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Annesley SJ, Missailidis D, Heng B, Josev EK, Armstrong CW. Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies. Trends Mol Med 2024; 30:443-458. [PMID: 38443223 DOI: 10.1016/j.molmed.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic illness often triggered by an initiating acute event, mainly viral infections. The transition from acute to chronic disease remains unknown, but interest in this phenomenon has escalated since the COVID-19 pandemic and the post-COVID-19 illness, termed 'long COVID' (LC). Both ME/CFS and LC share many clinical similarities. Here, we present recent findings in ME/CFS research focussing on proposed disease pathologies shared with LC. Understanding these disease pathologies and how they influence each other is key to developing effective therapeutics and diagnostic tests. Given that ME/CFS typically has a longer disease duration compared with LC, with symptoms and pathologies evolving over time, ME/CFS may provide insights into the future progression of LC.
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Affiliation(s)
- Sarah J Annesley
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, VIC, Australia.
| | - Daniel Missailidis
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, VIC, Australia
| | - Benjamin Heng
- Macquarie Medical School, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Elisha K Josev
- Neurodisability & Rehabilitation, Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia; Mercy Hospital for Women, Heidelberg, VIC, Australia
| | - Christopher W Armstrong
- Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, VIC, Australia
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Patil T, Raguindin JJ, Radtke M, Smigiel J, Savona N, Kavuru B, Sekhri A. Evaluating the Association of Montelukast Use on Neuropsychiatry-Related Healthcare Utilization and Depression in COVID-19-Hospitalized Veterans: A Nationwide VA Observational Cohort Study. Clin Drug Investig 2023; 43:605-619. [PMID: 37498493 DOI: 10.1007/s40261-023-01292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Montelukast's new boxed warning for neuropsychiatric events questions its use in the setting of coronavirus disease 2019 (COVID-19) due to increased risk for new-onset psychiatric diagnoses. OBJECTIVE We aim to evaluate the impact of using montelukast in patients hospitalized with COVID-19 on neuropsychiatry-related healthcare utilization and depression. METHODS This retrospective nationwide observational cohort study using the Veterans Health Administration database included patients from January 1, 2020, through July 1, 2021. The treatment cohorts consisted of patients with and without montelukast use prior to COVID-19 hospitalization and matched using propensity score (PS) to two control cohorts: patients with COVID-19-related hospitalization without prior montelukast use and patients with prior montelukast use who were hospitalized for reasons other than COVID-19. The primary outcome of psychiatric hospitalizations at 90 days and 180 days and mental health visits at 180 days were compared using Poisson or negative binomial regression. Secondary outcomes of new-onset depression and new use of antidepressants were analyzed using multivariable logistic regression. RESULTS After PS matching, a total of 415 patients were included in COVID-19 with and without montelukast matched cohort and 409 patients in montelukast with and without COVID-19-related hospitalization matched cohorts. For the primary outcomes, inpatient psychiatric hospitalization at 90 days [incidence rate ratio (IRR) 95% CI 1.79 (1.36-2.36)] and 180 days [IRR 95% CI 1.79 (1.32-2.25)] and mental health visits at 180 days [IRR 95% CI 1.72 (1.45-2.03)] were significantly higher in the montelukast with COVID-19 hospitalization group compared with those hospitalized without COVID-19. No difference in primary outcomes were noted in patients hospitalized with COVID-19 with and without use of montelukast. No significant difference was found in the secondary outcomes between either comparator group. CONCLUSIONS Patients with prior montelukast use who were hospitalized with COVID-19 appeared to have increased rate of neuropsychiatry-related healthcare utilization.
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Affiliation(s)
- Tanvi Patil
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA.
| | - Jasper Jade Raguindin
- Central Western Massachusetts Veterans Affair Health Care System, 421 N Main St, Leeds, MA, 01053, USA
| | - Michelle Radtke
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Joseph Smigiel
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Natalie Savona
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Bush Kavuru
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Anuradha Sekhri
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
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Karosanidze I, Kiladze U, Kirtadze N, Giorgadze M, Amashukeli N, Parulava N, Iluridze N, Kikabidze N, Gudavadze N, Gelashvili L, Koberidze V, Gigashvili E, Jajanidze N, Latsabidze N, Mamageishvili N, Shengelia R, Hovhannisyan A, Panossian A. Efficacy of Adaptogens in Patients with Long COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial. Pharmaceuticals (Basel) 2022; 15:ph15030345. [PMID: 35337143 PMCID: PMC8953947 DOI: 10.3390/ph15030345] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/01/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
Currently, no effective treatment of comorbid complications or COVID-19 long-haulers during convalescence is known. This randomized, quadruple-blind, placebo-controlled trial aimed to assess the efficacy of adaptogens on the recovery of patients with Long COVID symptoms. One hundred patients with confirmed positive SARS-CoV-2 test, discharged from COVID Hotel isolation, Intensive Care Unit (ICU), or Online Clinics, and who experienced at least three of nine Long COVID symptoms (fatigue, headache, respiratory insufficiency, cognitive performance, mood disorders, loss of smell, taste, and hair, sweatiness, cough, pain in joints, muscles, and chest) in the 30 days before randomization were included in the study of the efficacy of Chisan®/ADAPT-232 (a fixed combination of adaptogens Rhodiola, Eleutherococcus, and Schisandra) supplementation for two weeks. Chisan® decreased the duration of fatigue and pain for one and two days, respectively, in 50% of patients. The number of patients with lack of fatigue and pain symptoms was significantly less in the Chisan® treatment group than in the placebo group on Days 9 (39% vs. 57%, pain relief, p = 0.0019) and 11 (28% vs. 43%, relief of fatigue, * p = 0.0157). Significant relief of severity of all Long COVID symptoms over the time of treatment and the follow-up period was observed in both groups of patients, notably decreasing the level of anxiety and depression from mild and moderate to normal, as well as increasing cognitive performance in patients in the d2 test for attention and increasing their physical activity and workout (daily walk time). However, the significant difference between placebo and Chisan® treatment was observed only with a workout (daily walk time) and relieving respiratory insufficiency (cough). A clinical assessment of blood markers of the inflammatory response (C-reactive protein) and blood coagulation (D-dimer) did not reveal any significant difference over time between treatment groups except significantly lower IL-6 in the Chisan® treatment group. Furthermore, a significant difference between the placebo and Chisan® treatment was observed for creatinine: Chisan® significantly decreased blood creatinine compared to the placebo, suggesting prevention of renal failure progression in Long COVID. In this study, we, for the first time, demonstrate that adaptogens can increase physical performance in Long COVID and reduce the duration of fatigue and chronic pain. It also suggests that Chisan®/ADAPT-232 might be useful for preventing the progression of renal failure associated with increasing creatinine.
