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Baslet G, Aybek S, Ducharme S, Modirrousta M, Nicholson TR. Neuropsychiatry's Role in the Postacute Sequelae of COVID-19: Report From the American Neuropsychiatric Association Committee on Research. J Neuropsychiatry Clin Neurosci 2022; 34:341-350. [PMID: 35578802 DOI: 10.1176/appi.neuropsych.21080209] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Postacute sequelae of COVID-19 can occur in patients who had only mild acute disease. A comprehensive neuropsychiatric approach reviews historical factors, provides objective assessment of symptoms, considers potential etiologies, and offers a therapeutic approach aimed at restoring premorbid functioning.
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Affiliation(s)
- Gaston Baslet
- Brigham and Women's Hospital, Harvard Medical School, Boston (Baslet); Bern University Hospital, Bern, Switzerland (Aybek); Department of Psychiatry, Douglas Mental Health University Institute, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal (Ducharme); University of Manitoba, Winnipeg (Modirrousta); Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Nicholson)
| | - Selma Aybek
- Brigham and Women's Hospital, Harvard Medical School, Boston (Baslet); Bern University Hospital, Bern, Switzerland (Aybek); Department of Psychiatry, Douglas Mental Health University Institute, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal (Ducharme); University of Manitoba, Winnipeg (Modirrousta); Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Nicholson)
| | - Simon Ducharme
- Brigham and Women's Hospital, Harvard Medical School, Boston (Baslet); Bern University Hospital, Bern, Switzerland (Aybek); Department of Psychiatry, Douglas Mental Health University Institute, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal (Ducharme); University of Manitoba, Winnipeg (Modirrousta); Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Nicholson)
| | - Mandana Modirrousta
- Brigham and Women's Hospital, Harvard Medical School, Boston (Baslet); Bern University Hospital, Bern, Switzerland (Aybek); Department of Psychiatry, Douglas Mental Health University Institute, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal (Ducharme); University of Manitoba, Winnipeg (Modirrousta); Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Nicholson)
| | - Timothy R Nicholson
- Brigham and Women's Hospital, Harvard Medical School, Boston (Baslet); Bern University Hospital, Bern, Switzerland (Aybek); Department of Psychiatry, Douglas Mental Health University Institute, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal (Ducharme); University of Manitoba, Winnipeg (Modirrousta); Institute of Psychiatry, Psychology and Neuroscience, King's College London, London (Nicholson)
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102
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The Challenge of Long COVID-19 Management: From Disease Molecular Hallmarks to the Proposal of Exercise as Therapy. Int J Mol Sci 2022; 23:ijms232012311. [PMID: 36293160 PMCID: PMC9603679 DOI: 10.3390/ijms232012311] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 01/24/2023] Open
Abstract
Long coronavirus disease 19 (COVID-19) is the designation given to a novel syndrome that develops within a few months after infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and that is presenting with increasing incidence because of the numerous cases of infection. Long COVID-19 is characterized by a sequela of clinical symptoms that concern different organs and tissues, from nervous, respiratory, gastrointestinal, and renal systems to skeletal muscle and cardiovascular apparatus. The main common molecular cause for all long COVID-19 facets appears to be related to immune dysregulations, the persistence of inflammatory status, epigenetic modifications, and alterations of neurotrophin release. The prevention and management of long COVID-19 are still inappropriate because many aspects need further clarification. Exercise is known to exert a deep action on molecular dysfunctions elicited by long COVID-19 depending on training intensity, duration, and continuity. Evidence suggests that it could improve the quality of life of long COVID-19 patients. This review explores the main clinical features and the known molecular mechanisms underlying long COVID-19 in the perspective of considering exercise as a co-medication in long COVID-19 management.
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103
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Phenotyping Post-COVID Pain as a Nociceptive, Neuropathic, or Nociplastic Pain Condition. Biomedicines 2022; 10:biomedicines10102562. [PMID: 36289827 PMCID: PMC9599440 DOI: 10.3390/biomedicines10102562] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Pain after an acute Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) condition (post-COVID pain) is becoming a new healthcare emergency. Precision medicine refers to an evidence-based method of grouping patients based on their diagnostic/symptom presentation and then tailoring specific treatments accordingly. Evidence suggests that post-COVID pain can be categorized as nociceptive (i.e., pain attributable to the activation of the peripheral receptive terminals of primary afferent neurons in response to noxious chemical, mechanical, or thermal stimuli), neuropathic (i.e., pain associated with a lesion or disease of the somatosensory nervous system and limited to a “neuroanatomically plausible” distribution of the system), nociplastic (i.e., pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain), or mixed type (when two pain phenotypes co-exist). Each of these pain phenotypes may require a different treatment approach to maximize treatment effectiveness. Accordingly, the ability to classify post-COVID pain patients into one of these phenotypes would likely be critical for producing successful treatment outcomes. The 2021 International Association for the Study of Pain (IASP) clinical criteria and grading system provide a framework for classifying pain within a precision pain medicine approach. Here we present data supporting the possibility of grouping patients with post-COVID pain into pain phenotypes, using the 2021 IASP classification criteria, with a specific focus on nociplastic pain, which is probably the primary mechanism involved in post-COVID pain. Nociplastic pain, which is usually associated with comorbid symptomology (e.g., poor sleep quality, fatigue, cognitive–emotional disturbances, etc.) and is considered to be more difficult to treat than other pain types, may require a more nuanced multimodal treatment approach to achieve better treatment outcomes.
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104
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Albelbeisi AH, Arab-Zozani M, Nemati MK, Shaqfa KM, Kakemam E. Prevalence of physical activity using validated tools among adults during the COVID-19 pandemic in the Eastern Mediterranean region: A systematic review and meta-analysis. SAGE Open Med 2022; 10:20503121221118712. [PMID: 36212230 PMCID: PMC9536142 DOI: 10.1177/20503121221118712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/20/2022] [Indexed: 11/06/2022] Open
Abstract
Many interventions have been taken around the world to limit the spread of COVID-19. These interventions have affected people’s lifestyles such as physical activity. The aim of this systematic review and meta-analysis was to determine the prevalence of physical activity using validated tools among adults during the COVID-19 pandemic in the Eastern Mediterranean region. A systematic literature review and meta-analysis were conducted in October 2021. We searched three electronic databases (Web of Science, Scopus, and PubMed) for English-language original articles of observational studies (cross-sectional, case–control, and cohort studies) with original data reporting the prevalence of physical activity among adults in 22 countries from EMR during the COVID-19 pandemic. Hoy’s risk of Bias tool was applied to assess the biases in individual studies. The result was reported as a percentage for prevalence. A meta-analysis was conducted using the random-effect model with a 95% confidence interval. A total of 363 articles were retrieved. Finally, 15 articles were selected and included in the statistical analysis. The selected studies included 16,585 participants. The result of the meta-analysis showed that the overall physical activity was 51.6% (95% confidence interval: 42.1, 61: p = 0.745). The result of subgroup analysis based on different tools was 60.2%, 39.5%, 36.3%, 39.4%, and 55.2% for Global Physical Activity Questionnaire , The Godin-Shephard Leisure-Time Physical Activity Questionnaire, International Physical Activity Questionnaire, International Physical Activity Questionnaire–BREF, and International Physical Activity Questionnaire–short form, respectively. Our study highlights the urgent need for large-scale measurement and reporting of physical activity and the use of standard tools that can allow for the regular assessment and screening of the PA prevalence to support evidence-informed policy and programs development at both national and regional levels.
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Affiliation(s)
- Ahmed Hassan Albelbeisi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences–International Campus (TUMS-IC), Tehran, Iran,Medical Services Directorate, Gaza Strip, Palestine
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Marjan Khabiri Nemati
- Department of Health Management, Faculty of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Khalil Mostafa Shaqfa
- General Directorate of Nursing, Palestinian Ministry of Health, Gaza Strip, Palestine
| | - Edris Kakemam
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran,Edris Kakemam, Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, 18559, Iran.
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105
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Martínez Rolando L, Villafañe JH, Cercadillo García S, Sanz Argüello A, Villanueva Rosa M, Sánchez Romero EA. Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912396. [PMID: 36231696 PMCID: PMC9566039 DOI: 10.3390/ijerph191912396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 05/10/2023]
Abstract
COVID-19 placed teams of professionals in a hostile and unfamiliar environment where the lack of knowledge of its pathology led to the adaptation of programs used so far for other conditions to try to address the immediate sequelae of COVID-19 infection. That is why the aim of this study was to assess the effects of a multicomponent exercise program (MEP) in improving cardio-respiratory performance, health status, disability due to dyspnea, aerobic capacity and endurance, and the immediate sequelae of COVID-19. Thirty-nine patients referred from different hospital services were included in this study. An intervention of seven weeks with sessions twice a week was carried out, where patients underwent intervallic training sessions followed by strengthening exercises and individualized respiratory physiotherapy exercises. The results of this study show a significant improvement in cardio-respiratory performance, health status, disability due to dyspnea, and aerobic capacity and endurance after intervention; and an increase in health status and reduction in disability due to dyspnea at the 2-year follow-up. In addition, none of the patients had any adverse effects either pre-post treatment or at the 2-year follow-up. Individualized and monitored MEP in survivors of COVID-19 showed positive effects in a pre-post evaluation and the 2-year follow up, improving the immediate sequelae of post-COVID-19 patients. This highlights the importance of the professional background of the rehabilitation teams in adapting to an unknown clinical environment.
