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Rofail D, Hussein M, Naumann U, Podolanczuk AJ, Norton T, Ali S, Mastey V, Ivanescu C, Hirshberg B, Geba GP. Patient-Reported Outcomes in COVID-19 Treatment with Monoclonal Antibodies Reveal Benefits in Return to Usual Activities. Infect Dis Ther 2024; 13:1861-1876. [PMID: 38961047 PMCID: PMC11266324 DOI: 10.1007/s40121-024-01013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION This study aimed to assess the effects of a monoclonal antibody (mAb) combination on symptoms, daily function, and overall health-related quality of life. METHODS We analyzed patient-reported outcomes data from symptomatic outpatients in a phase 1/2/3 trial. Patients with confirmed SARS-CoV-2 infection and ≥ 1 risk factor for severe COVID-19 received mAb treatment (casirivimab plus imdevimab 1200 mg) or placebo. Prespecified exploratory assessments included time to sustained symptoms resolution, usual health, and return to usual activities (assessed daily for 29 days). The trial was conducted from September 2020 to February 2021, prior to widespread COVID-19 vaccination programs and Omicron-lineage variants against which casirivimab + imdevimab is not active. RESULTS In this analysis 736 outpatients received mAb and 1341 received placebo. Median time to sustained symptoms resolution was consistently shorter with mAb versus placebo (≥ 2 consecutive days: 14 vs 17 days, [nominal p = 0.0017]; ≥ 3 consecutive days: 17 vs 21 days, [nominal p = 0.0046]). Median time to sustained return to usual health and usual activities were both consistently shorter with mAb versus placebo (≥ 2 consecutive days: 12 vs 15 days [nominal p = 0.0001] and 9 vs 11 days [nominal p = 0.0001], respectively; ≥ 3 consecutive days: 14 vs 18 days [nominal p = 0.0003] and 10 vs 13 days [nominal p = 0.0041], respectively). CONCLUSIONS mAb treatment against susceptible SARS-CoV-2 strains improved how patients feel and function, as evidenced by shortened time to sustained symptoms resolution and return to usual health and activities. Future studies are warranted to assess the patient experience with next generation mAbs. CLINICALTRIALS GOV: Registration number, NCT04425629; Submission date June 11, 2020.
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Affiliation(s)
- Diana Rofail
- Regeneron Pharmaceuticals, Inc., 1 Rockwood Road, Sleepy Hollow, NY, 10591, USA.
| | - Mohamed Hussein
- Regeneron Pharmaceuticals, Inc., 1 Rockwood Road, Sleepy Hollow, NY, 10591, USA
| | | | | | | | - Shazia Ali
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - Vera Mastey
- Regeneron Pharmaceuticals, Inc., 1 Rockwood Road, Sleepy Hollow, NY, 10591, USA
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Kustura L, Bobek D, Poljičanin A, Pavelin S, Buljubašić Šoda M, Šoda J, Aksentijević J, Duka Glavor K, Narančić Knez N, Viali V, Cukrov A, Todorić Laidlaw I, Ipavec N, Vukorepa D, Stipica I, Bakrač K, Bošković B, Mastelić A, Režić Mužinić N, Markotić A, Đogaš Z, Dolić K, Rogić Vidaković M. Psychometric properties and observational data for COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) for post-COVID-19 syndrome. QJM 2024; 117:38-47. [PMID: 37788123 DOI: 10.1093/qjmed/hcad224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/14/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The recently developed modified COVID-19 (coronavirus of 2019) Yorkshire Rehabilitation Scale (C19-YRSm) captures comprehensive biopsychosocial components of WHO's International Classification of Functioning, Disability, and Health related to the Long Covid or post-COVID syndrome. The scale response categories on C19-YRSm were done post hoc on data collected from the original version of C19-YRS. AIM To evaluate the C19-YRSm scale using reliability and validity measures. DESIGN Prospective, observational study. METHODS The study includes 369 patients (clinical group) and 426 subjects of the general population (control group) and captures their post-COVID-19 symptoms. In addition, the reliability of C19-YRSm was estimated by Cronbach's alpha coefficients of internal consistency and inter-item correlations for subscales ('Symptom severity, Functional disability, and Other symptoms'). Convergent validity was established using correlations between C19-YRSm and Fatigue Severity Scale (FSS). The incremental validity of C19-YRSm was measured by introducing a hierarchical regression model using the C19-YRSm 'Overall health' subscale and FSS as criterion variables. RESULTS C19-YRSm subscales have excellent internal consistencies (Cronbach's α value 0.81-0.96) and acceptable inter-item correlations (r value 0.23-0.79). Hereafter, the convergent validity of the C19-YRSm is good due to significant correlations between C19-YRSm subscales and FSS and C19-YRSm subscales. Finally, the hierarchical regression analysis supported consistent evidence for the incremental validity of the C19-YRSm subscales. CONCLUSION C19-YRSm is a reliable and valid self-assessment scale for the assessment of post-COVID-19 syndrome.
