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Lupi L, Vitiello A, Parolin C, Calistri A, Garzino-Demo A. The Potential Role of Viral Persistence in the Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). Pathogens 2024; 13:388. [PMID: 38787240 PMCID: PMC11123686 DOI: 10.3390/pathogens13050388] [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: 04/06/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
The infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated not only with the development of acute disease but also with long-term symptoms or post-acute sequelae of SARS-CoV-2 (PASC). Multiple lines of evidence support that some viral antigens and RNA can persist for up to 15 months in multiple organs in the body, often after apparent clearance from the upper respiratory system, possibly leading to the persistence of symptoms. Activation of the immune system to viral antigens is observed for a prolonged time, providing indirect evidence of the persistence of viral elements after acute infection. In the gastrointestinal tract, the persistence of some antigens could stimulate the immune system, shaping the local microbiota with potential systemic effects. All of these interactions need to be investigated, taking into account predisposing factors, multiplicity of pathogenic mechanisms, and stratifying populations of vulnerable individuals, particularly women, children, and immunocompromised individuals, where SARS-CoV-2 may present additional challenges.
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Affiliation(s)
- Lorenzo Lupi
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Adriana Vitiello
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Cristina Parolin
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Arianna Calistri
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
| | - Alfredo Garzino-Demo
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (L.L.); (A.V.); (C.P.); (A.C.)
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
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2
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Laporte LR, Chavez AVFG, Ranzani OT, Caldas J, Passos RDH, Ramos JGR. Long-term outcomes for epidemic viral pneumonia survivors after discharge from the intensive care unit: a systematic review. EINSTEIN-SAO PAULO 2024; 22:eRW0352. [PMID: 38477798 DOI: 10.31744/einstein_journal/2024rw0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/13/2023] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVE To review the long-term outcomes (functional status and psychological sequelae) of survivors of critical illnesses due to epidemic viral pneumonia before the COVID-19 pandemic and to establish a benchmark for comparison of the COVID-19 long-term outcomes. METHODS This systematic review of clinical studies reported the long-term outcomes in adults admitted to intensive care units who were diagnosed with viral epidemic pneumonia. An electronic search was performed using databases: MEDLINE®, Web of Science™, LILACS/IBECS, and EMBASE. Additionally, complementary searches were conducted on the reference lists of eligible studies. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The results were grouped into tables and textual descriptions. RESULTS The final analysis included 15 studies from a total of 243 studies. This review included 771 patients with Influenza A, Middle East Respiratory Syndrome, and Severe Acute Respiratory Syndrome. It analyzed the quality of life, functionality, lung function, mortality, rate of return to work, rehospitalization, and psychiatric symptoms. The follow-up periods ranged from 1 to 144 months. We found that the quality of life, functional capacity, and pulmonary function were below expected standards. CONCLUSION This review revealed great heterogeneity between studies attributed to different scales, follow-up time points, and methodologies. However, this systematic review identified negative long-term effects on patient outcomes. Given the possibility of future pandemics, it is essential to identify the long-term effects of viral pneumonia outbreaks. This review was not funded. Prospero database registration: (www.crd.york.ac.uk/prospero) under registration ID CRD42021190296.
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Affiliation(s)
- Larrie Rabelo Laporte
- Clínica Florence, Salvador, BA, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| | | | - Otavio Tavares Ranzani
- Barcelona Institute for Global Health, Universitat Pompeu Fabra; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Barcelona, Spain
- Pulmonary Division, Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Juliana Caldas
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
- Intensive Care Unit, Hospital São Rafael, Salvador, BA, Brazil
- Instituto D'Or de Ensino e Pesquisa, Salvador, BA, Brazil
| | - Rogerio da Hora Passos
- Intensive Care Unit, Hospital São Rafael, Salvador, BA, Brazil
- Instituto D'Or de Ensino e Pesquisa, Salvador, BA, Brazil
| | - João Gabriel Rosa Ramos
- Clínica Florence, Salvador, BA, Brazil
- Instituto D'Or de Ensino e Pesquisa, Salvador, BA, Brazil
- Internal Medicine Department, Universidade Federal da Bahia, Salvador, BA, Brazil
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3
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Noh SS, Shin HJ. Role of Virus-Induced EGFR Trafficking in Proviral Functions. Biomolecules 2023; 13:1766. [PMID: 38136637 PMCID: PMC10741569 DOI: 10.3390/biom13121766] [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: 11/16/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Since its discovery in the early 1980s, the epidermal growth factor receptor (EGFR) has emerged as a pivotal and multifaceted player in elucidating the intricate mechanisms underlying various human diseases and their associations with cell survival, proliferation, and cellular homeostasis. Recent advancements in research have underscored the profound and multifaceted role of EGFR in viral infections, highlighting its involvement in viral entry, replication, and the subversion of host immune responses. In this regard, the importance of EGFR trafficking has also been highlighted in recent studies. The dynamic relocation of EGFR to diverse intracellular organelles, including endosomes, lysosomes, mitochondria, and even the nucleus, is a central feature of its functionality in diverse contexts. This dynamic intracellular trafficking is not merely a passive process but an orchestrated symphony, facilitating EGFR involvement in various cellular pathways and interactions with viral components. Furthermore, EGFR, which is initially anchored on the plasma membrane, serves as a linchpin orchestrating viral entry processes, a crucial early step in the viral life cycle. The role of EGFR in this context is highly context-dependent and varies among viruses. Here, we present a comprehensive summary of the current state of knowledge regarding the intricate interactions between EGFR and viruses. These interactions are fundamental for successful propagation of a wide array of viral species and affect viral pathogenesis and host responses. Understanding EGFR significance in both normal cellular processes and viral infections may not only help develop innovative antiviral therapies but also provide a deeper understanding of the intricate roles of EGFR signaling in infectious diseases.
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Affiliation(s)
- Se Sil Noh
- Department of Microbiology, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea;
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
- Brain Korea 21 FOUR Project for Medical Science, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Hye Jin Shin
- Department of Microbiology, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea;
- Department of Medical Science, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
- Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
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4
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Sun L, Wang X, Hong Y, Li C, Zeng W, Liu P, Xiong Y, Chen Y, Lian Y, Wang Y. COVID-19 pandemic-related depression and anxiety under lockdown: The chain mediating effect of self-efficacy and perceived stress. Front Psychiatry 2023; 14:1100242. [PMID: 37181887 PMCID: PMC10169693 DOI: 10.3389/fpsyt.2023.1100242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Objective In early March 2022, the highly contagious Omicron variant rapidly emerged in Shanghai. This study aimed to explore the prevalence and associated factors of depression and anxiety in isolated or quarantined populations under lockdown. Methods A cross-sectional study was conducted between May 12 and 25, 2022. The depressive and anxiety symptoms, perceived stress, self-efficacy and perceived social support in the 167 participants under isolated or quarantined were examined using the Patient Health Questionnaires-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Perceived Stress Scale-10 (PSS-10), the General Self-Efficacy Scale (GSES) and the Perceived Social Support Scale (PSSS). Data on demographic information were also collected. Findings The prevalence of depression and anxiety in isolated or quarantined populations was estimated to be 12 and 10.8%, respectively. Higher education level, being healthcare workers, being infected, longer duration of segregation and higher perceived stress level were identified as risk factors for depression and anxiety. Furthermore, the relationship between perceived social support and depression (anxiety) was mediated not only by perceived stress but also the chain of self-efficacy and perceived stress. Conclusion Being infected, higher education level, longer duration of segregation and higher perceived stress were associated with higher levels of depression and anxiety among isolated or quarantined populations under lockdown. The formulation of psychological strategies that promote one's perceived social support and self-efficacy as well as reduce perceived stress is supposed to be drawn.
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Affiliation(s)
- Luna Sun
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Xiaoran Wang
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yi Hong
- Department of Special Medical, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chaoran Li
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Wenfeng Zeng
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Peng Liu
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
- Academic Affairs Office, Naval Medical University, Shanghai, China
| | - Yani Xiong
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yanping Chen
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yongjie Lian
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yunxia Wang
- Department of Nautical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
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Furuhata H, Araki K. Validation of a specialized evaluation system for COVID-19 in Japan: A retrospective, multicenter cohort study. J Infect Chemother 2023; 29:294-301. [PMID: 36529450 PMCID: PMC9753483 DOI: 10.1016/j.jiac.2022.12.004] [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: 09/08/2022] [Revised: 11/22/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Evaluation of a severity grade (SG) is important to classify patients for efficient use of limited medical resources. This study validates two existing evaluation systems for the prevention of the coronavirus disease 2019 (COVID-19) in Japan: a criterion of SG and a list of 14 specialized underlying diseases (SUDs). METHODS A retrospective cohort was created using electronic medical records from 18 research institutes. The cohort includes 6,050 COVID-19 patients with two types of diagnosis information as follows: SG at hospitalization among mild, moderate I, moderate II, and severe and aggravation after hospitalization. RESULTS A crude mortality rate and an aggravation rate increased by the worsening of SG in the COVID-19 cohort. The transition of the aggravation rate was notable for COVID-19 patients with SUD. A conditional probability of the mortality given the aggravation in the COVID-19 cohort was 87.4% compared to mild or moderate patients (approximately 21%-45%) who have the possibility of the aggravation. An odds ratio of the mortality and aggravation information about the SUD list was higher than other variables. CONCLUSIONS We demonstrated the possibility of improving the criteria of SG by including the SUD list for more effective operation of the criteria of SG. Furthermore, we demonstrated the importance of the prevention of the aggravation based on the conditional probability, and the possibility of predicting the aggravation using the risk factors.
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Affiliation(s)
- Hiroki Furuhata
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, 5200 Kibara Kiyotake-cho, Miyazaki, 8891692, Japan.
| | - Kenji Araki
- Department of Patient Advocacy Center, University of Miyazaki Hospital, 5200 Kibara Kiyotake-cho, Miyazaki, 8891692, Japan
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Levin OS, Vashchilin VV, Pikija S, Khasanova DR, Turuspekova ST, Bogolepova AN, Shmonin AA, Maltceva MN, Vozniuk IA, Yanishevskiy SN, Huseynov DK, Karakulova YV, Obidov FK. [Current approaches in the treatment and rehabilitation of patients with neurological diseases after COVID-19. Resolution of the International Experts Forum]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:44-51. [PMID: 36843458 DOI: 10.17116/jnevro202312302144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Despite the significant shift in global attention away from the pandemic, the problem of a new coronavirus infection remains important in the medical community. Almost 3 years after the start of the COVID-19 pandemic the issues of rehabilitation and management of delayed manifestations and sequelae of the disease are especially important. According to numerous available data, the new coronavirus infection is characterized by multiorgan lesions. Respiratory dysfunction, clotting disorders, myocardial dysfunction and various arrhythmias, acute coronary syndrome, acute renal failure, GI disorders, hepatocellular damage, hyperglycemia and ketosis, dermatological complications, ophthalmological symptoms and neurological disorders may be found. Significant prevalence of the latter in the post-coronavirus period necessitated this International Expert Forum to develop unified approaches to the management of patients with neurological complications and sequelae of new coronavirus infection based on practical experience and considering the scientific information available on COVID-19. The expert council developed a resolution formulating the tactics for the management of patients with neurological manifestations of COVID-19.
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Affiliation(s)
- O S Levin
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - V V Vashchilin
- Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Republic of Belarus
| | - S Pikija
- Paracelsus Private Medical University, Salzburg, Austria
| | | | - S T Turuspekova
- Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
| | - A N Bogolepova
- Pirogov Russian National Research Medical University, Moscow, Russia.,Federal Center for Brain and Neurotechnology, Moscow, Russia
| | - A A Shmonin
- Pavlov First Saint Petersburg Medical University, St. Petersburg, Russia
| | - M N Maltceva
- Pavlov First Saint Petersburg Medical University, St. Petersburg, Russia.,Russian Canis-therapy Support and Development Association, St. Petersburg, Russia
| | - I A Vozniuk
- Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine, St. Petersburg, Russia
| | - S N Yanishevskiy
- Kirov Military Medical Academy, St. Petersburg, Russia.,Almazov National Medical Research Centre, St. Petersburg, Russia
| | - D K Huseynov
- Mingachevir City Hospital, Mingachevir, Republic of Azerbaijan
| | | | - F Kh Obidov
- Regional Hospital of Samarkand Region, Samarkand, Republic of Uzbekistan
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Ali Dahhas M, M Alkahtani H, Malik A, Almehizia AA, Bakheit AH, Akber Ansar S, AlAbdulkarim AS, S Alrasheed L, Alsenaidy MA. Screening and identification of potential MERS-CoV papain-like protease (PLpro) inhibitors; Steady-state kinetic and Molecular dynamic studies. Saudi Pharm J 2023; 31:228-244. [PMID: 36540698 PMCID: PMC9756750 DOI: 10.1016/j.jsps.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
MERS-CoV belongs to the coronavirus group. Recent years have seen a rash of coronavirus epidemics. In June 2012, MERS-CoV was discovered in the Kingdom of Saudi Arabia, with 2,591 MERSA cases confirmed by lab tests by the end of August 2022 and 894 deaths at a case-fatality ratio (CFR) of 34.5% documented worldwide. Saudi Arabia reported the majority of these cases, with 2,184 cases and 813 deaths (CFR: 37.2%), necessitating a thorough understanding of the molecular machinery of MERS-CoV. To develop antiviral medicines, illustrative investigation of the protein in coronavirus subunits are required to increase our understanding of the subject. In this study, recombinant expression and purification of MERS-CoV (PLpro), a primary goal for the development of 22 new inhibitors, were completed using a high throughput screening methodology that employed fragment-based libraries in conjunction with structure-based virtual screening. Compounds 2, 7, and 20, showed significant biological activity. Moreover, a docking analysis revealed that the three compounds had favorable binding mood and binding free energy. Molecular dynamic simulation demonstrated the stability of compound 2 (2-((Benzimidazol-2-yl) thio)-1-arylethan-1-ones) the strongest inhibitory activity against the PLpro enzyme. In addition, disubstitutions at the meta and para locations are the only substitutions that may boost the inhibitory action against PLpro. Compound 2 was chosen as a MERS-CoV PLpro inhibitor after passing absorption, distribution, metabolism, and excretion studies; however, further investigations are required.
