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Natarajan A, Su HW, Heneghan C. Occurrence of Relative Bradycardia and Relative Tachycardia in Individuals Diagnosed With COVID-19. Front Physiol 2022; 13:898251. [PMID: 35620612 PMCID: PMC9127385 DOI: 10.3389/fphys.2022.898251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/08/2022] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become one of the worst global pandemics of the century. Wearable devices are well suited for continuously measuring heart rate. Here we show that the Resting Heart Rate is modified for several weeks following a COVID-19 infection. The Resting Heart Rate shows 3 phases: 1) elevated during symptom onset, with average peak increases relative to the baseline of 1.8% (3.4%) for females (males), 2) decrease thereafter, reaching a minimum on average ≈13 days after symptom onset, and 3) subsequent increase, reaching a second peak on average ≈28 days from symptom onset, before falling back to the baseline ≈112 days from symptom onset. All estimates vary with disease severity1.
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352
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The Pathophysiology of Long COVID throughout the Renin-Angiotensin System. Molecules 2022; 27:molecules27092903. [PMID: 35566253 PMCID: PMC9101946 DOI: 10.3390/molecules27092903] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has expanded across the world since its discovery in Wuhan (China) and has had a significant impact on people’s lives and health. Long COVID is a term coined by the World Health Organization (WHO) to describe a variety of persistent symptoms after acute SARS-CoV-2 infection. Long COVID has been demonstrated to affect various SARS-CoV-2-infected persons, independently of the acute disease severity. The symptoms of long COVID, like acute COVID-19, consist in the set of damage to various organs and systems such as the respiratory, cardiovascular, neurological, endocrine, urinary, and immune systems. Fatigue, dyspnea, cardiac abnormalities, cognitive and attention impairments, sleep disturbances, post-traumatic stress disorder, muscle pain, concentration problems, and headache were all reported as symptoms of long COVID. At the molecular level, the renin-angiotensin system (RAS) is heavily involved in the pathogenesis of this illness, much as it is in the acute phase of the viral infection. In this review, we summarize the impact of long COVID on several organs and tissues, with a special focus on the significance of the RAS in the disease pathogenesis. Long COVID risk factors and potential therapy approaches are also explored.
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353
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Akbari N, Ostadrahimi A, Tutunchi H, Pourmoradian S, Farrin N, Najafipour F, Soleimanzadeh H, Kafil B, Mobasseri M. Possible therapeutic effects of boron citrate and oleoylethanolamide supplementation in patients with COVID-19: A pilot randomized, double-blind, clinical trial. J Trace Elem Med Biol 2022; 71:126945. [PMID: 35183882 PMCID: PMC8837486 DOI: 10.1016/j.jtemb.2022.126945] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/29/2022] [Accepted: 02/08/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND The present study aimed to assess the therapeutic effects of boron citrate and oleoylethanolamide supplementation in patients with COVID-19. METHODS Forty adult patients with a diagnosis of COVID-19 were recruited in the present study. Patients were randomized in a 1:1:1:1 allocation ratio to 1of 4 treatment groups: (A) 5 mg of boron citrate twice a day, (B) 200 mg of oleoylethanolamide twice a day, (C) both therapies, or (D) routine treatments without any study medications. At pre-and post-intervention phase, some clinical and biochemical parameters were assessed. RESULTS Supplementation with boron citrate alone or in combination with oleoylethanolamide significantly improved O2 saturation and respiratory rate (p < 0.01). At the end of the study, significant increases in white blood cell and lymphocyte count were observed in the boron citrate and combined groups (p < 0.001). Boron citrate supplementation led to a significant decrease in serum lactate dehydrogenase (p = 0.026) and erythrocyte sedimentation rate (p = 0.014), compared with other groups. Furthermore, boron citrate in combination with oleoylethanolamide resulted in a significant reduction in the high-sensitivity C-reactive protein and interleukin-1β concentrations (p = 0.031 and p = 0.027, respectively). No significant differences were found among four groups post-intervention, in terms of hemoglobin concentrations, platelet count, and serum interleukin-6 levels. At the end of the study, common symptoms of COVID-19 including cough, fatigue, shortness of breath, and myalgia significantly improved in the supplemented groups, compared to the placebo (p < 0.05). CONCLUSION Supplementation with boron citrate alone or in combination with oleoylethanolamide could improve some clinical and biochemical parameters in COVID-19 patients.
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Affiliation(s)
- Neda Akbari
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Helda Tutunchi
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samira Pourmoradian
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazila Farrin
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Najafipour
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Soleimanzadeh
- Department of Applied Chemistry, Faculty of Chemistry, University of Tabriz, Iran
| | - Behnam Kafil
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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354
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Shah A, Bhattad D. Immediate and short-term prevalence of depression in covid-19 patients and its correlation with continued symptoms experience. Indian J Psychiatry 2022; 64:301-306. [PMID: 35859555 PMCID: PMC9290425 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_840_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 infection can result in prolonged illness in those infected irrespective of disease severity. Infectious diseases are associated with a higher risk of mood disorders. A better understanding of convalescence, symptom duration, as well as the prevalence of depression among recovering patients, could help plan better care for the survivors of COVID-19. AIM The study aimed to estimate the immediate and short-term prevalence of major depressive disorder and its correlation with continued symptom experience. METHODS In this non-interventional, observational, and cross-sectional telephone survey study, 273 participants were included from January 2021 to April 2021 and 261 completed follow-up by July 2021. The symptoms at the time of RT-PCR testing and during the two phone calls were captured and the Patient Health Questionnaire 9 item (PHQ-9) version was administered. RESULTS During the immediate and short-term period following COVID-19, 144/261 (55.1%) and 71/261 (27.2%) patients had not returned to usual health, respectively, and 33/261 (12.8%) and 13/261 (5%) of the patients developed depression, respectively. The binary logistic regression analysis revealed that the independent predictors of depression in short-term period following COVID-19 were comorbid diabetes mellitus (OR = 32.99, 95% CI- 2.19-496, P = 0.011), number of symptoms at the time of RT-PCR testing (OR = 1.89, 95% CI 1.23-1.92, P = 0.018), and number of symptoms at short-term period following COVID-19 (OR = 2.85, 95% CI 1.47-5.51, P = 0.002). CONCLUSIONS Individuals with a greater number of symptoms at the time of RT-PCR testing, with post-COVID symptoms persisting 3 months later, and those who have comorbid diabetes mellitus, are at greater odds to have comorbid depression.
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Affiliation(s)
- Ashutosh Shah
- Department of Psychiatry and Internal Medicine, Sir H N Reliance Foundation Hospital, Prathana Samaj, Mumbai, Maharashtra, India
| | - Dhiraj Bhattad
- Department of Psychiatry and Internal Medicine, Sir H N Reliance Foundation Hospital, Prathana Samaj, Mumbai, Maharashtra, India
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355
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Tan L, Ganapathy SS, Chan YM, Alias N, Nasaruddin NH, Khaw WF, Omar A. Estimating the COVID-19 mortality burden over two full years of the pandemic in Malaysia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 22:100456. [PMID: 35493790 PMCID: PMC9042593 DOI: 10.1016/j.lanwpc.2022.100456] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- LeeAnn Tan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | | | - Yee Mang Chan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Nazirah Alias
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Nur Hamizah Nasaruddin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Wan-Fei Khaw
- Institute for Public Health, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health, Selangor, Malaysia
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356
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Llorente BC, López AC, Sánchez RH, Gutiérrez CH. [Diagnostic protocol for chronic manifestations of COVID-19]. Medicine (Baltimore) 2022; 13:3256-3260. [PMID: 35582695 PMCID: PMC9097968 DOI: 10.1016/j.med.2022.05.007] [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] [Indexed: 02/02/2023] Open
Abstract
Many people who have had COVID-19 continue to have symptoms weeks and months after recovering from the acute disease. They present with a highly heterogeneous set of manifestations whose pathophysiology is unknown. There is no uniform nomenclature or agreed-upon diagnostic criteria. One of the main risk factors for its onset is having required intensive care unit admission. The most common manifestations are fatigue and respiratory symptoms, of note among which is dyspnea. The diagnostic approach is focused on ruling out other possible causes that could be responsible for said manifestations. Therefore, a comprehensive evaluation of the patient is conducted followed by a later approach aimed at the nonspecific symptoms.
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357
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Romaszko-Wojtowicz A, Maksymowicz S, Jarynowski A, Jaśkiewicz Ł, Czekaj Ł, Doboszyńska A. Telemonitoring in Long-COVID Patients-Preliminary Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095268. [PMID: 35564663 PMCID: PMC9103243 DOI: 10.3390/ijerph19095268] [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] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has revealed the high usefulness of telemedicine. To date, no uniform recommendations or diagnostic protocols for long-COVID patients have been developed. This article presents the preliminary results of the examination of patients after SARS-CoV-2 infection who were provided with medical telemonitoring devices in order to oversee their pulmonological and cardiological health. Three cases have been analyzed. Each patient underwent a 10-day registration of basic vital signs, in three 15-min sessions daily: RR (respiratory rate), ECG (electrocardiogram), HR (pulse), SPO2 (saturation), body temperature and cough. Rule methods and machine learning were employed to automatically detect events. As a result, serious disorders of all the three patients were detected: cardiological and respiratory disorders that required extended diagnostics. Furthermore, average values of the selected parameters (RR, HR, SPO2) were calculated for every patient, including an indication of how often they exceeded the alarm thresholds. In conclusion, monitoring parameters in patients using telemedicine, especially in a time of limited access to the healthcare system, is a valuable clinical instrument. It enables medical professionals to recognize conditions which may endanger a patient’s health or life. Telemedicine provides a reliable assessment of a patient’s health status made over a distance, which can alleviate a patient’s stress caused by long-COVID syndrome. Telemedicine allows identification of disorders and performing further diagnosis, which is possible owing to the implementation of advanced analysis. Telemedicine, however, requires flexibility and the engagement of a multidisciplinary team, who will respond to patients’ problems on an ongoing basis.
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Affiliation(s)
- Anna Romaszko-Wojtowicz
- Department of Pulmonology, School of Public Health, Collegium Medicum of the University of Warmia and Mazury, ul. Jagiellońska 78, 10-357 Olsztyn, Poland; (A.R.-W.); (A.D.)
| | - Stanisław Maksymowicz
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, Collegium Medicum of the University of Warmia and Mazury, al. Warszawska 30, 10-082 Olsztyn, Poland
- Correspondence:
| | - Andrzej Jarynowski
- Aidmed Sp. z o.o., ul. Uphagena 27, 80-237 Gdańsk, Poland; (A.J.); (Ł.C.)
| | - Łukasz Jaśkiewicz
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum of the University of Warmia and Mazury, al. Warszawska 30, 10-082 Olsztyn, Poland;
| | - Łukasz Czekaj
- Aidmed Sp. z o.o., ul. Uphagena 27, 80-237 Gdańsk, Poland; (A.J.); (Ł.C.)
| | - Anna Doboszyńska
- Department of Pulmonology, School of Public Health, Collegium Medicum of the University of Warmia and Mazury, ul. Jagiellońska 78, 10-357 Olsztyn, Poland; (A.R.-W.); (A.D.)
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358
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Raghavan S, Leo MD. Histamine Potentiates SARS-CoV-2 Spike Protein Entry Into Endothelial Cells. Front Pharmacol 2022; 13:872736. [PMID: 35548336 PMCID: PMC9084361 DOI: 10.3389/fphar.2022.872736] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes coronavirus disease (COVID-19) is one of the most serious global health crises in recent history. COVID-19 patient symptoms range from life-threatening to mild and asymptomatic, which presents unique problems in identifying, quarantining, and treating the affected individuals. The emergence of unusual symptoms among survivors, now referred to as “Long COVID”, is concerning, especially since much about the condition and the treatment of it is still relatively unknown. Evidence so far also suggests that some of these symptoms can be attributed to vascular inflammation. Although famotidine, the commonly used histamine H2 receptor (H2R) blocker, was shown to have no antiviral activity, recent reports indicate that it could prevent adverse outcomes in COVID-19 patients. Histamine is a classic proinflammatory mediator, the levels of which increase along with other cytokines during COVID-19 infection. Histamine activates H2R signaling, while famotidine specifically blocks H2R activation. Investigating the effects of recombinant SARS-CoV-2 spike protein S1 Receptor-Binding Domain (Spike) on ACE2 expression in cultured human coronary artery endothelial cells, we found that the presence of histamine potentiated spike-mediated ACE2 internalization into endothelial cells. This effect was blocked by famotidine, protein kinase A inhibition, or by H2 receptor protein knockdown. Together, these results indicate that histamine and histamine receptor signaling is likely essential for spike protein to induce ACE2 internalization in endothelial cells and cause endothelial dysfunction and that this effect can be blocked by the H2R blocker, famotidine.
