Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments.
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TLDR
In this paper, a review of the literature on long COVID-19 syndrome is presented, which is driven by long-term tissue damage (e.g. lung, brain, and heart) and pathological inflammation (i.e. from viral persistence, immune dysregulation, and autoimmunity).Abstract:
Long COVID or post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific and medical communities. This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity, even younger adults, children, and those not hospitalized. While the precise definition of long COVID may be lacking, the most common symptoms reported in many studies are fatigue and dyspnoea that last for months after acute COVID-19. Other persistent symptoms may include cognitive and mental impairments, chest and joint pains, palpitations, myalgia, smell and taste dysfunctions, cough, headache, and gastrointestinal and cardiac issues. Presently, there is limited literature discussing the possible pathophysiology, risk factors, and treatments in long COVID, which the current review aims to address. In brief, long COVID may be driven by long-term tissue damage (e.g. lung, brain, and heart) and pathological inflammation (e.g. from viral persistence, immune dysregulation, and autoimmunity). The associated risk factors may include female sex, more than five early symptoms, early dyspnoea, prior psychiatric disorders, and specific biomarkers (e.g. D-dimer, CRP, and lymphocyte count), although more research is required to substantiate such risk factors. While preliminary evidence suggests that personalized rehabilitation training may help certain long COVID cases, therapeutic drugs repurposed from other similar conditions, such as myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, and mast cell activation syndrome, also hold potential. In sum, this review hopes to provide the current understanding of what is known about long COVID.read more
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Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis
TL;DR: In this paper , a meta-analysis of proportions was conducted to pool Freeman-Tukey double arcsine transformed proportions using the random-effects restricted maximum-likelihood model to quantify the proportion of individuals experiencing fatigue and cognitive impairment 12 or more weeks following COVID-19 diagnosis.
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The Lancet Commission on lessons for the future from the COVID-19 pandemic
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Persistent COVID-19 symptoms in a community study of 606,434 people in England
Matthew Whitaker,Joshua Elliott,Marc Chadeau-Hyam,Steven Riley,Ara Darzi,Graham S Cooke,Helen Marie Ward,Paul Elliott +7 more
TL;DR: In this article , the authors used data from rounds 3-5 of the REACT-2 study (n = 508,707; September 2020- February 2021) to estimate the prevalence and identify predictors of persistent symptoms lasting 12 weeks or more; and unsupervised learning to cluster individuals by reported symptoms.
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Pathophysiology and mechanism of long COVID: a comprehensive review
Diego Castanares-Zapatero,Patrice Chalon,L. Winfield Kohn,Marie Dauvrin,Jens Detollenaere,Charline Maertens de Noordhout,C. Primus-de Jong,Irina Cleemput,K. Van den Heede +8 more
TL;DR: A comprehensive review of the putative pathophysiology underlying the persisting symptoms of long COVID found that organ damage from the acute infection phase likely accounts for symptoms, and specific long-lasting inflammatory mechanisms have been proposed, as well.
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Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study
TL;DR: In this article , the authors analyse the nature, prevalence, and severity of long-term symptoms related to COVID-19, while correcting for symptoms present before SARS-CoV-2 infection and controlling for the symptom dynamics in the population without infection.
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