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Key Words
- 3CLpro, 3-Chymotrypsin -like Protease
- ADMET, Absorption, distribution, metabolism, excretion and toxicity
- CFR, Case fatality rate
- DTT, Dithiothreitol
- Drug Design
- Drug Discovery
- E. coli, Escherichia coli
- EDTA, Ethylenediaminetetraacetic acid
- HCoV-, Human Coronavirus
- HIA, Human intestinal absorption
- His-tag, Histidine tag
- IPTG, Isopropyl b-D-1-thiogalactopyranoside
- Inhibitors
- Kan, Kanamicyn
- LB, Luria–Bertani
- MD, Molecular dynamic
- MERS-CoV PLpro Inhibitors
- MOE, Molecular Operating Environment
- MPLpro, MERS papain-like protease
- Molecular Docking
- Molecular dynamic simulation
- Ni-NTA, Nickel-nitrilotri
- Nonstructural proteins
- PLIF, Protein- ligand interaction fingerprint
- Papain-like protease
- Protease
- RMSD, Root Mean Square Deviation
- RMSF, Root Mean Square Fluctuation
- pp1a, Polyprotein 1a
- pp1b, Polyprotein 1b
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Affiliation(s)
- Mohammed Ali Dahhas
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Hamad M Alkahtani
- Department of Pharmaceutical Chemistry, Department Chairman, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Ajamaluddin Malik
- Department of Biochemistry, College of Science, King Saud University. King Saud University, PO Box 2455, Riyadh 11451, Saudi Arabia
| | | | - Ahmed H Bakheit
- Department of Pharmaceutical Chemistry, Department Chairman, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Siddique Akber Ansar
- Department of Pharmaceutical Chemistry, Department Chairman, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Abdullah S AlAbdulkarim
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Lamees S Alrasheed
- Department of Pharmaceutical Chemistry, Department Chairman, P.O. Box 2457, Riyadh 11451, Saudi Arabia
| | - Mohammad A Alsenaidy
- Department of Pharmaceutics, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia
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Sánchez-García AM, Martínez-López P, Gómez-González AM, Rodriguez-Capitán J, Pavón-Morón FJ, Jiménez-López RJ, García-Almeida JM, Avanesi-Molina E, Zamboschi N, Rueda-Molina C, Doncel-Abad V, Molina-Ramos AI, Cabrera-César E, Ben-Abdellatif I, Gordillo-Resina M, Pérez-Mesa E, Nieto-González M, Nuevo-Ortega P, Reina-Artacho C, Sánchez-Fernández PL, Jiménez-Navarro MF, Estecha-Foncea MA. Post-Intensive Care Unit Multidisciplinary Approach in Patients with Severe Bilateral SARS-CoV-2 Pneumonia. Int J Med Sci 2023; 20:1-10. [PMID: 36619225 PMCID: PMC9812800 DOI: 10.7150/ijms.77792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/06/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Short and long-term sequelae after admission to the intensive care unit (ICU) for coronavirus disease 2019 (COVID-19) are to be expected, which makes multidisciplinary care key in the support of physical and cognitive recovery. Objective: To describe, from a multidisciplinary perspective, the sequelae one month after hospital discharge among patients who required ICU admission for severe COVID-19 pneumonia. Design: Prospective cohort study. Environment: Multidisciplinary outpatient clinic. Population: Patients with severe COVID-19 pneumonia, post- ICU admission. Methods: A total of 104 patients completed the study in the multidisciplinary outpatient clinic. The tests performed included spirometry, measurement of respiratory muscle pressure, loss of body cell mass (BCM) and BCM index (BCMI), general joint and muscular mobility, the short physical performance battery (SPPB or Guralnik test), grip strength with hand dynamometer, the six-minute walk test (6-MWT), the functional assessment of chronic illness therapy-fatigue scale (FACIT-F), the European quality of life-5 dimensions (EQ-5D), the Barthel index and the Montreal cognitive assessment test (MoCA). While rehabilitation was not necessary for 23 patients, 38 patients attended group rehabilitation sessions and other 43 patients received home rehabilitation. Endpoints: The main sequelae detected in patients were fatigue (75.96%), dyspnoea (64.42%) and oxygen therapy on discharge (37.5%). The MoCA showed a mean score compatible with mild cognitive decline. The main impairment of joint mobility was limited shoulder (11.54%) and shoulder girdle (2.88%) mobility; whereas for muscle mobility, lower limb limitations (16.35%) were the main dysfunction. Distal neuropathy was present in 23.08% of patients, most frequently located in lower limbs (15.38%). Finally, 50% of patients reported moderate limitation in the EQ-5D, with a mean score of 60.62 points (SD 20.15) in perceived quality of life. Conclusions: Our findings support the need for a multidisciplinary and comprehensive evaluation of patients after ICU admission for COVID-19 because of the wide range of sequelae, which also mean that these patients need a long-term follow-up. Impact on clinical rehabilitation: This study provides data supporting the key role of rehabilitation during the follow-up of severe patients, thus facilitating their reintegration in society and a suitable adaptation to daily living.
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Affiliation(s)
- Ana María Sánchez-García
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Pilar Martínez-López
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Adela María Gómez-González
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Physical Medicine and Rehabilitation Service, Hospital Clínico Universitario Virgen de la Victoria, Malaga, Spain
| | - Jorge Rodriguez-Capitán
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Cardiology and Cardiac Surgery Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Francisco-Javier Pavón-Morón
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Cardiology and Cardiac Surgery Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Rafael José Jiménez-López
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Family and Community Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - José Manuel García-Almeida
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Cardiology and Cardiac Surgery Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Elma Avanesi-Molina
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Mental Health Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Nicolás Zamboschi
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Carolina Rueda-Molina
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Victoria Doncel-Abad
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Cardiology and Cardiac Surgery Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Ana Isabel Molina-Ramos
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Cardiology and Cardiac Surgery Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Eva Cabrera-César
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Pneumology Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Imad Ben-Abdellatif
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Marina Gordillo-Resina
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Esteban Pérez-Mesa
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - María Nieto-González
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Pilar Nuevo-Ortega
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Carmen Reina-Artacho
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Pedro Luis Sánchez-Fernández
- Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Cardiología, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, Spain
| | - Manuel Francisco Jiménez-Navarro
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.,Cardiology and Cardiac Surgery Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - María Antonia Estecha-Foncea
- Instituto de Investigación Biomedica de Malaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Malaga, Spain.,Intensive Medicine Service, Hospital Universitario Virgen de la Victoria, Malaga, Spain
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9
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Chang YC, Lee DJ, Wei CLH, Pa CH, Chen CC, Chen HC, Chang YT, Wang HE, Chu P, Lu KC, Wu CC. SARS-CoV-2 versus other minor viral infection on kidney injury in asymptomatic and mildly symptomatic patients. Virulence 2022; 13:1349-1357. [PMID: 35924838 PMCID: PMC9354764 DOI: 10.1080/21505594.2022.2107602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has become a global pandemic since December 2019. Most of the patients are mild or asymptomatic and recovered well as those suffered from other respiratory viruses. SARS-CoV-2 infection is supposed to demonstrate more sequelae. Acute kidney injury (AKI) is common among COVID-19 patients and is associated with disease severity and outcomes. Only a few studies focused on a detailed analysis of kidney damage in asymptomatic or mildly symptomatic COVID-19 patients. Whether any minor viral infection is likely to exhibit similar minor effect on renal function as COVID-19 is still unclear, and the definite pathophysiology of viral invasion is not fully understood. Currently, the proposed mechanisms of AKI include direct effects of virus on kidney, dysregulated immune response, or as a result of multi-organs failure have been proposed. This study will discuss the difference between COVID-19 and other viruses, focusing on proposed mechanisms, biomarkers and whether it matters with clinical significance.
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Affiliation(s)
- Ya-Chieh Chang
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Internal Medicine, Division of Nephrology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Ding-Jie Lee
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Ling Helen Wei
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Han Pa
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Chou Chen
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsi-Chih Chen
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Tien Chang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Han-En Wang
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Pauling Chu
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuo-Cheng Lu
- Department of Medicine, Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chia-Chao Wu
- Department of Internal Medicine, Division of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
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10
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Argyropoulos CD, Skoulou V, Efthimiou G, Michopoulos AK. Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review. AIR QUALITY, ATMOSPHERE, & HEALTH 2022; 16:477-533. [PMID: 36467894 PMCID: PMC9703444 DOI: 10.1007/s11869-022-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.
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Affiliation(s)
| | - Vasiliki Skoulou
- B3 Challenge Group, Chemical Engineering, School of Engineering, University of Hull, Cottingham Road, Hull, HU6 7RX UK
| | - Georgios Efthimiou
- Centre for Biomedicine, Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX UK
| | - Apostolos K. Michopoulos
- Energy & Environmental Design of Buildings Research Laboratory, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
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11
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Meng H, Wang S, Tang X, Guo J, Xu X, Wang D, Jin F, Zheng M, Yin S, He C, Han Y, Chen J, Han J, Ren C, Gao Y, Liu H, Wang Y, Jin R. Respiratory immune status and microbiome in recovered COVID-19 patients revealed by metatranscriptomic analyses. Front Cell Infect Microbiol 2022; 12:1011672. [PMID: 36483456 PMCID: PMC9724627 DOI: 10.3389/fcimb.2022.1011672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/28/2022] [Indexed: 11/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is currently a severe threat to global public health, and the immune response to COVID-19 infection has been widely investigated. However, the immune status and microecological changes in the respiratory systems of patients with COVID-19 after recovery have rarely been considered. We selected 72 patients with severe COVID-19 infection, 57 recovered from COVID-19 infection, and 65 with non-COVID-19 pneumonia, for metatranscriptomic sequencing and bioinformatics analysis. Accordingly, the differentially expressed genes between the infected and other groups were enriched in the chemokine signaling pathway, NOD-like receptor signaling pathway, phagosome, TNF signaling pathway, NF-kappa B signaling pathway, Toll-like receptor signaling pathway, and C-type lectin receptor signaling pathway. We speculate that IL17RD, CD74, and TNFSF15 may serve as disease biomarkers in COVID-19. Additionally, principal coordinate analysis revealed significant differences between groups. In particular, frequent co-infections with the genera Streptococcus, Veillonella, Gemella, and Neisseria, among others, were found in COVID-19 patients. Moreover, the random forest prediction model with differential genes showed a mean area under the curve (AUC) of 0.77, and KCNK12, IL17RD, LOC100507412, PTPRT, MYO15A, MPDZ, FLRT2, SPEG, SERPINB3, and KNDC1 were identified as the most important genes distinguishing the infected group from the recovered group. Agrobacterium tumefaciens, Klebsiella michiganensis, Acinetobacter pittii, Bacillus sp. FJAT.14266, Brevundimonas naejangsanensis, Pseudopropionibacterium propionicum, Priestia megaterium, Dialister pneumosintes, Veillonella rodentium, and Pseudomonas protegens were selected as candidate microbial markers for monitoring the recovery of COVID patients. These results will facilitate the diagnosis, treatment, and prognosis of COVID patients recovering from severe illness.
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Affiliation(s)
- Huan Meng
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Shuang Wang
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xiaomeng Tang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jingjing Guo
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xinming Xu
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Dagang Wang
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Fangfang Jin
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Mei Zheng
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Shangqi Yin
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Chaonan He
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Ying Han
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jin Chen
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jinyu Han
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Chaobo Ren
- Translational R&D Center, Guangzhou Vision Medicals Co. LTD, Guangzhou, China
| | - Yantao Gao
- Translational R&D Center, Guangzhou Vision Medicals Co. LTD, Guangzhou, China
| | - Huifang Liu
- Translational R&D Center, Guangzhou Vision Medicals Co. LTD, Guangzhou, China
| | - Yajie Wang
- Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China,*Correspondence: Yajie Wang, ; Ronghua Jin,
| | - Ronghua Jin
- Beijing Ditan Hospital, Capital Medical University, Beijing, China,*Correspondence: Yajie Wang, ; Ronghua Jin,
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12
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Afsin E, Demirkol ME. Post-COVID Pulmonary Function Test Evaluation. Turk Thorac J 2022; 23:387-394. [PMID: 36101980 PMCID: PMC9682963 DOI: 10.5152/turkthoracj.2022.21230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 07/23/2022] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Since the lung is the most affected organ by COVID-19 disease, we aimed to evaluate the pulmonary function test, presence of hypoxemia, and Post-COVID-19 Functional Status Scale in 3- to 6-month post-COVID period. MATERIAL AND METHODS Post-COVID-19 Functional Status Scale, pulse oxygen saturation, and pulmonary function test were evaluated in 67 outpatients/inpatients after 3-6 months following COVID-19 (positive reverse transcription-polymerase chain reaction on nasopharyngeal swab) disease. Pre-COVID pulmonary function test parameters were available in 33 patients, and these were compared with post-COVID pulmonary function test parameters. RESULTS We found 20.9% (14 patients) restrictive and 11.9% (8 patients) obstructive patterns in pulmonary function test. Of those with forced vital capacity < 80%, 53.3% were patients without known lung diseases. When pulmonary function test values before and after COVID-19 were compared, only a loss of 130 mL in forced expiratory volume in 1 second was determined (P = .005). About 65.4% of the patients with dyspnea were in the group without a lung disease (P = .002) and 66.7% of patients with forced expiratory volume in 1 second and forced vital capacity of .05). Smoking, hospitalization, oxygen support, and the severity of computed tomography involvement did not impact pulmonary function test. CONCLUSION In post-COVID patients, the major disorder in the respiratory function test was determined as a restriction. However, advanced tests such as lung volumes and carbon monoxide diffusing capacity (DLCO) measurement and high-resolution lung tomography are needed to differentiate in terms of physical functional limitation or parenchymal fibrosis.
