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Steenblock C, Hassanein M, Khan EG, Yaman M, Kamel M, Barbir M, Lorke DE, Rock JA, Everett D, Bejtullah S, Heimerer A, Tahirukaj E, Beqiri P, Bornstein SR. Diabetes and COVID-19: Short- and Long-Term Consequences. Horm Metab Res 2022; 54:503-509. [PMID: 35724689 PMCID: PMC9363150 DOI: 10.1055/a-1878-9566] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
When the corona pandemic commenced more than two years ago, it was quickly recognized that people with metabolic diseases show an augmented risk of severe COVID-19 and an increased mortality compared to people without these comorbidities. Furthermore, an infection with SARS-CoV-2 has been shown to lead to an aggravation of metabolic diseases and in single cases to new-onset metabolic disorders. In addition to the increased risk for people with diabetes in the acute phase of COVID-19, this patient group also seems to be more often affected by long-COVID and to experience more long-term consequences than people without diabetes. The mechanisms behind these discrepancies between people with and without diabetes in relation to COVID-19 are not completely understood yet and will require further research and follow-up studies during the following years. In the current review, we discuss why patients with diabetes have this higher risk of developing severe COVID-19 symptoms not only in the acute phase of the disease but also in relation to long-COVID, vaccine breakthrough infections and re-infections. Furthermore, we discuss the effects of lockdown on glycemic control.
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Affiliation(s)
- Charlotte Steenblock
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mohamed Hassanein
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United Arab Emirates
| | - Emran G Khan
- Endocrinology and Diabetology, King's College Hospital London, Dubai, United Arab Emirates
| | - Mohamad Yaman
- Building 6, Nesmah Technology, Dubai, United Arab Emirates
| | - Margrit Kamel
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mahmoud Barbir
- Department of Cardiology, Harefield Hospital, Harefield, United Kingdom of Great Britain and Northern Ireland
| | - Dietrich E Lorke
- Department of Anatomy and Cellular Biology, Khalifa University, Abu Dhabi, United Arab Emirates
| | - John A Rock
- College of Medicine & Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Dean Everett
- Department of Pathology and Infectious Diseases, Khalifa University, Abu Dhabi, United Arab Emirates
| | | | - Adrian Heimerer
- Research Unit, College Heimerer, Prishtina, Republic of Kosovo
| | - Ermal Tahirukaj
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Petrit Beqiri
- Research Unit, College Heimerer, Prishtina, Republic of Kosovo
| | - Stefan R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Steenblock C, Hassanein M, Khan EG, Yaman M, Kamel M, Barbir M, Lorke DE, Everett D, Bejtullah S, Lohmann T, Lindner U, Tahirukaj E, Jirjees FJ, Soliman SS, Quitter F, Bornstein SR. Obesity and COVID-19: What are the Consequences? Horm Metab Res 2022; 54:496-502. [PMID: 35724688 PMCID: PMC9427204 DOI: 10.1055/a-1878-9757] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Obesity is an increasing health problem all over the world. In combination with the current COVID-19 pandemic, this has turned into a massive challenge as individuals with overweight and obesity at all ages show a significant increase in their risk of getting severe COVID-19. Around 20% of all patients that were hospitalized for COVID-19 suffered from obesity alone, whereas obesity in combination with other metabolic comorbidities, such as type 2 diabetes and hypertension, account for up to 60% of all hospitalizations in relation to COVID-19. Therefore, it is of immense importance to put the spotlight on the high incidence of obesity present already in childhood both by changing the individual minds and by encouraging politicians and the whole society to commence preventive interventions for achieving a better nutrition for all social classes all over the world. In the current review, we aim to explain the different pathways and mechanisms that are responsible for the increased risk of severe COVID-19 in people with overweight and obesity. Furthermore, we discuss how the pandemic has led to weight gains in many people during lockdown. At the end, we discuss the importance of preventing such an interface between a non-communicable disease like obesity and a communicable disease like COVID-19 in the future.
