructural abnormalities but no signs of inflammation or dystrophy in post-COVID-19 condition. Eur J Neurol 2023; 30:970-981. [PMID: 36693812 DOI: 10.1111/ene.15709] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/22/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Post-COVID-19 condition (PCC) has high impact on quality of life, with myalgia and fatigue affecting at least 25% of PCC patients. This case-control study aims to noninvasively assess muscular alterations via quantitative muscle magnetic resonance imaging (MRI) as possible mechanisms for ongoing musculoskeletal complaints and premature exhaustion in PCC. METHODS Quantitative muscle MRI was performed on a 3 Tesla MRI scanner of the whole legs in PCC patients compared to age- and sex-matched healthy controls, including a Dixon sequence to determine muscle fat fraction (FF), a multi-echo spin-echo sequence for quantitative water mapping reflecting putative edema, and a diffusion-weighted spin-echo echo-planar imaging sequence to assess microstructural alterations. Clinical examination, nerve conduction studies, and serum creatine kinase were performed in all patients. Quantitative muscle MRI results were correlated to the results of the 6-min walk test and standardized questionnaires assessing quality of life, fatigue, and depression. RESULTS Twenty PCC patients (female: n = 15, age = 48.8 ± 10.1 years, symptoms duration = 13.4 ± 4.2 months, body mass index [BMI] = 28.8 ± 4.7 kg/m2 ) were compared to 20 healthy controls (female: n = 15, age = 48.1 ± 11.1 years, BMI = 22.9 ± 2.2 kg/m2 ). Neither FF nor T2 revealed signs of muscle degeneration or inflammation in either study groups. Diffusion tensor imaging (DTI) revealed reduced mean, axial, and radial diffusivity in the PCC group. CONCLUSIONS Quantitative muscle MRI did not depict any signs of ongoing inflammation or dystrophic process in the skeletal muscles in PCC patients. However, differences observed in muscle DTI depict microstructural abnormalities, which may reflect potentially reversible fiber hypotrophy due to deconditioning. Further longitudinal and interventional studies should prove this hypothesis.
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Affiliation(s)
- Elena Enax-Krumova
- Department of Neurology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Johannes Forsting
- Department of Neurology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Marlena Rohm
- Department of Neurology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Peter Schwenkreis
- Department of Neurology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Martin Tegenthoff
- Department of Neurology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Christine H Meyer-Frießem
- Department of Anaesthesiology, Intensive Care, and Pain Management, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Lara Schlaffke
- Department of Neurology, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
- Heimer Institute for Muscle Research, BG University Hospital Bergmannsheil, Bochum, Germany
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Mariani F, Morello R, Traini DO, La Rocca A, De Rose C, Valentini P, Buonsenso D. Risk Factors for Persistent Anosmia and Dysgeusia in Children with SARS-CoV-2 Infection: A Retrospective Study. Children (Basel) 2023; 10:children10030597. [PMID: 36980155 PMCID: PMC10047825 DOI: 10.3390/children10030597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Olfactory and gustative dysfunctions are two of the most common post-acute sequelae of SARS-CoV-2 infection in children, which can have a negative impact on the routines of children and families. As several children have had COVID-19 since the Omicron variant, it is important to investigate if this increase in infections is reflected in higher olfactory/taste disfunctions. The primary aim of this study was to characterize the presence of olfactory/gustative problems in a cohort of children, its evolution, and its association with risk factors such as COVID-19 variant, hospitalization, presence of olfactory/gustative dysfunction during the acute phase, and vaccination. METHODS This was a retrospective analysis of children with microbiologically confirmed SARS-CoV-2 infection evaluated in person at a referral pediatric post-COVID-19 clinic in Rome, Italy. We included children younger than 19 years old, evaluated from the beginning of the pandemic up to October 2022. At specific timepoints, we investigated the presence of olfactory/taste disfunctions and evaluated them according to the SARS-CoV-2 variants circulating at the time of infection. RESULTS A total of 1250 children (650 females; 52.0%) with a mean age of 6.77 (±4.12) years were included in the study. At 3, 6, 12, and 18 months, 12 (9.6%), 7 (5.6%), 2 (1.6%), and 1 (0.8%) of the children reported anosmia and dysgeusia post-COVID-19 infection, respectively. The presence of anosmia and dysgeusia during the acute phase of infection and being infected with a pre-Omicron variant were found to be significant risk factors for persistent olfactory and gustatory dysfunction during all follow-up periods. CONCLUSIONS anosmia and dysgeusia symptoms tended to decrease gradually over time, but not all children recovered quickly.