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Affiliation(s)
- Emine Afsin
- Department of Chest Diseases, Abant İzzet Baysal University Hospital, Bolu, Turkey
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13
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Williams ESCP, Martins TB, Hill HR, Coiras M, Shah KS, Planelles V, Spivak AM. Plasma cytokine levels reveal deficiencies in IL-8 and gamma interferon in Long-COVID. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.10.03.22280661. [PMID: 36238724 PMCID: PMC9558442 DOI: 10.1101/2022.10.03.22280661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Up to half of individuals who contract SARS-CoV-2 develop symptoms of long-COVID approximately three months after initial infection. These symptoms are highly variable, and the mechanisms inducing them are yet to be understood. We compared plasma cytokine levels from individuals with long-COVID to healthy individuals and found that those with long-COVID had 100% reductions in circulating levels of interferon gamma (IFNγ) and interleukin-8 (IL-8). Additionally, we found significant reductions in levels of IL-6, IL-2, IL-17, IL-13, and IL-4 in individuals with long-COVID. We propose immune exhaustion as the driver of long-COVID, with the complete absence of IFNγ and IL-8 preventing the lungs and other organs from healing after acute infection, and reducing the ability to fight off subsequent infections, both contributing to the myriad of symptoms suffered by those with long-COVID.
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14
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Zhang Y, Wang S, Xia H, Guo J, He K, Huang C, Luo R, Chen Y, Xu K, Gao H, Sheng J, Li L. Identification of Monocytes Associated with Severe COVID-19 in the PBMCs of Severely Infected Patients Through Single-Cell Transcriptome Sequencing. ENGINEERING (BEIJING, CHINA) 2022; 17:161-169. [PMID: 34150352 PMCID: PMC8196473 DOI: 10.1016/j.eng.2021.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/07/2021] [Accepted: 05/17/2021] [Indexed: 05/15/2023]
Abstract
Understanding the immunological characteristics of monocytes-including the characteristics associated with fibrosis-in severe coronavirus disease 2019 (COVID-19) is crucial for understanding the pathogenic mechanism of the disease and preventing disease severity. In this study, we performed single-cell transcriptomic sequencing of peripheral blood samples collected from six healthy controls and 14 COVID-19 samples including severe, moderate, and convalescent samples from three severely/critically ill and four moderately ill patients. We found that the monocytes were strongly remodeled in the severely/critically ill patients with COVID-19, with an increased proportion of monocytes and seriously reduced diversity. In addition, we discovered two novel severe-disease-specific monocyte subsets: Mono 0 and Mono 5. These subsets expressed amphiregulin (AREG), epiregulin (EREG), and cytokine interleukin-18 (IL-18) gene, exhibited an enriched erythroblastic leukemia viral oncogene homolog (ErbB) signaling pathway, and appeared to exhibit pro-fibrogenic and pro-inflammation characteristics. We also found metabolic changes in Mono 0 and Mono 5, including increased glycolysis/gluconeogenesis and an increased hypoxia inducible factor-1 (HIF-1) signaling pathway. Notably, one pre-severe sample displayed a monocyte atlas similar to that of the severe/critical samples. In conclusion, our study discovered two novel severe-disease-specific monocyte subsets as potential predictors and therapeutic targets for severe COVID-19. Overall, this study provides potential predictors for severe disease and therapeutic targets for COVID-19 and thus provides a resource for further studies on COVID-19.
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Affiliation(s)
- Yan Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Shuting Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - He Xia
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jing Guo
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Kangxin He
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chenjie Huang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Rui Luo
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Yanfei Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Kaijin Xu
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Hainv Gao
- Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 310022, China
| | - Jifang Sheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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15
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Uniyal N, Sethi Y, Sharma PC, Sayana A, Jeet N, Agarwal A, Rawat V. Post-COVID Syndrome and Severity of COVID-19: A Cross-Sectional Epidemiological Evaluation From North India. Cureus 2022; 14:e27345. [PMID: 36046290 PMCID: PMC9417061 DOI: 10.7759/cureus.27345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background COVID-19 has now lasted for more than two years as a pandemic and has had enduring effects on the health of people as the post-COVID syndrome. Recent literature has shown the long-term effects of COVID‐19 on various organ systems, including but not limited to respiratory, cardiovascular, neurological, musculoskeletal, and gastrointestinal systems. Methods and objectives We aimed to estimate the prevalence of post-acute COVID symptoms in a tertiary care center in northern India; observe the effects of the demographic profile of age, BMI, gender, and presence of comorbidities on the persistence of post-COVID syndrome, and explore any correlation between the severity of COVID-19 disease and the persistence of post-COVID symptoms. We designed a survey containing structured questions evaluating post-COVID symptoms beyond three weeks (post-acute COVID phase), six weeks (post-COVID phase), and 12 weeks of acute illness. It was administered online. Results Prevalence of post-COVID symptoms both after three and six weeks was reported to be 16.67% and 7.37%, respectively. The most common symptoms to persist were musculoskeletal symptoms (fatigue), followed by upper respiratory symptoms. Disease severity (p<0.05), BMI (p<0.05), and comorbidities were seen to affect post-COVID symptoms significantly, whereas gender and age of the patient had no significant effect. Disease severity significantly affected the persistence of post-COVID symptoms up to 12 weeks; however, this effect does not hold true in long COVID haulers. Also, the risk of developing persistent post-acute COVID symptoms was more in moderate to severe disease than in mild disease. Conclusion The pandemic might be close to over, but it is not out of our lives yet, and the persistence of post-COVID symptoms is exigent.
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16
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Helding L, Carroll TL, Nix J, Johns MM, LeBorgne WD, Meyer D. COVID-19 After Effects: Concerns for Singers. J Voice 2022; 36:586.e7-586.e14. [PMID: 32839055 PMCID: PMC7409791 DOI: 10.1016/j.jvoice.2020.07.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Lynn Helding
- Vocology and Voice Pedagogy University of Southern California, Thornton School of Music, Los Angeles, CA, USA
| | - Thomas L Carroll
- Department of Otolaryngology, Head and Neck Surgery Harvard Medical School, Boston, MA, USA
| | - John Nix
- Voice and Voice Pedagogy University of Texas at San Antonio, San Antonio, TX, USA
| | - Michael M Johns
- USC Voice Center Division Director, Laryngology Professor USC Caruso, Department of Otolaryngology Head and Neck Surgery, Los Angeles, CA, USA
| | - Wendy D LeBorgne
- The Blaine Block Institute for Voice Analysis and Rehabilitation, The Professional Voice Center of Greater Cincinnati University of Cincinnati, CIncinnati, OH, USA
| | - David Meyer
- Janette Ogg Voice Research Center, Shenandoah Conservatory, Winchester, VA, USA.
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17
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Rapin A, Noujaim PJ, Taiar R, Carazo-Mendez S, Deslee G, Jolly D, Boyer FC. Characteristics of COVID-19 Inpatients in Rehabilitation Units during the First Pandemic Wave: A Cohort Study from a Large Hospital in Champagne Region. BIOLOGY 2022; 11:biology11060937. [PMID: 35741459 PMCID: PMC9219626 DOI: 10.3390/biology11060937] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 06/01/2023]
Abstract
Background: Data describing patients hospitalized in medical rehabilitation wards after the acute phase of COVID-19 could help to better understand the rehabilitation needs in the current pandemic situation. Methods: Cohort including all patients with COVID-19 hospitalized in a single, large university hospital in Northeast France from 25 February to 30 April 2020. Results: 479 patients were admitted with COVID-19 during the study period, of whom 128 died (26.7%). Among the 351 survivors, 111 were referred to rehabilitation units, including 63 (17.9%) referred to physical and rehabilitation medicine (PRM) units. The median age of patients referred to rehabilitation units was 72 years. Patients who had been in intensive care, or who had had a long hospital stay, required referral to PRM units. Two biomarkers were associated with referral to rehabilitation units, namely, elevated troponin (p = 0.03) and impaired renal function (p = 0.03). Age was associated with referral to PRM units (p = 0.001). Conclusions: Almost one-third of COVID-19 patients required post-acute care, but only one-fifth had access to PRM units. The optimal strategy for post-acute management of COVID-19 patients remains to be determined. The need for rehabilitation wards during a pandemic is a primary concern in enabling the long-term functioning of infected patients.
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Affiliation(s)
- Amandine Rapin
- Faculté de Médecine, Université de Reims Champagne Ardennes, UR 3797 VieFra, 51097 Reims, France; (A.R.); (D.J.); (F.C.B.)
- Service de Médecine Physique et de Réadaptation, Hôpital Sébastopol, CHU de Reims, 51092 Reims, France;
| | - Peter-Joe Noujaim
- Unité D’aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Robert Debré, CHU de Reims, 51092 Reims, France;
| | - Redha Taiar
- Matériaux et Ingénierie Mécanique MATIM, Université de Reims Champagne Ardennes, CEDEX 2, 51687 Reims, France
| | - Sandy Carazo-Mendez
- Service de Médecine Physique et de Réadaptation, Hôpital Sébastopol, CHU de Reims, 51092 Reims, France;
| | - Gaetan Deslee
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 51092 Reims, France;
- Inserm UMR-S1250, P3Cell, University of Reims Champagne-Ardenne, SFR CAP-SANTE, 51092 Reims, France
| | - Damien Jolly
- Faculté de Médecine, Université de Reims Champagne Ardennes, UR 3797 VieFra, 51097 Reims, France; (A.R.); (D.J.); (F.C.B.)
- Unité D’aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Robert Debré, CHU de Reims, 51092 Reims, France;
| | - François Constant Boyer
- Faculté de Médecine, Université de Reims Champagne Ardennes, UR 3797 VieFra, 51097 Reims, France; (A.R.); (D.J.); (F.C.B.)
- Service de Médecine Physique et de Réadaptation, Hôpital Sébastopol, CHU de Reims, 51092 Reims, France;
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18
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Nazarinia D, Behzadifard M, Gholampour J, Karimi R, Gholampour M. Eotaxin-1 (CCL11) in neuroinflammatory disorders and possible role in COVID-19 neurologic complications. Acta Neurol Belg 2022; 122:865-869. [PMID: 35690992 PMCID: PMC9188656 DOI: 10.1007/s13760-022-01984-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 05/18/2022] [Indexed: 12/20/2022]
Abstract
The related neurologic complications of SARS-CoV-2 infection in COVID-19 patients and survivors comprise symptoms including depression, anxiety, muscle pain, dizziness, headaches, fatigue, and anosmia/hyposmia that may continue for months. Recent studies have been demonstrated that chemokines have brain-specific attraction and effects such as chemotaxis, cell adhesion, modulation of neuroendocrine functions, and neuroinflammation. CCL11 is a member of the eotaxin family that is chemotactic agents for eosinophils and participate in innate immunity. Eotaxins may exert physiological and pathological functions in the central nerve system, and CCL11 may induce neuronal cytotoxicity effects by inducing the production of reactive oxygen species (ROS) in microglia cells. Plasma levels of CCL11 elevated in neuroinflammation and neurodegenerative disorders. COVID-19 patients display elevations in CCL11 levels. As CCL11 plays roles in physiosomatic and neuroinflammation, analyzing the level of this chemokine in COVID-19 patients during hospitalization and to predicting post-COVID-19-related neurologic complications may be worthwhile. Moreover, using chemokine modulators may be helpful in lessening the neurologic complications in such patients.
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Affiliation(s)
- Donya Nazarinia
- Department of Physiology, School of Paramedical Sciences, Dezful University of Medical Sciences, Dezful, Iran
| | - Mahin Behzadifard
- Department of Physiology, School of Paramedical Sciences, Dezful University of Medical Sciences, Dezful, Iran.
| | - Javad Gholampour
- Department of Nursing, Faculty of Nursing and Midwifery, Mashhad Branch of Islamic Azad University, Mashhad, Iran
| | - Roqaye Karimi
- Department of Hematology and Cell Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammadali Gholampour
- Department of Medicine, Lung Biology Center, Cardiovascular Research Institute, University of California, San Francisco, CA, USA
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19
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Keijsers CJPW, Broeders MEAC, Baptista Lopes V, Klinkert AF, van Baar JWM, Nahar-van Venrooij LMW, Kerckhoffs APM. Memory impairment and concentration problems in COVID-19 survivors eight weeks after non-ICU hospitalization: a retrospective cohort study. J Med Virol 2022; 94:4512-4517. [PMID: 35509111 PMCID: PMC9348267 DOI: 10.1002/jmv.27831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 11/21/2022]
Abstract
Studies on the severe acute respiratory syndrome coronavirus 1 have shown long‐term effects on health, rehabilitation, and quality of life in patients.To evaluate effects on recovery and mental health in COVID‐19 survivors.A single center, retrospective cohort study in (non‐ICU admitted) adult patients with COVID‐19 infection was conducted. Next to baseline characteristics during hospital admission, data on remaining symptoms and radiographic abnormalities were extracted at the 8‐week follow‐up at the outpatient clinic. The Hospital Anxiety and Depression Scale (HADS) was used to detect anxiety and depression.Resulting in two hundred and eleven patients were included, median age of 63 years, 61% male, with overweight (average body mass index 28.6 kg/m2). At the outpatient clinic 13% of the patients were symptom free, whereas 25% reported more than three symptoms. Persisting physical symptoms were mainly fatigue 68%, dyspnea 56%, and cough 26%. Most patients had normalization of chest X‐ray (61.1%) and oxygen saturation (89.9%). Interestingly, 33% reported memory impairment and concentration problems 28%. 7.8% scored for anxiety and 7.1% for depression on the HADS. Correlations were found between the number of physical symptoms and scores on the HADS.In conclusion, only 13% had symptom‐free recovery after 8 weeks. Besides physical symptoms memory problems were frequently seen. The number of mental and physical symptoms were correlated.