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Affiliation(s)
- L Kustura
- Department of Psychiatry, University Hospital of Split, Split, Croatia
| | - D Bobek
- Department of Physical and Rehabilitation Medicine with Rheumatology, Dubrava University Hospital, Zagreb, Croatia
| | - A Poljičanin
- Department of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, Split, Croatia
- Department of Health Studies, University of Split, Split, Croatia
| | - S Pavelin
- Department of Neurology, University Hospital of Split, Split, Croatia
| | - M Buljubašić Šoda
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - J Šoda
- Department of Marine Electrical Engineering and Information Technologies, Signal Processing, Analysis, and Advanced Diagnostics Research and Education Laboratory (SPAADREL), Faculty of Maritime Studies, University of Split, Split, Croatia
| | - J Aksentijević
- Department of Physical and Rehabilitation Medicine with Rheumatology, Dubrava University Hospital, Zagreb, Croatia
| | - K Duka Glavor
- Department of Neurology, General Hospital Zadar, Zadar, Croatia
- Department of Health Studies, University of Zadar, Zadar, Croatia
| | - N Narančić Knez
- Department of Neurology, General Hospital Zadar, Zadar, Croatia
| | - V Viali
- Family Medicine Vanja Viali, Split, Split-Dalmatia County, Croatia
| | - A Cukrov
- Primary/Family Care Office, Slunj Community Health Centre, Slunj, Croatia
| | - I Todorić Laidlaw
- Department for Forensic Psychiatry, University Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - N Ipavec
- Department for Transfusion Medicine, University Hospital of Split, Split, Croatia
| | - D Vukorepa
- Department of Psychiatry, University Hospital of Split, Split, Croatia
| | - I Stipica
- Department of Family Medicine, University of Split School of Medicine, Split, Croatia
| | - K Bakrač
- Institute of Emergency Medicine, Split-Dalmatia County, Split, Croatia
| | - B Bošković
- Department of Otorhinolaryngology, Head and Neck surgery, University Hospital of Split, Split, Croatia
| | - A Mastelić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - N Režić Mužinić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - A Markotić
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - Z Đogaš
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), School of Medicine, University of Split, Split, Croatia
- Sleep Medicine Centre, University Hospital of Split, Split, Croatia
| | - K Dolić
- Department of Interventional and Diagnostic Radiology, University Hospital of Split, Split, Croatia
- Department of Radiology, University of Split School of Medicine, Split, Croatia
| | - M Rogić Vidaković
- Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), School of Medicine, University of Split, Split, Croatia
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Wu L, Zhang Z, Liang X, Wang Y, Cao Y, Li M, Zhou F. Glymphatic system dysfunction in recovered patients with mild COVID-19: A DTI-ALPS study. iScience 2024; 27:108647. [PMID: 38155770 PMCID: PMC10753064 DOI: 10.1016/j.isci.2023.108647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/07/2023] [Accepted: 12/04/2023] [Indexed: 12/30/2023] Open
Abstract
Central nervous sequelae are often reported in recovered patients with COVID-19. It is not clear whether recovered COVID-19 patients have glymphatic impairment and clinical correlation. In this study, we demonstrated that mild COVID-19 patients experienced asymmetric bilateral glymphatic function decline after four months of recovery, and the decrease in glymphatic function was more obvious in older recovered patients. Our results further showed that recovered patients with right-sided glymphatic dysfunction experienced a greater proportion of cognitive decline (MoCA score <26) than patients with left-sided glymphatic dysfunction. With COVID-19 infection over 90% of the general population currently, future studies of cognitive disorders in the older population should consider the impact of COVID-19 infection.