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Affiliation(s)
- Charlotte Steenblock
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
- Correspondence Dr. Charlotte Steenblock University Hospital Carl Gustav Carus, Technische Universität
Dresden, Department of Medicine IIIFetscherstraße 7401307 DresdenGermany+493514586130+493514586398
| | - Mohamed Hassanein
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United
Arab Emirates
| | - Emran G. Khan
- Endocrinology and Diabetology, King’s College Hospital London,
Dubai, United Arab Emirates
| | - Mohamad Yaman
- Building 6, Nesmah Technology, Dubai, United Arab
Emirates
| | - Margrit Kamel
- Center for Regenerative Therapies Dresden, Technische Universitat
Dresden, Dresden, Germany
| | - Mahmoud Barbir
- Department of Cardiology, Harefield Hospital, Harefield, United Kingdom
of Great Britain and Northern Ireland
| | - Dietrich E. Lorke
- Department of Anatomy and Cellular Biology, Khalifa University, Abu
Dhabi, United Arab Emirates
| | - Dean Everett
- Department of Pathology and Infectious Diseases, Khalifa University,
Abu Dhabi, United Arab Emirates
| | | | | | - Uwe Lindner
- Internal Medicine II, Klinikum Chemnitz, Chemnitz,
Germany
| | - Ermal Tahirukaj
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
| | | | - Sameh S.M. Soliman
- College of Pharmacy, University of Sharjah, Sharjah, United Arab
Emirates
| | - Friederike Quitter
- Klinik für Kinder- und Jugendmedizin,
Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Stefan R. Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
- School of Cardiovascular and Metabolic Medicine and Sciences, Faculty
of Life Sciences & Medicine, King’s College London, London,
UK
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Bornstein SR, Cozma D, Kamel M, Hamad M, Mohammad MG, Khan NA, Saber MM, Semreen MH, Steenblock C. Long-COVID, Metabolic and Endocrine Disease. Horm Metab Res 2022; 54:562-566. [PMID: 35724687 PMCID: PMC9363148 DOI: 10.1055/a-1878-9307] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the aftermath of the corona pandemic, long-COVID or post-acute COVID-19 syndrome still represents a great challenge, and this topic will continue to represent a significant health problem in the coming years. At present, the impact of long-COVID on our health system cannot be fully assessed but according to current studies, up to 40% of people who have been infected with SARS-CoV-2 suffer from clinically relevant symptoms of long-COVID syndrome several weeks to months after the acute phase. The main symptoms are chronic fatigue, dyspnea, and various cognitive symptoms. Initial studies have shown that people with overweight and diabetes mellitus have a higher risk of developing long-COVID associated symptoms. Furthermore, repeated treatment of acute COVID-19 and long-COVID with steroids can contribute to long-term metabolic and endocrine disorders. Therefore, a structured program with rehabilitation and physical activity as well as optimal dietary management is of utmost importance, especially for patients with metabolic diseases and/or long-COVID. Furthermore, the removal of autoantibodies and specific therapeutic apheresis procedures could lead to a significant improvement in the symptoms of long-COVID in individual patients.
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Affiliation(s)
- Stefan R. Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
- School of Cardiovascular and Metabolic Medicine and Sciences, Faculty
of Life Sciences & Medicine, King’s College London, London,
UK
| | - Diana Cozma
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
| | - Margrit Kamel
- Center for Regenerative Therapies Dresden, Technische
Universität Dresden, Dresden, Germany
| | - Mawieh Hamad
- Sharjah Institute for Medical Research, University of Sharjah College
of Health Sciences, Sharjah, United Arab Emirates
| | - Mohammad G. Mohammad
- Department of Medical Laboratory Sciences, College of Health Sciences,
University of Sharjah, Sharjah, United Arab Emirates
| | - Naveed A. Khan
- College of Medicine, University of Sharjah, Sharjah, United Arab
Emirates
| | - Maha M. Saber
- College of Medicine, University of Sharjah, Sharjah, United Arab
Emirates
| | | | - Charlotte Steenblock
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
- Correspondence Dr. Charlotte
Steenblock University Hospital Carl Gustav Carus,
Technische Universität DresdenDepartment of
Medicine IIIFetscherstraße
7401307
DresdenGermany+493514586130+493514586336
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Ohira M, Sano T, Takao M. Clinical features of patients who visited the outpatient clinic for long COVID in Japan. eNeurologicalSci 2022; 28:100418. [PMID: 35919910 PMCID: PMC9335519 DOI: 10.1016/j.ensci.2022.100418] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/28/2022] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