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Affiliation(s)
| | | | | | - A F Klinkert
- department of pulmonary disease, Jeroen Bosch hospital
| | | | | | - A P M Kerckhoffs
- department of geriatric medicine and internal medicine, Jeroen Bosch hospital
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20
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Vijayakumar B, Tonkin J, Devaraj A, Philip KEJ, Orton CM, Desai SR, Shah PL. CT Lung Abnormalities after COVID-19 at 3 Months and 1 Year after Hospital Discharge. Radiology 2022; 303:444-454. [PMID: 34609195 PMCID: PMC8515207 DOI: 10.1148/radiol.2021211746] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 12/18/2022]
Abstract
Background Data on the long-term pulmonary sequelae in COVID-19 are lacking. Purpose To assess symptoms, functional impairment, and residual pulmonary abnormalities on serial chest CT scans in COVID-19 survivors discharged from hospital at up to 1-year follow-up. Materials and Methods Adult patients with COVID-19 discharged between March 2020 and June 2020 were prospectively evaluated at 3 months and 1 year through systematic assessment of symptoms, functional impairment, and thoracic CT scans as part of the PHENOTYPE study, an observational cohort study in COVID-19 survivors. Lung function testing was limited to participants with CT abnormalities and/or persistent breathlessness. Bonferroni correction was used. Results Eighty participants (mean age, 59 years ± 13 [SD]; 53 men) were assessed. At outpatient review, persistent breathlessness was reported in 37 of the 80 participants (46%) and cough was reported in 17 (21%). CT scans in 73 participants after discharge (median, 105 days; IQR, 95-141 days) revealed persistent abnormalities in 41 participants (56%), with ground-glass opacification (35 of 73 participants [48%]) and bands (27 of 73 participants [37%]) predominating. Unequivocal signs indicative of established fibrosis (ie, volume loss and/or traction bronchiectasis) were present in nine of 73 participants (12%). Higher admission serum C-reactive protein (in milligrams per liter), fibrinogen (in grams per deciliter), urea (millimoles per liter), and creatinine (micromoles per liter) levels; longer hospital stay (in days); older age (in years); and requirement for invasive ventilation were associated with CT abnormalities at 3-month follow-up. Thirty-two of 41 participants (78%) with abnormal findings at 3-month follow-up CT underwent repeat imaging at a median of 364 days (range, 360-366 days), with 26 (81%) showing further radiologic improvement (median, 18%; IQR, 10%-40%). Conclusion CT abnormalities were common at 3 months after COVID-19 but with signs of fibrosis in a minority. More severe acute disease was linked with CT abnormalities at 3 months. However, radiologic improvement was seen in the majority at 1-year follow-up. ClinicalTrials.gov identifier: NCT04459351. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Bavithra Vijayakumar
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
| | - James Tonkin
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
| | - Anand Devaraj
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
| | - Keir E. J. Philip
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
| | - Christopher M. Orton
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
| | - Sujal R. Desai
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
| | - Pallav L. Shah
- From the Department of Respiratory Medicine, Chelsea and Westminster
NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, England (B.V.,
J.T., C.M.O., P.L.S.); Departments of Respiratory Medicine (B.V., J.T.,
K.E.J.P., C.M.O., P.L.S.) and Radiology (A.D., S.R.D.), Royal Brompton and
Harefield Hospitals, London, England; National Heart and Lung Institute,
Imperial College London, London, England (B.V., J.T., A.D., K.E.J.P., C.M.O.,
S.R.D., P.L.S.); and The Margaret Turner-Warwick Centre for Fibrosing Lung
Disease, London, England (S.R.D.)
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21
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Chandan JS, Brown K, Simms-Williams N, Camaradou J, Bashir N, Heining D, Aiyegbusi OL, Turner G, Cruz Rivera S, Hotham R, Nirantharakumar K, Sivan M, Khunti K, Raindi D, Marwaha S, Hughes SE, McMullan C, Calvert M, Haroon S. Non-pharmacological therapies for postviral syndromes, including Long COVID: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e057885. [PMID: 35410933 PMCID: PMC9002258 DOI: 10.1136/bmjopen-2021-057885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Postviral syndromes (PVS) describe the sustained presence of symptoms following an acute viral infection, for months or even years. Exposure to the SARS-CoV-2 virus and subsequent development of COVID-19 has shown to have similar effects with individuals continuing to exhibit symptoms for greater than 12 weeks. The sustained presence of symptoms is variably referred to as 'post COVID-19 syndrome', 'post-COVID condition' or more commonly 'Long COVID'. Knowledge of the long-term health impacts and treatments for Long COVID are evolving. To minimise overlap with existing work in the field exploring treatments of Long COVID, we have only chosen to focus on non-pharmacological treatments. AIMS This review aims to summarise the effectiveness of non-pharmacological treatments for PVS, including Long COVID. A secondary aim is to summarise the symptoms and health impacts associated with PVS in individuals recruited to treatment studies. METHODS AND ANALYSIS Primary electronic searches will be performed in bibliographic databases including: Embase, MEDLINE, PyscINFO, CINAHL and MedRxiv from 1 January 2001 to 29 October 2021. At least two independent reviewers will screen each study for inclusion and data will be extracted from all eligible studies onto a data extraction form. The quality of all included studies will be assessed using Cochrane risk of bias tools and the Newcastle-Ottawa grading system. Non-pharmacological treatments for PVS and Long COVID will be narratively summarised and effect estimates will be pooled using random effects meta-analysis where there is sufficient methodological homogeneity. The symptoms and health impacts reported in the included studies on non-pharmacological interventions will be extracted and narratively reported. ETHICS AND DISSEMINATION This systematic review does not require ethical approval. The findings from this study will be submitted for peer-reviewed publication, shared at conference presentations and disseminated to both clinical and patient groups. PROSPERO REGISTRATION NUMBER The review will adhere to this protocol which has also been registered with PROSPERO (CRD42021282074).
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Affiliation(s)
- Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK, Birmingham, UK
| | - Kirsty Brown
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | - Nasir Bashir
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - Dominic Heining
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Grace Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Samantha Cruz Rivera
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Richard Hotham
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK, Birmingham, UK
| | | | - Kamlesh Khunti
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Devan Raindi
- School of Dentistry, University of Birmingham, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Health Data Research UK, Birmingham, UK
- Centre for Patient-Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research and Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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22
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Marando M, Fusi-Schmidhauser T, Tamburello A, Grazioli Gauthier L, Rigamonti E, Argentieri G, Puligheddu C, Pagnamenta A, Valenti A, Pons M, Gianella P. 1-year radiological, functional and quality-of-life outcomes in patients with SARS-CoV-2 pneumonia - A prospective observational study. NPJ Prim Care Respir Med 2022; 32:8. [PMID: 35241685 PMCID: PMC8894490 DOI: 10.1038/s41533-022-00273-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
All over the world, SARS-CoV-2 pneumonia is causing a significant short and medium-term morbidity and mortality, with reported persisting symptoms, radiological and lung alterations up to 6 months after symptoms onset. Nevertheless, the 1-year impact on affected patients is still poorly known. In this prospective observational study, 39 patients with SARS-CoV-2 pneumonia were recruited from a single COVID-19 hospital in Southern Switzerland. They underwent a 3-month and 1-year follow-ups. At 1 year, 38 patients underwent functional follow-up through lung function tests and six minutes walking test and submitted SF-12 and SGRQ questionnaires about health-related quality of life. At 1 year most of the patients showed a persistence of the radiological and functional abnormalities and a reduction of the health-related quality of life. Thirty patients (96.8%) still presented some residual abnormalities on CT scans (31 patients at 3 months), though with a general reduction of the lesional load in all lung lobes. Twenty patients (52.6%) had persisting lung function tests impairment, with an overall improvement of DLCO. As concerning the functional status, lowest SpO2 during 6MWT increased significantly. Finally, 19 patients (50%) reported a pathological St. George’s Respiratory Questionnaire, and respectively 12 (31.6%) and 11 (28.9%) patients a pathological Short Form Survey-12 in physical and mental components. At 1-year follow-up SARS-CoV-2 pneumonia survivors still present a substantial impairment in radiological and functional findings and in health-related quality of life, despite showing a progressive recovery.
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Affiliation(s)
- Marco Marando
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Tanja Fusi-Schmidhauser
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Adriana Tamburello
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland.
| | - Lorenzo Grazioli Gauthier
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Elia Rigamonti
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Gianluca Argentieri
- IIMSI - Radiology Department, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Carla Puligheddu
- IIMSI - Radiology Department, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Alberto Pagnamenta
- Department of intensive care, Ospedale Regionale di Mendrisio, Ente Ospedaliero Cantonale, Mendrisio, Switzerland.,Clinical Trial Unit, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Antonio Valenti
- Division of Pneumology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Marco Pons
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland.,Division of Pneumology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland.,Division of Pneumology, University of Geneva, Geneva, Switzerland
| | - Pietro Gianella
- Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland.,Division of Pneumology, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
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23
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Klinkert AF, Baptista Lopes V, van Baar JM, Broeders MEAC, van Rijswijk HNAJ(R, Cornegé‐Blokland E, Siegers‐Siebelink C, Kerckhoffs APM, Keijsers CJPW. Integrating healthcare for follow-up of adult COVID-19 patients in an outpatient clinic: A matter of cooperation. Health Sci Rep 2022; 5:e504. [PMID: 35155829 PMCID: PMC8827273 DOI: 10.1002/hsr2.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
RATIONALE AIMS AND OBJECTIVES A large number of patients infected with SARS-CoV-2 (COVID-19) need outpatient follow-up after hospitalization. As these patients may experience a broad range of symptoms, as do patients infected with the related SARS-CoV-1 virus, we set up a multidisciplinary outpatient clinic involving pulmonologists, internists, and geriatricians. Patients were allocated to a specialist based on symptoms reported on a self-developed questionnaire of expected symptoms of COVID-19. This study aimed to evaluate the effectiveness of this outpatient clinic. METHODS In this retrospective study, the medical records of patients who presented to the outpatient clinic for follow-up after hospitalization for COVID-19 up to 31 August 2020, were reviewed. RESULTS In total, 266 patients were seen at the outpatient clinic at least once. Overall, 100 patients were seen by a pulmonologist, 97 by an internist, and 65 by a geriatrician. A referral between these 3 medical specialists was needed for only 14 patients (5.3%). Fifty patients were seen by a psychologist, mostly those with a HADS score >10. Only 5 (2.2%) of the 221 patients who were not directly referred to a psychologist based on triage needed psychological support. Forty-eight patients (18%) were also seen by a physiatrist. CONCLUSION Identifying which medical specialist (pulmonologist, internist, and/or geriatrician) should see patients attending a post-COVID outpatient clinic based on patient-reported symptoms proved an effective approach to managing the flow of post-COVID patients.
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Affiliation(s)
- Aryan F. Klinkert
- Department of PulmonologyJeroen Bosch Hospital's‐HertogenboschNetherlands
| | | | | | | | | | | | | | - Angèle P. M. Kerckhoffs
- Department of GeriatricsJeroen Bosch Hospital's‐HertogenboschNetherlands
- Department of Internal MedicineJeroen Bosch Hospital's‐HertogenboschNetherlands
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24
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Vargas Centanaro G, Calle Rubio M, Álvarez-Sala Walther JL, Martinez-Sagasti F, Albuja Hidalgo A, Herranz Hernández R, Rodríguez Hermosa JL. Long-term outcomes and recovery of patients who survived COVID-19: LUNG INJURY COVID-19 Study. Open Forum Infect Dis 2022; 9:ofac098. [PMID: 35360197 PMCID: PMC8903519 DOI: 10.1093/ofid/ofac098] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background LUNG INJURY COVID-19 (clinicaltrials.gov NCT 21/399-E) is a registry-based prospective observational cohort study to evaluate long-term outcomes and recovery 12 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection according to severity. Methods Three hundred five coronavirus disease 2019 (COVID-19) survivors were included (moderate, 162; severe, 143). Twelve months after SARS-CoV-2 infection, there was resolution of respiratory symptoms (37.9% in severe vs 27.3% in moderate pneumonia; P = .089). Results Exertional dyspnea was present (20% in severe vs 18.4% in moderate; P = .810). Abnormalities on chest radiology imaging were detected more often in severe COVID-19 infection vs moderate infection (29% vs 8.8%; P < .001). Pulmonary function testing (forced spirometry or diffusion) performed at 12 months of mean follow-up according to protocol detected anomalies in 31.4% of patients with severe COVID-19 courses and in 27.7% of moderate patients. Risk factors associated with diffusion impairment at 12 months were age (odds ratio [OR], 1.05; 95% CI, 1.01–1.10; P = .008), forced expiratory volume in 1 second predicted at follow-up (OR, 0.96; 95% CI, 0.93–0.99; P = .017), and dyspnea score at follow-up (OR, 3.16; 95% CI, 1.43–6.97; P = .004). Computed tomography (CT) scans performed at 12 months of mean follow-up showed evidence of fibrosis in almost half of patients with severe COVID-19 courses, who underwent CT according to protocol. Conclusions At 12 months from infection onset, most patients refer to symptoms, particularly muscle weakness and dyspnea, and almost one-third of patients with severe COVID-19 pneumonia had impaired pulmonary diffusion and abnormalities on chest radiology imaging. These results emphasize the importance of systematic follow-up after severe COVID-19, with appropriate management of pulmonary sequelae.
