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Núñez I, Gillard J, Fragoso-Saavedra S, Feyaerts D, Islas-Weinstein L, Gallegos-Guzmán AA, Valente-García U, Meyerowitz J, Kelly JD, Chen H, Ganio E, Benkendorff A, Flores-Gouyonnet J, Dammann-Beltrán P, Heredia-González JF, Rangel-Gutiérrez GA, Blish CA, Nadeau KC, Nolan G, Crispín JC, McIlwain DR, Gaudillière B, Valdés-Ferrer SI. Longitudinal clinical phenotyping of post COVID condition in Mexican adults recovering from severe COVID-19: a prospective cohort study. Front Med (Lausanne) 2023; 10:1236702. [PMID: 37727759 PMCID: PMC10505811 DOI: 10.3389/fmed.2023.1236702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/08/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction Few studies have evaluated the presence of Post COVID-19 conditions (PCC) in people from Latin America, a region that has been heavily afflicted by the COVID-19 pandemic. In this study, we describe the frequency, co-occurrence, predictors, and duration of 23 symptoms in a cohort of Mexican patients with PCC. Methods We prospectively enrolled and followed adult patients hospitalized for severe COVID-19 at a tertiary care centre in Mexico City. The incidence of PCC symptoms was determined using questionnaires. Unsupervised clustering of PCC symptom co-occurrence and Kaplan-Meier analyses of symptom persistence were performed. The effect of baseline clinical characteristics was evaluated using Cox regression models and reported with hazard ratios (HR). Results We found that amongst 192 patients with PCC, respiratory problems were the most prevalent and commonly co-occurred with functional activity impairment. 56% had ≥5 persistent symptoms. Symptom persistence probability at 360 days 0.78. Prior SARS-CoV-2 vaccination and infection during the Delta variant wave were associated with a shorter duration of PCC. Male sex was associated with a shorter duration of functional activity impairment and respiratory symptoms. Hypertension and diabetes were associated with a longer duration of functional impairment. Previous vaccination accelerated PCC recovery. Discussion In our cohort, PCC symptoms were frequent (particularly respiratory and neurocognitive ones) and persistent. Importantly, prior SARS-CoV-2 vaccination resulted in a shorter duration of PCC.
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Affiliation(s)
- Isaac Núñez
- Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Division of Postrgraduate Studies, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Joshua Gillard
- Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
- Center for Molecular and Biomolecular Informatics, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Sergio Fragoso-Saavedra
- Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Division of Postrgraduate Studies, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Combined Study Plan in Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Dorien Feyaerts
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - León Islas-Weinstein
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Angel A. Gallegos-Guzmán
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Uriel Valente-García
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Justin Meyerowitz
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States
- Institute for Global Health Sciences, UCSF, San Francisco, CA, United States
- F.IProctor Foundation, UCSF, San Francisco, CA, United States
| | - Han Chen
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
| | - Edward Ganio
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Alexander Benkendorff
- Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jaime Flores-Gouyonnet
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Pedro Dammann-Beltrán
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Gabriela A. Rangel-Gutiérrez
- Combined Study Plan in Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Catherine A. Blish
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Chan Zuckerberg Biohub, San Francisco, CA, United States
- Division of Infectious Diseases, Stanford University, Stanford, CA, United States
| | - Kari C. Nadeau
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, United States
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, Stanford, CA, United States
- Institute for Immunity, Transplantation, and Infectious Diseases, Stanford University, Stanford, CA, United States
| | - Garry Nolan
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Jose C. Crispín
- School of Medicine and Health Sciencies, Tecnologico de Monterrey, Mexico City, Mexico
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - David R. McIlwain
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
| | - Brice Gaudillière
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Sergio I. Valdés-Ferrer
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Center for Biomedical Science, Feinstein Institutes for Medical Research, New York, NY, United States
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McCarthy MW. Intravenous immunoglobulin as a potential treatment for long COVID. Expert Opin Biol Ther 2023; 23:1211-1217. [PMID: 38100573 DOI: 10.1080/14712598.2023.2296569] [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: 10/21/2023] [Accepted: 12/14/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION On 31 July 2023, the United States Department of Health and Human Services announced the formation of the Office of Long COVID Research and Practice and the United States National Institutes of Health (NIH) opened enrollment for the therapeutic arm of the RECOVER initiative, a prospective, randomized study to evaluate new treatment options for long coronavirus disease 2019 (long COVID). AREAS COVERED One of the first drugs to be studied in this nationwide initiative is intravenous immunoglobulin (IVIG), which will be a treatment option for subjects enrolled in RECOVER-AUTO, a randomized trial to investigate therapeutic strategies for autonomic dysfunction related to long COVID. EXPERT OPINION IVIG is a mixture of human antibodies (human immunoglobulin) that has been widely used to treat a variety of diseases, including immune thrombocytopenia purpura, Kawasaki disease, chronic inflammatory demyelinating polyneuropathy, and certain infections such as influenza, human immunodeficiency virus, and measles. However, the role of IVIG in the treatment of post-COVID-19 conditions is uncertain. This manuscript examines what is known about IVIG in the treatment of long COVID and explores how this therapeutic agent may be used in the future to address this condition.
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Carpio-Orantes LD, Aguilar-Silva A, García-Méndez S, Sánchez-Diaz JS, Rodríguez-Contreras Y, Lara-Hernández E, Fernández-Márquez D. Neuropsychiatric manifestations in patients with long COVID in Mexico. Brain Circ 2023; 9:196-197. [PMID: 38020953 PMCID: PMC10679627 DOI: 10.4103/bc.bc_13_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/30/2023] [Accepted: 07/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Luis Del Carpio-Orantes
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
| | - Andrés Aguilar-Silva
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
| | - Sergio García-Méndez
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
| | - Jesús Salvador Sánchez-Diaz
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
| | - Yamir Rodríguez-Contreras
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
| | - Estefanía Lara-Hernández
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
| | - Daniela Fernández-Márquez
- Department of Internal Medicine, Study Group for the Diagnosis and Treatment of COVID-19 in Veracruz, Mexico
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