@article {pmid38711990,
year = {2024},
author = {Zifko, U and Guendling, K and Seet, R and Kasper, S},
title = {Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care.},
journal = {Frontiers in pharmacology},
volume = {15},
number = {},
pages = {1338235},
pmid = {38711990},
issn = {1663-9812},
abstract = {Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking. Methods: A systematic literature search evaluating the diagnosis and treatment of cognitive impairment associated with PCS was conducted. Practical recommendations for the management of PCS-associated cognitive impairment in primary care are summarized, based on an evaluation of pharmacological plausibility and clinical applications. Results: Currently, the pathology of cognitive impairment associated with PCS remains unclear with no high-quality data to support targeted interventions. Existing treatment approaches are directed towards symptom relief where counseling on the chronicity of the disease and regular reassessments at 4- to 8-week intervals is considered reasonable. Patients should be informed and encouraged to adopt a healthy lifestyle that centers around balanced nutrition and appropriate physical activities. They may also benefit from the intake of vitamins, micronutrients, and probiotics. The administration of Ginkgo biloba extract could offer a safe and potentially beneficial treatment option. Other non-pharmacological measures include physiotherapy, digitally supported cognitive training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, or when new symptoms occur, specialized diagnostic measures such as comprehensive neurocognitive testing or neuroimaging should be initiated. Very few patients would require inpatient rehabilitation. Conclusion: PCS with cognitive impairment is a debilitating condition that could affect daily functioning and reduce work productivity. Management in primary care should adopt a multidisciplinary approach, centering around physical, cognitive, and pharmacological therapies.},
}

@article {pmid38710760,
year = {2024},
author = {Gietl, M and Burkert, F and Hofer, S and Gostner, JM and Sonnweber, T and Tancevski, I and Pizzini, A and Sahanic, S and Schroll, A and Brigo, N and Egger, A and Bellmann-Weiler, R and Löffler-Ragg, J and Weiss, G and Kurz, K},
title = {Laboratory parameters related to disease severity and physical performance after reconvalescence of acute COVID-19 infection.},
journal = {Scientific reports},
volume = {14},
number = {1},
pages = {10388},
pmid = {38710760},
issn = {2045-2322},
support = {GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; GZ 75759//TYROLEAN REGIONAL GOVERNMENT/ ; },
mesh = {Humans ; *COVID-19/blood/complications/diagnosis ; Female ; Male ; Middle Aged ; *Severity of Illness Index ; *Biomarkers/blood ; *SARS-CoV-2/isolation & purification ; Aged ; Adult ; Physical Functional Performance ; Interleukin-6/blood ; C-Reactive Protein/metabolism/analysis ; Inflammation ; Tryptophan/blood/metabolism ; Neopterin/blood ; Phenylalanine/blood/metabolism ; Amino Acids/blood ; },
abstract = {Research into the molecular basis of disease trajectory and Long-COVID is important to get insights toward underlying pathophysiological processes. The objective of this study was to investigate inflammation-mediated changes of metabolism in patients with acute COVID-19 infection and throughout a one-year follow up period. The study enrolled 34 patients with moderate to severe COVID-19 infection admitted to the University Clinic of Innsbruck in early 2020. The dynamics of multiple laboratory parameters (including inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), neopterin] as well as amino acids [tryptophan (Trp), phenylalanine (Phe) and tyrosine (Tyr)], and parameters of iron and vitamin B metabolism) was related to disease severity and patients' physical performance. Also, symptom load during acute illness and at approximately 60 days (FU1), and one year after symptom onset (FU2) were monitored and related with changes of the investigated laboratory parameters: During acute infection many investigated laboratory parameters were elevated (e.g., inflammatory markers, ferritin, kynurenine, phenylalanine) and enhanced tryptophan catabolism and phenylalanine accumulation were found. At FU2 nearly all laboratory markers had declined back to reference ranges. However, kynurenine/tryptophan ratio (Kyn/Trp) and the phenylalanine/tyrosine ratio (Phe/Tyr) were still exceeding the 95th percentile of healthy controls in about two thirds of our cohort at FU2. Lower tryptophan concentrations were associated with B vitamin availability (during acute infection and at FU1), patients with lower vitamin B12 levels at FU1 had a prolonged and more severe impairment of their physical functioning ability. Patients who had fully recovered (ECOG 0) presented with higher concentrations of iron parameters (ferritin, hepcidin, transferrin) and amino acids (phenylalanine, tyrosine) at FU2 compared to patients with restricted ability to work. Persistent symptoms at FU2 were tendentially associated with IFN-γ related parameters. Women were affected by long-term symptoms more frequently. Conclusively, inflammation-mediated biochemical changes appear to be related to symptoms of patients with acute and Long Covid.},
}

Humans
*COVID-19/blood/complications/diagnosis
Female
Male
Middle Aged
*Severity of Illness Index
*Biomarkers/blood
*SARS-CoV-2/isolation & purification
Aged
Adult
Physical Functional Performance
Interleukin-6/blood
C-Reactive Protein/metabolism/analysis
Inflammation
Tryptophan/blood/metabolism
Neopterin/blood
Phenylalanine/blood/metabolism
Amino Acids/blood

@article {pmid38710681,
year = {2024},
author = {Naidu, AS and Wang, CK and Rao, P and Mancini, F and Clemens, RA and Wirakartakusumah, A and Chiu, HF and Yen, CH and Porretta, S and Mathai, I and Naidu, SAG},
title = {Author Correction: Precision nutrition to reset virus-induced human metabolic reprogramming and dysregulation (HMRD) in long-COVID.},
journal = {NPJ science of food},
volume = {8},
number = {1},
pages = {26},
doi = {10.1038/s41538-024-00267-w},
pmid = {38710681},
issn = {2396-8370},
}

@article {pmid38708693,
year = {2024},
author = {Sadat Larijani, M and Bavand, A and Banifazl, M and Ashrafian, F and Moradi, L and Ramezani, A},
title = {Determination of COVID-19 Late Disorders as Possible Long-COVID and/or Vaccination Consequences.},
journal = {Journal of primary care & community health},
volume = {15},
number = {},
pages = {21501319241251941},
doi = {10.1177/21501319241251941},
pmid = {38708693},
issn = {2150-1327},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Female ; Adult ; *COVID-19 Vaccines/adverse effects/administration & dosage ; Male ; Middle Aged ; Iran/epidemiology ; SARS-CoV-2 ; Vaccination/adverse effects/statistics & numerical data ; Immunization, Secondary ; },
abstract = {In this era in which the vast majority of the global population have developed COVID-19 infection and/or got vaccinated against it, identification of the late disorders as the vaccines' side effect or long-COVID manifestation seems essential. This study included the vaccinated individuals of 4 different vaccine regimens including inactivated virus-based, subunit protein, and adenovirus-based vaccines in a follow-up schedule 6-month post the booster shot. All the documented vaccine adverse events were thoroughly assessed considering the cases' medical history by Adverse Events Committee of Pasteur Institute of Iran. Totally 329 individuals who got 3 doses of vaccination were followed 6 months after the booster shots among whom 41 (12.4%) cases with the mean age of 40.9 ± 10.48 years had a type of disorder. Gynecological and osteoarticular involvements were the most common recorded disorders of which 73.1% were possibly linked to vaccination outcomes and the rest were affected by both long-COVID-19 and vaccination. Notably, the average time of symptoms persistence was 155 ± 10.4 days. This study has the advantage of long-term follow-up which presents various forms of late events in each episode of COVID-19 infection and vaccination. About 26.8% of people with persistent complications suffered from both long-COVOD/ vaccination in whom the differentiation between the vaccine side effect and long-COVID manifestation was quite challenging. Long-term follow-up studies in large population seems essential to outline the role of long-COVID and vaccination regarding persistent complications.},
}

Humans
*COVID-19/prevention & control/epidemiology
Female
Adult
*COVID-19 Vaccines/adverse effects/administration & dosage
Male
Middle Aged
Iran/epidemiology
SARS-CoV-2
Vaccination/adverse effects/statistics & numerical data
Immunization, Secondary

@article {pmid38708532,
year = {2024},
author = {Rinnenburger, D},
title = {[Breathless, without strength, forgetful: Long Covid, the pandemic within the pandemic.].},
journal = {Recenti progressi in medicina},
volume = {115},
number = {5},
pages = {215-217},
doi = {10.1701/4262.42400},
pmid = {38708532},
issn = {2038-1840},
mesh = {Humans ; *COVID-19/epidemiology ; *Post-Acute COVID-19 Syndrome ; Pandemics ; Memory Disorders/etiology/epidemiology ; },
abstract = {Following the Covid-19 pandemic, a new disease has emerged: Long Covid syndrome, about which we know little and on which too little research is being done. It is a chronic disease, which is diagnosed when Covid symptoms last more than 12 weeks. To date, there is no pharmacological or other approach to Long Covid. The main symptoms of Long Covid are pain similar to those of rheumatic and autoimmune diseases, headaches, concentration and memory disorders, sometimes also perceived as brain fog and fatigue. Research and education and sensible, bipartisan social policy, away from all ideologies, are needed to address this additional aspect of the SARS-CoV-2 pandemic.},
}

Humans
*COVID-19/epidemiology
*Post-Acute COVID-19 Syndrome
Pandemics
Memory Disorders/etiology/epidemiology

@article {pmid38707697,
year = {2024},
author = {Yamamoto, K and Nakagawa, K and Otsuka, F},
title = {Idiopathic ventricular tachycardia detected after coronavirus disease 2019.},
journal = {Journal of general and family medicine},
volume = {25},
number = {3},
pages = {164-165},
pmid = {38707697},
issn = {2189-7948},
abstract = {We present a 23-year-old woman with depression and long COVID in whom a diagnosis of idiopathic ventricular tachycardia (VT) was made. Although the relationship between idiopathic VT and long COVID remains unknown, this is the first report of idiopathic VT detected in a patient with long COVID.},
}

@article {pmid38707018,
year = {2024},
author = {Shweikeh, F and Hong, G and Rabeeah, S and Shabir, U and Sofi, A},
title = {COVID-19 and Its Sequelae Masquerading as Gastrointestinal Ailments: A Report of Gastroesophageal Reflux Disease (GERD) and Review of Recent Cases.},
journal = {Cureus},
volume = {16},
number = {4},
pages = {e57617},
pmid = {38707018},
issn = {2168-8184},
abstract = {Coronavirus disease 2019 (COVID-19) predominantly causes respiratory symptoms. However, a rare segment of patients recovering from COVID-19 may develop gastrointestinal (GI) symptoms. We describe a case of a female who presented with symptoms suggestive of refractory gastroesophageal reflux disease (GERD) for 18 months following COVID-19 infection. Her symptoms included epigastric and chest pain, coughing, and vomiting. Upper endoscopy and 24-hour pH monitoring were negative. Following hospital admission due to worsening symptoms, she was diagnosed with chronic pulmonary embolism (PE) presumed to be related to COVID-19. Her reflux symptoms resolved within two days of the initiation of anticoagulation. Our findings suggest that chronic PE should be considered in patients presenting with GERD refractory to treatment following COVID-19 infection. Generally, as COVID-19 and its sequelae may masquerade as GI conditions, they should be on the differential diagnosis, especially in the post-pandemic era when routine testing has significantly declined.},
}

@article {pmid38704055,
year = {2024},
author = {Altmayer, S and Leung, AN and de Oliveira, GS and Prodigios, J and Patel, P and Mohammed, TL and Verma, N and Hochhegger, B},
title = {Chronic Chest CT Findings following COVID-19 pneumonia.},
journal = {Seminars in ultrasound, CT, and MR},
volume = {},
number = {},
pages = {},
doi = {10.1053/j.sult.2024.02.008},
pmid = {38704055},
issn = {1558-5034},
abstract = {Respiratory symptoms are a frequent manifestation of patients with post-acute sequela of SARS-CoV-2 (PASC), also known as long-COVID. Many cohorts of predominantly hospitalized patients have shown that a significant subset may have persistent chest CT findings for more than 12 months after the acute infection. Proper understanding of the evolving long-term imaging findings and terminology is crucial for accurate imaging interpretation and patient care. The goal of this article is to review the chronic chest CT findings of patients with PASC and common pitfalls.},
}

@article {pmid38700929,
year = {2024},
author = {Maripuri, M and Dey, A and Honerlaw, J and Hong, C and Ho, YL and Tanukonda, V and Chen, AW and Panickan, VA and Wang, X and Zhang, HG and Yang, D and Samayamuthu, MJ and Morris, M and Visweswaran, S and Beaulieu-Jones, B and Ramoni, R and Muralidhar, S and Gaziano, JM and Liao, K and Xia, Z and Brat, GA and Cai, T and Cho, K},
title = {Characterization of Post-COVID-19 Definitions and Clinical Coding Practices: Longitudinal Study.},
journal = {Online journal of public health informatics},
volume = {16},
number = {},
pages = {e53445},
doi = {10.2196/53445},
pmid = {38700929},
issn = {1947-2579},
abstract = {BACKGROUND: Post-COVID-19 condition (colloquially known as "long COVID-19") characterized as postacute sequelae of SARS-CoV-2 has no universal clinical case definition. Recent efforts have focused on understanding long COVID-19 symptoms, and electronic health record (EHR) data provide a unique resource for understanding this condition. The introduction of the International Classification of Diseases, Tenth Revision (ICD-10) code U09.9 for "Post COVID-19 condition, unspecified" to identify patients with long COVID-19 has provided a method of evaluating this condition in EHRs; however, the accuracy of this code is unclear.

OBJECTIVE: This study aimed to characterize the utility and accuracy of the U09.9 code across 3 health care systems-the Veterans Health Administration, the Beth Israel Deaconess Medical Center, and the University of Pittsburgh Medical Center-against patients identified with long COVID-19 via a chart review by operationalizing the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) definitions.

METHODS: Patients who were COVID-19 positive with either a U07.1 ICD-10 code or positive polymerase chain reaction test within these health care systems were identified for chart review. Among this cohort, we sampled patients based on two approaches: (1) with a U09.9 code and (2) without a U09.9 code but with a new onset long COVID-19-related ICD-10 code, which allows us to assess the sensitivity of the U09.9 code. To operationalize the long COVID-19 definition based on health agency guidelines, symptoms were grouped into a "core" cluster of 11 commonly reported symptoms among patients with long COVID-19 and an extended cluster that captured all other symptoms by disease domain. Patients having ≥2 symptoms persisting for ≥60 days that were new onset after their COVID-19 infection, with ≥1 symptom in the core cluster, were labeled as having long COVID-19 per chart review. The code's performance was compared across 3 health care systems and across different time periods of the pandemic.

RESULTS: Overall, 900 patient charts were reviewed across 3 health care systems. The prevalence of long COVID-19 among the cohort with the U09.9 ICD-10 code based on the operationalized WHO definition was between 23.2% and 62.4% across these health care systems. We also evaluated a less stringent version of the WHO definition and the CDC definition and observed an increase in the prevalence of long COVID-19 at all 3 health care systems.

CONCLUSIONS: This is one of the first studies to evaluate the U09.9 code against a clinical case definition for long COVID-19, as well as the first to apply this definition to EHR data using a chart review approach on a nationwide cohort across multiple health care systems. This chart review approach can be implemented at other EHR systems to further evaluate the utility and performance of the U09.9 code.},
}

@article {pmid38700879,
year = {2024},
author = {Cogliandro, V and Bonfanti, P},
title = {Long COVID: lights and shadows on the clinical characterization of this emerging pathology.},
journal = {The new microbiologica},
volume = {47},
number = {1},
pages = {15-27},
pmid = {38700879},
issn = {1121-7138},
mesh = {Humans ; *COVID-19/epidemiology/virology ; *SARS-CoV-2 ; *Post-Acute COVID-19 Syndrome ; Fatigue Syndrome, Chronic/virology ; Risk Factors ; Quality of Life ; Postural Orthostatic Tachycardia Syndrome/physiopathology ; },
abstract = {More than 800 million individuals have contracted SARSCOV2 infection worldwide. It was estimated that almost 10-20% of these might suffer from Long COVID. It is a multisystemic syndrome, which negatively affects the quality of life with a significant burden of health loss compared to COVID negative individuals. Moreover, the risk of sequelae still remains high at 2 years in both nonhospitalized and hospitalized individuals. This review summarizes studies regarding long COVID and clarifies the definitions, the risk factors and the management of this syndrome. Finally, it delves into the most frequent long-term outcomes, especially postural orthostatic tachycardia syndrome" (POTS), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), brain fog, and their therapeutical possibilities.},
}

Humans
*COVID-19/epidemiology/virology
*SARS-CoV-2
*Post-Acute COVID-19 Syndrome
Fatigue Syndrome, Chronic/virology
Risk Factors
Quality of Life
Postural Orthostatic Tachycardia Syndrome/physiopathology

@article {pmid38700658,
year = {2024},
author = {Degli Antoni, M and Maifredi, G and Storti, S and Tiecco, G and Di Gregorio, M and Rossi, B and Gasparotti, C and Focà, E and Castelli, F and Quiros-Roldan, E},
title = {Long-term symptoms after SARS-CoV-2 infection in a cohort of people living with HIV.},
journal = {Infection},
volume = {},
number = {},
pages = {},
pmid = {38700658},
issn = {1439-0973},
abstract = {BACKGROUND: Our Hospital in Northern Italy assists 3817 people living with HIV (PLWH) and has faced the impact of COVID-19. Little is known about the impact of HIV infection on the risk of post-COVID-19 conditions (PCCs) onset. We aim to assess the incidence of PCC in PLWH and the factors associated with its occurrence.

METHODS: We performed a retrospective, observational study including all PLWH > 18 years registered in the Brescia Health Protection Agency database, assessing SARS-CoV-2 burden, vaccination status, socio-demographic, and viro-immunological parameters from February 2020 until May 2022. Persistence of self-reported symptoms (clustered into gastrointestinal, respiratory, osteo-muscular, and neuro-behavioral symptoms) was evaluated after 3 months by a telephone-administered questionnaire. We estimated the associations between all variables and outcomes through univariate and multivariable logistic models.

RESULTS: In the study period, 653 PLWH were diagnosed with SARS-CoV-2 infection (17.1%). We observed 19 (2.9%) reinfections, 71 (10.9%) hospitalizations, and 3 (0.5%) deaths. We interviewed 510/653 PLWH (78%), and 178 (PCCs prevalence 34.9%; CI 95% 30.7-39.2) reported persistent symptoms. Asthenia/fatigue was the most reported symptom (60/178), followed by muscular pain (54/178). In the multivariate regression model, there was a lower risk of PCCs in males respect to females (adjusted OR = 0.64; CI 95% 0.99-3.66), while hospitalization during acute infection was associated with an increased the risk of PCCs (adjusted OR = 1.9; CI 95% 0.99-3.66). Notably, no viro-immunological variable modified the PCCs risk onset.

CONCLUSIONS: Our study highlights a substantial prevalence of PCCs among PLWH, three months post-SARS-CoV-2 infection, independent of viro-immunological features or vaccination status.},
}

@article {pmid37574270,
year = {2024},
author = {Abe, K and Sugiyama, A and Ito, N and Miwata, K and Kitahara, Y and Okimoto, M and Mirzaev, U and Kurisu, A and Akita, T and Ko, K and Takahashi, K and Kubo, T and Takafuta, T and Tanaka, J},
title = {Variant-specific Symptoms After COVID-19: A Hospital-based Study in Hiroshima.},
journal = {Journal of epidemiology},
volume = {34},
number = {5},
pages = {238-246},
pmid = {37574270},
issn = {1349-9092},
mesh = {Humans ; *COVID-19/epidemiology ; Male ; Female ; Middle Aged ; Aged ; Japan/epidemiology ; *SARS-CoV-2 ; Surveys and Questionnaires ; Adult ; Cluster Analysis ; Risk Factors ; },
abstract = {BACKGROUND: Symptoms after novel coronavirus disease 2019 (COVID-19) recovery by severe acute respiratory syndrome coronavirus 2 strains are unspecified.

METHODS: This self-administered questionnaire-based study was conducted to investigate symptoms after COVID-19 recovery at one of the main hospitals for COVID-19 treatment in Hiroshima, Japan, from September 2020 to March 2022 for patients who visited follow-up consultations after COVID-19. Study subjects were divided into four groups (Wild-type, Alpha, Delta, and Omicron periods) according to COVID-19 onset date. Hierarchical cluster analysis was performed to determine symptom clusters and investigate risk factors for each symptom cluster using multivariate analysis.

RESULTS: Among 385 patients who enrolled in this study, 249 patients had any persistent symptoms at a median of 23.5 (interquartile range, 20-31) days after COVID-19 onset. Among patients with any persistent symptoms, symptom clusters including olfactory or taste disorders, respiratory symptoms, and cardiac symptoms were found. Respiratory symptoms were more frequent among patients infected in the Omicron period compared to the Wild-type period (adjusted odds ratio [AOR] 3.13; 95% confidence interval [CI], 1.31-7.48). Compared to patients who recovered from mild COVID-19, patients who needed oxygen or ventilation support suffered fewer post-COVID-19 respiratory symptoms (AOR 0.46; 95% CI, 0.22-0.97) but more post-COVID-19 cardiac symptoms among them (AOR 2.67; 95% CI, 1.26-5.65). Olfactory or taste disorders were fewer among patients infected in the Omicron period compared to the Wild-type period (AOR 0.14; 95% CI, 0.04-0.46).