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Affiliation(s)
- Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | | | - Anna La Rocca
- Medicine and Surgery, Catholic University of Rome, 00168 Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Morón-López S, Riveira-Muñoz E, Urrea V, Gutiérrez-Chamorro L, Ávila-Nieto C, Noguera-Julian M, Carrillo J, Mitjà O, Mateu L, Massanella M, Ballana E, Martinez-Picado J. Comparison of Reverse Transcription (RT)-Quantitative PCR and RT-Droplet Digital PCR for Detection of Genomic and Subgenomic SARS-CoV-2 RNA. Microbiol Spectr 2023; 11:e0415922. [PMID: 36943067 PMCID: PMC10100669 DOI: 10.1128/spectrum.04159-22] [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: 10/25/2022] [Accepted: 02/24/2023] [Indexed: 03/23/2023] Open
Abstract
Most individuals acutely infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibit mild symptoms. However, 10 to 20% of those infected develop long-term symptoms, referred to as post-coronavirus disease 2019 (COVID-19) condition (PCC). One hypothesis is that PCC might be exacerbated by viral persistence in tissue sanctuaries. Therefore, the accurate detection and quantification of SARS-CoV-2 are not only necessary for viral load monitoring but also crucial for detecting long-term viral persistence and determining whether viral replication is occurring in tissue reservoirs. In this study, the sensitivity and robustness of reverse transcription (RT)-droplet digital PCR (ddPCR) and RT-quantitative PCR (qPCR) techniques have been compared for the detection and quantification of SARS-CoV-2 genomic and subgenomic RNAs from oropharyngeal swabs taken from confirmed SARS-CoV-2-positive, SARS-CoV-2-exposed, and nonexposed individuals as well as from samples from mice infected with SARS-CoV-2. Our data demonstrated that both techniques presented equivalent results in the mid- and high-viral-load ranges. Additionally, RT-ddPCR was more sensitive than RT-qPCR in the low-viral-load range, allowing the accurate detection of positive results in individuals exposed to the virus. Overall, these data suggest that RT-ddPCR might be an alternative to RT-qPCR for detecting low viral loads in samples and for assessing viral persistence in samples from individuals with PCC. IMPORTANCE We developed one-step reverse transcription (RT)-droplet digital PCR (ddPCR) protocols to detect SARS-CoV-2 RNA and compared them to the gold-standard RT-quantitative PCR (RT-qPCR) method. RT-ddPCR was more sensitive than RT-qPCR in the low-viral-load range, while both techniques were equivalent in the mid- and high-viral-load ranges. Overall, these results suggest that RT-ddPCR might be a viable alternative to RT-qPCR when it comes to detecting low viral loads in samples, which is a highly relevant issue for determining viral persistence in as-yet-unknown tissue reservoirs in individuals suffering from post-COVID conditions or long COVID.