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Affiliation(s)
- Lidia Martínez Rolando
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Jorge Hugo Villafañe
- IRCCS Fondazione Don Carlo Gnocchi, 20141 Milan, Italy
- Correspondence: (J.H.V.); (E.A.S.R.)
| | - Soledad Cercadillo García
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Ana Sanz Argüello
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Marta Villanueva Rosa
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Rey Juan Carlos University Hospital of Móstoles, 28933 Madrid, Spain
| | - Eleuterio A. Sánchez Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Correspondence: (J.H.V.); (E.A.S.R.)
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106
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Haunhorst S, Bloch W, Wagner H, Ellert C, Krüger K, Vilser DC, Finke K, Reuken P, Pletz MW, Stallmach A, Puta C. Long COVID: a narrative review of the clinical aftermaths of COVID-19 with a focus on the putative pathophysiology and aspects of physical activity. OXFORD OPEN IMMUNOLOGY 2022; 3:iqac006. [PMID: 36846561 PMCID: PMC9494493 DOI: 10.1093/oxfimm/iqac006] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 11/14/2022] Open
Abstract
The pandemic coronavirus disease 2019 (COVID-19) can cause multi-systemic symptoms that can persist beyond the acute symptomatic phase. The post-acute sequelae of COVID-19 (PASC), also referred to as long COVID, describe the persistence of symptoms and/or long-term complications beyond 4 weeks from the onset of the acute symptoms and are estimated to affect at least 20% of the individuals infected with SARS-CoV-2 regardless of their acute disease severity. The multi-faceted clinical picture of long COVID encompasses a plethora of undulating clinical manifestations impacting various body systems such as fatigue, headache, attention disorder, hair loss and exercise intolerance. The physiological response to exercise testing is characterized by a reduced aerobic capacity, cardiocirculatory limitations, dysfunctional breathing patterns and an impaired ability to extract and use oxygen. Still, to this day, the causative pathophysiological mechanisms of long COVID remain to be elucidated, with long-term organ damage, immune system dysregulation and endotheliopathy being among the hypotheses discussed. Likewise, there is still a paucity of treatment options and evidence-based strategies for the management of the symptoms. In sum, this review explores different aspects of long COVID and maps the literature on what is known about its clinical manifestations, potential pathophysiological mechanisms, and treatment options.
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Affiliation(s)
- Simon Haunhorst
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena 07749, Germany,Department of Movement Science, University of Münster, Münster 48149, Germany
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne 50933, Germany
| | - Heiko Wagner
- Department of Movement Science, University of Münster, Münster 48149, Germany
| | - Claudia Ellert
- Department for Vascular Surgery, Lahn-Dill Clinics Wetzlar, Wetzlar 35578, Germany
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen 35394, Germany
| | - Daniel C Vilser
- Hospital for Pediatrics and Adolescent Medicine, Jena University Hospital, Jena 07747, Germany
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena 07747, Germany
| | - Philipp Reuken
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena 07747, Germany
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena 07747, Germany
| | - Andreas Stallmach
- Clinic for Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena 07747, Germany
| | - Christian Puta
- Correspondence address. Department for Sports Medicine and Health Promotion, Friedrich-Schiller-Universität Jena, Wöllnitzer Straße 42, Jena 07749, Germany. Tel: +49 3641 9-45607; Fax: +49 3641 9-45652; E-mail:
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107
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Paul E, Fancourt D. Health behaviours the month prior to COVID-19 infection and the development of self-reported long COVID and specific long COVID symptoms: a longitudinal analysis of 1581 UK adults. BMC Public Health 2022; 22:1716. [PMID: 36085055 PMCID: PMC9462889 DOI: 10.1186/s12889-022-14123-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Demographic and infection-related characteristics have been identified as risk factors for long COVID, but research on the influence of health behaviours (e.g., exercise, smoking) immediately preceding the index infection is lacking. The aim of this study was to examine whether specific health behaviours in the month preceding infection with COVID-19 act as upstream risk factors for long COVID as well as well as three specific long COVID symptoms.
Methods
One thousand five hundred eighty-one UK adults from the UCL COVID-19 Social Study and who had previously been infected with COVID-19 were analysed. Health behaviours in the month before infection were weekly exercise frequency, days of fresh air per week, sleep quality, smoking, consuming more than the number of recommended alcoholic drinks per week (> 14), and the number of mental health care behaviours (e.g., online mental health programme). Logistic regressions controlling for covariates (e.g., COVID-19 infection severity, socio-demographics, and pre-existing health conditions) examined the impact of health behaviours on long COVID and three long COVID symptoms (difficulty with mobility, cognition, and self-care).
Results
In the month before infection with COVID-19, poor quality sleep increased the odds of long COVID (odds ratio [OR]: 3.53; (95% confidence interval [CI]: 2.01 to 6.21), as did average quality sleep (OR: 2.44; 95% CI: 1.44 to 4.12). Having smoked (OR: 8.39; 95% CI: 1.86 to 37.91) increased and meeting recommended weekly physical activity guidelines (3h hours) (OR: 0.05; 95% CI: 0.01 to 0.39) reduced the likelihood of difficulty with self-care (e.g., washing all over or dressing) amongst those with long COVID.
Conclusions
Results point to the importance of sleep quality for long COVID, potentially helping to explain previously demonstrated links between stress and long COVID. Results also suggest that exercise and smoking may be modifiable risk factors for preventing the development of difficulty with self-care.
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108
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Zhang F, Zhang Y, Yu Y, Lu W, Zhang H. Bibliometric analysis of the top-50 cited articles on COVID-19 and physical activity. Front Public Health 2022; 10:926244. [PMID: 36159319 PMCID: PMC9500202 DOI: 10.3389/fpubh.2022.926244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/24/2022] [Indexed: 01/24/2023] Open
Abstract
Background Since the 2019 novel coronavirus (COVID-19) pneumonia outbreak in late 2019, an endless stream of research has emerged surrounding physical activity. This study analyzes the 50 most influential articles on COVID-19 and physical activity over the past 2 years to describe the research landscape and hotspots from bibliometric citation analysis. Methods The top-50 cited articles were extracted from the Web of Science Core Collection database, and bibliometric citation analysis was performed by Excel 2019 and VOSviewer software. Results The top-50 articles were cited 160.48 ± 106.90 (range: 70-587). Most of the articles were from the United States (14), followed by Italy (11) and England (9). The International Journal of Environmental Research and Public Health (n = 10) is the journal with the top-50 cited articles. The collaboration between authors was mainly among three teams, including Smith L, Musumeci G, and Napoli C. The hotspot of research around COVID-19 and physical activity focused on lifestyle change (sedentary behavior, sitting time), mental health (depressive, anxiety, loneliness), the credibility of physical activity assessment tools (reliability, validity), and physical activity of different populations (gender, youth, children). Conclusions Based on a bibliometric analysis of high-impact articles on COVID-19 and physical activity highlights physical activity as an essential lifestyle change and developments and hotspots in this field. These data will provide insights for future researchers regarding the direction of physical activity research in the COVID-19 pandemic.
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Affiliation(s)
- Fan Zhang
- Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Zhang
- Department of Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yaqi Yu
- Department of Cancer, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Lu
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Wei Lu
| | - Huachun Zhang
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China,Huachun Zhang
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109
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Barrea L, Vetrani C, Caprio M, Cataldi M, Ghoch ME, Elce A, Camajani E, Verde L, Savastano S, Colao A, Muscogiuri G. From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome). Curr Obes Rep 2022; 11:144-165. [PMID: 35524067 PMCID: PMC9075143 DOI: 10.1007/s13679-022-00475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW This review primarily examines the evidence for areas of consensus and on-going uncertainty or controversy about diet and physical exercise approaches for in the post-CoVID. We propose an ideal dietary and physical activity approach that the patient with obesity should follow after CoVID-19 infection in order to reduce the clinical conditions associated with post-CoVID syndrome. RECENT FINDINGS The CoVID-19 disease pandemic, caused by the severe acute respiratory syndrome coronavirus-2, has spread all over the globe, infecting hundreds of millions of individuals and causing millions of death. It is also known to be is associated with several medical and psychological complications, especially in patients with obesity and weight-related disorders who in general pose a significant global public health problem, and in specific affected individuals are on a greater risk of developing poorer CoVID-19 clinical outcomes and experience a higher rate of mortality. Little is still known about the best nutritional approach to be adopted in this disease especially in the patients post-CoVID syndrome. To the best of our knowledge, no specific nutritional recommendations exist to manage in the patients post-CoVID syndrome. We report a presentation of nutritional therapeutic approach based on a ketogenic diet protocol followed by a transition to the Mediterranean diet in patients post-infection by CoVID, combined to a physical activity program to address conditions associated with post-CoVID syndrome.