Background The clinical course, comorbidity, and management of symptoms after the acute phase of coronavirus disease 2019 (COVID-19) remain controversial. Methods This was a descriptive case series study, examining the characteristics of patients with longstanding symptoms related to COVID-19 who visited our outpatient clinic between 1 June and 31 December 2021. We analyzed patients’ background, chief complaints, clinical course after COVID-19 onset, and clinical examination results. Results A total of 90 patients with a mean age of 39.8 years were confirmed as having long COVID. The median time between diagnosis of COVID-19 and visiting our clinic was 66.8 days, and 89 patients (98.9%) were unvaccinated. Depression was the most common comorbidity (nine patients, 10.0%). The most common chief complaint was disturbance of smell and/or taste (35, 38.9%), followed by memory disturbance (22, 24.4%) and fatigue (29, 31.1%). Head MRI was performed for 42 (46.7%) patients, and the most common finding was sinusitis (four patients). Olfactory testing was conducted in 25 patients (27.8%) using a T&T olfactometer, and 14 patients (56%) had mild olfactory impairment. Of the five odors in the T&T, recognition of β-phenylethyl alcohol was most impaired. Conclusions This study describes the basic characteristics of long COVID in Japan. It suggests that long COVID is complex because it results in a wide range of symptoms. Overall, 90 patients with long COVID were confirmed and examined by neurologists. Disturbance of smell and/or taste was the most common complaint. Olfactory tests showed different disturbance of the five main odors. Only one patient with long COVID had been vaccinated against COVID-19. Cross-disciplinary approaches are needed for treating patients with long COVID.
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Affiliation(s)
- Masayuki Ohira
- Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
| | - Terunori Sano
- Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
| | - Masaki Takao
- Department of General Internal Medicine and Clinical Laboratory, National Center of Neurology and Psychiatry National Center Hospital, Kodaira, Tokyo, Japan
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Zhang Q, Li J, Weng L. A bibliometric analysis of COVID-19 publications in neurology by using the visual mapping method. Front Public Health 2022; 10:937008. [PMID: 35958855 PMCID: PMC9362596 DOI: 10.3389/fpubh.2022.937008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/30/2022] [Indexed: 01/08/2023] Open
Abstract
Background The characteristic symptom of coronavirus disease 2019 (COVID-19) is respiratory distress, but neurological symptoms are the most frequent extra-pulmonary symptoms. This study aims to explore the current status and hot topics of neurology-related research on COVID-19 using bibliometric analysis. Methods Publications regarding neurology and COVID-19 were retrieved from the Web of Science Core Collection (WoSCC) on March 28 2022. The Advanced search was conducted using “TS = (‘COVID 19’ or ‘Novel Coronavirus 2019’ or ‘Coronavirus disease 2019’ or ‘2019-nCOV’ or ‘SARS-CoV-2’ or ‘coronavirus-2’) and TS = (‘neurology’or ‘neurological’ or ‘nervous system’ or ‘neurodegenerative disease’ or ‘brain’ or ‘cerebra’ or ‘nerve’)”. Microsoft Excel 2010 and VOSviewer were used to characterize the largest contributors, including the authors, journals, institutions, and countries. The hot topics and knowledge network were analyzed by CiteSpace and VOSviewer. Results A total of 5,329 publications between 2020 and 2022 were retrieved. The United States, Italy, and the United Kingdom were three key contributors to this field. Harvard Medical School, the Tehran University of Medical Sciences, and the UCL Queen Square Institute of Neurology were the major institutions with the largest publications. Josef Finsterer from the University of São Paulo (Austria) was the most prolific author. Tom Solomon from the University of Liverpool (UK) was the most cited author. Neurological Sciences and Frontiers in Neurology were the first two most productive journals, while Journal of Neurology held the first in terms of total citations and citations per publication. Cerebrovascular diseases, neurodegenerative diseases, encephalitis and encephalopathy, neuroimmune complications, neurological presentation in children, long COVID and mental health, and telemedicine were the central topics regarding the neurology-related research on COVID-19. Conclusion Neurology-related research on COVID-19 has attracted considerable attention worldwide. Research topics shifted from “morality, autopsy, and telemedicine” in 2020 to various COVID-19-related neurological symptoms in 2021, such as “stroke,” “Alzheimer's disease,” “Parkinson's disease,” “Guillain–Barre syndrome,” “multiple sclerosis,” “seizures in children,” and “long COVID.” “Applications of telemedicine in neurology during COVID-19 pandemic,” “COVID-19-related neurological complications and mechanism,” and “long COVID” require further study.
