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Xiang Y, Feng Y, Qiu J, Zhang R, So HC. Association of COVID-19 vaccination with risks of hospitalization due to cardiovascular and other diseases: A study using data from the UK Biobank. Int J Infect Dis 2024; 145:107080. [PMID: 38701913 DOI: 10.1016/j.ijid.2024.107080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/08/2024] [Accepted: 04/29/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES To explore whether COVID-19 vaccination protects against hospital admission by preventing infections and severe disease. METHODS We leveraged the UK Biobank and studied associations of COVID-19 vaccination (BioNTech-BNT162b2 or Oxford-AstraZeneca-ChAdOx1) with hospitalizations from cardiovascular and other selected diseases (N = 393,544; median follow-up = 54 days among vaccinated individuals). Multivariable Cox, Poisson regression, propensity score matching, and inverse probability treatment weighting analyses were performed. We also performed adjustment using prescription-time distribution matching, and prior event rate ratio. RESULTS We observed that COVID-19 vaccination (at least one dose), compared with no vaccination, was associated with reduced short-term risks of hospitalizations from stroke (hazard ratio [HR] = 0.178, 95% confidence interval [CI]: 0.127-0.250, P = 1.50e-23), venous thromboembolism (HR = 0.426, CI: 0.270-0.673, P = 2.51e-4), dementia (HR = 0.114, CI: 0.060-0.216; P = 2.24e-11), non-COVID-19 pneumonia (HR = 0.108, CI: 0.080-0.145; P = 2.20e-49), coronary artery disease (HR = 0.563, CI: 0.416-0.762; P = 2.05e-4), chronic obstructive pulmonary disease (HR = 0.212, CI: 0.126-0.357; P = 4.92e-9), type 2 diabetes (HR = 0.216, CI: 0.096-0.486, P = 2.12e-4), heart failure (HR = 0.174, CI: 0.118-0.256, P = 1.34e-18), and renal failure (HR = 0.415, CI: 0.255-0.677, P = 4.19e-4), based on standard Cox regression models. Among the previously mentioned results, reduced hospitalizations for stroke, heart failure, non-COVID-19 pneumonia, and dementia were consistently observed across regression, propensity score matching/inverse probability treatment weighting, prescription-time distribution matching, and prior event rate ratio. The results for two-dose vaccination were similar. CONCLUSIONS Taken together, this study provides further support to the safety and benefits of COVID-19 vaccination, and such benefits may extend beyond reduction of infection risk or severity per se. However, causal relationship cannot be concluded and further studies are required.
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Affiliation(s)
- Yong Xiang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yaning Feng
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jinghong Qiu
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ruoyu Zhang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong; KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology and The Chinese University of Hong Kong, Hong Kong, China; CUHK Shenzhen Research Institute, Shenzhen, China; Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong; Margaret K.L. Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Shatin, Hong Kong; Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong; Hong Kong Branch of the Chinese Academy of Sciences Center for Excellence in Animal Evolution and Genetics, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Takamatsu A, Honda H, Miwa T, Tabuchi T, Taniguchi K, Shibuya K, Tokuda Y. Prevalence and trends in persistent symptoms following COVID-19 in Japan: A nationwide cross-sectional survey. J Infect Chemother 2024; 30:725-733. [PMID: 38346670 DOI: 10.1016/j.jiac.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/12/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Even during the endemic phase of the COVID-19 pandemic, the impact of persistent symptoms on patients and healthcare systems remains significant. Thus, a more comprehensive understanding of these symptoms is essential. METHODS Using data from the Japan Society and New Tobacco Internet Survey conducted in February 2023, this cross-sectional study investigated the prevalence of, and changes in, persistent COVID-19 symptoms. RESULTS In total, 21,108 individuals responded to the survey. Of these, 29.1 % (6143) had a history of COVID-19. Our analysis found that arm/leg/joint pain (adjusted odds ratio [aOR]: 1.17; 95 % confidence interval [95 % CI]: 1.03-1.33), back pain (aOR: 1.13; 95 % CI: 1.01-1.27), chest pain (aOR: 1.53; 95 % CI: 1.20-1.96), malaise (aOR: 1.14; 95 % CI: 1.02-1.28), loss of taste (aOR: 2.55; 95 % CI: 1.75-3.72), loss of smell (aOR: 2.33; 95 % CI: 1.67-3.26), memory impairment (aOR: 1.27; 95 % CI: 1.04-1.56), and cough (aOR: 1.72; 95 % CI: 1.38-2.13) were independently associated with a history of COVID-19 contracted more than two months but less than six months previously. Further, back pain (aOR: 1.24; 95 % CI: 1.04-1.47) and loss of taste (aOR: 2.28; 95 % CI: 1.24-4.21) showed independent association with COVID-19 contracted more than 12 months previously. CONCLUSIONS Various symptoms were independently associated with a history of COVID-19. While most patients tend to recover within a year after contracting COVID-19, certain symptoms, such as back pain and loss of taste, persist longer than a year, underscoring public health concerns and emphasizing the need for health care services to support patients suffering from persistent symptoms.
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Affiliation(s)
- Akane Takamatsu
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Hitoshi Honda
- Department of Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan
| | - Toshiki Miwa
- Department of Infectious Diseases, University of Tokyo Hospital, Tokyo, Japan
| | - Takahiro Tabuchi
- Tokyo Foundation for Policy Research, Tokyo, Japan; Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Kiyosu Taniguchi
- Tokyo Foundation for Policy Research, Tokyo, Japan; National Hospital Organization, Mie Medical Center, Mie, Japan
| | | | - Yasuharu Tokuda
- Tokyo Foundation for Policy Research, Tokyo, Japan; Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan.
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3
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Wee LE, Lim JT, Tan JYJ, Malek MIBA, Chiew C, Ng LC, Chia PY, Leo YS, Lye DCB, Tan KB. Dengue versus COVID-19: comparing the incidence of cardiovascular, neuropsychiatric and autoimmune complications. J Travel Med 2024; 31:taae081. [PMID: 38864568 DOI: 10.1093/jtm/taae081] [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: 04/10/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND While persistence of chronic symptoms following dengue infection has been documented in small prospective cohorts, population-based studies are limited. The post-acute risk of new-incident multi-systemic complications following dengue infection was contrasted against that following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a multi-ethnic adult Asian population. METHODS National testing and healthcare claims that databases in Singapore were utilized to build a retrospective population-based adult cohort with laboratory-confirmed infection during overlapping waves of SARS-CoV-2 and dengue transmission (1 July 2021 to 31 October 2022). Risks of new-incident cardiovascular/neuropsychiatric/autoimmune complications 31-300 days of post-dengue infection, contrasted with SARS-CoV-2 infection, were estimated using Cox regression with overlap weights. Risks were reported in terms of adjusted hazard ratio (aHR) and excess burden per 1000 persons. RESULTS 11 707 dengue-infected individuals and 1 248 326 contemporaneous coronavirus disease 2019 (COVID-19) cases were included; the majority had mild initial infection not requiring hospitalization. Amongst dengue-infected individuals, there was 21% [aHR = 1.21 (1.06-1.38)] increased risk of any sequelae, with 55% [aHR = 1.55 (1.27-1.89)] increased risk of cardiovascular sequelae. Specifically, increased risk of dysrhythmias [aHR = 1.79(1.35-2.37)], ischemic heart disease [aHR = 1.45(1.12-1.89)], other cardiac disorders [aHR = 2.21(1.54-3.16)] and thrombotic disorders [aHR = 2.55(1.50-4.35)] was noted. Elevated risk of individual neuropsychiatric sequelae, including cerebrovascular disorders [aHR = 1.49(1.09-2.13)], cognition/memory disorders [aHR = 2.13(1.55-2.93)], extrapyramidal/movement disorders [aHR = 1.98(1.33-2.94)] and anxiety disorders [aHR = 1.61(1.01-2.56)], was observed in dengue-infected individuals compared to COVID-19 cases. Elevated risks of post-acute sequelae in dengue survivors were observed when contrasted against COVID-19 survivors infected during Delta/Omicron predominance, as well as across vaccination strata. CONCLUSION Increased risk of post-acute cardiovascular/neuropsychiatric complications was observed in dengue survivors, when contrasted against COVID-19 survivors infected during Delta/Omicron predominance. RESEARCH IN CONTEXT
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Affiliation(s)
- Liang En Wee
- National Centre for Infectious Diseases, Singapore
- Duke-NUS Graduate Medical School, National University of Singapore, Singapore
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Jue Tao Lim
- National Centre for Infectious Diseases, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Calvin Chiew
- National Centre for Infectious Diseases, Singapore
- Ministry of Health, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
| | - Po Ying Chia
- National Centre for Infectious Diseases, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Yee Sin Leo
- National Centre for Infectious Diseases, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - David Chien Boon Lye
- National Centre for Infectious Diseases, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kelvin Bryan Tan
- National Centre for Infectious Diseases, Singapore
- Duke-NUS Graduate Medical School, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Ministry of Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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4
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Shigematsu L, Kimura R, Terai H, Mimura Y, Ito D, Bun S, Namkoong H, Asakura T, Chubachi S, Masaki K, Ohgino K, Miyata J, Kawada I, Ishii M, Takemura R, Ueda S, Yoshiyama T, Kokuto H, Kusumoto T, Oashi A, Miyawaki M, Saito F, Tani T, Ishioka K, Takahashi S, Nakamura M, Sato Y, Fukunaga K. Social impact of brain fog and analysis of risk factors: Long COVID in Japanese population. Ann Clin Transl Neurol 2024. [PMID: 38961833 DOI: 10.1002/acn3.52139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/03/2024] [Accepted: 06/12/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE To reveal the clinical features and assess risk factors linked to brain fog and its societal implications, including labor productivity, providing valuable insights for the future care of individuals who have experienced coronavirus disease 2019 (COVID-19). METHODS We analyzed a comprehensive cohort dataset comprising 1,009 patients with COVID-19 admitted to Japanese hospitals. To assess brain fog, we analyzed patients who responded to a questionnaire indicating symptoms such as memory impairment and poor concentration. RESULTS The prevalence of brain fog symptoms decreased 3 months posthospitalization but remained stable up to 12 months. Neurological symptoms such as taste and smell disorders and numbness at hospitalization correlated with a higher frequency of identifying brain fog as a long COVID manifestation. Our findings indicated that advanced age, female sex, a high body mass index, oxygen required during hospitalization, chronic obstructive pulmonary disease, asthma, and elevated C-reactive protein and elevated D-dimer levels were risk factors in patients exhibiting brain fog. Additionally, we demonstrated the negative impact of brain fog on labor productivity by presenteeism scores. INTERPRETATIONS This study clarified the clinical characteristics of patients experiencing brain fog as a long COVID manifestation, specifically emphasizing neurological symptoms during hospitalization and their correlation with brain fog. Additionally, the study identified associated risk factors for its onset and revealed that the emergence of brain fog was linked to a decline in labor productivity.
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Affiliation(s)
- Lisa Shigematsu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ryusei Kimura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Yu Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Ito
- Department of Physiology/Memory Center, Keio University School of Medicine, Tokyo, Japan
| | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ho Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Clinical Medicine (Laboratory of Bioregulatory Medicine), Kitasato University School of Pharmacy, Tokyo, Japan
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Ishii
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Soichiro Ueda
- Department of Internal Medicine, Saitama Medical Center, Saitama, Japan
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hiroyuki Kokuto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Tatsuya Kusumoto
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Ayano Oashi
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | | | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Tetsuo Tani
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kota Ishioka
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Saeko Takahashi
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Morio Nakamura
- Department of Pulmonary Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
- Department of Pulmonary Medicine, NHO Kanagawa National Hospital, Hatano, Kanagawa, Japan
| | - Yasunori Sato
- Department of Biostatistics, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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5
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Meagher T. Diabetes Following COVID-19 Infection: Is It Common? J Insur Med 2024; 51:4-7. [PMID: 38802085 DOI: 10.17849/insm-51-1-4-7.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
New-onset diabetes mellitus following COVID-19 infection has been frequently reported. This article will review the evidence that supports this observation and provide an opinion about its validity and relevance to insured cohorts.
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Affiliation(s)
- Timothy Meagher
- Vice-President and Medical Director, Munich Re, Montréal; Associate Professor of Medicine, McGill University, Montréal, Québec
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6
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Cheong C, Park J, Park J, Jo H, Lee K, Lee JH, Kim HJ, Choi Y, Kim H, Nehs CJ, Fond G, Boyer L, Rahmati M, Koyanagi A, Smith L, López Sánchez GF, Dragioti E, Woo S, Lee H, Kang J, Kim T, Yon DK. National trends in alcohol consumption, smoking, suicide attempts, and COVID-19 pandemic-related factors among South Korean adolescents, 2012-2022. Asian J Psychiatr 2024; 97:104085. [PMID: 38815441 DOI: 10.1016/j.ajp.2024.104085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Chanyoung Cheong
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Junjae Park
- College of Pharmacy, Chungbuk National University, Cheongju, South Korea
| | - Hyesu Jo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Kyeongmin Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Jun Hyuk Lee
- Health and Human Science, University of Southern California, Los Angeles, CA, USA
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Yujin Choi
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Korean Medicine, Kyung Hee University College of Korean Medicine, Seoul, South Korea
| | - Hyejun Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Applied Information Engineering, Yonsei University, Seoul, South Korea
| | - Christa J Nehs
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Guillaume Fond
- Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Laurent Boyer
- Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France
| | - Masoud Rahmati
- Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France; Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo Felipe López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jiseung Kang
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - Tae Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, South Korea.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea; Department of Regulatory Science, Kyung Hee University, Seoul, South Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
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7
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Mejía Alonso LA, Espinosa-Poblano E, de Regil López S, Lemus Eslava V, Serrano Sánchez JG, Paredes-Manjarrez C, Balderas-Chairéz AT, Anda-Garay JC, Miguel-Puga JA, Jáuregui-Renaud K. Malnutrition contribution to the functional status and health related quality of life after COVID-19, a correlational follow-up study. Sci Rep 2024; 14:15005. [PMID: 38951534 PMCID: PMC11217498 DOI: 10.1038/s41598-024-65698-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/24/2024] [Indexed: 07/03/2024] Open
Abstract
To assess malnutrition contribution to the functional status and health related quality of life after hospitalization due to COVID-19 pneumonia, 66 selected adults referred for physical rehabilitation accepted to participate in the study; none of them required oxygen supply or had history of lung/musculoskeletal/neurological/immune/rheumatic disease or trauma, or contraindication for respiratory-function tests. At three evaluations, with 3 months in-between, assessments included: self-report of functional status, the St. George's Respiratory Questionnaire, spirometry, the 6-min-walk-test, the MRC-scale, the 30-s sit-to-stand-test, the timed-up-and-go-test, nutritional status, and ultrasound imaging (vastus medialis and diaphragm). At referral, patients had nutritional deficits with protein deficiency, which gradually improved; while muscle thickness (of both vastus medialis and diaphragm) increased, along with muscle strength and mobility (ANOVA, p < 0.05). Contrarywise, the distance covered during the 6-min-walk-test decreased (ANOVA, p < 0.05), with a negative influence from excess body mass. During rehabilitation, health-related quality of life and functional status improved, with negative influence from a history of tobacco use and referral delay, respectively. After hospitalization due to COVID-19, early diagnosis of both protein deficiency and decrease of skeletal muscle thickness could be relevant for rehabilitation, while pondering the negative impact of excess body mass on submaximal exercise performance.