CONCLUSION: This study revealed that symptoms after COVID-19 may vary depending on the infected strain.},
}

Humans
*COVID-19/epidemiology
Male
Female
Middle Aged
Aged
Japan/epidemiology
*SARS-CoV-2
Surveys and Questionnaires
Adult
Cluster Analysis
Risk Factors

@article {pmid38700307,
year = {2023},
author = {Karuturi, S},
title = {Long COVID-19: A Systematic Review.},
journal = {The Journal of the Association of Physicians of India},
volume = {71},
number = {9},
pages = {82-94},
doi = {10.59556/japi.71.0337},
pmid = {38700307},
issn = {0004-5772},
mesh = {Humans ; *COVID-19/epidemiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {Coronavirus disease 2019's (COVID-19's) wide dissemination casts long-term health jeopardy for millions. Long COVID-19, a lingering multisystem malady, weaves a complex array of symptoms. Understanding its full impact requires extensive research over months or years. The pace of recovery remains uncertain, challenging healthcare systems. An evidence-based symphony of medical care and support is urgently needed for long haulers. Understanding long COVID's genesis and advocating for patients is vital. Our comprehension remains limited, prompting a systematic scoping study to explore the existing knowledge and pave the way for future research, illuminating the enigma of "long COVID" and guiding the path towards understanding this relentless condition. How to cite this article: Karuturi S. Long COVID-19: A Systematic Review. J Assoc Physicians India 2023;71(9):82-94.},
}

Humans
*COVID-19/epidemiology
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid38699316,
year = {2024},
author = {Azhir, A and Hügel, J and Tian, J and Cheng, J and Bassett, IV and Bell, DS and Bernstam, EV and Farhat, MR and Henderson, DW and Lau, ES and Morris, M and Semenov, YR and Triant, VA and Visweswaran, S and Strasser, ZH and Klann, JG and Murphy, SN and Estiri, H},
title = {Precision Phenotyping for Curating Research Cohorts of Patients with Post-Acute Sequelae of COVID-19 (PASC) as a Diagnosis of Exclusion.},
journal = {medRxiv : the preprint server for health sciences},
volume = {},
number = {},
pages = {},
doi = {10.1101/2024.04.13.24305771},
pmid = {38699316},
abstract = {Scalable identification of patients with the post-acute sequelae of COVID-19 (PASC) is challenging due to a lack of reproducible precision phenotyping algorithms and the suboptimal accuracy, demographic biases, and underestimation of the PASC diagnosis code (ICD-10 U09.9). In a retrospective case-control study, we developed a precision phenotyping algorithm for identifying research cohorts of PASC patients, defined as a diagnosis of exclusion. We used longitudinal electronic health records (EHR) data from over 295 thousand patients from 14 hospitals and 20 community health centers in Massachusetts. The algorithm employs an attention mechanism to exclude sequelae that prior conditions can explain. We performed independent chart reviews to tune and validate our precision phenotyping algorithm. Our PASC phenotyping algorithm improves precision and prevalence estimation and reduces bias in identifying Long COVID patients compared to the U09.9 diagnosis code. Our algorithm identified a PASC research cohort of over 24 thousand patients (compared to about 6 thousand when using the U09.9 diagnosis code), with a 79.9 percent precision (compared to 77.8 percent from the U09.9 diagnosis code). Our estimated prevalence of PASC was 22.8 percent, which is close to the national estimates for the region. We also provide an in-depth analysis outlining the clinical attributes, encompassing identified lingering effects by organ, comorbidity profiles, and temporal differences in the risk of PASC. The PASC phenotyping method presented in this study boasts superior precision, accurately gauges the prevalence of PASC without underestimating it, and exhibits less bias in pinpointing Long COVID patients. The PASC cohort derived from our algorithm will serve as a springboard for delving into Long COVID's genetic, metabolomic, and clinical intricacies, surmounting the constraints of recent PASC cohort studies, which were hampered by their limited size and available outcome data.},
}

@article {pmid38697866,
year = {2024},
author = {Korapatti, C and Vera, L and Miller, K},
title = {Biosound Therapy as a treatment for long COVID patients: A pre-post pilot study.},
journal = {Explore (New York, N.Y.)},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.explore.2024.04.004},
pmid = {38697866},
issn = {1878-7541},
abstract = {BACKGROUND: 43 % of people who are diagnosed with COVID-19 will experience persistent symptoms, also known as "long COVID," which lasts past the recovery of the acute infection. Long COVID symptoms overlap with symptoms that the Biosound Therapy System (BTS) has been shown to improve. The BTS is a multimodal treatment that includes biofeedback, vibroacoustic therapy synchronized with music that plays binaural beats, and video content. This study aimed to determine feasibility for a future full-scale Randomized Controlled Trial (RCT) and explore the impact of the BTS on long COVID symptoms.

METHODS: This pre-post pilot study was conducted in an outpatient mental health clinic. Adults aged 20-65 years old with persistent COVID-19 symptoms were screened and randomly assigned to the intervention or control group. The intervention group was given 8 Biosound Therapy sessions during a period of 4 weeks. All participants were assessed at baseline and at post-intervention using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), Cambridge Brain Sciences (CBS) tasks, and the COVID-19 Persistent Symptom Questionnaire. The feasibility outcomes were recruitment rates, retention rates, and open-ended questions about participants' experiences.

RESULTS: 15 participants enrolled in the study and 13 completed the study (9 intervention, 4 control). Trial recruitment ended prematurely due to the emergence of the Omicron variant of COVID-19. Participants responded to open-ended questions with only positive remarks and made no comments on the study not being feasible. A Wilcoxon signed-rank test indicated that compared to baseline, participants in the intervention group had significant improvement in their GAD-7 score, PHQ9 score, 2 Cambridge Brain Science tasks ("Odd" and "Double Trouble"), fatigue, and difficulties in concentrating or remembering (p < 0.05; 95 % CI).

CONCLUSION: The intervention group showed promising improvement without reported side effects. A full-scale RCT is feasible as long as the recruitment setting is changed to a location that allows access to more patients with long COVID. Results were limited due to the small sample size; therefore, a full-scale trial is needed.},
}

@article {pmid38697594,
year = {2024},
author = {Chao, TC and Chiang, SL and Lai, CY and Huang, CY and Lee, MS and Lin, CH and Chang, CC and Lin, CH},
title = {Association between Physical Activity Amount and Cardiorespiratory Fitness, Sleep Quality, and Health-related Quality of Life in Patients with Long COVID: A Cross-Sectional Study.},
journal = {Archives of physical medicine and rehabilitation},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.apmr.2024.04.010},
pmid = {38697594},
issn = {1532-821X},
abstract = {OBJECTIVE: To investigate the association between physical activity (PA) amount and gender differences on cardiorespiratory fitness (CRF), sleep quality, and health-related quality of life (HRQoL) in individuals with long COVID.

DESIGN: Cross-sectional study.

SETTING: An integrated outpatient clinic for post-COVID-19 at a medical center.

PARTICIPANTS: Convenience sample of patients (N=264) diagnosed with long COVID.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: PA amounts, sleep quality, and HRQoL were measured by the International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, and the World Health Organization Questionnaire on Quality of Life: Short Form, respectively. CRF was evaluated through graded exercise testing.

RESULTS: The participants had a mean age of 42.5±13.5 years and a mean duration of post-COVID-19 symptoms of 12.7±6.8 weeks. More than half (n=149, 56.5%) were female patients. Female participants had significantly lower CRF compared to male participants (P<.05). Older age and higher body mass index were associated with worse CRF and HRQoL (P<.05). Less sitting behavior and greater amounts of vigorous-intensity physical activity (VPA) or total PA were associated with better CRF (P<.05). In addition, greater total PA and moderate-intensity physical activity (MPA) were associated with better sleep quality and HRQoL (P<.05), respectively.

CONCLUSIONS: Gender differences were found in CRF among patients with long COVID. Greater self-reported VPA or total PA was associated with better CRF, while greater total PA and MPA were associated with better sleep quality and HRQoL, respectively, in patients with long COVID. Further research is needed to explore these associations in longitudinal studies.},
}

@article {pmid38696415,
year = {2024},
author = {Hua, MJ and Butera, G and Akinyemi, O and Porterfield, D},
title = {Biases and limitations in observational studies of Long COVID prevalence and risk factors: A rapid systematic umbrella review.},
journal = {PloS one},
volume = {19},
number = {5},
pages = {e0302408},
doi = {10.1371/journal.pone.0302408},
pmid = {38696415},
issn = {1932-6203},
mesh = {Humans ; *COVID-19/epidemiology ; Risk Factors ; Prevalence ; *SARS-CoV-2/isolation & purification ; *Observational Studies as Topic ; Bias ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: Observational studies form the foundation of Long COVID knowledge, however combining data from Long COVID observational studies has multiple methodological challenges. This umbrella review synthesizes estimates of Long COVID prevalence and risk factors as well as biases and limitations in the primary and review literatures.

METHODS AND FINDINGS: A systematic literature search was conducted using multiple electronic databases (PubMed, EMBASE, LitCOVID) from Jan 1, 2019 until June 9, 2023. Eligible studies were systematic reviews including adult populations assessed for at least one Long COVID symptom four weeks or more after SARS-CoV-2 infection. Overall and subgroup prevalence and risk factors as well as risk of bias (ROB) assessments were extracted and descriptively analyzed. The protocol was registered with PROSPERO (CRD42023434323). Fourteen reviews of 5-196 primary studies were included: 8 reported on Long COVID prevalence, 5 on risk/protective factors, and 1 on both. Prevalence of at least 1 Long COVID symptom ranged from 21% (IQR: 8.9%-35%) to 74.5% (95% CI: 55.6%-78.0%). Risk factor reviews found significant associations between vaccination status, sex, acute COVID-19 severity, and comorbidities. Both prevalence and risk factor reviews frequently identified selection and ascertainment biases. Using the AMSTAR 2 criteria, the quality of included reviews, particularly the prevalence reviews, were concerning for the adequacy of ROB assessments and justifications for conducting meta-analysis.

CONCLUSION: A high level of heterogeneity render the interpretation of pooled prevalence estimates of Long COVID challenging, further hampered by the lack of robust critical appraisals in the included reviews. Risk factor reviews were of higher quality overall and suggested consistent associations between Long COVID risk and patient characteristics.},
}

Humans
*COVID-19/epidemiology
Risk Factors
Prevalence
*SARS-CoV-2/isolation & purification
*Observational Studies as Topic
Bias
Post-Acute COVID-19 Syndrome

@article {pmid38695969,
year = {2024},
author = {Gorenshtein, A and Liba, T and Leibovitch, L and Stern, S and Stern, Y},
title = {Intervention modalities for brain fog caused by long-COVID: systematic review of the literature.},
journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology},
volume = {},
number = {},
pages = {},
pmid = {38695969},
issn = {1590-3478},
abstract = {Individuals suffering from long-COVID can present with "brain fog", which is characterized by a range of cognitive impairments, such as confusion, short-term memory loss, and difficulty concentrating. To date, several potential interventions for brain fog have been considered. Notably, no systematic review has comprehensively discussed the impact of each intervention type on brain fog symptoms. We included studies on adult (aged > 18 years) individuals with proven long- COVID brain-fog symptoms from PubMed, MEDLINE, Central, Scopus, and Embase. A search limit was set for articles published between 01/2020 and 31/12/2023. We excluded studies lacking an objective assessment of brain fog symptoms and patients with preexisting neurological diseases that affected cognition before COVID-19 infection. This review provided relevant information from 17 studies. The rehabilitation studies utilized diverse approaches, leading to a range of outcomes in terms of the effectiveness of the interventions. Six studies described noninvasive brain stimulation, and all showed improvement in cognitive ability. Three studies described hyperbaric oxygen therapy, all of which showed improvements in cognitive assessment tests and brain perfusion. Two studies showed that the use of Palmitoylethanolamide and Luteolin (PEA-LUT) improved cognitive impairment. Noninvasive brain stimulation and hyperbaric oxygen therapy showed promising results in the treatment of brain fog symptoms caused by long-COVID, with improved perfusion and cortical excitability. Furthermore, both rehabilitation strategies and PEA-LUT administration have been associated with improvements in symptoms of brain fog. Future studies should explore combinations of interventions and include longer follow-up periods to assess the long-term effects of these treatments.},
}

@article {pmid38695877,
year = {2024},
author = {Finsterer, J},
title = {All available diagnostic and therapeutic options should be fully exploited in order to quickly identify and optimally treat neuropathic pain in long-COVID.},
journal = {European archives of psychiatry and clinical neuroscience},
volume = {},
number = {},
pages = {},
pmid = {38695877},
issn = {1433-8491},
}

@article {pmid38695461,
year = {2024},
author = {Batista, KBC and Fernandez, MV and Barberia, LG and Silva, ETD and Pedi, VD and Pontes, BMLM and Araujo, G and Moreira, RDS and Pedrosa, M and Verotti, MP and Henriques, CMP and Florêncio, AC and Amorim, MMR},
title = {[Overview of long COVID in Brazil: a preliminary analysis of a survey to think about health policies].},
journal = {Cadernos de saude publica},
volume = {40},
number = {4},
pages = {e00094623},
doi = {10.1590/0102-311XPT094623},
pmid = {38695461},
issn = {1678-4464},
mesh = {Humans ; Brazil/epidemiology ; *COVID-19/epidemiology/prevention & control ; Adult ; Female ; Male ; *Post-Acute COVID-19 Syndrome ; *Health Policy ; Middle Aged ; Surveys and Questionnaires ; SARS-CoV-2 ; Quality of Life ; Young Adult ; Aged ; Socioeconomic Factors ; Adolescent ; },
abstract = {Characterized by symptoms that remain or appear for the first time within three months of SARS-CoV-2 infection, long COVID can manifest itself in different ways, including in non-hospitalized or asymptomatic cases. Thus, this study offers an overview of long COVID in Brazil, especially of its diagnosis, symptoms, and challenges for new health management. Data from a study that investigated long COVID in people affected by COVID-19 were used. These original data stem from a survey with adult Brazilians (aged 18 years or older) who had COVID-19 that collected information from March 14 to April 14, 2022, by a questionnaire on social media. The questionnaire addressed sociodemographic characteristics, history of COVID-19 infections, vaccination against the disease, investigation of health status and quality of life before and after COVID-19, and search and access to treatment. Of the 1,728 respondents, 720 were considered eligible for analysis, of which 496 (69%) had long COVID. Individuals with long COVID reported clinical manifestations such as anxiety (80%), memory loss (78%), generalized pain (77%), lack of attention (75%), fatigue (73%), hair loss (71%), sleep changes (70%), mood swings (62%), malaise (60%), and joint pain (59%). Most sought health services during and after the acute phase of COVID-19 (94 and 80%, respectively), representing the need to structure the healthcare system for these patients.},
}

Humans
Brazil/epidemiology
*COVID-19/epidemiology/prevention & control
Adult
Female
Male
*Post-Acute COVID-19 Syndrome
*Health Policy
Middle Aged
Surveys and Questionnaires
SARS-CoV-2
Quality of Life
Young Adult
Aged
Socioeconomic Factors
Adolescent

@article {pmid38694270,
year = {2024},
author = {Xavier de Brito, AS and Bronchtein, AI and Schaustz, EB and Glavam, AP and Pinheiro, MVT and Secco, JCP and Camargo, GC and Almeida, SA and Quintella, TA and Albuquerque, DC and Luiz, RR and Medei, E and Souza, OF and Sales, ARK and Sousa, AS and Rosado-de-Castro, PH and Moll-Bernardes, RJ},
title = {Value of [123]I-MIBG SPECT for the assessment of dysautonomia in patients with long COVID.},
journal = {International journal of cardiology. Heart & vasculature},
volume = {52},
number = {},
pages = {101413},
doi = {10.1016/j.ijcha.2024.101413},
pmid = {38694270},
issn = {2352-9067},
}

@article {pmid38693641,
year = {2024},
author = {Apostolou, E and Rosén, A},
title = {Epigenetic reprograming in myalgic encephalomyelitis/chronic fatigue syndrome: A narrative of latent viruses.},
journal = {Journal of internal medicine},
volume = {},
number = {},
pages = {},
doi = {10.1111/joim.13792},
pmid = {38693641},
issn = {1365-2796},
support = {4.3-2019-00201 GD-2020-138//Swedish Research Council/ ; 211832Pj01H2//Swedish Cancer Society/ ; },
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease presenting with severe fatigue, post-exertional malaise, and cognitive disturbances-among a spectrum of symptoms-that collectively render the patient housebound or bedbound. Epigenetic studies in ME/CFS collectively confirm alterations and/or malfunctions in cellular and organismal physiology associated with immune responses, cellular metabolism, cell death and proliferation, and neuronal and endothelial cell function. The sudden onset of ME/CFS follows a major stress factor that, in approximately 70% of cases, involves viral infection, and ME/CFS symptoms overlap with those of long COVID. Viruses primarily linked to ME/CFS pathology are the symbiotic herpesviruses, which follow a bivalent latent-lytic lifecycle. The complex interaction between viruses and hosts involves strategies from both sides: immune evasion and persistence by the viruses, and immune activation and viral clearance by the host. This dynamic interaction is imperative for herpesviruses that facilitate their persistence through epigenetic regulation of their own and the host genome. In the current article, we provide an overview of the epigenetic signatures demonstrated in ME/CFS and focus on the potential strategies that latent viruses-particularly Epstein-Barr virus-may employ in long-term epigenetic reprograming in ME/CFS. Epigenetic studies could aid in elucidating relevant biological pathways impacted in ME/CFS and reflect the physiological variations among the patients that stem from environmental triggers, including exogenous viruses and/or altered viral activity.},
}

@article {pmid38693436,
year = {2024},
author = {Văcăraş, V and Vulturar, R and Chiş, A and Damian, L},
title = {Inclusion body myositis, viral infections, and TDP-43: a narrative review.},
journal = {Clinical and experimental medicine},
volume = {24},
number = {1},
pages = {91},
pmid = {38693436},
issn = {1591-9528},
mesh = {*Myositis, Inclusion Body/virology ; Humans ; *Virus Diseases/immunology/virology ; *DNA-Binding Proteins/genetics/metabolism ; },
abstract = {The ubiquitous RNA-processing molecule TDP-43 is involved in neuromuscular diseases such as inclusion body myositis, a late-onset acquired inflammatory myopathy. TDP-43 solubility and function are disrupted in certain viral infections. Certain viruses, high viremia, co-infections, reactivation of latent viruses, and post-acute expansion of cytotoxic T cells may all contribute to inclusion body myositis, mainly in an age-shaped immune landscape. The virally induced senescent, interferon gamma-producing cytotoxic CD8+ T cells with increased inflammatory, and cytotoxic features are involved in the occurrence of inclusion body myositis in most such cases, in a genetically predisposed host. We discuss the putative mechanisms linking inclusion body myositis, TDP-43, and viral infections untangling the links between viruses, interferon, and neuromuscular degeneration could shed a light on the pathogenesis of the inclusion body myositis and other TDP-43-related neuromuscular diseases, with possible therapeutic implications.},
}

*Myositis, Inclusion Body/virology
Humans
*Virus Diseases/immunology/virology
*DNA-Binding Proteins/genetics/metabolism

@article {pmid38693285,
year = {2024},
author = {Pinto Pereira, SM and Nugawela, MD and Stephenson, T and Foret-Bruno, P and Dalrymple, E and Xu, L and Whittaker, E and Heyman, I and Ford, T and Segal, T and Chalder, T and Ladhani, SN and Mensah, AA and McOwat, K and Simmons, R and , and Shafran, R},
title = {Post-Covid-19 condition (Long Covid) in children and young people 12 months after infection or reinfection with the Omicron variant: a prospective observational study.},
journal = {Scientific reports},
volume = {14},
number = {1},
pages = {9957},
pmid = {38693285},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/virology/complications/epidemiology ; Child ; *SARS-CoV-2/isolation & purification ; Adolescent ; Male ; Female ; *Reinfection/virology ; Prospective Studies ; Post-Acute COVID-19 Syndrome ; },
abstract = {Our previous study in children and young people (CYP) at 3- and 6-months post-infection showed that 12-16% of those infected with the Omicron (B.1.1.529) variant of SARS-CoV-2 met the research definition of Long Covid, with no differences between first-positive and reinfected CYP. The primary objective of the current study is to explore the impact of the Omicron variant of SARS-CoV-2 infection on young people 12 months post infection. 345 CYP aged 11-17 years with a first laboratory-confirmed infection with the Omicron variant and 360 CYP reinfected with the Omicron variant completed an online questionnaire assessing demographics, symptoms, and their impact shortly after testing and again at 3-, 6-and 12-months post-testing. Vaccination status was determined from information held at UKHSA. Comparisons between groups were made using chi-squared, Mann-Whitney U, and Kruskal-Wallis tests. The most common symptoms in first-positive and reinfected CYP 12-months post-testing were tiredness (35.7 and 33.6% respectively) and sleeping difficulties (27.5 and 28.3% respectively). Symptom profiles, severity and impact were similar in the two infection status groups. Overall, by 12-months, 17.4% of first-positives and 21.9% of reinfected CYP fulfilled the research consensus Long Covid definition (p = 0.13). 12-months post Omicron infection, there is little difference between first-positive and reinfected CYP with respect to symptom profiles and impact. Clinicians may not therefore need to consider number of infections and type of variant when developing treatment plans. Further studies are needed to assess causality of reported symptoms up to 12-months after SARS-CoV-2 infection.},
}

Humans
*COVID-19/virology/complications/epidemiology
Child
*SARS-CoV-2/isolation & purification
Adolescent
Male
Female
*Reinfection/virology
Prospective Studies
Post-Acute COVID-19 Syndrome

@article {pmid38692805,
year = {2024},
author = {Borczuk, AC},
title = {Pathology of COVID-19 Lung Disease.},
journal = {Surgical pathology clinics},
volume = {17},
number = {2},
pages = {203-214},
doi = {10.1016/j.path.2023.11.006},
pmid = {38692805},
issn = {1875-9157},
mesh = {Humans ; *COVID-19/pathology/complications ; *Lung/pathology ; *SARS-CoV-2 ; Lung Diseases/pathology ; },
abstract = {The pathology of severe COVID-19 lung injury is predominantly diffuse alveolar damage, with other reported patterns including acute fibrinous organizing pneumonia, organizing pneumonia, and bronchiolitis. Lung injury was caused by primary viral injury, exaggerated immune responses, and superinfection with bacteria and fungi. Although fatality rates have decreased from the early phases of the pandemic, persistent pulmonary dysfunction occurs and its pathogenesis remains to be fully elucidated.},
}

Humans
*COVID-19/pathology/complications
*Lung/pathology
*SARS-CoV-2
Lung Diseases/pathology

@article {pmid38691776,
year = {2024},
author = {Kurakh, AV and Ahii, VI and Chopey, IV and Hechko, MM and Chubirko, KI},
title = {Characteristics of brain lesions found using MRI imaging in patients with post-COVID with signs of cognitive decline.},
journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)},
volume = {77},
number = {3},
pages = {383-386},
doi = {10.36740/WLek202403102},
pmid = {38691776},
issn = {0043-5147},
mesh = {Humans ; *COVID-19/complications/diagnostic imaging/psychology ; *Magnetic Resonance Imaging ; Female ; Male ; *Cognitive Dysfunction/diagnostic imaging/etiology ; Middle Aged ; *Brain/diagnostic imaging/pathology ; SARS-CoV-2 ; Aged ; Adult ; },
abstract = {OBJECTIVE: Aim: To describe and evaluate abnormalities of the brain in post-COVID patients with neurologic symptoms and cognitive deficits using MRI imaging of the brain.

PATIENTS AND METHODS: Materials and Methods: We included 21 patients with a previous positive PCR testing for SARS-CoV-2 and one or more of the following symptoms: memory and cognitive decline, dizziness, anxiety, depression, chronic headaches. All patients had MRI imaging done at onset of symptoms, but after at least 1 year after positive testing for COVID-19 based on the patient's previous medical history.