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359
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Akbari HA, Yoosefi M, Pourabbas M, Weiss K, Knechtle B, Vancini RL, Trakada G, Ben Saad H, Lavie CJ, Ghram A. Association of Ramadan Participation with Psychological Parameters: A Cross-Sectional Study during the COVID-19 Pandemic in Iran. J Clin Med 2022; 11:jcm11092346. [PMID: 35566470 PMCID: PMC9103718 DOI: 10.3390/jcm11092346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023] Open
Abstract
COVID-19 restrictions are associated with poor physical-activity (PA). Less is known about the relationship between the combination of these restrictions with Ramadan intermittent fasting (RIF), PA, mental health, and sleep-quality. The present study aimed to evaluate whether COVID-19 restrictions and RIF during the fourth wave of the COVID-19 pandemic in Iran are associated with poor PA, anxiety, well-being, and sleep-quality outcomes. A total of 510 individuals participated in an online questionnaire that was disseminated to adults (≥18 years) residing in Iran from 13 May 2021 to 16 May 2021 (~3 days), just after the end of Ramadan 2021. PA behavior (Godin-Shephard Leisure-Time Exercise Questionnaire), anxiety (General Anxiety Disorder-7), well-being (Mental Health Continuum-Short Form), and sleep-quality (Pittsburgh Sleep Quality Index). Of 510 individuals included in the study (331 female (64.9%); mean ± SD, 31 ± 12 years), 172 (33.7%) reported less PA during the Ramadan 2021. PA was associated with better well-being and sleep-quality outcomes. Regardless of PA, participants who fasted for all of Ramadan had less anxiety and better well-being outcomes than those who fasted part of Ramadan or did not fast at all. However, the fasting part of Ramadan decreased the sleep-quality of active participants. The Ramadan 2021 was associated with poor PA, well-being, and sleep-quality of Iranians. However, PA was associated with better well-being and sleep-quality outcomes, and those who fasted all Ramadan had better anxiety and well-being outcomes. Therefore, PA during Ramadan might be an essential and scalable mental health resilience builder during COVID-19 restrictions which should be encouraged.
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Affiliation(s)
- Hesam Addin Akbari
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
| | - Mohammad Yoosefi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
| | - Maryam Pourabbas
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
| | - Katja Weiss
- Medbase St. Gallen Am Vadianplatz, 9100 St. Gallen, Switzerland; (K.W.); (B.K.)
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, 9100 St. Gallen, Switzerland; (K.W.); (B.K.)
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Vitória 29075-910, Brazil;
| | - Georgia Trakada
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, 115 28 Athens, Greece;
| | - Helmi Ben Saad
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse 4054, Tunisia;
| | - Carl J. Lavie
- Healthy Living for Pandemic Event Protection (HL—PIVOT) Network, Chicago, IL 60612, USA;
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA
| | - Amine Ghram
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
- Healthy Living for Pandemic Event Protection (HL—PIVOT) Network, Chicago, IL 60612, USA;
- Correspondence:
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360
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The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study. J Clin Med 2022; 11:jcm11082219. [PMID: 35456309 PMCID: PMC9025013 DOI: 10.3390/jcm11082219] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 01/27/2023] Open
Abstract
Myocarditis and pericarditis are potential post-acute cardiac sequelae of COVID-19 infection, arising from adaptive immune responses. We aimed to study the incidence of post-acute COVID-19 myocarditis and pericarditis. Retrospective cohort study of 196,992 adults after COVID-19 infection in Clalit Health Services members in Israel between March 2020 and January 2021. Inpatient myocarditis and pericarditis diagnoses were retrieved from day 10 after positive PCR. Follow-up was censored on 28 February 2021, with minimum observation of 18 days. The control cohort of 590,976 adults with at least one negative PCR and no positive PCR were age- and sex-matched. Since the Israeli vaccination program was initiated on 20 December 2020, the time-period matching of the control cohort was calculated backward from 15 December 2020. Nine post-COVID-19 patients developed myocarditis (0.0046%), and eleven patients were diagnosed with pericarditis (0.0056%). In the control cohort, 27 patients had myocarditis (0.0046%) and 52 had pericarditis (0.0088%). Age (adjusted hazard ratio [aHR] 0.96, 95% confidence interval [CI]; 0.93 to 1.00) and male sex (aHR 4.42; 95% CI, 1.64 to 11.96) were associated with myocarditis. Male sex (aHR 1.93; 95% CI 1.09 to 3.41) and peripheral vascular disease (aHR 4.20; 95% CI 1.50 to 11.72) were associated with pericarditis. Post COVID-19 infection was not associated with either myocarditis (aHR 1.08; 95% CI 0.45 to 2.56) or pericarditis (aHR 0.53; 95% CI 0.25 to 1.13). We did not observe an increased incidence of neither pericarditis nor myocarditis in adult patients recovering from COVID-19 infection.
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361
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Soejima Y, Otsuka Y, Tokumasu K, Nakano Y, Harada K, Nakamoto K, Sunada N, Sakurada Y, Hasegawa K, Hagiya H, Ueda K, Otsuka F. Late-Onset Hypogonadism in a Male Patient with Long COVID Diagnosed by Exclusion of ME/CFS. Medicina (B Aires) 2022; 58:medicina58040536. [PMID: 35454374 PMCID: PMC9025899 DOI: 10.3390/medicina58040536] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
After the acute phase of COVID-19, some patients have been reported to have persistent symptoms including general fatigue. We have established a COVID-19 aftercare clinic (CAC) to provide care for an increasing number of these patients. Here, we report the case of a 36-year-old man who developed post-COVID fatigue after acute infection with SARS-CoV-2. In the acute phase of COVID-19, the patient’s fever resolved within four days; however, general fatigue persisted for three months, and he visited our CAC 99 days after the initial infection. Examination revealed a high Aging Male’s Symptoms (AMS) score of 44 and low free testosterone (FT) level of 5.5 pg/mL, which meet the Japanese criteria of late-onset hypogonadism (LOH) syndrome. Imaging studies revealed an atrophic pituitary in addition to fatty liver and low bone mineral density. Anterior pituitary function tests showed a low follicle-stimulating hormonelevel and delayed reaction of luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation, indicating the possibility of hypothalamic hypogonadism in addition to primary hypogonadism seen in patients with post-COVID-19 conditions. After the initiation of Japanese traditional medicine (Kampo medicine: hochuekkito followed by juzentaihoto), the patient’s symptoms as well as his AMS score and serum FT level were noticeably improved. Furthermore, follow-up tests of GnRH stimulation revealed improvements in LH responsiveness. Although many patients have been reported to meet the criteria of ME/CFS such as our case, we emphasize the possibility of other underlying pathologies including LOH syndrome. In conclusion, LOH syndrome should be considered a cause of general fatigue in patients with post-COVID-19 conditions and herbal treatment might be effective for long COVID symptoms due to LOH (264 words).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Fumio Otsuka
- Correspondence: ; Tel.: +81-86-235-7342; Fax: +81-86-235-7345
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362
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The Post-COVID 19 long term surveillance study sequel to an add-on Ayurveda Regimen. J Ayurveda Integr Med 2022; 13:100575. [PMID: 35400975 PMCID: PMC8983476 DOI: 10.1016/j.jaim.2022.100575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 11/21/2022] Open
Abstract
It has been 18 months now since the world-wide outbreak of COVID 19 (Corona Virus Disease 19) and still the ongoing research is being done for disease specific medicines. During June 2020 to August 2020, an attempt was made to explore if an add-on Ayurveda regimen comprising of Dasamoolkadutrayadi Kashayam and Guluchyadi Kwatham in tablet forms can be prescribed along with standard of care; which has established the clinical evidence that there is advantage of accelerated symptomatic recovery, early discharge from hospital, reducing the duration of hospital stay. After informed consent the patients were followed up over 9 months after discharged from hospital. The purpose of the present extended study was to find the impact of disease even though patients were discharged after appropriate treatment and if there were any late effects in the add-on Ayurveda treatment group after 9 months as it was one of the first few formal studies world-wide; since there was no long term follow up data available. The study concluded that no additional late effects or symptoms or complications which were known in Post COVID phase; were observed in study group who received the add-on Ayurveda regimen as compared to the control group with conventional standard of care.
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363
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Exploring Health Trends Prior to State Pension Age for The Netherlands up to 2040. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074209. [PMID: 35409891 PMCID: PMC8998719 DOI: 10.3390/ijerph19074209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND In many Western countries, the state pension age is being raised to stimulate the extension of working lives. It is not yet well understood whether the health of older adults supports this increase. In this study, future health of Dutch adults aged 60 to 68 (i.e., the expected state pension age) is explored up to 2040. METHODS Data are from the Dutch Health Interview Survey 1990-2017 (N ≈ 10,000 yearly) and the Dutch Public Health Monitor 2016 (N = 205,151). Health is operationalized using combined scores of self-reported health and limitations in mobility, hearing or seeing. Categories are: good, moderate and poor health. Based on historical health trends, two scenarios are explored: a stable health trend (neither improving nor declining) and an improving health trend. RESULTS In 2040, the health distribution among men aged 60-68 is estimated to be 63-71% in good, 17-28% in moderate and 9-12% in poor health. Among women, this is estimated to be 64-69%, 17-24% and 12-14%, respectively. CONCLUSIONS This study's explorations suggest that a substantial share of people will be in moderate or poor health and, thus, may have difficulty continuing working. Policy aiming at sustainable employability will, therefore, remain important, even in the case of the most favorable scenario.
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Hollenberg MD, Epstein M. The innate immune response, microenvironment proteinases, and the COVID-19 pandemic: pathophysiologic mechanisms and emerging therapeutic targets. Kidney Int Suppl (2011) 2022; 12:48-62. [PMID: 35316977 PMCID: PMC8931295 DOI: 10.1016/j.kisu.2021.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/19/2021] [Accepted: 12/11/2021] [Indexed: 12/13/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, causing considerable mortality and morbidity worldwide, has fully engaged the biomedical community in attempts to elucidate the pathophysiology of COVID-19 and develop robust therapeutic strategies. To this end, the predominant research focus has been on the adaptive immune response to COVID-19 infections stimulated by mRNA and protein vaccines and on the duration and persistence of immune protection. In contrast, the role of the innate immune response to the viral challenge has been underrepresented. This overview focuses on the innate immune response to COVID-19 infection, with an emphasis on the roles of extracellular proteases in the tissue microenvironment. Proteinase-mediated signaling caused by enzymes in the extracellular microenvironment occurs upstream of the increased production of inflammatory cytokines that mediate COVID-19 pathology. These enzymes include the coagulation cascade, kinin-generating plasma kallikrein, and the complement system, as well as angiotensin-generating proteinases of the renin–angiotensin system. Furthermore, in the context of several articles in this Supplement elucidating and detailing the trajectory of diverse profibrotic pathways, we extrapolate these insights to explore how fibrosis and profibrotic pathways participate importantly in the pathogenesis of COVID-19. We propose that the lessons garnered from understanding the roles of microenvironment proteinases in triggering the innate immune response to COVID-19 pathology will identify potential therapeutic targets and inform approaches to the clinical management of COVID-19. Furthermore, the information may also provide a template for understanding the determinants of COVID-19–induced tissue fibrosis that may follow resolution of acute infection (so-called “long COVID”), which represents a major new challenge to our healthcare systems.