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Affiliation(s)
- Gianna Vargas Centanaro
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain
- Medical Department, School of Medicine, Universidad Complutense de Madrid, Spain
| | - Myriam Calle Rubio
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain
- Medical Department, School of Medicine, Universidad Complutense de Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - José Luis Álvarez-Sala Walther
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain
- Medical Department, School of Medicine, Universidad Complutense de Madrid, Spain
| | | | | | - Rafael Herranz Hernández
- Departament of Preventive Medicine, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Juan Luis Rodríguez Hermosa
- Pulmonology Department, Hospital Clínico San Carlos, Madrid, Spain
- Medical Department, School of Medicine, Universidad Complutense de Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
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25
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Nopp S, Moik F, Klok FA, Gattinger D, Petrovic M, Vonbank K, Koczulla AR, Ay C, Zwick RH. Outpatient Pulmonary Rehabilitation in Patients with Long COVID Improves Exercise Capacity, Functional Status, Dyspnea, Fatigue, and Quality of Life. Respiration 2022; 101:593-601. [PMID: 35203084 DOI: 10.1159/000522118] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/03/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND COVID-19 survivors face the risk of long-term sequelae including fatigue, breathlessness, and functional limitations. Pulmonary rehabilitation has been recommended, although formal studies quantifying the effect of rehabilitation in COVID-19 patients are lacking. METHODS We conducted a prospective observational cohort study including consecutive patients admitted to an outpatient pulmonary rehabilitation center due to persistent symptoms after COVID-19. The primary endpoint was change in 6-min walk distance (6MWD) after undergoing a 6-week interdisciplinary individualized pulmonary rehabilitation program. Secondary endpoints included change in the post-COVID-19 functional status (PCFS) scale, Borg dyspnea scale, Fatigue Assessment Scale, and quality of life. Further, changes in pulmonary function tests were explored. RESULTS Of 64 patients undergoing rehabilitation, 58 patients (mean age 47 years, 43% women, 38% severe/critical COVID-19) were included in the per-protocol-analysis. At baseline (i.e., in mean 4.4 months after infection onset), mean 6MWD was 584.1 m (±95.0), and functional impairment was graded in median at 2 (IQR, 2-3) on the PCFS. On average, patients improved their 6MWD by 62.9 m (±48.2, p < 0.001) and reported an improvement of 1 grade on the PCFS scale. Accordingly, we observed significant improvements across secondary endpoints including presence of dyspnea (p < 0.001), fatigue (p < 0.001), and quality of life (p < 0.001). Also, pulmonary function parameters (forced expiratory volume in 1 s, lung diffusion capacity, inspiratory muscle pressure) significantly increased during rehabilitation. CONCLUSION In patients with long COVID, exercise capacity, functional status, dyspnea, fatigue, and quality of life improved after 6 weeks of personalized interdisciplinary pulmonary rehabilitation. Future studies are needed to establish the optimal protocol, duration, and long-term benefits as well as cost-effectiveness of rehabilitation.
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Affiliation(s)
- Stephan Nopp
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Florian Moik
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Frederikus A Klok
- Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Milos Petrovic
- Outpatient Pulmonary Rehabilitation, Therme Wien Med, Vienna, Austria
| | - Karin Vonbank
- Clinical Division of Pulmonology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
| | - Andreas R Koczulla
- Department of Pulmonary Rehabilitation, Member of the German Center for Lung Research (DZL), Philipps-University of Marburg, Marburg, Germany.,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Cihan Ay
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Ralf Harun Zwick
- Outpatient Pulmonary Rehabilitation, Therme Wien Med, Vienna, Austria.,Ludwig Boltzmann Institute Rehabilitation Research, Vienna, Austria
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Hamady A, Lee J, Loboda ZA. Waning antibody responses in COVID-19: what can we learn from the analysis of other coronaviruses? Infection 2022; 50:11-25. [PMID: 34324165 PMCID: PMC8319587 DOI: 10.1007/s15010-021-01664-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/08/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19), caused by the novel betacoronavirus severe acute respiratory syndrome 2 (SARS-CoV-2), was declared a pandemic in March 2020. Due to the continuing surge in incidence and mortality globally, determining whether protective, long-term immunity develops after initial infection or vaccination has become critical. METHODS/RESULTS In this narrative review, we evaluate the latest understanding of antibody-mediated immunity to SARS-CoV-2 and to other coronaviruses (SARS-CoV, Middle East respiratory syndrome coronavirus and the four endemic human coronaviruses) in order to predict the consequences of antibody waning on long-term immunity against SARS-CoV-2. We summarise their antibody dynamics, including the potential effects of cross-reactivity and antibody waning on vaccination and other public health strategies. At present, based on our comparison with other coronaviruses we estimate that natural antibody-mediated protection for SARS-CoV-2 is likely to last for 1-2 years and therefore, if vaccine-induced antibodies follow a similar course, booster doses may be required. However, other factors such as memory B- and T-cells and new viral strains will also affect the duration of both natural and vaccine-mediated immunity. CONCLUSION Overall, antibody titres required for protection are yet to be established and inaccuracies of serological methods may be affecting this. We expect that with standardisation of serological testing and studies with longer follow-up, the implications of antibody waning will become clearer.
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Affiliation(s)
- Ali Hamady
- Department of Immunology and Inflammation, Imperial College London, London, UK
| | - JinJu Lee
- Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Zuzanna A Loboda
- Department of Immunology and Inflammation, Imperial College London, London, UK.
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van Kessel SAM, Olde Hartman TC, Lucassen PLBJ, van Jaarsveld CHM. Post-acute and long-COVID-19 symptoms in patients with mild diseases: a systematic review. Fam Pract 2022; 39:159-167. [PMID: 34268556 PMCID: PMC8414057 DOI: 10.1093/fampra/cmab076] [Citation(s) in RCA: 149] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND It is expected that GPs are increasingly confronted with a large group of patients with symptoms persisting three weeks after initial symptoms of a mild (managed in the outpatient setting) COVID-19 infection. Currently, research on these persistent symptoms mainly focuses on patients with severe infections (managed in an inpatient setting) whereas patients with mild disease are rarely studied. OBJECTIVE The main objective of this systematic review was to create an overview of the nature and frequency of persistent symptoms experienced by patients after mild COVID-19 infection. METHODS Systematic literature searches were performed in Pubmed, Embase and PsychINFO on 2 February 2021. Quantitative studies, qualitative studies, clinical lessons and case reports were considered eligible designs. RESULTS In total, nine articles were included in this literature review. The frequency of persistent symptoms in patients after mild COVID-19 infection ranged between 10% and 35%. Symptoms persisting after a mild COVID-19 infection can be distinguished into physical, mental and social symptoms. Fatigue was the most frequently described persistent symptom. Other frequently occurring persistent symptoms were dyspnoea, cough, chest pain, headache, decreased mental and cognitive status and olfactory dysfunction. In addition, it was found that persisting symptoms after a mild COVID-19 infection can have major consequences for work and daily functioning. CONCLUSION There is already some evidence that symptoms of mild COVID-19 persist after 3 weeks in a third of patients. However, there is a lack of data about symptoms persisting after 3 months (long-COVID). More research is needed to help GPs in managing long-COVID.
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Affiliation(s)
- Sophie A M van Kessel
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Tim C Olde Hartman
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Peter L B J Lucassen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Cornelia H M van Jaarsveld
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
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28
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Augustine R, S A, Nayeem A, Salam SA, Augustine P, Dan P, Maureira P, Mraiche F, Gentile C, Hansbro PM, McClements L, Hasan A. Increased complications of COVID-19 in people with cardiovascular disease: Role of the renin-angiotensin-aldosterone system (RAAS) dysregulation. Chem Biol Interact 2022; 351:109738. [PMID: 34740598 PMCID: PMC8563522 DOI: 10.1016/j.cbi.2021.109738] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/19/2021] [Accepted: 11/01/2021] [Indexed: 01/28/2023]
Abstract
The rapid spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19), has had a dramatic negative impact on public health and economies worldwide. Recent studies on COVID-19 complications and mortality rates suggest that there is a higher prevalence in cardiovascular diseases (CVD) patients. Past investigations on the associations between pre-existing CVDs and susceptibility to coronavirus infections including SARS-CoV and the Middle East Respiratory Syndrome coronavirus (MERS-CoV), have demonstrated similar results. However, the underlying mechanisms are poorly understood. This has impeded adequate risk stratification and treatment strategies for CVD patients with SARS-CoV-2 infections. Generally, dysregulation of the expression of angiotensin-converting enzyme (ACE) and the counter regulator, angiotensin-converting enzyme 2 (ACE2) is a hallmark of cardiovascular risk and CVD. ACE2 is the main host receptor for SARS-CoV-2. Although further studies are required, dysfunction of ACE2 after virus binding and dysregulation of the renin-angiotensin-aldosterone system (RAAS) signaling may worsen the outcomes of people affected by COVID-19 and with preexisting CVD. Here, we review the current knowledge and outline the gaps related to the relationship between CVD and COVID-19 with a focus on the RAAS. Improved understanding of the mechanisms regulating viral entry and the role of RAAS may direct future research with the potential to improve the prevention and management of COVID-19.
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Affiliation(s)
- Robin Augustine
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
| | - Abhilash S
- Department of Microbiology, Majlis Arts and Science College, Puramannur, Malappuram, Kerala, 676552, India
| | - Ajisha Nayeem
- Department of Biotechnology, St. Mary's College, Thrissur, 680020, Kerala, India
| | - Shaheen Abdul Salam
- Department of Biosciences, MES College Marampally, Aluva, Ernakulam, 683107, Kerala, India
| | - Priya Augustine
- Department of Zoology, Kongunadu Arts and Science College, Coimbatore, Tamil Nadu, 641029, India
| | - Pan Dan
- Department of Cardiovascular and Transplantation Surgery, Regional Central Hospital of Nancy, Lorraine University, France; Department of Thoracic and Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Pablo Maureira
- Department of Cardiovascular and Transplantation Surgery, Regional Central Hospital of Nancy, Lorraine University, France
| | - Fatima Mraiche
- College of Pharmacy, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Carmine Gentile
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, NSW, Australia; School of Medicine, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Philip M Hansbro
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, NSW, Australia; School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW, Australia
| | - Lana McClements
- School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW, Australia
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
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Covid-19 Preventive Behaviors in Iranian People: Applying Health Belief Model. CURRENT HEALTH SCIENCES JOURNAL 2022; 48:203-210. [PMID: 36320877 PMCID: PMC9590361 DOI: 10.12865/chsj.48.02.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/18/2022] [Indexed: 11/21/2022]
Abstract
Covid-19 disease, as a common infectious disease, has caused infection and death. Preventive behaviors are among the most important essential strategies of the Covid-19 disease prevention and control program. The health belief model (HBM) is one of the models that have been used to investigate the effective motivational factors and ultimately the protective behavior of the individual. Therefore, this study was conducted to define the factors related with Covid-19 protection behaviors among patients referred to comprehensive health service centers in Tuyserkan city using the HBM. A total of 800 patients referred to the comprehensive health service centers of Tuyserkan city during November 2021 were selected as the statistical population of this descriptive-analytical study. Clients were selected by multi-stage cluster random sampling from 21 comprehensive health service centers and health bases and then entered the study through simple random sampling. Data collection was online and based on a questionnaire. The questionnaire consisted of two parts: demographic information and HBM structure. The analysis was performed using SPSS24 software after data collection. The mean age of the subjects was 48.80 years and the income of the majority of the subjects was low (86.5%). People who washed their hands frequently kept a social distance, avoided losing others, used masks and gloves were 54.2%, 72.5%, 79.8%, 53.9%, 7.9% respectively. The results showed that with one unit increase in self-efficacy score and practice guide, the average behavior score increased by 0.27 and 0.31. The results show that the importance of prevention of Covid-19 infection among the population is necessary due to the high prevalence of infection and mortality. It seems that in intervention and prevention programs, the factors of prevention of Covid-19 transmission should be fully identified and proper interventions should be planned and implemented based on affective factors.
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Elhiny R, Al-Jumaili AA, Yawuz MJ. OUP accepted manuscript. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:404-413. [PMID: 35881153 PMCID: PMC9384593 DOI: 10.1093/ijpp/riac026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022]
Abstract
Objectives Methods Key findings Conclusion
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Affiliation(s)
- Rehab Elhiny
- Clinical Pharmacy Department, Faculty of Pharmacy, Minia University, Minia, Egypt
| | - Ali Azeez Al-Jumaili
- Correspondence: Ali Azeez Al-Jumaili, University of Baghdad College of Pharmacy, Bab Al Muadham, Baghdad 10047, Iraq; The University of Iowa, Iowa City, IA, USA; and UC Davis School of Medicine/PHS Department, USA.
| | - Mohammed Jamal Yawuz
- Clinical Pharmacy Department, College of Pharmacy, University of Baghdad, Baghdad, Iraq
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31
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Williams ESCP, Martins TB, Shah KS, Hill HR, Coiras M, Spivak AM, Planelles V. Cytokine Deficiencies in Patients with Long-COVID. JOURNAL OF CLINICAL & CELLULAR IMMUNOLOGY 2022; 13:672. [PMID: 36742994 PMCID: PMC9894377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Up to half of individuals who contract SARS-CoV-2 develop symptoms of long-COVID approximately three months after initial infection. These symptoms are highly variable, and the mechanisms inducing them are yet to be understood. We compared plasma cytokine levels from individuals with long-COVID to healthy individuals and found that those with long-COVID had 100% reductions in circulating levels of Interferon Gamma (IFNγ) and Interleukin-8 (IL-8). Additionally, we found significant reductions in levels of IL-6, IL-2, IL-17, IL-13, and IL-4 in individuals with long-COVID. We propose immune exhaustion as the driver of long-COVID, with the complete absence of IFNγ and IL-8preventing the lungs and other organs from healing after acute infection, and reducing the ability to fight off subsequent infections, both contributing to the myriad of symptoms suffered by those with long-COVID.