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Affiliation(s)
- Lin Wu
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, China
- Clinical Research Center For Medical Imaging, Nanchang, Jiangxi, China
| | - Zhi Zhang
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, China
- Clinical Research Center For Medical Imaging, Nanchang, Jiangxi, China
| | - Xiao Liang
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, China
- Clinical Research Center For Medical Imaging, Nanchang, Jiangxi, China
| | - Yao Wang
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, China
- Clinical Research Center For Medical Imaging, Nanchang, Jiangxi, China
| | - Yuan Cao
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, China
- Clinical Research Center For Medical Imaging, Nanchang, Jiangxi, China
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Lau B, Wentz E, Ni Z, Yenokyan K, Vergara C, Mehta SH, Duggal P. Physical Health and Mental Fatigue Disability Associated with Long COVID: Baseline Results from a US Nationwide Cohort. Am J Med 2023:S0002-9343(23)00540-5. [PMID: 37690503 PMCID: PMC10924070 DOI: 10.1016/j.amjmed.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Persistent symptoms after severe acute respiratory disease coronavirus 2 (SARS-COV-2; long COVID) occur in 10%-55% of individuals, but the impact on daily functioning and disability remains unquantified. METHODS To characterize disability associated with long COVID, we analyzed baseline data from an online, US-based cohort study. Adult participants included those reporting a history of COVID-19 (n = 8874) or never having COVID-19 (n = 633) without prior disability. The main outcomes were self-reported physical mobility, instrumental activities of daily living (IADL), and mental fatigue disability, assessed by measuring 5 disability components: difficulty walking a quarter mile or climbing 10 stairs (mobility), difficulty doing light or heavy housework (IADL), and Wood Mental Fatigue Inventory score (mental fatigue). RESULTS Of 7926 participants with long COVID, 65% were classified with at least one disability, as compared with 6% and 14% for resolved COVID and no COVID, respectively. Additionally, 22% were classified as disabled in all 3 categories. Age, prior comorbidity, increased body mass index, female sex, COVID-19 hospitalization, non-white/multi-race were associated with higher disability burden. Dizziness and heavy limbs at infection were associated with disability regardless of hospitalization. Dyspnea and tremors were associated with disability in non-hospitalized individuals. Vaccination was protective against disability. CONCLUSIONS We observed a high burden of new disability associated with long COVID, which has serious implications for individual and societal health. Longitudinal evaluation of COVID-19 patients is necessary to identify patterns of recovery and treatment options.
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Affiliation(s)
- Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Eryka Wentz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Zhanmo Ni
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Karine Yenokyan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Candelaria Vergara
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
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Karyakarte RP, Das R, Rajmane MV, Dudhate S, Agarasen J, Pillai P, Chandankhede PM, Labhshetwar RS, Gadiyal Y, Kulkarni PP, Nizarudeen S, Mukade S, Joshi S. The Burden and Characteristics of Post-COVID-19 Conditions Among Laboratory-Confirmed Delta and Omicron COVID-19 Cases: A Preliminary Study From Maharashtra, India. Cureus 2023; 15:e44888. [PMID: 37814744 PMCID: PMC10560400 DOI: 10.7759/cureus.44888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Post-COVID-19 conditions (PCC) have emerged as a significant global health concern due to their potential impact on patients' quality of life and healthcare resources. The present study aims to understand the burden and characteristics of PCC in Maharashtra, India, and compares its prevalence among cases infected with Delta and Omicron variants. MATERIAL AND METHODS A retrospective observational study included 617 laboratory-confirmed Delta and Omicron variant cases. These cases were telephonically followed up to document persistent COVID-19 symptoms using a questionnaire based on the Post-COVID-19 Clinical Form from the Global COVID-19 Clinical Platform of the World Health Organization (WHO), and the results were analyzed. RESULTS Out of 617 laboratory-confirmed COVID-19 cases, 82.97% and 17.03% were Omicron and Delta cases, respectively. The mean follow-up period for Delta and Omicron cases was 78.05 and 21.56 weeks, respectively. A total of 40 (6.48%) cases reported persistent symptoms at follow-up, with a higher prevalence among those infected with the Delta variant (12.38%) compared to the Omicron variant (5.27%). The most common long COVID symptoms reported were malaise (25%), dyspnea (20%), post-exertional fatigue (17.5%), joint pain (15%), and frequent episodes of cough and cold (15%). Additionally, 1.94% of participants developed a new medical condition following COVID-19 infection, most commonly hypertension (25%), lung fibrosis (16.67%), and asthma (8.33%). Factors such as more than five acute symptoms, a moderate to severe disease, the need for hospitalization, and hospitalization for more than five days were significantly associated with PCC. CONCLUSION Long COVID results in extended disability and illness. The varying impacts of different COVID-19 variants highlight the complex nature of post-COVID-19 complications. Our findings highlight the need for strategic planning of healthcare resources to ensure optimal response and preparedness to manage the burden of PCC.