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Affiliation(s)
- Morley D. Hollenberg
- Inflammation Research Network–Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Murray Epstein
- Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, Florida, USA
- Correspondence: Murray Epstein, Division of Nephrology and Hypertension, P.O. Box 016960 (R-126), Miami, Florida 33101 USA.
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365
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Yamamoto Y, Otsuka Y, Sunada N, Tokumasu K, Nakano Y, Honda H, Sakurada Y, Hagiya H, Hanayama Y, Otsuka F. Detection of Male Hypogonadism in Patients with Post COVID-19 Condition. J Clin Med 2022; 11:jcm11071955. [PMID: 35407562 PMCID: PMC8999458 DOI: 10.3390/jcm11071955] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023] Open
Abstract
The pathogenesis and prognosis of post COVID-19 condition have remained unclear. We set up an outpatient clinic specializing in long COVID in February 2021 and we have been investigating post COVID-19 condition. Based on the results of our earlier study showing that “general fatigue” mimicking myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is the most common symptom in long COVID patients, a retrospective analysis was performed for 39 male patients in whom serum free testosterone (FT) levels were measured out of 61 male patients who visited our clinic. We analyzed the medical records of the patients’ backgrounds, symptoms and laboratory results. Among the 39 patients, 19 patients (48.7%) met the criteria for late-onset hypogonadism (LOH; FT < 8.5 pg/mL: LOH group) and 14 patients were under 50 years of age. A weak negative correlation was found between age and serum FT level (r = −0.301, p = 0.0624). Symptoms including general fatigue, anxiety, cough and hair loss were more frequent in the LOH group than in the non-LOH group (FT ≥ 8.5 pg/mL). Among various laboratory parameters, blood hemoglobin level was slightly, but significantly, lower in the LOH group. Serum level of FT was positively correlated with the levels of blood hemoglobin and serum total protein and albumin in the total population, whereas these interrelationships were blurred in the LOH group. Collectively, the results indicate that the incidence of LOH is relatively high in male patients, even young male patients, with post COVID-19 and that serum FT measurement is useful for revealing occult LOH status in patients with long COVID.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Fumio Otsuka
- Correspondence: ; Tel.: +81-86-235-7342; Fax: +81-86-235-7345
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366
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Boaventura P, Macedo S, Ribeiro F, Jaconiano S, Soares P. Post-COVID-19 Condition: Where Are We Now? Life (Basel) 2022; 12:life12040517. [PMID: 35455008 PMCID: PMC9029703 DOI: 10.3390/life12040517] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 02/06/2023] Open
Abstract
COVID-19 is currently considered a systemic infection involving multiple systems and causing chronic complications. Compared to other post-viral fatigue syndromes, these complications are wider and more intense. The most frequent symptoms are profound fatigue, dyspnea, sleep difficulties, anxiety or depression, reduced lung capacity, memory/cognitive impairment, and hyposmia/anosmia. Risk factors for this condition are severity of illness, more than five symptoms in the first week of the disease, female sex, older age, the presence of comorbidities, and a weak anti-SARS-CoV-2 antibody response. Different lines of research have attempted to explain these protracted symptoms; chronic persistent inflammation, autonomic nervous system disruption, hypometabolism, and autoimmunity may play a role. Due to thyroid high ACE expression, the key molecular complex SARS-CoV-2 uses to infect the host cells, thyroid may be a target for the coronavirus infection. Thyroid dysfunction after SARS-CoV-2 infection may be a combination of numerous mechanisms, and its role in long-COVID manifestations is not yet established. The proposed mechanisms are a direct effect of SARS-CoV-2 on target cells, an indirect effect of systemic inflammatory immune response, and a dysfunction of the hypothalamic-pituitary-thyroid (HPT) axis leading to decreased serum TSH. Only a few studies have reported the thyroid gland status in the post-COVID-19 condition. The presence of post-COVID symptoms deserves recognition of COVID-19 as a cause of post-viral fatigue syndrome. It is important to recognize the affected individuals at an early stage so we can offer them the most adequate treatments, helping them thrive through the uncertainty of their condition.
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Affiliation(s)
- Paula Boaventura
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal; (S.M.); (F.R.); (P.S.)
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Faculty of Medicine of the University of Porto (FMUP), 4200-319 Porto, Portugal
- Correspondence:
| | - Sofia Macedo
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal; (S.M.); (F.R.); (P.S.)
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Filipa Ribeiro
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal; (S.M.); (F.R.); (P.S.)
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
| | - Sónia Jaconiano
- School of Architecture, Art and Design (EAAD), University of Minho, 4800-058 Guimarães, Portugal;
| | - Paula Soares
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal; (S.M.); (F.R.); (P.S.)
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Faculty of Medicine of the University of Porto (FMUP), 4200-319 Porto, Portugal
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367
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Staffolani S, Iencinella V, Cimatti M, Tavio M. Long COVID-19 syndrome as a fourth phase of SARS-CoV-2 infection. LE INFEZIONI IN MEDICINA 2022; 30:22-29. [PMID: 35350258 DOI: 10.53854/liim-3001-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/22/2022] [Indexed: 01/13/2023]
Abstract
The SARS-CoV-2 pandemic has affected in the last two years a large number of subjects, with a high cost in terms of morbidity and mortality. The scientific community made progress in understanding risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of acute SARS-CoV-2 infection. In the last months, another condition has become evident and caught the attention of the scientific community: the so-called long COVID syndrome. The pathophysiology of this condition is not known, even if some hypothesis have been made but not demonstrated yet. Long COVID is characterized by a very heterogeneous group of subacute and/or chronic symptoms and signs that follow the acute phase of SARS-CoV-2 infection and have a very variable duration. The presence of this syndrome in an individual is not dependent from the severity of the acute SARS-CoV-2 infection. Because of the extreme clinical heterogeneity, and also due to the lack of a shared and specific definition of the disease, it is very difficult to know the real prevalence and incidence of this condition. Some risk factors for the development of the disease have been identified: advanced age, elevated body mass index, comorbidities, specific symptoms of acute COVID-19 (in particular dyspnea), number of symptoms in the acute phase and female sex. The number of individuals affected by long COVID is high, even if it occurs only in a part of the subjects who had COVID-19. Therefore, long COVID constitutes now a major health issue and has to be managed in order to ensure an adequate access to care for all the people that need it. "Post COVID" clinics have been created in various countries, especially in Europe, for the management of people affected by long COVID syndrome. Guidelines have been written to help clinicians. An important role in the management of long COVID patients is played by the general practitioner, directly or indirectly linked to post COVID hospital clinics. The extreme heterogeneity of clinical presentation needs a patient-tailored, multidisciplinary approach. As NHS guidelines say, the three principal of care for long COVID patients are personalized care, multidisciplinary support and rehabilitation. More studies are needed in order to know better the pathophysiology of the disease. It is also necessary to create standardized and shared definitions of the disease, in order to better understand the epidemiology, the diagnostic criteria and to offer the right treatment to all the individuals who need it, without social or economic diffeences.
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Affiliation(s)
- Silvia Staffolani
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - Valentina Iencinella
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - Matteo Cimatti
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
| | - Marcello Tavio
- Gastroenterological and Transplant Department, S.O.D. Malattie Infettive Emergenti e degli Immunodepressi, University Hospital "Ospedali Riuniti", Ancona, Italy
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368
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Galán M, Vigón L, Fuertes D, Murciano-Antón MA, Casado-Fernández G, Domínguez-Mateos S, Mateos E, Ramos-Martín F, Planelles V, Torres M, Rodríguez-Mora S, López-Huertas MR, Coiras M. Persistent Overactive Cytotoxic Immune Response in a Spanish Cohort of Individuals With Long-COVID: Identification of Diagnostic Biomarkers. Front Immunol 2022; 13:848886. [PMID: 35401523 PMCID: PMC8990790 DOI: 10.3389/fimmu.2022.848886] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/25/2022] [Indexed: 12/12/2022] Open
Abstract
Long-COVID is a new emerging syndrome worldwide that is characterized by the persistence of unresolved signs and symptoms of COVID-19 more than 4 weeks after the infection and even after more than 12 weeks. The underlying mechanisms for Long-COVID are still undefined, but a sustained inflammatory response caused by the persistence of SARS-CoV-2 in organ and tissue sanctuaries or resemblance with an autoimmune disease are within the most considered hypotheses. In this study, we analyzed the usefulness of several demographic, clinical, and immunological parameters as diagnostic biomarkers of Long-COVID in one cohort of Spanish individuals who presented signs and symptoms of this syndrome after 49 weeks post-infection, in comparison with individuals who recovered completely in the first 12 weeks after the infection. We determined that individuals with Long-COVID showed significantly increased levels of functional memory cells with high antiviral cytotoxic activity such as CD8+ TEMRA cells, CD8±TCRγδ+ cells, and NK cells with CD56+CD57+NKG2C+ phenotype. The persistence of these long-lasting cytotoxic populations was supported by enhanced levels of CD4+ Tregs and the expression of the exhaustion marker PD-1 on the surface of CD3+ T lymphocytes. With the use of these immune parameters and significant clinical features such as lethargy, pleuritic chest pain, and dermatological injuries, as well as demographic factors such as female gender and O+ blood type, a Random Forest algorithm predicted the assignment of the participants in the Long-COVID group with 100% accuracy. The definition of the most accurate diagnostic biomarkers could be helpful to detect the development of Long-COVID and to improve the clinical management of these patients.
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Affiliation(s)
- Miguel Galán
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Lorena Vigón
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Fuertes
- School of Telecommunications Engineering, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Guiomar Casado-Fernández
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Elena Mateos
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Fernando Ramos-Martín
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Vicente Planelles
- Division of Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Montserrat Torres
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Rodríguez-Mora
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - María Rosa López-Huertas
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Mayte Coiras
- Immunopathology Unit, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Biomedical Research Center Network in Infectious Diseases (CIBERINFEC), Madrid, Spain
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369
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Naseef H, Damin Abukhalil A, Orabi T, Joza M, Mashaala C, Elsheik M, Dababat A, Qattosa M, Al-Shami N. Evaluation of the Health Situation among Recovered Cases of COVID-19 in West Bank, Palestine, and Their Onset/Recovery Time. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022. [DOI: https://doi.org/10.1155/2022/3431014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background and Aims. COVID-19 emerged at the end of 2019 and was classified as a global pandemic in March 2020. Infected cases of SARS-CoV-2 experience symptoms during initial infection 2–14 days after virus exposure, and some symptoms and complications may persist after recovery. This study evaluated the onset/recovery time, postrecovery symptoms, complications, and factors affecting the health situation of recovered cases of COVID-19 in West Bank, Palestine. Methods. This cross-sectional study was conducted using a questionnaire based on related scientific articles and expert recommendations. It was distributed to recovered COVID-19 patients either face-to-face or online. Chi-square and Fisher’s exact tests were used to investigate the significant relationships. The data were analyzed using SPSS version 22. Findings. A total of 686 participants completed the questionnaire; the mean age was 28·1 ± 11·8. SARS-CoV-2 infection recovery time was 1–2 weeks in most participants. A total of 72·4% developed post-COVID-19 symptoms. Fatigue (260, 38.0%), loss of smell (224, 32.7%), headache (207, 30.7%), and joint pain (188, 27.4%) were the most reported postrecovery symptoms. In women, fatigue and headaches were the most common symptoms that persisted after recovery. Diabetic patients endured continuous muscle and joint pain. Interpretation. Patient health situation, recovery time, and symptoms post-COVID-19 infections are affected by many demographic factors and disease status.