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Affiliation(s)
- Luigi Barrea
- Dipartimento Di Scienze Umanistiche, Centro Direzionale, Università Telematica Pegaso, Via Porzio, isola F2, 80143, Napoli, Italy.
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, 00166, Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
| | - Mauro Cataldi
- Department of Neuroscience, Reproductive Medicine and Dentistry, Section of Pharmacology, Medical School of Naples, Federico II University, 80131, Naples, Italy
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020, Riad El Solh, Beirut, 11072809, Lebanon
| | - Ausilia Elce
- Dipartimento Di Scienze Umanistiche, Centro Direzionale, Università Telematica Pegaso, Via Porzio, isola F2, 80143, Napoli, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- PhD Programme in Endocrinological Sciences, Sapienza University of Rome, 00161, Rome, Italy
| | - Ludovica Verde
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
| | - Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Endocrinology Unit, Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento Di Medicina Clinica E Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, Naples, Italy
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Fagevik Olsén M, Lannefors L, Nygren-Bonnier M, Johansson EL. Long COVID – respiratory symptoms in non-hospitalised subjects – a cross-sectional study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2101692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Monika Fagevik Olsén
- Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Louise Lannefors
- Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Nygren-Bonnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Ewa-Lena Johansson
- Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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111
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Orendáčová M, Kvašňák E. Effects of vaccination, new SARS-CoV-2 variants and reinfections on post-COVID-19 complications. Front Public Health 2022; 10:903568. [PMID: 35968477 PMCID: PMC9372538 DOI: 10.3389/fpubh.2022.903568] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Post-COVID-19 complications involve a variety of long-lasting health complications emerging in various body systems. Since the prevalence of post-COVID-19 complications ranges from 8-47% in COVID-19 survivors, it represents a formidable challenge to COVID-19 survivors and the health care system. Post-COVID-19 complications have already been studied in the connection to risk factors linked to their higher probability of occurrence and higher severity, potential mechanisms underlying the pathogenesis of post-COVID-19 complications, and their functional and structural correlates. Vaccination status has been recently revealed to represent efficient prevention from long-term and severe post-COVID-19 complications. However, the exact mechanisms responsible for vaccine-induced protection against severe and long-lasting post-COVID-19 complications remain elusive. Also, to the best of our knowledge, the effects of new SARS-CoV-2 variants and SARS-CoV-2 reinfections on post-COVID-19 complications and their underlying pathogenesis remain to be investigated. This hypothesis article will be dedicated to the potential effects of vaccination status, SARS-CoV-2 reinfections, and new SARS-CoV-2 variants on post-COVID-19 complications and their underlying mechanisms Also, potential prevention strategies against post-COVID complications will be discussed.
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Affiliation(s)
- Mária Orendáčová
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
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Gyöngyösi M, Alcaide P, Asselbergs FW, Brundel BJJM, Camici GG, da Costa Martins P, Ferdinandy P, Fontana M, Girao H, Gnecchi M, Gollmann-Tepeköylü C, Kleinbongard P, Krieg T, Madonna R, Paillard M, Pantazis A, Perrino C, Pesce M, Schiattarella GG, Sluijter JPG, Steffens S, Tschöpe C, Van Linthout S, Davidson SM. Long COVID and the cardiovascular system - elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies: A joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial & Pericardial Diseases. Cardiovasc Res 2022; 119:336-356. [PMID: 35875883 PMCID: PMC9384470 DOI: 10.1093/cvr/cvac115] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 02/07/2023] Open
Abstract
Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multi-organ symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious peri-myocarditis with consequent left or right ventricular failure, arterial wall inflammation or micro-thrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, micro-thrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.
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Affiliation(s)
- Mariann Gyöngyösi
- Corresponding Author: Mariann Gyöngyösi Division of Cardiology, 2nd Department of Internal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria Tel.: +43-1-40400-46140 , Fax: +43-1-40400-42160
| | - Pilar Alcaide
- Department of Immunology, Tufts University School of Medicine, Boston, MA, USA
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands,Health Data Research UK and Institute of Health Informatics, University College London, London, United Kingdom
| | - Bianca J J M Brundel
- Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland,University Heart Center, Department of Cardiology, University Hospital, Zurich, Switzerland
| | - Paula da Costa Martins
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary,Pharmahungary Group, Szeged, Hungary
| | - Marianna Fontana
- Royal Free Hospital London, Division of Medicine, University College London, London, UK
| | - Henrique Girao
- Center for Innovative Biomedicine and Biotechnology (CIBB), Clinical Academic Centre of Coimbra (CACC), Faculty of Medicine, Univ Coimbra, Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal
| | - Massimiliano Gnecchi
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia,Unit of Translational Cardiology, Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Petra Kleinbongard
- Institut für Pathophysiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Thomas Krieg
- Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Rosalinda Madonna
- Department of Pathology, Institute of Cardiology, University of Pisa, Pisa, Italy
| | - Melanie Paillard
- Laboratoire CarMeN-équipe IRIS, INSERM, INRA, Université Claude Bernard Lyon-1, INSA-Lyon, Univ-Lyon, 69500 Bron, France
| | - Antonis Pantazis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Cardiovascular Research Centre at Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples
| | - Maurizio Pesce
- Unità di Ingegneria Tissutale cardiovascolare, Centro Cardiologico Monzino, IRCCS
| | - Gabriele G Schiattarella
- Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy,Center for Cardiovascular Research (CCR), Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany,Translational Approaches in Heart Failure and Cardiometabolic Disease, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Joost P G Sluijter
- Laboratory of Experimental Cardiology, Cardiology, UMC Utrecht Regenerative Medicine Center,Circulatory Health Laboratory, Utrecht University, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sabine Steffens
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität, Munich,Germany and Munich Heart Alliance, DZHK partner site Munich, Germany
| | - Carsten Tschöpe
- Berlin Institute of Health (BIH) at Charité, - Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner site Berlin and Dept Cardiology (CVK), Charité, Berlin; Germany
| | - Sophie Van Linthout
- Berlin Institute of Health (BIH) at Charité, - Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner site Berlin and Dept Cardiology (CVK), Charité, Berlin; Germany
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, WC1E 6HX, London, United Kingdom
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113
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Chudzik M, Burzyńska M, Kapusta J. Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients after COVID-19. Nutrients 2022; 14:3004. [PMID: 35893858 PMCID: PMC9331270 DOI: 10.3390/nu14153004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 02/08/2023] Open
Abstract
COVID-19 is not only a short-term infection, as patients (pts) recovering from SARS-CoV-2 infection complain of persisting symptoms, which may lead to chronic fatigue syndrome. There is currently no evidence that nutritional supplements can assist in the recovery of pts with chronic fatigue syndrome. 1-Methylnicotinamide (1-MNA) is an endogenic substance that is produced in the liver when nicotinic acid is metabolized. 1-MNA demonstrates anti-inflammatory and anti-thrombotic properties. Therefore, we investigated whether 1-MNA supplements could improve exercise tolerance and decrease fatigue among patients recovering from SARS-CoV-2. METHODS The study population was composed of 50 pts who had recovered from symptomatic COVID-19. The selected pts were randomized into two groups: Gr 1 (NO-1-MNA)-without supplementation; Gr 2 (1-MNA) with 1-MNA supplementation. At the beginning of the study (Phase 0), in both groups, a 6-minute walk test (6MWT) was carried out and fatigue assessment was performed using the Fatigue Severity Scale (FSS). Both FSS and 6MWT were repeated after 1 month. RESULTS A significant improvement in the mean distance covered in the 6MWT was noted at follow-up in Gr 1-MNA, compared with Gr NO-1-MNA. We also noted that in Gr 1-MNA, the 6MWT distance was significantly higher after 1 month of supplementation with 1-MNA, compared with the beginning of the study (515.18 m in Phase 0 vs. 557.8 m in Phase 1; p = 0.000034). In Gr 1-MNA, significantly more pts improved their distance in the 6MWT (23 out of 25 pts, equal to 92%), by a mean of 47 m, compared with Gr NO-1-MNA (15 of 25 pts, equal to 60%) (p = 0.0061). After one month, significantly more patients in the group without 1-MNA had severe fatigue (FSS ≥ 4) compared with the group with supplementation (Gr 1-MNA = 5 pts (20%) vs. Gr NO-1-MNA = 14pts (56%); p = 0.008). CONCLUSIONS 1-MNA supplementation significantly improved physical performance in a 6-min walk test and reduced the percentage of patients with severe fatigue after COVID-19. The comprehensive action of 1-MNA, including anti-inflammatory and anticoagulant effects, may be beneficial for the recovery of patients with persistent symptoms of fatigue and low tolerance to exercise after COVID-19.