RESULTS: Results: All of the patients complained of lack of concentration, forgetfulness, hard to process information. 15 patients suffered from confusion, 10 from anxiety. Of the 21 patients 14 had isolated chronic headaches, 3 had isolated dizziness, 4 patients had both symptoms upon inclusion. All patients underwent MRI imaging as a part of the diagnostic workup and had varying degrees of neurodegeneration.

CONCLUSION: Conclusions: Our data correlates with existing research and shows tendency for cognitive decline in post-COVID patients. This provides groundwork for further research to determine correlation between acceleration of neurodegeneration and post-COVID.},
}

Humans
*COVID-19/complications/diagnostic imaging/psychology
*Magnetic Resonance Imaging
Female
Male
*Cognitive Dysfunction/diagnostic imaging/etiology
Middle Aged
*Brain/diagnostic imaging/pathology
SARS-CoV-2
Aged
Adult

@article {pmid38690892,
year = {2024},
author = {Bramante, CT and Beckman, KB and Mehta, T and Karger, AB and Odde, DJ and Tignanelli, CJ and Buse, JB and Johnson, DM and Watson, RHB and Daniel, JJ and Liebovitz, DM and Nicklas, JM and Cohen, K and Puskarich, MA and Belani, HK and Siegel, LK and Klatt, NR and Anderson, B and Hartman, KM and Rao, V and Hagen, AA and Patel, B and Fenno, SL and Avula, N and Reddy, NV and Erickson, SM and Fricton, RD and Lee, S and Griffiths, G and Pullen, MF and Thompson, JL and Sherwood, NE and Murray, TA and Rose, MR and Boulware, DR and Huling, JD and , },
title = {Favorable Antiviral Effect of Metformin on Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load in a Randomized, Placebo-Controlled Clinical Trial of Coronavirus Disease 2019.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {},
number = {},
pages = {},
doi = {10.1093/cid/ciae159},
pmid = {38690892},
issn = {1537-6591},
support = {/TR/NCATS NIH HHS/United States ; K23 DK124654-01-A1/NH/NIH HHS/United States ; /DK/NIDDK NIH HHS/United States ; /HL/NHLBI NIH HHS/United States ; U54 CA210190/CA/NCI NIH HHS/United States ; INV-017069/GATES/Bill & Melinda Gates Foundation/United States ; },
abstract = {BACKGROUND: Metformin has antiviral activity against RNA viruses including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The mechanism appears to be suppression of protein translation via targeting the host mechanistic target of rapamycin pathway. In the COVID-OUT randomized trial for outpatient coronavirus disease 2019 (COVID-19), metformin reduced the odds of hospitalizations/death through 28 days by 58%, of emergency department visits/hospitalizations/death through 14 days by 42%, and of long COVID through 10 months by 42%.

METHODS: COVID-OUT was a 2 × 3 randomized, placebo-controlled, double-blind trial that assessed metformin, fluvoxamine, and ivermectin; 999 participants self-collected anterior nasal swabs on day 1 (n = 945), day 5 (n = 871), and day 10 (n = 775). Viral load was quantified using reverse-transcription quantitative polymerase chain reaction.

RESULTS: The mean SARS-CoV-2 viral load was reduced 3.6-fold with metformin relative to placebo (-0.56 log10 copies/mL; 95% confidence interval [CI], -1.05 to -.06; P = .027). Those who received metformin were less likely to have a detectable viral load than placebo at day 5 or day 10 (odds ratio [OR], 0.72; 95% CI, .55 to .94). Viral rebound, defined as a higher viral load at day 10 than day 5, was less frequent with metformin (3.28%) than placebo (5.95%; OR, 0.68; 95% CI, .36 to 1.29). The metformin effect was consistent across subgroups and increased over time. Neither ivermectin nor fluvoxamine showed effect over placebo.

CONCLUSIONS: In this randomized, placebo-controlled trial of outpatient treatment of SARS-CoV-2, metformin significantly reduced SARS-CoV-2 viral load, which may explain the clinical benefits in this trial. Metformin is pleiotropic with other actions that are relevant to COVID-19 pathophysiology.

CLINICAL TRIALS REGISTRATION: NCT04510194.},
}

@article {pmid38690504,
year = {2024},
author = {Amir-Kabirian, B and Annie, FH and Koontz, M and Ihle, R},
title = {Sinus Tachycardia Following COVID-19 and Its Implications.},
journal = {Cureus},
volume = {16},
number = {3},
pages = {e57320},
doi = {10.7759/cureus.57320},
pmid = {38690504},
issn = {2168-8184},
abstract = {Background Within the cardiovascular system, sinus tachycardia has been a noted finding in patients with post-COVID-19 syndrome (symptoms persisting beyond 12 weeks post-infection). To better understand post-COVID-19 tachycardia, we examined the prevalence of sinus tachycardia 12-16 weeks after diagnosis of SARS-COV-2 infection and its correlation with intensive care utilization, ventilator use, and mortality in vaccinated and unvaccinated patients. Methods We identified adult patients in the TriNetX COVID-19 Research Network with confirmed SARS-COV-2 diagnosis from January 20th, 2020, to February 14th, 2022, and sinus tachycardia 12-16 weeks after diagnosis. Two cohorts were created: patients who developed tachycardia 12 weeks after initial diagnosis and patients without tachycardia. The tachycardia cohort was divided further based on vaccination status. Results Of 1,363,907 patients included, 30,705 (2.2%) developed tachycardia. The patients with tachycardia had more comorbidities. Using propensity score matching (PSM), two cohorts of 30,702 were created. The SARS-COV-2 tachycardic cohort had higher mortality (5.1% vs 2.1%, p<0.001), critical care utilization (5.8% vs 2.2%, p<0.001), and ventilator use (1.8% vs 0.5%, p<0.001). Out of 22,878 patients with persistent tachycardia and recorded vaccination status, 14,840 (65%) were not vaccinated. Mortality (5.9% vs 2.3%, p<0.001), critical care utilization (8.3% vs 3.6%, p<0.001), and ventilator use (3.8% vs 0.6%, p<0.001) were higher in the non-vaccinated patients compared with the vaccinated patients after PSM. Conclusion The prevalence of persistent tachycardia after SARS-COV-2 infection is notable at 2.2%. Patients with persistent tachycardia have higher mortality rates and demonstrate greater healthcare utilization at one year compared to patients without persistent tachycardia, particularly if unvaccinated.},
}

@article {pmid38690133,
year = {2024},
author = {Sun, K and Zhou, R and Xu, F and Lu, H and Asakawa, T},
title = {Proposal to apply a "Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA)" based approach to manage the COVID-19-related mental health problems in the era of long COVID.},
journal = {Global health & medicine},
volume = {6},
number = {2},
pages = {160-163},
doi = {10.35772/ghm.2023.01102},
pmid = {38690133},
issn = {2434-9194},
abstract = {Long COVID (LC)-related health problems are highly concerned. Many patients seem to have "recovered" from an acute SARS-CoV-2 infection, however, they might experience various symptoms, almost involving all organs and systems. Of those, neuropsychiatric symptoms like depression, anxiety, and post-traumatic stress disorder (PTSD) are not rare. These problems significantly impact the quality of life (QOL) of patients, family, and caregivers, even lead a tragic suicide outcome. Other than the conventional psychological and medical approaches, here, we proposal a positive emotion, engagement, relationships, meaning, and accomplishment (PERMA)-based approach to fight against these COVID-19-related mental health problems (CRMHPs). This approach is characterized by positive psychological interventions and self-achievements, which has been proved to be a powerful tool against mood disorders in common people. Nowadays, abolishment of certain prophylactic measures (such as isolation, lockdown, compulsorily wearing a mask and maintaining social distance, measures to avoid crowding) enables us to have more opportunities to contact patients and implement the PERMA-based approach to the patients with CRMHPs. We believe that application of PERMA-based approach is conducive to alleviate the influence of the CRMHPs and improve their QOL.},
}

@article {pmid38689605,
year = {2024},
author = {Carlile, O and Briggs, A and Henderson, AD and Butler-Cole, BFC and Tazare, J and Tomlinson, LA and Marks, M and Jit, M and Lin, LY and Bates, C and Parry, J and Bacon, SCJ and Dillingham, I and Dennison, WA and Costello, RE and Walker, AJ and Hulme, W and Goldacre, B and Mehrkar, A and MacKenna, B and , and Herrett, E and Eggo, RM},
title = {Impact of long COVID on health-related quality-of-life: an OpenSAFELY population cohort study using patient-reported outcome measures (OpenPROMPT).},
journal = {The Lancet regional health. Europe},
volume = {40},
number = {},
pages = {100908},
doi = {10.1016/j.lanepe.2024.100908},
pmid = {38689605},
issn = {2666-7762},
abstract = {BACKGROUND: Long COVID is a major problem affecting patient health, the health service, and the workforce. To optimise the design of future interventions against COVID-19, and to better plan and allocate health resources, it is critical to quantify the health and economic burden of this novel condition. We aimed to evaluate and estimate the differences in health impacts of long COVID across sociodemographic categories and quantify this in Quality-Adjusted Life-Years (QALYs), widely used measures across health systems.

METHODS: With the approval of NHS England, we utilised OpenPROMPT, a UK cohort study measuring the impact of long COVID on health-related quality-of-life (HRQoL). OpenPROMPT invited responses to Patient Reported Outcome Measures (PROMs) using a smartphone application and recruited between November 2022 and October 2023. We used the validated EuroQol EQ-5D questionnaire with the UK Value Set to develop disutility scores (1-utility) for respondents with and without Long COVID using linear mixed models, and we calculated subsequent Quality-Adjusted Life-Months (QALMs) for long COVID.

FINDINGS: The total OpenPROMPT cohort consisted of 7575 individuals who consented to data collection, with which we used data from 6070 participants who completed a baseline research questionnaire where 24.6% self-reported long COVID. In multivariable regressions, long COVID had a consistent impact on HRQoL, showing a higher likelihood or odds of reporting loss in quality-of-life (Odds Ratio (OR): 4.7, 95% CI: 3.72-5.93) compared with people who did not report long COVID. Reporting a disability was the largest predictor of losses of HRQoL (OR: 17.7, 95% CI: 10.37-30.33) across survey responses. Self-reported long COVID was associated with an 0.37 QALM loss.

INTERPRETATION: We found substantial impacts on quality-of-life due to long COVID, representing a major burden on patients and the health service. We highlight the need for continued support and research for long COVID, as HRQoL scores compared unfavourably to patients with conditions such as multiple sclerosis, heart failure, and renal disease.

FUNDING: This research was supported by the National Institute for Health and Care Research (NIHR) (OpenPROMPT: COV-LT2-0073).},
}

@article {pmid38688088,
year = {2024},
author = {Kaplan, K and Mendenhall, E},
title = {Framing Long Covid through Patient activism in the United States: Patient, Provider, Academic, and Policymaker Views.},
journal = {Social science & medicine (1982)},
volume = {350},
number = {},
pages = {116901},
doi = {10.1016/j.socscimed.2024.116901},
pmid = {38688088},
issn = {1873-5347},
abstract = {In 2020, when COVID-19 patients first recognized their complex and progressive symptoms, patient activists defined "Long Covid" on social media. While patient support groups are by no means new, the predominance of online support groups and those leveraging the power of social media has become a defining characteristic of Long Covid. In this article, we argue that naming Long Covid served as a powerful conduit of legitimacy for patient activists in media, medicine, and policy. We conducted 57 in-depth qualitative interviews with patients (n = 22), clinicians (n = 20), and policy and academic experts (n = 15). We found naming was not a primary area of contention. In contrast, patients found pride and a sense of identity within the terms. Many clinicians struggled with diagnostics because Long Covid lacks clear biological tests, while patients were consistently disappointed by the lack of positive tests and clarity around their symptomatology. The heterogeneity of the Long Covid experience, as well as the diversity of symptoms, further provides opportunities for contestation and disbelief among clinicians and policymakers not only in diagnostics but also in disability rights. Thus, the power of patient activism has transformed how the condition is perceived among and between patients, clinicians, policymakers, and the media in unprecedented ways that will likely have longstanding impacts on how IACCs are viewed in medicine and the public alike.},
}

@article {pmid38687984,
year = {2024},
author = {Resendez, S and Brown, SH and Ruiz Ayala, HS and Rangan, P and Nebeker, J and Montella, D and Elkin, PL},
title = {Defining the Subtypes of Long COVID and Risk Factors for Prolonged Disease: Population-Based Case-Crossover Study.},
journal = {JMIR public health and surveillance},
volume = {10},
number = {},
pages = {e49841},
doi = {10.2196/49841},
pmid = {38687984},
issn = {2369-2960},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Risk Factors ; Male ; *Post-Acute COVID-19 Syndrome ; Female ; *Cross-Over Studies ; Middle Aged ; United States/epidemiology ; Aged ; International Classification of Diseases ; Adult ; },
abstract = {BACKGROUND: There have been over 772 million confirmed cases of COVID-19 worldwide. A significant portion of these infections will lead to long COVID (post-COVID-19 condition) and its attendant morbidities and costs. Numerous life-altering complications have already been associated with the development of long COVID, including chronic fatigue, brain fog, and dangerous heart rhythms.

OBJECTIVE: We aim to derive an actionable long COVID case definition consisting of significantly increased signs, symptoms, and diagnoses to support pandemic-related clinical, public health, research, and policy initiatives.

METHODS: This research employs a case-crossover population-based study using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) data generated at Veterans Affairs medical centers nationwide between January 1, 2020, and August 18, 2022. In total, 367,148 individuals with ICD-10-CM data both before and after a positive COVID-19 test were selected for analysis. We compared ICD-10-CM codes assigned 1 to 7 months following each patient's positive test with those assigned up to 6 months prior. Further, 350,315 patients had novel codes assigned during this window of time. We defined signs, symptoms, and diagnoses as being associated with long COVID if they had a novel case frequency of ≥1:1000, and they significantly increased in our entire cohort after a positive test. We present odds ratios with CIs for long COVID signs, symptoms, and diagnoses, organized by ICD-10-CM functional groups and medical specialty. We used our definition to assess long COVID risk based on a patient's demographics, Elixhauser score, vaccination status, and COVID-19 disease severity.

RESULTS: We developed a long COVID definition consisting of 323 ICD-10-CM diagnosis codes grouped into 143 ICD-10-CM functional groups that were significantly increased in our 367,148 patient post-COVID-19 population. We defined 17 medical-specialty long COVID subtypes such as cardiology long COVID. Patients who were COVID-19-positive developed signs, symptoms, or diagnoses included in our long COVID definition at a proportion of at least 59.7% (268,320/449,450, based on a denominator of all patients who were COVID-19-positive). The long COVID cohort was 8 years older with more comorbidities (2-year Elixhauser score 7.97 in the patients with long COVID vs 4.21 in the patients with non-long COVID). Patients who had a more severe bout of COVID-19, as judged by their minimum oxygen saturation level, were also more likely to develop long COVID.

CONCLUSIONS: An actionable, data-driven definition of long COVID can help clinicians screen for and diagnose long COVID, allowing identified patients to be admitted into appropriate monitoring and treatment programs. This long COVID definition can also support public health, research, and policy initiatives. Patients with COVID-19 who are older or have low oxygen saturation levels during their bout of COVID-19, or those who have multiple comorbidities should be preferentially watched for the development of long COVID.},
}

Humans
*COVID-19/epidemiology/complications
Risk Factors
Male
*Post-Acute COVID-19 Syndrome
Female
*Cross-Over Studies
Middle Aged
United States/epidemiology
Aged
International Classification of Diseases
Adult

@article {pmid38686827,
year = {2024},
author = {Blitshteyn, S and Verduzco-Gutierrez, M},
title = {Long COVID: A major public health issue.},
journal = {American journal of physical medicine & rehabilitation},
volume = {},
number = {},
pages = {},
doi = {10.1097/PHM.0000000000002486},
pmid = {38686827},
issn = {1537-7385},
}

@article {pmid38684843,
year = {2024},
author = {Delgado-Alonso, C and Delgado-Alvarez, A and Díez-Cirarda, M and Oliver-Mas, S and Cuevas, C and Montero-Escribano, P and Ramos-Leví, AM and Gil-Moreno, MJ and López-Carbonero, JI and Hermann, BP and Matias-Guiu, J and Matias-Guiu, JA},
title = {Cognitive profile in multiple sclerosis and post-COVID condition: a comparative study using a unified taxonomy.},
journal = {Scientific reports},
volume = {14},
number = {1},
pages = {9806},
pmid = {38684843},
issn = {2045-2322},
support = {INT20/00079//Ministry of Economy and Competitiveness | Instituto de Salud Carlos III (Institute of Health Carlos III)/ ; INT23/00017//Ministry of Economy and Competitiveness | Instituto de Salud Carlos III (Institute of Health Carlos III)/ ; CD22/00043//Ministry of Economy and Competitiveness | Instituto de Salud Carlos III (Institute of Health Carlos III)/ ; },
mesh = {Humans ; *Multiple Sclerosis/complications/psychology ; Male ; Female ; Middle Aged ; Adult ; Cross-Sectional Studies ; *COVID-19/complications/psychology/virology ; *Fatigue ; *Neuropsychological Tests ; *Cognition ; *Cognitive Dysfunction ; Depression ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/isolation & purification ; },
abstract = {Post-COVID condition (PCC) and multiple sclerosis (MS) share some clinical and demographic features, including cognitive symptoms and fatigue. Some pathophysiological mechanisms well-known in MS, such as autoimmunity, neuroinflammation and myelin damage, have also been implicated in PCC. In this study, we aimed to compare the cognitive phenotypes of two large cohorts of patients with PCC and MS, and to evaluate the relationship between fatigue and cognitive performance. Cross-sectional study including 218 patients with PCC and 218 with MS matched by age, sex, and years of education. Patients were evaluated with a comprehensive neuropsychological protocol and were categorized according to the International Classification of Cognitive Disorders system. Fatigue and depression were also assessed. Cognitive profiles of PCC and MS largely overlapped, with a greater impairment in episodic memory in MS, but with small effect sizes. The most salient deficits in both disorders were in attention and processing speed. The severity of fatigue was greater in patients with PCC. Still, the correlations between fatigue severity and neuropsychological tests were more prominent in the case of MS. There were no differences in the severity of depression among groups. Our study found similar cognitive profiles in PCC and MS. Fatigue was more severe in PCC, but was more associated with cognitive performance in MS. Further comparative studies addressing the mechanisms related to cognitive dysfunction and fatigue may be of interest to advance the knowledge of these disorders and develop new therapies.},
}

Humans
*Multiple Sclerosis/complications/psychology
Male
Female
Middle Aged
Adult
Cross-Sectional Studies
*COVID-19/complications/psychology/virology
*Fatigue
*Neuropsychological Tests
*Cognition
*Cognitive Dysfunction
Depression
Post-Acute COVID-19 Syndrome
SARS-CoV-2/isolation & purification

@article {pmid38684819,
year = {2024},
author = {Jansen, EB and Ostadgavahi, AT and Hewins, B and Buchanan, R and Thivierge, BM and Sganzerla Martinez, G and Goncin, U and Francis, ME and Swan, CL and Scruten, E and Bell, J and Darbellay, J and Facciuolo, A and Falzarano, D and Gerdts, V and Fenton, ME and Hedlin, P and Kelvin, DJ and Kelvin, AA},
title = {PASC (Post Acute Sequelae of COVID-19) is associated with decreased neutralizing antibody titers in both biological sexes and increased ANG-2 and GM-CSF in females.},
journal = {Scientific reports},
volume = {14},
number = {1},
pages = {9854},
pmid = {38684819},
issn = {2045-2322},
support = {GA2-177714//Canadian Institutes for Health Research/ ; 6425//Saskatchewan Health Research Foundation/ ; },
mesh = {Humans ; *COVID-19/immunology/blood/virology ; Female ; *Antibodies, Neutralizing/blood/immunology ; Male ; Middle Aged ; *SARS-CoV-2/immunology/isolation & purification ; *Granulocyte-Macrophage Colony-Stimulating Factor/immunology/blood ; Adult ; *Antibodies, Viral/blood/immunology ; Cross-Sectional Studies ; Post-Acute COVID-19 Syndrome ; Aged ; Sex Factors ; Angiotensin-Converting Enzyme 2/metabolism ; },
abstract = {Post-acute sequelae of COVID-19 (PASC) or the continuation of COVID-19 (Coronavirus disease 2019) symptoms past 12 weeks may affect as many as 30% of people recovering from a SARS-CoV-2 (severe acute respiratory coronavirus 2) infection. The mechanisms regulating the development of PASC are currently not known; however, hypotheses include virus reservoirs, pre-existing conditions, microblood clots, immune dysregulation, as well as poor antibody responses. Importantly, virus neutralizing antibodies are essential for COVID-19 recovery and protection from reinfection but there is currently limited information on these immune regulators and associated cytokines in PASC patients. Understanding the key drivers of general and specific symptoms associated with Long COVID and the presence of virus neutralizing antibodies in PASC will aid in the development of therapeutics, diagnostics, and vaccines which currently do not exist. We designed a cross-sectional study to investigate systemic antibody and cytokine responses during COVID-19 recovery and PASC. In total, 195 participants were recruited in one of four groups: (1) Those who never had COVID-19 (No COVID); (2) Those in acute COVID-19 recovery (Acute Recovery) (4-12 weeks post infection); (3) Those who recovered from COVID-19 (Recovered) (+ 12 weeks from infection); and (4) those who had PASC (PASC) (+ 12 weeks from infection). Participants completed a questionnaire on health history, sex, gender, demographics, experiences with COVID-19 acute and COVID-19 recovery/continuing symptoms. Serum samples collected were evaluated for antibody binding to viral proteins, virus neutralizing antibody titers, and serum cytokine levels using Ella SimplePlex Immunoassay™ panels. We found participants with PASC reported more pre-existing conditions (e.g. such as hypertension, asthma, and obesity), and PASC symptoms (e.g. fatigue, brain fog, headaches, and shortness of breath) following COVID-19 than COVID-19 Recovered individuals. Importantly, we found PASC individuals to have significantly decreased levels of neutralizing antibodies toward both SARS-CoV-2 and the Omicron BA.1 variant. Sex analysis indicated that female PASC study participants had sustained antibody levels as well as levels of the inflammatory cytokines GM-CSF and ANG-2 over time following COVID-19. Our study reports people experiencing PASC had lower levels of virus neutralizing antibodies; however, the results are limited by the collection time post-COVID-19 and post-vaccination. Moreover, we found females experiencing PASC had sustained levels of GM-CSF and ANG-2. With lower levels of virus neutralizing antibodies, this data suggests that PASC individuals not only have had a suboptimal antibody response during acute SARS-CoV-2 infection but may also have increased susceptibility to subsequent infections which may exacerbate or prolong current PASC illnesses. We also provide evidence suggesting GM-CSF and ANG-2 to play a role in the sex-bias of PASC. Taken together, our findings maybe important for understanding immune molecular drivers of PASC and PASC subgroups.},
}