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Affiliation(s)
- Laura Alejandra Mejía Alonso
- Unidad de Rehabilitación, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, Mexico
| | - Eliseo Espinosa-Poblano
- Departamento de Inhaloterapia y Neumología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Sarahi de Regil López
- Departamento de Nutrición y Dieta, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Verónica Lemus Eslava
- Departamento de Nutrición y Dieta, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Jesús Guadalupe Serrano Sánchez
- Departamento de Nutrición y Dieta, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Carlos Paredes-Manjarrez
- Departamento de Imagenología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Andrés Tlacaelel Balderas-Chairéz
- Departamento de Imagenología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Juan Carlos Anda-Garay
- Departamento de Medicina Interna, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico city, México
| | - José Adán Miguel-Puga
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico city, México
| | - Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Mexico city, México.
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8
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Vanderheiden A, Hill JD, Jiang X, Deppen B, Bamunuarachchi G, Soudani N, Joshi A, Cain MD, Boon ACM, Klein RS. Vaccination reduces central nervous system IL-1β and memory deficits after COVID-19 in mice. Nat Immunol 2024; 25:1158-1171. [PMID: 38902519 DOI: 10.1038/s41590-024-01868-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/13/2024] [Indexed: 06/22/2024]
Abstract
Up to 25% of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibit postacute cognitive sequelae. Although millions of cases of coronavirus disease 2019 (COVID-19)-mediated memory dysfunction are accumulating worldwide, the underlying mechanisms and how vaccination lowers risk are unknown. Interleukin-1 (IL-1), a key component of innate immune defense against SARS-CoV-2 infection, is elevated in the hippocampi of individuals with COVID-19. Here we show that intranasal infection of C57BL/6J mice with SARS-CoV-2 Beta variant leads to central nervous system infiltration of Ly6Chi monocytes and microglial activation. Accordingly, SARS-CoV-2, but not H1N1 influenza virus, increases levels of brain IL-1β and induces persistent IL-1R1-mediated loss of hippocampal neurogenesis, which promotes postacute cognitive deficits. Vaccination with a low dose of adenoviral-vectored spike protein prevents hippocampal production of IL-1β during breakthrough SARS-CoV-2 infection, loss of neurogenesis and subsequent memory deficits. Our study identifies IL-1β as one potential mechanism driving SARS-CoV-2-induced cognitive impairment in a new mouse model that is prevented by vaccination.
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Affiliation(s)
- Abigail Vanderheiden
- Center for Neuroimmunology and Neuroinfectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jeremy D Hill
- Center for Neuroimmunology and Neuroinfectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Xiaoping Jiang
- Center for Neuroimmunology and Neuroinfectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Ben Deppen
- Center for Neuroimmunology and Neuroinfectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Gayan Bamunuarachchi
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Nadia Soudani
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Astha Joshi
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Matthew D Cain
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Adrianus C M Boon
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Robyn S Klein
- Schulich School of Medicine and Dentistry, Department of Microbiology and Immunology, Western University, London, Ontario, Canada.
- Schulich School of Medicine and Dentistry, Western Institute of Neuroscience, Western University, London, Ontario, Canada.
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9
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Dashtban A, Mizani M, Pasea L, Tomlinson C, Mu Y, Islam N, Rafferty S, Warren-Gash PC, Denaxas PS, Horstmanshof K, Kontopantelis PE, Petersen PS, Sudlow PC, Khunti PK, Banerjee PA. Vaccinations, cardiovascular drugs, hospitalisation and mortality in COVID-19 and Long COVID. Int J Infect Dis 2024:107155. [PMID: 38942167 DOI: 10.1016/j.ijid.2024.107155] [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: 03/04/2024] [Revised: 06/06/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVE To identify highest-risk subgroups for COVID-19 and Long COVID(LC), particularly in contexts of influenza and cardiovascular disease(CVD). METHODS Using national, linked electronic health records for England(NHS England Secure Data Environment via CVD-COVID-UK/COVID-IMPACT Consortium), we studied individuals(of all ages) with COVID-19 and LC (2020-2023). We compared all-cause hospitalisation and mortality by prior CVD, high CV risk, vaccination status(COVID-19/influenza), and CVD drugs, investigating impact of vaccination and CVD prevention using population preventable fractions. RESULTS Hospitalisation and mortality were 15.3% and 2.0% among 17,373,850 individuals with COVID-19(LC rate 1.3%), and 16.8% and 1.4% among 301,115 with LC. Adjusted risk of mortality and hospitalisation were reduced with COVID-19 vaccination≥2 doses(COVID-19:HR 0.36 and 0.69; LC:0.44 and 0.90). With influenza vaccination, mortality was reduced, but not hospitalisation(COVID-19:0.86 and 1.01, and LC:0.72 and 1.05). Mortality and hospitalisation were reduced by CVD prevention in those with CVD, e.g. anticoagulants- COVID:19:0.69 and 0.92; LC:0.59 and 0.88; lipid lowering- COVID-19:0.69 and 0.86; LC:0.68 and 0.90. COVID-19 vaccination averted 245044 of 321383 and 7586 of 8738 preventable deaths after COVID-19 and LC, respectively. INTERPRETATION Prior CVD and high CV risk are associated with increased hospitalisation and mortality in COVID-19 and LC. Targeted COVID-19 vaccination and CVD prevention are priority interventions. FUNDING NIHR. HDR UK.
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Affiliation(s)
- Ashkan Dashtban
- Institute of Health Informatics, University College London, London, UK
| | - Mehrdad Mizani
- Institute of Health Informatics, University College London, London, UK; British Heart Foundation Data Science Centre, Health Data Research UK, London, UK
| | - Laura Pasea
- Institute of Health Informatics, University College London, London, UK
| | - Chris Tomlinson
- Institute of Health Informatics, University College London, London, UK
| | - Yi Mu
- Institute of Health Informatics, University College London, London, UK
| | - Nazrul Islam
- Primary Care Research Centre, Faculty of Medicine, University of Southampton, SO16 5ST, UK
| | | | | | | | - Kim Horstmanshof
- Institute of Health Informatics, University College London, London, UK
| | | | | | - Prof Cathie Sudlow
- British Heart Foundation Data Science Centre, Health Data Research UK, London, UK; Health Data Research UK, University College London, London, UK
| | | | - Prof Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK; Health Data Research UK, University College London, London, UK; Barts Health NHS Trust, London, UK; University College London Hospitals NHS Trust, London, UK.
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10
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Biondi MJ, Addo M, Zahoor MA, Salvant E, Yip P, Barber B, Smookler D, Wasif S, Gaete K, Kandel C, Feld JJ, Tsui H, Kozak RA. Differential Gene Expression in the Upper Respiratory Tract following Acute COVID-19 Infection in Ambulatory Patients That Develop Long COVID. Pathogens 2024; 13:510. [PMID: 38921807 PMCID: PMC11206334 DOI: 10.3390/pathogens13060510] [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: 04/30/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Background: Post-acute sequelae of COVID-19, or long COVID, is a condition characterized by persistent COVID-19 symptoms. As long COVID is defined by clinical criteria after an elapsed period, an opportunity for early intervention may aid in future prophylactic approaches; however, at present, the pathobiological mechanisms are multifactorial. By analyzing early virally infected upper respiratory tract tissue prior to eventual clinical diagnosis, it may be possible to identify biomarkers of altered immune response to facilitate future studies and interventions. Methods: This is a sub-group analysis of samples collected from those with confirmed COVID-19. RNA extraction from nasopharyngeal/mid-turbinate samples, sequencing, and bioinformatic analysis were performed to analyze long COVID and non-long COVID cohorts at day 14 post infection. Differences in mean viral load at various timepoints were analyzed as well as serological data. Results: We identified 26 upregulated genes in patients experiencing long COVID. Dysregulated pathways including complement and fibrinolysis pathways and IL-7 upregulation. Additionally, genes involved in neurotransmission were dysregulated, and the long COVID group had a significantly higher viral load and slower viral clearance. Conclusions: Uncovering early gene pathway abnormalities associated with eventual long COVID diagnosis may aid in early identification. We show that, post acute infection, in situ pathogenic deviations in viral response are associated with patients destined to meet consensus long COVID diagnosis that is entirely dependent on clinical factors. These results identify an important biological temporal window in the natural history of COVID-19 infection and long COVID pathogenesis amenable to testing from standard-of-care upper respiratory tract specimens.
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Affiliation(s)
- Mia J. Biondi
- School of Nursing, York University, Toronto, ON M3J 1P3, Canada
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON M5G 2C4, Canada; (M.A.Z.); (B.B.); (D.S.); (J.J.F.)
| | - Mary Addo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (M.A.); (P.Y.); (H.T.)
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
| | - Muhammad Atif Zahoor
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON M5G 2C4, Canada; (M.A.Z.); (B.B.); (D.S.); (J.J.F.)
| | - Elsa Salvant
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
| | - Paul Yip
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (M.A.); (P.Y.); (H.T.)
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
- Precision Diagnostics and Therapeutics Program, Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Bethany Barber
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON M5G 2C4, Canada; (M.A.Z.); (B.B.); (D.S.); (J.J.F.)
| | - David Smookler
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON M5G 2C4, Canada; (M.A.Z.); (B.B.); (D.S.); (J.J.F.)
| | - Sumaiyah Wasif
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
| | - Kayla Gaete
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
| | | | - Jordan J. Feld
- Toronto Centre for Liver Disease, University Health Network, Toronto, ON M5G 2C4, Canada; (M.A.Z.); (B.B.); (D.S.); (J.J.F.)
| | - Hubert Tsui
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (M.A.); (P.Y.); (H.T.)
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
- Precision Diagnostics and Therapeutics Program, Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Robert A. Kozak
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (M.A.); (P.Y.); (H.T.)
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; (E.S.); (K.G.)
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11
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Scott HM, Neale S, Harrington E, Hodgson H, Hitch D. Occupational therapy practice for post-acute COVID-19 inpatients requiring rehabilitation. Aust Occup Ther J 2024. [PMID: 38877567 DOI: 10.1111/1440-1630.12976] [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: 10/19/2023] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION COVID-19 caused significant occupational disruption to people's life roles, with some people requiring an inpatient rehabilitation admission. Occupational therapists assessed and treated these patients using previous knowledge of similar conditions due to limited specificity in available guidelines to inform practice. The aim of this study was to investigate current practice with post-acute COVID-19 (PAC) patients within an inpatient rehabilitation setting in Australia, to better understand the role and impact of occupational therapy. METHODS A mixed-method study was conducted, including electronic medical record audits (October 2021 October 2022) and descriptive patient interviews at a large metropolitan subacute service. Descriptive statistics and qualitative analysis were used to summarise and interpret data. CONSUMER AND COMMUNITY INVOLVEMENT No involvement. RESULTS A total of 24 patient electronic medical records were audited, and 10 patient interviews were completed. Three overarching categories were identified within the 685 occasions of occupational therapy service audited-occupational engagement, education provision and discharge planning. Patients identified the value of occupational therapy by reflecting on their lived experiences of engaging with occupational therapists and associated changes in occupational performance between COVID-19 diagnoses and discharge home. CONCLUSION Occupational therapists possess a unique skill set that directly addresses the occupational needs and priorities of PAC patients. This study adds to the growing body of evidence supporting the contribution of occupational therapy to the management of COVID-19; however, further research is needed to develop evidence-based practice resources and advocate for system changes that improve quality of life for COVID-19 patients. PLAIN LANGUAGE SUMMARY During the COVID-19 pandemic, a lot of people got very sick. Some of these people needed more time and support to get better. Occupational therapists were important during this time because they helped these people to do their daily activities again. Because there were not many resources on how to do this, we looked into what occupational therapists were doing to help these people. We looked at patient hospital files and also talked to them to understand this better. We found that occupational therapists focused on three main areas: helping patients do activities that were important to them, teaching them about COVID-19 and helping them plan to leave the hospital. This study shows that occupational therapists are skilled at helping people with COVID-19. But more research is needed to make resources and also help with changing the healthcare system to further help people get better from COVID-19.
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Affiliation(s)
- Hayley M Scott
- Occupational Therapy Lecturer, Institute of Health and Well-Being, Federation University, Melbourne, Australia
- Occupational Therapy Department, Western Health, Melbourne, Australia
| | - Sharon Neale
- Occupational Therapy Department, Western Health, Melbourne, Australia
| | | | - Hayley Hodgson
- Occupational Therapy Department, Western Health, Melbourne, Australia
| | - Danielle Hitch
- School of Health and Social Development, Deakin University and Occupational Therapy Department, Western Health, Melbourne, Australia
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12
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Hone AJ, Santiago U, Harvey PJ, Tekarli B, Gajewiak J, Craik DJ, Camacho CJ, McIntosh JM. Design, Synthesis, and Structure-Activity Relationships of Novel Peptide Derivatives of the Severe Acute Respiratory Syndrome-Coronavirus-2 Spike-Protein that Potently Inhibit Nicotinic Acetylcholine Receptors. J Med Chem 2024; 67:9587-9598. [PMID: 38814877 DOI: 10.1021/acs.jmedchem.4c00735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
The spike-protein of SARS-CoV-2 has a distinctive amino-acid sequence (682RRARS686) that forms a cleavage site for the enzyme furin. Strikingly, the structure of the spike-protein loop containing the furin cleavage site bears substantial similarity to neurotoxin peptides found in the venoms of certain snakes and marine cone snails. Leveraging this relationship, we designed and synthesized disulfide-constrained peptides with amino-acid sequences corresponding to the furin cleavage-sites of wild-type (B.1 variant) SARS-CoV-2 or the Alpha, Delta, and Omicron variants. Remarkably, some of these peptides potently inhibited α7 and α9α10 nicotinic acetylcholine receptors (nAChR) with nM affinity and showed SARS-CoV-2 variant and nAChR subtype-dependent potencies. Nuclear magnetic resonance spectroscopy and molecular dynamics were used to rationalize structure-activity relationships between peptides and their cognate receptors. These findings delineate nAChR subtypes that can serve as high-affinity spike-protein targets in tissues central to COVID-19 pathophysiology and identify ligands and target receptors to inform the development of novel SARS-CoV-2 therapeutics.
