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Tariq M, Mahak FNU, Kumar R, Kumar A, Kumar A, Khan J, Muhammad MA, Memon U, Maqsood KM, Tanveer FS, Gill A, Jawed A, Shrestha S, Waheed MH. Unmasking the long-term effects: unravelling neuropsychiatric and neurological consequences of COVID-19. Ann Med Surg (Lond) 2024; 86:1490-1495. [PMID: 38463084 PMCID: PMC10923314 DOI: 10.1097/ms9.0000000000001624] [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: 10/10/2023] [Accepted: 12/05/2023] [Indexed: 03/12/2024] Open
Abstract
The COVID-19 pandemic has not only burdened healthcare systems but has also led to a new emerging medical enigma that is post-COVID-19 syndrome or "long COVID." Characterized by persistent symptoms that extend beyond the acute phase of the illness, long COVID has rapidly become a public health concern with ambiguous neurological and neuropsychiatric dimensions. This narrative review aims at synthesizing available research to decode the long-term impacts of COVID-19 on neurological and mental health. Drawing from a multitude of studies, this review synthesizes evidence on various neuropsychiatric and neurological symptoms, including cognitive deficits, mood disorders, and more. The narrative delves into potential pathogenic mechanisms, hoping to fill existing research gaps and offering directions for future inquiry. The objective is not just academic; it has immediate real-world implications. Understanding these long-term effects is crucial for developing effective treatments and interventions, thereby better serving the millions of individuals living with these lingering symptoms. As healthcare systems continue to grapple with the fallout from the pandemic, this review provides much-needed context and insights into an area that demands urgent research and action.
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Affiliation(s)
- Mahnoor Tariq
- Foundation University college of dentistry, Islamabad
| | - FNU Mahak
- Jinnah Postgraduate Medical Center, Karachi
| | - Rahul Kumar
- Department of Internal Medicine, Anklesaria Hospital, Karachi
| | - Ajay Kumar
- Jinnah Postgraduate Medical Center, Karachi
| | - Anish Kumar
- Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | | | - Marvi Ali Muhammad
- Department of Accident and Emergency, Jinnah Postgraduate Medical Center, Karachi
| | - Unaiza Memon
- Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | | | | | - Anosh Gill
- Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | | | - Sunita Shrestha
- Department of Neurology, Upendra Devkota Memorial, Bansbari, Khatmandu, Nepal
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Aprile I, Bramante L, La Russa C, Germanotta M, Barletta VT, Falchini F, Brambilla L, Guglielmelli E, Rossi P. A Multiaxial Rehabilitation Programme for Workers with COVID-19 Sequelae Using a Conventional and Technological-Robotic Approach: The Proposal of INAIL and Fondazione Don Carlo Gnocchi. Healthcare (Basel) 2023; 11:1593. [PMID: 37297733 PMCID: PMC10252900 DOI: 10.3390/healthcare11111593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/11/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023] Open
Abstract
The COVID-19 sequelae have been shown to affect respiratory and cardiological functions as well as neuro-psychological functions, and, in some cases, metabolic/nutritional aspects. The Italian National Institute for Insurance against Accidents at Work (Istituto Nazionale Assicurazione Infortuni sul Lavoro, INAIL) recorded that, until December 2022, 315,055 workers were affected by COVID-19; therefore, there is a need to identify an effective approach to treat such patients. Robotic and technological devices could be integrated into the rehabilitation programme of people with long COVID conditions. A review of the literature showed that telerehabilitation may improve functional capacity, dyspnoea, performance, and quality of life in these patients, but no studies were found evaluating the effects of robot-mediated therapy or virtual reality systems. Considering the above, Fondazione Don Carlo Gnocchi and INAIL propose a multi-axial rehabilitation for workers with COVID-19 sequelae. To accomplish this goal, the two institutions merged the epidemiological information gathered by INAIL, the expertise in robotic and technological rehabilitation of Fondazione Don Carlo Gnocchi, and the literature review. Our proposal aims to facilitate a multi-axial rehabilitation approach customized to meet the unique needs of each individual, with a particular emphasis on utilizing advanced technologies to address the current and future challenges of patient care.
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Affiliation(s)
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Lucia Bramante
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
| | - Chiara La Russa
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
| | - Marco Germanotta
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | | | - Francesca Falchini
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Lorenzo Brambilla
- IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy; (I.A.); (V.T.B.); (F.F.); (L.B.)
| | - Eugenio Guglielmelli
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy;
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy
| | - Patrizio Rossi
- Central Medical Department, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy; (L.B.); (C.L.R.); (P.R.)