Humans
*COVID-19/immunology/blood/virology
Female
*Antibodies, Neutralizing/blood/immunology
Male
Middle Aged
*SARS-CoV-2/immunology/isolation & purification
*Granulocyte-Macrophage Colony-Stimulating Factor/immunology/blood
Adult
*Antibodies, Viral/blood/immunology
Cross-Sectional Studies
Post-Acute COVID-19 Syndrome
Aged
Sex Factors
Angiotensin-Converting Enzyme 2/metabolism

@article {pmid38684388,
year = {2024},
author = {Slankamenac, J and Ranisavljev, M and Todorovic, N and Ostojic, J and Stajer, V and Candow, DG and Ratgeber, L and Betlehem, J and Acs, P and Ostojic, SM},
title = {Eight-Week Creatine-Glucose Supplementation Alleviates Clinical Features of Long COVID.},
journal = {Journal of nutritional science and vitaminology},
volume = {70},
number = {2},
pages = {174-178},
doi = {10.3177/jnsv.70.174},
pmid = {38684388},
issn = {1881-7742},
mesh = {Humans ; *Creatine/administration & dosage ; Male ; Female ; Double-Blind Method ; *Dietary Supplements ; Adult ; *Glucose/administration & dosage ; Middle Aged ; *COVID-19/complications ; SARS-CoV-2 ; Fatigue/drug therapy ; Post-Acute COVID-19 Syndrome ; Brain/drug effects/metabolism ; Treatment Outcome ; },
abstract = {Preliminary studies demonstrated beneficial effects of dietary creatine across different post-viral fatigue syndromes. Creatine is often co-administered with glucose to improve its potency yet whether glucose boost the efficacy of creatine in long COVID remains currently unknown. In this report, we investigate the effects of 8-wk creatine intake with and without glucose on patient-reported outcomes, exercise tolerance, and tissue creatine levels in patients with long COVID. Fifteen male and female long COVID adult patients (age 39.7±16.0 y; 9 women) with moderate fatigue and at least one of additional long COVID-related symptoms volunteered to participate in this randomized controlled parallel-group interventional trial. All patients were allocated in a double-blind parallel-group design (1 : 1 : 1) to receive creatine (8 g of creatine monohydrate per day), a mixture of creatine and glucose (8 g of creatine monohydrate and 3 g of glucose per day), or placebo (3 g of glucose per day) t.i.d. during an 8-wk intervention interval. Two-way ANOVA with repeated measures (treatment vs. time interaction) revealed significant differences in changes in total creatine levels between the groups, showing an interaction effect at two brain locations (right precentral white matter F=34.740, p=0.008; partial η[2]=0.72; left paracentral grey matter F=19.243, p=0.019; partial η[2]=0.88), with creatine and creatine-glucose outcompeted placebo to elevate creatine levels at these two locations. Several long COVID symptoms (including body aches, breathing problems, difficulties concentrating, headache, and general malaise) were significantly reduced in creatine-glucose group at 8-wk follow-up (p≤0.05); the effect sizes for reducing body aches, difficulties concentrating, and headache were 1.33, 0.80, and 1.12, respectively, suggesting a large effect of creatine-glucose mixture for these outcomes. Our preliminary findings suggest that supplying exogenous creatine with glucose could be recommended as an effective procedure in replenishing brain creatine pool and alleviating long COVID features in this prevalent condition.},
}

Humans
*Creatine/administration & dosage
Male
Female
Double-Blind Method
*Dietary Supplements
Adult
*Glucose/administration & dosage
Middle Aged
*COVID-19/complications
SARS-CoV-2
Fatigue/drug therapy
Post-Acute COVID-19 Syndrome
Brain/drug effects/metabolism
Treatment Outcome

@article {pmid38683740,
year = {2024},
author = {},
title = {Corrections to: COVID-19 and the Postviral Syndrome of Long COVID: Where We Have Come from and Where We Are Going.},
journal = {Health & social work},
volume = {49},
number = {2},
pages = {e1},
doi = {10.1093/hsw/hlae010},
pmid = {38683740},
issn = {1545-6854},
}

@article {pmid38681774,
year = {2023},
author = {Salihoğlu, R and Saraçoğlu, F and Sibai, M and Zengin, T and Abak Masud, B and Karasoy, O and Süzek, T},
title = {CompCorona: A web application for comparative transcriptome analyses of coronaviruses reveals SARS-CoV-2-specific host response.},
journal = {Turkish journal of biology = Turk biyoloji dergisi},
volume = {47},
number = {6},
pages = {393-405},
pmid = {38681774},
issn = {1303-6092},
abstract = {BACKGROUND/AIM: Understanding the mechanism of host transcriptomic response to infection by the SARS-CoV-2 virus is crucial, especially for patients suffering from long-term effects of COVID-19, such as long COVID or pericarditis inflammation, potentially linked to side effects of the SARS-CoV-2 spike proteins. We conducted comprehensive transcriptome and enrichment analyses on lung and peripheral blood mononuclear cells (PBMCs) infected with SARS-CoV-2, as well as on SARS-CoV and MERS-CoV, to uncover shared pathways and elucidate their common disease progression and viral replication mechanisms.

MATERIALS AND METHODS: We developed CompCorona, the first interactive online tool for visualizing gene response variance among the family Coronaviridae through 2D and 3D principal component analysis (PCA) and exploring systems biology variance using pathway plots. We also made preprocessed datasets of lungs and PBMCs infected by SARS-CoV-2, SARS-CoV, and MERS-CoV publicly available through CompCorona.

RESULTS: One remarkable finding from the lung and PBMC datasets for infections by SARS-CoV-2, but not infections by other coronaviruses (CoVs), was the significant downregulation of the angiogenin (ANG) and vascular endothelial growth factor A (VEGFA) genes, both directly involved in epithelial and vascular endothelial cell dysfunction. Suppression of the TNF signaling pathway was also observed in cells infected by SARS-CoV-2, along with simultaneous activation of complement and coagulation cascades and pertussis pathways. The ribosome pathway was found to be universally suppressed across all three viruses. The CompCorona online tool enabled the comparative analysis of 9 preprocessed host transcriptome datasets of cells infected by CoVs, revealing the specific host response differences in cases of SARS-CoV-2 infection. This included identifying markers of epithelial dysfunction via interactive 2D and 3D PCA, Venn diagrams, and pathway plots.

CONCLUSION: Our findings suggest that infection by SARS-CoV-2 might induce pulmonary epithelial dysfunction, a phenomenon not observed in cells infected by other CoVs. The publicly available CompCorona tool, along with the preprocessed datasets of cells infected by various CoVs, constitutes a valuable resource for further research into CoV-associated syndromes.},
}

@article {pmid38678084,
year = {2024},
author = {Gutman, EG and Salvio, AL and Fernandes, RA and Duarte, LA and Raposo-Vedovi, JV and Alcaraz, HF and Teixeira, MA and Passos, GF and de Medeiros, KQM and Hammerle, MB and Pires, KL and Vasconcelos, CCF and Leon, LAA and Figueiredo, CP and Alves-Leon, SV},
title = {Long COVID: plasma levels of neurofilament light chain in mild COVID-19 patients with neurocognitive symptoms.},
journal = {Molecular psychiatry},
volume = {},
number = {},
pages = {},
pmid = {38678084},
issn = {1476-5578},
support = {E-26/210.254/2020//Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro)/ ; E-26/210.657/2021//Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro)/ ; E-26/210.273/2018//Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro)/ ; E-26/201.040/2021//Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro)/ ; E-26/201.406/2021//Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro)/ ; VPPCB-005-FIO-20-2-56//Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz (Centro de Pesquisas Aggeu Magalhães, FIOCRUZ)/ ; },
abstract = {It is well known the potential of severe acute respiratory coronavirus type 2 (SARS-CoV-2) infection to induce post-acute sequelae, a condition called Long COVID. This syndrome includes several symptoms, but the central nervous system (CNS) main one is neurocognitive dysfunction. Recently it has been demonstrated the relevance of plasma levels of neurofilament light chain (pNfL), as a biomarker of early involvement of the CNS in COVID-19. The aim of this study was to investigate the relationship between pNfL in patients with post-acute neurocognitive symptoms and the potential of NfL as a prognostic biomarker in these cases. A group of 63 long COVID patients ranging from 18 to 59 years-old were evaluated, submitted to a neurocognitive battery assessment, and subdivided in different groups, according to results. Plasma samples were collected during the long COVID assessment and used for measurement of pNfL with the Single molecule array (SIMOA) assays. Levels of pNfL were significantly higher in long COVID patients with neurocognitive symptoms when compared to HC (p = 0.0031). Long COVID patients with cognitive impairment and fatigue symptoms presented higher pNfL levels when compared to long COVID patients without these symptoms, individually and combined (p = 0.0263, p = 0.0480, and 0.0142, respectively). Correlation analysis showed that levels of cognitive lost and exacerbation of fatigue in the neurocognitive evaluation had a significative correlation with higher pNfL levels (p = 0.0219 and 0.0255, respectively). Previous reports suggested that pNfL levels are related with higher risk of severity and predict lethality of COVID-19. Our findings demonstrate that SARS-CoV-2 infection seems to have a long-term impact on the brain, even in patients who presented mild acute disease. NfL measurements might be useful to identify CNS involvement in long COVID associated with neurocognitive symptoms and to identify who will need continuous monitoring and treatment support.},
}

@article {pmid38678079,
year = {2024},
author = {Tangsathajaroenporn, W and Panumasvivat, J and Wangsan, K and Muangkaew, S and Kiratipaisarl, W},
title = {Factors affecting the work ability of nursing personnel with post-COVID infection.},
journal = {Scientific reports},
volume = {14},
number = {1},
pages = {9694},
pmid = {38678079},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/epidemiology/complications ; Male ; Female ; Adult ; Retrospective Studies ; Middle Aged ; Surveys and Questionnaires ; SARS-CoV-2/isolation & purification ; Nurses ; },
abstract = {Post-COVID infection have raised concerns regarding their impact on nursing personnel's work ability. This study aimed to assess the relationship between post-COVID infection and work ability among nursing personnel. A retrospective observational study from December 2022 to January 2023 involved 609 nursing personnel with a history of COVID-19 infection at a tertiary hospital. An online questionnaire measured post-COVID infection, personal and working factors, and the Work Ability Index (WAI). Long COVID was defined as the continuation or development of new symptoms 1 month post COVID-19 infection. Of 609 personnel, 586 showed post-COVID symptoms (fatigue, cough, difficulty breathing, etc.), with 73.72% in the short COVID group and 26.28% in the long COVID group. A significant association was found between WAI and post-COVID infection (aOR: 3.64, 95% CI 1.59-8.30), with the short COVID group had a significantly higher WAI than the long COVID group (mean difference 2.25, 95% CI 1.44-3.05). The factors related to work ability in the long COVID group were chronic diseases, work limitation, low job control (P < 0.05). Post-COVID infection, especially long COVID, adversely affect nursing personnel's work ability. Enhancing job control and addressing work limitations are crucial for supporting their return to work.},
}

Humans
*COVID-19/epidemiology/complications
Male
Female
Adult
Retrospective Studies
Middle Aged
Surveys and Questionnaires
SARS-CoV-2/isolation & purification
Nurses

@article {pmid38675974,
year = {2024},
author = {Antia, A and Alvarado, DM and Zeng, Q and Casorla-Perez, LA and Davis, DL and Sonnek, NM and Ciorba, MA and Ding, S},
title = {SARS-CoV-2 Omicron BA.1 Variant Infection of Human Colon Epithelial Cells.},
journal = {Viruses},
volume = {16},
number = {4},
pages = {},
pmid = {38675974},
issn = {1999-4915},
support = {R01 AI167285/AI/NIAID NIH HHS/United States ; },
mesh = {Humans ; *SARS-CoV-2/genetics/physiology/pathogenicity ; *Colon/virology ; *COVID-19/virology ; *Epithelial Cells/virology ; *Spike Glycoprotein, Coronavirus/metabolism/genetics ; Virus Replication ; Interferon Lambda ; },
abstract = {The Omicron variant of SARS-CoV-2, characterized by multiple subvariants including BA.1, XBB.1.5, EG.5, and JN.1, became the predominant strain in early 2022. Studies indicate that Omicron replicates less efficiently in lung tissue compared to the ancestral strain. However, the infectivity of Omicron in the gastrointestinal tract is not fully defined, despite the fact that 70% of COVID-19 patients experience digestive disease symptoms. Here, using primary human colonoids, we found that, regardless of individual variability, Omicron infects colon cells similarly or less effectively than the ancestral strain or the Delta variant. The variant induced limited type III interferon expression and showed no significant impact on epithelial integrity. Further experiments revealed inefficient cell-to-cell spread and spike protein cleavage in the Omicron spike protein, possibly contributing to its lower infectious particle levels. The findings highlight the variant-specific replication differences in human colonoids, providing insights into the enteric tropism of Omicron and its relevance to long COVID symptoms.},
}

Humans
*SARS-CoV-2/genetics/physiology/pathogenicity
*Colon/virology
*COVID-19/virology
*Epithelial Cells/virology
*Spike Glycoprotein, Coronavirus/metabolism/genetics
Virus Replication
Interferon Lambda

@article {pmid38675914,
year = {2024},
author = {Nunes, JM and Kell, DB and Pretorius, E},
title = {Herpesvirus Infection of Endothelial Cells as a Systemic Pathological Axis in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Viruses},
volume = {16},
number = {4},
pages = {},
pmid = {38675914},
issn = {1999-4915},
support = {142142//National Research Foundation/ ; NNF10CC1016517//Novo Nordisk Foundation/ ; },
mesh = {Humans ; *Fatigue Syndrome, Chronic/virology/physiopathology ; *Endothelial Cells/virology ; *Herpesviridae Infections/virology ; Virus Latency ; Herpesviridae/physiology ; COVID-19/virology/physiopathology/pathology ; },
abstract = {Understanding the pathophysiology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is critical for advancing treatment options. This review explores the novel hypothesis that a herpesvirus infection of endothelial cells (ECs) may underlie ME/CFS symptomatology. We review evidence linking herpesviruses to persistent EC infection and the implications for endothelial dysfunction, encompassing blood flow regulation, coagulation, and cognitive impairment-symptoms consistent with ME/CFS and Long COVID. This paper provides a synthesis of current research on herpesvirus latency and reactivation, detailing the impact on ECs and subsequent systemic complications, including latent modulation and long-term maladaptation. We suggest that the chronicity of ME/CFS symptoms and the multisystemic nature of the disease may be partly attributable to herpesvirus-induced endothelial maladaptation. Our conclusions underscore the necessity for further investigation into the prevalence and load of herpesvirus infection within the ECs of ME/CFS patients. This review offers conceptual advances by proposing an endothelial infection model as a systemic mechanism contributing to ME/CFS, steering future research toward potentially unexplored avenues in understanding and treating this complex syndrome.},
}

Humans
*Fatigue Syndrome, Chronic/virology/physiopathology
*Endothelial Cells/virology
*Herpesviridae Infections/virology
Virus Latency
Herpesviridae/physiology
COVID-19/virology/physiopathology/pathology

@article {pmid38673548,
year = {2024},
author = {Blitshteyn, S and Lange, A and Corinaldi, C and Guy, P and Brook, J},
title = {Sexual Dysfunction in Postural Orthostatic Tachycardia Syndrome (POTS): A Cross-Sectional, Case-Control Study.},
journal = {Journal of clinical medicine},
volume = {13},
number = {8},
pages = {},
pmid = {38673548},
issn = {2077-0383},
support = {xx//Dysautonomia Information Network (DINET)/ ; },
abstract = {Background: We aimed to determine whether patients with postural orthostatic tachycardia syndrome (POTS) have sexual dysfunction compared to age-matched healthy controls. Methods: Utilizing online COMPASS-31 to evaluate dysautonomia symptom severity, Beck's Depression Inventory Second Edition (BDII), Female Sexual Function (FSF), and International Index of Erection Function (IIEF) questionnaires, we compared sexual function scores in patients with POTS to scores obtained from sex- and age-matched healthy controls via a cross-sectional case-control study. Results: A total of 160 women with POTS, mean age 30.2 ± 7.9 (range 21-50 years), had lower FSF scores than 62 healthy age-matched female controls. IIEF scores in 29 male patients with POTS with a mean age of 30.1 ± 6.0 (range 21-47) were significantly lower than in 27 healthy age-matched male controls. Female POTS patients had significantly lower scores in the sub-domains of desire, arousal, and satisfaction, while male POTS patients had significantly lower scores in erectile and orgasmic function, desire, and satisfaction than healthy controls. Predictive factors of sexual dysfunction were depression in women and age in men. The severity of autonomic symptoms correlated with sexual dysfunction in women, but this effect disappeared after controlling for depression. Conclusions: Compared to healthy controls, women and men with POTS have significant sexual dysfunction, which needs to be considered in the diagnostic and therapeutic approaches as part of comprehensive patient care.},
}

@article {pmid38675888,
year = {2024},
author = {Thümmler, L and Beckmann, N and Sehl, C and Soddemann, M and Braß, P and Bormann, M and Brochhagen, L and Elsner, C and Hoertel, N and Cougoule, C and Ciesek, S and Widera, M and Dittmer, U and Lindemann, M and Horn, PA and Witzke, O and Kadow, S and Kamler, M and Gulbins, E and Becker, KA and Krawczyk, A},
title = {Fluoxetine and Sertraline Potently Neutralize the Replication of Distinct SARS-CoV-2 Variants.},
journal = {Viruses},
volume = {16},
number = {4},
pages = {},
doi = {10.3390/v16040545},
pmid = {38675888},
issn = {1999-4915},
mesh = {*SARS-CoV-2/drug effects ; *Sertraline/pharmacology ; *Fluoxetine/pharmacology ; *Virus Replication/drug effects ; Humans ; *Antiviral Agents/pharmacology ; Chlorocebus aethiops ; Vero Cells ; *COVID-19/virology ; Animals ; COVID-19 Drug Treatment ; },
abstract = {The pandemic caused by SARS-CoV-2 is still a major health problem. Newly emerging variants and long-COVID-19 represent a challenge for the global health system. In particular, individuals in developing countries with insufficient health care need easily accessible, affordable and effective treatments of COVID-19. Previous studies have demonstrated the efficacy of functional inhibitors of acid sphingomyelinase against infections with various viruses, including early variants of SARS-CoV-2. This work investigated whether the acid sphingomyelinase inhibitors fluoxetine and sertraline, usually used as antidepressant molecules in clinical practice, can inhibit the replication of the former and recently emerged SARS-CoV-2 variants in vitro. Fluoxetine and sertraline potently inhibited the infection with pseudotyped virus-like particles and SARS-CoV-2 variants D614G, alpha, delta, omicron BA.1 and omicron BA.5. These results highlight fluoxetine and sertraline as priority candidates for large-scale phase 3 clinical trials at different stages of SARS-CoV-2 infections, either alone or in combination with other medications.},
}

*SARS-CoV-2/drug effects
*Sertraline/pharmacology
*Fluoxetine/pharmacology
*Virus Replication/drug effects
Humans
*Antiviral Agents/pharmacology
Chlorocebus aethiops
Vero Cells
*COVID-19/virology
Animals
COVID-19 Drug Treatment

@article {pmid38675423,
year = {2024},
author = {Noce, A and Marrone, G and Di Lauro, M and Vita, C and Montalto, G and Giorgino, G and Chiaramonte, C and D'Agostini, C and Bernardini, S and Pieri, M},
title = {Potential Anti-Inflammatory and Anti-Fatigue Effects of an Oral Food Supplement in Long COVID Patients.},
journal = {Pharmaceuticals (Basel, Switzerland)},
volume = {17},
number = {4},
pages = {},
doi = {10.3390/ph17040463},
pmid = {38675423},
issn = {1424-8247},
abstract = {Long coronavirus disease (COVID) syndrome leads to chronic inflammatory state onset that can have a multisystem impact and compromise organ function. Moreover, long COVID syndrome is often characterized by the presence of chronic fatigue, which affects subjects' daily activities and worsens their quality of life. The aim of our double-blind, placebo-controlled randomized trial (protocol code RS 150.21, approved on 4 November 2021) was to evaluate the beneficial effects of the consumption of 2 cps/day, for two months, of an oral food supplement (OFS), based on Echinacea angustifolia, rosehip, propolis, royal jelly and zinc, in long COVID patients, compared to a two-month placebo period. The OFS's vitamin C content was equal to 22.17 mg/g (8.87 mg/capsule). The OFS's total polyphenol content was 43.98 mg/g gallic acid equivalents. At the end of the in vivo study, we highlighted a significant decrease in the inflammatory parameters in the OFS period, compared to the placebo period (neutrophil-to-lymphocyte ratio, p = 0.0455; monocyte to-lymphocyte ratio, p = 0.0005; C-reactive protein, p = 0.0145). Our study also highlighted a significant increase in vitamin D serum values (p = 0.0005) and, at the same time, an improvement in patients' life quality and a reduction in fatigue, monitored by the fatigue severity scale. This study showed the OFS's beneficial effects on the inflammatory state, fatigue and quality of life in long COVID patients.},
}

@article {pmid38674588,
year = {2024},
author = {Brogna, C and Bisaccia, DR and Costanzo, V and Lettieri, G and Montano, L and Viduto, V and Fabrowski, M and Cristoni, S and Prisco, M and Piscopo, M},
title = {Who Is the Intermediate Host of RNA Viruses? A Study Focusing on SARS-CoV-2 and Poliovirus.},
journal = {Microorganisms},
volume = {12},
number = {4},
pages = {},
doi = {10.3390/microorganisms12040643},
pmid = {38674588},
issn = {2076-2607},
abstract = {The COVID-19 pandemic has sparked a surge in research on microbiology and virology, shedding light on overlooked aspects such as the infection of bacteria by RNA virions in the animal microbiome. Studies reveal a decrease in beneficial gut bacteria during COVID-19, indicating a significant interaction between SARS-CoV-2 and the human microbiome. However, determining the origins of the virus remains complex, with observed phenomena such as species jumps adding layers to the narrative. Prokaryotic cells play a crucial role in the disease's pathogenesis and transmission. Analyzing previous studies highlights intricate interactions from clinical manifestations to the use of the nitrogen isotope test. Drawing parallels with the history of the Poliovirus underscores the need to prioritize investigations into prokaryotic cells hosting RNA viruses.},
}