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Affiliation(s)
- Hani Naseef
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Abdallah Damin Abukhalil
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Tala Orabi
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Mohammad Joza
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Carmen Mashaala
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Malak Elsheik
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Aseel Dababat
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Maram Qattosa
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
| | - Ni'Meh Al-Shami
- Department of Pharmacy, Nursing and Health Professions, Birzeit University, West Bank, State of Palestine
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370
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Evaluation of the Health Situation among Recovered Cases of COVID-19 in West Bank, Palestine, and Their Onset/Recovery Time. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:3431014. [PMID: 35342434 PMCID: PMC8944917 DOI: 10.1155/2022/3431014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/10/2022] [Accepted: 02/07/2022] [Indexed: 02/05/2023]
Abstract
Background and Aims COVID-19 emerged at the end of 2019 and was classified as a global pandemic in March 2020. Infected cases of SARS-CoV-2 experience symptoms during initial infection 2–14 days after virus exposure, and some symptoms and complications may persist after recovery. This study evaluated the onset/recovery time, postrecovery symptoms, complications, and factors affecting the health situation of recovered cases of COVID-19 in West Bank, Palestine. Methods This cross-sectional study was conducted using a questionnaire based on related scientific articles and expert recommendations. It was distributed to recovered COVID-19 patients either face-to-face or online. Chi-square and Fisher's exact tests were used to investigate the significant relationships. The data were analyzed using SPSS version 22. Findings. A total of 686 participants completed the questionnaire; the mean age was 28·1 ± 11·8. SARS-CoV-2 infection recovery time was 1–2 weeks in most participants. A total of 72·4% developed post-COVID-19 symptoms. Fatigue (260, 38.0%), loss of smell (224, 32.7%), headache (207, 30.7%), and joint pain (188, 27.4%) were the most reported postrecovery symptoms. In women, fatigue and headaches were the most common symptoms that persisted after recovery. Diabetic patients endured continuous muscle and joint pain. Interpretation. Patient health situation, recovery time, and symptoms post-COVID-19 infections are affected by many demographic factors and disease status.
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371
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Hamazaki K, Nishigaki T, Kuramoto N, Oh K, Konishi H. Secondary Adrenal Insufficiency After COVID-19 Diagnosed by Insulin Tolerance Test and Corticotropin-Releasing Hormone Test. Cureus 2022; 14:e23021. [PMID: 35281581 PMCID: PMC8908067 DOI: 10.7759/cureus.23021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/05/2022] Open
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372
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Asaba E, Sy M, Pineda RC, Aldrich R, Anzai T, Bontje P, Bratun U, Farias L, Kapanadze M, Šuc L, Åkesson E. Return to work after COVID-19: an international perspective. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2022. [DOI: 10.1080/14473828.2022.2045819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Eric Asaba
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Unit for Research, Education, Development, & Innovation, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Michael Sy
- National Teacher Training Center for the Health Professions, University of the Philippines Manilla, Manila, Philippines
| | - Roi Charles Pineda
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Rebecca Aldrich
- Herman Ostrow School of Dentistry, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Tetsuya Anzai
- Faculty of Health Sciences, Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Peter Bontje
- Faculty of Health Sciences, Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Urša Bratun
- Faculty of Health Sciences, Department of Occupational Therapy, University of Ljubljana, Ljubljana, Slovenia
| | - Lisette Farias
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Maria Kapanadze
- Department of Occupational Therapy, University School of Nursing and Occupational Therapy of Terrassa (EUIT), Autonomous University of Barcelona, Barcelona, Spain
| | - Lea Šuc
- Department of Occupational Therapy, University Rehabilitation Institute Republic of Slovenia, Ljubljana, Slovenia
| | - Elisabet Åkesson
- Unit for Research, Education, Development, & Innovation, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
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373
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Aryanian Z, Balighi K, Hatami P, Afshar ZM, Mohandesi NA. The role of SARS-CoV-2 infection and its vaccines in various types of hair loss. Dermatol Ther 2022; 35:e15433. [PMID: 35266262 PMCID: PMC9111640 DOI: 10.1111/dth.15433] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022]
Abstract
The prevalence of hair loss has increased during COVID‐19. In this study, we review the current literature on incidence and characteristics of various types of COVID‐19‐related and COVID‐19‐vaccine‐ related hair loss including telogen effluvium, alopecia areata, friction alopecia and anagen effluvium. Regarding most of them, the more severe the infection, the more profound and prolonged the course of alopecia. However, the most important issue is reassuring the patients of the non‐serious nature of this complication, since psychological support is the most important factor in the earlier resolution of the condition.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, School of Medicine Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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374
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Rovetta A, Bhagavathula AS. The Effects of COVID-19 First Waves in Italy: An Answer Through a Retrospective Analysis of Mortality. JMIR Public Health Surveill 2022; 8:e36022. [PMID: 35238784 PMCID: PMC8993143 DOI: 10.2196/36022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 02/06/2023] Open
Abstract
Background Despite the available evidence on its severity, COVID-19 has often been compared with seasonal flu by some conspirators and even scientists. Various public discussions arose about the noncausal correlation between COVID-19 and the observed deaths during the pandemic period in Italy. Objective This paper aimed to search for endogenous reasons for the mortality increase recorded in Italy during 2020 to test this controversial hypothesis. Furthermore, we provide a framework for epidemiological analyses of time series. Methods We analyzed deaths by age, sex, region, and cause of death in Italy from 2011 to 2019. Ordinary least squares (OLS) linear regression analyses and autoregressive integrated moving average (ARIMA) were used to predict the best value for 2020. A Grubbs 1-sided test was used to assess the significance of the difference between predicted and observed 2020 deaths/mortality. Finally, a 1-sample t test was used to compare the population of regional excess deaths to a null mean. The relationship between mortality and predictive variables was assessed using OLS multiple regression models. Since there is no uniform opinion on multicomparison adjustment and false negatives imply great epidemiological risk, the less-conservative Siegel approach and more-conservative Holm-Bonferroni approach were employed. By doing so, we provided the reader with the means to carry out an independent analysis. Results Both ARIMA and OLS linear regression models predicted the number of deaths in Italy during 2020 to be between 640,000 and 660,000 (range of 95% CIs: 620,000-695,000) against the observed value of above 750,000. We found strong evidence supporting that the death increase in all regions (average excess=12.2%) was not due to chance (t21=7.2; adjusted P<.001). Male and female national mortality excesses were 18.4% (P<.001; adjusted P=.006) and 14.1% (P=.005; adjusted P=.12), respectively. However, we found limited significance when comparing male and female mortality residuals’ using the Mann-Whitney U test (P=.27; adjusted P=.99). Finally, mortality was strongly and positively correlated with latitude (R=0.82; adjusted P<.001). In this regard, the significance of the mortality increases during 2020 varied greatly from region to region. Lombardy recorded the highest mortality increase (38% for men, adjusted P<.001; 31% for women, P<.001; adjusted P=.006). Conclusions Our findings support the absence of historical endogenous reasons capable of justifying the mortality increase observed in Italy during 2020. Together with the current knowledge on SARS-CoV-2, these results provide decisive evidence on the devastating impact of COVID-19. We suggest that this research be leveraged by government, health, and information authorities to furnish proof against conspiracy hypotheses that minimize COVID-19–related risks. Finally, given the marked concordance between ARIMA and OLS regression, we suggest that these models be exploited for public health surveillance. Specifically, meaningful information can be deduced by comparing predicted and observed epidemiological trends.
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Affiliation(s)
| | - Akshaya Srikanth Bhagavathula
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, AE, AE
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375
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Su Y, Yuan D, Chen DG, Ng RH, Wang K, Choi J, Li S, Hong S, Zhang R, Xie J, Kornilov SA, Scherler K, Pavlovitch-Bedzyk AJ, Dong S, Lausted C, Lee I, Fallen S, Dai CL, Baloni P, Smith B, Duvvuri VR, Anderson KG, Li J, Yang F, Duncombe CJ, McCulloch DJ, Rostomily C, Troisch P, Zhou J, Mackay S, DeGottardi Q, May DH, Taniguchi R, Gittelman RM, Klinger M, Snyder TM, Roper R, Wojciechowska G, Murray K, Edmark R, Evans S, Jones L, Zhou Y, Rowen L, Liu R, Chour W, Algren HA, Berrington WR, Wallick JA, Cochran RA, Micikas ME, Wrin T, Petropoulos CJ, Cole HR, Fischer TD, Wei W, Hoon DSB, Price ND, Subramanian N, Hill JA, Hadlock J, Magis AT, Ribas A, Lanier LL, Boyd SD, Bluestone JA, Chu H, Hood L, Gottardo R, Greenberg PD, Davis MM, Goldman JD, Heath JR. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 2022; 185:881-895.e20. [PMID: 35216672 PMCID: PMC8786632 DOI: 10.1016/j.cell.2022.01.014] [Citation(s) in RCA: 545] [Impact Index Per Article: 272.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/14/2021] [Accepted: 01/19/2022] [Indexed: 01/14/2023]
Abstract
Post-acute sequelae of COVID-19 (PASC) represent an emerging global crisis. However, quantifiable risk factors for PASC and their biological associations are poorly resolved. We executed a deep multi-omic, longitudinal investigation of 309 COVID-19 patients from initial diagnosis to convalescence (2-3 months later), integrated with clinical data and patient-reported symptoms. We resolved four PASC-anticipating risk factors at the time of initial COVID-19 diagnosis: type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific auto-antibodies. In patients with gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics during recovery from COVID-19. Analysis of symptom-associated immunological signatures revealed coordinated immunity polarization into four endotypes, exhibiting divergent acute severity and PASC. We find that immunological associations between PASC factors diminish over time, leading to distinct convalescent immune states. Detectability of most PASC factors at COVID-19 diagnosis emphasizes the importance of early disease measurements for understanding emergent chronic conditions and suggests PASC treatment strategies.
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Affiliation(s)
- Yapeng Su
- Institute for Systems Biology, Seattle, WA 98109, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Clinical Research Division, Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
| | - Dan Yuan
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Daniel G Chen
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Microbiology and Department of Informatics, University of Washington, Seattle, WA 98195, USA
| | - Rachel H Ng
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Kai Wang
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Jongchan Choi
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Sarah Li
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Sunga Hong
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Rongyu Zhang
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Jingyi Xie
- Institute for Systems Biology, Seattle, WA 98109, USA; Molecular Engineering & Sciences Institute, University of Washington, Seattle, WA 98105, USA
| | | | | | - Ana Jimena Pavlovitch-Bedzyk
- Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Shen Dong
- Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | | | - Inyoul Lee
- Institute for Systems Biology, Seattle, WA 98109, USA
| | | | | | | | - Brett Smith
- Institute for Systems Biology, Seattle, WA 98109, USA
| | | | - Kristin G Anderson
- Clinical Research Division, Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Departments of Immunology and Medicine, University of Washington, Seattle, WA 98109, USA
| | - Jing Li
- Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Fan Yang
- Department of Pathology, Stanford University, Stanford, CA 94304, USA
| | | | - Denise J McCulloch
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA
| | | | | | - Jing Zhou
- Isoplexis Corporation, Branford, CT 06405, USA
| | - Sean Mackay
- Isoplexis Corporation, Branford, CT 06405, USA
| | | | - Damon H May
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | | | - Mark Klinger
- Adaptive Biotechnologies, Seattle, WA 98109, USA
| | | | - Ryan Roper
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Gladys Wojciechowska
- Institute for Systems Biology, Seattle, WA 98109, USA; Medical University of Białystok, Białystok 15089, Poland
| | - Kim Murray
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Rick Edmark
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Simon Evans
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Lesley Jones
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Yong Zhou
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Lee Rowen
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Rachel Liu
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - William Chour
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Heather A Algren
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA
| | - William R Berrington
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA
| | - Julie A Wallick
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA
| | - Rebecca A Cochran
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA
| | - Mary E Micikas
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA
| | - Terri Wrin
- Monogram Biosciences, South San Francisco, CA 94080, USA
| | | | - Hunter R Cole
- St. John's Cancer Institute at Saint John's Health Center, Santa Monica, CA 90404, USA
| | - Trevan D Fischer
- St. John's Cancer Institute at Saint John's Health Center, Santa Monica, CA 90404, USA
| | - Wei Wei
- Institute for Systems Biology, Seattle, WA 98109, USA
| | - Dave S B Hoon
- St. John's Cancer Institute at Saint John's Health Center, Santa Monica, CA 90404, USA
| | | | - Naeha Subramanian
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Global Heath and Department of Immunology, University of Washington, Seattle, WA 98109, USA
| | - Joshua A Hill
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA
| | | | | | - Antoni Ribas
- Department of Medicine, University of California, Los Angeles, and Parker Institute for Cancer Immunotherapy, Los Angeles, CA 90095, USA
| | - Lewis L Lanier
- Department of Microbiology and Immunology, University of California, San Francisco, and Parker Institute for Cancer Immunotherapy, San Francisco, CA 94143, USA
| | - Scott D Boyd
- Department of Pathology, Stanford University, Stanford, CA 94304, USA
| | - Jeffrey A Bluestone
- Diabetes Center, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Helen Chu
- Division of Global Health, University of Washington, Seattle, WA 98105, USA; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA
| | - Raphael Gottardo
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Department of Statistics, University of Washington, Seattle, WA 98195, USA; Biomedical Data Sciences, Lausanne University Hospital, University of Lausanne, Lausanne, 1011, Switzerland
| | - Philip D Greenberg
- Clinical Research Division, Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Departments of Immunology and Medicine, University of Washington, Seattle, WA 98109, USA
| | - Mark M Davis
- Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA; The Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jason D Goldman
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98109, USA; Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA 98109, USA; Providence St. Joseph Health, Renton, WA 98057, USA.
| | - James R Heath
- Institute for Systems Biology, Seattle, WA 98109, USA; Department of Bioengineering, University of Washington, Seattle, WA 98105, USA.