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Affiliation(s)
- Sara Morón-López
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | | | - Victor Urrea
- IrsiCaixa AIDS Research Institute, Badalona, Spain
| | | | | | - Marc Noguera-Julian
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Jorge Carrillo
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Oriol Mitjà
- Fight Infections Foundation, Badalona, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Lihir Medical Centre, International SOS, Londolovit, Lihir Island, Papua New Guinea
| | - Lourdes Mateu
- Fight Infections Foundation, Badalona, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Marta Massanella
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Ester Ballana
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Javier Martinez-Picado
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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Bernas SN, Baldauf H, Real R, Sauter J, Markert J, Trost S, Tausche K, Behrends U, Schmidt AH, Schetelig J. Post-COVID-19 condition in the German working population: A cross-sectional study of 200,000 registered stem cell donors. J Intern Med 2023; 293:354-370. [PMID: 36373223 PMCID: PMC10107314 DOI: 10.1111/joim.13587] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The SARS-CoV-2 pandemic has strained health systems worldwide, and infection numbers continue to rise. While previous data have already shown that many patients suffer from symptoms for months after an acute infection, data on risk factors and long-term outcomes are incomplete, particularly for the working population. OBJECTIVES We aimed to provide information on the prevalence of post-COVID-19 conditions in a subset of the German working-age population (18-61 years old) and to analyze risk factors. METHODS We conducted an online survey with a health questionnaire among registered potential stem cell donors with or without a self-reported history of polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection. Logistic regression models were used to examine the risks of severity of acute infection, sex, age, body mass index, diabetes mellitus, and arterial hypertension medication on post-COVID-19 symptoms. RESULTS A total of 199,377 donors reported evaluable survey questionnaires-12,609 cases had a history of SARS-CoV-2 infection and 186,768 controls had none. Overall, cases reported physical, cognitive, and psychological complaints more frequently compared to controls. Increased rates of complaints persisted throughout 15 months postinfection, for example, 28.4%/19.3% of cases/controls reported fatigue (p <0.0001) and 9.5%/3.6% of cases/controls reported loss of concentration (p <0.0001). No significant differences were observed in the frequency of reported symptoms between 3 and 15 months postinfection. Multivariate analysis revealed a strong influence of the severity of the acute SARS-CoV-2 infection episode and age on the risk for post-COVID-19 conditions. CONCLUSION We report the prevalence of post-COVID-19 conditions in mainly unvaccinated individuals with SARS-CoV-2 infections between February 2020 and August 2021. The severity of the acute course and age were major risk factors. Vaccinations may reduce the risk of post-COVID-19 conditions by reducing the risk of severe infections.
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Affiliation(s)
| | | | - Ruben Real
- DKMS, Clinical Trials Unit, Dresden, Germany
| | | | - Jan Markert
- DKMS, Stem Cell Donor Registry, Tübingen, Germany
| | - Sarah Trost
- DKMS, Clinical Trials Unit, Dresden, Germany
| | - Kristin Tausche
- Division of Pulmonology, Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Uta Behrends
- School of Medicine, Department of Pediatrics, MRI Chronic Fatigue Center for Young People, Technical University of Munich, Munich, Germany
| | - Alexander H Schmidt
- DKMS, Stem Cell Donor Registry, Tübingen, Germany.,DKMS, Clinical Trials Unit, Dresden, Germany
| | - Johannes Schetelig
- DKMS, Clinical Trials Unit, Dresden, Germany.,Division of Stem Cell Transplantation, Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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Levin OS, Vashchilin VV, Pikija S, Khasanova DR, Turuspekova ST, Bogolepova AN, Shmonin AA, Maltceva MN, Vozniuk IA, Yanishevskiy SN, Huseynov DK, Karakulova YV, Obidov FK. [Current approaches in the treatment and rehabilitation of patients with neurological diseases after COVID-19. Resolution of the International Experts Forum]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:44-51. [PMID: 36843458 DOI: 10.17116/jnevro202312302144] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Despite the significant shift in global attention away from the pandemic, the problem of a new coronavirus infection remains important in the medical community. Almost 3 years after the start of the COVID-19 pandemic the issues of rehabilitation and management of delayed manifestations and sequelae of the disease are especially important. According to numerous available data, the new coronavirus infection is characterized by multiorgan lesions. Respiratory dysfunction, clotting disorders, myocardial dysfunction and various arrhythmias, acute coronary syndrome, acute renal failure, GI disorders, hepatocellular damage, hyperglycemia and ketosis, dermatological complications, ophthalmological symptoms and neurological disorders may be found. Significant prevalence of the latter in the post-coronavirus period necessitated this International Expert Forum to develop unified approaches to the management of patients with neurological complications and sequelae of new coronavirus infection based on practical experience and considering the scientific information available on COVID-19. The expert council developed a resolution formulating the tactics for the management of patients with neurological manifestations of COVID-19.