@article {pmid38674318,
year = {2024},
author = {Mujovic, N and Nikolic, D and Markovic, F and Stjepanovic, M and Zekovic, M and Ali, HSH and Zivanovic, D and Savic, M and Laban, M},
title = {The Effects of Six Weeks Pulmonary Rehabilitation on Functional and Psychological Outcomes in Long-COVID Patients: Preliminary Results from Serbian Single Center Study.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {60},
number = {4},
pages = {},
doi = {10.3390/medicina60040671},
pmid = {38674318},
issn = {1648-9144},
mesh = {Humans ; *COVID-19/rehabilitation/psychology ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; SARS-CoV-2 ; Treatment Outcome ; Walk Test ; Anxiety ; Adult ; },
abstract = {Background and Objectives: In this study, we aimed to evaluate the effects of six weeks of pulmonary rehabilitation on functional and psychological outcomes in long-COVID patients. Material and Methods: The prospective clinical study included 46 patients that were diagnosed with COVID-19. A respiratory rehabilitation program was implemented for six weeks. Further valuables were tested before the beginning of the rehabilitation program (admission) and six weeks after (discharge): SpO2, heart rate, respiratory rate, Visual Analogue Scale (VAS) score, Borg score, Sit-to-Stand (StS) test number of repetition, distance of 6-Minute Walking Test (6MWT), Patient Health Questionnaire (PHQ) 9 score and Generalized anxiety disorder (GAD) anxiety score. These parameters were tested before the rehabilitation program on admission and at discharge and after the rehabilitation program on admission and at discharge. The results were presented with standard descriptive and analytical methods. Differences between the continuous variables before and after physical rehabilitation intervention were tested using the Wilcoxon test. Graphical analysis is presented with a box plot. Results: On discharge, in comparison with admission, the values of SpO2 were significantly lower (p = 0.007) before the 6MWT, and VAS scores were significantly higher (p = 0.036), while after the 6MWT, VAS scores were significantly lower (p < 0.001) as were Borg scores (p = 0.016). On discharge, in comparison with admission, the respiratory rate was significantly higher (p = 0.005) before the StS test, and Borg scores were significantly lower (p = 0.001), while after the StS test, SpO2 levels were significantly higher (p = 0.036) and VAS scores were significantly lower (p < 0.001), as were Borg scores (p = 0.008). After discharge, the values of the StS test were significantly higher (p = 0.011), PHQ9 scores were significantly lower (p < 0.001) and GAD anxiety scores were significantly lower as well (p = 0.005), while the distances measured in meters on the 6MWT were significantly increased (p < 0.001). Conclusions: A structured rehabilitation program in our study was shown to have beneficial effects on physiological, psychological and functional improvements in patients with long-COVID, and therefore it is advisable for these patients.},
}

Humans
*COVID-19/rehabilitation/psychology
Male
Female
Prospective Studies
Middle Aged
Aged
SARS-CoV-2
Treatment Outcome
Walk Test
Anxiety
Adult

@article {pmid38673514,
year = {2024},
author = {Wiśniewska, A and Kijak, A and Nowak, K and Lulek, M and Skwarek, A and Małecka-Giełdowska, M and Śmiarowski, M and Wąsik, S and Ciepiela, O},
title = {Organ-Dysfunction Markers in Mild-to-Moderate COVID-19 Convalescents.},
journal = {Journal of clinical medicine},
volume = {13},
number = {8},
pages = {},
doi = {10.3390/jcm13082241},
pmid = {38673514},
issn = {2077-0383},
abstract = {Background: A coronavirus disease 2019 (COVID-19) outbreak led to a worldwide pandemic. COVID-19 not only caused acute symptoms during the severe phase of the disease, but also induced long-term side effects on the functioning of many organs and systems. Symptoms that were associated with the disease and present at least 3 months after recovery were named long COVID. The aim of this study was to assess if mild-to-moderate COVID-19 may lead to the dysfunction of respiratory, cardiovascular, neural, and renal systems in healthy blood donors who recovered from the disease at least 6 months earlier. Methods: Here, we examined 294 adults among volunteer blood donors divided into convalescents (n = 215) and healthy controls (n = 79). Concentrations of soluble CD163, TGF beta, Lp-PLA2, NCAM-1, S100, NGAL, and creatinine were measured either by ELISA or automated methods. The probability value p < 0.05 was considered as statistically significant. Results: We found significant differences in Lp-PLA2, S100, and NCAM-1 between convalescents and never-infected subjects. Lp-PLA2 and NCAM-1 were lower, and S100 higher, in convalescents than in the control group. Conclusion: Mild-to-moderate COVID-19 convalescents are at a low risk of developing lung fibrosis or chronic kidney disease. However, they should regularly carry out their prophylaxis examinations for early detection of possible negative outcomes of COVID-19.},
}

@article {pmid38673384,
year = {2024},
author = {Diar Bakerly, N and Smith, N and Darbyshire, JL and Kwon, J and Bullock, E and Baley, S and Sivan, M and Delaney, B},
title = {Pathophysiological Mechanisms in Long COVID: A Mixed Method Systematic Review.},
journal = {International journal of environmental research and public health},
volume = {21},
number = {4},
pages = {},
doi = {10.3390/ijerph21040473},
pmid = {38673384},
issn = {1660-4601},
mesh = {Humans ; *COVID-19/physiopathology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Long COVID (LC) is a global public health crisis affecting more than 70 million people. There is emerging evidence of different pathophysiological mechanisms driving the wide array of symptoms in LC. Understanding the relationships between mechanisms and symptoms helps in guiding clinical management and identifying potential treatment targets.

METHODS: This was a mixed-methods systematic review with two stages: Stage one (Review 1) included only existing systematic reviews (meta-review) and Stage two (Review 2) was a review of all primary studies. The search strategy involved Medline, Embase, Emcare, and CINAHL databases to identify studies that described symptoms and pathophysiological mechanisms with statistical analysis and/or discussion of plausible causal relationships between mechanisms and symptoms. Only studies that included a control arm for comparison were included. Studies were assessed for quality using the National Heart, Lung, and Blood Institute quality assessment tools.

RESULTS: 19 systematic reviews were included in Review 1 and 46 primary studies in Review 2. Overall, the quality of reporting across the studies included in this second review was moderate to poor. The pathophysiological mechanisms with strong evidence were immune system dysregulation, cerebral hypoperfusion, and impaired gas transfer in the lungs. Other mechanisms with moderate to weak evidence were endothelial damage and hypercoagulation, mast cell activation, and auto-immunity to vascular receptors.

CONCLUSIONS: LC is a complex condition affecting multiple organs with diverse clinical presentations (or traits) underpinned by multiple pathophysiological mechanisms. A 'treatable trait' approach may help identify certain groups and target specific interventions. Future research must include understanding the response to intervention based on these mechanism-based traits.},
}

Humans
*COVID-19/physiopathology
SARS-CoV-2
Post-Acute COVID-19 Syndrome

@article {pmid38672973,
year = {2024},
author = {Ferous, S and Siafakas, N and Boufidou, F and Patrinos, GP and Tsakris, A and Anastassopoulou, C},
title = {Investigating ABO Blood Groups and Secretor Status in Relation to SARS-CoV-2 Infection and COVID-19 Severity.},
journal = {Journal of personalized medicine},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/jpm14040346},
pmid = {38672973},
issn = {2075-4426},
abstract = {The ABO blood groups, Lewis antigens, and secretor systems are important components of transfusion medicine. These interconnected systems have been also shown to be associated with differing susceptibility to bacterial and viral infections, likely as the result of selection over the course of evolution and the constant tug of war between humans and infectious microbes. This comprehensive narrative review aimed to explore the literature and to present the current state of knowledge on reported associations of the ABO, Lewis, and secretor blood groups with SARS-CoV-2 infection and COVID-19 severity. Our main finding was that the A blood group may be associated with increased susceptibility to SARS-CoV-2 infection, and possibly also with increased disease severity and overall mortality. The proposed pathophysiological pathways explaining this potential association include antibody-mediated mechanisms and increased thrombotic risk amongst blood group A individuals, in addition to altered inflammatory cytokine expression profiles. Preliminary evidence does not support the association between ABO blood groups and COVID-19 vaccine response, or the risk of developing long COVID. Even though the emergency state of the pandemic is over, further research is needed especially in this area since tens of millions of people worldwide suffer from lingering COVID-19 symptoms.},
}

@article {pmid38672710,
year = {2024},
author = {Wu, BQ and Liu, DY and Shen, TC and Lai, YR and Yu, TL and Hsu, HL and Lee, HM and Liao, WC and Hsia, TC},
title = {Effects of Hyperbaric Oxygen Therapy on Long COVID: A Systematic Review.},
journal = {Life (Basel, Switzerland)},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/life14040438},
pmid = {38672710},
issn = {2075-1729},
abstract = {The coronavirus disease (COVID-19) pandemic has resulted in an increasing population that is experiencing a wide range of long-lasting symptoms after recovery from the acute infection. Long COVID refers to this specific condition and is associated with diverse symptoms, such as fatigue, myalgias, dyspnea, headache, cognitive impairment, neurodegenerative symptoms, anxiety, depression, and a sense of despair. The potential of hyperbaric oxygen therapy (HBOT) to improve chronic fatigue, cognitive impairments, and neurological disorders has been established; therefore, the use of HBOT to treat long COVID has also been studied. We conducted a literature search between 1 January 2019 and 30 October 2023, focusing on the clinical efficacy and utility of HBOT for treating long COVID and found ten clinical studies that fit the review topic, including one case report, five one-group pretest-posttest design studies, one safety report from a randomized controlled trial (RCT), and three complete reports of RCTs. Most studies found that HBOT can improve quality of life, fatigue, cognition, neuropsychiatric symptoms, and cardiopulmonary function. Although HBOT has shown some benefits for long COVID symptoms, further rigorous large-scale RCTs are required to establish precise indications, protocols, and post-treatment evaluations.},
}

@article {pmid38672267,
year = {2024},
author = {Golzardi, M and Hromić-Jahjefendić, A and Šutković, J and Aydin, O and Ünal-Aydın, P and Bećirević, T and Redwan, EM and Rubio-Casillas, A and Uversky, VN},
title = {The Aftermath of COVID-19: Exploring the Long-Term Effects on Organ Systems.},
journal = {Biomedicines},
volume = {12},
number = {4},
pages = {},
doi = {10.3390/biomedicines12040913},
pmid = {38672267},
issn = {2227-9059},
abstract = {BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection (PASC) is a complicated disease that affects millions of people all over the world. Previous studies have shown that PASC impacts 10% of SARS-CoV-2 infected patients of which 50-70% are hospitalised. It has also been shown that 10-12% of those vaccinated against COVID-19 were affected by PASC and its complications. The severity and the later development of PASC symptoms are positively associated with the early intensity of the infection.

RESULTS: The generated health complications caused by PASC involve a vast variety of organ systems. Patients affected by PASC have been diagnosed with neuropsychiatric and neurological symptoms. The cardiovascular system also has been involved and several diseases such as myocarditis, pericarditis, and coronary artery diseases were reported. Chronic hematological problems such as thrombotic endothelialitis and hypercoagulability were described as conditions that could increase the risk of clotting disorders and coagulopathy in PASC patients. Chest pain, breathlessness, and cough in PASC patients were associated with the respiratory system in long-COVID causing respiratory distress syndrome. The observed immune complications were notable, involving several diseases. The renal system also was impacted, which resulted in raising the risk of diseases such as thrombotic issues, fibrosis, and sepsis. Endocrine gland malfunction can lead to diabetes, thyroiditis, and male infertility. Symptoms such as diarrhea, nausea, loss of appetite, and taste were also among reported observations due to several gastrointestinal disorders. Skin abnormalities might be an indication of infection and long-term implications such as persistent cutaneous complaints linked to PASC.

CONCLUSIONS: Long-COVID is a multidimensional syndrome with considerable public health implications, affecting several physiological systems and demanding thorough medical therapy, and more study to address its underlying causes and long-term effects is needed.},
}

@article {pmid38672245,
year = {2024},
author = {Kell, DB and Lip, GYH and Pretorius, E},
title = {Fibrinaloid Microclots and Atrial Fibrillation.},
journal = {Biomedicines},
volume = {12},
number = {4},
pages = {},
doi = {10.3390/biomedicines12040891},
pmid = {38672245},
issn = {2227-9059},
abstract = {Atrial fibrillation (AF) is a comorbidity of a variety of other chronic, inflammatory diseases for which fibrinaloid microclots are a known accompaniment (and in some cases, a cause, with a mechanistic basis). Clots are, of course, a well-known consequence of atrial fibrillation. We here ask the question whether the fibrinaloid microclots seen in plasma or serum may in fact also be a cause of (or contributor to) the development of AF. We consider known 'risk factors' for AF, and in particular, exogenous stimuli such as infection and air pollution by particulates, both of which are known to cause AF. The external accompaniments of both bacterial (lipopolysaccharide and lipoteichoic acids) and viral (SARS-CoV-2 spike protein) infections are known to stimulate fibrinaloid microclots when added in vitro, and fibrinaloid microclots, as with other amyloid proteins, can be cytotoxic, both by inducing hypoxia/reperfusion and by other means. Strokes and thromboembolisms are also common consequences of AF. Consequently, taking a systems approach, we review the considerable evidence in detail, which leads us to suggest that it is likely that microclots may well have an aetiological role in the development of AF. This has significant mechanistic and therapeutic implications.},
}

@article {pmid38672208,
year = {2024},
author = {Casal-Guisande, M and Comesaña-Campos, A and Núñez-Fernández, M and Torres-Durán, M and Fernández-Villar, A},
title = {Proposal and Definition of an Intelligent Clinical Decision Support System Applied to the Prediction of Dyspnea after 12 Months of an Acute Episode of COVID-19.},
journal = {Biomedicines},
volume = {12},
number = {4},
pages = {},
doi = {10.3390/biomedicines12040854},
pmid = {38672208},
issn = {2227-9059},
abstract = {Long COVID is a condition that affects a significant proportion of patients who have had COVID-19. It is characterised by the persistence of associated symptoms after the acute phase of the illness has subsided. Although several studies have investigated the risk factors associated with long COVID, identifying which patients will experience long-term symptoms remains a complex task. Among the various symptoms, dyspnea is one of the most prominent due to its close association with the respiratory nature of COVID-19 and its disabling consequences. This work proposes a new intelligent clinical decision support system to predict dyspnea 12 months after a severe episode of COVID-19 based on the SeguiCovid database from the Álvaro Cunqueiro Hospital in Vigo (Galicia, Spain). The database is initially processed using a CART-type decision tree to identify the variables with the highest predictive power. Based on these variables, a cascade of expert systems has been defined with Mamdani-type fuzzy-inference engines. The rules for each system were generated using the Wang-Mendel automatic rule generation algorithm. At the output of the cascade, a risk indicator is obtained, which allows for the categorisation of patients into two groups: those with dyspnea and those without dyspnea at 12 months. This simplifies follow-up and the performance of studies aimed at those patients at risk. The system has produced satisfactory results in initial tests, supported by an AUC of 0.75, demonstrating the potential and usefulness of this tool in clinical practice.},
}

@article {pmid38672194,
year = {2024},
author = {Urbiola-Salvador, V and Lima de Souza, S and Macur, K and Czaplewska, P and Chen, Z},
title = {Plasma Proteomics Elucidated a Protein Signature in COVID-19 Patients with Comorbidities and Early-Diagnosis Biomarkers.},
journal = {Biomedicines},
volume = {12},
number = {4},
pages = {},
doi = {10.3390/biomedicines12040840},
pmid = {38672194},
issn = {2227-9059},
support = {decision numbers 325965, 335579//Research Council of Finland/ ; },
abstract = {Despite great scientific efforts, deep understanding of coronavirus-19 disease (COVID-19) immunopathology and clinical biomarkers remains a challenge. Pre-existing comorbidities increase the mortality rate and aggravate the exacerbated immune response against the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which can result in more severe symptoms as well as long-COVID and post-COVID complications. In this study, we applied proteomics analysis of plasma samples from 28 patients with SARS-CoV-2, with and without pre-existing comorbidities, as well as their corresponding controls to determine the systemic protein changes caused by the SARS-CoV-2 infection. As a result, the protein signature shared amongst COVID-19 patients with comorbidities was revealed to be characterized by alterations in the coagulation and complement pathways, acute-phase response proteins, tissue damage and remodeling, as well as cholesterol metabolism. These altered proteins may play a relevant role in COVID-19 pathophysiology. Moreover, several novel potential biomarkers for early diagnosis of the SARS-CoV-2 infection were detected, such as increased levels of keratin K22E, extracellular matrix protein-1 (ECM1), and acute-phase response protein α-2-antiplasmin (A2AP). Importantly, elevated A2AP may contribute to persistent clotting complications associated with the long-COVID syndrome in patients with comorbidities. This study provides new insights into COVID-19 pathogenesis and proposes novel potential biomarkers for early diagnosis that could be facilitated for clinical application by further validation studies.},
}

@article {pmid38672163,
year = {2024},
author = {Maniaci, A and Lavalle, S and Masiello, E and Lechien, JR and Vaira, L and Boscolo-Rizzo, P and Musa, M and Gagliano, C and Zeppieri, M},
title = {Platelet-Rich Plasma (PRP) in the Treatment of Long COVID Olfactory Disorders: A Comprehensive Review.},
journal = {Biomedicines},
volume = {12},
number = {4},
pages = {},
doi = {10.3390/biomedicines12040808},
pmid = {38672163},
issn = {2227-9059},
abstract = {Background: Long COVID has brought numerous challenges to healthcare, with olfactory dysfunction (OD) being a particularly distressing outcome for many patients. The persistent loss of smell significantly diminishes the affected individual's quality of life. Recent attention has been drawn to the potential of platelet-rich plasma (PRP) therapy as a treatment for OD. This comprehensive review aims to evaluate the effectiveness of PRP therapy in ameliorating OD, especially when associated with long-term COVID-19. Methods: We executed a comprehensive search of the literature, encompassing clinical trials and observational studies that utilized PRP in treating OD limited to COVID-19. We retrieved and comprehensively discussed data such as design, participant demographics, and reported outcomes, focusing on the efficacy and safety of PRP therapy for OD in COVID-19 patients. Results: Our comprehensive analysis interestingly found promising perspectives for PRP in OD following COVID-19 infection. The collective data indicate that PRP therapy contributed to a significant improvement in olfactory function after COVID-19 infection. Conclusions: The evidence amassed suggests that PRP is a promising and safe therapeutic option for OD, including cases attributable to Long COVID-19. The observed uniform enhancement of olfactory function in patients receiving PRP highlights the necessity for well-designed, controlled trials. Such studies would help to refine treatment protocols and more definitively ascertain the efficacy of PRP in a broader, more varied patient cohort.},
}

@article {pmid38671529,
year = {2024},
author = {de Pádua Serafim, A and Saffi, F and Soares, ARA and Morita, AM and Assed, MM and de Toledo, S and Rocca, CCA and Durães, RSS},
title = {Cognitive performance of post-covid patients in mild, moderate, and severe clinical situations.},
journal = {BMC psychology},
volume = {12},
number = {1},
pages = {236},
pmid = {38671529},
issn = {2050-7283},
support = {2020/07957-2//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; Adult ; *Cognition ; Severity of Illness Index ; Aged ; Attention ; Cognitive Dysfunction/psychology ; SARS-CoV-2 ; Depression/psychology ; Anxiety/psychology ; Neuropsychological Tests ; },
abstract = {BACKGROUND: Studying individuals with varying symptoms, from mild to severe, can provide valuable insights into the spectrum of cognitive outcomes after COVID-19. We investigated the cognitive performance of adults who recovered from the novel coronavirus disease (COVID-19) without prior cognitive complaints, considering mild (not hospitalized), moderate (ward), and severe (intensive care unit) symptoms.

METHODS: This cross-sectional study included 302 patients who recovered from COVID-19 (mild, n = 102; moderate, n = 102; severe, n = 98). We assessed intellectual quotient (IQ), attention, memory, processing speed, visual-constructive ability, as well as symptoms of depression, anxiety, and stress, at least eighteen months after infection. The mean length of hospitalization was Mdays=8.2 (SD = 3.9) and Mdays=14.4 (SD = 8.2) in the moderate and severe groups, respectively.

RESULTS: Cognitive difficulties were present in all three groups: mild (n = 12, 11.7%), moderate (n = 40, 39.2%), and severe (n = 48, 48.9%). Using Multinomial Logistic Regression and considering the odds ratio, our results indicated that a one-point increase in sustained attention, visual memory, and working memory might decrease the odds of being categorized in the severe group by 20%, 24%, and 77%, respectively, compared to the mild group.