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Affiliation(s)
- Elizabeth SCP Williams
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, United States
| | - Thomas B. Martins
- ARUP Institute for Clinical and Experimental Pathology, 1950 Circle of Hope Drive, Salt Lake City, United States
| | - Kevin S. Shah
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, United States
| | - Harry R. Hill
- ARUP Institute for Clinical and Experimental Pathology, 1950 Circle of Hope Drive, Salt Lake City, United States;,Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, United States;,Department of Pathology and Pediatrics, University of Utah School of Medicine, Salt Lake City, United States
| | - Mayte Coiras
- AIDS Immunopathology Unit, National Center of Microbiology, Madrid, Spain
| | - Adam M. Spivak
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, United States;,Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, United States
| | - Vicente Planelles
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, United States
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Aamir M, Ahmad W, Ahmad B, Khan A, Fawad M, Abdullah M. PREVALENCE OF MORTALITY AND ITS DISTRIBUTION BY SEX AND AGE GROUPS IN INDOOR COVID-19 PATIENTS IN D.I.KHAN DIVISION, PAKISTAN. GOMAL JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.46903/gjms/19.03.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background: COVID-19 has become one of the leading causes of morbidity and mortality. The objectives of this study were to determine the prevalence of mortality and its distribution by sex and age groups in indoor COVID-19 patients in D.I.Khan Division, Pakistan.Materials Methods: This cross-sectional study was conducted in the Department of Medicine, Gomal Medical College, D.I.Khan, Pakistan. A sample of 438 patients with positive SARS-CoV-2 RT-PCR was selected. Sex age-groups were two demographic and presence of mortality was a research variable. The data type for all variables was nominal, except ordinal age groups. Prevalence distribution were described by count and percentage with 95%CI. The hypotheses were tested by chi-square goodness of fit test.Results: Out of 438 COVID-19 patients, mortality was 43 (9.82%), including 34 (7.76%) men and nine (2.06%) women. The mortality was 0% for 0-19 years, four (0.92%) for 20-39 years, 12 (2.74%) for 40-59 years and 27 (6.16%) ≥60 years. Our mortality 9.82% was lower than expected 20.95% (p=.001). It was higher in men than women (p=.001). It was highest in age group ≥60 years, while 0% in 0-19 years. It was similar to expected by sex (p=.070) and age group (p=.207).Conclusion: Our study showed 9.82% mortality in indoor COVID-19 patients. The mortality was lower than expected. The mortality was higher in men than women. It was highest in elderly, while zero in children and adolescents. It was similar to expected by sex and age group.
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33
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Deng Y, Shi L, Li J, Jiang Z, Xie C, Luo S, Ling L, Lin H, Chen Z, Zhao Y, Kang L, Yuan J, Wen W. The Trends of Psychological Status of People Entering from High-Risk Areas of COVID-19 Coronavirus During the Quarantine in Dedicated Hotels: A Longitudinal Survey Study from Guangzhou, China. Risk Manag Healthc Policy 2021; 14:5005-5014. [PMID: 34938136 PMCID: PMC8685548 DOI: 10.2147/rmhp.s331735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background The quarantine in dedicated hotels has become an inevitable safety measure due to the frequent cross-border travel since the outbreak of COVID-19. The aim of the present study was to explore the trends in the psychological status of individuals entering from high-risk areas of COVID-19 coronavirus while quarantining in dedicated hotels. Methods A total of 591 individuals who isolated in dedicated hotels were recruited between March and June 2020. Participants self-reported mental symptoms [Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS)] every three days during the quarantine. A mixed-effects linear regression model was used to assess the trends. Results Participants reporting anxiety and depression symptoms at least one time during quarantine accounted for 4.5% and 18.4%, respectively. Their psychological status was alleviated during some first 9 days, and then it slightly deteriorated, which was suggested by SAS and SDS scores that were negatively correlated with the days of quarantine (T) (adjusted coefficient [β] -0.81, 95% CI -1.00 to -0.62; and β -0.75, 95% CI -0.97 to -0.53, respectively), and were positively correlated with the square of T (β 0.04, 95% CI 0.02 to 0.06; and β 0.04, 95% CI 0.02 to 0.06, respectively). The unemployed and 18~30-year-old participants were prone to greater levels of psychological distress. No significant difference in the trend of mental health was found among different subgroups. Conclusion The mental health of the people entering Guangzhou from high-risk areas of COVID-19 coronavirus resulted positive during the early period of quarantine in dedicated hotels, after which it deteriorated. The psychological status of individuals should be closely monitored at the beginning and after more than 9 days of quarantine, especially for individuals who are unemployed and 18~30-year-old ones.
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Affiliation(s)
- Yanhong Deng
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Lishuo Shi
- Clinical Research Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Jianxia Li
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Zhipeng Jiang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Chaojun Xie
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, 510440, People's Republic of China
| | - Shuangling Luo
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Zongqiu Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, 510440, People's Republic of China
| | - Yunlong Zhao
- Medical Department, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Liang Kang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
| | - Jun Yuan
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, 510440, People's Republic of China
| | - Weiping Wen
- Department of Otolaryngology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangzhou, 510655, People's Republic of China
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Khodeir MM, Shabana HA, Rasheed Z, Alkhamiss AS, Khodeir M, Alkhowailed MS, Alharbi S, Alsoghair M, Alsagaby SA, Al Abdulmonem W. COVID-19: Post-recovery long-term symptoms among patients in Saudi Arabia. PLoS One 2021; 16:e0260259. [PMID: 34879074 PMCID: PMC8654233 DOI: 10.1371/journal.pone.0260259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND After recovery from acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many patients experience long-term symptoms in different body systems. The aim of the present study was to identify these symptoms, their severity, and their duration as a first step in building a system to classify post-recovery long-term symptoms of coronavirus disease 2019 (COVID-19). METHODS An online-based cross-sectional survey was administered between September and October 2020. Data regarding the severity of post-recovery symptoms and their duration were collected using an Arabic questionnaire divided into six categories encompassing the 20 most prevalent symptoms. RESULTS A total of 979 patients recovered from COVID-19 in Saudi Arabia in the study period, of whom 53% were male and 47% were female. The most common symptoms included general fatigue and weakness (73% each), with moderate severity of neurological symptoms including mood changes (41%) and insomnia (39%). Among the special senses, loss of smell and taste of marked severity were reported by 64% and 55% among respiratory symptoms, cough of mild severity (47%), and dyspnea of moderate severity (43%). Loss of appetite of moderate severity was reported in 42%, and diarrhea, abdominal pain, and nausea of mild severity were reported by 53%, 50%, and 44% of respondents, respectively. CONCLUSIONS Long-term symptoms after recovery from COVID-19 warrant patient follow-up. The authors propose a classification system as a starting point to guide the identification and follow-up of long-term symptoms post-recovery, and recommend larger-scale studies to broaden the definition of recovery from COVID-19, which appears to have two phases, acute and chronic.
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Affiliation(s)
- Mostafa M. Khodeir
- Faculty of Medicine, Department of Pathology, Cairo University, Cairo, Egypt
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Hassan A. Shabana
- Faculty of Medicine, Chest Diseases Department, Cairo University, Cairo, Egypt
| | - Zafar Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Abdullah S. Alkhamiss
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Mohamed Khodeir
- Psychiatric Department, Brook Hospital, Louisville, Kentucky, United States of America
| | - Mohammad S. Alkhowailed
- Department of Dermatology, College of Medicine, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Sami Alharbi
- Pulmonary Department, King Fahad Specialist Hospital, Ministry of Health, Buraidah, Saudi Arabia
| | - Mansour Alsoghair
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Qassim, KSA
| | - Suliman A. Alsagaby
- Department of Medical Laboratories, Central Biosciences Research Laboratories, College of Science in Al Zulfi, Majmaah University, Al Majma’ah, Saudi Arabia
| | - Waleed Al Abdulmonem
- Department of Pathology, College of Medicine, Qassim University, Buraidah, Qassim, KSA
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35
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A trial of pirfenidone in hospitalized adult patients with severe coronavirus disease 2019. Chin Med J (Engl) 2021; 135:368-370. [PMID: 34855641 PMCID: PMC8812696 DOI: 10.1097/cm9.0000000000001614] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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36
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Adu-Amankwaah J, Mprah R, Adekunle AO, Ndzie Noah ML, Adzika GK, Machuki JO, Sun H. The cardiovascular aspect of COVID-19. Ann Med 2021; 53:227-236. [PMID: 33345626 PMCID: PMC7784826 DOI: 10.1080/07853890.2020.1861644] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease-2019 (COVID-19), an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2), has hit the world very hard by affecting millions of people across countries hence posing a major health threat on a global scale. This novel virus is thought to enter and cause infection in its host through the attachment of its structural protein known as the S-glycoprotein to angiotensin-converting enzyme 2 (ACE2). Given the rapid spread of COVID-19 with its consequences globally, it is mandatory that health caregivers and researchers across all disciplines abreast themselves with the potential effects that this novel virus may have on their fields and the medical society at large. During the infection, the cardiovascular system is affected by unknown pathomechanistic processes, hence accounting for an increased prevalence of cardiovascular diseases (CVDs) among COVID-19 patients. As cardiovascular researchers, we are more concerned about the cardiovascular aspect of SARS-CoV-2/COVID-19. Hence, this concise review addresses these aspects where CVD as a risk factor of COVID-19, the prevalence of CVDs in COVID-19, and the potential cardiovascular disorders which may evolve owing to COVID-19 are discussed. A better understanding of these issues will be pivotal to improve cardiovascular health during this SARS-CoV-2/COVID-19 pandemic and beyond.
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Affiliation(s)
| | - Richard Mprah
- Department of Physiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | | | | | | | | | - Hong Sun
- Department of Physiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Chen X, Li Y, Shao TR, Yang LL, Li SJ, Wang XJ, Li A, Wu YY, Liu XF, Liu CM, Liu YH, Zeng F, Cen Y. Some characteristics of clinical sequelae of COVID-19 survivors from Wuhan, China: A multi-center longitudinal study. Influenza Other Respir Viruses 2021; 16:395-401. [PMID: 34796652 PMCID: PMC8652839 DOI: 10.1111/irv.12943] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/07/2021] [Indexed: 01/10/2023] Open
Abstract
Background The pandemic of COVID‐19 has a persistent impact on global health, yet its sequelae need to be addressed at a wide scale around the globe. This study aims to investigate the characteristics, prevalence, and risk factors for mid‐term (>6 months) clinical sequelae in a cohort of COVID‐19 survivors. Methods Totally 715 COVID‐19 survivors discharged before April 1, 2020, from three medical centers in Wuhan, China, were included. The longitudinal study was conducted by telephone interviews based on a questionnaire including the clinical sequelae of general, respiratory, and cardiovascular systems. Demographics and some characteristics of clinical sequelae of the survivors were recorded and analyzed. Multivariate logistic regression analysis was applied to explore the risk factors for the sequelae. Results The median time interval from discharge to telephone interview was 225.0 days. The COVID‐19 survivors' median ages were 69 years, and 51.3% were male. Among them, 29.9% had at least one clinical sequela. There were 19.2%, 22.7%, and 5.0% of the survivors reporting fatigue, respiratory symptoms, and cardiovascular symptoms, respectively. Comorbidities, disease severity, the application of mechanical ventilation and high‐flow oxygen therapy, and the history of re‐admission were associated with the presence of clinical sequelae. Conclusions Our study provides further evidence for the prevalence and characteristics of clinical sequelae of COVID‐19 survivors, suggesting long‐term monitoring and management is needed for their full recovery.
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Affiliation(s)
- Xian Chen
- Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Ying Li
- Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing, China
| | - Tong-Ren Shao
- Department of Medical Education, Daping Hospital, Army Medical University, Chongqing, China
| | - Ling-Li Yang
- Department of Orthopedics, Daping Hospital, Army Medical University, Chongqing, China
| | - Si-Jing Li
- Department of Orthopedics, Daping Hospital, Army Medical University, Chongqing, China
| | - Xiu-Juan Wang
- Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Ao Li
- Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yin-Yu Wu
- Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, China
| | - Xue-Fei Liu
- Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing, China
| | - Chun-Mei Liu
- Department of Ophthalmology, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu-Hui Liu
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Army Medical University, Chongqing, China
| | - Fan Zeng
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Army Medical University, Chongqing, China
| | - Yuan Cen
- Department of Orthopedics, Daping Hospital, Army Medical University, Chongqing, China
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38
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Hu C, Zeng JP, Peng K, Xia H, Zhang HM, Zhong Z, Jiang MY. Clinical Features and Temporal Lung Radiographic Changes in 25 Patients Recovering from COVID-19 Pneumonia: A Retrospective Case-Control Study. Med Sci Monit 2021; 27:e933381. [PMID: 34775462 PMCID: PMC8600820 DOI: 10.12659/msm.933381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Little is known of the changes in lung radiographic characteristics over time in patients recovering from COVID-19. This study analyzed the clinical features and temporal lung radiographic changes in patients with moderate and severe COVID-19 pneumonia who did not require invasive mechanical ventilation during the acute and convalescent periods. Material/Methods The data of 25 patients with COVID-19 pneumonia from January 29, 2020, to November 24, 2020, who did not require invasive mechanical ventilation and who were followed up were retrospectively collected. The 25 patients were divided into severe and moderate groups. Clinical characteristics and computed tomography (CT) manifestations were compared. A total of 121 consecutive thin-slice CT scans were collected at 4 weeks, 2 months, and 5 months after admission to evaluate lung abnormalities in the patients. The CT score was used to assess disease severity. Results The severe group had a lower rate of nucleic acid conversion within 10 days of admission and higher D-dimer, creatine kinase, and lactate dehydrogenase values. In the severe group, hospital stay was longer and hospitalization costs were higher. The average CT score of the severe group peaked in the second week, while the moderate group peaked in the first week and then decreased over time. There were no statistically significant differences in the average CT score between the 2 groups at the 5-month follow-up. Conclusions The pulmonary lesions of patients recovering from COVID-19 and who do not require invasive mechanical ventilation were gradually absorbed and resolved over time.