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Affiliation(s)
- Arik J Hone
- School of Biological Sciences, University of Utah, Salt Lake City, Utah 84112, United States
- MIRECC, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah 84148, United States
| | - Ulises Santiago
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Peta J Harvey
- Institute for Molecular Bioscience, ARC Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Bassel Tekarli
- School of Biological Sciences, University of Utah, Salt Lake City, Utah 84112, United States
| | - Joanna Gajewiak
- School of Biological Sciences, University of Utah, Salt Lake City, Utah 84112, United States
| | - David J Craik
- Institute for Molecular Bioscience, ARC Centre of Excellence for Innovations in Peptide and Protein Science, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Carlos J Camacho
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - J Michael McIntosh
- School of Biological Sciences, University of Utah, Salt Lake City, Utah 84112, United States
- Department of Psychiatry, University of Utah, Salt Lake City, Utah 84112, United States
- George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah 84148, United States
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13
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Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 DOI: 10.1128/cmr.00124-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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14
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Wee LE, Tan JYJ, Chiew CJ, Abisheganaden JA, Chotirmall SH, Lye DCB, Tan KB. A Nationwide Cohort Study of Delta and Omicron SARS-CoV-2 Outcomes in Vaccinated Individuals With Chronic Lung Disease. Chest 2024:S0012-3692(24)00696-2. [PMID: 38871281 DOI: 10.1016/j.chest.2024.05.017] [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: 01/09/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Individuals with chronic lung disease (CLD) are more susceptible to respiratory viral infections; however, significant heterogeneity exists in the literature on CLD and COVID-19 outcomes. Data are lacking on outcomes with newer variants (eg, Omicron) and in vaccinated and boosted populations. RESEARCH QUESTION What are the outcomes of SARS-CoV-2 infection in individuals with CLD during Delta and Omicron transmission in a highly vaccinated and boosted population-based cohort? STUDY DESIGN AND METHODS Outcomes of Delta and Omicron SARS-CoV-2 infection in a highly vaccinated and boosted cohort of adult Singaporeans with CLD (including asthma, COPD, bronchiectasis, and pulmonary fibrosis) were contrasted against matched population control participants. Calendar time-scale Cox regressions were used to compare risk of infection, COVID-19-related hospitalizations, and severe COVID-19 disease, adjusting for sociodemographic factors and comorbidities. RESULTS Overall, 68,782 individual patients with CLD and 534,364 matched population control participants were included. By the end of the Omicron wave, 92.7% of patients with CLD were boosted. Compared with control participants, patients with CLD showed higher risk of SARS-CoV-2 infection, COVID-19-related hospitalization, and severe COVID-19 during both the Delta wave (infection: adjusted hazards ratio [aHR], 1.22 [95% CI, 1.17-1.28]; hospitalization: aHR, 1.76 [95% CI, 1.61-1.92]; severe COVID-19: aHR, 1.75 [95% CI, 1.50-2.05]) and Omicron wave (infection: aHR, 1.15 [95% CI, 1.14-1.17]; hospitalization: aHR, 1.82 [95% CI, 1.74-1.91]; severe COVID-19: aHR, 2.39 [95% CI, 2.18-2.63]). During Omicron, significantly higher risk of infection, hospitalization, and severe COVID-19 was observed among patients with asthma (severe COVID-19: aHR, 1.31 [95% CI, 1.10-1.55]) and COPD (severe COVID-19: aHR, 1.36 [95% CI, 1.12-1.66]) compared with control participants. Severe exacerbation (requiring hospitalization) in the preceding year was associated with higher risk of poorer outcomes (Delta severe COVID-19: aHR, 9.84 [95% CI, 6.33-15.28]; Omicron severe COVID-19: aHR, 19.22 [95% CI, 15.35-24.06]). Risk was attenuated in the boosted group, with numerically lower HRs against hospitalization and severe COVID-19 in the four-dose group compared with the three-dose group. INTERPRETATION Increased risk of COVID-19-related hospitalization and severe COVID-19 was observed among patients with CLD compared with matched population control participants during Delta and Omicron predominance. Boosting attenuated serious COVID-19 outcomes.
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Affiliation(s)
- Liang En Wee
- National Centre for Infectious Diseases, National University of Singapore, Singapore, Republic of Singapore; Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Republic of Singapore; Department of Infectious Diseases, Singapore General Hospital, Nanyang Technological University, Singapore, Republic of Singapore.
| | - Janice Yu Jin Tan
- Ministry of Health, Tan Tock Seng Hospital, Nanyang Technological University, Singapore, Republic of Singapore
| | - Calvin J Chiew
- National Centre for Infectious Diseases, National University of Singapore, Singapore, Republic of Singapore; Ministry of Health, Tan Tock Seng Hospital, Nanyang Technological University, Singapore, Republic of Singapore
| | - John Arputhan Abisheganaden
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Nanyang Technological University, Singapore, Republic of Singapore
| | - Sanjay H Chotirmall
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Nanyang Technological University, Singapore, Republic of Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Republic of Singapore
| | - David Chien Boon Lye
- National Centre for Infectious Diseases, National University of Singapore, Singapore, Republic of Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Nanyang Technological University, Singapore, Republic of Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Republic of Singapore
| | - Kelvin Bryan Tan
- National Centre for Infectious Diseases, National University of Singapore, Singapore, Republic of Singapore; Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Republic of Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore; Ministry of Health, Tan Tock Seng Hospital, Nanyang Technological University, Singapore, Republic of Singapore
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15
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Fox J, Verduzco-Gutierrez M, Sanchez S, Lopez M, Ali F, Quesada O, Henry TD, Shah SA. Enhanced External Counterpulsation Improves Long COVID-Associated Symptoms. Am J Cardiol 2024; 224:12-13. [PMID: 38866353 DOI: 10.1016/j.amjcard.2024.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/26/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Affiliation(s)
- Jessie Fox
- Director of Medical Affairs, Flow Therapy, Fort Worth, Texas.
| | - Monica Verduzco-Gutierrez
- Department of Physical Medicine and Rehabilitation, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, Texas
| | - Steven Sanchez
- Department of Physical Medicine and Rehabilitation, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, Texas
| | - Marielisa Lopez
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas
| | - Farhan Ali
- Heart Center of North Texas, Fort Worth, Texas
| | - Odayme Quesada
- Women's Heart Center at the Christ Hospital, Cincinnati, Ohio; The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio
| | - Timothy D Henry
- Women's Heart Center at the Christ Hospital, Cincinnati, Ohio; The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio; The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio
| | - Sachin A Shah
- Thomas J Long School of Pharmacy, University of the Pacific, Stockton, California
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16
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Ge Q, Zhou S, Porras J, Fu P, Wang T, Du J, Li K. SARS-CoV-2 neurotropism-induced anxiety/depression-like behaviors require Microglia activation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.02.560570. [PMID: 37873397 PMCID: PMC10592887 DOI: 10.1101/2023.10.02.560570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with a wide range of "long COVID" neurological symptoms. However, the mechanisms governing SARS-CoV-2 neurotropism and its effects on long-term behavioral changes remain poorly understood. Using a highly virulent mouse-adapted SARS-CoV-2 strain, denoted as SARS2-N501Y MA30 , we demonstrated that intranasal inoculation of SARS2-N501Y MA30 results in viral dissemination to multiple brain regions, including the amygdala and hippocampus. Behavioral assays indicated a marked elevation in anxiety- and depression-like behaviors post infection. A comparative analysis of RNA expression profiles disclosed alterations in the post-infected brains. Additionally, we observed dendritic spine remodeling on neurons within the amygdala after infection. Infection with SARS2-N501Y MA30 was associated with microglial activation and a subsequent increase in microglia-dependent neuronal activity in the amygdala. Pharmacological inhibition of microglial activity subsequent to viral spike inoculation mitigates microglia-dependent neuronal hyperactivity. Transcriptomic analysis of infected brains revealed the upregulation of inflammatory and cytokine-related pathways, implicating microglia-driven neuroinflammation in the pathogenesis of neuronal hyperactivity and behavioral abnormality. Overall, these data provide critical insights into the neurological consequences of SARS-CoV-2 infection and underscore microglia as a potential therapeutic target for ameliorating virus-induced neurobehavioral abnormalities.
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17
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Khoramjoo M, Wang K, Srinivasan K, Gheblawi M, Mandal R, Rousseau S, Wishart D, Prasad V, Richer L, Cheung AM, Oudit GY. Plasma taurine level is linked to symptom burden and clinical outcomes in post-COVID condition. PLoS One 2024; 19:e0304522. [PMID: 38837993 DOI: 10.1371/journal.pone.0304522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND A subset of individuals (10-20%) experience post-COVID condition (PCC) subsequent to initial SARS-CoV-2 infection, which lacks effective treatment. PCC carries a substantial global burden associated with negative economic and health impacts. This study aims to evaluate the association between plasma taurine levels with self-reported symptoms and adverse clinical outcomes in patients with PCC. METHODS AND FINDINGS We analyzed the plasma proteome and metabolome of 117 individuals during their acute COVID-19 hospitalization and at the convalescence phase six-month post infection. Findings were compared with 28 age and sex-matched healthy controls. Plasma taurine levels were negatively associated with PCC symptoms and correlated with markers of inflammation, tryptophan metabolism, and gut dysbiosis. Stratifying patients based on the trajectories of plasma taurine levels during six-month follow-up revealed a significant association with adverse clinical events. Increase in taurine levels during the transition to convalescence were associated with a reduction in adverse events independent of comorbidities and acute COVID-19 severity. In a multivariate analysis, increased plasma taurine level between acute and convalescence phase was associated with marked protection from adverse clinical events with a hazard ratio of 0.13 (95% CI: 0.05-0.35; p<0.001). CONCLUSIONS Taurine emerges as a promising predictive biomarker and potential therapeutic target in PCC. Taurine supplementation has already demonstrated clinical benefits in various diseases and warrants exploration in large-scale clinical trials for alleviating PCC.
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Affiliation(s)
- Mobin Khoramjoo
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kaiming Wang
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Karthik Srinivasan
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Mahmoud Gheblawi
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Rupasri Mandal
- The Metabolomics Innovation Center, University of Alberta, Edmonton, Alberta, Canada
| | - Simon Rousseau
- Department of Medicine, McGill University & The Research Institute of the McGill University Health Centre, Montreal, Canada
| | - David Wishart
- The Metabolomics Innovation Center, University of Alberta, Edmonton, Alberta, Canada
| | - Vinay Prasad
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Lawrence Richer
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Angela M Cheung
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Gavin Y Oudit
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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18
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Cai M, Xie Y, Topol EJ, Al-Aly Z. Three-year outcomes of post-acute sequelae of COVID-19. Nat Med 2024; 30:1564-1573. [PMID: 38816608 PMCID: PMC11186764 DOI: 10.1038/s41591-024-02987-8] [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: 01/09/2024] [Accepted: 04/10/2024] [Indexed: 06/01/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes post-acute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in many organ systems. Risks of these sequelae have been characterized up to 2 years after infection, but longer-term follow-up is limited. Here we built a cohort of 135,161 people with SARS-CoV-2 infection and 5,206,835 controls from the US Department of Veterans Affairs who were followed for 3 years to estimate risks of death and PASC. Among non-hospitalized individuals, the increased risk of death was no longer present after the first year of infection, and risk of incident PASC declined over the 3 years but still contributed 9.6 (95% confidence interval (CI): 0.4-18.7) disability-adjusted life years (DALYs) per 1,000 persons in the third year. Among hospitalized individuals, risk of death declined but remained significantly elevated in the third year after infection (incidence rate ratio: 1.29 (95% CI: 1.19-1.40)). Risk of incident PASC declined over the 3 years, but substantial residual risk remained in the third year, leading to 90.0 (95% CI: 55.2-124.8) DALYs per 1,000 persons. Altogether, our findings show reduction of risks over time, but the burden of mortality and health loss remains in the third year among hospitalized individuals.
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Affiliation(s)
- Miao Cai
- Clinical Epidemiology Center, Research and Development Service, VA St. Louis Health Care System, St. Louis, MO, USA
- Veterans Research and Education Foundation of St. Louis, St. Louis, MO, USA
| | - Yan Xie
- Clinical Epidemiology Center, Research and Development Service, VA St. Louis Health Care System, St. Louis, MO, USA
- Veterans Research and Education Foundation of St. Louis, St. Louis, MO, USA
- Division of Pharmacoepidemiology, Clinical Epidemiology Center, Research and Development Service, VA St. Louis Health Care System, St. Louis, MO, USA
| | | | - Ziyad Al-Aly
- Clinical Epidemiology Center, Research and Development Service, VA St. Louis Health Care System, St. Louis, MO, USA.
- Veterans Research and Education Foundation of St. Louis, St. Louis, MO, USA.
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
- Nephrology Section, Medicine Service, VA St. Louis Health Care System, St. Louis, MO, USA.
- Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA.
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19
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Tang Y, Zou X, Liu P, Dai Y, Wang S, Su X, Yu Y, Tang W, Zhou J, Li C, Mei H, Xiao N, Ou Y, Wang J, Lu G, Lin G, Cheng L. Human umbilical cord-derived mesenchymal stem cell transplantation improves the long COVID. J Med Virol 2024; 96:e29757. [PMID: 38899432 DOI: 10.1002/jmv.29757] [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: 11/21/2023] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
No effective treatments can ameliorate symptoms of long COVID patients. Our study assessed the safety and efficacy of human umbilical cord-derived mesenchymal stem cells (UC-MSCs) in the treatment of long COVID patients. Ten long COVID patients were enrolled and received intravenous infusions of UC-MSCs on Days 0, 7, and 14. Adverse events and clinical symptoms were recorded, and chest-high-resolution CT (HRCT) images and laboratory parameters were analyzed. During UC-MSCs treatment and follow-up, we did not observe serious adverse events, the symptoms of long COVID patients were significantly relieved in a short time, especially sleep difficulty, depression or anxiety, memory issues, and so forth, and the lung lesions were also repaired. The routine laboratory parameters did not exhibit any significant abnormalities following UC-MSCs transplantation (UMSCT). The proportion of regulatory T cells gradually increased, but it was not statistically significant until 12 months. The proportion of naive B cells was elevated, while memory B cells, class-switched B-cells, and nonswitched B-cells decreased at 1 month after infusion. Additionally, we observed a transient elevation in circulating interleukin (IL)-6 after UMSCT, while tumor necrosis factor (TNF)-α, IL-17A, and IL-10 showed no significant changes. The levels of circulating immunoglobulin (Ig) M increased significantly at month 2, while IgA increased significantly at month 6. Furthermore, the SARS-CoV-2 IgG levels remained consistently high in all patients at Month 6, and there was no significant decrease during the subsequent 12-month follow-up. UMSCT was safe and tolerable in long COVID patients. It showed potential in alleviating long COVID symptoms and improving interstitial lung lesions.
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Affiliation(s)
- Yuling Tang
- The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiao Zou
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Ping Liu
- The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yanni Dai
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Siqi Wang
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Xian Su
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Yan Yu
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Wenfang Tang
- The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jia Zhou
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Chuang Li
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Hua Mei
- National Engineering Research Center of Human Stem cell, Changsha, China
| | - Na Xiao
- National Engineering Research Center of Human Stem cell, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Yangqi Ou
- National Engineering Research Center of Human Stem cell, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Jian Wang
- National Engineering Research Center of Human Stem cell, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, China
| | - Guangxiu Lu
- National Engineering Research Center of Human Stem cell, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Ge Lin
- National Engineering Research Center of Human Stem cell, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Lamei Cheng
- National Engineering Research Center of Human Stem cell, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha, China
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, China
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20
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Elfessi ZZ, Gardner J, Gordon HS, Rubinstein I. Long COVID in Women Veterans Residing in Underserved, Socioeconomically Disadvantaged Neighborhoods of Chicago. Popul Health Manag 2024; 27:227-230. [PMID: 38607581 DOI: 10.1089/pop.2024.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Affiliation(s)
- Zane Z Elfessi
- Emergency Medicine, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
- Research Services, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
| | - Jessica Gardner
- Research Services, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
| | - Howard S Gordon
- Medical Services, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
- Research Services, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
| | - Israel Rubinstein
- Medical Services, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
- Research Services, Jesse Brown VA Medical Center and University of Illinois Colleges of Pharmacy and Medicine in Chicago, Chicago, Illinois, USA
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21
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Li Z, Xia Q, Feng J, Chen X, Wang Y, Ren X, Wu S, Yang R, Li J, Liu Y, Lu Y, Chen J. The causal role of gut microbiota in susceptibility of Long COVID: a Mendelian randomization study. Front Microbiol 2024; 15:1404673. [PMID: 38873142 PMCID: PMC11169722 DOI: 10.3389/fmicb.2024.1404673] [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: 03/21/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
Background Long COVID is a major challenge facing the public. Gut microbiota is closely related to Long COVID. However, the causal effects between gut microbiota and Long COVID remains unclear. Methods Using summary statistics from Genome-Wide Association Studies (GWAS), Mendelian randomization (MR) analyses were performed to investigate the relationship between gut microbiota and Long COVID. The primary statistical method employed was Inverse Variance Weighted (IVW). Sensitivity analyses were then conducted to evaluate the reliability of the findings and account for potential confounding variables. Finally, a reverse MR analysis was conducted to examine potential associations between Long COVID and genetically predicted gut microbiota compositions. Results There were 2 positive and 1 negative causal effect between gut microbiota and Long COVID. Meta-analysis results show that genus Parasutterella (OR = 1.145, 95%CI = 1.035 ∼ 1.266, P = 0.008) and genus Oscillospira (OR = 1.425, 95%CI = 1.235 ∼ 1.645, P < 0.001) significantly increased the risk of Long COVID. And genus Eisenbergiella (OR = 0.861, 95%CI = 0.785 ∼ 0.943, P = 0.001) significantly decreased the risk of Long COVID. Neither the pleiotropy nor the heterogeneity was observed. Reverse causal effect does not hold. Conclusion Our research has provided genetic evidence that establishes multiple causal relationships between the gut microbiota and Long COVID, supporting the role of the gut microbiota in Long COVID. It is possible that different taxa play a role in the development of Long COVID. The causal relationships identified in this study require further investigation.