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Affiliation(s)
- Michał Chudzik
- Medical Center, Saint Family Hospital, 90-302 Lodz, Poland;
| | - Monika Burzyńska
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90-752 Lodz, Poland;
| | - Joanna Kapusta
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 70-445 Lodz, Poland
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114
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Carpallo-Porcar B, Romo-Calvo L, Pérez-Palomares S, Jiménez-Sánchez C, Herrero P, Brandín-de la Cruz N, Calvo S. Efficacy of an asynchronous telerehabilitation program in post-COVID-19 patients: A protocol for a pilot randomized controlled trial. PLoS One 2022; 17:e0270766. [PMID: 35853037 PMCID: PMC9295945 DOI: 10.1371/journal.pone.0270766] [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: 03/14/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background
About 40% of patients who have had COVID-19 still have symptoms three months later whereas a 10% may experience physical and/or psychological consequences two years later. Therefore, it is necessary to perform preventive interventions when patients are discharged from the hospital to decrease the aforementioned sequelae. The purpose of this pilot-controlled trial will be to determine the efficacy of a rehabilitation program on functional status and psychosocial factors for post-COVID-19 patients when it is delivered through a tele-care platform versus a booklet-based rehabilitation.
Methods
The estimated sample size will be of 50 participants who have been discharged after COVID-19 and have a level of fatigue equal or greater than 4 on the Fatigue Severity Scale. The primary outcome will be the severity of fatigue. Participants will be randomly allocated to an “asynchronous telerehabilitation group” or to a “booklet-based rehabilitation group”. Treatment in both groups will be the same and will consist of a combination of therapeutic exercise and an educative program. Treatment outcomes will be evaluated the last day of the intervention and at three- and six-months follow-up.
Discussion
The telerehabilitation intervention appears to be a viable and efficacy option in decreasing severe fatigue and other fitness variables such as strength and aerobic capacity, similar to other traditional rehabilitation formats such as through an explanatory booklet.
Clinical trial registration
This trial has been prospectively registered at clinialtrials.gov identifier: NCT04794036.
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Affiliation(s)
- Beatriz Carpallo-Porcar
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Laura Romo-Calvo
- Hospital Real y Provincial Nuestra Señora de Gracia, Zaragoza, Spain
| | - Sara Pérez-Palomares
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
| | - Carolina Jiménez-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
- * E-mail:
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
| | - Natalia Brandín-de la Cruz
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Sandra Calvo
- Department of Physiatry and Nursing, Faculty of Health Sciences, IIS Aragon, University of Zaragoza, Zaragoza, Spain
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Jafarnezhadgero AA, Noroozi R, Fakhri E, Granacher U, Oliveira AS. The Impact of COVID-19 and Muscle Fatigue on Cardiorespiratory Fitness and Running Kinetics in Female Recreational Runners. Front Physiol 2022; 13:942589. [PMID: 35923233 PMCID: PMC9340252 DOI: 10.3389/fphys.2022.942589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/24/2022] [Indexed: 01/08/2023] Open
Abstract
Background: There is evidence that fully recovered COVID-19 patients usually resume physical exercise, but do not perform at the same intensity level performed prior to infection. The aim of this study was to evaluate the impact of COVID-19 infection and recovery as well as muscle fatigue on cardiorespiratory fitness and running biomechanics in female recreational runners. Methods: Twenty-eight females were divided into a group of hospitalized and recovered COVID-19 patients (COV, n = 14, at least 14 days following recovery) and a group of healthy age-matched controls (CTR, n = 14). Ground reaction forces from stepping on a force plate while barefoot overground running at 3.3 m/s was measured before and after a fatiguing protocol. The fatigue protocol consisted of incrementally increasing running speed until reaching a score of 13 on the 6–20 Borg scale, followed by steady-state running until exhaustion. The effects of group and fatigue were assessed for steady-state running duration, steady-state running speed, ground contact time, vertical instantaneous loading rate and peak propulsion force. Results: COV runners completed only 56% of the running time achieved by the CTR (p < 0.0001), and at a 26% slower steady-state running speed (p < 0.0001). There were fatigue-related reductions in loading rate (p = 0.004) without group differences. Increased ground contact time (p = 0.002) and reduced peak propulsion force (p = 0.005) were found for COV when compared to CTR. Conclusion: Our results suggest that female runners who recovered from COVID-19 showed compromised running endurance and altered running kinetics in the form of longer stance periods and weaker propulsion forces. More research is needed in this area using larger sample sizes to confirm our study findings.
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Affiliation(s)
- Amir Ali Jafarnezhadgero
- Department of Sport Managements and Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Raha Noroozi
- Department of Sport Managements and Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Ehsan Fakhri
- Department of Sport Managements and Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
- *Correspondence: Urs Granacher, , orcid.org/0000-0002-7095-813X
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116
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The Use of Palmitoylethanolamide in the Treatment of Long COVID: A Real-Life Retrospective Cohort Study. Med Sci (Basel) 2022; 10:medsci10030037. [PMID: 35893119 PMCID: PMC9326613 DOI: 10.3390/medsci10030037] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/26/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
COVID-19 can cause symptoms that last weeks or months after the infection has gone, with a significant impairment of quality of life. Palmitoylethanolamide (PEA) is a naturally occurring lipid mediator that has an entourage effect on the endocannabinoid system mitigating the cytokine storm. The aim of this retrospective study is to evaluate the potential efficacy of PEA in the treatment of long COVID. Patients attending the Neurological Out Clinic of the IRCCS Centro Neurolesi Bonino-Pulejo (Messina, Italy) from August 2020 to September 2021 were screened for potential inclusion in the study. We included only long COVID patients who were treated with PEA 600 mg two times daily for about 3 months. All patients performed the post-COVID-19 Functional Status (PCFS) scale. Thirty-three patients (10 males, 43.5%, mean age 47.8 ± 12.4) were enrolled in the study. Patients were divided into two groups based on hospitalization or home care observation. A substantial difference in the PCFS score between the two groups at baseline and after treatment with PEA were found. We found that smoking was a risk factor with an odds ratio of 8.13 CI 95% [0.233, 1.167]. Our findings encourage the use of PEA as a potentially effective therapy in patients with long COVID.
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117
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Luijten D, de Jong CMM, Klok FA. Post Pulmonary Embolism Syndrome. Arch Bronconeumol 2022; 58:533-535. [PMID: 35312578 DOI: 10.1016/j.arbres.2021.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Dieuwke Luijten
- Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Cindy M M de Jong
- Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Frederikus A Klok
- Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
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118
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The Impact of COVID-19 Infection on Cognitive Function and the Implication for Rehabilitation: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137748. [PMID: 35805406 PMCID: PMC9266128 DOI: 10.3390/ijerph19137748] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/11/2022]
Abstract
There is mounting evidence that patients with severe COVID-19 disease may have symptoms that continue beyond the acute phase, extending into the early chronic phase. This prolonged COVID-19 pathology is often referred to as ‘Long COVID’. Simultaneously, case investigations have shown that COVID-19 individuals might have a variety of neurological problems. The accurate and accessible assessment of cognitive function in patients post-COVID-19 infection is thus of increasingly high importance for both public and individual health. Little is known about the influence of COVID-19 on the general cognitive levels but more importantly, at sub-functions level. Therefore, we first aim to summarize the current level of evidence supporting the negative impact of COVID-19 infection on cognitive functions. Twenty-seven studies were included in the systematic review representing a total of 94,103 participants (90,317 COVID-19 patients and 3786 healthy controls). We then performed a meta-analysis summarizing the results of five studies (959 participants, 513 patients) to quantify the impact of COVID-19 on cognitive functions. The overall effect, expressed in standardized mean differences, is −0.41 [95%CI −0.55; −0.27]. To prevent disability, we finally discuss the different approaches available in rehabilitation to help these patients and avoid long-term complications.
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119
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Ward B, Yombi JC, Balligand JL, Cani PD, Collet JF, de Greef J, Dewulf JP, Gatto L, Haufroid V, Jodogne S, Kabamba B, Pyr dit Ruys S, Vertommen D, Elens L, Belkhir L. HYGIEIA: HYpothesizing the Genesis of Infectious Diseases and Epidemics through an Integrated Systems Biology Approach. Viruses 2022; 14:v14071373. [PMID: 35891354 PMCID: PMC9318602 DOI: 10.3390/v14071373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 12/13/2022] Open
Abstract
More than two years on, the COVID-19 pandemic continues to wreak havoc around the world and has battle-tested the pandemic-situation responses of all major global governments. Two key areas of investigation that are still unclear are: the molecular mechanisms that lead to heterogenic patient outcomes, and the causes of Post COVID condition (AKA Long-COVID). In this paper, we introduce the HYGIEIA project, designed to respond to the enormous challenges of the COVID-19 pandemic through a multi-omic approach supported by network medicine. It is hoped that in addition to investigating COVID-19, the logistics deployed within this project will be applicable to other infectious agents, pandemic-type situations, and also other complex, non-infectious diseases. Here, we first look at previous research into COVID-19 in the context of the proteome, metabolome, transcriptome, microbiome, host genome, and viral genome. We then discuss a proposed methodology for a large-scale multi-omic longitudinal study to investigate the aforementioned biological strata through high-throughput sequencing (HTS) and mass-spectrometry (MS) technologies. Lastly, we discuss how a network medicine approach can be used to analyze the data and make meaningful discoveries, with the final aim being the translation of these discoveries into the clinics to improve patient care.
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Affiliation(s)
- Bradley Ward
- Integrated Pharmacometrics, Pharmacogenomics and Pharmacokinetics Group (PMGK), Louvain Drug Research Institute (LDRI), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (B.W.); (S.P.d.R.)