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Polyzogopoulou E, Amoiridou P, Abraham TP, Ventoulis I. Acute liver injury in COVID-19 patients hospitalized in the intensive care unit: Narrative review. World J Gastroenterol 2022; 28:6662-6688. [PMID: 36620339 PMCID: PMC9813941 DOI: 10.3748/wjg.v28.i47.6662] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/14/2022] [Accepted: 12/05/2022] [Indexed: 12/19/2022] Open
Abstract
In recent years, humanity has been confronted with a global pandemic due to coronavirus disease 2019 (COVID-19), which has caused an unprecedented health and economic crisis worldwide. Apart from the respiratory symptoms, which are considered the principal manifestations of COVID-19, it has been recognized that COVID-19 constitutes a systemic inflammatory process affecting multiple organ systems. Across the spectrum of organ involvement in COVID-19, acute liver injury (ALI) has been gradually gaining increasing attention by the international scientific community. COVID-19 associated liver impairment can affect a considerable proportion of COVID-19 patients and seems to correlate with the severity of the disease course. Indeed, COVID-19 patients hospitalized in the intensive care unit (ICU) run a greater risk of developing ALI due to the severity of their clinical condition and in the context of multi-organ failure. The putative pathophysiological mechanisms of COVID-19 induced ALI in ICU patients remain poorly understood and appear to be multifactorial in nature. Several theories have been proposed to explain the occurrence of ALI in the ICU setting, such as hypoperfusion and ischemia due to hemodynamic instability, passive liver congestion as a result of congestive heart failure, ischemia-reperfusion injury, hypoxia due to respiratory failure, mechanical ventilation itself, sepsis and septic shock, cytokine storm, endotheliitis with concomitant coagulopathy, drug-induced liver injury, parenteral nutrition and direct cytopathic viral effect. It should be noted that no specific therapy for COVID-19 induced ALI exists. Therefore, the therapeutic approach lies in preventive measures and is exclusively supportive once ALI ensues. The aim of the current review is to scrutinize the existing evidence on COVID-19 associated ALI in ICU patients, explore its clinical implications, shed light on the underlying pathophysiological mechanisms and propose potential therapeutic approaches. Ongoing research on the particular scientific field will further elucidate the pathophysiology behind ALI and address unresolved issues, in the hope of mitigating the tremendous health consequences imposed by COVID-19 on ICU patients.
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Affiliation(s)
- Effie Polyzogopoulou
- Department of Emergency Medicine, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens 12462, Greece
| | - Pinelopi Amoiridou
- Department of Intensive Care, AHEPA University Hospital, Thessaloniki 54621, Greece
| | - Theodore P Abraham
- Hypertrophic Cardiomyopathy Center of Excellence, University of California, San Francisco, CA 94117, United States
| | - Ioannis Ventoulis
- Department of Occupational Therapy, University of Western Macedonia, Ptolemaida 50200, Greece
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Zargarzadeh N, Tadbir Vajargah K, Ebrahimzadeh A, Mousavi SM, Khodaveisi H, Akhgarjand C, Toyos FMP, Cerqueira HS, Santos HO, Taghizadeh M, Milajerdi A. Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study. Front Med (Lausanne) 2022; 9:911273. [PMID: 35928288 PMCID: PMC9343686 DOI: 10.3389/fmed.2022.911273] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background and Aims Adherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients. Methods In this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD. Results The participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat. Conclusion Higher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.
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Affiliation(s)
- Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Armin Ebrahimzadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Seyed Mohammad Mousavi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Khodaveisi
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Camellia Akhgarjand
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Heitor O. Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Brazil
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
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Bhagat YV, Hussien S, Queenan H, Michael MB. Exacerbation of Secondary Cold Agglutinin Syndrome in the Setting of SARS-CoV-2. Cureus 2021; 13:e19387. [PMID: 34925989 PMCID: PMC8655486 DOI: 10.7759/cureus.19387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/05/2022] Open
Abstract
In this report, we present a case of exacerbation of cold agglutinin syndrome (CAS) potentially due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. An 83-year-old female with a history of cold agglutinin hemolytic anemia presented with shortness of breath, productive cough, worsening orthopnea, darkening fingers and urine, and jaundice. Laboratory investigations found elevated white blood cells (WBC) and total bilirubin, severely low hemoglobin, and positive direct Coombs test. Moreover, SARS-CoV-2 RNA was also found to be positive in a sample from the nasal swab by reverse transcription-polymerase chain reaction (RT-PCR), indicating exacerbation of CAS secondary to viral coronavirus 2019 (COVID-19) infection. A treatment regime for SARS-CoV-2 consisting of five days of remdesivir and seven days of dexamethasone 6 mg IV was initiated, resulting in significant improvement in the patient's condition.
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Affiliation(s)
- Yash V Bhagat
- Internal Medicine, University of Maryland Midtown Campus, Baltimore, USA.,College of Medicine, American University of Antigua, St. John's, ATG
| | - Siham Hussien
- Internal Medicine, University of Maryland Midtown Campus, Baltimore, USA
| | - Helen Queenan
- Internal Medicine, Howard University College of Medicine, Washington, D.C., USA
| | - Miriam B Michael
- Internal Medicine, Howard University College of Medicine, Washington, D.C., USA.,Internal Medicine, University of Maryland Midtown Campus, Baltimore, USA
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