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Affiliation(s)
- Zuming Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qinghua Xia
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Qingyuan Hospital of Traditional Chinese Medicine, Qingyuan, China
| | - Jieni Feng
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xueru Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yushi Wang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaolei Ren
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Siyi Wu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rongyuan Yang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiqiang Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuntao Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yue Lu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Jiankun Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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22
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Li Y, Lin J, Gao J, Tang L, Liu Y, Zhang Z. Efficacy and safety of hyperbaric oxygen therapy for long COVID: a protocol for systematic review and meta-analysis. BMJ Open 2024; 14:e083868. [PMID: 38806438 PMCID: PMC11138265 DOI: 10.1136/bmjopen-2024-083868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/29/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION There is still a lack of therapeutic options for long COVID. Several studies have shown the benefit of hyperbaric oxygen therapy (HBOT) on long COVID. However, the efficacy and safety of HBOT for long COVID remain unclear. Therefore, we will conduct this systematic review to assess the feasibility of HBOT as a primary or complemental therapy for long COVID. METHODS AND ANALYSIS Databases such as Web of Science, PubMed, Embase, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, International Clinical Trials Registry Platform, Wanfang Database, China National Knowledge Infrastructure, SINOMED, VIP Database and the Chinese Clinical Trial Registry will be searched systematically from the establishment to 9 December 2023. All articles will be reviewed by two independent reviewers. Cochrane risk of bias tool will be used to assess the risk of bias in the study. We will evaluate heterogeneity using a visual inspection of the funnel plot. If an available number of studies are identified, we will perform a meta-analysis. ETHICS AND DISSEMINATION No ethical approval is required since this study is based on published articles. The findings will be published in a peer-reviewed journal or disseminated through conference presentations. PROSPERO REGISTRATION NUMBER CRD42023482523.
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Affiliation(s)
- Yuxin Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingnan Lin
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiazhu Gao
- Guangzhou University of Chinese Medicine, Guangzhou, China
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lijuan Tang
- Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yuntao Liu
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Zhongde Zhang
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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23
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Zhang Y, Chen S, Tian Y, Fu X. Host factors of SARS-CoV-2 in infection, pathogenesis, and long-term effects. Front Cell Infect Microbiol 2024; 14:1407261. [PMID: 38846354 PMCID: PMC11155306 DOI: 10.3389/fcimb.2024.1407261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
SARS-CoV-2 is the causative virus of the devastating COVID-19 pandemic that results in an unparalleled global health and economic crisis. Despite unprecedented scientific efforts and therapeutic interventions, the fight against COVID-19 continues as the rapid emergence of different SARS-CoV-2 variants of concern and the increasing challenge of long COVID-19, raising a vast demand to understand the pathomechanisms of COVID-19 and its long-term sequelae and develop therapeutic strategies beyond the virus per se. Notably, in addition to the virus itself, the replication cycle of SARS-CoV-2 and clinical severity of COVID-19 is also governed by host factors. In this review, we therefore comprehensively overview the replication cycle and pathogenesis of SARS-CoV-2 from the perspective of host factors and host-virus interactions. We sequentially outline the pathological implications of molecular interactions between host factors and SARS-CoV-2 in multi-organ and multi-system long COVID-19, and summarize current therapeutic strategies and agents targeting host factors for treating these diseases. This knowledge would be key for the identification of new pathophysiological aspects and mechanisms, and the development of actionable therapeutic targets and strategies for tackling COVID-19 and its sequelae.
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Affiliation(s)
| | | | - Yan Tian
- Department of Endocrinology and Metabolism, Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Medical School, West China Hospital and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, Sichuan, Chengdu, China
| | - Xianghui Fu
- Department of Endocrinology and Metabolism, Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Medical School, West China Hospital and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, Sichuan, Chengdu, China
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24
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He Q, An Y, Zhou X, Xie H, Tao L, Li D, Zheng A, Li L, Xu Z, Yu S, Wang R, Hu H, Liu K, Wang Q, Dai L, Xu K, Gao GF. Neutralization of EG.5, EG.5.1, BA.2.86, and JN.1 by antisera from dimeric receptor-binding domain subunit vaccines and 41 human monoclonal antibodies. MED 2024; 5:401-413.e4. [PMID: 38574739 DOI: 10.1016/j.medj.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/03/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The recently circulating Omicron variants BA.2.86 and JN.1 were identified with more than 30 amino acid changes on the spike protein compared to BA.2 or XBB.1.5. This study aimed to comprehensively assess the immune escape potential of BA.2.86, JN.1, EG.5, and EG.5.1. METHODS We collected human and murine sera to evaluate serological neutralization activities. The participants received three doses of coronavirus disease 2019 (COVID-19) vaccines or a booster dose of the ZF2022-A vaccine (Delta-BA.5 receptor-binding domain [RBD]-heterodimer immunogen) or experienced a breakthrough infection (BTI). The ZF2202-A vaccine is under clinical trial study (ClinicalTrials.gov: NCT05850507). BALB/c mice were vaccinated with a panel of severe acute respiratory syndrome coronavirus 2 RBD-dimer proteins. The antibody evasion properties of these variants were analyzed with 41 representative human monoclonal antibodies targeting the eight RBD epitopes. FINDINGS We found that BA.2.86 had less neutralization evasion than EG.5 and EG.5.1 in humans. The ZF2202-A booster induced significantly higher neutralizing titers than BTI. Furthermore, BA.2.86 and JN.1 exhibited stronger antibody evasion than EG.5 and EG.5.1 on RBD-4 and RBD-5 epitopes. Compared to BA.2.86, JN.1 further lost the ability to bind to several RBD-1 monoclonal antibodies and displayed further immune escape. CONCLUSIONS Our data showed that the currently dominating sub-variant, JN.1, showed increased immune evasion compared to BA.2.86 and EG.5.1, which is highly concerning. This study provides a timely risk assessment of the interested sub-variants and the basis for updating COVID-19 vaccines. FUNDING This work was funded by the National Key R&D Program of China, the National Natural Science Foundation of China, the Beijing Life Science Academy, the Bill & Melinda Gates Foundation, and the Postdoctoral Fellowship Program of China Postdoctoral Science Foundation (CPSF).
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MESH Headings
- Humans
- Animals
- Antibodies, Monoclonal/immunology
- SARS-CoV-2/immunology
- Mice
- Mice, Inbred BALB C
- COVID-19 Vaccines/immunology
- COVID-19 Vaccines/administration & dosage
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/blood
- COVID-19/prevention & control
- COVID-19/immunology
- Spike Glycoprotein, Coronavirus/immunology
- Spike Glycoprotein, Coronavirus/chemistry
- Vaccines, Subunit/immunology
- Vaccines, Subunit/administration & dosage
- Female
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Betacoronavirus/immunology
- Male
- Immune Sera/immunology
- Adult
- Immune Evasion
- Neutralization Tests
- Epitopes/immunology
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Affiliation(s)
- Qingwen He
- Department of Microbiology, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Yaling An
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Xuemei Zhou
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China; School of Life Sciences, Hebei University, Baoding, Hebei Province, China
| | - Haitang Xie
- Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Lifeng Tao
- Anhui Zhifei Longcom Biopharmaceutical Co., Ltd., Hefei, Anhui Province, China
| | - Dedong Li
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Anqi Zheng
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Linjie Li
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Zepeng Xu
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China; Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Shufan Yu
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Ruyue Wang
- Anhui Zhifei Longcom Biopharmaceutical Co., Ltd., Hefei, Anhui Province, China
| | - Hua Hu
- Yijishan Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Kefang Liu
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Qihui Wang
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Lianpan Dai
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Kun Xu
- Research Network of Immunity and Health (RNIH), Beijing Institutes of Life Science, Chinese Academy of Sciences (CAS), Beijing, China.
| | - George F Gao
- Department of Microbiology, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences (CAS), Beijing, China; Research Network of Immunity and Health (RNIH), Beijing Institutes of Life Science, Chinese Academy of Sciences (CAS), Beijing, China; D. H. Chen School of Universal Health and School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China.
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Dacosta-Aguayo R, Puig J, Lamonja-Vicente N, Carmona-Cervelló M, León-Gómez BB, Monté-Rubio G, López-Linfante VM, Zamora-Putin V, Montero-Alia P, Chacon C, Bielsa J, Moreno-Gabriel E, Garcia-Sierra R, Pachón A, Costa A, Mataró M, Prado JG, Martinez-Cáceres E, Mateu L, Massanella M, Violán C, Torán-Monserrat P. Reduced Cortical Thickness Correlates of Cognitive Dysfunction in Post-COVID-19 Condition: Insights from a Long-Term Follow-up. AJNR Am J Neuroradiol 2024; 45:647-654. [PMID: 38575319 DOI: 10.3174/ajnr.a8167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/03/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND AND PURPOSE There is a paucity of data on long-term neuroimaging findings from individuals who have developed the post-coronavirus 2019 (COVID-19) condition. Only 2 studies have investigated the correlations between cognitive assessment results and structural MR imaging in this population. This study aimed to elucidate the long-term cognitive outcomes of participants with the post-COVID-19 condition and to correlate these cognitive findings with structural MR imaging data in the post-COVID-19 condition. MATERIALS AND METHODS A cohort of 53 participants with the post-COVID-19 condition underwent 3T brain MR imaging with T1 and FLAIR sequences obtained a median of 1.8 years after Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection. A comprehensive neuropsychological battery was used to assess several cognitive domains in the same individuals. Correlations between cognitive domains and whole-brain voxel-based morphometry were performed. Different ROIs from FreeSurfer were used to perform the same correlations with other neuroimaging features. RESULTS According to the Frascati criteria, more than one-half of the participants had deficits in the attentional (55%, n = 29) and executive (59%, n = 31) domains, while 40% (n = 21) had impairment in the memory domain. Only 1 participant (1.89%) showed problems in the visuospatial and visuoconstructive domains. We observed that reduced cortical thickness in the left parahippocampal region (t(48) = 2.28, P = .03) and the right caudal-middle-frontal region (t(48) = 2.20, P = .03) was positively correlated with the memory domain. CONCLUSIONS Our findings suggest that cognitive impairment in individuals with the post-COVID-19 condition is associated with long-term alterations in the structure of the brain. These macrostructural changes may provide insight into the nature of cognitive symptoms.