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Affiliation(s)
- Rajesh P Karyakarte
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
- Microbiology, Byramjee Jeejeebhoy Government Medical College (BJGMC), Pune, IND
| | - Rashmita Das
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
- Microbiology, Byramjee Jeejeebhoy Government Medical College (BJGMC), Pune, IND
| | - Mansi V Rajmane
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Sonali Dudhate
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Jeanne Agarasen
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Praveena Pillai
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Priyanka M Chandankhede
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Rutika S Labhshetwar
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Yogita Gadiyal
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Preeti P Kulkarni
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Safanah Nizarudeen
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Savita Mukade
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
| | - Suvarna Joshi
- Microbiology, Byramjee Jeejeebhoy (BJ) Government Medical College and Sassoon General Hospitals, Pune, IND
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Kopańska M, Rydzik Ł, Błajda J, Sarzyńska I, Jachymek K, Pałka T, Ambroży T, Szczygielski J. The Use of Quantitative Electroencephalography (QEEG) to Assess Post-COVID-19 Concentration Disorders in Professional Pilots: An Initial Concept. Brain Sci 2023; 13:1264. [PMID: 37759865 PMCID: PMC10526237 DOI: 10.3390/brainsci13091264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Announced by WHO in 2020, the global COVID-19 pandemic caused by SARS-CoV-2 has affected many people, leading to serious health consequences. These consequences are observed in the daily lives of infected patients as various dysfunctions and limitations. More and more people are suffering post-COVID-19 complications that interfere with or completely prevent them from working or even functioning independently on a daily basis. The aim of our study was to demonstrate that innovative quantitative electroencephalography (QEEG) can be used to assess cognitive function disorders reported after the COVID-19 pandemic. It is worth noting that no similar study has been conducted to date in a group of pilots. The QEEG method we used is currently one of the basic neurological examinations, enabling easy observation of post-COVID-19 changes in the nervous system. With the innovativeness of this technique, our study shows that the use of quantitative electroencephalography can be a precursor in identifying complications associated with cognitive function disorders after COVID-19. Our study was conducted on twelve 26-year-old pilots. All participants had attended the same flight academy and had contracted SARS-CoV-2 infection. The pilots began to suspect COVID-19 infection when they developed typical symptoms such as loss of smell and taste, respiratory problems, and rapid fatigue. Quantitative electroencephalography (QEEG), which is one of the most innovative forms of diagnostics, was used to diagnose the patients. Comparison of the results between the study and control groups showed significantly higher values of all measurements of alpha, theta, and beta2 waves in the study group. In the case of the sensorimotor rhythm (SMR), the measurement results were significantly higher in the control group compared to the study group. Our study, conducted on pilots who had recovered from COVID-19, showed changes in the amplitudes of brain waves associated with relaxation and concentration. The results confirmed the issues reported by pilots as evidenced by the increased amplitudes of alfa, theta, and beta2 waves. It should be emphasized that the modern diagnostic method (QEEG) presented here has significant importance in the medical diagnosis of various symptoms and observation of treatment effects in individuals who have contracted the SARS-CoV-2 virus. The present study demonstrated an innovative approach to the diagnosis of neurological complications after COVID-19.