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Affiliation(s)
- Irina Karosanidze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Ushangi Kiladze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Nino Kirtadze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Mikhail Giorgadze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Nana Amashukeli
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Nino Parulava
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Neli Iluridze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Nana Kikabidze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Nana Gudavadze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Lali Gelashvili
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Vazha Koberidze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Eka Gigashvili
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Natela Jajanidze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Naira Latsabidze
- National Family Medicine Training Centre, 57 M. Tsinamdzghvrishvili Str., Tbilisi 0102, Georgia; (I.K.); (U.K.); (N.K.); (M.G.); (N.A.); (N.P.); (N.I.); (N.K.); (N.G.); (L.G.); (V.K.); (E.G.); (N.J.); (N.L.)
| | - Nato Mamageishvili
- Department for History of Medicine and Bioethics, Faculty of Medicine, Tbilisi State Medical University, Vazha-Pshavela Ave. 33, Tbilisi 0162, Georgia; (N.M.); (R.S.)
| | - Ramaz Shengelia
- Department for History of Medicine and Bioethics, Faculty of Medicine, Tbilisi State Medical University, Vazha-Pshavela Ave. 33, Tbilisi 0162, Georgia; (N.M.); (R.S.)
| | - Areg Hovhannisyan
- Institute of Fine Organic Chemistry, National Academy of Science, Azatutian ave. 26, Yerevan 375014, Armenia;
| | - Alexander Panossian
- Phytomed AB, Bofinksvagen 1, 31275 Våxtorp, Sweden
- Correspondence: ; Tel.: +46-733306226
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Mera-Cordero F, Bonet-Monne S, Almeda-Ortega J, García-Sangenís A, Cunillera-Puèrtolas O, Contreras-Martos S, Alvarez-Muñoz G, Monfà R, Balanzó-Joué M, Morros R, Salvador-Gonzalez B. Correction to: Double-blind placebo-controlled randomized clinical trial to assess the efficacy of montelukast in mild to moderate respiratory symptoms of patients with long COVID: E-SPERANZA COVID Project study protocol. Trials 2022; 23:130. [PMID: 35139906 PMCID: PMC8827194 DOI: 10.1186/s13063-022-06073-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Francisco Mera-Cordero
- Primary Care EAP El Pla Sant Feliu de Llobregat, Primary Care Management Costa de Ponent, Catalan Institute of Health, L'Hospitalet de Llobregat, Spain. .,Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.
| | - Sara Bonet-Monne
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Pharmacy Unit SAP Baix Llobregat Centre, Primary Care Management Costa Ponent. Catalan Institute of Health, Cornellà de Llobregat, Spain
| | - Jesús Almeda-Ortega
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Primary Care Research Support Unit (USR) Costa de Ponent, Primary Care Management Costa de Ponent, Catalan Institute of Health, Cornellà de Llobregat, Spain
| | - Ana García-Sangenís
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Clinical Trials Research Unit (UICEC) IDIAPJGol, Platform SCReN, Barcelona, Spain
| | - Oriol Cunillera-Puèrtolas
- Primary Care Research Support Unit (USR) Costa Ponent, Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIAPJGol), Cornellà de Llobregat, Spain
| | - Sara Contreras-Martos
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Primary Care Research Support Unit (USR) Costa de Ponent, Primary Care Management Costa de Ponent, Catalan Institute of Health, Cornellà de Llobregat, Spain
| | - Gemma Alvarez-Muñoz
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Primary Care Covid Notification and Monitoring Unit UNSC Metropolitana SUD, Primary Care Management Costa de Ponent, Catalan Institute of Health, L'Hospitalet de Llobregat, Spain
| | - Ramon Monfà
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Clinical Trials Research Unit (UICEC) IDIAPJGol, Platform SCReN, Barcelona, Spain
| | - Marina Balanzó-Joué
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Pharmacy Unit SAP Baix Llobregat Centre, Primary Care Management Costa Ponent. Catalan Institute of Health, Cornellà de Llobregat, Spain
| | - Rosa Morros
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain.,Clinical Trials Research Unit (UICEC) IDIAPJGol, Platform SCReN, Barcelona, Spain.,Department of Pharmacology and Therapeutics, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Betlem Salvador-Gonzalez
- Institut Universitari de Recerca en Atenció Primària Jordi Gol i Gurina (IDIA PJGol), Barcelona, Spain
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