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Affiliation(s)
- Rosalia Dacosta-Aguayo
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Department of Clinical Psychology and Psychobiology (R.D.-A., M.M.), University of Barcelona, Barcelona, Spain. Institut de Neurociències, University of Barcelona, Barcelona, Spain. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Josep Puig
- Comparative Medicine and Bioimaging Center (J.P., G.M.-R.), Germans Trias i Pujol Research Institute, Badalona, Spain
- Department of Radiology (IDI) (J.P.), IDIBGI Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Noemi Lamonja-Vicente
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Multidisciplinary Research Group in Health and Society (N.L.-V., V.M.L.-L., P.M.-A., E.M.-G., R.G.-S., P.T.-M.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - Meritxell Carmona-Cervelló
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
| | - Brenda Biaani León-Gómez
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
| | - Gemma Monté-Rubio
- Comparative Medicine and Bioimaging Center (J.P., G.M.-R.), Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Victor M López-Linfante
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Multidisciplinary Research Group in Health and Society (N.L.-V., V.M.L.-L., P.M.-A., E.M.-G., R.G.-S., P.T.-M.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
- Palau-Solità Healthcare Centre (V.M.L.-L., V.Z.-P.), Palau-Solità Plegamans Institut Català de la Salut, Barcelona, Spain
- Department of Medicine (V.M.L.-L., E.M.-C.), Universitat Autònoma de Barcelona, Cerdanyola de Vallès, Bellaterra, Spain
| | - Valeria Zamora-Putin
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Palau-Solità Healthcare Centre (V.M.L.-L., V.Z.-P.), Palau-Solità Plegamans Institut Català de la Salut, Barcelona, Spain
| | - Pilar Montero-Alia
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Multidisciplinary Research Group in Health and Society (N.L.-V., V.M.L.-L., P.M.-A., E.M.-G., R.G.-S., P.T.-M.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - Carla Chacon
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Grup de REcerca en Impacte de les Malalties Cròniques i les seves Trajectòries (C.C., C.V.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol; Barcelona, Spain. Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Jofre Bielsa
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
| | - Eduard Moreno-Gabriel
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Multidisciplinary Research Group in Health and Society (N.L.-V., V.M.L.-L., P.M.-A., E.M.-G., R.G.-S., P.T.-M.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
- Department of Social Psychology (E.M.-G.), Universitat Autònoma de Barcelona, Cerdanyola de Vallès, Bellaterra, Spain
| | - Rosa Garcia-Sierra
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Multidisciplinary Research Group in Health and Society (N.L.-V., V.M.L.-L., P.M.-A., E.M.-G., R.G.-S., P.T.-M.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
- Nursing Department, Faculty of Medicine (R.G.-S.), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alba Pachón
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
| | - Anna Costa
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology (R.D.-A., M.M.), University of Barcelona, Barcelona, Spain. Institut de Neurociències, University of Barcelona, Barcelona, Spain. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Julia G Prado
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (J.G.P., M.M.), Can Ruti Campus, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (J.G.-., L.M., M.M.), Instituto de Salud Carlos III, Madrid, Spain
- Germans Trias i Pujol Research Institute (J.G.P., E.M.-C., L.M., M.M., C.V., P.T.-M.), Can Ruti Campus, Badalona, Spain
| | - Eva Martinez-Cáceres
- Department of Medicine (V.M.L.-L., E.M.-C.), Universitat Autònoma de Barcelona, Cerdanyola de Vallès, Bellaterra, Spain
- Germans Trias i Pujol Research Institute (J.G.P., E.M.-C., L.M., M.M., C.V., P.T.-M.), Can Ruti Campus, Badalona, Spain
- Immunology Department (E.M.-C.), FOCIS Center of Excellence, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Immunology Division, Laboratori Clinic Metropolitana Nord (E.M.-C.), Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Lourdes Mateu
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (J.G.-., L.M., M.M.), Instituto de Salud Carlos III, Madrid, Spain
- Germans Trias i Pujol Research Institute (J.G.P., E.M.-C., L.M., M.M., C.V., P.T.-M.), Can Ruti Campus, Badalona, Spain
- Infectious Diseases Department (L.M.), Fight against AIDS Foundation (FLS), Germans Trias I Pujol Hospital, Can Ruti Campus, Badalona, Spain
- Red Española de Investigación en Covid Persisitente (L.M., M.M.), European Innovation and Collaboration Programme, Badalona, Spain
| | - Marta Massanella
- IrsiCaixa-AIDS Research Institute and Germans Trias i Pujol Health Research Institute (J.G.P., M.M.), Can Ruti Campus, Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (J.G.-., L.M., M.M.), Instituto de Salud Carlos III, Madrid, Spain
- Germans Trias i Pujol Research Institute (J.G.P., E.M.-C., L.M., M.M., C.V., P.T.-M.), Can Ruti Campus, Badalona, Spain
- Red Española de Investigación en Covid Persisitente (L.M., M.M.), European Innovation and Collaboration Programme, Badalona, Spain
| | - Concepción Violán
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Grup de REcerca en Impacte de les Malalties Cròniques i les seves Trajectòries (C.C., C.V.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol; Barcelona, Spain. Germans Trias i Pujol Research Institute, Badalona, Spain
- Germans Trias i Pujol Research Institute (J.G.P., E.M.-C., L.M., M.M., C.V., P.T.-M.), Can Ruti Campus, Badalona, Spain
- Red de Investigación en Cronicidad (C.V.), Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
- Universitat Autónoma de Barcelona (C.V.), Bellaterra, Spain
| | - Pere Torán-Monserrat
- From the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) (R.D.-A., N.L.-V., M.C.-C., B.B.L.-G., V.M.L.-L., V.Z.-P., P.M.-A., C.C., J.B., E.M.-G., R.G.-S., A.P., A.C., C.V., P.T.-M.), Unitat de Suport a la Recerca Metropolitana Nord, Mataró, Spain
- Multidisciplinary Research Group in Health and Society (N.L.-V., V.M.L.-L., P.M.-A., E.M.-G., R.G.-S., P.T.-M.), Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
- Germans Trias i Pujol Research Institute (J.G.P., E.M.-C., L.M., M.M., C.V., P.T.-M.), Can Ruti Campus, Badalona, Spain
- Department of Medicine (P.T.-M.), Faculty of Medicine, Universitat de Girona, Girona, Spain
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26
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Su Q, Lau RI, Liu Q, Li MKT, Yan Mak JW, Lu W, Lau ISF, Lau LHS, Yeung GTY, Cheung CP, Tang W, Liu C, Ching JYL, Cheong PK, Chan FKL, Ng SC. The gut microbiome associates with phenotypic manifestations of post-acute COVID-19 syndrome. Cell Host Microbe 2024; 32:651-660.e4. [PMID: 38657605 DOI: 10.1016/j.chom.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/28/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
The mechanisms underlying the many phenotypic manifestations of post-acute COVID-19 syndrome (PACS) are poorly understood. Herein, we characterized the gut microbiome in heterogeneous cohorts of subjects with PACS and developed a multi-label machine learning model for using the microbiome to predict specific symptoms. Our processed data covered 585 bacterial species and 500 microbial pathways, explaining 12.7% of the inter-individual variability in PACS. Three gut-microbiome-based enterotypes were identified in subjects with PACS and associated with different phenotypic manifestations. The trained model showed an accuracy of 0.89 in predicting individual symptoms of PACS in the test set and maintained a sensitivity of 86% and a specificity of 82% in predicting upcoming symptoms in an independent longitudinal cohort of subjects before they developed PACS. This study demonstrates that the gut microbiome is associated with phenotypic manifestations of PACS, which has potential clinical utility for the prediction and diagnosis of PACS.
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Affiliation(s)
- Qi Su
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Raphaela I Lau
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Qin Liu
- Microbiota I-Center (MagIC), Hong Kong SAR, China
| | - Moses K T Li
- Microbiota I-Center (MagIC), Hong Kong SAR, China
| | - Joyce Wing Yan Mak
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wenqi Lu
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ivan S F Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Louis H S Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Giann T Y Yeung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun Pan Cheung
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Whitney Tang
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chengyu Liu
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessica Y L Ching
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Pui Kuan Cheong
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Francis K L Chan
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Siew C Ng
- Microbiota I-Center (MagIC), Hong Kong SAR, China; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Li Ka Shing Institute of Health Sciences, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China.
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27
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Mohammadi S, Ghaderi S. Post-COVID-19 conditions: a systematic review on advanced magnetic resonance neuroimaging findings. Neurol Sci 2024; 45:1815-1833. [PMID: 38421524 DOI: 10.1007/s10072-024-07427-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
Post-COVID conditions (PCCs) cover a wide spectrum of lingering symptoms experienced by survivors of coronavirus disease 2019 (COVID-19). Neurological and neuropsychiatric sequelae are common in PCCs. Advanced magnetic resonance imaging (MRI) techniques can reveal subtle alterations in brain structure, function, and perfusion that underlie these sequelae. This systematic review aimed to synthesize findings from studies that used advanced MRI to characterize brain changes in individuals with PCCs. A detailed literature search was conducted in the PubMed and Scopus databases to identify relevant studies that used advanced MRI modalities, such as structural MRI (sMRI), diffusion tensor imaging (DTI), functional MRI (fMRI), and perfusion-weighted imaging (PWI), to evaluate brain changes in PCCs. Twenty-five studies met the inclusion criteria, comprising 1219 participants with PCCs. The most consistent findings from sMRI were reduced gray matter volume (GMV) and cortical thickness (CTh) in cortical and subcortical regions. DTI frequently reveals increased mean diffusivity (MD), radial diffusivity (RD), and decreased fractional anisotropy (FA) in white matter tracts (WMTs) such as the corpus callosum, corona radiata, and superior longitudinal fasciculus. fMRI demonstrated altered functional connectivity (FC) within the default mode, salience, frontoparietal, somatomotor, subcortical, and cerebellar networks. PWI showed decreased cerebral blood flow (CBF) in the frontotemporal area, thalamus, and basal ganglia. Advanced MRI shows changes in the brain networks and regions of the PCCs, which may cause neurological and neuropsychiatric problems. Multimodal neuroimaging may help understand brain-behavior relationships. Longitudinal studies are necessary to better understand the progression of these brain anomalies.
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Affiliation(s)
- Sana Mohammadi
- Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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28
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Fust K, Joshi K, Beck E, Maschio M, Kohli M, Lee A, Hagiwara Y, Van de Velde N, Igarashi A. The Potential Economic Impact of the Updated COVID-19 mRNA Fall 2023 Vaccines in Japan. Vaccines (Basel) 2024; 12:434. [PMID: 38675816 PMCID: PMC11054439 DOI: 10.3390/vaccines12040434] [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: 01/16/2024] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
This analysis estimates the economic and clinical impact of a Moderna updated COVID-19 mRNA Fall 2023 vaccine for adults ≥18 years in Japan. A previously developed Susceptible-Exposed-Infected-Recovered (SEIR) model with a one-year analytic time horizon (September 2023-August 2024) and consequences decision tree were used to estimate symptomatic infections, COVID-19 related hospitalizations, deaths, quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratio (ICER) for a Moderna updated Fall 2023 vaccine versus no additional vaccination, and versus a Pfizer-BioNTech updated mRNA Fall 2023 vaccine. The Moderna vaccine is predicted to prevent 7.2 million symptomatic infections, 272,100 hospitalizations and 25,600 COVID-19 related deaths versus no vaccine. In the base case (healthcare perspective), the ICER was ¥1,300,000/QALY gained ($9400 USD/QALY gained). Sensitivity analyses suggest results are most affected by COVID-19 incidence, initial vaccine effectiveness (VE), and VE waning against infection. Assuming the relative VE between both bivalent vaccines apply to updated Fall 2023 vaccines, the base case suggests the Moderna version will prevent an additional 1,100,000 symptomatic infections, 27,100 hospitalizations, and 2600 deaths compared to the Pfizer-BioNTech vaccine. The updated Moderna vaccine is expected to be highly cost-effective at a ¥5 million willingness-to-pay threshold across a wide range of scenarios.
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Affiliation(s)
- Kelly Fust
- Quadrant Health Economics Inc., 92 Cottonwood Crescent, Cambridge, ON N1T 2J1, Canada (A.L.)
| | - Keya Joshi
- Moderna, Inc., 325 Binney Street, Cambridge, MA 02142, USA; (K.J.)
| | - Ekkehard Beck
- Moderna, Inc., 325 Binney Street, Cambridge, MA 02142, USA; (K.J.)
| | - Michael Maschio
- Quadrant Health Economics Inc., 92 Cottonwood Crescent, Cambridge, ON N1T 2J1, Canada (A.L.)
| | - Michele Kohli
- Quadrant Health Economics Inc., 92 Cottonwood Crescent, Cambridge, ON N1T 2J1, Canada (A.L.)
| | - Amy Lee
- Quadrant Health Economics Inc., 92 Cottonwood Crescent, Cambridge, ON N1T 2J1, Canada (A.L.)
| | - Yuriko Hagiwara
- Moderna, Inc., Kamiyacho Trust Tower, 4-1-1 Toranomon, Minato-ku, Tokyo 105-6923, Japan
| | | | - Ataru Igarashi
- Graduate School of Pharmaceutical Sciences, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Graduate School of Data Sciences, Yokohama City University School of Medicine, 22-2 Seto, Kanazawa Ward, Yokohama 236-0027, Japan
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29
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Azhir A, Hügel J, Tian J, Cheng J, Bassett IV, Bell DS, Bernstam EV, Farhat MR, Henderson DW, Lau ES, Morris M, Semenov YR, Triant VA, Visweswaran S, Strasser ZH, Klann JG, Murphy SN, Estiri H. Precision Phenotyping for Curating Research Cohorts of Patients with Post-Acute Sequelae of COVID-19 (PASC) as a Diagnosis of Exclusion. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.13.24305771. [PMID: 38699316 PMCID: PMC11065031 DOI: 10.1101/2024.04.13.24305771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Scalable identification of patients with the post-acute sequelae of COVID-19 (PASC) is challenging due to a lack of reproducible precision phenotyping algorithms and the suboptimal accuracy, demographic biases, and underestimation of the PASC diagnosis code (ICD-10 U09.9). In a retrospective case-control study, we developed a precision phenotyping algorithm for identifying research cohorts of PASC patients, defined as a diagnosis of exclusion. We used longitudinal electronic health records (EHR) data from over 295 thousand patients from 14 hospitals and 20 community health centers in Massachusetts. The algorithm employs an attention mechanism to exclude sequelae that prior conditions can explain. We performed independent chart reviews to tune and validate our precision phenotyping algorithm. Our PASC phenotyping algorithm improves precision and prevalence estimation and reduces bias in identifying Long COVID patients compared to the U09.9 diagnosis code. Our algorithm identified a PASC research cohort of over 24 thousand patients (compared to about 6 thousand when using the U09.9 diagnosis code), with a 79.9 percent precision (compared to 77.8 percent from the U09.9 diagnosis code). Our estimated prevalence of PASC was 22.8 percent, which is close to the national estimates for the region. We also provide an in-depth analysis outlining the clinical attributes, encompassing identified lingering effects by organ, comorbidity profiles, and temporal differences in the risk of PASC. The PASC phenotyping method presented in this study boasts superior precision, accurately gauges the prevalence of PASC without underestimating it, and exhibits less bias in pinpointing Long COVID patients. The PASC cohort derived from our algorithm will serve as a springboard for delving into Long COVID's genetic, metabolomic, and clinical intricacies, surmounting the constraints of recent PASC cohort studies, which were hampered by their limited size and available outcome data.
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Gu X, Huang L, Zhang H, Cao B. Post-COVID-19 condition symptoms 6-12 months after hospitalisation in Wuhan - Authors' reply. Lancet 2024; 403:1336-1337. [PMID: 38582557 DOI: 10.1016/s0140-6736(24)00415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/27/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Xiaoying Gu
- Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Lixue Huang
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Capital Medical University, Beijing, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing 100084, China.
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Canderan G, Muehling LM, Kadl A, Ladd S, Bonham C, Cross CE, Lima SM, Yin X, Sturek JM, Wilson JM, Keshavarz B, Bryant N, Murphy DD, Cheon IS, McNamara CA, Sun J, Utz PJ, Dolatshahi S, Irish JM, Woodfolk JA. Distinct Type 1 Immune Networks Underlie the Severity of Restrictive Lung Disease after COVID-19. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.03.587929. [PMID: 38617217 PMCID: PMC11014603 DOI: 10.1101/2024.04.03.587929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
The variable etiology of persistent breathlessness after COVID-19 have confounded efforts to decipher the immunopathology of lung sequelae. Here, we analyzed hundreds of cellular and molecular features in the context of discrete pulmonary phenotypes to define the systemic immune landscape of post-COVID lung disease. Cluster analysis of lung physiology measures highlighted two phenotypes of restrictive lung disease that differed by their impaired diffusion and severity of fibrosis. Machine learning revealed marked CCR5+CD95+ CD8+ T-cell perturbations in mild-to-moderate lung disease, but attenuated T-cell responses hallmarked by elevated CXCL13 in more severe disease. Distinct sets of cells, mediators, and autoantibodies distinguished each restrictive phenotype, and differed from those of patients without significant lung involvement. These differences were reflected in divergent T-cell-based type 1 networks according to severity of lung disease. Our findings, which provide an immunological basis for active lung injury versus advanced disease after COVID-19, might offer new targets for treatment.
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Wee LE, Lim JT, Tay AT, Pang D, Dickens B, Chiew CJ, Ong B, Lye DCB, Tan KB. Long-term neuropsychiatric sequelae of Delta versus Omicron SARS-CoV-2 infection. Clin Microbiol Infect 2024; 30:531-539. [PMID: 38141822 DOI: 10.1016/j.cmi.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES Studies have reported increased rates of long-term neuropsychiatric sequelae after SARS-CoV-2 infection using electronic health-record (EHR) data; however, the majority were conducted before Omicron and booster rollout. We estimated the long-term risks and excess burdens of pre-specified new-incident neuropsychiatric diagnoses after Delta versus Omicron BA.1/2 infection in a highly-vaccinated and boosted cohort of adult Singaporeans. METHODS The national SARS-CoV-2 testing registry was used to construct cohorts of Singaporean adults infected during periods of Delta and Omicron BA.1/2 predominance and a contemporaneous test-negative control group. New-incident neuropsychiatric diagnoses recorded in the national health care claims database were identified up to 300 days postinfection. Risks and excess burden were estimated using a doubly robust competing-risks survival analysis. RESULTS 104 179 and 375 903 infected cases were assigned to Delta and Omicron cohorts and compared against test-negative controls (Delta: N = 666 575 and Omicron: N = 619 379). Elevated risk of cognition or memory disorders was consistently reported across Omicron (Adjusted hazards ratio [aHR], 1.24; 95% CI, 1.12-1.38) and Delta cohorts (aHR, 1.63; 95% CI, 1.39-1.92). Delta-variant infection was associated with an increased risk of anosmia or dysgeusia (aHR, 4.53; 95% CI, 2.78-7.41) and psychosis (aHR, 1.65; 95% CI, 1.22-2.22). By contrast, Omicron-variant infection was associated with a risk of abnormal involuntary movements (aHR, 1.93; 95% CI, 1.32-2.83). Risks of neuropsychiatric sequelae predominantly accrued in hospitalized individuals. DISCUSSIONS A modestly increased risk of cognition and memory disorders at 300 days after SARS-CoV-2 infection was observed among adult Singaporeans infected during the Delta/Omicron BA.1/2 transmission. There was no overall increased risk of neuropsychiatric sequelae observed across other domains. Variant-specific differences were also observed in individual neuropsychiatric sequelae, including an elevated risk of anosmia or dysgeusia after Delta-variant infection.