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Affiliation(s)
- Marta Kopańska
- Department of Pathophysiology, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Łukasz Rydzik
- Institute of Sports Sciences, University of Physical Education, 31-571 Kraków, Poland (T.A.)
| | - Joanna Błajda
- Institute of Health Sciences, Medical College, University of Rzeszow, Kopisto 2a, 35-959 Rzeszow, Poland;
| | - Izabela Sarzyńska
- Students Science Club “Reh-Tech”, Institute of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Katarzyna Jachymek
- Students Science Club “Reh-Tech”, Institute of Medical Sciences, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Tomasz Pałka
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education, 31-571 Kraków, Poland
| | - Tadeusz Ambroży
- Institute of Sports Sciences, University of Physical Education, 31-571 Kraków, Poland (T.A.)
| | - Jacek Szczygielski
- Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland
- Department of Neurosurgery, Faculty of Medicine, Saarland University, 66421 Homburg, Germany
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Del Borgo C, Garattini S, Bortignon C, Carraro A, Di Trento D, Gasperin A, Grimaldi A, De Maria SG, Corazza S, Tieghi T, Belvisi V, Kertusha B, De Masi M, D'Onofrio O, Bagaglini G, Bonanni G, Zuccalà P, Fabietti P, Tortellini E, Guardiani M, Spagnoli A, Marocco R, Alunni Fegatelli D, Lichtner M. Effectiveness, Tolerability and Prescribing Choice of Antiviral Molecules Molnupiravir, Remdesivir and Nirmatrelvir/r: A Real-World Comparison in the First Ten Months of Use. Viruses 2023; 15:v15041025. [PMID: 37113006 PMCID: PMC10145588 DOI: 10.3390/v15041025] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
In 2022, three antiviral drugs-molnupiravir, remdesivir and nirmatrelvir/ritonavir-were introduced for treatment of mild-to-moderate COVID-19 in high-risk patients. The aim of this study is the evaluation of their effectiveness and tolerability in a real-life setting. A single-center observational study was set up, with the involvement of 1118 patients, with complete follow-up data, treated between the 5th of January and the 3rd of October 2022 at Santa Maria Goretti's hospital in Latina, Central Italy. A univariable and a multivariable analysis were performed on clinical and demographic data and composite outcome, the persistence of symptoms at 30 days and time to negativization, respectively. The three antivirals showed a similar effectiveness in containing the progression of the infection to severe COVID-19 and a good tolerability in the absence of serious adverse effects. Persistence of symptoms after 30 days was more common in females than males and less common in patients treated with molnupiravir and nirmatrelvir/r. The availability of different antiviral molecules is a strong tool and, if correctly prescribed, they can have a significant role in changing the natural history of infection for frail persons, in which vaccination could be not sufficient for the prevention of severe COVID-19.
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Affiliation(s)
- Cosmo Del Borgo
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Silvia Garattini
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Bortignon
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Anna Carraro
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Daniela Di Trento
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Gasperin
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandra Grimaldi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Sara Giovanna De Maria
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Sara Corazza
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Tiziana Tieghi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Valeria Belvisi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Blerta Kertusha
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Margherita De Masi
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Ombretta D'Onofrio
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Gabriele Bagaglini
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Gabriella Bonanni
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Paola Zuccalà
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Paolo Fabietti
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Eeva Tortellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Mariasilvia Guardiani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Alessandra Spagnoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Raffaella Marocco
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
| | - Miriam Lichtner
- Infectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Department of Neurosciences, Mental Health, and Sense Organs, NESMOS, Sapienza University of Rome, 00189 Rome, Italy
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8
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Baranova A, Cao H, Teng S, Zhang F. A phenome-wide investigation of risk factors for severe COVID-19. J Med Virol 2023; 95:e28264. [PMID: 36316288 PMCID: PMC9874597 DOI: 10.1002/jmv.28264] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/14/2022] [Accepted: 10/27/2022] [Indexed: 11/07/2022]
Abstract
With the continued spread of COVID-19 globally, it is crucial to identify the potential risk or protective factors associated with COVID-19. Here, we performed genetic correlation analysis and Mendelian randomization analysis to examine genetic relationships between COVID-19 hospitalization and 405 health conditions and lifestyle factors in 456 422 participants from the UK Biobank. The genetic correlation analysis revealed 134 positive and 65 negative correlations, including those with intakes of a variety of dietary components. The MR analysis indicates that a set of body fat-related traits, maternal smoking around birth, basal metabolic rate, lymphocyte count, peripheral enthesopathies and allied syndromes, blood clots in the leg, and arthropathy are causal risk factors for severe COVID-19, while higher education attainment, physical activity, asthma, and never smoking status protect against the illness. Our findings have implications for risk stratification in patients with COVID-19 and the prevention of its severe outcomes.