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Affiliation(s)
- Qian Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Hydrocephalus Center, Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
| | - Ling Weng
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Ling Weng
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Jung YH, Ha EH, Choe KW, Lee S, Jo DH, Lee WJ. Persistent Symptoms After Acute COVID-19 Infection in Omicron Era. J Korean Med Sci 2022; 37:e213. [PMID: 35818704 PMCID: PMC9274102 DOI: 10.3346/jkms.2022.37.e213] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/07/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND We aim to compare the clinical characteristics and subjectively reported symptoms of the acute coronavirus disease (COVID) phase and those of the post-acute COVID phase to examine varying factors that affect the number of persistent symptoms and their categories. METHODS We categorized 1,122 patients who visited the post coronavirus disease 2019 (COVID-19) clinic into two groups: "acute group" (< 4 weeks following diagnosis of COVID-19) and "post-acute group" (> 4 weeks following diagnosis of COVID-19). We statistically compared clinical characteristics between the two groups and determined which factors are associated with the number of persistent symptoms and their categories. RESULTS The persistent symptoms of post COVID-19 conditions were classified into three categories as follows: Category A (the prevalence of symptoms is higher in the acute-visit group than in the post-acute-visit group), Category B (the prevalence of symptoms is not different between the two groups) and Category C (the prevalence of symptoms is higher in the post-acute-visit group than in the acute-visit group). Category A mainly included respiratory symptoms. Category B had generalized weakness, weight loss, cardiologic symptoms, hypogeusia, hyposmia, anxiety, and various gastrointestinal symptoms. Category C included fatigue, decreased attention, depression, blurred vision, hair loss, and sexual dysfunction. Anxiety, depression, fatigue and age were also associated with the number of symptoms and their categories, and anxiety is the most correlated factor (P < 0.001) among them. CONCLUSION The persistent symptoms of post COVID-19 condition involve multi-organ and continue for four weeks or greater. Therefore, long-term observation and multidisciplinary interventions are essential for patients with post COVID-19 conditions.
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Affiliation(s)
- Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Eun-Hye Ha
- Division of Pulmonary and Critical Care Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Kang Won Choe
- Department of Infectious Disease, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Seungbok Lee
- Department of Physical Medicine and Rehabilitation, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Dong Ho Jo
- Department of Infectious Disease, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
| | - Wang Jun Lee
- The Office of Chief Executive Officer and Chairman, Department of General Surgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
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Helmsdal G, Hanusson KD, Kristiansen MF, Foldbo BM, Danielsen ME, Steig BÁ, Gaini S, Strøm M, Weihe P, Petersen MS. Long COVID in the long run - 23 months follow-up study of persistent symptoms. Open Forum Infect Dis 2022; 9:ofac270. [PMID: 35891696 PMCID: PMC9308378 DOI: 10.1093/ofid/ofac270] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Symptoms of long coronavirus disease (COVID) were found in 38% of 170 patients followed for a median of 22.6 months. The most prevalent symptoms were fatigue, affected taste and smell, and difficulties remembering and concentrating. Predictors for long COVID were older age and number of symptoms in the acute phase. Long COVID may take many months, maybe years, to resolve.