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (J.d.G.); (J.P.D.); (V.H.)
| | - Jean Cyr Yombi
- Department of Internal Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Jean-Luc Balligand
- WELBIO (Walloon Excellence in Life Sciences and Biotechnology), Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Patrice D. Cani
- WELBIO (Walloon Excellence in Life Sciences and Biotechnology), Metabolism and Nutrition Research Group, Louvain Drug Research Institute (LDRI), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Jean-François Collet
- WELBIO (Walloon Excellence in Life Sciences and Biotechnology), de Duve Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Julien de Greef
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (J.d.G.); (J.P.D.); (V.H.)
- Department of Internal Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Joseph P. Dewulf
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (J.d.G.); (J.P.D.); (V.H.)
- Department of Laboratory Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
- Department of Biochemistry, de Duve Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Laurent Gatto
- Computational Biology and Bioinformatics Unit (CBIO), de Duve Institute, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Vincent Haufroid
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (J.d.G.); (J.P.D.); (V.H.)
- Department of Laboratory Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Sébastien Jodogne
- Computer Science and Engineering Department (INGI), Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTEAM), UCLouvain, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
| | - Benoît Kabamba
- Department of Laboratory Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
- Pôle de Microbiologie, Institut de Recherche Expérimentale et Clinique, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium
| | - Sébastien Pyr dit Ruys
- Integrated Pharmacometrics, Pharmacogenomics and Pharmacokinetics Group (PMGK), Louvain Drug Research Institute (LDRI), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (B.W.); (S.P.d.R.)
| | - Didier Vertommen
- De Duve Institute, and MASSPROT Platform, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Laure Elens
- Integrated Pharmacometrics, Pharmacogenomics and Pharmacokinetics Group (PMGK), Louvain Drug Research Institute (LDRI), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (B.W.); (S.P.d.R.)
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (J.d.G.); (J.P.D.); (V.H.)
- Correspondence: (L.E.); (L.B.)
| | - Leïla Belkhir
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium; (J.d.G.); (J.P.D.); (V.H.)
- Department of Internal Medicine, Cliniques Universitaires Saint-Luc, UCLouvain, Université Catholique de Louvain, 1200 Brussels, Belgium;
- Correspondence: (L.E.); (L.B.)
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Rehabilitation for COVID-19 in conjunction with early awake extracorporeal membrane oxygenation support: a case report. Int J Rehabil Res 2022; 45:287-290. [PMID: 35730065 DOI: 10.1097/mrr.0000000000000533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 can lead to acute respiratory distress syndrome. Awake venovenous extracorporeal membrane oxygenation is known to be effective in patients with critical COVID-19 and respiratory failure. This report describes the rehabilitation course and functional progress of a 63-year-old man who contracted severe COVID-19 and underwent awake venovenous extracorporeal membrane oxygenation. He started rehabilitation from the time of isolation while receiving venovenous extracorporeal membrane oxygenation and underwent a 30-day course of inpatient comprehensive rehabilitation. He regained functional independence and cognitive abilities and was able to walk without assistance at hospital discharge without any complications. This study demonstrates the feasibility of starting rehabilitation for COVID-19 early while the patient is on awake venovenous extracorporeal membrane oxygenation and eventually achieving a favorable outcome.
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Qiu M, Jayasekara D, Jayasekara A. Post-COVID-19 Infection With Meticillin-Sensitive Staphylococcus aureus (MSSA) Bacteremia, Discitis/Osteomyelitis, and Diffuse Abscesses: A Case Report. Cureus 2022; 14:e25824. [PMID: 35836448 PMCID: PMC9273202 DOI: 10.7759/cureus.25824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 11/18/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has been associated with a plethora of symptoms weeks after the acute infection. While many reports have investigated the novel syndrome of post-acute sequelae of COVID-19, fewer studies have examined post-COVID-19 secondary infections, which may be distinct from typical post-viral bacterial infections due to the multiorgan involvement of COVID-19. This case report aims to highlight a presentation in which a 65-year-old man had COVID-19 and subsequently developed methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia with widespread seeding of secondary infections, including abscesses in the hand and paravertebral regions as well as discitis/osteomyelitis of the cervical spine. Further studies are needed to investigate whether an increased susceptibility to unusual secondary bacterial infections is present in post-COVID-19 patients.
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Utility of High Flow Nasal Cannula during Pulmonary Rehabilitation in COVID-19 Patients in Acute Respiratory Failure. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
High-flow nasal cannula (HFNC) has often been used in the treatment of acute respiratory failure during pulmonary rehabilitation setting. The aim of this retrospective study was to investigate the utility of HCFN during the early rehabilitation in COVID-19 pneumonia. Twenty-two patients (10 males and 12 females, mean age 64.5 ± 5.9 years) with COVID-19 pneumonia were considered. Medical data and rehabilitative scales were used to evaluate acute hypoxemic respiratory failure (PaO2/FiO2 < 300), treated with HFNC three times during evaluation. Overall clinical outcomes from the evaluation of the synergy between HFNC strategy and rehabilitation were evaluated. A statistically significant improvement was observed at T2 (and of treatment) in 1 minute sit to stand test (1STST) (4 ± 3 vs. 17 ± 5, p < 0.05), short physical performance battery (SPPB) (4.3 ± 2.81 vs. 9.15 ± 2.39, p < 0.05), SpO2% post effort (93 ± 1.26 vs. 98 ± 1.01, p < 0.05), respiratory rate post effort (RR) (24 ± 3.91 vs. 20 ± 3.13, p < 0.05), heart rate (HR) (97 ± 11.9 vs. 87 ± 9.17, p < 0.05), P/F rate (235 ± 7.35 vs. 331 ± 10.91, p < 0.05), SpO2 (86 ± 4.54 vs. 97 ± 1.01 p < 0.05), RR (20 ± 4 vs. 12 ± 1.39, p < 0.05). Then, treated HFNC patients showed a good improvement in physical performance at T2 and a good compliance with treatments proved to be extremely useful in the control and reduction of dyspnea and fatigue symptoms.
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Effects and Causes of Detraining in Athletes Due to COVID-19: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095400. [PMID: 35564795 PMCID: PMC9102934 DOI: 10.3390/ijerph19095400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/23/2022]
Abstract
Several aspects of systemic alterations caused by the SARS-CoV-2 virus and the resultant COVID-19 disease have been currently explored in the general population. However, very little is known about these particular aspects in sportsmen and sportswomen. We believe that the most important element to take into account is the neuromuscular aspect, due to the implications that this system entails in motion execution and coordination. In this context, deficient neuromuscular control when performing dynamic actions can be an important risk factor for injury. Therefore, data in this review refer mainly to problems derived in the short term from athletes who have suffered this pathology, taking into account that COVID-19 is a very new disease and the presented data are still not conclusive. The review addresses two key aspects: performance alteration and the return to regular professional physical activity. COVID-19 causes metabolic-respiratory, muscular, cardiac, and neurological alterations that are accompanied by a situation of stress. All of these have a clear influence on performance but at the same time in the strategy of returning to optimal conditions to train and compete again after infection. From the clinical evidence, the resumption of physical training and sports activity should be carried out progressively, both in terms of time and intensity.
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Wright J, Astill SL, Sivan M. The Relationship between Physical Activity and Long COVID: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5093. [PMID: 35564488 PMCID: PMC9105041 DOI: 10.3390/ijerph19095093] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 01/04/2023]
Abstract
The relationship between Long Covid (LC) symptoms and physical activity (PA) levels are unclear. In this cross-sectional study, we examined this association, and the advice that individuals with LC received on PA. Adults with LC were recruited via social media. The New Zealand physical activity questionnaire short form (NZPAQ-SF) was adapted to capture current and pre-COVID-19 PA levels and activities of daily living (ADLs). Participants reported how PA affected their symptoms, and what PA recommendations they had received from healthcare professionals and other resources; 477 participants completed the survey. Mean age (SD) was 45.69 (10.02) years, 89.1% female, 92.7% white, and median LC duration was 383.5 days (IQR: 168.25,427). Participants were less active than pre-COVID-19 (26.88 ± 74.85 vs. 361.68 ± 396.29 min per week, p < 0.001) and required more assistance with ADLs in a 7-day period compared to pre-COVID-19 (2.23 ± 2.83 vs. 0.11 ± 0.74 days requiring assistance, p < 0.001). No differences were found between the number of days of assistance required with ADLs, or the amount of PA, and the different durations of LC illness (p > 0.05). Participants reported the effect of PA on LC symptoms as: worsened (74.84%), improved (0.84%), mixed effect (20.96%), or no effect (28.72%). Participants received contradictory advice on whether to be physically active in LC. LC is associated with a reduction in PA and a loss of independence, with most participants reporting PA worsened LC symptoms. PA level reduction is independent of duration of LC. Research is needed to understand how to safely return to PA without worsening LC symptoms.