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Abstract
ABSTRACT Coronavirus disease (COVID) has become a global pandemic that has widely impacted athletes at all levels of competition. For many athletes infected with COVID, the course is mild or asymptomatic, and most athletes are able to return to play in a matter of weeks. However, 10% to 15% of people infected with COVID will go on to have prolonged COVID symptoms that last for weeks to months and impact their ability to function and exercise. Not much is known about why certain people become "COVID long-haulers," nor are there any predictive tools to predetermine who may have prolonged symptoms. However, many athletes will suffer from prolonged symptoms that may require further evaluation and may prolong their return to exercise, training, and competition. The purpose of this article is to discuss a framework in which sports medicine and primary care physicians can use to evaluate COVID long-haulers and help them return to sport.
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Affiliation(s)
- Elisa Giusto
- Lehigh Valley Health Network Pediatrics, Allentown, PA
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377
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Sanoudou D, Hill MA, Belanger MJ, Arao K, Mantzoros CS. Editorial: Obesity, metabolic phenotypes and COVID-19. Metabolism 2022; 128:155121. [PMID: 35026232 PMCID: PMC8743503 DOI: 10.1016/j.metabol.2021.155121] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Despina Sanoudou
- 4th Department of Internal Medicine, Clinical Genomics and Pharmacogenomics Unit, 'Attikon' Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Michael A Hill
- Dalton Cardiovascular Research Center and Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri, Columbia, 65211, MO, USA.
| | | | - Kevin Arao
- Department of Medicine, Boston VA Healthcare System and Boston University School of Medicine, Boston, MA 02115, USA
| | - Christos S Mantzoros
- Department of Medicine, Boston VA Healthcare System and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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378
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Verveen A, Müller F, Lloyd A, Moss-Morris R, Omland T, Penninx B, Raijmakers RPH, van der Schaaf M, Sandler CX, Stavem K, Wessely S, Wyller VBB, Nieuwkerk P, Knoop H. A research agenda for post-COVID-19 fatigue. J Psychosom Res 2022; 154:110726. [PMID: 35086054 PMCID: PMC8786369 DOI: 10.1016/j.jpsychores.2022.110726] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Anouk Verveen
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Fabiola Müller
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Andrew Lloyd
- The Kirby Institute, UNSW Sydney, NSW, Australia
| | - Rona Moss-Morris
- Health Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Torbjørn Omland
- Department of Cardiology, Akershus University Hospital, Norway and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Brenda Penninx
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Ruud P H Raijmakers
- Department of Primary Care, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marike van der Schaaf
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Carolina X Sandler
- The Kirby Institute, UNSW Sydney, NSW, Australia; School of Health Sciences, Western Sydney University, NSW, Australia
| | - Knut Stavem
- Department of Pulmonary Medicine, Akershus University Hospital, Norway and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Simon Wessely
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Vegard B B Wyller
- Department of Pediatrics and Adolescent Medicine, Akershus University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pythia Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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379
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Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID. J Clin Med 2022; 11:jcm11051309. [PMID: 35268400 PMCID: PMC8911256 DOI: 10.3390/jcm11051309] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one month or more after infection. Methods: To determine the key factors that affect the onset and clinical course of sequelae, a retrospective analysis was performed at Okayama University Hospital (Japan) between February and July 2021. We focused on changes in the numbers of symptoms and the background of the patients during a three-month period from the first outpatient visit. We also examined the relationship with SARS-CoV-2 antibody titers. Results: Information was obtained from medical records for 65 patients. The symptoms of sequelae were diverse, with more than 20 types. The most frequent symptoms were general malaise, dysosmia, dysgeusia, sleeplessness, and headache. These symptoms improved in about 60% of the patients after 3 months. Patients who required hospitalization and had a poor condition in the acute phase and patients who received oxygen/dexamethasone therapy had higher antibody titers at the time of consultation. Patients with antibody titers ≥200 U/mL showed significantly fewer improvements in long COVID symptoms in 1 month, but they showed improvements at 3 months after the first visit. Conclusion: Long COVID symptoms were improved at 3 months after the initial visit in more than half of the patients. Serum antibody titers were higher in patients who experienced a severe acute phase, but the serum antibody titers did not seem to be directly related to the long-term persistence of long COVID symptoms.
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380
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Titze-de-Almeida R, da Cunha TR, Dos Santos Silva LD, Ferreira CS, Silva CP, Ribeiro AP, de Castro Moreira Santos Júnior A, de Paula Brandão PR, Silva APB, da Rocha MCO, Xavier MAE, Titze-de-Almeida SS, Shimizu HE, Delgado-Rodrigues RN. Persistent, new-onset symptoms and mental health complaints in Long COVID in a Brazilian cohort of non-hospitalized patients. BMC Infect Dis 2022; 22:133. [PMID: 35135496 PMCID: PMC8821794 DOI: 10.1186/s12879-022-07065-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/17/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections lead to acute- and chronic Long COVID (LC) symptoms. However, few studies have addressed LC sequelae on brain functions. This study was aimed to examine if acute symptoms of coronavirus disease 2019 (COVID-19) would persist during LC, and if memory problems would be correlated with sleep, depressive mood, or anxious complaints. METHODS Our work followed a cohort of 236 patients from two public hospitals of the Federal District in mid-western Brazil. Patients' interviews checked for clinical symptoms during acute and LC (5-8 months after real-time reverse transcription polymerase chain reaction, RT-qPCR). RESULTS Most cases were non-hospitalized individuals (86.3%) with a median age of 41.2 years. While myalgia (50%), hyposmia (48.3%), and dysgeusia (45.8%) were prevalent symptoms in acute phase, fatigue (21.6%) followed by headache (19.1%) and myalgia (16.1%) commonly occurred during LC. In LC, 39.8% of individuals reported memory complaints, 36.9% felt anxious, 44.9% felt depressed, and 45.8% had sleep problems. Furthermore, memory complaints were associated with sleep problems (adjusted OR 3.206; 95% CI 1.723-6.030) and depressive feelings (adjusted OR 3.981; 95% CI 2.068-7.815). CONCLUSIONS The SARS-CoV-2 infection leads to persistent symptoms during LC, in which memory problems may be associated with sleep and depressive complaints.
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Affiliation(s)
- Ricardo Titze-de-Almeida
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil.
- Central Institute of Sciences, Technology for Gene Therapy Laboratory-FAV, University of Brasília, Brasília, Brazil.
| | - Thaylise Ramalho da Cunha
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil
| | | | - Clarisse Santos Ferreira
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil
| | - Caroline Pena Silva
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil
| | | | | | | | - Andrezza Paula Brito Silva
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil
| | | | - Mary-Ann Elvina Xavier
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil
- Central Institute of Sciences, Technology for Gene Therapy Laboratory-FAV, University of Brasília, Brasília, Brazil
| | - Simoneide Souza Titze-de-Almeida
- Research Center for Major Themes, University of Brasília-Central Institute of Sciences, Brasília, Brazil
- Central Institute of Sciences, Technology for Gene Therapy Laboratory-FAV, University of Brasília, Brasília, Brazil
| | - Helena Eri Shimizu
- Department of Collective Health, Research Center for Major Themes, University of Brasília, Brasília, Brazil
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381
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Niess AM, Widmann M, Gaidai R, Gölz C, Schubert I, Castillo K, Sachs JP, Bizjak D, Vollrath S, Wimbauer F, Vogel A, Keller K, Burgstahler C, Quermann A, Kerling A, Schneider G, Zacher J, Diebold K, Grummt M, Beckendorf C, Buitenhuis J, Egger F, Venhorst A, Morath O, Barsch F, Mellwig KP, Oesterschlink J, Wüstenfeld J, Predel HG, Deibert P, Friedmann-Bette B, Mayer F, Hirschmüller A, Halle M, Steinacker JM, Wolfarth B, Meyer T, Böttinger E, Flechtner-Mors M, Bloch W, Haller B, Roecker K, Reinsberger C. COVID-19 in German Competitive Sports: Protocol for a Prospective Multicenter Cohort Study (CoSmo-S). Int J Public Health 2022; 67:1604414. [PMID: 35197815 PMCID: PMC8859834 DOI: 10.3389/ijph.2022.1604414] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/07/2022] [Indexed: 01/03/2023] Open
Abstract
Objective: It is unclear whether and to what extent COVID-19 infection poses health risks and a chronic impairment of performance in athletes. Identification of individual health risk is an important decision-making basis for managing the pandemic risk of infection with SARS-CoV-2 in sports and return to play (RTP).Methods: This study aims 1) to analyze the longitudinal rate of seroprevalence of SARS-CoV-2 in German athletes, 2) to assess health-related consequences in athletes infected with SARS-CoV-2, and 3) to reveal effects of the COVID-19 pandemic in general and of a cleared SARS-CoV-2 infection on exercise performance. CoSmo-S is a prospective observational multicenter study establishing two cohorts: 1) athletes diagnosed positive for COVID-19 (cohort 1) and 2) federal squad athletes who perform their annual sports medical preparticipation screening (cohort 2). Comprehensive diagnostics including physical examination, laboratory blood analyses and blood biobanking, resting and exercise electrocardiogram (ECG), echocardiography, spirometry and exercise testing added by questionnaires are conducted at baseline and follow-up.Results and Conclusion: We expect that the results obtained, will allow us to formulate recommendations regarding RTP on a more evidence-based level.