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Affiliation(s)
- O S Levin
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - V V Vashchilin
- Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
| | - S Pikija
- Paracelsus Private Medical University, Salzburg, Austria
| | | | - S T Turuspekova
- Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
| | - A N Bogolepova
- Pirogov Russian National Research Medical University, Moscow, Russia.,Federal Center for Brain and Neurotechnology, Moscow, Russia
| | - A A Shmonin
- Pavlov First Saint Petersburg Medical University, St. Petersburg, Russia
| | - M N Maltceva
- Pavlov First Saint Petersburg Medical University, St. Petersburg, Russia.,Russian Canis-therapy Support and Development Association, St. Petersburg, Russia
| | - I A Vozniuk
- Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine, St. Petersburg, Russia
| | - S N Yanishevskiy
- Kirov Military Medical Academy, St. Petersburg, Russia.,Almazov National Medical Research Centre, St. Petersburg, Russia
| | - D K Huseynov
- Mingachevir City Hospital, Mingachevir, Republic of Azerbaijan
| | | | - F Kh Obidov
- Regional Hospital of Samarkand Region, Samarkand, Republic of Uzbekistan
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44
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Adang EAMC, Strous MTA, van den Bergh JP, Gach D, van Kampen VEM, van Zeeland REP, Barten DG, van Osch FHM. Association of Heart Rate Variability with Pulmonary Function Impairment and Symptomatology Post-COVID-19 Hospitalization. Sensors (Basel) 2023; 23:s23052473. [PMID: 36904676 PMCID: PMC10007596 DOI: 10.3390/s23052473] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 06/12/2023]
Abstract
The persistence of symptoms beyond three months after COVID-19 infection, often referred to as post-COVID-19 condition (PCC), is commonly experienced. It is hypothesized that PCC results from autonomic dysfunction with decreased vagal nerve activity, which can be indexed by low heart rate variability (HRV). The aim of this study was to assess the association of HRV upon admission with pulmonary function impairment and the number of reported symptoms beyond three months after initial hospitalization for COVID-19 between February and December 2020. Follow-up took place three to five months after discharge and included pulmonary function tests and the assessment of persistent symptoms. HRV analysis was performed on one 10 s electrocardiogram obtained upon admission. Analyses were performed using multivariable and multinomial logistic regression models. Among 171 patients who received follow-up, and with an electrocardiogram at admission, decreased diffusion capacity of the lung for carbon monoxide (DLCO) (41%) was most frequently found. After a median of 119 days (IQR 101-141), 81% of the participants reported at least one symptom. HRV was not associated with pulmonary function impairment or persistent symptoms three to five months after hospitalization for COVID-19.
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Affiliation(s)
- Estelle A. M. C. Adang
- Department of Emergency Medicine, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
| | - Maud T. A. Strous
- Department of Internal Medicine, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
| | - Joop P. van den Bergh
- Department of Internal Medicine, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Debbie Gach
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
| | | | | | - Dennis G. Barten
- Department of Emergency Medicine, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
| | - Frits H. M. van Osch
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands
- Department of Epidemiology, Maastricht University, 6229 ER Maastricht, The Netherlands
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Chandan JS, Brown KR, Simms-Williams N, Bashir NZ, Camaradou J, Heining D, Turner GM, Rivera SC, Hotham R, Minhas S, Nirantharakumar K, Sivan M, Khunti K, Raindi D, Marwaha S, Hughes SE, McMullan C, Marshall T, Calvert MJ, Haroon S, Aiyegbusi OL. Non-Pharmacological Therapies for Post-Viral Syndromes, Including Long COVID: A Systematic Review. Int J Environ Res Public Health 2023; 20:3477. [PMID: 36834176 PMCID: PMC9967466 DOI: 10.3390/ijerph20043477] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Post-viral syndromes (PVS), including Long COVID, are symptoms sustained from weeks to years following an acute viral infection. Non-pharmacological treatments for these symptoms are poorly understood. This review summarises the evidence for the effectiveness of non-pharmacological treatments for PVS. METHODS We conducted a systematic review to evaluate the effectiveness of non-pharmacological interventions for PVS, as compared to either standard care, alternative non-pharmacological therapy, or placebo. The outcomes of interest were changes in symptoms, exercise capacity, quality of life (including mental health and wellbeing), and work