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Affiliation(s)
- Liang En Wee
- National Centre for Infectious Diseases, Singapore General Hospital, Singapore; Duke-NUS Graduate Medical School, National University of Singapore, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore.
| | - Jue Tao Lim
- National Centre for Infectious Diseases, Singapore General Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - An Ting Tay
- Division of Communicable Disease, Ministry of Health, Singapore
| | - Deanette Pang
- Division of Communicable Disease, Ministry of Health, Singapore
| | - Borame Dickens
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Calvin J Chiew
- National Centre for Infectious Diseases, Singapore General Hospital, Singapore; Division of Communicable Disease, Ministry of Health, Singapore
| | - Benjamin Ong
- Division of Communicable Disease, Ministry of Health, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - David Chien Boon Lye
- National Centre for Infectious Diseases, Singapore General Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Kelvin Bryan Tan
- National Centre for Infectious Diseases, Singapore General Hospital, Singapore; Division of Communicable Disease, Ministry of Health, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Qiu Y, Mo C, Chen L, Ye W, Chen G, Zhu T. Alterations in microbiota of patients with COVID-19: implications for therapeutic interventions. MedComm (Beijing) 2024; 5:e513. [PMID: 38495122 PMCID: PMC10943180 DOI: 10.1002/mco2.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently caused a global pandemic, resulting in more than 702 million people being infected and over 6.9 million deaths. Patients with coronavirus disease (COVID-19) may suffer from diarrhea, sleep disorders, depression, and even cognitive impairment, which is associated with long COVID during recovery. However, there remains no consensus on effective treatment methods. Studies have found that patients with COVID-19 have alterations in microbiota and their metabolites, particularly in the gut, which may be involved in the regulation of immune responses. Consumption of probiotics may alleviate the discomfort caused by inflammation and oxidative stress. However, the pathophysiological process underlying the alleviation of COVID-19-related symptoms and complications by targeting the microbiota remains unclear. In the current study, we summarize the latest research and evidence on the COVID-19 pandemic, together with symptoms of SARS-CoV-2 and vaccine use, with a focus on the relationship between microbiota alterations and COVID-19-related symptoms and vaccine use. This work provides evidence that probiotic-based interventions may improve COVID-19 symptoms by regulating gut microbiota and systemic immunity. Probiotics may also be used as adjuvants to improve vaccine efficacy.
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Affiliation(s)
- Yong Qiu
- Department of AnesthesiologyNational Clinical Research Center for Geriatrics and The Research Units of West China (2018RU012)West China HospitalSichuan UniversityChengduChina
- Laboratory of Anesthesia and Critical Care MedicineNational‐Local Joint Engineering Research Center of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduChina
| | - Chunheng Mo
- Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOEState Key Laboratory of BiotherapyWest China Second University HospitalSichuan UniversityChengduChina
| | - Lu Chen
- Department of AnesthesiologyNational Clinical Research Center for Geriatrics and The Research Units of West China (2018RU012)West China HospitalSichuan UniversityChengduChina
- Laboratory of Anesthesia and Critical Care MedicineNational‐Local Joint Engineering Research Center of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduChina
| | - Wanlin Ye
- Department of AnesthesiologyNational Clinical Research Center for Geriatrics and The Research Units of West China (2018RU012)West China HospitalSichuan UniversityChengduChina
- Laboratory of Anesthesia and Critical Care MedicineNational‐Local Joint Engineering Research Center of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduChina
| | - Guo Chen
- Department of AnesthesiologyNational Clinical Research Center for Geriatrics and The Research Units of West China (2018RU012)West China HospitalSichuan UniversityChengduChina
- Laboratory of Anesthesia and Critical Care MedicineNational‐Local Joint Engineering Research Center of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduChina
| | - Tao Zhu
- Department of AnesthesiologyNational Clinical Research Center for Geriatrics and The Research Units of West China (2018RU012)West China HospitalSichuan UniversityChengduChina
- Laboratory of Anesthesia and Critical Care MedicineNational‐Local Joint Engineering Research Center of Translational Medicine of AnesthesiologyWest China HospitalSichuan UniversityChengduChina
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Gishe J, Edmondson D, Kanu M, Barredo R, Raynes EA, Parker D, Cosby B. Mandatory COVID Vaccination: Perspectives from Graduate Allied Health Students at a Mid-size University in the United States. J Community Health 2024; 49:355-365. [PMID: 37991628 DOI: 10.1007/s10900-023-01297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 11/23/2023]
Abstract
Because many students enrolled in Allied Health programs are on track to becoming health practitioners or clinicians and frontline workers who would become critical sources of information for patients it is critical to understand their perspectives about mandatory COVID-19 vaccination. Results: COVID-19 Risk Perception. A significant majority of the respondents had high or strongly high-risk perception of COVID-19, 82(56.6%) strongly agreed and 29(20%) agreed with the statement, COVID-19 is a public health issue (P-value < 0.0001), Comparing by demographic characteristics: African American/Black compared with other races (P-Value = 0.0462), Master of Public Health program, compared with all other graduate programs (P-Value = 0.0140) and fully vaccinated and fully vaccinated and boosted compared with incomplete or not-vaccinated for COVID-19 (P-value = 0.0059) had higher COVID-19 risk perceptions. strongly high-risk perception of COVID-19, 82(56.6%) strongly agreed and 29(20%) agreed with the statement, COVID-19 is a public health issue (P-value < 0.0001), Comparing by demographic characteristics: African American/Black compared with other races (P-Value = 0.0462), Master of Public Health program, compared with all other graduate programs (P-Value = 0.0140) and fully vaccinated and fully vaccinated and boosted compared with incomplete or not-vaccinated for COVID-19 (P-value = 0.0059) had higher COVID-19 risk perceptions.
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Affiliation(s)
- Jemal Gishe
- Department of Public Health, Health Administration, and Health Sciences, College of Health Sciences, Tennessee State University, 330 10th Avenue North, D-405, Nashville, TN, 37203, USA
| | - Deborah Edmondson
- Physical Therapy Department, Tennessee State University, 3500 John A. Merritt Blvd., Nashville, Tenn, 37209-1561, USA
| | - Mohamed Kanu
- College of Health Sciences, Tennessee State University, Health Sciences Bld., 1108 37th Avenue North, Nashville, TN, 37209, USA.
| | - Ronald Barredo
- Department of Physical Therapy, College of Health Sciences, Tennessee State University, Room 447 Health Sciences, Building, 1108 37th Avenue North, Nashville, TN, 37209, USA
| | - Edilberto A Raynes
- Department of Professional and Medical Education, Meharry Medical College, School of Medicine, Nashville, USA
| | - Dalin Parker
- College of Health Sciences, Tennessee State University, Nashville, USA
| | - Brittany Cosby
- Tennessee State University, 3500 John A. Merritt Boulevard, Nashville, TN, 37209, USA
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Zhu C, Pang S, Liu J, Duan Q. Current Progress, Challenges and Prospects in the Development of COVID-19 Vaccines. Drugs 2024; 84:403-423. [PMID: 38652356 DOI: 10.1007/s40265-024-02013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 04/25/2024]
Abstract
The COVID-19 pandemic has resulted in over 772 million confirmed cases, including nearly 7 million deaths, according to the World Health Organization (WHO). Leveraging rapid development, accelerated vaccine approval processes, and large-scale production of various COVID-19 vaccines using different technical platforms, the WHO declared an end to the global health emergency of COVID-19 on May 5, 2023. Current COVID-19 vaccines encompass inactivated, live attenuated, viral vector, protein subunit, nucleic acid (DNA and RNA), and virus-like particle (VLP) vaccines. However, the efficacy of these vaccines is diminishing due to the constant mutation of SARS-CoV-2 and the heightened immune evasion abilities of emerging variants. This review examines the impact of the COVID-19 pandemic, the biological characteristics of the virus, and its diverse variants. Moreover, the review underscores the effectiveness, advantages, and disadvantages of authorized COVID-19 vaccines. Additionally, it analyzes the challenges, strategies, and future prospects of developing a safe, broad-spectrum vaccine that confers sufficient and sustainable immune protection against new variants of SARS-CoV-2. These discussions not only offer insight for the development of next-generation COVID-19 vaccines but also summarize experiences for combating future emerging viruses.
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Affiliation(s)
- Congrui Zhu
- Guangdong Laboratory of Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Animal Nutrition Control, State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science, South China Agricultural University, Guangzhou, 510000, China
| | - Shengmei Pang
- Department of Veterinary Microbiology, College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
- Jiangsu Joint Laboratory for International Cooperation in Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
| | - Jiaqi Liu
- Department of Veterinary Microbiology, College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, China
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
- Jiangsu Joint Laboratory for International Cooperation in Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China
| | - Qiangde Duan
- Department of Veterinary Microbiology, College of Veterinary Medicine, Yangzhou University, Yangzhou, 225009, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China.
- Jiangsu Joint Laboratory for International Cooperation in Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, China.
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Naidu AS, Wang CK, Rao P, Mancini F, Clemens RA, Wirakartakusumah A, Chiu HF, Yen CH, Porretta S, Mathai I, Naidu SAG. Precision nutrition to reset virus-induced human metabolic reprogramming and dysregulation (HMRD) in long-COVID. NPJ Sci Food 2024; 8:19. [PMID: 38555403 PMCID: PMC10981760 DOI: 10.1038/s41538-024-00261-2] [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: 10/12/2023] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
SARS-CoV-2, the etiological agent of COVID-19, is devoid of any metabolic capacity; therefore, it is critical for the viral pathogen to hijack host cellular metabolic machinery for its replication and propagation. This single-stranded RNA virus with a 29.9 kb genome encodes 14 open reading frames (ORFs) and initiates a plethora of virus-host protein-protein interactions in the human body. These extensive viral protein interactions with host-specific cellular targets could trigger severe human metabolic reprogramming/dysregulation (HMRD), a rewiring of sugar-, amino acid-, lipid-, and nucleotide-metabolism(s), as well as altered or impaired bioenergetics, immune dysfunction, and redox imbalance in the body. In the infectious process, the viral pathogen hijacks two major human receptors, angiotensin-converting enzyme (ACE)-2 and/or neuropilin (NRP)-1, for initial adhesion to cell surface; then utilizes two major host proteases, TMPRSS2 and/or furin, to gain cellular entry; and finally employs an endosomal enzyme, cathepsin L (CTSL) for fusogenic release of its viral genome. The virus-induced HMRD results in 5 possible infectious outcomes: asymptomatic, mild, moderate, severe to fatal episodes; while the symptomatic acute COVID-19 condition could manifest into 3 clinical phases: (i) hypoxia and hypoxemia (Warburg effect), (ii) hyperferritinemia ('cytokine storm'), and (iii) thrombocytosis (coagulopathy). The mean incubation period for COVID-19 onset was estimated to be 5.1 days, and most cases develop symptoms after 14 days. The mean viral clearance times were 24, 30, and 39 days for acute, severe, and ICU-admitted COVID-19 patients, respectively. However, about 25-70% of virus-free COVID-19 survivors continue to sustain virus-induced HMRD and exhibit a wide range of symptoms that are persistent, exacerbated, or new 'onset' clinical incidents, collectively termed as post-acute sequelae of COVID-19 (PASC) or long COVID. PASC patients experience several debilitating clinical condition(s) with >200 different and overlapping symptoms that may last for weeks to months. Chronic PASC is a cumulative outcome of at least 10 different HMRD-related pathophysiological mechanisms involving both virus-derived virulence factors and a multitude of innate host responses. Based on HMRD and virus-free clinical impairments of different human organs/systems, PASC patients can be categorized into 4 different clusters or sub-phenotypes: sub-phenotype-1 (33.8%) with cardiac and renal manifestations; sub-phenotype-2 (32.8%) with respiratory, sleep and anxiety disorders; sub-phenotype-3 (23.4%) with skeleto-muscular and nervous disorders; and sub-phenotype-4 (10.1%) with digestive and pulmonary dysfunctions. This narrative review elucidates the effects of viral hijack on host cellular machinery during SARS-CoV-2 infection, ensuing detrimental effect(s) of virus-induced HMRD on human metabolism, consequential symptomatic clinical implications, and damage to multiple organ systems; as well as chronic pathophysiological sequelae in virus-free PASC patients. We have also provided a few evidence-based, human randomized controlled trial (RCT)-tested, precision nutrients to reset HMRD for health recovery of PASC patients.
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Affiliation(s)
- A Satyanarayan Naidu
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA.
- N-terminus Research Laboratory, 232659 Via del Rio, Yorba Linda, CA, 92887, USA.
| | - Chin-Kun Wang
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- School of Nutrition, Chung Shan Medical University, 110, Section 1, Jianguo North Road, Taichung, 40201, Taiwan
| | - Pingfan Rao
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- College of Food and Bioengineering, Fujian Polytechnic Normal University, No.1, Campus New Village, Longjiang Street, Fuqing City, Fujian, China
| | - Fabrizio Mancini
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- President-Emeritus, Parker University, 2540 Walnut Hill Lane, Dallas, TX, 75229, USA
| | - Roger A Clemens
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- University of Southern California, Alfred E. Mann School of Pharmacy/D. K. Kim International Center for Regulatory & Quality Sciences, 1540 Alcazar St., CHP 140, Los Angeles, CA, 90089, USA
| | - Aman Wirakartakusumah
- International Union of Food Science and Technology (IUFoST), Guelph, ON, Canada
- IPMI International Business School Jakarta; South East Asian Food and Agriculture Science and Technology, IPB University, Bogor, Indonesia
| | - Hui-Fang Chiu
- Department of Chinese Medicine, Taichung Hospital, Ministry of Health & Well-being, Taichung, Taiwan
| | - Chi-Hua Yen
- Department of Family and Community Medicine, Chung Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Sebastiano Porretta
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- President, Italian Association of Food Technology (AITA), Milan, Italy
- Experimental Station for the Food Preserving Industry, Department of Consumer Science, Viale Tanara 31/a, I-43121, Parma, Italy
| | - Issac Mathai
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- Soukya International Holistic Health Center, Whitefield, Bengaluru, India
| | - Sreus A G Naidu
- Global Nutrition Healthcare Council (GNHC) Mission-COVID, Yorba Linda, CA, USA
- N-terminus Research Laboratory, 232659 Via del Rio, Yorba Linda, CA, 92887, USA
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Ferous S, Siafakas N, Boufidou F, Patrinos GP, Tsakris A, Anastassopoulou C. Investigating ABO Blood Groups and Secretor Status in Relation to SARS-CoV-2 Infection and COVID-19 Severity. J Pers Med 2024; 14:346. [PMID: 38672973 PMCID: PMC11051264 DOI: 10.3390/jpm14040346] [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: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The ABO blood groups, Lewis antigens, and secretor systems are important components of transfusion medicine. These interconnected systems have been also shown to be associated with differing susceptibility to bacterial and viral infections, likely as the result of selection over the course of evolution and the constant tug of war between humans and infectious microbes. This comprehensive narrative review aimed to explore the literature and to present the current state of knowledge on reported associations of the ABO, Lewis, and secretor blood groups with SARS-CoV-2 infection and COVID-19 severity. Our main finding was that the A blood group may be associated with increased susceptibility to SARS-CoV-2 infection, and possibly also with increased disease severity and overall mortality. The proposed pathophysiological pathways explaining this potential association include antibody-mediated mechanisms and increased thrombotic risk amongst blood group A individuals, in addition to altered inflammatory cytokine expression profiles. Preliminary evidence does not support the association between ABO blood groups and COVID-19 vaccine response, or the risk of developing long COVID. Even though the emergency state of the pandemic is over, further research is needed especially in this area since tens of millions of people worldwide suffer from lingering COVID-19 symptoms.