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Affiliation(s)
- Ancha Baranova
- School of Systems Biology, George Mason University, Manassas, Virginia, USA.,Research Centre for Medical Genetics, Moscow, Russia
| | - Hongbao Cao
- School of Systems Biology, George Mason University, Manassas, Virginia, USA
| | - Shaolei Teng
- Department of Biology, Howard University, Washington, District of Columbia, USA
| | - Fuquan Zhang
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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9
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Baranova A, Song Y, Cao H, Zhang F. Causal Associations Between Basal Metabolic Rate and COVID-19. Diabetes 2023; 72:149-154. [PMID: 36215434 DOI: 10.2337/db22-0610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/05/2022] [Indexed: 11/13/2022]
Abstract
Many coronavirus disease 2019 (COVID-19) risk factors, including obesity and diabetes, are associated with an abnormal basal metabolic rate (BMR). We aimed to evaluate whether BMR could impact the susceptibility to or severity of COVID-19. We performed genetic correlation and Mendelian randomization (MR) analyses to assess genetic correlations and potential causal associations between BMR (n = 448,348) and three COVID-19 outcomes: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, COVID-19 hospitalization, and critical COVID-19 (n = 1,086,211-2,597,856). A multivariable MR (MVMR) analysis was used to estimate the direct effect of BMR on COVID-19 independent of BMI and type 2 diabetes. BMR has positive genetic correlations with the COVID-19 outcomes (genetic correlations 0.213-0.266). The MR analyses indicated that genetic liability to BMR confers causal effects on SARS-CoV-2 infection (odds ratio 1.14, 95% CI 1.09-1.20, P = 1.65E-07), hospitalized COVID-19 (1.31, 1.18-1.46, P = 8.69E-07), and critical COVID-19 (1.04, 1.19-1.64, P = 4.89E-05). Sensitivity analysis of MR showed no evidence of directional pleiotropy or heterogeneity, indicating the robustness of its results. The MVMR analysis showed that the causal effects of BMR on hospitalized COVID-19 and critical COVID-19 were dependent on BMI and type 2 diabetes but that BMR may affect the SARS-CoV-2 infection risk independently of BMI and type 2 diabetes (odds ratio 1.09, 95% CI 1.03-1.15, P = 4.82E-03). Our study indicates that a higher BMR contributes to amplifying the susceptibility to and severity of COVID-19. The causal effect of BMR on the severity of COVID-19 may be mediated by BMI and type 2 diabetes.