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Affiliation(s)
| | - Manuel Widmann
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- *Correspondence: Manuel Widmann,
| | - Roman Gaidai
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Paderborn, Germany
| | - Christian Gölz
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Paderborn, Germany
| | - Isabel Schubert
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Katty Castillo
- Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan Philipp Sachs
- Hasso Plattner Institute, Digital Health Center, University of Potsdam, Potsdam, Germany
| | - Daniel Bizjak
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital of Ulm, Ulm, Germany
| | - Shirin Vollrath
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital of Ulm, Ulm, Germany
| | - Fritz Wimbauer
- Department of Prevention and Sports Medicine, Center for Sports Cardiology/EAPC, School of Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich, Munich, Germany
| | - Azin Vogel
- Department of Prevention and Sports Medicine, Center for Sports Cardiology/EAPC, School of Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich, Munich, Germany
| | - Karsten Keller
- Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Christof Burgstahler
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Anne Quermann
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Arno Kerling
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Gerald Schneider
- Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Jonas Zacher
- Department I—Preventative and Rehabilitative Sports and Performance Medicine, Institute of Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | - Katharina Diebold
- Department I—Preventative and Rehabilitative Sports and Performance Medicine, Institute of Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | - Maximilian Grummt
- Department of Sports Medicine, Charité—Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Beckendorf
- Center of Sports Medicine, University Outpatient Clinic, Potsdam, Germany
| | | | - Florian Egger
- Institute for Sport and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Andreas Venhorst
- Institute for Sport and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Oliver Morath
- Institute for Exercise and Occupational Medicine, Department of Medicine, Faculty of Medicince, Medical Center University of Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - Friedrich Barsch
- Institute for Exercise and Occupational Medicine, Department of Medicine, Faculty of Medicince, Medical Center University of Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - Klaus-Peter Mellwig
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Julian Oesterschlink
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Jan Wüstenfeld
- Department of Sports Medicine, Charité—Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Applied Training Science, Leipzig University, Leipzig, Germany
| | - Hans-Georg Predel
- Department I—Preventative and Rehabilitative Sports and Performance Medicine, Institute of Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | - Peter Deibert
- Institute for Exercise and Occupational Medicine, Department of Medicine, Faculty of Medicince, Medical Center University of Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - Birgit Friedmann-Bette
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Frank Mayer
- Center of Sports Medicine, University Outpatient Clinic, Potsdam, Germany
| | - Anja Hirschmüller
- Department of Orthopedics and Traumatology, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, Center for Sports Cardiology/EAPC, School of Medicine, University Hospital “Klinikum Rechts der Isar”, Technical University of Munich, Munich, Germany
| | - Jürgen Michael Steinacker
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital of Ulm, Ulm, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, Charité—Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Applied Training Science, Leipzig University, Leipzig, Germany
| | - Tim Meyer
- Institute for Sport and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Erwin Böttinger
- Hasso Plattner Institute, Digital Health Center, University of Potsdam, Potsdam, Germany
| | - Marion Flechtner-Mors
- Division of Sports and Rehabilitation Medicine, Department of Internal Medicine, University Hospital of Ulm, Ulm, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University, Cologne, Germany
| | - Bernhard Haller
- Institute of Medical Informatics, Statistics and Epidemiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kai Roecker
- Institute for Applied Health Promotion and Exercise Medicine (IfAG), Furtwangen University, Furtwangen, Germany
| | - Claus Reinsberger
- Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Paderborn, Germany
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382
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Blanchard M, Backhaus L, Ming Azevedo P, Hügle T. An mHealth App for Fibromyalgia-like Post-COVID-19 Syndrome: Protocol for the Analysis of User Experience and Clinical Data. JMIR Res Protoc 2022; 11:e32193. [PMID: 34982039 PMCID: PMC8820761 DOI: 10.2196/32193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/20/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background Post–COVID-19 syndrome, also referred as “long covid,” describes persisting symptoms after SARS-CoV-2 infection, including myalgia, fatigue, respiratory, or neurological symptoms. Objective symptoms are often lacking, thus resembling a fibromyalgia-like syndrome. Digital therapeutics have shown efficiency in similar chronic disorders such as fibromyalgia, offering specific disease monitoring and interventions such as cognitive behavioral therapy or physical and respiratory exercise guidance. Objective This protocol aims to study the requirements and features of a new mobile health (mHealth) app among patients with fibromyalgia-like post–COVID-19 syndrome in a clinical trial. Methods We created a web application prototype for the post–COVID-19 syndrome called “POCOS,” as a web-based rehabilitation tool aiming to improve clinical outcomes. Patients without organ damage or ongoing inflammation will be included in the study. App use will be assessed through user experience questionnaires, focus groups, and clinical data analysis. Subsequently, we will analyze cross-sectional and longitudinal clinical data. Results The developed mHealth app consists of a clinically adapted app interface with a simplified patient-reported outcome assessment, monitoring of medical interventions, and disease activity as well as web-based instructions for specific physical and respiratory exercises, stress reduction, and lifestyle instructions. The enrollment of participants is expected to be carried out in November 2021. Conclusions User experience plays an important role in digital therapeutics and needs to be clinically tested to allow further improvement. We here describe this process for a new app for the treatment of the fibromyalgia-like post–COVID-19 syndrome and discuss the relevance of the potential outcomes such as natural disease course and disease phenotypes. International Registered Report Identifier (IRRID) PRR1-10.2196/32193
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Affiliation(s)
- Marc Blanchard
- Department of Rheumatology, University Hospital of Lausanne, University of Lausanne, Vaud, Switzerland
| | - Lars Backhaus
- Department of Rheumatology, University Hospital of Lausanne, University of Lausanne, Vaud, Switzerland
| | - Pedro Ming Azevedo
- Department of Rheumatology, University Hospital of Lausanne, University of Lausanne, Vaud, Switzerland
| | - Thomas Hügle
- Department of Rheumatology, University Hospital of Lausanne, University of Lausanne, Vaud, Switzerland
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383
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Gusev E, Sarapultsev A, Solomatina L, Chereshnev V. SARS-CoV-2-Specific Immune Response and the Pathogenesis of COVID-19. Int J Mol Sci 2022; 23:1716. [PMID: 35163638 PMCID: PMC8835786 DOI: 10.3390/ijms23031716] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/13/2022] Open
Abstract
The review aims to consolidate research findings on the molecular mechanisms and virulence and pathogenicity characteristics of coronavirus disease (COVID-19) causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and their relevance to four typical stages in the development of acute viral infection. These four stages are invasion; primary blockade of antiviral innate immunity; engagement of the virus's protection mechanisms against the factors of adaptive immunity; and acute, long-term complications of COVID-19. The invasion stage entails the recognition of the spike protein (S) of SARS-CoV-2 target cell receptors, namely, the main receptor (angiotensin-converting enzyme 2, ACE2), its coreceptors, and potential alternative receptors. The presence of a diverse repertoire of receptors allows SARS-CoV-2 to infect various types of cells, including those not expressing ACE2. During the second stage, the majority of the polyfunctional structural, non-structural, and extra proteins SARS-CoV-2 synthesizes in infected cells are involved in the primary blockage of antiviral innate immunity. A high degree of redundancy and systemic action characterizing these pathogenic factors allows SARS-CoV-2 to overcome antiviral mechanisms at the initial stages of invasion. The third stage includes passive and active protection of the virus from factors of adaptive immunity, overcoming of the barrier function at the focus of inflammation, and generalization of SARS-CoV-2 in the body. The fourth stage is associated with the deployment of variants of acute and long-term complications of COVID-19. SARS-CoV-2's ability to induce autoimmune and autoinflammatory pathways of tissue invasion and development of both immunosuppressive and hyperergic mechanisms of systemic inflammation is critical at this stage of infection.
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Affiliation(s)
- Evgenii Gusev
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
| | - Alexey Sarapultsev
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
- Russian-Chinese Education and Research Center of System Pathology, South Ural State University, 454080 Chelyabinsk, Russia
| | - Liliya Solomatina
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
| | - Valeriy Chereshnev
- Laboratory of Immunology of Inflammation, Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia
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384
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France K, Glick M. Long COVID and oral health care considerations. J Am Dent Assoc 2022; 153:167-174. [PMID: 34756590 PMCID: PMC8553648 DOI: 10.1016/j.adaj.2021.08.007] [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: 06/08/2021] [Revised: 08/08/2021] [Accepted: 08/15/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND People who have recovered from the initial severe acute respiratory syndrome coronavirus 2 infection are at risk of developing long COVID, a prolonged suite of signs and symptoms that may interfere with daily life and the ability to undergo routine oral health care. METHODS The available literature on long COVID was reviewed and compiled to produce a review of the syndrome as currently understood. Articles were evaluated with a focus on how long COVID may affect the provision of oral health care and on ways in which treatment may need to be modified to best care for this vulnerable patient population. RESULTS Long COVID includes a wide variety of symptoms, such as fatigue, shortness of breath, chest pain, risk of developing thromboembolism, and neurologic and psychiatric complications. These symptoms may arise at various times and in a wide range of patients, and they may necessitate modification of routine oral health care interventions. CONCLUSIONS Recommendations for the treatment of affected people in an oral health care setting are presented, including a thorough evaluation of the patient history and current status, understanding of how related symptoms may affect oral health care interventions, and which modifications to treatment are needed to provide safe and appropriate care. PRACTICAL IMPLICATIONS Oral health care professionals must be aware of long COVID, an increasingly prevalent condition with a widely variable presentation and impact. Oral health care professionals should be prepared to treat these patients safely in an outpatient oral health setting.
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385
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Lutz CB, Giabbanelli PJ. When Do We Need Massive Computations to Perform Detailed COVID-19 Simulations? ADVANCED THEORY AND SIMULATIONS 2022; 5:2100343. [PMID: 35441122 PMCID: PMC9011599 DOI: 10.1002/adts.202100343] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/01/2021] [Indexed: 12/25/2022]
Abstract
The COVID‐19 pandemic has infected over 250 million people worldwide and killed more than 5 million as of November 2021. Many intervention strategies are utilized (e.g., masks, social distancing, vaccinations), but officials making decisions have a limited time to act. Computer simulations can aid them by predicting future disease outcomes, but they also require significant processing power or time. It is examined whether a machine learning model can be trained on a small subset of simulation runs to inexpensively predict future disease trajectories resembling the original simulation results. Using four previously published agent‐based models (ABMs) for COVID‐19, a decision tree regression for each ABM is built and its predictions are compared to the corresponding ABM. Accurate machine learning meta‐models are generated from ABMs without strong interventions (e.g., vaccines, lockdowns) using small amounts of simulation data: the root‐mean‐square error (RMSE) with 25% of the data is close to the RMSE for the full dataset (0.15 vs 0.14 in one model; 0.07 vs 0.06 in another). However, meta‐models for ABMs employing strong interventions require much more training data (at least 60%) to achieve a similar accuracy. In conclusion, machine learning meta‐models can be used in some scenarios to assist in faster decision‐making.
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Affiliation(s)
- Christopher B. Lutz
- Department of Computer Science & Software Engineering Miami University 205 Benton Hall Oxford OH 45056 USA
| | - Philippe J. Giabbanelli
- Department of Computer Science & Software Engineering Miami University 205 Benton Hall Oxford OH 45056 USA
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386
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Pain Burden in Post-COVID-19 Syndrome following Mild COVID-19 Infection. J Clin Med 2022; 11:jcm11030771. [PMID: 35160223 PMCID: PMC8836662 DOI: 10.3390/jcm11030771] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 12/21/2022] Open
Abstract
The global pandemic of SARS-CoV-2 has affected several hundred million people, and many infected people have suffered from a milder initial infection but have never fully recovered. This observational study investigates the pain burden in sufferers of post-COVID-19 syndrome after a milder initial infection. One hundred post-COVID-19 patients filled out questionnaires regarding sociodemographic data, previous comorbidities, present pharmacological treatment, pain intensity and pain localisation. Health-related quality of life, fatigue, emotional status, and insomnia were measured by validated questionnaires. Multiple post-COVID-19 symptoms, including post-exertional malaise, were evaluated by a symptom questionnaire. Among the 100 participants (mean age 44.5 years), 82% were women, 61% had higher education, and 56% were working full or part time. Nine participants reported previous pain or inflammatory conditions. Among the most painful sites were the head/face, chest, lower extremities, and migrating sites. Generalised pain was self-reported by 75 participants and was estimated in 50 participants. Diagnosis of fibromyalgia according to the 2016 criteria was suspected in 40 participants. Subgroup analyses indicated that comorbidities might play a role in the development of pain. In conclusion, a major part of sufferers from post-COVID-19 syndrome develop pain, and in addition to its many disabling symptoms, there is an urgent need for pain management in post-COVID-19 syndrome.