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Affiliation(s)
- Stefanos Ferous
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
| | - Nikolaos Siafakas
- Department of Clinical Microbiology, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Fotini Boufidou
- Neurochemistry and Biological Markers Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - George P. Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece;
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (S.F.); (A.T.)
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McClelland AC, Benitez SJ, Burns J. COVID-19 Neuroimaging Update: Pathophysiology, Acute Findings, and Post-Acute Developments. Semin Ultrasound CT MR 2024:S0887-2171(24)00026-X. [PMID: 38518814 DOI: 10.1053/j.sult.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
COVID-19 has prominent effects on the nervous system with important manifestations on neuroimaging. In this review, we discuss the neuroimaging appearance of acute COVID-19 that became evident during the early stages of the pandemic. We highlight the underlying pathophysiology mediating nervous system effects and neuroimaging appearances including systemic inflammatory response such as cytokine storm, coagulopathy, and para/post-infections immune mediated phenomena. We also discuss the nervous system manifestations of COVID-19 and the role of imaging as the pandemic has evolved over time, including related to the development of vaccines and the emergence of post-acute sequalae such as long COVID.
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Affiliation(s)
| | - Steven J Benitez
- Department of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Judah Burns
- Department of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
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Kitsios GD, Blacka S, Jacobs JJ, Mirza T, Naqvi A, Gentry H, Murray C, Wang X, Golubykh K, Qurashi H, Dodia A, Risbano M, Benigno M, Emir B, Weinstein E, Bramson C, Jiang L, Dai F, Szigethy E, Mellors JW, Methe B, Sciurba FC, Nouraie SM, Morris A. Subphenotypes of self-reported symptoms and outcomes in long COVID: a prospective cohort study with latent class analysis. BMJ Open 2024; 14:e077869. [PMID: 38485476 PMCID: PMC10941166 DOI: 10.1136/bmjopen-2023-077869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/21/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE To characterise subphenotypes of self-reported symptoms and outcomes (SRSOs) in postacute sequelae of COVID-19 (PASC). DESIGN Prospective, observational cohort study of subjects with PASC. SETTING Academic tertiary centre from five clinical referral sources. PARTICIPANTS Adults with COVID-19 ≥20 days before enrolment and presence of any new self-reported symptoms following COVID-19. EXPOSURES We collected data on clinical variables and SRSOs via structured telephone interviews and performed standardised assessments with validated clinical numerical scales to capture psychological symptoms, neurocognitive functioning and cardiopulmonary function. We collected saliva and stool samples for quantification of SARS-CoV-2 RNA via quantitative PCR. OUTCOMES MEASURES Description of PASC SRSOs burden and duration, derivation of distinct PASC subphenotypes via latent class analysis (LCA) and relationship with viral load. RESULTS We analysed baseline data for 214 individuals with a study visit at a median of 197.5 days after COVID-19 diagnosis. Participants reported ever having a median of 9/16 symptoms (IQR 6-11) after acute COVID-19, with muscle-aches, dyspnoea and headache being the most common. Fatigue, cognitive impairment and dyspnoea were experienced for a longer time. Participants had a lower burden of active symptoms (median 3 (1-6)) than those ever experienced (p<0.001). Unsupervised LCA of symptoms revealed three clinically active PASC subphenotypes: a high burden constitutional symptoms (21.9%), a persistent loss/change of smell and taste (20.6%) and a minimal residual symptoms subphenotype (57.5%). Subphenotype assignments were strongly associated with self-assessments of global health, recovery and PASC impact on employment (p<0.001) as well as referral source for enrolment. Viral persistence (5.6% saliva and 1% stool samples positive) did not explain SRSOs or subphenotypes. CONCLUSIONS We identified three distinct PASC subphenotypes. We highlight that although most symptoms progressively resolve, specific PASC subpopulations are impacted by either high burden of constitutional symptoms or persistent olfactory/gustatory dysfunction, requiring prospective identification and targeted preventive or therapeutic interventions.
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Affiliation(s)
- Georgios D Kitsios
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shawna Blacka
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jana J Jacobs
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Taaha Mirza
- Internal Medicine Residency Program, UPMC in Central Pa, Harrisburg, Pennsylvania, USA
| | - Asma Naqvi
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Heather Gentry
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cathy Murray
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xiaohong Wang
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Konstantin Golubykh
- Internal Medicine Residency Program, UPMC in Central Pa, Harrisburg, Pennsylvania, USA
| | - Hafiz Qurashi
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Akash Dodia
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Risbano
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | | | - Feng Dai
- Pfizer Inc, New York, New York, USA
| | - Eva Szigethy
- Department of Psychiatry and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John W Mellors
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Barbara Methe
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Frank C Sciurba
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Emphysema Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Seyed Mehdi Nouraie
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alison Morris
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Gerayeli FV, Eddy R, Sin DD. A Proposed Approach to Pulmonary Long COVID: A Viewpoint. Eur Respir J 2024:2302302. [PMID: 38453258 DOI: 10.1183/13993003.02302-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Firoozeh V Gerayeli
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columia, Canada
| | - Rachel Eddy
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columia, Canada
- Division of Respiratory Medicine, Department of Medicine University of British Columbia, Vancouver, British Columia, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columia, Canada
- Division of Respiratory Medicine, Department of Medicine University of British Columbia, Vancouver, British Columia, Canada
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Poland GA, Raina MacIntyre C. Celebrating vaccines: The 2023 Nobel prize in medicine or physiology. Vaccine 2024; 42:1409-1410. [PMID: 38365486 DOI: 10.1016/j.vaccine.2023.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 02/18/2024]
Affiliation(s)
- Gregory A Poland
- Mayo Vaccine Research Group, 200 First Street, SW, Guggenheim 611B, Mayo Clinic, Rochester, MN 55905, United States.
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute for Infection and Immunity, UNSW Sydney, Australia
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Iversen A, Blomberg B, Haug K, Kittang B, Özgümüs T, Cox RJ, Langeland N. Symptom trajectories of post-COVID sequelae in patients with acute Delta or Omicron infection in Bergen, Norway. Front Public Health 2024; 12:1320059. [PMID: 38504678 PMCID: PMC10948556 DOI: 10.3389/fpubh.2024.1320059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction A substantial proportion of the over 700 million COVID-19 cases world-wide experience long-term symptoms. The objectives of this study were to compare symptom trajectories and risk factors for post-COVID-19 condition after Delta and Omicron infection. Methods This study consecutively recruited patients with SARS-CoV-2 infection from November 2021 to March 2022. We recorded demographics, comorbidities, vaccination status, sick leave, and 18 symptoms during acute infection and after 4 months. The primary outcome measures were symptoms during acute infection and after 4 months. Secondary outcome measures were work and school absenteeism. Results We followed a cohort of 1,374 non-hospitalized COVID-19 patients in Bergen, Norway, at three time points. The median age was 39.8 years and 11% were children <16 years. Common acute upper respiratory symptoms waned during follow-up. Fatigue remained common from acute infection (40%) until after 4 months (37%). Four months post-infection, patients reported increased frequencies of dyspnea (from 15% during acute illness to 25% at 4 months, p < 0.001), cognitive symptoms (from 9 to 32%, p < 0.001) and depression (from 1 to 17%, p < 0.001). Patients infected with Omicron reported less dyspnea (22% versus 27%, p = 0.046) and smell/taste problems (5% versus 19%, p < 0.001) at 4 months follow-up than those with Delta infection. Comorbidities and female sex were risk factors for persistent dyspnea and cognitive symptoms. Ten percent reported sick leave after acute illness, and vaccination reduced the risk of absenteeism (adjusted risk ratio: 0.36, 95% confidence interval: 0.15, 0.72, p = 0.008). Conclusion At 4 months, home-isolated patients infected with Omicron reported overall comparable symptom burden, but less dyspnea and smell/taste problems than Delta infected patients. Several acute symptoms waned during follow-up. It is worrying that dyspnea, neurocognitive symptoms, and particularly depression, increased significantly during the first 4 months after acute infection. Previous vaccination was protective against prolonged sick leave.
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Affiliation(s)
- Arild Iversen
- Chief Municipal Doctor’s Office, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kjell Haug
- Chief Municipal Doctor’s Office, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bård Kittang
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Nursing Home Medicine, Bergen Municipality, Bergen, Norway
| | - Türküler Özgümüs
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rebecca Jane Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Iwashyna TJ, Smith VA, Seelye S, Bohnert ASB, Boyko EJ, Hynes DM, Ioannou GN, Maciejewski ML, O’Hare AM, Viglianti EM, Berkowitz TS, Pura J, Womer J, Kamphuis LA, Monahan ML, Bowling CB. Self-Reported Everyday Functioning After COVID-19 Infection. JAMA Netw Open 2024; 7:e240869. [PMID: 38427352 PMCID: PMC10907923 DOI: 10.1001/jamanetworkopen.2024.0869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
Importance Changes in everyday functioning are crucial to assessing the long-term impact of COVID-19 infection. Objective To examine the impact of COVID-19 infection on everyday functioning 18 months after infection among veterans with and without histories of COVID-19 infection. Design, Setting, and Participants This cohort study used data from the US Veterans Affairs (VA) and included 186 veterans who had COVID-19 between October 2020 and April 2021 (ie, COVID-19 cohort) and 186 matched comparators who did not have documented COVID-19 infections (ie, control cohort). This match balanced the risk of COVID-19 based on 39 variables measured in the 24 months before infection or match, using principles of target trial emulation. Data were analyzed from December 2022 to December 2023. Exposure First documented COVID-19. Main Outcome and Measures The differences in self-reported everyday functioning 18 months after COVID-19 infection were estimated and compared with their matched comparators. Within-matched pair logistic and linear regressions assessed differences in outcomes and were weighted to account for sampling and nonresponse. Results Among the 186 matched pairs of participants, their weighted mean age was 60.4 (95% CI, 57.5 to 63.2) years among veterans in the COVID-19 cohort (weighted sample, 91 459 of 101 133 [90.4%] male; 30 611 [30.3%] Black or African American veterans; 65 196 [64.4%] White veterans) and 61.1 (95% CI, 57.8 to 64.4) years among their comparators in the control cohort (91 459 [90.4%] male; 24 576 [24.3%] Black or African American veterans; 70 157 [69.4%] White veterans). A high proportion of veterans in the COVID-19 cohort (weighted percentage, 44.9% [95% CI, 34.2% to 56.2%]) reported that they could do less than what they felt they could do at the beginning of 2020 compared with the control cohort (weighted percentage, 35.3%; [95% CI, 25.6% to 46.4%]; within-matched pair adjusted odds ratio [OR], 1.52 [95% CI, 0.79 to 2.91]). There was no association of documented COVID-19 infection with fatigue, substantial pain, limitations in either activities of daily living and instrumental activities of daily living, severely curtailed life-space mobility, employment, or mean health-related quality of life on a utility scale. Conclusions and Relevance In this cohort study of veterans with and without documented COVID-19, many reported a substantial loss of everyday functioning during the pandemic regardless of whether or not they had a documented infection with COVID-19. Future work with larger samples is needed to validate the estimated associations.
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Affiliation(s)
- Theodore J. Iwashyna
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
- Department of Medicine, University of Michigan Medical School, Ann Arbor
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
- School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Valerie A. Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
- Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Sarah Seelye
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
| | - Amy S. B. Bohnert
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
- Departments of Anesthesiology, Epidemiology, and Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Edward J. Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington
- University of Washington, Seattle
| | - Denise M. Hynes
- VA Portland Healthcare System, Center to Improve Veteran Involvement in Care, Portland, Oregon
- College of Health, and Center for Quantitative Life Sciences, Oregon State University, Corvallis
- School of Nursing, Oregon Health and Science University, Portland
| | - George N. Ioannou
- University of Washington, Seattle
- VA Puget Sound Health Care System Hospital and Specialty Medicine Service and Seattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
- School of Nursing, Oregon Health and Science University, Portland
| | - Ann M. O’Hare
- University of Washington, Seattle
- VA Puget Sound Health Care System Hospital and Specialty Medicine Service and Seattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington
| | - Elizabeth M. Viglianti
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
- Department of Medicine, University of Michigan Medical School, Ann Arbor
| | - Theodore S. Berkowitz
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina
| | - John Pura
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina
| | - James Womer
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Lee A. Kamphuis
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
| | - Max L. Monahan
- VA Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - C. Barrett Bowling
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Medical Center, Durham, North Carolina
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
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Gu X, Wong CCL, Cao B. Authors' reply to Letter regarding "Probing Long COVID through a Proteomic Lens: a Comprehensive Two-Year Longitudinal Cohort Study of Hospitalised Survivor". EBioMedicine 2024; 101:105029. [PMID: 38387405 PMCID: PMC10900247 DOI: 10.1016/j.ebiom.2024.105029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Affiliation(s)
- Xiaoying Gu
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, PR China
| | - Catherine C L Wong
- State Key Laboratory of Complex Severe and Rare Diseases, Clinical Research Institute, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, PR China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, PR China
| | - Bin Cao
- Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, PR China; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, PR China; Department of Pulmonary and Critical Care Medicine, Capital Medical University, Beijing, PR China.