capability. We searched five databases (Embase, MEDLINE, PsycINFO, CINAHL, MedRxiv) for randomised controlled trials (RCTs) published between 1 January 2001 to 29 October 2021. The relevant outcome data were extracted, the study quality was appraised using the Cochrane risk-of-bias tool, and the findings were synthesised narratively. FINDINGS Overall, five studies of five different interventions (Pilates, music therapy, telerehabilitation, resistance exercise, neuromodulation) met the inclusion criteria. Aside from music-based intervention, all other selected interventions demonstrated some support in the management of PVS in some patients. INTERPRETATION In this study, we observed a lack of robust evidence evaluating the non-pharmacological treatments for PVS, including Long COVID. Considering the prevalence of prolonged symptoms following acute viral infections, there is an urgent need for clinical trials evaluating the effectiveness and cost-effectiveness of non-pharmacological treatments for patients with PVS. REGISTRATION The study protocol was registered with PROSPERO [CRD42021282074] in October 2021 and published in BMJ Open in 2022.
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Affiliation(s)
- Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Kirsty R. Brown
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nikita Simms-Williams
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Nasir Z. Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Jenny Camaradou
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK
| | - Dominic Heining
- Department of Microbiology, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
| | - Grace M. Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Samantha Cruz Rivera
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
| | - Richard Hotham
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Sonica Minhas
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Midlands Health Data Research UK, Birmingham B15 2TT, UK
| | - Manoj Sivan
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester LE1 7RH, UK
| | - Devan Raindi
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham B5 7EG, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham and Solihull Mental Health NHS Foundation Trust, Unit 1, B1, 50 Summer Hill Road, Birmingham B1 3RB, UK
| | - Sarah E. Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
- National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Melanie J. Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
- National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham B15 2TT, UK
- Health Data Research UK, London WC1E 6BT, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham B15 2TT, UK
- National Institute for Health Research (NIHR), Applied Research Collaboration, Birmingham B15 2TT, UK
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Cavalcante TF, Lourenço CE, Ferreira JEDSM, Oliveira LR, Neto JC, Amaro JP, Moreira RP. Models of Support for Caregivers and Patients with the Post-COVID-19 Condition: A Scoping Review. Int J Environ Res Public Health 2023; 20:2563. [PMID: 36767926 PMCID: PMC9916224 DOI: 10.3390/ijerph20032563] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In December 2019, an outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in the city of Wuhan, China. On 30 January 2020, the World Health Organization declared the outbreak a public health emergency of international concern. In October 2021, with the advancement of the disease, the World Health Organization defined the post-COVID-19 condition. The post-COVID-19 condition occurs in individuals with a history of probable or confirmed infection with SARS-CoV-2, usually 3 months after the onset of the disease. The chronicity of COVID-19 has increased the importance of recognizing caregivers and their needs. METHODS We conducted a scoping review following international guidelines to map the models of support for caregivers and patients with the post-COVID-19 condition. The searches were conducted in electronic databases and the grey literature. The Population, Concept, and Context framework was used: Population: patients with the post-COVID-19 condition and caregivers; Concept: models of caregiver and patient support; and Context: post-COVID-19 condition. A total of 3258 records were identified through the electronic search, and 20 articles were included in the final sample. RESULTS The studies approached existing guidelines and health policies for post-COVID-19 condition patients and support services for patients and home caregivers such as telerehabilitation, multidisciplinary care, hybrid models of care, and follow-up services. Only one study specifically addressed the home caregivers of patients with this clinical condition. CONCLUSIONS The review indicates that strategies such as telerehabilitation are effective for training and monitoring the patient-family dyad, but the conditions of access and digital literacy must be considered.