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Affiliation(s)
- Ancha Baranova
- School of Systems Biology, George Mason University, Manassas, VA
- Research Centre for Medical Genetics, Moscow, Russia
| | - Yuqing Song
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
- Key Laboratory of Mental Health, Ministry of Health and National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Hongbao Cao
- School of Systems Biology, George Mason University, Manassas, VA
| | - Fuquan Zhang
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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10
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Lau B, Wentz E, Ni Z, Yenokyan K, Coggiano C, Mehta SH, Duggal P. Physical and mental health disability associated with long-COVID: Baseline results from a US nationwide cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.12.07.22283203. [PMID: 36523402 PMCID: PMC9753791 DOI: 10.1101/2022.12.07.22283203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Importance Persistent symptoms after SARS-COV-2 infection, or long-COVID, may occur in anywhere from 10-55% of those who have had COVID-19, but the extent of impact on daily functioning and disability remains unquantified. Objective To characterize physical and mental disability associated with long-COVID. Design Cross-sectional analysis of baseline data from a cohort study. Setting Online US nationwide survey. Participants Adults 18 years of age and older who live in the US who either report a history of COVID-19 illness (n=8,874) or report never having had COVID-19 (n=633). Main Outcome and Measures Self-reported mobility disability (difficulty walking a quarter of a mile and/or up 10 stairs, instrumental activities of daily living [IADL] disability (difficulty doing light or heavy housework), and mental fatigue as measured by the Wood Mental Fatigue Inventory (WMFI). Results Of 7,926 participants with long-COVID, the median age was 45 years, 84% were female, 89% self-reported white race, and 7.4% self-reported Hispanic/Latino ethnicity. Sixty-five percent of long-COVID participants were classified as having at least one disability, compared to 6% of those with resolved-COVID (n=948) and 14% of those with no-COVID (n=633). Of long-COVID participants, about 1% and 5% were classified as critically physically disabled or mentally fatigued, respectively. Age, prior comorbidity, increased BMI, female gender, hospitalization for COVID-19, non-white race, and multi-race were all associated with significantly higher disability burden. Dizziness at the time of infection (33% non-hospitalized, 39% hospitalized) was associated with all five disability components in both hospitalized and non-hospitalized groups. Heavy limbs, dyspnea, and tremors were associated with four of the five components of disability in the non-hospitalized group, and heavy limbs was associated with four of the five components in the hospitalized group. Vaccination was protective against development of disability. Conclusion and Relevance We observed a high burden of physical and mental disability associated with long-COVID which has serious implications for individual and societal health that may be partially mitigated by vaccination. Longitudinal characterization and evaluation of COVID-19 patients is necessary to identify patterns of recovery and treatment options.
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Affiliation(s)
- Bryan Lau
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Eryka Wentz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Zhanmo Ni
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Karine Yenokyan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Candelaria Coggiano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- These authors contributed equally
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- These authors contributed equally
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11
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Du M, Ma Y, Deng J, Liu M, Liu J. Comparison of Long COVID-19 Caused by Different SARS-CoV-2 Strains: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16010. [PMID: 36498103 PMCID: PMC9736973 DOI: 10.3390/ijerph192316010] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 06/01/2023]
Abstract
Although many studies of long COVID-19 were reported, there was a lack of systematic research which assessed the differences of long COVID-19 in regard to what unique SARS-CoV-2 strains caused it. As such, this systematic review and meta-analysis aims to evaluate the characteristics of long COVID-19 that is caused by different SARS-CoV-2 strains. We systematically searched the PubMed, EMBASE, and ScienceDirect databases in order to find cohort studies of long COVID-19 as defined by the WHO (Geneva, Switzerland). The main outcomes were in determining the percentages of long COVID-19 among patients who were infected with different SARS-CoV-2 strains. Further, this study was registered in PROSPERO (CRD42022339964). A total of 51 studies with 33,573 patients was included, of which three studies possessed the Alpha and Delta variants, and five studies possessed the Omicron variant. The highest pooled estimate of long COVID-19 was found in the CT abnormalities (60.5%; 95% CI: 40.4%, 80.6%) for the wild-type strain; fatigue (66.1%; 95% CI: 42.2%, 89.9%) for the Alpha variant; and ≥1 general symptoms (28.4%; 95% CI: 7.9%, 49.0%) for the Omicron variant. The pooled estimates of ≥1 general symptoms (65.8%; 95% CI: 47.7%, 83.9%) and fatigue were the highest symptoms found among patients infected with the Alpha variant, followed by the wild-type strain, and then the Omicron variant. The pooled estimate of myalgia was highest among patients infected with the Omicron variant (11.7%; 95%: 8.3%, 15.1%), compared with those infected with the wild-type strain (9.4%; 95%: 6.3%, 12.5%). The pooled estimate of sleep difficulty was lowest among the patients infected with the Delta variant (2.5%; 95%: 0.2%, 4.9%) when compared with those infected with the wild-type strain (24.5%; 95%: 17.5%, 31.5%) and the Omicron variant (18.7%; 95%: 1.0%, 36.5%). The findings of this study suggest that there is no significant difference between long COVID-19 that has been caused by different strains, except in certain general symptoms (i.e., in the Alpha or Omicron variant) and in sleep difficulty (i.e., the wild-type strain). In the context of the ongoing COVID-19 pandemic and its emerging variants, directing more attention to long COVID-19 that is caused by unique strains, as well as implementing targeted intervention measures to address it are vital.