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van der Feltz-Cornelis C, Turk F, Sweetman J, Khunti K, Gabbay M, Shepherd J, Montgomery H, Strain WD, Lip GYH, Wootton D, Watkins CL, Cuthbertson DJ, Williams N, Banerjee A. Prevalence of mental health conditions and brain fog in people with long COVID: A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 88:10-22. [PMID: 38447388 DOI: 10.1016/j.genhosppsych.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Long COVID can include impaired cognition ('brain fog'; a term encompassing multiple symptoms) and mental health conditions. We performed a systematic review and meta-analysis to estimate their prevalence and to explore relevant factors associated with the incidence of impaired cognition and mental health conditions. METHODS Searches were conducted in Medline and PsycINFO to cover the start of the pandemic until August 2023. Included studies reported prevalence of mental health conditions and brain fog in adults with long COVID after clinically-diagnosed or PCR-confirmed SARS-CoV-2 infection. FINDINGS 17 studies were included, reporting 41,249 long COVID patients. Across all timepoints (3-24 months), the combined prevalence of mental health conditions and brain fog was 20·4% (95% CI 11·1%-34·4%), being lower among those previously hospitalised than in community-managed patients(19·5 vs 29·7% respectively; p = 0·047). The odds of mental health conditions and brain fog increased over time and when validated instruments were used. Odds of brain fog significantly decreased with increasing vaccination rates (p = ·000). CONCLUSIONS Given the increasing prevalence of mental health conditions and brain fog over time, preventive interventions and treatments are needed. Research is needed to explore underlying mechanisms that could inform further research in development of effective treatments. The reduced risk of brain fog associated with vaccination emphasizes the need for ongoing vaccination programs.
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Affiliation(s)
- Christina van der Feltz-Cornelis
- Department of Health Sciences, University of York, York, United Kingdom; Hull York Medical School, (HYMS), University of York, York, United Kingdom; Institute of Health Informatics, University College London, London, United Kingdom.
| | - Fidan Turk
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jennifer Sweetman
- Department of Health Sciences, University of York, York, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Mark Gabbay
- Department of Primary Care and Mental Health University of Liverpool, Liverpool, United Kingdom
| | - Jessie Shepherd
- Department of Health Sciences, University of York, York, United Kingdom
| | - Hugh Montgomery
- Department of Medicine, University College London, London, United Kingdom
| | - W David Strain
- Diabetes and Vascular Medicine Research Centre, Institute of Clinical and Biomedical Science and College of Medicine and Health, University of Exeter, Exeter, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dan Wootton
- Institute of Infection Veterinary and Ecological Sciences and NIHR HPRU in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom; Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Caroline Leigh Watkins
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, United Kingdom; School of Nursing and Midwifery, University of Central Lancashire, Preston, United Kingdom
| | - Daniel J Cuthbertson
- Institute of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Nefyn Williams
- Department of Primary Care and Mental Health University of Liverpool, Liverpool, United Kingdom
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom; Department of Cardiology, University College London Hospitals NHS Trust, London, United Kingdom; Department of Cardiology, Barts Health NHS Trust, London, United Kingdom
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Harhala MA, Gembara K, Baniecki K, Pikies A, Nahorecki A, Jędruchniewicz N, Kaźmierczak Z, Rybicka I, Klimek T, Witkiewicz W, Barczyk K, Kłak M, Dąbrowska K. Experimental Identification of Cross-Reacting IgG Hotspots to Predict Existing Immunity Evasion of SARS-CoV-2 Variants by a New Biotechnological Application of Phage Display. Viruses 2023; 16:58. [PMID: 38257758 PMCID: PMC10820762 DOI: 10.3390/v16010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Multiple pathogens are competing against the human immune response, leading to outbreaks that are increasingly difficult to control. For example, the SARS-CoV-2 virus continually evolves, giving rise to new variants. The ability to evade the immune system is a crucial factor contributing to the spread of these variants within the human population. With the continuous emergence of new variants, it is challenging to comprehend all the possible combinations of previous infections, various vaccination types, and potential exposure to new variants in an individual patient. Rather than conducting variant-to-variant comparisons, an efficient approach could involve identifying key protein regions associated with the immune evasion of existing immunity against the virus. In this study, we propose a new biotechnological application of bacteriophages, the phage display platform for experimental identification of regions (linear epitopes) that may function as cross-reacting IgG hotspots in SARS-CoV-2 structural proteins. A total of 34,949 epitopes derived from genomes of all SARS-CoV-2 variants deposited prior to our library design were tested in a single assay. Cross-reacting IgG hotspots are protein regions frequently recognized by cross-reacting antibodies in many variants. The assay facilitated the one-step identification of immunogenic regions of proteins that effectively induced specific IgG in SARS-CoV-2-infected patients. We identified four regions demonstrating both significant immunogenicity and the activity of a cross-reacting IgG hotspot in protein S (located at NTD, RBD, HR1, and HR2/TM domains) and two such regions in protein N (at 197-280 and 358-419 aa positions). This novel method for identifying cross-reacting IgG hotspots holds promise for informing vaccine design and serological diagnostics for COVID-19 and other infectious diseases.
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Affiliation(s)
- Marek Adam Harhala
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
- Hirszfeld Institute of Immunology and Experimental Therapy, Weigla 12 St., 53-114 Wrocław, Poland;
| | - Katarzyna Gembara
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
- Hirszfeld Institute of Immunology and Experimental Therapy, Weigla 12 St., 53-114 Wrocław, Poland;
| | - Krzysztof Baniecki
- Healthcare Centre in Bolesławiec, Jeleniogórska 4, 59-700 Bolesławiec, Poland; (K.B.); (A.P.); (A.N.); (K.B.)
| | - Aleksandra Pikies
- Healthcare Centre in Bolesławiec, Jeleniogórska 4, 59-700 Bolesławiec, Poland; (K.B.); (A.P.); (A.N.); (K.B.)
| | - Artur Nahorecki
- Healthcare Centre in Bolesławiec, Jeleniogórska 4, 59-700 Bolesławiec, Poland; (K.B.); (A.P.); (A.N.); (K.B.)
| | - Natalia Jędruchniewicz
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
| | - Zuzanna Kaźmierczak
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
- Hirszfeld Institute of Immunology and Experimental Therapy, Weigla 12 St., 53-114 Wrocław, Poland;
| | - Izabela Rybicka
- Hirszfeld Institute of Immunology and Experimental Therapy, Weigla 12 St., 53-114 Wrocław, Poland;
| | - Tomasz Klimek
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
| | - Wojciech Witkiewicz
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
| | - Kamil Barczyk
- Healthcare Centre in Bolesławiec, Jeleniogórska 4, 59-700 Bolesławiec, Poland; (K.B.); (A.P.); (A.N.); (K.B.)
| | - Marlena Kłak
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
| | - Krystyna Dąbrowska
- Research and Development Center, Regional Specialist Hospital in Wrocław, Kamieńskiego 73a St., 51-124 Wrocław, Poland; (M.A.H.); (K.G.); (N.J.); (Z.K.); (T.K.); (W.W.); (M.K.)
- Hirszfeld Institute of Immunology and Experimental Therapy, Weigla 12 St., 53-114 Wrocław, Poland;
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