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Affiliation(s)
- Jack Wright
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK;
| | - Sarah L. Astill
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK;
| | - Manoj Sivan
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK;
- Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
- Community Healthcare NHS Trust, Leeds LS12 5SG, UK
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Exercise Preferences and Benefits in Patients Hospitalized with COVID-19. J Pers Med 2022; 12:jpm12040645. [PMID: 35455761 PMCID: PMC9032495 DOI: 10.3390/jpm12040645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Obese people are at risk of becoming severely ill due to SARS-CoV-2. The exercise benefits on health have been emphasized. Aim: To investigate the correlation of obesity with the length of hospitalization, the pre- and post-hospitalization exercise preferences of COVID-19 patients, and the impact of pre-admission or post-hospitalization physical activity on dyspnea one month after hospitalization and recovery time. Methods: A telephone survey was conducted in patients hospitalized at the Respiratory Medicine Department, University of Thessaly, Greece, from November to December 2020. Results: Two-thirds of the patients were obese. Obesity was not associated with the hospitalization time. Two-thirds of the patients used to engage in physical activity before hospitalization. Males exercised in a higher percentage and more frequently than women before and after hospitalization. The methodical pre-hospitalization exercise was associated with lower levels of dyspnea one month after hospitalization. In-hospital weight loss, comorbidities, and dyspnea on admission independently predicted longer recovery time. Lockdown had boosted men’s desire to exercise than females who were negatively affected. Conclusions: Obesity is common in COVID-19 hospitalized patients. In-hospital weight loss, comorbidities, and dyspnea on admission predicted a longer post-hospitalization recovery time. The pre-hospitalization exercise was associated with less post-hospitalization dyspnea and recovery time.
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126
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Exercise Training in Post-COVID-19 Patients: The Need for a Multifactorial Protocol for a Multifactorial Pathophysiology. J Clin Med 2022; 11:jcm11082228. [PMID: 35456321 PMCID: PMC9028177 DOI: 10.3390/jcm11082228] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 02/04/2023] Open
Abstract
The battle against COVID-19 has entered a new phase with Rehabilitation Centres being among the major players, because the medical outcome of COVID-19 patients does not end with the control of pulmonary inflammation marked by a negative virology test, as many patients continue to suffer from long-COVID-19 syndrome. Exercise training is known to be highly valuable in patients with cardiac or lung disease, and it exerts beneficial effects on the immune system and inflammation. We therefore reviewed past and recent papers about exercise training, considering the multifactorial features characterizing post-COVID-19 patients’ clinical conditions. Consequently, we conceived a proposal for a post-COVID-19 patient exercise protocol as a combination of multiple recommended exercise training regimens. Specifically, we built pre-evaluation and exercise training for post-COVID-19 patients taking advantage of the various programs of exercise already validated for diseases that may share pathophysiological and clinical characteristics with long-COVID-19.
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127
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Nazir A, Hasri IP. Pathophysiology and rehabilitation management of exercise intolerance in COVID-19 patients. Ann Thorac Med 2022; 17:87-93. [PMID: 35651896 PMCID: PMC9150663 DOI: 10.4103/atm.atm_357_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This review aimed to explore the pathophysiology and rehabilitation management of exercise intolerance in COVID-19 patients. METHODS We reviewed articles published in 2019-2021 using PubMed, Google Scholar, and CINAHL databases as an electronic database. Data obtained were pathophysiology and rehabilitation management of exercise intolerance in COVID-19 survivors. Types of the article were original articles and systematic or narrative reviews, both published and preprint articles. Articles that were written in English and freely accessible in pdf or HTML format were included. RESULTS There were 28 articles eligible for this review. Pathophysiology, rehabilitation management, and both pathophysiology and rehabilitation management were explained in 7, 24, and 4 articles, consecutively. DISCUSSION Exercise intolerance is caused by some pathological processes in the respiratory, cardiovascular, and musculoskeletal systems as a result of systemic inflammation. Fatigue and shortness of breath during the activity were the most common symptom in the early phase of COVID-19 and persisted until the follow-up phase. Hospital admission, especially prolonged use of ventilators and immobilization worsen functional impairment resulting in persistent symptoms. Rehabilitation management begins with a functional assessment consisting of symptom assessment and physical examination of the body systems affected. The goals of rehabilitation management are to increase functional capacity, reduce symptoms, improve the ability to perform daily activities, facilitate social reintegration, and improve quality of life. Exercise is an effective intervention to reach these goals. Several studies recommend breathing, and aerobic exercises, as well as resistance exercises for peripheral and respiratory muscles, to improve symptoms and increase functional capacity.
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Affiliation(s)
- Arnengsih Nazir
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Indra Putera Hasri
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia
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128
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Said CM, Batchelor F, Duque G. The impact of the COVID-19 pandemic on physical activity, function, and quality of life. Clin Geriatr Med 2022; 38:519-531. [PMID: 35868670 PMCID: PMC9023337 DOI: 10.1016/j.cger.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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McNarry MA, Berg RMG, Shelley J, Hudson J, Saynor ZL, Duckers J, Lewis K, Davies GA, Mackintosh KA. Inspiratory Muscle Training Enhances Recovery Post COVID-19: A Randomised Controlled Trial. Eur Respir J 2022; 60:13993003.03101-2021. [PMID: 35236727 PMCID: PMC8900538 DOI: 10.1183/13993003.03101-2021] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/14/2022] [Indexed: 12/17/2022]
Abstract
Background Many people recovering from coronavirus disease 2019 (COVID-19) experience prolonged symptoms, particularly breathlessness. We urgently need to identify safe and effective COVID-19 rehabilitative strategies. The aim of the current study was to investigate the potential rehabilitative role of inspiratory muscle training (IMT). Methods 281 adults (age 46.6±12.2 years; 88% female) recovering from self-reported COVID-19 (9.0±4.2 months post-acute infection) were randomised 4:1 to an 8-week IMT or a “usual care” waitlist control arm. Health-related quality-of-life and breathlessness questionnaires (King's Brief Interstitial Lung Disease (K-BILD) and Transition Dyspnoea Index (TDI)), respiratory muscle strength, and fitness (Chester Step Test) were assessed pre- and post-intervention. The primary end-point was K-BILD total score, with the K-BILD domains and TDI being key secondary outcomes. Results According to intention to treat, there was no difference between groups in K-BILD total score post-intervention (control: 59.5±12.4; IMT: 58.2±12.3; p<0.05) but IMT elicited clinically meaningful improvements in the K-BILD domains for breathlessness (control: 59.8±12.6; IMT: 62.2±16.2; p<0.05) and chest symptoms (control: 59.2±18.7; IMT: 64.5±18.2; p<0.05), along with clinically meaningful improvements in breathlessness according to TDI (control: 0.9±1.7 versus 2.0±2.0; p<0.05). IMT also improved respiratory muscle strength and estimated aerobic fitness. Conclusions IMT may represent an important home-based rehabilitation strategy for wider implementation as part of COVID-19 rehabilitative strategies. Given the diverse nature of long COVID, further research is warranted on the individual responses to rehabilitation; the withdrawal rate herein highlights that no one strategy is likely to be appropriate for all. IMT can significantly improve breathlessness and respiratory muscle function in people with long COVID, and represents an effective, home-based rehabilitation strategy that could be widely implemented as part of COVID-19 recovery strategieshttps://bit.ly/3HiEyz0
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Affiliation(s)
- Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Ronan M G Berg
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Centre for Physical Activity Research, and Department of Clinical Physiology and Nuclear Medicine, University Hospital Copenhagen - Rigshospitalet, Kobenhavn, Denmark
| | - James Shelley
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Joanne Hudson
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK
| | - Zoe L Saynor
- Physical Activity, Health and Rehabilitation Thematic Research Group Lead, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Jamie Duckers
- All Wales Adult CF Centre, Cardiff and Vale University Health Board, Cardiff, UK
| | - Keir Lewis
- Hywel Dda University Health Board, Llanelli, UK.,School of Medicine, Swansea University, Swansea, UK
| | | | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK
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Role of senescence in the chronic health consequences of COVID-19. Transl Res 2022; 241:96-108. [PMID: 34695606 PMCID: PMC8532377 DOI: 10.1016/j.trsl.2021.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/28/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023]
Abstract
While the full impact of COVID-19 is not yet clear, early studies have indicated that upwards of 10% of patients experience COVID-19 symptoms longer than 3 weeks, known as Long-Hauler's Syndrome or PACS (postacute sequelae of SARS-CoV-2 infection). There is little known about risk factors or predictors of susceptibility for Long-Hauler's Syndrome, but older adults are at greater risk for severe outcomes and mortality from COVID-19. The pillars of aging (including cellular senescence, telomere dysfunction, impaired proteostasis, mitochondrial dysfunction, deregulated nutrient sensing, genomic instability, progenitor cell exhaustion, altered intercellular communication, and epigenetic alterations) that contribute to age-related dysfunction and chronic diseases (the "Geroscience Hypothesis") may interfere with defenses against viral infection and consequences of these infections. Heightening of the low-grade inflammation that is associated with aging may generate an exaggerated response to an acute COVID-19 infection. Innate immune system dysfunction that leads to decreased senescent cell removal and/or increased senescent cell formation could contribute to accumulation of senescent cells with both aging and viral infections. These processes may contribute to increased risk for long-term COVID-19 sequelae in older or chronically ill patients. Hence, senolytics and other geroscience interventions that may prolong healthspan and alleviate chronic diseases and multimorbidity linked to fundamental aging processes might be an option for delaying, preventing, or alleviating Long-Hauler's Syndrome.