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Affiliation(s)
- Gunnhild Helmsdal
- Department of Occupational Medicine and Public Health, The Faroese Hospital System , Sigmundargøta 5, Tórshavn, Faroe Islands
| | - Katrin Dahl Hanusson
- Department of Occupational Medicine and Public Health, The Faroese Hospital System , Sigmundargøta 5, Tórshavn, Faroe Islands
| | - Marnar Fríðheim Kristiansen
- Centre of Health Sciences, University of the Faroe Islands , Vestara Bryggja 15, Tórshavn, Faroe Islands
- Medical Department, National Hospital of the Faroe Islands , J.C. Svabosgøta 41-49, Tórshavn, Faroe Islands
| | - Billa Mouritsardóttir Foldbo
- Department of Occupational Medicine and Public Health, The Faroese Hospital System , Sigmundargøta 5, Tórshavn, Faroe Islands
| | - Marjun Eivindardóttir Danielsen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System , Sigmundargøta 5, Tórshavn, Faroe Islands
- Department of Epidemiology Research , Statens Serum Institut, Artillerivej 5, Copenhagen S, Denmark
| | - Bjarni á Steig
- Medical Department, National Hospital of the Faroe Islands , J.C. Svabosgøta 41-49, Tórshavn, Faroe Islands
| | - Shahin Gaini
- Medical Department, National Hospital of the Faroe Islands , J.C. Svabosgøta 41-49, Tórshavn, Faroe Islands
- Department of Epidemiology Research , Statens Serum Institut, Artillerivej 5, Copenhagen S, Denmark
- Department of Clinical Research, University of Southern Denmark , Winsløwparken 19, Odense, Denmark, DK-5000, Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, Copenhagen S, Denmark
| | - Marin Strøm
- Centre of Health Sciences, University of the Faroe Islands , Vestara Bryggja 15, Tórshavn, Faroe Islands
- Department of Epidemiology Research , Statens Serum Institut, Artillerivej 5, Copenhagen S, Denmark
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System , Sigmundargøta 5, Tórshavn, Faroe Islands
- Centre of Health Sciences, University of the Faroe Islands , Vestara Bryggja 15, Tórshavn, Faroe Islands
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System , Sigmundargøta 5, Tórshavn, Faroe Islands
- Centre of Health Sciences, University of the Faroe Islands , Vestara Bryggja 15, Tórshavn, Faroe Islands
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Long-Term Consequences of COVID-19 at 6 Months and Above: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116865. [PMID: 35682448 PMCID: PMC9180091 DOI: 10.3390/ijerph19116865] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 02/07/2023]
Abstract
We aimed to review the data available to evaluate the long-term consequences of coronavirus disease 2019 (COVID-19) at 6 months and above. We searched relevant observational cohort studies up to 9 February 2022 in Pubmed, Embase, and Web of Science. Random-effects inverse-variance models were used to evaluate the Pooled Prevalence (PP) and its 95% confidence interval (CI) of long-term consequences. The Newcastle−Ottawa quality assessment scale was used to assess the quality of the included cohort studies. A total of 40 studies involving 10,945 cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were included. Of the patients, 63.87% had at least one consequence at the 6 month follow-up, which decreased to 58.89% at 12 months. The most common symptoms were fatigue or muscle weakness (PP 6−12 m = 54.21%, PP ≥ 12 m = 34.22%) and mild dyspnea (Modified Medical Research Council Dyspnea Scale, mMRC = 0, PP 6−12 m = 74.60%, PP ≥ 12 m = 80.64%). Abnormal computerized tomography (CT; PP 6−12 m = 55.68%, PP ≥ 12 m = 43.76%) and lung diffuse function impairment, i.e., a carbon monoxide diffusing capacity (DLCO) of < 80% were common (PP 6−12 m = 49.10%, PP ≥ 12 m = 31.80%). Anxiety and depression (PP 6−12 m = 33.49%, PP ≥ 12 m = 35.40%) and pain or discomfort (PP 6−12 m = 33.26%, PP ≥ 12 m = 35.31%) were the most common problems that affected patients’ quality of life. Our findings suggest a significant long-term impact on health and quality of life due to COVID-19, and as waves of ASRS-CoV-2 infections emerge, the long-term effects of COVID-19 will not only increase the difficulty of care for COVID-19 survivors and the setting of public health policy but also might lead to another public health crisis following the current pandemic, which would also increase the global long-term burden of disease.
