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Greenhalgh T, Sivan M, Perlowski A, Nikolich JŽ. Long COVID: a clinical update. Lancet 2024; 404:707-724. [PMID: 39096925 DOI: 10.1016/s0140-6736(24)01136-x] [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: 01/27/2024] [Revised: 05/07/2024] [Accepted: 05/30/2024] [Indexed: 08/05/2024]
Abstract
Post-COVID-19 condition (also known as long COVID) is generally defined as symptoms persisting for 3 months or more after acute COVID-19. Long COVID can affect multiple organ systems and lead to severe and protracted impairment of function as a result of organ damage. The burden of this disease, both on the individual and on health systems and national economies, is high. In this interdisciplinary Review, with a coauthor with lived experience of severe long COVID, we sought to bring together multiple streams of literature on the epidemiology, pathophysiology (including the hypothesised mechanisms of organ damage), lived experience and clinical manifestations, and clinical investigation and management of long COVID. Although current approaches to long COVID care are largely symptomatic and supportive, recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification might herald a more mechanism-informed and personally tailored approach to clinical care. We also cover the organisation of services for long COVID, approaches to preventing long COVID, and suggestions for future research.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK.
| | - Manoj Sivan
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds, Leeds General Infirmary, Leeds, UK
| | | | - Janko Ž Nikolich
- Department of Immunobiology and University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA; The Aegis Consortium for Pandemic-Free Future, University of Arizona Health Sciences, Tucson, AZ, USA
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Fernández-de-las-Peñas C, Franco-Moreno A, Ruiz-Ruigómez M, Arrieta-Ortubay E, Ryan-Murua P, Lumbreras-Bermejo C, del-Valle-Loarte P, Pellicer-Valero OJ, Giordano R, Arendt-Nielsen L, Martín-Garrido I, Torres-Macho J. Is Antiviral Treatment with Remdesivir at the Acute Phase of SARS-CoV-2 Infection Effective for Decreasing the Risk of Long-Lasting Post-COVID Symptoms? Viruses 2024; 16:947. [PMID: 38932239 PMCID: PMC11209434 DOI: 10.3390/v16060947] [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: 05/23/2024] [Revised: 06/08/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
The aim of this study was to investigate the effects of administrating Remdesivir at the acute COVID-19 phase on developing post-COVID symptoms in previously hospitalized COVID-19 survivors by controlling factors such as age, sex, body mass index, and vaccination status. A case-control study was performed. Hospitalized COVID-19 survivors who had received intravenous Remdesivir during the acute phase (n = 216) were matched by age, sex, body mass index, and vaccination status with survivors who did not receive antiviral treatment (n = 216). Participants were asked to self-report the presence of any post-COVID symptom (defined as a symptom that started no later than three months after infection) and whether the symptom persisted at the time of study (mean: 18.4, SD: 0.8 months). Anxiety levels (HADS-A), depressive symptoms (HADS-D), sleep quality (PSQI), and severity/disability (FIC) were also compared. The multivariate analysis revealed that administration of Remdesivir at the acute COVID-19 phase was a protective factor for long-term COVID development (OR0.401, 95%CI 0.256-0.628) and specifically for the following post-COVID symptoms: fatigue (OR0.399, 95%CI 0.270-0.590), pain (OR0.368, 95% CI 0.248-0.548), dyspnea at rest (OR0.580, 95%CI 0.361-0.933), concentration loss (OR0.368, 95%CI 0.151-0.901), memory loss (OR0.399, 95%CI 0.270-0.590), hair loss (OR0.103, 95%CI 0.052-0.207), and skin rashes (OR0.037, 95%CI 0.005-0.278). This study supports the potential protective role of intravenous administration of Remdesivir during the COVID-19 acute phase for long-lasting post-COVID symptoms in previously hospitalized COVID-19 survivors.
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Affiliation(s)
- César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Madrid, Spain
- Center for Neuroplasticity and Pain (CNAP), Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK 9220 Aalborg, Denmark; (R.G.); (L.A.-N.)
| | - Anabel Franco-Moreno
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain; (A.F.-M.); (P.R.-M.); (J.T.-M.)
| | - María Ruiz-Ruigómez
- Department of Internal Medicine, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (M.R.-R.); (E.A.-O.); (C.L.-B.)
| | - Estibaliz Arrieta-Ortubay
- Department of Internal Medicine, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (M.R.-R.); (E.A.-O.); (C.L.-B.)
| | - Pablo Ryan-Murua
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain; (A.F.-M.); (P.R.-M.); (J.T.-M.)
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Investigación Carlos III (ISCIIII), 28220 Madrid, Spain
| | - Carlos Lumbreras-Bermejo
- Department of Internal Medicine, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (M.R.-R.); (E.A.-O.); (C.L.-B.)
| | - Pablo del-Valle-Loarte
- Department of Internal Medicine, Hospital Universitario Severo Ochoa, 28911 Madrid, Spain;
| | - Oscar J. Pellicer-Valero
- Image Processing Laboratory (IPL), Universitat de València, Parc Científic, Paterna, 46980 València, Spain;
| | - Rocco Giordano
- Center for Neuroplasticity and Pain (CNAP), Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK 9220 Aalborg, Denmark; (R.G.); (L.A.-N.)
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, DK 9100 Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK 9220 Aalborg, Denmark; (R.G.); (L.A.-N.)
- Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, DK 9100 Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, DK 9100 Aalborg, Denmark
| | | | - Juan Torres-Macho
- Department of Internal Medicine, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain; (A.F.-M.); (P.R.-M.); (J.T.-M.)
- Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Soriano V, Moreno-Torres V. Oral antivirals for acute symptoms and post-acute sequelae in SARS-CoV-2 infection. THE LANCET. INFECTIOUS DISEASES 2024:S1473-3099(24)00258-5. [PMID: 38710191 DOI: 10.1016/s1473-3099(24)00258-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024]
Affiliation(s)
- Vicente Soriano
- UNIR Health Sciences School and Medical Center, Universidad Internacional de La Rioja, Madrid 28010, Spain.
| | - Víctor Moreno-Torres
- UNIR Health Sciences School and Medical Center, Universidad Internacional de La Rioja, Madrid 28010, Spain; Department of Internal Medicine, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
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