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yirui Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
- Institute for Global Health and Development, Peking University, No. 5, Yiheyuan Road, Haidian District, Beijing 100871, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People’s Republic of China, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
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12
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Gyöngyösi M, Alcaide P, Asselbergs FW, Brundel BJJM, Camici GG, da Costa Martins P, Ferdinandy P, Fontana M, Girao H, Gnecchi M, Gollmann-Tepeköylü C, Kleinbongard P, Krieg T, Madonna R, Paillard M, Pantazis A, Perrino C, Pesce M, Schiattarella GG, Sluijter JPG, Steffens S, Tschöpe C, Van Linthout S, Davidson SM. Long COVID and the cardiovascular system - elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies: A joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial & Pericardial Diseases. Cardiovasc Res 2022; 119:336-356. [PMID: 35875883 PMCID: PMC9384470 DOI: 10.1093/cvr/cvac115] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 02/07/2023] Open
Abstract
Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multi-organ symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious peri-myocarditis with consequent left or right ventricular failure, arterial wall inflammation or micro-thrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, micro-thrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.
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Affiliation(s)
- Mariann Gyöngyösi
- Corresponding Author: Mariann Gyöngyösi Division of Cardiology, 2nd Department of Internal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria Tel.: +43-1-40400-46140 , Fax: +43-1-40400-42160
| | - Pilar Alcaide
- Department of Immunology, Tufts University School of Medicine, Boston, MA, USA
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands,Health Data Research UK and Institute of Health Informatics, University College London, London, United Kingdom
| | - Bianca J J M Brundel
- Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland,University Heart Center, Department of Cardiology, University Hospital, Zurich, Switzerland
| | - Paula da Costa Martins
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary,Pharmahungary Group, Szeged, Hungary
| | - Marianna Fontana
- Royal Free Hospital London, Division of Medicine, University College London, London, UK
| | - Henrique Girao
- Center for Innovative Biomedicine and Biotechnology (CIBB), Clinical Academic Centre of Coimbra (CACC), Faculty of Medicine, Univ Coimbra, Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal
| | - Massimiliano Gnecchi
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia,Unit of Translational Cardiology, Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Petra Kleinbongard
- Institut für Pathophysiologie, Westdeutsches Herz- und Gefäßzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Thomas Krieg
- Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Rosalinda Madonna
- Department of Pathology, Institute of Cardiology, University of Pisa, Pisa, Italy
| | - Melanie Paillard
- Laboratoire CarMeN-équipe IRIS, INSERM, INRA, Université Claude Bernard Lyon-1, INSA-Lyon, Univ-Lyon, 69500 Bron, France
| | - Antonis Pantazis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; Cardiovascular Research Centre at Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples
| | - Maurizio Pesce
- Unità di Ingegneria Tissutale cardiovascolare, Centro Cardiologico Monzino, IRCCS
| | - Gabriele G Schiattarella
- Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy,Center for Cardiovascular Research (CCR), Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany,Translational Approaches in Heart Failure and Cardiometabolic Disease, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Joost P G Sluijter
- Laboratory of Experimental Cardiology, Cardiology, UMC Utrecht Regenerative Medicine Center,Circulatory Health Laboratory, Utrecht University, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sabine Steffens
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität, Munich,Germany and Munich Heart Alliance, DZHK partner site Munich, Germany
| | - Carsten Tschöpe
- Berlin Institute of Health (BIH) at Charité, - Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner site Berlin and Dept Cardiology (CVK), Charité, Berlin; Germany
| | - Sophie Van Linthout
- Berlin Institute of Health (BIH) at Charité, - Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), German Center for Cardiovascular Research (DZHK), Partner site Berlin and Dept Cardiology (CVK), Charité, Berlin; Germany
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, WC1E 6HX, London, United Kingdom
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13
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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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