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Key Words
- ampk, amp-activated protein kinase
- covid-19, coronavirus disease 2019
- covid-fis, a phase 2 placebo-controlled pilot study in covid-19 of fisetin to alleviate dysfunction and excessive inflammatory response in older adults in nursing homes
- cr, caloric restriction
- fga, facility for geroscience analysis
- icu, intensive care unit
- if, intermittent fasting
- ltcf, long-term care facility
- mcc, multiple chronic conditions
- mers-cov, middle east respiratory syndrome coronavirus
- mtor, mammalian target of rapamycin
- nad+, nicotinamide adenine dinucleotide
- nmn, nicotinamide mononucleotide
- nr, nicotinamide riboside
- pacs, postacute sequalae of sars-cov-2 infection
- pamps, pathogen-associated molecular profile factors
- ros, reactive oxygen species
- sars, severe acute respiratory syndrome
- sars-cov-1, severe acute respiratory syndrome coronavirus 1
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
- sasp, senescence-associated secretory phenotype
- snf, skilled nursing facility
- tgn, translational geroscience network
- who, world health organization
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Rodriguez-Sanchez I, Rodriguez-Mañas L, Laosa O. Long COVID-19: The Need for an Interdisciplinary Approach. Clin Geriatr Med 2022; 38:533-544. [PMID: 35868671 PMCID: PMC8934714 DOI: 10.1016/j.cger.2022.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Isabel Rodriguez-Sanchez
- Geriatrics Department, Hospital Clínico San Carlos, c/ Profesor Martín Lagos s/n, 28040-Madrid, Spain
| | - Leocadio Rodriguez-Mañas
- Servicio de Geriatría, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.5, 28905-Getafe, Spain; Centro de Investigación Biomédica en Red "Fragilidad y Envejecimiento Saludable" (CIBERFES), Instituto de Salud Carlos III, c/ Sinesio Delgado, 10, 28029-Madrid, Spain.
| | - Olga Laosa
- Servicio de Geriatría, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.5, 28905-Getafe, Spain; Geriatric Research Group, Biomedical Research Foundation at Hospital Universitario de Getafe, Carretera de Toledo, Km 12.5, 28905-Getafe, Spain
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Changes of 25(OH)D Concentration, Bone Resorption Markers and Physical Performance as an Effect of Sun Exposure, Supplementation of Vitamin D and Lockdown among Young Soccer Players during a One-Year Training Season. Nutrients 2022; 14:nu14030521. [PMID: 35276883 PMCID: PMC8838295 DOI: 10.3390/nu14030521] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 12/10/2022] Open
Abstract
The main purpose of this research was to demonstrate the changes in 25(OH)D concentration, bone resorption markers, and physical fitness along the one-year training season in young soccer players. A total of 24 young soccer players (age: 17.2 ± 1.16 years, mass: 70.2 ± 5.84, height: 179.1 ± 4.26 cm) were tested at four different time points across one year (T1—September 2019; T2—December 2019; T3—May 2020; T4—August 2020). After T2 (during COVID-19 lockdown), players were divided into a supplemented (GS) group and a placebo group (GP). Variables such as 25(OH)D, calcium (Ca), phosphorus (P), parathyroid hormone (PTH), aerobic capacity, speed, and explosive power were measured. Analyses performed for all participants indicated significant changes in all selected blood markers and running speed. The highest values in 25(OH)D were noted during summertime in T1 and T4. After individuals were split into two groups, a two-factorial ANOVA demonstrated a significant time interaction for 25(OH)D, Ca, P, PTH, 30 m sprint, and counter-movement jump. Significant time x group effect was calculated for aerobic capacity. This study confirmed that 25(OH)D concentration varies between four seasons, with the greatest decreases in the low sunlight periods. Vitamin D supplementation did not cause a preventive and long-lasting effect of increasing the 25(OH)D concentration in the young soccer players.
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Lvovna PO, Sergeevna SI. Using Neuro-Stimulating Physical Exercises to Restore Cognitive Functions in the Correction of the Post-COVID Syndrome. JOURNAL OF BIOCHEMICAL TECHNOLOGY 2022. [DOI: 10.51847/ugvstnjdmp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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134
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Myroshnychenko MS, Kalashnyk-Vakulenko YM, Kapustnyk NV, Babycheva OO, Yurevych NO, Bondarenko OV, Kalashnyk MV, Torianyk II, Shapkin AS, Lupyr AV. RHINOSINUSITIS IN PATIENTS IN POST-COVID-19 PERIOD: ETIOLOGY, CLINICAL AND MORPHOLOGICAL CHARACTERISTICS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1945-1953. [PMID: 36129076 DOI: 10.36740/wlek202208201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. PATIENTS AND METHODS Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. RESULTS Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). CONCLUSION Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.
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Affiliation(s)
| | | | - Nataliia V Kapustnyk
- MUNICIPAL NONPROFIT ORGANIZATION OF THE KHARKIV DISTRICT COUNCIL «REGIONAL CLINICAL PERINATAL CENTRE», KHARKIV, UKRAINE
| | | | | | | | - Mykhailo V Kalashnyk
- MUNICIPAL NONPROFIT ORGANIZATION OF THE KHARKIV DISTRICT COUNCIL «REGIONAL CLINICAL HOSPITAL», KHARKIV, UKRAINE
| | - Inna I Torianyk
- STATE INSTITUTION «INSTITUTE OF MICROBIOLOGY AND IMMUNOLOGY NAMED BY I.I. МЕCHNIKOV NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE», KHARKIV, UKRAINE
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135
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Martínez-Gallego R, Fuentes-García JP, Crespo M. COVID-19 Prevention Measures Implemented by Tennis Coaches: The Role of Continent, Experience, and Type of Facility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312679. [PMID: 34886411 PMCID: PMC8656888 DOI: 10.3390/ijerph182312679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/28/2021] [Indexed: 12/30/2022]
Abstract
The prevention strategies used by tennis coaches when delivering tennis lessons during the COVID-19 pandemic were analyzed in this study. An ad hoc questionnaire collected data from 655 Spanish and Portuguese speaking tennis coaches working in Latin America and Europe. Differences in the prevention measures were analyzed according to the continent, the coaches’ experience, and the type of facility they worked in. Results showed that coaches used information provided from local and national organizations more than from international ones. Hand hygiene, communication of preventive strategies, and changes in the coaching methodology were the most used prevention measures. Latin American coaches and those working in public facilities implemented the measures more often than their European colleagues or those working in private venues. Finally, more experienced coaches showed a greater awareness of the adoption of the measures than their less experienced counterparts. The data provided by this research may assist in developing new specific guidelines, protocols, and interventions to help better understand the daily delivery of tennis coaching in this challenging context.
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Affiliation(s)
| | - Juan Pedro Fuentes-García
- Didactic and Behavioral Analysis of Sports Research Group (ADICODE), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
- Correspondence:
| | - Miguel Crespo
- Development Department, International Tennis Federation, London SW15 5XZ, UK;
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136
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Rabady S, Altenberger J, Brose M, Denk-Linnert DM, Fertl E, Götzinger F, de la Cruz Gomez Pellin M, Hofbaur B, Hoffmann K, Hoffmann-Dorninger R, Koczulla R, Lammel O, Lamprecht B, Löffler-Ragg J, Müller CA, Poggenburg S, Rittmannsberger H, Sator P, Strenger V, Vonbank K, Wancata J, Weber T, Weber J, Weiss G, Wendler M, Zwick RH. [Guideline S1: Long COVID: Diagnostics and treatment strategies]. Wien Klin Wochenschr 2021; 133:237-278. [PMID: 34851455 PMCID: PMC8633909 DOI: 10.1007/s00508-021-01974-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 02/07/2023]
Abstract
This guideline comprises the state of science at the time of the editorial deadline. In view of the high turnover of knowledge the guideline is designed as a living guideline. The main objective was to provide a tool for the use in primary care, being considered well suited as a first point of entry and for the provision of care. The guideline gives recommendations on the differential diagnosis of symptoms following SARS-CoV‑2 infection, on their therapeutic options, as well as for guidance and care of the patients concerned. It also offers advice concerning return to daily life and rehabilitation. Long COVID being a very variable condition, we chose an interdisciplinary approach.