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387
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Al-Jabr H, Windle K, Thompson DR, Jenkins ZM, Castle DJ, Ski CF. Long COVID Optimal Health Programme (LC-OHP) to enhance psychological and physical health: a feasibility randomised controlled trial protocol (Preprint). JMIR Res Protoc 2022; 11:e36673. [PMID: 35468586 PMCID: PMC9106280 DOI: 10.2196/36673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Long COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, which continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far is the adoption of holistic management approaches. The Optimal Health Program (OHP) is a brief 5-session, plus booster, psychosocial program designed to support mental and physical well-being that has been used effectively for a range of chronic conditions. Objective This study examines the feasibility and acceptability of employing an especially customized version of OHP (long COVID OHP [LC-OHP]) to improve psychological and physical health of people with long COVID. Methods This is a feasibility randomized controlled trial that will be running from November 2021 to February 2023. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. A total of 60 participants will be randomized into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the program (primary); and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy, and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the program. Quantitative data will be analyzed using SPSS, and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analyzed to identify common emerging themes. Results This is an ongoing study, which began in November 2021. Conclusions Long COVID has a significant impact on an individual’s mental and physical functioning. The LC-OHP has a potential to provide people living with long COVID with additional support and to improve self-efficacy. The findings of this study would identify the feasibility of delivering this program to this population and will provide an indication for the program’s effectiveness. Trial Registration ISRCTN Registry ISRCTN38746119; https://www.isrctn.com/ISRCTN38746119 International Registered Report Identifier (IRRID) DERR1-10.2196/36673
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Affiliation(s)
- Hiyam Al-Jabr
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
| | - Karen Windle
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Zoe M Jenkins
- Mental Health Service, St Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Chantal F Ski
- Integrated Care Academy, University of Suffolk, Ipswich, United Kingdom
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388
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Changes in Physical Activity and the Occurrence of Specific Symptoms of "Long-COVID Syndrome" in Men Aged 18-25. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031199. [PMID: 35162225 PMCID: PMC8834557 DOI: 10.3390/ijerph19031199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 01/08/2023]
Abstract
The aim of this study was to assess the occurrence of non-specific symptoms of “long-COVID syndrome” depending on the physical activity undertaken resulting from the imposed forms of study (distance learning–contact learning); 136 men aged 21.5 ± 1.58 from universities educating students of medical faculties were examined. The difference between the universities was mainly due to the nature of the classes undertaken (classes remotely-hybrid form) in the period from March 2020 to February 2021. Among the respondents, 17% in Group I and 16% in Group II were infected with the SARS-CoV-2 virus, including 50% in Group I with moderate symptoms, and in Group II—most people 45% with mild symptoms. The conducted research clearly shows the impact of the COVID-19 pandemic on students. They show a number of important problems, such as reduced physical activity, as well as increased body weight and time spent in front of the monitor. They also make it clear that the health consequences of the pandemic affect both people who were infected with the SARS-CoV-2 virus and those who did not suffer from this infection.
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389
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Visco V, Vitale C, Rispoli A, Izzo C, Virtuoso N, Ferruzzi GJ, Santopietro M, Melfi A, Rusciano MR, Maglio A, Di Pietro P, Carrizzo A, Galasso G, Vatrella A, Vecchione C, Ciccarelli M. Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems. J Clin Med 2022; 11:jcm11030524. [PMID: 35159974 PMCID: PMC8836767 DOI: 10.3390/jcm11030524] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Though the acute effects of SARS-CoV-2 infection have been extensively reported, the long-term effects are less well described. Specifically, while clinicians endure to battle COVID-19, we also need to develop broad strategies to manage post-COVID-19 symptoms and encourage those affected to seek suitable care. This review addresses the possible involvement of the lung, heart and brain in post-viral syndromes and describes suggested management of post-COVID-19 syndrome. Post-COVID-19 respiratory manifestations comprise coughing and shortness of breath. Furthermore, arrhythmias, palpitations, hypotension, increased heart rate, venous thromboembolic diseases, myocarditis and acute heart failure are usual cardiovascular events. Among neurological manifestations, headache, peripheral neuropathy symptoms, memory issues, lack of concentration and sleep disorders are most commonly observed with varying frequencies. Finally, mental health issues affecting mental abilities and mood fluctuations, namely anxiety and depression, are frequently seen. Finally, long COVID is a complex syndrome with protracted heterogeneous symptoms, and patients who experience post-COVID-19 sequelae require personalized treatment as well as ongoing support.
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Affiliation(s)
- Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Carolina Vitale
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Antonella Rispoli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Carmine Izzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Nicola Virtuoso
- Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84081 Salerno, Italy; (N.V.); (A.M.)
| | - Germano Junior Ferruzzi
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Mario Santopietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Americo Melfi
- Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84081 Salerno, Italy; (N.V.); (A.M.)
| | - Maria Rosaria Rusciano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Angelantonio Maglio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed Mediterranean Neurological Institute, 86077 Pozzilli, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Alessandro Vatrella
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed Mediterranean Neurological Institute, 86077 Pozzilli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
- Correspondence: ; Tel.: +39-08996-5021
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390
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COVID-19 in Joint Ageing and Osteoarthritis: Current Status and Perspectives. Int J Mol Sci 2022; 23:ijms23020720. [PMID: 35054906 PMCID: PMC8775477 DOI: 10.3390/ijms23020720] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 12/16/2022] Open
Abstract
COVID-19 is a trending topic worldwide due to its immense impact on society. Recent trends have shifted from acute effects towards the long-term morbidity of COVID-19. In this review, we hypothesize that SARS-CoV-2 contributes to age-related perturbations in endothelial and adipose tissue, which are known to characterize the early aging process. This would explain the long-lasting symptoms of SARS-CoV-2 as the result of an accelerated aging process. Connective tissues such as adipose tissue and musculoskeletal tissue are the primary sites of aging. Therefore, current literature was analyzed focusing on the musculoskeletal symptoms in COVID-19 patients. Hypovitaminosis D, increased fragility, and calcium deficiency point towards bone aging, while joint and muscle pain are typical for joint and muscle aging, respectively. These characteristics could be classified as early osteoarthritis-like phenotype. Exploration of the impact of SARS-CoV-2 and osteoarthritis on endothelial and adipose tissue, as well as neuronal function, showed similar perturbations. At a molecular level, this could be attributed to the angiotensin-converting enzyme 2 expression, renin-angiotensin system dysfunction, and inflammation. Finally, the influence of the nicotinic cholinergic system is being evaluated as a new treatment strategy. This is combined with the current knowledge of musculoskeletal aging to pave the road towards the treatment of long-term COVID-19.
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391
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Otsuka Y, Nakano Y, Hagiya H, Tokumasu K, Otsuka F. Recovery From Alopecia After COVID-19. Cureus 2022; 14:e21160. [PMID: 35165610 PMCID: PMC8831424 DOI: 10.7759/cureus.21160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 12/31/2022] Open
Abstract
Herein, we report a remarkable case of post-coronavirus disease 2019 (COVID-19) diffuse alopecia that gradually improved and recovered, and the hair volume returned approximately to the pre-infection level, seven months after the patient's first diagnosis of COVID-19. Approximately 20% of patients with COVID-19 develop alopecia a few months after the acute infection phase. Telogen effluvium is the major type of COVID-19 sequela secondary to physical or psychological distress. It is reversible and is expected to improve without any treatment, and it can be addressed by explaining to the patients their conditions, sharing medical information, and eliminating psychophysical stress by managing systemic complications.
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Affiliation(s)
- Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
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392
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Yaksi N, Teker AG, Imre A. Long COVID in Hospitalized COVID-19 Patients: A Retrospective Cohort Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:88-95. [PMID: 35223629 PMCID: PMC8837882 DOI: 10.18502/ijph.v51i1.8297] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/10/2021] [Indexed: 01/26/2023]
Abstract
Background: We aimed to evaluate the Long COVID frequency, and related factors in patients followed up after hospitalization. Methods: This retrospective cohort study included 133 inpatients with COVID-19 PCR test positivity from Nigde Province, Turkey between 01.01.2021 and 28.02.2021. The characteristics of the patients were recorded by examining the files, and the symptom questioning was made by telephone interviewing with the patients approximately four months after the date of diagnosis. The presence of at least one symptom lasting more than four weeks was described as Long COVID. Results: The frequency of Long COVID was 64.7%. The most common Long COVID symptoms were fatigue (45.9%), respiratory distress (25.6%), and muscle / joint pain (24.8%), respectively. In comparison analysis to identify factors associated with Long COVID; Long COVID was found to be more frequent among women (P=0.04); patients with severe COVID-19 (P<0.01), patients with prolonged hospital stay (P=0.03), patients with the comorbid disease (P=0.03), and Diabetes Mellitus patients (P=0.02). Additionally, the frequency of Long COVID increased as the depression score stated by the person increased after COVID-19 disease (P=0.02). Conclusion: The treatment of COVID-19 patients should not end when they are discharged from the hospital. On the contrary, these patients, especially high-risk patients, should be followed up in post-COVID clinics and rehabilitated physically and psychosocially with a multidisciplinary approach following the recovery period of the acute illness.
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Affiliation(s)
- Nese Yaksi
- Nigde Community Health Center, Nigde, Turkey
| | - Ayse Gulsen Teker
- Department of Public Health, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ayfer Imre
- Infectious Diseases and Clinical Microbiology, Nigde Training and Research Hospital, Nigde, Turkey
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393
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Oto OA, Ozturk S, Arici M, Velioğlu A, Dursun B, Guller N, Şahin İ, Eser ZE, Paydaş S, Trabulus S, Koyuncu S, Uyar M, Ural Z, Sadioğlu RE, Dheir H, Koç NS, Özer H, Durak BA, Gül CB, Kasapoğlu U, Oğuz EG, Tanrısev M, Kuzgun GŞ, Mirioglu S, Dervişoğlu E, Erken E, Görgülü N, Özkurt S, Aydın Z, Kurultak İ, Öğütmen MB, Bakırdöğen S, Kaya B, Karadağ S, Ulu MS, Güngör Ö, Bakır EA, Odabaş AR, Seyahi N, Yıldız A, Ateş K. OUP accepted manuscript. Clin Kidney J 2022; 15:999-1006. [PMID: 35498893 PMCID: PMC8903384 DOI: 10.1093/ckj/sfac045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background In this study, we evaluated 3-month clinical outcomes of kidney transplant recipients (KTR) recovering from COVID-19 and compared them with a control group. Method The primary endpoint was death in the third month. Secondary endpoints were ongoing respiratory symptoms, need for home oxygen therapy, rehospitalization for any reason, lower respiratory tract infection, urinary tract infection, biopsy-proven acute rejection, venous/arterial thromboembolic event, cytomegalovirus (CMV) infection/disease and BK viruria/viremia at 3 months. Results A total of 944 KTR from 29 different centers were included in this study (523 patients in the COVID-19 group; 421 patients in the control group). The mean age was 46 ± 12 years (interquartile range 37–55) and 532 (56.4%) of them were male. Total number of deaths was 8 [7 (1.3%) in COVID-19 group, 1 (0.2%) in control group; P = 0.082]. The proportion of patients with ongoing respiratory symptoms [43 (8.2%) versus 4 (1.0%); P < 0.001] was statistically significantly higher in the COVID-19 group compared with the control group. There was no significant difference between the two groups in terms of other secondary endpoints. Conclusion The prevalence of ongoing respiratory symptoms increased in the first 3 months post-COVID in KTRs who have recovered from COVID-19, but mortality was not significantly different.