CONCLUSIONS: Our findings provide empirical evidence regarding the long-term cognitive effects of COVID-19, particularly in individuals experiencing severe manifestations of the disease. We also highlighted the need for a comprehensive, multidimensional approach in rehabilitation programs to address the enduring cognitive impacts of COVID-19.},
}

Humans
*COVID-19/psychology/epidemiology
Male
Female
Cross-Sectional Studies
Middle Aged
Adult
*Cognition
Severity of Illness Index
Aged
Attention
Cognitive Dysfunction/psychology
SARS-CoV-2
Depression/psychology
Anxiety/psychology
Neuropsychological Tests

@article {pmid38671455,
year = {2024},
author = {Ghasemiyeh, P and Mohammadi-Samani, S},
title = {Lessons we learned during the past four challenging years in the COVID-19 era: pharmacotherapy, long COVID complications, and vaccine development.},
journal = {Virology journal},
volume = {21},
number = {1},
pages = {98},
pmid = {38671455},
issn = {1743-422X},
mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/adverse effects/administration & dosage ; *SARS-CoV-2/immunology ; *Vaccine Development ; COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use ; Post-Acute COVID-19 Syndrome ; Drug Repositioning ; },
abstract = {About four years have passed since the detection of the first cases of COVID-19 in China. During this lethal pandemic, millions of people have lost their lives around the world. Since the first waves of COVID-19 infection, various pharmacotherapeutic agents have been examined in the management of COVID-19. Despite all these efforts in pharmacotherapy, drug repurposing, and design and development of new drugs, multiple organ involvement and various complications occurred during COVID-19. Some of these complications became chronic and long-lasting which led to the "long COVID" syndrome appearance. Therefore, the best way to eradicate this pandemic is prophylaxis through mass vaccination. In this regard, various vaccine platforms including inactivated vaccines, nucleic acid-based vaccines (mRNA and DNA vaccines), adenovirus-vectored vaccines, and protein-based subunit vaccines have been designed and developed to prevent or reduce COVID-19 infection, hospitalization, and mortality rates. In this focused review, at first, the most commonly reported clinical presentations of COVID-19 during these four years have been summarized. In addition, different therapeutic regimens and their latest status in COVID-19 management have been listed. Furthermore, the "long COVID" and related signs, symptoms, and complications have been mentioned. At the end, the effectiveness of available COVID-19 vaccines with different platforms against early SARS-CoV-2 variants and currently circulating variants of interest (VOI) and the necessity of booster vaccine shots have been summarized and discussed in more detail.},
}

Humans
*COVID-19/prevention & control/immunology
*COVID-19 Vaccines/immunology/adverse effects/administration & dosage
*SARS-CoV-2/immunology
*Vaccine Development
COVID-19 Drug Treatment
Antiviral Agents/therapeutic use
Post-Acute COVID-19 Syndrome
Drug Repositioning

@article {pmid38670844,
year = {2024},
author = {Xie, Z and Stallings-Smith, S and Patel, S and Case, S and Hong, YR},
title = {COVID-19 booster vaccine uptake and reduced risks for long-COVID: A cross-sectional study of a U.S. adult population.},
journal = {Vaccine},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.vaccine.2024.04.070},
pmid = {38670844},
issn = {1873-2518},
abstract = {Long-COVID (having symptoms lasting 3 months or longer post-infection) is an emerging public health concern, yet research on whether COVID-19 booster vaccines can mitigate this condition is limited. This study examined associations between booster uptake and long-COVID prevalence among U.S. adults. Data were analyzed from 8757 adults aged 18 years or older with a history of COVID-19 infection from the 2022 National Health Interview Survey. Weighted prevalence and logistic regression models examined relationships between self-reported COVID-19 booster vaccination status and long-COVID, adjusting for sociodemographics and health factors. 19.5 % reported experiencing long-COVID. Individuals receiving the COVID-19 booster vaccine had significantly lower adjusted odds of long-COVID (OR 0.75, 95 % CI 0.61-0.93) compared to unvaccinated individuals. Overall, these findings suggest that COVID-19 booster vaccination is associated with a reduced prevalence of long-COVID among the U.S. adult population, underscoring the importance of optimizing booster uptake to mitigate the long-term impacts of COVID-19.},
}

@article {pmid38669034,
year = {2024},
author = {Bock, A},
title = {Researchers See Hope in Symptom-Guided Exercise for Long COVID With Postexertional Malaise.},
journal = {JAMA},
volume = {},
number = {},
pages = {},
doi = {10.1001/jama.2024.7255},
pmid = {38669034},
issn = {1538-3598},
}

@article {pmid38668888,
year = {2024},
author = {Molnar, T and Lehoczki, A and Fekete, M and Varnai, R and Zavori, L and Erdo-Bonyar, S and Simon, D and Berki, T and Csecsei, P and Ezer, E},
title = {Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches.},
journal = {GeroScience},
volume = {},
number = {},
pages = {},
pmid = {38668888},
issn = {2509-2723},
abstract = {The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has introduced the medical community to the phenomenon of long COVID, a condition characterized by persistent symptoms following the resolution of the acute phase of infection. Among the myriad of symptoms reported by long COVID sufferers, chronic fatigue, cognitive disturbances, and exercise intolerance are predominant, suggesting systemic alterations beyond the initial viral pathology. Emerging evidence has pointed to mitochondrial dysfunction as a potential underpinning mechanism contributing to the persistence and diversity of long COVID symptoms. This review aims to synthesize current findings related to mitochondrial dysfunction in long COVID, exploring its implications for cellular energy deficits, oxidative stress, immune dysregulation, metabolic disturbances, and endothelial dysfunction. Through a comprehensive analysis of the literature, we highlight the significance of mitochondrial health in the pathophysiology of long COVID, drawing parallels with similar clinical syndromes linked to post-infectious states in other diseases where mitochondrial impairment has been implicated. We discuss potential therapeutic strategies targeting mitochondrial function, including pharmacological interventions, lifestyle modifications, exercise, and dietary approaches, and emphasize the need for further research and collaborative efforts to advance our understanding and management of long COVID. This review underscores the critical role of mitochondrial dysfunction in long COVID and calls for a multidisciplinary approach to address the gaps in our knowledge and treatment options for those affected by this condition.},
}

@article {pmid38668125,
year = {2024},
author = {Rudroff, T},
title = {Decoding Post-Viral Fatigue: The Basal Ganglia's Complex Role in Long-COVID.},
journal = {Neurology international},
volume = {16},
number = {2},
pages = {380-393},
doi = {10.3390/neurolint16020028},
pmid = {38668125},
issn = {2035-8385},
abstract = {Long-COVID afflicts millions with relentless fatigue, disrupting daily life. The objective of this narrative review is to synthesize current evidence on the role of the basal ganglia in long-COVID fatigue, discuss potential mechanisms, and highlight promising therapeutic interventions. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases. Mounting evidence from PET, MRI, and functional connectivity data reveals basal ganglia disturbances in long-COVID exhaustion, including inflammation, metabolic disruption, volume changes, and network alterations focused on striatal dopamine circuitry regulating motivation. Theories suggest inflammation-induced signaling disturbances could impede effort/reward valuation, disrupt cortical-subcortical motivational pathways, or diminish excitatory input to arousal centers, attenuating drive initiation. Recent therapeutic pilots targeting basal ganglia abnormalities show provisional efficacy. However, heterogeneous outcomes, inconsistent metrics, and perceived versus objective fatigue discrepancies temper insights. Despite the growing research, gaps remain in understanding the precise pathways linking basal ganglia dysfunction to fatigue and validating treatment efficacy. Further research is needed to advance understanding of the basal ganglia's contribution to long-COVID neurological sequelae and offer hope for improving function across the expanding affected population.},
}

@article {pmid38666878,
year = {2024},
author = {Paradiso, B and Pauza, DH and Limback, C and Ottaviani, G and Thiene, G},
title = {From Psychostasis to the Discovery of Cardiac Nerves: The Origins of the Modern Cardiac Neuromodulation Concept.},
journal = {Biology},
volume = {13},
number = {4},
pages = {},
doi = {10.3390/biology13040266},
pmid = {38666878},
issn = {2079-7737},
abstract = {This review explores the historical development of cardiology knowledge, from ancient Egyptian psychostasis to the modern comprehension of cardiac neuromodulation. In ancient Egyptian religion, psychostasis was the ceremony in which the deceased was judged before gaining access to the afterlife. This ritual was also known as the "weighing of the heart" or "weighing of the soul". The Egyptians believed that the heart, not the brain, was the seat of human wisdom, emotions, and memory. They were the first to recognize the cardiocentric nature of the body, identifying the heart as the center of the circulatory system. Aristotle (fourth century BC) considered the importance of the heart in human physiology in his philosophical analyses. For Galen (third century AD), the heart muscle was the site of the vital spirit, which regulated body temperature. Cardiology knowledge advanced significantly in the 15th century, coinciding with Leonardo da Vinci and Vesalius's pioneering anatomical and physiological studies. It was William Harvey, in the 17th century, who introduced the concept of cardiac circulation. Servet's research and Marcello Malpighi's discovery of arterioles and capillaries provided a more detailed understanding of circulation. Richard Lower emerged as the foremost pioneer of experimental cardiology in the late 17th century. He demonstrated the heart's neural control by tying off the vagus nerve. In 1753, Albrecht von Haller, a professor at Göttingen, was the first to discover the heart's automaticity and the excitation of muscle fibers. Towards the end of the 18th century, Antonio Scarpa challenged the theories of Albrecht von Haller and Johann Bernhard Jacob Behrends, who maintained that the myocardium possessed its own "irritability", on which the heartbeat depended, and was independent of neuronal sensitivity. Instead, Scarpa argued that the heart required innervation to maintain life, refuting Galenic notions. In contemporary times, the study of cardiac innervation has regained prominence, particularly in understanding the post-acute sequelae of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (PASC), which frequently involves cardiorespiratory symptoms and dysregulation of the intrinsic cardiac innervation. Recently, it has been recognized that post-acute sequelae of acute respiratory infections (ARIs) due to other pathogens can also be a cause of long-term vegetative and somatic symptoms. Understanding cardiac innervation and modulation can help to recognize and treat long COVID and long non-COVID-19 (coronavirus disease 2019) ARIs. This analysis explores the historical foundations of cardiac neuromodulation and its contemporary relevance. By focusing on this concept, we aim to bridge the gap between historical understanding and modern applications. This will illuminate the complex interplay between cardiac function, neural modulation, cardiovascular health, and disease management in the context of long-term cardiorespiratory symptoms and dysregulation of intrinsic cardiac innervations.},
}

@article {pmid38664674,
year = {2024},
author = {Fang, C and Akhtar Baz, S and Sheard, L and Carpentieri, JD},
title = {Correction: "They seemed to be like cogs working in different directions": a longitudinal qualitative study on long COVID healthcare services in the United Kingdom from a person-centred lens.},
journal = {BMC health services research},
volume = {24},
number = {1},
pages = {525},
doi = {10.1186/s12913-024-11015-x},
pmid = {38664674},
issn = {1472-6963},
}

@article {pmid38664324,
year = {2024},
author = {Noij, LCE and Blankestijn, JM and Lap, CR and van Houten, MA and Biesbroek, G and der Zee, AM and Abdel-Aziz, MI and van Goudoever, JB and Alsem, MW and Brackel, CLH and Oostrom, KJ and Hashimoto, S and Terheggen-Lagro, SWJ},
title = {Clinical-based phenotypes in children with pediatric post-COVID-19 condition.},
journal = {World journal of pediatrics : WJP},
volume = {},
number = {},
pages = {},
pmid = {38664324},
issn = {1867-0687},
abstract = {BACKGROUND: Pediatric post coronavirus disease 2019 (COVID-19) condition (PPCC) is a heterogeneous syndrome, which can significantly affect the daily lives of children. This study aimed to identify clinically meaningful phenotypes in children with PPCC, to better characterize and treat this condition.

METHODS: Participants were children with physician-diagnosed PPCC, referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March 2023. Demographic factors and information on post-COVID symptoms, comorbidities, and impact on daily life were collected. Clinical clusters were identified using an unsupervised and unbiased approach for mixed data types.

RESULTS: Analysis of 111 patients (aged 3-18 years) revealed three distinct clusters within PPCC. Cluster 1 (n = 62, median age = 15 years) predominantly consisted of girls (74.2%). These patients suffered relatively more from exercise intolerance, dyspnea, and smell disorders. Cluster 2 (n = 33, median age = 13 years) contained patients with an even gender distribution (51.5% girls). They suffered from relatively more sleep problems, memory loss, gastrointestinal symptoms, and arthralgia. Cluster 3 (n = 16, median age = 11 years) had a higher proportion of boys (75.0%), suffered relatively more from fever, had significantly fewer symptoms (median age of 5 years compared to 8 and 10 years for clusters 1 and 2 respectively), and experienced a lower impact on daily life.

CONCLUSIONS: This study identified three distinct clinical PPCC phenotypes, with variations in sex, age, symptom patterns, and impact on daily life. These findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.},
}

@article {pmid38664068,
year = {2024},
author = {Luedke, JC and Vargas, G and Jashar, DT and Malone, LA and Morrow, A and Ng, R},
title = {Neuropsychological functioning of pediatric patients with long COVID.},
journal = {The Clinical neuropsychologist},
volume = {},
number = {},
pages = {1-18},
doi = {10.1080/13854046.2024.2344455},
pmid = {38664068},
issn = {1744-4144},
abstract = {Objective: To determine the neurocognitive profile for youth with long COVID presenting with cognitive concerns. Method: This study is a case series of 54 pediatric patients (65% female, Mage = 13.48, SDage = 3.10, 5-19) with long COVID who were referred for neuropsychological testing from a post-COVID-19 multidisciplinary clinic. The outcomes of interest were neuropsychological test scores and parent ratings of mood, attention, and executive functioning. The percentage of patients with neuropsychological test scores below the 9th percentile (below average range) and those with at-risk or clinically significant scores (T-scores > 59) on parent-informant inventories were computed. Results: A portion of children with long COVID showed weaknesses in sustained attention (29%) and divided attention (35%). This portion of patients did not significantly differ when comparing patients with and without pre-existing attention and mood concerns. A high percentage of parents reported at-risk to clinically significant concerns for cognitive regulation (53%), depression (95%), anxiety (85%), and inattention (66%) on standardized questionnaires. Conclusions: The present case series showed that approximately a third of children with long COVID demonstrate objective weaknesses on sustained and divided attention tasks but were largely intact in other domains of neuropsychological functioning. Importantly, children with long COVID had similar difficulties in attention, regardless of pre-existing attention or mood concerns. Parents reported high rates of mood, anxiety, and executive functioning difficulties which likely impact daily functioning. Attention and emotional regulation should be closely monitored and treated as necessary in pediatric patients with long COVID to aid functional recovery.},
}

@article {pmid38663887,
year = {2024},
author = {Blankestijn, JM and Abdel-Aziz, MI and Baalbaki, N and Bazdar, S and Beekers, I and Beijers, RJHCG and Bloemsma, LD and Cornelissen, MEB and Gach, D and Houweling, L and Holverda, S and Jacobs, JJL and Jonker, R and van der Lee, I and Linders, PMA and Mohamed Hoesein, FAA and Noij, LCE and Nossent, EJ and van de Pol, MA and Schaminee, DW and Schols, AMWJ and Schuurman, LT and Sondermeijer, B and Geelhoed, JJM and van den Bergh, JP and Weersink, EJM and de Wit-van Wijck, Y and Maitland-van der Zee, AH and , },
title = {Long COVID exhibits clinically distinct phenotypes at 3-6 months post-SARS-CoV-2 infection: results from the P4O2 consortium.},
journal = {BMJ open respiratory research},
volume = {11},
number = {1},
pages = {},
doi = {10.1136/bmjresp-2023-001907},
pmid = {38663887},
issn = {2052-4439},
mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; Female ; Male ; Middle Aged ; *Post-Acute COVID-19 Syndrome ; *Phenotype ; *SARS-CoV-2 ; Aged ; Severity of Illness Index ; Adult ; Cohort Studies ; Respiratory Function Tests ; Cluster Analysis ; Forced Expiratory Volume ; Time Factors ; },
abstract = {BACKGROUND: Four months after SARS-CoV-2 infection, 22%-50% of COVID-19 patients still experience complaints. Long COVID is a heterogeneous disease and finding subtypes could aid in optimising and developing treatment for the individual patient.

METHODS: Data were collected from 95 patients in the P4O2 COVID-19 cohort at 3-6 months after infection. Unsupervised hierarchical clustering was performed on patient characteristics, characteristics from acute SARS-CoV-2 infection, long COVID symptom data, lung function and questionnaires describing the impact and severity of long COVID. To assess robustness, partitioning around medoids was used as alternative clustering.

RESULTS: Three distinct clusters of patients with long COVID were revealed. Cluster 1 (44%) represented predominantly female patients (93%) with pre-existing asthma and suffered from a median of four symptom categories, including fatigue and respiratory and neurological symptoms. They showed a milder SARS-CoV-2 infection. Cluster 2 (38%) consisted of predominantly male patients (83%) with cardiovascular disease (CVD) and suffered from a median of three symptom categories, most commonly respiratory and neurological symptoms. This cluster also showed a significantly lower forced expiratory volume within 1 s and diffusion capacity of the lung for carbon monoxide. Cluster 3 (18%) was predominantly male (88%) with pre-existing CVD and diabetes. This cluster showed the mildest long COVID, and suffered from symptoms in a median of one symptom category.

CONCLUSIONS: Long COVID patients can be clustered into three distinct phenotypes based on their clinical presentation and easily obtainable information. These clusters show distinction in patient characteristics, lung function, long COVID severity and acute SARS-CoV-2 infection severity. This clustering can help in selecting the most beneficial monitoring and/or treatment strategies for patients suffering from long COVID. Follow-up research is needed to reveal the underlying molecular mechanisms implicated in the different phenotypes and determine the efficacy of treatment.},
}

Humans
*COVID-19/complications/epidemiology/physiopathology
Female
Male
Middle Aged
*Post-Acute COVID-19 Syndrome
*Phenotype
*SARS-CoV-2
Aged
Severity of Illness Index
Adult
Cohort Studies
Respiratory Function Tests
Cluster Analysis
Forced Expiratory Volume
Time Factors

@article {pmid38663793,
year = {2024},
author = {Sawano, M and Wu, Y and Shah, RM and Zhou, T and Arun, AS and Khosla, P and Kaleem, S and Vashist, A and Bhattacharjee, B and Ding, Q and Lu, Y and Caraballo, C and Warner, F and Huang, C and Herrin, J and Putrino, D and Michelsen, T and Fisher, L and Adinig, C and Iwasaki, A and Krumholz, HM},
title = {Long COVID Characteristics and Experience: A Descriptive Study from the Yale LISTEN Research Cohort.},
journal = {The American journal of medicine},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.amjmed.2024.04.015},
pmid = {38663793},
issn = {1555-7162},
abstract = {OBJECTIVE: To describe the experience of people with long COVID symptomatology and characterize the psychological, social, and financial challenges they experience.

BACKGROUND: The experience of people with long COVID needs further amplification, especially with a comprehensive focus on symptomatology, treatments, and impact on daily life and finances.

METHODS: We collected data from individuals aged 18 and older reporting long COVID as participants in the Yale Listen to Immune, Symptom and Treatment Experiences Now (LISTEN) Study. The sample population included 441 participants surveyed between May 2022 and July 2023. We evaluated their demographic characteristics, socioeconomic and psychological status, index infection period, health status, quality of life, symptoms, treatments, pre-pandemic comorbidities, and new-onset conditions.

RESULTS: Overall, the median age of the participants with long COVID was 46 years (IQR: 38 to 57 years); 74% were women, 86% were Non-Hispanic White, and 93% were from the United States. Participants reported low health status measured by the Euro-QoL visual analogue scale, with a median score of 49 (IQR: 32 to 61). Participants documented a diverse range of symptoms, with all 96 possible symptom choices being reported. Additionally, participants had tried many treatments (median number of treatments: 19, IQR: 12 to 28). They were also experiencing psychological distress, social isolation, and financial stress.

CONCLUSIONS: Despite having tried numerous treatments, participants with long COVID continued to experience an array of health and financial challenges-findings that underscore the failure of the healthcare system to address the medical needs of people with long COVID. These insights highlight the need for crucial medical, mental health, financial, and community support services, as well as further scientific investigation, to address the complex impact of long COVID.},
}

@article {pmid38663424,
year = {2024},
author = {Buonsenso, D and Tantisira, KG},
title = {Long COVID and SARS-CoV-2 persistence: new answers, more questions.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(24)00216-0},
pmid = {38663424},
issn = {1474-4457},
}

@article {pmid38663423,
year = {2024},
author = {Zuo, W and He, D and Liang, C and Du, S and Hua, Z and Nie, Q and Zhou, X and Yang, M and Tan, H and Xu, J and Yu, Y and Zhan, Y and Zhang, Y and Gu, X and Zhu, W and Zhang, H and Li, H and Sun, W and Sun, M and Liu, X and Liu, L and Cao, C and Li, R and Li, J and Zhang, Y and Zhang, Y and Guo, J and Zhao, L and Zhang, CP and Liu, H and Wang, S and Xiao, F and Wang, Y and Wang, Z and Li, H and Cao, B},
title = {The persistence of SARS-CoV-2 in tissues and its association with long COVID symptoms: a cross-sectional cohort study in China.},
journal = {The Lancet. Infectious diseases},
volume = {},
number = {},
pages = {},
doi = {10.1016/S1473-3099(24)00171-3},
pmid = {38663423},
issn = {1474-4457},
abstract = {BACKGROUND: Growing evidence suggests that symptoms associated with post-COVID-19 condition (also known as long COVID) can affect multiple organs and systems in the human body, but their association with viral persistence is not clear. The aim of this study was to investigate the persistence of SARS-CoV-2 in diverse tissues at three timepoints following recovery from mild COVID-19, as well as its association with long COVID symptoms.

METHODS: This single-centre, cross-sectional cohort study was done at China-Japan Friendship Hospital in Beijing, China, following the omicron wave of COVID-19 in December, 2022. Individuals with mild COVID-19 confirmed by PCR or a lateral flow test scheduled to undergo gastroscopy, surgery, or chemotherapy, or scheduled for treatment in hospital for other reasons, at 1 month, 2 months, or 4 months after infection were enrolled in this study. Residual surgical samples, gastroscopy samples, and blood samples were collected approximately 1 month (18-33 days), 2 months (55-84 days), or 4 months (115-134 days) after infection. SARS-CoV-2 was detected by digital droplet PCR and further confirmed through RNA in-situ hybridisation, immunofluorescence, and immunohistochemistry. Telephone follow-up was done at 4 months post-infection to assess the association between the persistence of SARS-CoV-2 RNA and long COVID symptoms.

FINDINGS: Between Jan 3 and April 28, 2023, 317 tissue samples were collected from 225 patients, including 201 residual surgical specimens, 59 gastroscopy samples, and 57 blood component samples. Viral RNA was detected in 16 (30%) of 53 solid tissue samples collected at 1 month, 38 (27%) of 141 collected at 2 months, and seven (11%) of 66 collected at 4 months. Viral RNA was distributed across ten different types of solid tissues, including liver, kidney, stomach, intestine, brain, blood vessel, lung, breast, skin, and thyroid. Additionally, subgenomic RNA was detected in 26 (43%) of 61 solid tissue samples tested for subgenomic RNA that also tested positive for viral RNA. At 2 months after infection, viral RNA was detected in the plasma of three (33%), granulocytes of one (11%), and peripheral blood mononuclear cells of two (22%) of nine patients who were immunocompromised, but in none of these blood compartments in ten patients who were immunocompetent. Among 213 patients who completed the telephone questionnaire, 72 (34%) reported at least one long COVID symptom, with fatigue (21%, 44 of 213) being the most frequent symptom. Detection of viral RNA in recovered patients was significantly associated with the development of long COVID symptoms (odds ratio 5·17, 95% CI 2·64-10·13, p<0·0001). Patients with higher virus copy numbers had a higher likelihood of developing long COVID symptoms.

INTERPRETATION: Our findings suggest that residual SARS-CoV-2 can persist in patients who have recovered from mild COVID-19 and that there is a significant association between viral persistence and long COVID symptoms. Further research is needed to verify a mechanistic link and identify potential targets to improve long COVID symptoms.

FUNDING: National Natural Science Foundation of China, National Key R&D Program of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, and New Cornerstone Science Foundation.

TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.},
}

@article {pmid38662331,
year = {2024},
author = {Mendes, D and Machira Krishnan, S and O'Brien, E and Padgett, T and Harrison, C and Strain, WD and Manca, A and Ustianowski, A and Butfield, R and Hamson, E and Reynard, C and Yang, J},
title = {Modelling COVID-19 Vaccination in the UK: Impact of the Autumn 2022 and Spring 2023 Booster Campaigns.},
journal = {Infectious diseases and therapy},
volume = {},
number = {},
pages = {},
pmid = {38662331},
issn = {2193-8229},
abstract = {INTRODUCTION: The delivery of COVID-19 vaccines was successful in reducing hospitalizations and mortality. However, emergence of the Omicron variant resulted in increased virus transmissibility. Consequently, booster vaccination programs were initiated to decrease the risk of severe disease and death among vulnerable members of the population. This study aimed to estimate the effects of the booster program and alternative vaccination strategies on morbidity and mortality due to COVID-19 in the UK.

METHOD: A Susceptible-Exposed-Infectious-Recovered (SEIR) model was used to assess the impact of several vaccination strategies on severe outcomes associated with COVID-19, including hospitalizations, mortality, National Health Service (NHS) capacity quantified by hospital general ward and intensive care unit (ICU) bed days, and patient productivity. The model accounted for age-, risk- and immunity-based stratification of the UK population. Outcomes were evaluated over a 48-week time horizon from September 2022 to August 2023 considering the actual UK autumn 2022/spring 2023 booster campaigns and six counterfactual strategies.

RESULTS: The model estimated that the autumn 2022/spring 2023 booster campaign resulted in a reduction of 18,921 hospitalizations and 1463 deaths, compared with a no booster scenario. Utilization of hospital bed days due to COVID-19 decreased after the autumn 2022/spring 2023 booster campaign. Expanding the booster eligibility criteria and improving uptake improved all outcomes, including averting twice as many ICU admissions, preventing more than 20% additional deaths, and a sevenfold reduction in long COVID, compared with the autumn 2022/spring 2023 booster campaign. The number of productive days lost was reduced by fivefold indicating that vaccinating a wider population has a beneficial impact on the morbidities associated with COVID-19.

CONCLUSION: Our modelling demonstrates that the autumn 2022/spring 2023 booster campaign reduced COVID-19-associated morbidity and mortality. Booster campaigns with alternative eligibility criteria warrant consideration in the UK, given their potential to further reduce morbidity and mortality as future variants emerge.},
}

@article {pmid38661341,
year = {2024},
author = {Reay, A and Dismore, L and Aujayeb, A and Dotchin, C and Tullo, E and Steer, J and Swainston, K},
title = {Analysing the patient experience of COVID-19: Exploring patients' experiences of hospitalisation and their quality of life post discharge.},
journal = {Journal of clinical nursing},
volume = {},
number = {},
pages = {},
doi = {10.1111/jocn.17194},
pmid = {38661341},
issn = {1365-2702},
abstract = {AIMS AND OBJECTIVES: We sought to gain an understanding of the patient experience during their hospital stay for COVID-19, and the impact of COVID-19 on quality of life post discharge.

BACKGROUND: Symptoms of COVID-19 include a persistent cough, dyspnoea and fatigue. Individuals with comorbidities such as cardiovascular disease have a higher risk of contracting COVID-19 and approximately 20% of those diagnosed with COVID-19 are admitted to hospital. Following discharge from hospital, 40% of patients report a worsened quality of life and up to 87% of those discharged from hospital have experienced 'long COVID'.

DESIGN: A qualitative design was used to understand patient experience of hospitalisation following a diagnosis of COVID-19, and their experiences following discharge from hospital.

METHODS: Ten patients with a previous diagnosis of COVID-19 took part in semi-structured interviews regarding their experiences of hospitalisation and the impact on quality of life post-discharge.

RESULTS: The results identified three key themes from the interviews: communication and the inpatient experience, symptoms following discharge and regaining independence. Patients discussed their experience of hospitalisation and how this continued to impact their emotional well-being post-discharge. However, patients appeared to push themselves physically to improve their health, despite continued COVID-19 symptoms.

CONCLUSION: Patients hospitalised following a diagnosis of COVID-19 experienced psychological distress during their hospital stay, as well as 3-months post-discharge. We suggest the use of psychosocial interventions to support patients post-discharge.

The results of this study provide a greater understanding of the patient experience during their hospital stay, which can support nursing staff practice. Additionally, the study provides in depth knowledge of personal experiences of patients diagnosed with COVID-19 and the impact following hospital discharge.

Patient's took part in semi-structured interviews via telephone to support the aims and objectives of this study.},
}

@article {pmid38659602,
year = {2024},
author = {Metelkina-Fernandez, V and Dumas, LE and Vandersteen, C and Chirio, D and Gros, A and Fernandez, A and Askenazy, F and Manera, V},
title = {Psychiatric outcomes in outpatients affected by long COVID: A link between mental health and persistence of olfactory complaint.},
journal = {World journal of psychiatry},
volume = {14},
number = {4},
pages = {507-512},
pmid = {38659602},
issn = {2220-3206},
abstract = {BACKGROUND: Anosmia was one of the main symptoms of coronavirus disease 2019 (COVID-19). A psychiatric history (i.e., depression) may be an independent contributor to the risk of COVID-19 diagnosis, and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae (bidirectional association).

AIM: To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints.

METHODS: We conducted a prospective case control study from March 2020 to May 2021. Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint (visual analogue scale) for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology. Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department. Psychiatric medical histories were collected by a psychiatrist during the assessments.

RESULTS: Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study. Fifty percent of the patients were female (n = 17). The group's mean age was 40.5 ± 12.9 years. The control group included 32 participants, of which 34.4% were female (n = 11), and had a mean age of 61.2 ± 12.2 years. The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher (41.7%) than among patients without (18.8%) (χ[2] = 5.9, P = 0.015).

CONCLUSION: The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia. It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients. Further prospective, translational, and collaborative studies are needed to extrapolate these results to the general population.},
}

@article {pmid38658821,
year = {2024},
author = {Benny, D and Giacobini, M and Costa, G and Gnavi, R and Ricceri, F},
title = {Multimorbidity in middle-aged women and COVID-19: binary data clustering for unsupervised binning of rare multimorbidity features and predictive modeling.},
journal = {BMC medical research methodology},
volume = {24},
number = {1},
pages = {95},
pmid = {38658821},
issn = {1471-2288},
mesh = {Humans ; *COVID-19/epidemiology ; Female ; *Multimorbidity ; Middle Aged ; Italy/epidemiology ; Cluster Analysis ; *SARS-CoV-2 ; Severity of Illness Index ; Hospitalization/statistics & numerical data ; Quality of Life ; Cohort Studies ; Machine Learning ; },
abstract = {BACKGROUND: Multimorbidity is typically associated with deficient health-related quality of life in mid-life, and the likelihood of developing multimorbidity in women is elevated. We address the issue of data sparsity in non-prevalent features by clustering the binary data of various rare medical conditions in a cohort of middle-aged women. This study aims to enhance understanding of how multimorbidity affects COVID-19 severity by clustering rare medical conditions and combining them with prevalent features for predictive modeling. The insights gained can guide the development of targeted interventions and improved management strategies for individuals with multiple health conditions.

METHODS: The study focuses on a cohort of 4477 female patients, (aged 45-60) in Piedmont, Italy, and utilizes their multimorbidity data prior to the COVID-19 pandemic from their medical history from 2015 to 2019. The COVID-19 severity is determined by the hospitalization status of the patients from February to May 2020. Each patient profile in the dataset is depicted as a binary vector, where each feature denotes the presence or absence of a specific multimorbidity condition. By clustering the sparse medical data, newly engineered features are generated as a bin of features, and they are combined with the prevalent features for COVID-19 severity predictive modeling.

RESULTS: From sparse data consisting of 174 input features, we have created a low-dimensional feature matrix of 17 features. Machine Learning algorithms are applied to the reduced sparsity-free data to predict the Covid-19 hospital admission outcome. The performance obtained for the corresponding models are as follows: Logistic Regression (accuracy 0.72, AUC 0.77, F1-score 0.69), Linear Discriminant Analysis (accuracy 0.7, AUC 0.77, F1-score 0.67), and Ada Boost (accuracy 0.7, AUC 0.77, F1-score 0.68).

CONCLUSION: Mapping higher-dimensional data to a low-dimensional space can result in information loss, but reducing sparsity can be beneficial for Machine Learning modeling due to improved predictive ability. In this study, we addressed the issue of data sparsity in electronic health records and created a model that incorporates both prevalent and rare medical conditions, leading to more accurate and effective predictive modeling. The identification of complex associations between multimorbidity and the severity of COVID-19 highlights potential areas of focus for future research, including long COVID and intervention efforts.},
}

Humans
*COVID-19/epidemiology
Female
*Multimorbidity
Middle Aged
Italy/epidemiology
Cluster Analysis
*SARS-CoV-2
Severity of Illness Index
Hospitalization/statistics & numerical data
Quality of Life
Cohort Studies
Machine Learning

@article {pmid38658496,
year = {2024},
author = {Gloeckl, R and Zwick, RH and Fürlinger, U and Schneeberger, T and Leitl, D and Jarosch, I and Behrends, U and Scheibenbogen, C and Koczulla, AR},
title = {Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal.},
journal = {Sports medicine - open},
volume = {10},
number = {1},
pages = {47},
pmid = {38658496},
issn = {2199-1170},
abstract = {People with long COVID may suffer from a wide range of ongoing symptoms including fatigue, exertional dyspnea, reduced exercise performance, and others. In particular, impaired exercise performance is a condition that can be recovered in many people through an individualized physical exercise training program. However, clinical experience has shown that the presence of post-exertional malaise (PEM) is a significant barrier to physical exercise training in people with long COVID. Currently, there is no guideline or consensus available on how to apply exercise training in this cohort. Therefore, we conducted a literature review in the PubMed library using the following search terms: "COVID", "post-COVID", "long COVID" and "exercise" searching for studies from January 2020 to January 2024. Data from 46 trials were included. Exercise training regimes were very heterogeneous and none of these studies reported on the management of PEM in the context of an exercise training program. Based on the feedback from an additional survey that was answered by 14 international experts in the field of exercise training in long COVID, combined with the authors´ own extensive practical experience, a best practice proposal for exercise training recommendations has been developed. This proposal differentiates exercise procedures according to the presence of no, mild/moderate or severe PEM in people with long COVID. These recommendations may guide allied healthcare professionals worldwide in initiating and adjusting exercise training programs for people with long COVID, stratified according to the presence and severity of PEM.},
}

@article {pmid38657605,
year = {2024},
author = {Su, Q and Lau, RI and Liu, Q and Li, MKT and Yan Mak, JW and Lu, W and Lau, ISF and Lau, LHS and Yeung, GTY and Cheung, CP and Tang, W and Liu, C and Ching, JYL and Cheong, PK and Chan, FKL and Ng, SC},
title = {The gut microbiome associates with phenotypic manifestations of post-acute COVID-19 syndrome.},
journal = {Cell host & microbe},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.chom.2024.04.005},
pmid = {38657605},
issn = {1934-6069},
abstract = {The mechanisms underlying the many phenotypic manifestations of post-acute COVID-19 syndrome (PACS) are poorly understood. Herein, we characterized the gut microbiome in heterogeneous cohorts of subjects with PACS and developed a multi-label machine learning model for using the microbiome to predict specific symptoms. Our processed data covered 585 bacterial species and 500 microbial pathways, explaining 12.7% of the inter-individual variability in PACS. Three gut-microbiome-based enterotypes were identified in subjects with PACS and associated with different phenotypic manifestations. The trained model showed an accuracy of 0.89 in predicting individual symptoms of PACS in the test set and maintained a sensitivity of 86% and a specificity of 82% in predicting upcoming symptoms in an independent longitudinal cohort of subjects before they developed PACS. This study demonstrates that the gut microbiome is associated with phenotypic manifestations of PACS, which has potential clinical utility for the prediction and diagnosis of PACS.},
}

@article {pmid38657468,
year = {2024},
author = {Rusu, EC and Monfort-Lanzas, P and Bertran, L and Barrientos-Riosalido, A and Solé, E and Mahmoudian, R and Aguilar, C and Briansó, S and Mohamed, F and Garcia, S and Camaron, J and Auguet, T},
title = {Towards understanding post-COVID-19 condition: A systematic meta-analysis of transcriptomic alterations with sex-specific insights.},
journal = {Computers in biology and medicine},
volume = {175},
number = {},
pages = {108507},
doi = {10.1016/j.compbiomed.2024.108507},
pmid = {38657468},
issn = {1879-0534},
abstract = {BACKGROUND: Post COVID-19 Condition (PCC), characterized by lingering symptoms post-acute COVID-19, poses clinical challenges, highlighting the need to understand its underlying molecular mechanisms. This meta-analysis aims to shed light on the transcriptomic landscapes and sex-specific molecular dynamics intrinsic to PCC.

METHODS: A systematic review identified three studies suitable for comprehensive meta-analysis, encompassing 135 samples (57 PCC subjects and 78 recovered subjects). We performed meta-analysis on differential gene expression, a gene set enrichment analysis of Reactome pathways, and weighted gene co-expression network analysis (WGCNA). We performed a drug and disease enrichment analysis and also assessed sex-specific differences in expression patterns.

KEY FINDINGS: A clear difference was observed in the transcriptomic profiles of PCC subjects, with 530 differentially expressed genes (DEGs) identified. Enrichment analysis revealed that the altered pathways were predominantly implicated in cell cycle processes, immune dysregulation and histone modifications. Antioxidant compounds such as hesperitin were predominantly linked to the hub genes of the DEGs. Sex-specific analyses highlighted disparities in DEGs and altered pathways in male and female PCC patients, revealing a difference in the expression of ribosomal proteins. PCC in men was mostly linked to neuro-cardiovascular disorders, while women exhibited more diverse disorders, with a high index of respiratory conditions.

CONCLUSION: Our study reveals the intricate molecular processes underlying PCC, highlighting that the differences in molecular dynamics between males and females could be key to understanding and effectively managing the varied symptomatology of this condition.},
}

@article {pmid38657236,
year = {2024},
author = {Wang, D and Li, P and Huang, X and Liu, Y and Mao, S and Yin, H and Wang, N and Luo, Y and Sun, S},
title = {Exploring the Prevalence of Tinnitus and Ear-Related Symptoms in China After the COVID-19 Pandemic: Online Cross-Sectional Survey.},
journal = {JMIR formative research},
volume = {8},
number = {},
pages = {e54326},
doi = {10.2196/54326},
pmid = {38657236},
issn = {2561-326X},
abstract = {BACKGROUND: Tinnitus is a complex and heterogeneous disease that has been identified as a common manifestation of COVID-19. To gain a comprehensive understanding of tinnitus symptoms in individuals following COVID-19 infection, we conducted an online survey called the China Ear Nose and Throat Symptom Survey in the COVID-19 Pandemic (CENTSS) among the Chinese population.

OBJECTIVE: Our objective was to investigate tinnitus and ear-related symptoms after COVID-19 infection in the Chinese population, with the aim of providing a solid empirical foundation for improved health care. The findings from CENTSS can contribute to the development of enhanced management strategies for tinnitus in the context of long COVID. By gaining a better understanding of the factors contributing to tinnitus in individuals with COVID-19, health care providers can tailor interventions to address the specific needs of affected patients. Furthermore, this study serves as a basis for research on the long-term consequences of COVID-19 infection and its associated tinnitus symptoms.

METHODS: A quantitative, online, cross-sectional survey study design was used to explore the impact of the COVID-19 pandemic on experiences with tinnitus in China. Data were collected through an online questionnaire designed to identify the presence of tinnitus and its impacts. Descriptive statistics were used to analyze individuals' demographic characteristics, COVID-19 infection-related ear symptoms, and the cognitive and emotional implications of tinnitus. Univariable and multivariable logistic regression analyses were used to model the cross-sectional baseline associations between demographic characteristics, noise exposure, educational level, health and lifestyle factors, and the occurrence of tinnitus.

RESULTS: Between December 19, 2022, and February 1, 2023, we obtained responses from 1262 Chinese participants representing 24 regions, with an average age of 37 years. Among them, 540 patients (42.8%) reported experiencing ear-related symptoms after COVID-19 infection. Only 114 (9%) of these patients sought medical attention specifically for their ear symptoms, while 426 (33.8%) did not seek hospital care. Tinnitus emerged as the most prevalent and impactful symptom among all ear-related symptoms experienced after COVID-19 infection. Of the respondents, female participants (688/888, 77.78%), younger individuals (<30 years), individuals with lower education levels, participants residing in western China, and those with a history of otolaryngology diseases were more likely to develop tinnitus following COVID-19 infection.

CONCLUSIONS: In summary, tinnitus was identified as the most common ear-related symptom during COVID-19 infection. Individuals experiencing tinnitus after COVID-19 infection were found to have poorer cognitive and emotional well-being. Different ear-related symptoms in patients post-COVID-19 infection may suggest viral invasion of various parts of the ear. It is therefore crucial to monitor and manage hearing-related changes resulting from COVID-19 as clinical services resume.},
}

@article {pmid38657151,
year = {2024},
author = {García-Dobarganes-Barlow, FE and Valadez-Soto, JM and Saavedra-Islas, N and García-Romo, VM and Mata-Coronado, J and Villavicencio-Ocampo, E and Encalada-Díaz, MI},
title = {[Avascular necrosis of the hip secondary to long-standing COVID].},
journal = {Acta ortopedica mexicana},
volume = {38},
number = {1},
pages = {48-51},
pmid = {38657151},
issn = {2306-4102},
mesh = {Humans ; Male ; *COVID-19/complications ; Adult ; *Femur Head Necrosis/etiology/surgery ; Time Factors ; Arthroplasty, Replacement, Hip ; Glucocorticoids/therapeutic use/administration & dosage ; },
abstract = {Long COVID is a term used to describe the long-terms effects of COVID-19 infection that continue for weeks or months after the patient has recovered from COVID-19. Long COVID is defined by the persistence of symptoms beyond 12 weeks from the onset of the disease. Corticosteroids are part of the treatment in this period with good results in controlling the disease; however, it is a predisposing factor for the development of avascular necrosis. We present a clinic case of a young man of 39 years old with diagnosis of avascular necrosis in his left hip, before the administration of corticosteroids for the treatment of COVID-19. There is a lack of consensus about the dosage and duration of steroids required to develop avascular necrosis. Some authors have reported that cumulative dose of 2,000 mg prednisone (or its equivalent) was required for avascular necrosis development. For patients with advanced avascular necrosis stages total hip arthroplasty is an attractive option with excellent outcomes in terms of pain relief and survivorship.},
}

Humans
Male
*COVID-19/complications
Adult
*Femur Head Necrosis/etiology/surgery
Time Factors
Arthroplasty, Replacement, Hip
Glucocorticoids/therapeutic use/administration & dosage

@article {pmid38656671,
year = {2024},
author = {Li, H and Zhao, J and Xing, Y and Chen, J and Wen, Z and Ma, R and Han, F and Huang, B and Wang, H and Li, C and Chen, Y and Ning, X},
title = {Identification of Age-Related Characteristic Genes Involved in Severe COVID-19 Infection Among Elderly Patients Using Machine Learning and Immune Cell Infiltration Analysis.},
journal = {Biochemical genetics},
volume = {},
number = {},
pages = {},
pmid = {38656671},
issn = {1573-4927},
support = {No. 2021E010//Health Research Project of Shaanxi Province/ ; No. 82270715//National Natural Science Foundation of China/ ; No.2023-ZDLSF-15//Key Research and Development Program of Shaanxi Province/ ; },
abstract = {Elderly patients infected with severe acute respiratory syndrome coronavirus 2 are at higher risk of severe clinical manifestation, extended hospitalization, and increased mortality. Those patients are more likely to experience persistent symptoms and exacerbate the condition of basic diseases with long COVID-19 syndrome. However, the molecular mechanisms underlying severe COVID-19 in the elderly patients remain unclear. Our study aims to investigate the function of the interaction between disease-characteristic genes and immune cell infiltration in patients with severe COVID-19 infection. COVID-19 datasets (GSE164805 and GSE180594) and aging dataset (GSE69832) were obtained from the Gene Expression Omnibus database. The combined different expression genes (DEGs) were subjected to Gene Ontology (GO) functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Diseases Ontology functional enrichment analysis, Gene Set Enrichment Analysis, machine learning, and immune cell infiltration analysis. GO and KEGG enrichment analyses revealed that the eight DEGs (IL23A, PTGER4, PLCB1, IL1B, CXCR1, C1QB, MX2, ALOX12) were mainly involved in inflammatory mediator regulation of TRP channels, coronavirus disease-COVID-19, and cytokine activity signaling pathways. Three-degree algorithm (LASSO, SVM-RFE, KNN) and correlation analysis showed that the five DEGs up-regulated the immune cells of macrophages M0/M1, memory B cells, gamma delta T cell, dendritic cell resting, and master cell resisting. Our study identified five hallmark genes that can serve as disease-characteristic genes and target immune cells infiltrated in severe COVID-19 patients among the elderly population, which may contribute to the study of pathogenesis and the evaluation of diagnosis and prognosis in aging patients infected with severe COVID-19.},
}

@article {pmid38656063,
year = {2024},
author = {Martins, WRM and Cardoso, TV and Oliveira, AL and Fernandes, GS and Fontes, IFL and Dantas, JG and Miranda, JS and Martins, JE and Antunes, LN and Leite, TG},
title = {Long COVID-19 and mnemonic effects: an integrative literature review.},
journal = {Revista da Associacao Medica Brasileira (1992)},
volume = {70},
number = {5},
pages = {e20231211},
doi = {10.1590/1806-9282.20231211},
pmid = {38656063},
issn = {1806-9282},
mesh = {Humans ; *COVID-19/prevention & control ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
}

Humans
*COVID-19/prevention & control
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid38655026,
year = {2024},
author = {Gutfreund, MC and Kobayashi, T and Callado, GY and Pardo, I and Hsieh, MK and Lin, V and Perencevich, EN and Salinas, JL and Edmond, MB and Mendonça, E and Rizzo, LV and Marra, AR},
title = {The effectiveness of the COVID-19 vaccines in the prevention of post-COVID conditions in children and adolescents: a systematic literature review and meta-analysis.},
journal = {Antimicrobial stewardship & healthcare epidemiology : ASHE},
volume = {4},
number = {1},
pages = {e54},
pmid = {38655026},
issn = {2732-494X},
abstract = {OBJECTIVE: We performed a systematic literature review and meta-analysis on the effectiveness of coronavirus disease 2019 (COVID-19) vaccination against post-COVID conditions (long COVID) in the pediatric population.

DESIGN: Systematic literature review/meta-analysis.

METHODS: We searched PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from December 1, 2019, to August 14, 2023, for studies evaluating the COVID-19 vaccine effectiveness against post-COVID conditions among vaccinated individuals < 21 years old who received at least 1 dose of COVID-19 vaccine. A post-COVID condition was defined as any symptom that was present 4 or more weeks after COVID-19 infection. We calculated the pooled diagnostic odds ratio (DOR) (95% CI) for post-COVID conditions between vaccinated and unvaccinated individuals.