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Affiliation(s)
- Chao Hu
- Department of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Jian Ping Zeng
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Ke Peng
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Hong Xia
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Huan Ming Zhang
- Department of Radiology, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Zhi Zhong
- Department of Radiology, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Ming Yan Jiang
- Department of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
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Abstract
The acute course of COVID-19 is variable and ranges from asymptomatic infection to fulminant respiratory failure. Patients recovering from COVID-19 can have persistent symptoms and CT abnormalities of variable severity. At 3 months after acute infection, a subset of patients will have CT abnormalities that include ground-glass opacity (GGO) and subpleural bands with concomitant pulmonary function abnormalities. At 6 months after acute infection, some patients have persistent CT changes to include the resolution of GGOs seen in the early recovery phase and the persistence or development of changes suggestive of fibrosis, such as reticulation with or without parenchymal distortion. The etiology of lung disease after COVID-19 may be a sequela of prolonged mechanical ventilation, COVID-19-induced acute respiratory distress syndrome (ARDS), or direct injury from the virus. Predictors of lung disease after COVID-19 include need for intensive care unit admission, mechanical ventilation, higher inflammatory markers, longer hospital stay, and a diagnosis of ARDS. Treatments of lung disease after COVID-19 are being investigated, including the potential of antifibrotic agents for prevention of lung fibrosis after COVID-19. Future research is needed to determine the long-term persistence of lung disease after COVID-19, its impact on patients, and methods to either prevent or treat it. © RSNA, 2021.
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Affiliation(s)
| | - Brooke Heyman
- Division of Pulmonary, Sleep and Critical Care Medicine, Department
of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York,
NY
| | - Jane P. Ko
- Department of Radiology, NYU Langone Health, NYU Grossman School of
Medicine, New York, NY
| | - Rany Condos
- Division of Pulmonary, Sleep and Critical Care Medicine, Department
of Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York,
NY
| | - David A. Lynch
- Department of Radiology, National Jewish Health, Denver, CO,
USA
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40
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Martini K, Larici AR, Revel MP, Ghaye B, Sverzellati N, Parkar AP, Snoeckx A, Screaton N, Biederer J, Prosch H, Silva M, Brady A, Gleeson F, Frauenfelder T. COVID-19 pneumonia imaging follow-up: when and how? A proposition from ESTI and ESR. Eur Radiol 2021; 32:2639-2649. [PMID: 34713328 PMCID: PMC8553396 DOI: 10.1007/s00330-021-08317-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/20/2021] [Accepted: 09/04/2021] [Indexed: 12/26/2022]
Abstract
Abstract This document from the European Society of Thoracic Imaging (ESTI) and the European Society of Radiology (ESR) discusses the role of imaging in the long-term follow-up of COVID-19 patients, to define which patients may benefit from imaging, and what imaging modalities and protocols should be used. Insights into imaging features encountered on computed tomography (CT) scans and potential pitfalls are discussed and possible areas for future review and research are also included. Key Points • Post-COVID-19 pneumonia changes are mainly consistent with prior organizing pneumonia and are likely to disappear within 12 months of recovery from the acute infection in the majority of patients. • At present, with the longest series of follow-up examinations reported not exceeding 12 months, the development of persistent or progressive fibrosis in at least some individuals cannot yet be excluded. • Residual ground glass opacification may be associated with persisting bronchial dilatation and distortion, and might be termed “fibrotic-like changes” probably consistent with prior organizing pneumonia. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08317-7.
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Affiliation(s)
- K Martini
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - A R Larici
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M P Revel
- Department of Radiology, Cochin Hospital, Université de Paris, Paris, France
| | - B Ghaye
- Department of Radiology, Cliniques Universitaires Saint Luc, Catholic University of Louvain, Brussels, Belgium
| | - N Sverzellati
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A P Parkar
- Department of Radiology, Haraldsplass Deaconess Hospital and Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - A Snoeckx
- Department of Radiology, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - N Screaton
- Department of Radiology, Royal Papworth Hospital, Cambridge, UK
| | - J Biederer
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.,Member of the German Lung Research Center (DZL), Translational Lung Research Center Heidelberg (TLRC), Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.,Faculty of Medicine, University of Latvia, Raina bulvaris 19, Riga, 1586, Latvia.,Faculty of Medicine, Christian-Albrechts-Universität Zu Kiel, 24098, Kiel, Germany
| | - H Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - M Silva
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A Brady
- Department of Radiology, Mercy University Hospital, Cork, and University College Cork, Cork, Ireland
| | - F Gleeson
- Department of Oncology, University of Oxford, Oxford, UK
| | - T Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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Pan F, Yang L, Liang B, Ye T, Li L, Li L, Liu D, Wang J, Hesketh RL, Zheng C. Chest CT Patterns from Diagnosis to 1 Year of Follow-up in COVID-19. Radiology 2021; 302:709-719. [PMID: 34609153 PMCID: PMC8515211 DOI: 10.1148/radiol.2021211199] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background The chest CT manifestations of COVID-19 from hospitalization to convalescence
after 1 year are unknown. Purpose To assess chest CT manifestations of COVID-19 up to 1 year after symptom
onset. Materials and Methods Patients were enrolled if they were admitted to the hospital because of
COVID-19 and underwent CT during hospitalization at two isolation centers
between January 27, 2020, and March 31, 2020. In a prospective study, three
serial chest CT scans were obtained at approximately 3, 7, and 12 months
after symptom onset and were longitudinally analyzed. The total CT score of
pulmonary lobe involvement, ranging from 0 to 25, was assessed (score of
1–5 for each lobe). Univariable and multivariable logistic regression
analyses were performed to explore independent risk factors for residual CT
abnormalities after 1 year. Results A total of 209 study participants (mean age, 49 years ± 13 [standard
deviation]; 116 women) were evaluated. CT abnormalities had resolved in 61%
of participants (128 of 209) at 3 months and in 75% of participants (156 of
209) at 12 months. Among participants with chest CT abnormalities that had
not resolved, there were residual linear opacities in 25 of the 209
participants (12%) and multifocal reticular or cystic lesions in 28 of the
209 participants (13%). Age 50 years or older, lymphopenia, and severe or
aggravation of acute respiratory distress syndrome were independent risk
factors for residual CT abnormalities at 1 year (odds ratios = 15.9, 18.9,
and 43.9, respectively; P < .001 for each
comparison). In 53 participants with residual CT abnormalities at 12 months,
reticular lesions (41 of 53 participants [77%]) and bronchial dilation (39
of 53 participants [74%]) were observed at discharge and were persistent in
28 (53%) and 24 (45%) of the 53 participants, respectively. Conclusion One year after COVID-19 diagnosis, chest CT scans showed abnormal findings in
53 of the 209 study participants (25%), with 28 of the 209 participants
(13%) showing subpleural reticular or cystic lesions. Older participants
with severe COVID-19 or acute respiratory distress syndrome were more likely
to develop lung sequelae that persisted at 1 year. © RSNA, 2021 Online supplemental material is available for this
article. See also the editorial by Lee and Wi et al in this issue.
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Affiliation(s)
- Feng Pan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Bo Liang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Tianhe Ye
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lingli Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Dehan Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jiazheng Wang
- MSC Clinical & Technical solutions, Philips Healthcare, Beijing, 100000, China
| | - Richard L Hesketh
- Department of Radiology, University College London Hospital, 235, Euston Road, London, NW1 2BU, UK
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
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Zhou SY, Zhang C, Shu WJ, Chong LY, He J, Xu Z, Pan HF. Emerging Roles of Coronavirus in Autoimmune Diseases. Arch Med Res 2021; 52:665-672. [PMID: 33875273 PMCID: PMC8031002 DOI: 10.1016/j.arcmed.2021.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/17/2021] [Accepted: 03/31/2021] [Indexed: 12/27/2022]
Abstract
Virus infection can alter immune regulatory activity, and thus may be involved in the occurrence of autoimmune diseases. Recently, the pandemic of COVID-19 has posed a huge threat to public health and emerging evidence suggests that coronavirus may be implicated in the development and pathogenesis of autoimmune diseases. However, how coronavirus infection impacts the risk of autoimmune disease remains largely unknown. In this review, we focused on the association between coronavirus and autoimmunity, and elucidated the molecular mechanisms linking coronavirus exposure to autoimmunity. Additionally, we briefly introduced the role that coronavirus plays in several autoimmune diseases including multiple sclerosis (MS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and idiopathicthrombocytopenic purpura (ITP).
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Affiliation(s)
- Si-Yu Zhou
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Chi Zhang
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Wen-Jing Shu
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Li-Ye Chong
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Jun He
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Zhiwei Xu
- Key Laboratory for Medical and Health of the 13th Five-Year Plan, Hefei, Anhui, China
| | - Hai-Feng Pan
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia,Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China,Address reprint requests to: Hai-Feng Pan Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230016, Anhui, China, Phone: +86 551 62965716; FAX: +86 551 62965716
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43
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Yin X, Xi X, Min X, Feng Z, Li B, Cai W, Fan C, Wang L, Xia L. Long-term chest CT follow-up in COVID-19 Survivors: 102-361 days after onset. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1231. [PMID: 34532368 PMCID: PMC8421980 DOI: 10.21037/atm-21-1438] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/21/2021] [Indexed: 01/13/2023]
Abstract
Background The aim of this study was to evaluate long-term longitudinal changes in chest computed tomography (CT) findings in coronavirus disease 2019 (COVID-19) survivors and their correlations with dyspnea after discharge. Methods A total of 337 COVID-19 survivors who underwent CT scan during hospitalization and between 102 and 361 days after onset were retrospectively included. Subjective CT findings, lesion volume, therapeutic measures and laboratory parameters were collected. The severity of the survivors' dyspnea was determined by follow-up questionnaire. The evolution of the CT findings from the peak period to discharge and throughout follow-up and the abilities of CT findings and clinical parameters to predict survival with and without dyspnea were analyzed. Results Ninety-one COVID-19 survivors still had dyspnea at follow-up. The age, comorbidity score, duration of hospital stays, receipt of hormone administration, receipt of immunoglobulin injections, intensive care unit (ICU) admission, receipt of mechanical ventilation, laboratory parameters, clinical classifications and parameters associated with lesion volume of the survivors with dyspnea were significantly different from those of survivors without dyspnea. Among the clinical parameters and CT parameters used to identify dyspnea, parameters associated with lesion volume showed the largest area under the curve (AUC) values, with lesion volume at discharge showing the largest AUC (0.820). Lesion volume decreased gradually from the peak period to discharge and through follow-up, with a notable decrease observed after discharge. Absorption of lesions continued 6 months after discharge. Conclusions Among the clinical parameters and subjective CT findings, CT findings associated with lesion volume were the best predictors of post-discharge dyspnea in COVID-19 survivors.
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Affiliation(s)
- Xi Yin
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of CT & MRI, The First Affiliated Hospital, College of Medicine, Shihezi University, Shihezi, China
| | - Xiaoqing Xi
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Shihezi University, Shihezi, China
| | - Xiangde Min
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaoyan Feng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Basen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Cai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chanyuan Fan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Vitiello A, Ferrara F. Physiopathology and prospectives for therapeutic treatment of pulmonary fibrotic state in COVID-19 patients. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2021; 2:100056. [PMID: 34870154 PMCID: PMC8444447 DOI: 10.1016/j.crphar.2021.100056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/12/2021] [Accepted: 09/09/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 global pandemic has caused about 4,30 Mln deaths. Recently the first vaccines have been licensed, representing the most powerful weapon available to stop the pandemic. The COVID-19 viral infection in the most severe cases can cause severe lung lesions with the presence of fibrotic tissue. Even among cured individuals, the presence of pulmonary fibrotic tissue may be the major cause of long-term complications of COVID-19 requiring antifibrotic therapeutic treatment even in the post-COVID-19 infection phase to accelerate the healing process and fully recover lung function. This article reviews the fibrogenic mechanism of SARS-CoV-2-induced viral damage and the antifibrotic treatments indicated to treat sequelae post COVID-19 infection.