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Affiliation(s)
- Susanne Rabady
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.
| | - Johann Altenberger
- Pensionsversicherungsanstalt, Rehabilitationszentrum Großgmain, Großgmain, Österreich
| | - Markus Brose
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich
| | - Doris-Maria Denk-Linnert
- Klinische Abteilung Phoniatrie-Logopädie, Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Österreich
| | - Elisabeth Fertl
- Neurologische Abteilung, Klinik Landstraße, Wiener Gesundheitsverbund, Wien, Österreich
| | - Florian Götzinger
- Abteilung für Kinder- und Jugendheilkunde, Klinik Ottakring, Wiener Gesundheitsverbund, Wien, Österreich
| | - Maria de la Cruz Gomez Pellin
- Unit Versorgungsforschung in der Primärversorgung, Zentrum für Public Health, Medizinische Universität Wien, Wien, Österreich
| | | | - Kathryn Hoffmann
- Unit Health Services Research and Telemedicine in Primary Care, Department of Preventive- and Social Medicine, Center for Public Health, Medical University of Vienna, Wien, Österreich
| | | | - Rembert Koczulla
- Abteilung für Pneumologische Rehabilitation, Philipps Universität Marburg, Marburg, Deutschland
| | - Oliver Lammel
- Praxis Dr Oliver Lammel, Ramsau am Dachstein, Österreich
| | - Bernd Lamprecht
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum, Linz, Österreich
| | | | - Christian A Müller
- Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Österreich
| | | | - Hans Rittmannsberger
- Abteilung Psychiatrie und Psychotherapie, Pyhrn-Eisenwurzen-Klinikum, Steyr, Österreich
| | - Paul Sator
- Dermatologische Abteilung, Klinik Hietzing, Wiener Gesundheitsverbund, Wien, Österreich
| | - Volker Strenger
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Karin Vonbank
- Klinische Abteilung für Pulmologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Wien, Österreich
| | - Johannes Wancata
- Klinische Abteilung für Sozialpsychiatrie, Medizinische Universität Wien, Wien, Österreich
| | - Thomas Weber
- Abteilung für Innere Medizin 2 (Kardiologie, Intensivmedizin), Klinikum Wels-Grieskirchen, Wels, Österreich
| | - Jörg Weber
- Klinikum Klagenfurt, Feschnigstraße 11, 9020, Klagenfurt, Österreich
| | - Günter Weiss
- Univ.-Klinik für Innere Medizin II, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Maria Wendler
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich
| | - Ralf-Harun Zwick
- Ambulante internistische Rehabilitation, Therme Wien Med, Wien, Österreich
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137
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Baker FL, Smith KA, Zúñiga TM, Batatinha H, Niemiro GM, Pedlar CR, Burgess SC, Katsanis E, Simpson RJ. Acute exercise increases immune responses to SARS CoV-2 in a previously infected man. Brain Behav Immun Health 2021; 18:100343. [PMID: 34514439 PMCID: PMC8423674 DOI: 10.1016/j.bbih.2021.100343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022] Open
Abstract
Evidence is emerging that exercise and physical activity provides protection against severe COVID-19 disease in patients infected with SARS-CoV-2, but it is not known how exercise affects immune responses to the virus. A healthy man completed a graded cycling ergometer test prior to and after SARS-CoV-2 infection, then again after receiving an adenovirus vector-based COVID-19 vaccine. Using whole blood SARS-CoV-2 peptide stimulation assays, IFN-γ ELISPOT assays, flow cytometry, ex vivo viral-specific T-cell expansion assays and deep T-cell receptor (TCR) β sequencing, we found that exercise robustly mobilized highly functional SARS-CoV-2 specific T-cells to the blood compartment that recognized spike protein, membrane protein, nucleocapsid antigen and the B.1.1.7 α-variant, and consisted mostly of CD3+/CD8+ T-cells and double-negative (CD4-/CD8-) CD3+ T-cells. The magnitude of SARS-CoV-2 T-cell mobilization with exercise was intensity dependent and robust when compared to T-cells recognizing other viruses (e.g. CMV, EBV, influenza). Vaccination enhanced the number of exercise-mobilized SARS-CoV-2 T-cells recognizing spike protein and the α-variant only. Exercise-mobilized SARS-CoV-2 specific T-cells proliferated more vigorously to ex vivo peptide stimulation and maintained broad TCR-β diversity against SARS-CoV-2 antigens both before and after ex vivo expansion. Neutralizing antibodies to SARS-CoV-2 were transiently elevated during exercise after both infection and vaccination. Finally, infection was associated with an increased metabolic demand to defined exercise workloads, which was restored to pre-infection levels after vaccination. This case study provides impetus for larger studies to determine if these immune responses to exercise can facilitate viral clearance, ameliorate symptoms of long COVID syndrome, and/or restore functional exercise capacity following SARS-CoV-2 infection.
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Affiliation(s)
- Forrest L. Baker
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Kyle A. Smith
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Tiffany M. Zúñiga
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Helena Batatinha
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
| | - Grace M. Niemiro
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
| | - Charles R. Pedlar
- Faculty of Sport, Health and Applied Performance Science, St. Mary's University, London, United Kingdom
| | - Shane C. Burgess
- Department of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
- Department of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Pathology, University of Arizona, Tucson, AZ, United States
| | - Richard J. Simpson
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ, USA
- Department of Pediatrics, University of Arizona, Tucson, AZ, USA
- The University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Immunobiology, University of Arizona, Tucson, AZ, United States
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138
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Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, Martínez-Cava A, Courel-Ibáñez J. Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome. J Clin Med 2021; 10:jcm10225434. [PMID: 34830716 PMCID: PMC8617992 DOI: 10.3390/jcm10225434] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/15/2022] Open
Abstract
Patients recovering from COVID-19 commonly report persistence of dyspnea, exertional fatigue, and difficulties in carrying out their daily activities. However, the nature of these symptoms is still unknown. The purpose of the study was to identify limiting causes of cardiopulmonary origin for the performance of physical exercise in post-COVID-19 condition that could explain the symptomatic persistence of dyspnea or fatigue-related symptoms. Thirty-two non-hospitalized patients with post-COVID-19 condition (i.e., still presenting a chronic symptomatic phase lasting >90 days since debut of symptoms that lasted for at least 2 months and cannot be explained by an alternative diagnosis) completed a clinical examination including echocardiography, submaximal and maximal cardiorespiratory fitness tests (Ekblom-Bak and Bruce’s protocols), and a battery of validated questionnaires about fatigue and exercise intolerance. Four participants (12.5%) reported an abnormal cardiac response to exercise during the submaximal test, which aroused suspicion of the presence of chronotropic incompetence. All of them were confirmed with a positive diagnosis maximal exercise test after cardiology screening, even with a comprehensive clinical examination, resting ECG, and echocardiogram, without other findings. No statistical differences were found in any physiological variables or questionnaire values, between patients with positive and negative diagnoses. Chronotropic incompetence and other autonomic disorders may appear in patients with mild forms of COVID-19 presentation and may persist in the long term, being responsible for exercise intolerance after resolution of acute infection. Clinicians should be aware that chronotropic incompetence and other autonomic disorders may be a complication of COVID-19 and should consider appropriate diagnostic and therapeutic interventions in these patients, especially when early exercise-related fatigability is reported.
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Affiliation(s)
- Amaya Jimeno-Almazán
- Department of Infectious Diseases, Hospital Universitario Santa Lucía, Cartagena, 30202 Murcia, Spain;
- Human Performance & Sport Sciences Laboratory, University of Murcia, 30720 Murcia, Spain; (J.G.P.); (Á.B.-R.); (A.M.-C.)
| | - Jesús G. Pallarés
- Human Performance & Sport Sciences Laboratory, University of Murcia, 30720 Murcia, Spain; (J.G.P.); (Á.B.-R.); (A.M.-C.)
| | - Ángel Buendía-Romero
- Human Performance & Sport Sciences Laboratory, University of Murcia, 30720 Murcia, Spain; (J.G.P.); (Á.B.-R.); (A.M.-C.)
| | - Alejandro Martínez-Cava
- Human Performance & Sport Sciences Laboratory, University of Murcia, 30720 Murcia, Spain; (J.G.P.); (Á.B.-R.); (A.M.-C.)
| | - Javier Courel-Ibáñez
- Human Performance & Sport Sciences Laboratory, University of Murcia, 30720 Murcia, Spain; (J.G.P.); (Á.B.-R.); (A.M.-C.)
- Correspondence:
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139
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Abstract
BACKGROUND AND AIMS Post Covid-19 syndrome (PCS) is a major cause of morbidity. In this article we intend to review the association and consequences of PCS and diabetes. METHODS We reviewed all studies on "Long Covid", "Post COVID-19 Syndrome" and diabetes in PubMed and Google Scholar. RESULTS The symptoms of PCS can be due to organ dysfunction, effects of hospitalisation and drugs, or unrelated to these. Type 2 diabetes mellitus has a bidirectional relationship with COVID-19. Presence of diabetes also influences PCS via various pathophysiological mechanisms. COVID-19 can add to or exacerbate tachycardia, sarcopenia (and muscle fatigue), and microvascular dysfunction (and organ damage) in patients with diabetes. CONCLUSION PCS in patients with diabetes could be detrimental in multiple ways. Strict control of diabetes and other comorbidities, supervised rehabilitation and physical exercise, and optimal nutrition could help in reducing and managing PCS.
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Affiliation(s)
- A V Raveendran
- Specialist in Internal Medicine, Badr Al Samaa, Barka, Oman
| | - Anoop Misra
- National-Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, 110016, India; Diabetes Foundation (India), New Delhi 110016, India; Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, B 16, Chirag Enclave, New Delhi, India.
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