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Affiliation(s)
- Ozgur Akin Oto
- Department of Internal Medicine, Division of Nephrology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Savas Ozturk
- Department of Internal Medicine, Division of Nephrology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | | | - Arzu Velioğlu
- Department of Internal Medicine, Division of Nephrology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Belda Dursun
- Department of Internal Medicine, Division of Nephrology, Pamukkale University, Faculty of Medicine, Denizli, Turkey
| | - Nurana Guller
- Department of Internal Medicine, Division of Nephrology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - İdris Şahin
- Department of Internal Medicine, Nephrology Division, Inonu University, Faculty of Medicine, Malatya, Turkey
| | - Zeynep Ebru Eser
- Department of Internal Medicine, Division of Nephrology, Mersin University, Mersin Faculty of Medicine, Mersin, Turkey
| | - Saime Paydaş
- Department of Internal Medicine, Division of Nephrology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Sinan Trabulus
- Department of Internal Medicine, Division of Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Sümeyra Koyuncu
- Department of Internal Medicine, Division of Nephrology, Erciyes University, Erciyes Faculty of Medicine, Kayseri, Turkey
| | - Murathan Uyar
- Department of Internal Medicine, Division of Nephrology, Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Istanbul, Turkey
| | - Zeynep Ural
- Department of İnternal Medicine, Division of Nephrology Gazi University, Faculty of Medicine, Ankara, Turkey
| | | | - Hamad Dheir
- Department of Internal Medicine, Division of Nephrology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Neriman Sıla Koç
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hakan Özer
- Division of Nephrology, Konya Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Beyza Algül Durak
- Department of Nephrology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Cuma Bülent Gül
- Department of Nephrology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Istanbul, Turkey
| | - Umut Kasapoğlu
- Department of Nephrology, University of Health Sciences, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ebru Gök Oğuz
- Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Mehmet Tanrısev
- Department of Nephrology, University of Health Sciences, Izmir Faculty of Medicine, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gülşah Şaşak Kuzgun
- Department of Nephrology, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Safak Mirioglu
- Division of Nephrology, Department of Internal Medicine, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Erkan Dervişoğlu
- Department of Internal Medicine, Division of Nephrology, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Ertuğrul Erken
- Department of Nephrology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Numan Görgülü
- Department of Nephrology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Sultan Özkurt
- Department of Internal Medicine, Division of Nephrology, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey
| | - Zeki Aydın
- Department of Nephrology, University of Health Sciences, Darıca Farabi Training and Research Hospital, Darica, Turkey
| | - İlhan Kurultak
- Department of Internal Medicine, Division of Nephrology, Trakya University, Faculty of Medicine, Edirne, Turkey
| | - Melike Betül Öğütmen
- Department of Nephrology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Serkan Bakırdöğen
- Department of Internal Medicine, Division of Nephrology, Canakkale Onsekiz Mart University, School of Medicine, Canakkale, Turkey
| | - Burcu Kaya
- Department of Internal Medicine, Division of Nephrology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Serhat Karadağ
- Department of Nephrology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Memnune Sena Ulu
- Department of Internal Medicine, Division of Nephrology, Bahçeşehir University, Faculty of Medicine, Istanbul, Turkey
| | - Özkan Güngör
- Department of Nephrology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Elif Arı Bakır
- Department of Internal Medicine, Division of Nephrology University of Health Sciences, Kartal Training Hospital, Istanbul, Turkey
| | - Ali Rıza Odabaş
- Department of Nephrology, University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Nurhan Seyahi
- Department of Internal Medicine, Division of Nephrology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Alaattin Yıldız
- Department of Internal Medicine, Division of Nephrology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Kenan Ateş
- Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey
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394
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Chu L, Grafton RQ, Kompas T. What vaccination rate(s) minimize total societal costs after 'opening up' to COVID-19? Age-structured SIRM results for the Delta variant in Australia (New South Wales, Victoria and Western Australia). PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000499. [PMID: 36962399 PMCID: PMC10021844 DOI: 10.1371/journal.pgph.0000499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/27/2022] [Indexed: 11/19/2022]
Abstract
Using three age-structured, stochastic SIRM models, calibrated to Australian data post July 2021 with community transmission of the Delta variant, we projected possible public health outcomes (daily cases, hospitalisations, ICU beds, ventilators and fatalities) and economy costs for three states: New South Wales (NSW), Victoria (VIC) and Western Australia (WA). NSW and VIC have had on-going community transmission from July 2021 and were in 'lockdown' to suppress transmission. WA did not have on-going community transmission nor was it in lockdown at the model start date (October 11th 2021) but did maintain strict state border controls. We projected the public health outcomes and the economic costs of 'opening up' (relaxation of lockdowns in NSW and VIC or fully opening the state border for WA) at alternative vaccination rates (70%, 80% and 90%), compared peak patient demand for ICU beds and ventilators to staffed state-level bed capacity, and calculated a 'preferred' vaccination rate that minimizes societal costs and that varies by state. We found that the preferred vaccination rate for all states is at least 80% and that the preferred population vaccination rate is increasing with: (1) the effectiveness (infection, hospitalization and fatality) of the vaccine; (2) the lower is the daily lockdown cost; (3) the larger are the public health costs from COVID-19; (4) the higher is the rate of community transmission before opening up; and (5) the less effective are the public health measures after opening up.
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Affiliation(s)
- Long Chu
- Crawford School of Public Policy, Australian National University, Canberra, Australia
| | - R Quentin Grafton
- Crawford School of Public Policy, Australian National University, Canberra, Australia
| | - Tom Kompas
- Crawford School of Public Policy, Australian National University, Canberra, Australia
- Centre of Excellence for Biosecurity Risk Analysis, School of Biosciences and School of Ecosystem and Forest Sciences, University of Melbourne, Melbourne, Australia
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395
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Sekar N, Jagan J, Viruthagiri A, Mandjiny N, Sivagnanam K. Management of Acute Limb Ischaemia Due to COVID-19 Induced Arterial Thrombosis: A Multi-Centre Indian Experience. Ann Vasc Dis 2022; 15:113-120. [PMID: 35860829 PMCID: PMC9257383 DOI: 10.3400/avd.oa.22-00012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/31/2022] [Indexed: 12/28/2022] Open
Abstract
Objective: To determine the outcomes following various surgical and medical treatments of Coronavirus disease 2019 (COVID-19) induced acute limb ischaemia. Methods: A retrospective study of patients presenting with COVID induced arterial ischaemia in three hospitals from Southern India during the months of May 2020 to August 2021 was undertaken. These patients were managed by either thrombectomy, primary bypass, thrombolysis, anticoagulation or primary amputation based on the stage of ischaemia and the severity of COVID. Results: A total of 67 limbs in 59 patients were analysed. The average time to intervention was 15 days. Upper limb involvement was seen in 16 and lower limb in 51 limbs. Of the 67 limbs, 39 (58.2%) were treated by open surgical revascularisation, 5 (7.4%) by catheter directed lysis, 17 (25.3%) were managed conservatively and 6 (8.9%) underwent primary amputation. Successful revascularisation could be carried out in 88.6% of patients. A limb salvage rate of 80.6% was achieved in these patients with a re-intervention rate of 13.6%. Major amputation rate was 14.92% and mortality was 13.56%. Conclusion: Limb ischaemia after COVID can be safely managed by open thrombectomy or bypass. Similar rates of limb salvage as in non-COVID acute limb ischaemia can be obtained.
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396
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Block T, Kuo J. Rationale for Nicotinamide Adenine Dinucleotide (NAD+) Metabolome Disruption as a Pathogenic Mechanism of Post-Acute COVID-19 Syndrome. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2022; 15:2632010X221106986. [PMID: 35769168 PMCID: PMC9234841 DOI: 10.1177/2632010x221106986] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022]
Abstract
Many acute COVID-19 convalescents experience a persistent sequelae of
infection, called post-acute COVID-19 syndrome (PACS). With incidence
ranging between 31% and 69%, PACS is becoming increasingly
acknowledged as a new disease state in the context of SARS-CoV-2
infection. As SARS-CoV-2 infection can affect several organ systems to
varying degrees and durations, the cellular and molecular
abnormalities contributing to PACS pathogenesis remain unclear.
Despite our limited understanding of how SARS-CoV-2 infection promotes
this persistent disease state, mitochondrial dysfunction has been
increasingly recognized as a contributing factor to acute SARS-CoV-2
infection and, more recently, to PACS pathogenesis. The biological
mechanisms contributing to this phenomena have not been well
established in previous literature; however, in this review, we
summarize the evidence that NAD+ metabolome disruption and subsequent
mitochondrial dysfunction following SARS-CoV-2 genome integration may
contribute to PACS biological pathogenesis. We also briefly examine
the coordinated and complex relationship between increased oxidative
stress, inflammation, and mitochondrial dysfunction and speculate as
to how SARS-CoV-2-mediated NAD+ depletion may be causing these
abnormalities in PACS. As such, we present evidence supporting the
therapeutic potential of intravenous administration of NAD+ as a novel
treatment intervention for PACS symptom management.
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397
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Long-COVID Syndrome and the Cardiovascular System: A Review of Neurocardiologic Effects on Multiple Systems. Curr Cardiol Rep 2022; 24:1711-1726. [PMID: 36178611 PMCID: PMC9524329 DOI: 10.1007/s11886-022-01786-2] [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] [Accepted: 09/12/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW Long-COVID syndrome is a multi-organ disorder that persists beyond 12 weeks post-acute SARS-CoV-2 infection (COVID-19). Here, we provide a definition for this syndrome and discuss neuro-cardiology involvement due to the effects of (1) angiotensin-converting enzyme 2 receptors (the entry points for the virus), (2) inflammation, and (3) oxidative stress (the resultant effects of the virus). RECENT FINDINGS These effects may produce a spectrum of cardio-neuro effects (e.g., myocardial injury, primary arrhythmia, and cardiac symptoms due to autonomic dysfunction) which may affect all systems of the body. We discuss the symptoms and suggest therapies that target the underlying autonomic dysfunction to relieve the symptoms rather than merely treating symptoms. In addition to treating the autonomic dysfunction, the therapy also treats chronic inflammation and oxidative stress. Together with a full noninvasive cardiac workup, a full assessment of the autonomic nervous system, specifying parasympathetic and sympathetic (P&S) activity, both at rest and in response to challenges, is recommended. Cardiac symptoms must be treated directly. Cardiac treatment is often facilitated by treating the P&S dysfunction. Cardiac symptoms of dyspnea, chest pain, and palpitations, for example, need to be assessed objectively to differentiate cardiac from neural (autonomic) etiology. Long-term myocardial injury commonly involves P&S dysfunction. P&S assessment usually connects symptoms of Long-COVID to the documented autonomic dysfunction(s).
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398
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Jadali Z. Long COVID: Information for urology health-care professionals. UROLOGICAL SCIENCE 2022. [DOI: 10.4103/uros.uros_39_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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399
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Rasker J, Bakar Siddiq M. COVID-19, Long COVID, and Psychosomatic Manifestations: A Possible Burden on Existing Rheumatology Facilities. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_63_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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400
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Carascal MB, Capistrano PE, Figueras MD, Cataylo OLAC, Zuñiga SMS, Reyes MES, Medriano KKS, Gamo AT, Mendoza PD, Macalipay SLB. Experiences of COVID-19-Recovered Healthcare Workers in a Tertiary Hospital in the Philippines: A Mixed-Method Inquiry. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221107051. [PMID: 35775124 PMCID: PMC9251963 DOI: 10.1177/00469580221107051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
COVID-19 pandemic affected the mental health of the global population. Among the
most vulnerable are the healthcare workers (HCWs) who got infected but returned
to the frontline after recovery. Currently, there is a dearth of information and
understanding on the psychological status and actual lived experience of the
recovered HCWs in the Philippines. The present study investigated the
psychological status and experiences of 93 COVID-19-recovered HCWs from a
tertiary hospital in the Philippines using a mixed-method approach, particularly
the explanatory-sequential design. Participants completed the Impact of Event
Scale-Revised, and the Depression, Anxiety, and Stress Scale-21 in the
quantitative phase. Selected participants took part in focus group discussions
in the qualitative phase. Integrated results showed that our participants
experienced significant COVID-19-related distress (mean IES-R score = 25.5;
partial impact), anxiety (mean subscale score = 7.4; mild), and depression (mean
subscale score = 8.1; mild). Certain sociodemographic and professional
characteristics and the length of quarantine days appear to affect the
psychometric scores. The quantitative results are supported by the participant’s
description of recovery experiences as living in uncertainty, distress, fatigue,
dissociation, and valuation of life. In summary, adequate psychological support
and intervention program should be prioritized and provided by hospital
management for recovered HCWs to prevent the development of more serious mental
health concerns that may significantly affect their tasks in caring for patients
and in-hospital management.
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Affiliation(s)
- Mark B. Carascal
- Clinical and Translational Research Institute, The Medical City, Pasig City, Philippines
- Institute of Biology, University of the Philippines, Diliman, Philippines
| | | | | | | | | | | | | | - Anthony T. Gamo
- Human Capital Management Group, The Medical City, Pasig City, Philippines
| | - Paz D. Mendoza
- Human Capital Management Group, The Medical City, Pasig City, Philippines
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