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Affiliation(s)
- Antonio Vitiello
- Clinical Pharmacologist, Pharmaceutical Department, Usl Umbria 1, A.Migliorati Street, 06132, Perugia, Italy
| | - Francesco Ferrara
- Hospital Pharmacist Manager, Pharmaceutical Department, Asl Napoli 3 Sud, Dell'amicizia Street 22, 80035, Nola, Naples, Italy
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45
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Zhao Y, Yang C, An X, Xiong Y, Shang Y, He J, Qiu Y, Zhang N, Huang L, Jia J, Xu Q, Zhang L, Zhao J, Pei G, Luo H, Wang J, Li Q, Gao Y, Xu A. Follow-up study on COVID-19 survivors one year after discharge from hospital. Int J Infect Dis 2021; 112:173-182. [PMID: 34520845 PMCID: PMC8434916 DOI: 10.1016/j.ijid.2021.09.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/05/2021] [Accepted: 09/08/2021] [Indexed: 01/25/2023] Open
Abstract
Objective To evaluate the long-term consequences of COVID-19 survivors one year after recovery, and to identify the risk factors associated with abnormal patterns in chest imaging manifestations or impaired lung function. Methods COVID-19 patients were recruited and prospectively followed up with symptoms, health-related quality of life, psychological questionnaires, 6-minute walking test, chest computed tomography (CT), pulmonary function tests, and blood tests. Multivariable logistic regression models were used to evaluate the association between the clinical characteristics and chest CT abnormalities or pulmonary function. Results Ninety-four patients with COVID-19 were recruited between January 16 and February 6, 2021. Muscle fatigue and insomnia were the most common symptoms. Chest CT scans were abnormal in 71.28% of participants. The results of multivariable regression showed an increased odds in age. Ten patients had diffusing capacity of the lung for carbon monoxide (DLCO) impairment. Urea nitrogen concentration on admission was significantly associated with impaired DLCO. IgG levels and neutralizing activity were significantly lower compared with those in the early phase. Conclusions One year after hospitalization for COVID-19, a cohort of survivors were mainly troubled with muscle fatigue and insomnia. Pulmonary structural abnormalities and pulmonary diffusion capacities were highly prevalent in surviving COVID-19 patients. It is necessary to intervene in the main target population for long-term recovery.
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Affiliation(s)
- Yumiao Zhao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Chunxia Yang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Xiaocai An
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Yajun Xiong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Yaomin Shang
- Department of Respiration, Henan Provincial Chest Hospital, Zhengzhou 450003, China
| | - Jiarong He
- Department of Respiration, The Fifth People's Hospital of Xinyang, Xinyang 464000, China
| | - Yan Qiu
- Department of Respiration, The Fifth People's Hospital of Xinyang, Xinyang 464000, China
| | - Ning Zhang
- Clinical Laboratory, The Fifth People's Hospital of Xinyang, Xinyang 464000, China
| | - Lisha Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Junli Jia
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Qinfu Xu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Long Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Junjie Zhao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China
| | - Guangzhong Pei
- Department of Neurology, Guangshan People's Hospital. Xinyang 465400, China
| | - Hong Luo
- Department of Respiratory and Critical Care Medicine, Guangshan People's Hospital, Xinyang 465400, China
| | - Jun Wang
- Department of Infectious Diseases, Luoshan People's Hospital, Xinyang 465400, China
| | - Qingquan Li
- Department of Respiratory and Critical Care Medicine, Xixian People's Hospital, Xinyang 464200, China.
| | - Yanfeng Gao
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
| | - Aiguo Xu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450051, China.
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Mohamed Hussein AA, Saad M, Zayan HE, Abdelsayed M, Moustafa M, Ezzat AR, Helmy R, Abd-Elaal H, Aly K, Abdelrheem S, Sayed I. Post-COVID-19 functional status: Relation to age, smoking, hospitalization, and previous comorbidities. Ann Thorac Med 2021; 16:260-265. [PMID: 34484441 PMCID: PMC8388571 DOI: 10.4103/atm.atm_606_20] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 04/08/2021] [Indexed: 01/30/2023] Open
Abstract
RATIONAL: Recently, a new “Post-COVID-19 Functional Status (PCFS) scale” is recommended in the current COVID-19 pandemic. It is proposed that it could be used to display direct retrieval and the functional sequelae of COVID-19. AIM OF THE STUDY: The aim of the study was to assess the PCFS and to evaluate if age, gender, smoking, hospitalization, and comorbidities have any effect on functional limitations in recovered COVID-19 patients. METHODS: A total of 444 registered confirmed COVID-19 patients were included. They were interviewed in our follow-up clinics and filled an Arabic translated PCFS scale as well as their demographic and clinical data. RESULTS: Eighty percent of COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible (63.1%), slight (14.4%), moderate (2%), to severe (0.5%) based on PCFS. Furthermore, there was a substantial variance between the score of PCFS with age (P = 0.003), gender (P = 0.014), the duration since the onset of the symptoms of COVID-19 (P < 0.001), need for oxygen supplementation (P < 0.001), need for intensive care unit (ICU) admittance (P = 0.003), previous periodic influenza vaccination (P < 0.001), smoking status (P < 0.001), and finally, the presence of any comorbid disorder (P < 0.001). CONCLUSIONS: Most of the COVID-19 recovered cases have diverse degrees of functional restrictions ranging from negligible to severe based on PCFS. These restrictions were affected by age, gender, periodic influenza vaccination, smoking, duration since symptoms onset, need for oxygen or ICU admittance, and finally the presence of coexisting comorbidity.
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Affiliation(s)
| | - Mahmoud Saad
- Faculty of Medicine, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hossam E Zayan
- Department of Gastroenterology and Infectious Disease, Assiut University Hospitals, Assiut, Egypt
| | | | | | | | - Radwa Helmy
- Faculty of Pharmacy, Asswan University, Aswan, Egypt
| | - Howaida Abd-Elaal
- Faculty of Medicine, Faculty of Nursing, Assiut University, Assiut, Egypt
| | - Karim Aly
- Department of Cardiology, Assiut University Hospitals, Assiut, Egypt
| | | | - Islam Sayed
- Faculty of Medicine, Aswan Faculty of Medicine, Aswan University, Aswan, Egypt
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Lindahl A, Aro M, Reijula J, Mäkelä MJ, Ollgren J, Puolanne M, Järvinen A, Vasankari T. Women report more symptoms and impaired quality of life: a survey of Finnish COVID-19 survivors. Infect Dis (Lond) 2021; 54:53-62. [PMID: 34410220 DOI: 10.1080/23744235.2021.1965210] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The long-term sequelae after COVID-19 are not yet fully known. Our aim was to evaluate subjective symptoms and quality of life in Finnish hospitalized COVID-19 patients at six months follow-up. METHODS Hospitalised adult patients with laboratory-confirmed SARS-CoV-2 infection from March to June 2020 were recruited. We conducted a survey on demographics and comorbidities, ten specific symptoms, and a RAND-36 quality of life questionnaire six months after hospital discharge. We collected clinical data manually from medical records. RESULTS 101 patients (54 male) out of 246 invited completed the survey. Their median age was 60 years, and the mean hospital length of stay was 15 d. Most patients (90%) experienced symptoms, the most common of which were tiredness (88%), fatigue (79%), sleeping problems (76%), and dyspnoea (70%). In regard to gender, women showed a shorter time of hospitalization (p = .048) and lower peak flow of supplementary oxygen (p = .043). Women reported more frequently dyspnoea, fatigue, tiredness, sleeping problems, and mood problems (p = .008-.033), and a lower quality of life in seven of eight dimensions (p < .001-.015). Five explanatory variables for the reduced quality of life were identified in multivariate analysis: age, female sex, BMI, sleep apnoea, and duration of mechanical ventilation. Of the patients who worked full-time before COVID-19, 11% had not returned to work. CONCLUSIONS Most patients experienced symptoms six months after hospital discharge. Women reported more symptoms and a lower quality of life than men. These findings highlight the differences in recovery between men and women and call for active rehabilitation of COVID-19 patients.
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Affiliation(s)
- Anna Lindahl
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Finnish Lung Health Association, Helsinki, Finland
| | - Miia Aro
- Finnish Lung Health Association, Helsinki, Finland
| | - Jere Reijula
- Department of Pulmonology, Helsinki University Central Hospital, Helsinki, Finland
| | - Mika J Mäkelä
- Skin and Allergy Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jukka Ollgren
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mervi Puolanne
- The Organization for Respiratory Health in Finland, Helsinki, Finland
| | - Asko Järvinen
- Inflammation Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association, Helsinki, Finland.,Faculty of Medicine, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
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Shanbehzadeh S, Tavahomi M, Zanjari N, Ebrahimi-Takamjani I, Amiri-arimi S. Physical and mental health complications post-COVID-19: Scoping review. J Psychosom Res 2021; 147:110525. [PMID: 34051516 PMCID: PMC8133797 DOI: 10.1016/j.jpsychores.2021.110525] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Several long-lasting health complications have been reported in previous coronavirus infections. Therefore, the aim of this study was to review studies that evaluated physical and mental health problems post-COVID-19. METHODS Articles for inclusion in this scoping review were identified by searching the PubMed, Scopus, Web of Science and Google Scholar databases for items dated from 1 January to 7 November 2020. Observational studies evaluating physical health (musculoskeletal symptoms, functional status) or mental health status with a follow-up period longer than 1 month after discharge or after the onset of symptoms were included. RESULTS This scoping review included 34 studies with follow-up periods of up to 3 months post-COVID-19. The most commonly reported physical health problems were fatigue (range 28% to 87%), pain (myalgia 4.5% to 36%), arthralgia (6.0% to 27%), reduced physical capacity (six-minute walking test range 180 to 561 m), and declines in physical role functioning, usual care and daily activities (reduced in 15% to 54% of patients). Common mental health problems were anxiety (range 6.5% to 63%), depression (4% to 31%) and post-traumatic stress disorder (12.1% to 46.9%). Greater fatigue, pain, anxiety and depression were reported in female patients and individuals admitted to intensive care. An overall lower quality of life was seen up to 3 months post-COVID-19. CONCLUSIONS This review highlights the presence of several physical and mental health problems up to 3 months post-COVID-19. The findings point to the need for comprehensive evaluation and rehabilitation post-COVID-19 to promote quality of life.
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Affiliation(s)
- Sanaz Shanbehzadeh
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Tavahomi
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasibeh Zanjari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ismail Ebrahimi-Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Amiri-arimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Bouza E, Cantón Moreno R, De Lucas Ramos P, García-Botella A, García-Lledó A, Gómez-Pavón J, González Del Castillo J, Hernández-Sampelayo T, Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Ruiz-Galiana J, De Pablo Brühlmann S, Porta Etessam J, Santos Sebastián M. [Post-COVID syndrome: A reflection and opinion paper]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2021; 34:269-279. [PMID: 33878844 PMCID: PMC8329562 DOI: 10.37201/req/023.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 11/10/2022]
Abstract
A high proportion of people who have suffered from COVID-19 report, after recovery from the acute phase of the disease, clinical manifestations, both subjective and objective, that continue beyond 3 weeks or even 3 months after the original clinical disease. There is still no agreed nomenclature to refer to this condition, but perhaps the most commonly used is post-COVID syndrome. The Scientific Committee on COVID of the Madrid College of Physicians (ICOMEM) has discussed this problem with a multidisciplinary approach in which internists, infectious disease specialists, psychiatrists, pneumologists, surgeons, geriatricians, pediatricians, microbiologists, family physicians and other specialists have participated, trying to gather the existing information and discussing it in the group. The clinical manifestations are very variable and range from simple fatigue to persistent fibrosing lung lesions with objective alterations of pulmonary function. Post-COVID syndrome seems to be particularly frequent and severe in adults who have required admission to Intensive Care Units and has a peculiar behavior in a very small group of children. The post-COVID syndrome, which undoubtedly exists, is at first sight not clearly distinguishable from clinical manifestations that which occur after other acute viral diseases and after prolonged stays in ICUs due to other diseases. Therefore, it offers excellent research opportunities to clarify its pathogenesis and possibly that of other related entities. It is possible that progressively there will be an increased demand for care among the millions of people who have suffered and overcome acute COVID for which the health authorities should design mechanisms for the agile management of care that will possibly require well-coordinated multidisciplinary groups. This paper, structured in questions on different aspects of the post-COVID syndrome, attempts to stage the current state of this problem.
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Affiliation(s)
- E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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Logette E, Lorin C, Favreau C, Oshurko E, Coggan JS, Casalegno F, Sy MF, Monney C, Bertschy M, Delattre E, Fonta PA, Krepl J, Schmidt S, Keller D, Kerrien S, Scantamburlo E, Kaufmann AK, Markram H. A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19. Front Public Health 2021; 9:695139. [PMID: 34395368 PMCID: PMC8356061 DOI: 10.3389/fpubh.2021.695139] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 started spreading toward the end of 2019 causing COVID-19, a disease that reached pandemic proportions among the human population within months. The reasons for the spectrum of differences in the severity of the disease across the population, and in particular why the disease affects more severely the aging population and those with specific preconditions are unclear. We developed machine learning models to mine 240,000 scientific articles openly accessible in the CORD-19 database, and constructed knowledge graphs to synthesize the extracted information and navigate the collective knowledge in an attempt to search for a potential common underlying reason for disease severity. The machine-driven framework we developed repeatedly pointed to elevated blood glucose as a key facilitator in the progression of COVID-19. Indeed, when we systematically retraced the steps of the SARS-CoV-2 infection, we found evidence linking elevated glucose to each major step of the life-cycle of the virus, progression of the disease, and presentation of symptoms. Specifically, elevations of glucose provide ideal conditions for the virus to evade and weaken the first level of the immune defense system in the lungs, gain access to deep alveolar cells, bind to the ACE2 receptor and enter the pulmonary cells, accelerate replication of the virus within cells increasing cell death and inducing an pulmonary inflammatory response, which overwhelms an already weakened innate immune system to trigger an avalanche of systemic infections, inflammation and cell damage, a cytokine storm and thrombotic events. We tested the feasibility of the hypothesis by manually reviewing the literature referenced by the machine-generated synthesis, reconstructing atomistically the virus at the surface of the pulmonary airways, and performing quantitative computational modeling of the effects of glucose levels on the infection process. We conclude that elevation in glucose levels can facilitate the progression of the disease through multiple mechanisms and can explain much of the differences in disease severity seen across the population. The study provides diagnostic considerations, new areas of research and potential treatments, and cautions on treatment strategies and critical care conditions that induce elevations in blood glucose levels.
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Affiliation(s)
- Emmanuelle Logette
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Henry Markram
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
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