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Sakurada Y, Otsuka Y, Tokumasu K, Sunada N, Honda H, Nakano Y, Matsuda Y, Hasegawa T, Ochi K, Hagiya H, Ueda K, Kataoka H, Otsuka F. Trends in Long COVID Symptoms in Japanese Teenage Patients. Medicina (Kaunas) 2023; 59. [PMID: 36837463 DOI: 10.3390/medicina59020261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Background: Since the start of the global pandemic of coronavirus disease 2019 (COVID-19), not only adults but also many children have suffered from it. However, the clinical characteristics of long COVID in children remain unclear. Methods: In this retrospective observational study conducted in a single facility, we reviewed the medical records of all long COVID patients who visited Okayama University Hospital from February 2021 to October 2022, and we compared the clinical characteristics of long COVID in teenagers (11 to 18 years of age) with those in adults. Results: Data for 452 long COVID patients including 54 teenagers (11.9%) were analyzed. Fatigue was the most frequent symptom in teenagers (55.6% of the patients) and also in adults. On the other hand, the percentage of teenagers who complained of headache, which was the second most frequent complaint, was significantly higher than the percentage of adults (35.2% vs. 21.9%, p < 0.05). A comparison of the frequencies of symptoms depending on the viral variant showed that fatigue and headache were predominant symptoms in the Omicron variant phase. Of the 50 teenagers who were enrolled in schools, 28 (56.0%) could not attend school due to long COVID symptoms. The most common symptoms as reasons for absence from school were fatigue (85.7% of the patients), headache (42.9%), and insomnia (32.1%). Conclusions: Attention should be paid to the symptoms of fatigue and headache in teenagers with long COVID.
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Abstract
An estimated 10-15% of those infected with SARS-CoV-2 may have post-COVID-19 condition. Common lingering signs and symptoms include shortness of breath, fatigue, high heart rate, and memory and cognitive dysfunction even several months after infection, often impacting survivors' quality of life. The prevalence and duration of individual symptoms remain difficult to ascertain due to the lack of standardized research methods across various studies and limited patient follow-up in clinical studies. Nonetheless, data indicate post-COVID-19 condition may occur independent of acuity of initial infection, hospitalization status, age, or pre-existing comorbidities. Risk factors may include female sex and underlying respiratory or psychiatric disease. Supportive therapies to mitigate symptoms remain the mainstay of treatment. Reassuringly, most patients experience a reduction in symptoms by 1 year. The use of a universal case definition and shared research methods will allow for further clarity regarding the pervasiveness of this entity and its long-term health consequences.
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Affiliation(s)
- Ani Nalbandian
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA; ,
| | - Amar D Desai
- Rutgers New Jersey Medical School, Newark, New Jersey, USA;
| | - Elaine Y Wan
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA; ,
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Van Wambeke E, Bezler C, Kasprowicz AM, Charles AL, Andres E, Geny B. Two-Years Follow-Up of Symptoms and Return to Work in Complex Post-COVID-19 Patients. J Clin Med 2023; 12:jcm12030741. [PMID: 36769389 PMCID: PMC9917586 DOI: 10.3390/jcm12030741] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 12/15/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Many COVID-19 patients present with severe long-lasting symptoms. They might benefit from a coordination team to manage such complex situations, but late efficacy still needs to be determined. POPULATION AND METHODS Out of 105 contacts, 45 patients had two phone consultations separated by personalized support 15 and 22 months, respectively, after COVID infection. Self-reported symptoms, feelings of improvement and ability to return to work allowed us to determine the efficacy of the therapeutic strategy proposed. RESULTS Unlike what was expected, many post-COVID-19 patients directly contacted the coordination team and had significant pre-existing comorbidities. Despite exercise, respiratory, olfactory rehabilitations, cognition/speech therapy and/or psychological support, the more frequent self-reported symptoms (fatigue, neurocognitive disorders, muscles and joint pain) did not resolve. However, dyspnea, anxiety and chest pain were significantly reduced. Finally, 2/3 of the patients felt some degree of improvement and returned to work either partially or fully, but 1/3 remained complaining of symptoms and out of work as late as 22 months after COVID occurrence. All patients greatly appreciated the second phone consultation. CONCLUSIONS In such complex situations, besides early and adapted rehabilitations and psychological help allowing better symptom management, relatively simple actions such as a phone call might be very useful to reduce patients' feelings of abandonment.