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Xie Y, Choi T, Al-Aly Z. Long-term outcomes following hospital admission for COVID-19 versus seasonal influenza: a cohort study. THE LANCET. INFECTIOUS DISEASES 2024; 24:239-255. [PMID: 38104583 DOI: 10.1016/s1473-3099(23)00684-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/14/2023] [Accepted: 10/24/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Previous comparative analyses of people admitted to hospital for COVID-19 versus influenza evaluated the risk of death, hospital readmission, and a narrow set of health outcomes up to 6 months following infection. We aimed to do a comparative evaluation of both acute and long-term risks and burdens of a comprehensive set of health outcomes following hospital admission for COVID-19 or seasonal influenza. METHODS For this cohort study we used the health-care databases of the US Department of Veterans Affairs to analyse data from 81 280 participants admitted to hospital for COVID-19 between March 1, 2020, and June 30, 2022, and 10 985 participants admitted to hospital for seasonal influenza between Oct 1, 2015, and Feb 28, 2019. Participants were followed up for up to 18 months to comparatively evaluate risks and burdens of death, a prespecified set of 94 individual health outcomes, ten organ systems, overall burden across all organ systems, readmission, and admission to intensive care. Inverse probability weighting was used to balance the baseline characteristics. Cox and Poisson models were used to generate estimates of risk on both the relative scale and absolute scale as the event rate and disability-adjusted life-years (DALYs) per 100 persons. FINDINGS Over 18 months of follow-up, compared to seasonal influenza, the COVID-19 group had an increased risk of death (hazard ratio [HR] 1·51 [95% CI 1·45-1·58]), corresponding to an excess death rate of 8·62 (95% CI 7·55-9·44) per 100 persons in the COVID-19 group versus the influenza group. Comparative analyses of 94 prespecified health outcomes showed that COVID-19 had an increased risk of 68·1% (64 of 94) pre-specified health outcomes; seasonal influenza was associated with an increased risk of 6·4% (six of 94) pre-specified health outcomes, including three out of four pre-specified pulmonary outcomes. Analyses of organ systems showed that COVID-19 had a higher risk across all organ systems except for the pulmonary system, the risk of which was higher in seasonal influenza. The cumulative rates of adverse health outcomes across all organ systems were 615·18 (95% CI 605·17-624·88) per 100 persons in COVID-19 and 536·90 (527·38-544·90) per 100 persons in seasonal influenza, corresponding to an excess rate of 78·72 (95% CI 66·15-91·24) per 100 persons in COVID-19. The total number of DALYs across all organ systems were 287·43 (95% CI 281·10-293·59) per 100 persons in the COVID-19 group and 242·66 (236·75, 247·67) per 100 persons in the seasonal influenza group, corresponding to 45·03 (95% CI 37·15-52·90) higher DALYs per 100 persons in COVID-19. Decomposition analyses showed that in both COVID-19 and seasonal influenza, there was a higher burden of health loss in the post-acute than the acute phase; and comparatively, except for the pulmonary system, COVID-19 had a higher burden of health loss across all other organ systems than seasonal influenza in both the acute and post-acute phase. Compared to seasonal influenza, COVID-19 also had an increased risk of hospital readmission (excess rate 20·50 [95% CI 16·10-24·86] per 100 persons) and admission to intensive care (excess rate 9·23 [6·68-11·82] per 100 persons). The findings were consistent in analyses comparatively evaluating risks in seasonal influenza versus COVID-19 by individuals' respective vaccination status and in those admitted to hospital during the pre-delta, delta, and omicron eras. INTERPRETATION Although rates of death and adverse health outcomes following hospital admission for either seasonal influenza or COVID-19 are high, this comparative analysis shows that hospital admission for COVID-19 was associated with higher long-term risks of death and adverse health outcomes in nearly every organ system (except for the pulmonary system) and significant cumulative excess DALYs than hospital admission for seasonal influenza. The substantial cumulative burden of health loss in both groups calls for greater prevention of hospital admission for these two viruses and for greater attention to the care needs of people with long-term health effects due to either seasonal influenza or SARS-CoV-2 infection. FUNDING US Department of Veterans Affairs.
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Affiliation(s)
- Yan Xie
- Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA; Veterans Research and Education Foundation of Saint Louis, Saint Louis, MO, USA; Division of Pharmacoepidemiology, Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA
| | - Taeyoung Choi
- Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA; Veterans Research and Education Foundation of Saint Louis, Saint Louis, MO, USA
| | - Ziyad Al-Aly
- Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA; Veterans Research and Education Foundation of Saint Louis, Saint Louis, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, Saint Louis, MO, USA; Institute for Public Health, Washington University in Saint Louis, Saint Louis, MO, USA.
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Al-Aly Z, Topol E. Solving the puzzle of Long Covid. Science 2024; 383:830-832. [PMID: 38386747 DOI: 10.1126/science.adl0867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Long Covid provides an opportunity to understand how acute infections cause chronic disease.
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Affiliation(s)
- Ziyad Al-Aly
- Clinical Epidemiology Center, Research and Development Service, VA Saint Louis Health Care System, Saint Louis, MO, USA
- Institute for Public Health, Washington University in Saint Louis, Saint Louis, MO, USA
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Eddy RL, Mummy D, Zhang S, Dai H, Bechtel A, Schmidt A, Frizzell B, Gerayeli FV, Leipsic JA, Leung JM, Driehuys B, Que LG, Castro M, Sin DD, Niedbalski PJ. Cluster Analysis to Identify Long COVID Phenotypes Using 129Xe Magnetic Resonance Imaging: A Multi-centre Evaluation. Eur Respir J 2024; 63:2302301. [PMID: 38331459 PMCID: PMC10973687 DOI: 10.1183/13993003.02301-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Long COVID impacts ∼10% of people diagnosed with COVID-19, yet the pathophysiology driving ongoing symptoms is poorly understood. We hypothesised that 129Xe magnetic resonance imaging (MRI) could identify unique pulmonary phenotypic subgroups of long COVID, therefore we evaluated ventilation and gas exchange measurements with cluster analysis to generate imaging-based phenotypes. METHODS COVID-negative controls and participants who previously tested positive for COVID-19 underwent 129XeMRI ∼14-months post-acute infection across three centres. Long COVID was defined as persistent dyspnea, chest tightness, cough, fatigue, nausea and/or loss of taste/smell at MRI; participants reporting no symptoms were considered fully-recovered. 129XeMRI ventilation defect percent (VDP) and membrane (Mem)/Gas, red blood cell (RBC)/Mem and RBC/Gas ratios were used in k-means clustering for long COVID, and measurements were compared using ANOVA with post-hoc Bonferroni correction. RESULTS We evaluated 135 participants across three centres: 28 COVID-negative (40±16yrs), 34 fully-recovered (42±14yrs) and 73 long COVID (49±13yrs). RBC/Mem (p=0.03) and FEV1 (p=0.04) were different between long- and COVID-negative; FEV1 and all other pulmonary function tests (PFTs) were within normal ranges. Four unique long COVID clusters were identified compared with recovered and COVID-negative. Cluster1 was the youngest with normal MRI and mild gas-trapping; Cluster2 was the oldest, characterised by reduced RBC/Mem but normal PFTs; Cluster3 had mildly increased Mem/Gas with normal PFTs; and Cluster4 had markedly increased Mem/Gas with concomitant reduction in RBC/Mem and restrictive PFT pattern. CONCLUSION We identified four 129XeMRI long COVID phenotypes with distinct characteristics. 129XeMRI can dissect pathophysiologic heterogeneity of long COVID to enable personalised patient care.
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Affiliation(s)
- Rachel L Eddy
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - David Mummy
- Department of Radiology, Duke University, Durham, NC, USA
| | - Shuo Zhang
- Department of Radiology, Duke University, Durham, NC, USA
| | - Haoran Dai
- Department of Medical Physics, Duke University, Durham, NC, USA
| | - Aryil Bechtel
- Department of Radiology, Duke University, Durham, NC, USA
| | - Alexandra Schmidt
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
| | - Bradie Frizzell
- Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Firoozeh V Gerayeli
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
| | - Jonathon A Leipsic
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Janice M Leung
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Bastiaan Driehuys
- Department of Radiology, Duke University, Durham, NC, USA
- Department of Medical Physics, Duke University, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Loretta G Que
- Division of Pulmonary, Department of Medicine, Duke University, Durham, NC, USA
| | - Mario Castro
- Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Peter J Niedbalski
- Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
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Caetano CCS, Azamor T, Meyer NM, Onwubueke C, Calabrese CM, Calabrese LH, Visperas A, Piuzzi NS, Husni ME, Foo SS, Chen W. Mechanistic insights into bone remodelling dysregulation by human viral pathogens. Nat Microbiol 2024; 9:322-335. [PMID: 38316931 PMCID: PMC11045166 DOI: 10.1038/s41564-023-01586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/12/2023] [Indexed: 02/07/2024]
Abstract
Bone-related diseases (osteopathologies) associated with human virus infections have increased around the globe. Recent findings have highlighted the intricate interplay between viral infection, the host immune system and the bone remodelling process. Viral infections can disrupt bone homeostasis, contributing to conditions such as arthritis and soft tissue calcifications. Osteopathologies can occur after arbovirus infections such as chikungunya virus, dengue virus and Zika virus, as well as respiratory viruses, such as severe acute respiratory syndrome coronavirus 2 and enteroviruses such as Coxsackievirus B. Here we explore how human viruses dysregulate bone homeostasis, detailing viral factors, molecular mechanisms, host immune response changes and bone remodelling that ultimately result in osteopathologies. We highlight model systems and technologies to advance mechanistic understanding of viral-mediated bone alterations. Finally, we propose potential prophylactic and therapeutic strategies, introduce 'osteovirology' as a research field highlighting the underestimated roles of viruses in bone-related diseases, and discuss research avenues for further investigation.
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Affiliation(s)
- Camila C S Caetano
- Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tamiris Azamor
- Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Nikki M Meyer
- Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Chineme Onwubueke
- Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Cassandra M Calabrese
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
| | - Leonard H Calabrese
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
| | - Anabelle Visperas
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - M Elaine Husni
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA
| | - Suan-Sin Foo
- Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Weiqiang Chen
- Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
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Frank N, Dickinson D, Garcia W, Liu Y, Yu H, Cai J, Patel S, Yao B, Jiang X, Hsu S. Feasibility Study of Developing a Saline-Based Antiviral Nanoformulation Containing Lipid-Soluble EGCG: A Potential Nasal Drug to Treat Long COVID. Viruses 2024; 16:196. [PMID: 38399972 PMCID: PMC10891529 DOI: 10.3390/v16020196] [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: 12/13/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
A recent estimate indicates that up to 23.7 million Americans suffer from long COVID, and approximately one million workers may be out of the workforce each day due to associated symptoms, leading to a USD 50 billion annual loss of salary. Post-COVID (Long COVID) neurologic symptoms are due to the initial robust replication of SARS-CoV-2 in the nasal neuroepithelial cells, leading to inflammation of the olfactory epithelium (OE) and the central nervous system (CNS), and the OE becoming a persistent infection site. Previously, our group showed that Epigallocatechin-3-gallate-palmitate (EC16) nanoformulations possess strong antiviral activity against human coronavirus, suggesting this green tea-derived compound in nanoparticle formulations could be developed as an intranasally delivered new drug to eliminate the persistent SARS-CoV-2 infection, leading to restored olfactory function and reduced inflammation in the CNS. The objective of the current study was to determine the compatibility of the nanoformulations with human nasal primary epithelial cells (HNpECs). METHODS Nanoparticle size was measured using the ZetaView Nanoparticle Tracking Analysis (NTA) system; contact antiviral activity was determined by TCID50 assay for cytopathic effect on MRC-5 cells; post-infection inhibition activity was determined in HNpECs; and cytotoxicity for these cells was determined using an MTT assay. The rapid inactivation of OC43 (a β-coronavirus) and 229E (α-coronavirus) viruses was further characterized by transmission electron microscopy. RESULTS A saline-based nanoformulation containing 0.1% w/v EC16 was able to inactivate 99.9999% β-coronavirus OC43 on direct contact within 1 min. After a 10-min incubation of infected HNpECs with a formulation containing drug-grade EC16 (EGCG-4' mono-palmitate or EC16m), OC43 viral replication was inhibited by 99%. In addition, all nanoformulations tested for their effect on cell viability were comparable to normal saline, a regularly used nasal irrigation solution. A 1-min incubation of an EC16 nanoformulation with either OC43 or 229E showed an altered viral structure. CONCLUSION Nanoformulations containing EC16 showed properties compatible with nasal application to rapidly inactivate SARS-CoV-2 residing in the olfactory mucosa and to reduce inflammation in the CNS, pending additional formulation and safety studies.
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Affiliation(s)
- Nicolette Frank
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
| | | | - William Garcia
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA; (Y.L.); (H.Y.); (J.C.)
| | - Hongfang Yu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA; (Y.L.); (H.Y.); (J.C.)
| | - Jingwen Cai
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA; (Y.L.); (H.Y.); (J.C.)
| | - Sahaj Patel
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
| | - Bo Yao
- Changxing Sanju Biotech Co., Ltd., Hangzhou 310013, China; (B.Y.); (X.J.)
| | - Xiaocui Jiang
- Changxing Sanju Biotech Co., Ltd., Hangzhou 310013, China; (B.Y.); (X.J.)
| | - Stephen Hsu
- Department of Oral Biology & Diagnostic Sciences, Augusta University, Augusta, GA 30912, USA; (N.F.); (W.G.); (S.P.)
- Camellix Research Laboratory, Augusta, GA 30912, USA;
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50
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Leung JM, Wu MJ, Kheradpour P, Chen C, Drake KA, Tong G, Ridaura VK, Zisser HC, Conrad WA, Hudson N, Allen J, Welberry C, Parsy-Kowalska C, Macdonald I, Tapson VF, Moy JN, deFilippi CR, Rosas IO, Basit M, Krishnan JA, Parthasarathy S, Prabhakar BS, Salvatore M, Kim CC. Early immune factors associated with the development of post-acute sequelae of SARS-CoV-2 infection in hospitalized and non-hospitalized individuals. Front Immunol 2024; 15:1348041. [PMID: 38318183 PMCID: PMC10838987 DOI: 10.3389/fimmu.2024.1348041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024] Open
Abstract
Background Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to post-acute sequelae of SARS-CoV-2 (PASC) that can persist for weeks to years following initial viral infection. Clinical manifestations of PASC are heterogeneous and often involve multiple organs. While many hypotheses have been made on the mechanisms of PASC and its associated symptoms, the acute biological drivers of PASC are still unknown. Methods We enrolled 494 patients with COVID-19 at their initial presentation to a hospital or clinic and followed them longitudinally to determine their development of PASC. From 341 patients, we conducted multi-omic profiling on peripheral blood samples collected shortly after study enrollment to investigate early immune signatures associated with the development of PASC. Results During the first week of COVID-19, we observed a large number of differences in the immune profile of individuals who were hospitalized for COVID-19 compared to those individuals with COVID-19 who were not hospitalized. Differences between individuals who did or did not later develop PASC were, in comparison, more limited, but included significant differences in autoantibodies and in epigenetic and transcriptional signatures in double-negative 1 B cells, in particular. Conclusions We found that early immune indicators of incident PASC were nuanced, with significant molecular signals manifesting predominantly in double-negative B cells, compared with the robust differences associated with hospitalization during acute COVID-19. The emerging acute differences in B cell phenotypes, especially in double-negative 1 B cells, in PASC patients highlight a potentially important role of these cells in the development of PASC.
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Affiliation(s)
| | - Michelle J. Wu
- Verily Life Sciences, South San Francisco, CA, United States
| | | | - Chen Chen
- Verily Life Sciences, South San Francisco, CA, United States
| | | | - Gary Tong
- Verily Life Sciences, South San Francisco, CA, United States
| | | | | | - William A. Conrad
- Providence Little Company of Mary Medical Center Torrance, Torrance, CA, United States
| | | | - Jared Allen
- Oncimmune Limited, Nottingham, United Kingdom
| | | | | | | | - Victor F. Tapson
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - James N. Moy
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | | | - Ivan O. Rosas
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Mujeeb Basit
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jerry A. Krishnan
- Breathe Chicago Center, University of Illinois Chicago, Chicago, IL, United States
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona, Tucson, AZ, United States
| | - Bellur S. Prabhakar
- Department of Microbiology and Immunology, University of Illinois - College of Medicine, Chicago, IL, United States
| | - Mirella Salvatore
- Department of Medicine and Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Charles C. Kim
- Verily Life Sciences, South San Francisco, CA, United States
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