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Ali ST, Kang AK, Patel TR, Clark JR, Perez-Giraldo GS, Orban ZS, Lim PH, Jimenez M, Graham EL, Batra A, Liotta EM, Koralnik IJ. Evolution of neurologic symptoms in non-hospitalized COVID-19 "long haulers". Ann Clin Transl Neurol 2022; 9:950-961. [PMID: 35607826 PMCID: PMC9268866 DOI: 10.1002/acn3.51570] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/13/2022] Open
Abstract
Objective We characterized the evolution of neurologic symptoms and self‐perceived recovery of non‐hospitalized COVID‐19 “long haulers” 6–9 months after their initial Neuro‐COVID‐19 clinic evaluation. Methods In this follow‐up study on the first 100 patients, 50 SARS‐CoV‐2 laboratory‐positive (SARS‐CoV‐2+), and 50 laboratory‐negative (SARS‐CoV‐2−), evaluated at our Neuro‐COVID‐19 clinic between May and November 2020, patients completed phone questionnaires on their neurologic symptoms, subjective impression of recovery and quality of life. Results Of 52 patients who completed the study (27 SARS‐CoV‐2+, 25 SARS‐CoV‐2−) a median 14.8 (range 11–18) months after symptom onset, mean age was 42.8 years, 73% were female, and 77% were vaccinated for SARS‐CoV‐2. Overall, there was no significant change in the frequency of most neurologic symptoms between first and follow‐up evaluations, including “brain fog” (81 vs. 71%), numbness/tingling (69 vs. 65%), headache (67 vs. 54%), dizziness (50 vs. 54%), blurred vision (34 vs. 44%), tinnitus (33 vs. 42%), and fatigue (87 vs. 81%). However, dysgeusia and anosmia decreased overall (63 vs. 27%, 58 vs. 21%, both p < 0.001). Conversely, heart rate and blood pressure variation (35 vs. 56%, p = 0.01) and gastrointestinal symptoms (27 vs. 48%, p = 0.04) increased at follow‐up. Patients reported improvements in their recovery, cognitive function, and fatigue, but quality of life measures remained lower than the US normative population (p < 0.001). SARS‐CoV‐2 vaccination did not have a positive or detrimental impact on cognitive function or fatigue. Interpretation Non‐hospitalized COVID‐19 “long haulers” continue to experience neurologic symptoms, fatigue, and compromised quality of life 14.8 months after initial infection.
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Affiliation(s)
- Sareen T Ali
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anthony K Kang
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Tulsi R Patel
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jeffrey R Clark
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gina S Perez-Giraldo
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Zachary S Orban
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Patrick H Lim
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Millenia Jimenez
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Edith L Graham
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ayush Batra
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eric M Liotta
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Igor J Koralnik
- Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Zazzara MB, Bellieni A, Calvani R, Coelho-Junior HJ, Picca A, Marzetti E. Inflamm-aging at the time of COVID-19. Clin Geriatr Med 2022; 38:473-481. [PMID: 35868667 PMCID: PMC8934712 DOI: 10.1016/j.cger.2022.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Maria Beatrice Zazzara
- Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go F. Vito 1, Rome 00168, Italy
| | - Andrea Bellieni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go F. Vito 1, Rome 00168, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go F. Vito 1, Rome 00168, Italy.
| | - Hélio Jose Coelho-Junior
- Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go F. Vito 1, Rome 00168, Italy; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, Rome 00168, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go F. Vito 1, Rome 00168, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go F. Vito 1, Rome 00168, Italy; Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, Rome 00168, Italy
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Kang YR, Oh JY, Lee JH, Small PM, Chung KF, Song WJ. Long-COVID severe refractory cough: discussion of a case with 6-week longitudinal cough characterization. Asia Pac Allergy 2022; 12:e19. [PMID: 35571551 PMCID: PMC9066079 DOI: 10.5415/apallergy.2022.12.e19] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 11/21/2022] Open
Abstract
Long coronavirus disease (COVID) refers to an array of variable and fluctuating symptoms experienced after acute illness, with signs and symptoms that persist for 8–12 weeks and are not otherwise explicable. Cough is the most common symptom of acute COVID-19, but cough may persist in some individuals for weeks or months after recovery from acute phase. Long-COVID cough patients may get stigmatised because of the public fear of contagion and reinfection. However, clinical characteristics and longitudinal course of long-COVID cough have not been reported in detail, and evidence-based treatment is also lacking. In this paper, we describe a case of long-COVID severe refractory cough with features of laryngeal hypersensitivity and dysfunction. We characterized cough using patient-reported outcomes and engaged in continuous cough frequency monitoring. Through the case study, we discuss potential mechanisms, managements, and clinical implications of long-COVID refractory cough problems.
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Affiliation(s)
- Yu Ri Kang
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Yoon Oh
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Peter M. Small
- Hyfe, Inc and University of Washington, Department of Global Health, Seattle, WA, USA
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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