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Affiliation(s)
- Erika Van Wambeke
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, NHC, 1 Place de l’Hôpital, CEDEX, 67091 Strasbourg, France
| | - Cécile Bezler
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, NHC, 1 Place de l’Hôpital, CEDEX, 67091 Strasbourg, France
| | - Anne-Marie Kasprowicz
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, NHC, 1 Place de l’Hôpital, CEDEX, 67091 Strasbourg, France
| | - Anne-Laure Charles
- Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, University of Strasbourg, 11 Rue Humann, 67000 Strasbourg, France
| | - Emmanuel Andres
- Department of Internal Medicine, University Hospital of Strasbourg, 1 Place de l’Hôpital, CEDEX, 67091 Strasbourg, France
| | - Bernard Geny
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, NHC, 1 Place de l’Hôpital, CEDEX, 67091 Strasbourg, France
- Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, University of Strasbourg, 11 Rue Humann, 67000 Strasbourg, France
- Correspondence:
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Goudman L, De Smedt A, Roggeman S, Fernández-de-las-Peñas C, Hatem SM, Schiltz M, Billot M, Roulaud M, Rigoard P, Moens M. Association between Experimental Pain Measurements and the Central Sensitization Inventory in Patients at Least 3 Months after COVID-19 Infection: A Cross-Sectional Pilot Study. J Clin Med 2023; 12:jcm12020661. [PMID: 36675590 PMCID: PMC9862134 DOI: 10.3390/jcm12020661] [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: 11/25/2022] [Revised: 01/02/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Fatigue, pain, headache, brain fog, anosmia, ageusia, mood symptoms, and sleep disorders are symptoms commonly experienced by people with post-COVID-19 condition. These symptoms could be considered as manifestations of central sensitization. The aim of this study is to evaluate whether there are indicators of central sensitization by using experimental pain measurements and to determine their association with patient-reported outcome measures (PROMs). A cross-sectional study including 42 patients after COVID-19 infection was conducted. The central sensitization inventory (CSI) was administered as a PROM to evaluate central-sensitization-associated symptoms. Pressure pain thresholds (PPT), temporal summation, and descending nociceptive pain inhibition (CPM) were assessed as experimental pain measurements. The median score on the CSI was 46.5 (Q1-Q3: 33-54). The presence of central-sensitization-associated symptoms was seen in 64.3% of patients based on the CSI (≥40/100 points). A deficient CPM was seen in 12% and 14% of patients when measured at the trapezius and rectus femoris, respectively. A negative correlation between pressure sensitivity on the rectus femoris and the CSI score (r = -0.36, 95%CI -0.13 to -0.65, p = 0.007) was observed. Central-sensitization-associated symptoms were present in up to 64.3% of patients post-COVID-19 infection, based on a PROM, i.e., the CSI. A more objective evaluation of nociceptive processing through experimental pain measurements was less suggestive of indicators of central sensitization. Only a small negative correlation between pressure sensitivity and the CSI was observed, thereby pointing towards the discrepancy between the CSI and experimental pain measurements and presumably the complementary need for both to evaluate potential indicators of central sensitization in this population.
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Affiliation(s)
- Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium
- Correspondence: ; Tel.: +32-24775514
| | - Ann De Smedt
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Stijn Roggeman
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark
| | - Samar M. Hatem
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Marc Schiltz
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Manuel Roulaud
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Philippe Rigoard
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
- Department of Spine Surgery & Neuromodulation, Poitiers University Hospital, 86021 Poitiers, France
- Pprime Institute UPR 3346, CNRS, ISAE-ENSMA, University of Poitiers, 86360 Chasseneuil-du-Poitou, France
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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