RESULTS: Eight studies with 23,995 individuals evaluated the effect of vaccination on post-COVID conditions, of which 5 observational studies were included in the meta-analysis. The prevalence of children who did not receive COVID-19 vaccines ranged from 65% to 97%. The pooled prevalence of post-COVID conditions was 21.3% among those unvaccinated and 20.3% among those vaccinated at least once. The pooled DOR for post-COVID conditions among individuals vaccinated with at least 1 dose and those vaccinated with 2 doses were 1.07 (95% CI, 0.77-1.49) and 0.82 (95% CI, 0.63-1.08), respectively.

CONCLUSIONS: A significant proportion of children and adolescents were unvaccinated, and the prevalence of post-COVID conditions was higher than reported in adults. While vaccination did not appear protective, conclusions were limited by the lack of randomized trials and selection bias inherent in observational studies.},
}

@article {pmid38654678,
year = {2024},
author = {Wei, J and Lu, C and Ding, Y and Lu, Y and Yang, X and Zhang, X and Tang, G},
title = {Gustatory dysfunction and long COVID in Chinese patients with COVID-19: A 6-month follow-up study.},
journal = {Oral diseases},
volume = {},
number = {},
pages = {},
doi = {10.1111/odi.14958},
pmid = {38654678},
issn = {1601-0825},
support = {SHSMU-ZLCX20212401//Innovative Research Team of High-level Local University in Shanghai/ ; },
abstract = {AIMS: To evaluate long COVID of gustatory dysfunction and the associated risk factors regarding onset and recovery in Chinese patients.

METHODS: We conducted a cross-sectional study of patients with SARS-CoV-2 Omicron infection at Changxing Mobile Cabin Hospital in Shanghai, China, from March to May 2022. A prospective follow-up of patients with gustatory dysfunction was conducted at 6 months after discharge.

RESULTS: In total, 18.48% (241/1304) reported gustatory dysfunction. The 6-month follow-up response rate was 89.63% (216/241) and 74.02% recovered their taste sense within 1-3 weeks. A total of 20.37% of patients (44/216) presented with long COVID. Symptoms persisted for 12 patients (5.56%) after 6 months. Having multiple taste impairments (OR, 2.364; 95% CI, 1.286-4.348; p = 0.006) was associated with a higher risk of gustatory dysfunction with long COVID. Having received a COVID-19 vaccine booster was positively associated with taste sensation recovery (HR, 1.344; 95% CI, 1.012-1.785; p = 0.041).

CONCLUSIONS: About 20.37% of patients with COVID-19 might develop long COVID of gustatory dysfunction and 5.56% with persisting changes in their sense of taste. Most patients recovered taste sensations within 1-3 weeks after COVID-19 symptom onset and receiving a booster shot of the COVID-19 vaccine presented a protective effect on the taste sensation recovery.},
}

@article {pmid38652733,
year = {2024},
author = {Wolf, FI and Trapani, V},
title = {Magnesium and vitamin D in long COVID syndrome; do they help?.},
journal = {Magnesium research},
volume = {0},
number = {0},
pages = {},
doi = {10.1684/mrh.2024.0521},
pmid = {38652733},
issn = {1952-4021},
abstract = {Since the start of the COVID-19 pandemic, it has become increasingly clear that the disease can have relevant multisystemic and long-term effects, and several studies have attempted to identify key determinants of the disease course. Here we discuss recent evidence suggesting that, in long COVID patients, combined magnesium and vitamin D deficiencies associate with a higher number of clinical manifestations, as compared to patients with normal levels of both nutrients. We highlight the potential synergistic effects of these deficiencies and propose that future studies should explore a causal link with the risk of developing long COVID. Most importantly, randomized clinical trials are needed to determine if magnesium and vitamin D supplementation can improve long COVID symptoms, providing a safe and affordable support therapy to the benefit of patients and society.},
}

@article {pmid38652535,
year = {2024},
author = {Patton, MJ and Benson, D and Robison, SW and Raval, D and Locy, ML and Patel, K and Grumley, S and Levitan, EB and Morris, P and Might, M and Gaggar, A and Erdmann, N},
title = {Characteristics and Determinants of Pulmonary Long COVID.},
journal = {JCI insight},
volume = {},
number = {},
pages = {},
doi = {10.1172/jci.insight.177518},
pmid = {38652535},
issn = {2379-3708},
abstract = {BACKGROUNDPersistent cough and dyspnea are prominent features of post-acute sequelae of SARS-CoV-2 (also termed 'Long COVID'); however, physiologic measures and clinical features associated with these pulmonary symptoms remain poorly defined. Using longitudinal pulmonary function testing (PFTs) and CT imaging, this study aimed to identify the characteristics and determinants of pulmonary Long COVID.METHODSThis single-center retrospective study included 1,097 patients with clinically defined Long COVID characterized by persistent pulmonary symptoms (dyspnea, cough, and chest discomfort) lasting for ≥1 month after resolution of primary COVID infection.RESULTSAfter exclusion, a total of 929 patients with post-COVID pulmonary symptoms and PFTs were stratified diffusion impairment and restriction as measured by percent predicted diffusion capacity for carbon monoxide (DLCO) and total lung capacity (TLC). Dyspnea was the predominant symptom in the cohort (78%) and had similar prevalence regardless of degree of diffusion impairment or restriction. Longitudinal evaluation revealed diffusion impairment (DLCO ≤80%) and pulmonary restriction (TLC ≤80%) in 51% of the cohort overall (n=479). In multivariable logistic regression analysis (adjusted odds ratio; aOR, 95% confidence interval [CI]), invasive mechanical ventilation during primary infection conferred the greatest increased odds of developing pulmonary Long COVID with diffusion impairment and restriction (aOR=10.9 [4.09-28.6]). Finally, a sub-analysis of CT imaging identified radiographic evidence of fibrosis in this patient population.CONCLUSIONSLongitudinal PFT measurements in patients with prolonged pulmonary symptoms after SARS-CoV-2 infection revealed persistent diffusion impaired restriction as a key feature of pulmonary Long COVID. These results emphasize the importance of incorporating PFTs into routine clinical practice for evaluation of patients with prolonged pulmonary symptoms after resolution of SARS-CoV-2. Subsequent clinical trials should leverage combined symptomatic and quantitative PFT measurements for more targeted enrollment of pulmonary Long COVID patients.FUNDINGThis work was supported by the National Institute of Allergy and Infectious Diseases (AI156898, K08AI129705), the National Heart, Lung, and Blood Institute (HL153113, OTA21-015E, HL149944), and the COVID-19 Urgent Research Response Fund established by the Hugh Kaul Precision Medicine Network at the University of Alabama at Birmingham.},
}

@article {pmid38652515,
year = {2024},
author = {Garrett, C and Aghaei, A and Aggarwal, A and Qiao, S},
title = {The Role of Social Media in the Experiences of COVID-19 Among Long-Hauler Women: Qualitative Study.},
journal = {JMIR human factors},
volume = {11},
number = {},
pages = {e50443},
doi = {10.2196/50443},
pmid = {38652515},
issn = {2292-9495},
mesh = {Humans ; *Social Media ; *COVID-19/psychology/epidemiology/prevention & control ; Female ; *Qualitative Research ; Adult ; Middle Aged ; SARS-CoV-2 ; Social Support ; Aged ; },
abstract = {BACKGROUND: The extant literature suggests that women are more vulnerable to COVID-19 infection and at higher risk for developing long COVID. Due to pandemic mitigation recommendations, social media was relied upon for various aspects of daily life, likely with differences of usage between genders.

OBJECTIVE: This study aimed to explore the role and functions of social media in the lives of long-hauler women.

METHODS: Participants were purposively snowball-sampled from an online health promotion intervention for long-hauler women with COVID-19 from March to June 2021. During this time, one-on-one, semistructured interviews were conducted online until data saturation was agreed to have been achieved (ie, 15 interviews). Interview transcripts and field notes were analyzed using an emergent, inductive approach.

RESULTS: In total, 15 women were enrolled. The main roles of social media included facilitating support group participation, experience sharing, interpersonal connections, and media consumption. Emergent themes demonstrated that participants rely on social media to fulfill needs of emotional support, social engagement, spirituality, health planning, information gathering, professional support, and recreationally for relaxation. As long-hauler women turn to social media to discuss symptom and health management as well as the intention to vaccinate, this study demonstrates both the associated benefits (ie, decreased isolation) and challenges (ie, misinformation, rumination, resentment, jealousy).

CONCLUSIONS: The public health implications of these findings support the development of gender-tailored health promotion interventions that leverage the benefits of social media, while mitigating the negative impacts, for women with long COVID.},
}

Humans
*Social Media
*COVID-19/psychology/epidemiology/prevention & control
Female
*Qualitative Research
Adult
Middle Aged
SARS-CoV-2
Social Support
Aged

@article {pmid38652364,
year = {2024},
author = {Jasiczek, J and Doroszko, A and Trocha, T and Trocha, M},
title = {Role of the RAAS in mediating the pathophysiology of COVID-19.},
journal = {Pharmacological reports : PR},
volume = {},
number = {},
pages = {},
pmid = {38652364},
issn = {2299-5684},
abstract = {The renin-angiotensin-aldosterone system (RAAS) holds a position of paramount importance as enzymatic and endocrine homeostatic regulator concerning the water-electrolyte and acid-base balance. Nevertheless, its intricacy is influenced by the presence of various complementary angiotensins and their specific receptors, thereby modifying the primary RAAS actions. Angiotensin-converting enzyme 2 (ACE2) acts as a surface receptor for SARS-CoV-2, establishing an essential connection between RAAS and COVID-19 infection. Despite the recurring exploration of the RAAS impact on the trajectory of COVID-19 along with the successful resolution of many inquiries, its complete role in the genesis of delayed consequences encompassing long COVID and cardiovascular thrombotic outcomes during the post-COVID phase as well as post-vaccination, remains not fully comprehended. Particularly noteworthy is the involvement of the RAAS in the molecular mechanisms underpinning procoagulant processes throughout COVID-19. These processes significantly contribute to the pathogenesis of organ complications as well as determine clinical outcomes and are discussed in this manuscript.},
}

@article {pmid38651133,
year = {2024},
author = {Staub, K and Ballouz, T and Puhan, M},
title = {An Unwanted but Long-Known Company: Post-Viral Symptoms in the Context of Past Pandemics in Switzerland (and Beyond).},
journal = {Public health reviews},
volume = {45},
number = {},
pages = {1606966},
pmid = {38651133},
issn = {0301-0422},
abstract = {Objectives: Some people do not fully recover from an acute viral infection and experience persistent symptoms or incomplete recovery for months or even years. This is not unique to the SARS-CoV-2 virus and history shows that post-viral conditions like post COVID-19 condition, also referred to as Long Covid, are not new. In particular, during and after pandemics caused by respiratory viruses in which large parts of the population were infected or exposed, professional and public attention was increased, not least because of the large number of people affected. Methods: Given the current relevance of the topic, this article aims to narratively review and summarize the literature on post-viral symptoms during past pandemics and to supplement and illustrate it with Swiss examples from the pandemics of 1890, 1918-1920 and later. Results: Post-viral diseases were an increasingly emphasised health topic during and after past pandemics triggered by respiratory infections over the last 150 years. Conclusion: In the next pandemic, it should not be surprising that post-viral conditions will again play a role, and pandemic plans should reflect this.},
}

@article {pmid38649285,
year = {2024},
author = {Lelesi, PJ and Bono, L and Gurenlian, JR},
title = {A Protocol for Treating Patients with Post-Covid Conditions in Dental Settings.},
journal = {Journal of dental hygiene : JDH},
volume = {98},
number = {2},
pages = {7-20},
pmid = {38649285},
issn = {1553-0205},
abstract = {Purpose The relative newness of Post-COVID Conditions (PCC) has revealed a void in assessment protocols and treatment guidelines for dental settings. Providing oral health care practitioners with an assessment and treatment protocol could facilitate the delivery of comprehensive oral health care. The purpose of this study was to test a protocol for assessing and treating patients with PCC in dental practice settings.Methods A qualitative exploratory research design was used to conduct the study. A PCC assessment and treatment protocol (ATP) was developed and was used by dental hygienists in clinical practice in California for a period of 6 weeks. Following the use of the PCC ATP practitioners were invited to participate in individual interviews. Online individual interviews were comprised of 20 dental hygienists recruited via purposive sampling. Participant anonymity was preserved using pseudonyms. A qualitative analysis software program was used to identify codes and themes. Investigator triangulation, member checks, and saturation were used to validate responses.Results Fifty-six participants completed the six-week PCC ATP and twenty participants took part in the interview session. Four themes were identified: awareness, accessibility, resources, and complications. Within the accessibility theme, subthemes of ease of use and guidance emerged. The complications theme yielded three subthemes: time, clinician hesitation, and patient lack of cooperation.Conclusion This study demonstrated that a PCC ATP created awareness of the varied symptoms of PCC and is a useful resource for clinical practitioners. Providing dental hygienists with a treatment protocol supports efforts to provide person-centered evidence-based care.},
}

@article {pmid38649004,
year = {2024},
author = {Shah, KM and Shah, RM and Sawano, M and Wu, Y and Bishop, P and Iwasaki, A and Krumholz, HM},
title = {Factors Associated with Long COVID Recovery among US Adults.},
journal = {The American journal of medicine},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.amjmed.2024.04.017},
pmid = {38649004},
issn = {1555-7162},
abstract = {BACKGROUND: While factors associated with long COVID (LC) continue to be illuminated, little is known about recovery. This study used national survey data to assess differences between adults in the United States with LC and those who recovered.

METHODS: We used COVID-19 and LC data from the 2022 National Health Interview Survey, a cross-sectional sample of non-institutionalized US adults. Survey analysis was used to account for oversampling and nonresponse bias and to obtain nationally representative estimates. A multivariable logistic regression model was used to identify potential predictors of LC recovery.

RESULTS: Among the study sample, 17.7% or an estimated 17.5 American adults reported ever having LC, and among those with LC, 48.5% or an estimated 8.5 million reported having recovered. Multivariable logistic regression analysis showed that Hispanic adults were significantly more likely than White adults to report recovery from LC. At the same time, those with severe COVID-19 symptoms and those who had more than a high school degree, were aged 40 years or older, or were female were less likely to report recovery.

CONCLUSION: Significant variations in LC recovery were noted across age, sex, race/ethnicity, and education independent of the severity of COVID-19 symptoms. Further work is needed to elucidate the causes of these differences and identify strategies to increase recovery rates.},
}

@article {pmid38648998,
year = {2024},
author = {Palau, P and Calvo, B and Sastre, C and Domínguez, E and Marín, P and Flor, C and Núñez, J and López, L},
title = {Unravelling the Mechanisms Behind Exercise Intolerance and Recovery in Long COVID.},
journal = {The American journal of medicine},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.amjmed.2024.04.023},
pmid = {38648998},
issn = {1555-7162},
abstract = {BACKGROUND: Patients suffering from long COVID may exhibit autonomic dysregulation. However, the association between autonomic dysregulation and exercise intolerance and the impact of therapeutic interventions on its modulation remain unclear. This study investigated the relationship between heart rate recovery at the first minute (HRR1), a proxy for autonomic imbalance, and exercise intolerance in patients with long COVID. Additionally, the study aimed to assess the effects of a 12-week home-based inspiratory muscle training program on autonomic modulation in this patient population.

METHODS: This study is a post hoc subanalysis of a randomized trial in which 26 patients with long COVID were randomly assigned to receive either a 12-week inspiratory muscle training program or usual care alone (NCT05279430). The data were analyzed using Pearson's correlation and linear mixed regression analysis.

RESULTS: The mean age was 50.4±12.2 years, and 11 (42.3%) were women. Baseline HRR1 was significantly correlated with maximal functional capacity (peakVO2) (r=0.402, p=0.041). Patients with lower baseline HRR1 (≤ 22 bpm) exhibited higher resting heart rates and lower peakVO2. Inspiratory muscle training led to a more substantial increase in peakVO2 in patients with lower HRR1 at baseline (p=0.019). Additionally, a significant improvement in HRR1 was observed in the IMT group compared to the usual care group after 12-week (Δ +9.39, 95% CI=2.4-16.4, p=0.010).

CONCLUSION: Lower baseline HRR1 is associated with exercise intolerance in long COVID patients and may serve as a valuable criterion for identifying individuals likely to benefit more from a home-based inspiratory muscle training program.},
}

@article {pmid38646896,
year = {2024},
author = {Sun, C and Liu, Z and Li, S and Wang, Y and Liu, G},
title = {Impact of Long COVID on Health-Related Quality of Life Among Patients After Acute COVID-19 Infection: A Cross-Sectional Study.},
journal = {Inquiry : a journal of medical care organization, provision and financing},
volume = {61},
number = {},
pages = {469580241246461},
doi = {10.1177/00469580241246461},
pmid = {38646896},
issn = {1945-7243},
mesh = {Humans ; *COVID-19 ; Post-Acute COVID-19 Syndrome ; Cross-Sectional Studies ; Quality of Life ; China ; },
abstract = {Concerns have been raised globally regarding the long-term effects of the novel coronavirus disease 2019 (COVID-19). This study aimed to investigate the impact of long COVID on the health of patients recovering from acute COVID-19 in China. We conducted a cross-sectional questionnaire survey from 1 February to 9 March 2023. Propensity score matching (PSM) was used to understand the differences in health utility values between individuals with and without long COVID. Factors associated with health-related quality of life (HRQoL) were determined using a multiple linear regression model. A chi-square test was used to compare differences between the 2 groups for each dimension of the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale. In total, 307 participants were included in the analysis, of which 40.39% exhibited at least 1 persistent symptom. The common symptoms of long COVID were fatigue/weakness, coughing, memory decline, poor concentration, and phlegm in the throat. Most patients with long COVID reported mild effects from their symptoms. After propensity score matching, the long-COVID group had lower health utility scores than the non-long-COVID group (0.94 vs 0.97). In the multivariable linear regression analysis, persistent symptoms and low annual household income were associated with lower health utility values (P < .05). Anxiety/depression and pain/discomfort were the major problems experienced by the participants with long COVID. Long-COVID symptoms following acute COVID-19 infection have a serious impact on health-related quality of life. Therefore, it is necessary to implement interventions to improve patient health after the recovery from acute COVID-19.},
}

Humans
*COVID-19
Post-Acute COVID-19 Syndrome
Cross-Sectional Studies
Quality of Life
China

@article {pmid38646658,
year = {2024},
author = {Fernández-de-Las-Peñas, C and Pellicer-Valero, OJ and Martín-Guerrero, JD and Hernández-Barrera, V and Arendt-Nielsen, L},
title = {Investigating the fluctuating nature of post-COVID pain symptoms in previously hospitalized COVID-19 survivors: the LONG-COVID-EXP multicenter study.},
journal = {Pain reports},
volume = {9},
number = {3},
pages = {e1153},
pmid = {38646658},
issn = {2471-2531},
abstract = {OBJECTIVE: This cohort study used Sankey plots and exponential bar plots for visualizing the fluctuating nature and trajectory of post-COVID pain in previously hospitalized COVID-19 survivors.

METHODS: A cohort of 1266 subjects hospitalised because of COVID-19 during the first wave of the pandemic were scheduled for a telephone interview at 8.4 (T1), 13.2 (T2), and 18.3 (T3) months in average after hospitalization for collecting data about post-COVID pain. Patients were asked for about pain symptomatology that was attributed to the infection. Hospitalization and clinical data were collected from medical records.

RESULTS: The prevalence of myalgia as COVID-19-associated symptom was 29.82% (n = 389) at hospitalization (T0). The prevalence of post-COVID pain was 41.07% (n = 520) at T1, 34.29% (n = 434) at T2, and 28.47% (n = 360) at T3. The recovery exponential curve revealed a decrease trend visualizing that post-COVID pain improved over the time span investigated. Pain in the lower extremity and widespread pain were the most prevalent locations. Female sex (OR 1.507, 95% CI 1.047-2.169), pre-existing pain symptoms (OR 1.724, 95% CI 1.237-2.403), headache as onset-symptom (OR 2.374, 95% CI 1.550-3.639), days at hospital (OR 1.012, 95% CI 1.000-1.025), and presence of post-COVID pain at T1 (OR 13.243, 95% CI 9.428-18.601) were associated with post-COVID pain at T2. Only the presence of post-COVID pain at T1 (OR 5.383, 95% CI 3.896-7.439) was associated with post-COVID pain at T3.

CONCLUSION: Current results show a fluctuating evolution with a decreasing tendency of post-COVID pain during the first years after hospitalization. The development of post-COVID pain soon after SARS-CoV-2 infection predispose for long-lasting chronic pain.},
}

@article {pmid38646408,
year = {2024},
author = {Masuko, T and Sasai-Masuko, H},
title = {Efficacy of Original Neurofeedback Treatment Method for Brain Fog From COVID-19: A Case Report.},
journal = {Cureus},
volume = {16},
number = {3},
pages = {e56519},
pmid = {38646408},
issn = {2168-8184},
abstract = {Brain fog is one of the most well-known sequelae of long COVID. It causes cognitive problems, mostly short-term memory disturbances, attention impairments, and problems with concentration. Although trials for treatment methods for brain fog have been carried out worldwide, effective methods have not yet been reported. Neurofeedback is effective for several common disorders and symptoms, including anxiety, depression, headaches, and pain. Neurofeedback is also reported to improve cognitive functions, such as processing speed and executive functions, including attention, planning, organization, problem-solving, and performance. Furthermore, neurofeedback is effective for "chemofog" and "chemobrain," which occur after chemotherapy and cause cognitive impairments in a similar manner to brain fog. However, there have been no reports of neurofeedback treatments for brain fog. Therefore, we have started to develop an original neurofeedback treatment method for brain fog using a Z-score neurofeedback technique. In this study, we present the first case report of a patient who has successfully recovered from brain fog via neurofeedback. Pain and psychological assessments revealed that the patient's pain improved and that the patient recovered from anxiety. Electroencephalograph data revealed several noble findings. C4 was thought to be the most affected site by brain fog, and this improved after treatment. The percentage increase at alpha wavelengths increased at almost all sites, and beta 1, beta 2, beta 3, and Hi beta decreased at almost all sites. The increased values at theta and alpha wavelengths after the 1st and 2nd sessions and the decreased values at higher beta wavelengths, such as beta 3 and Hi beta, were shown at all sessions.},
}

@article {pmid38642615,
year = {2024},
author = {VanElzakker, MB and Bues, HF and Brusaferri, L and Kim, M and Saadi, D and Ratai, EM and Dougherty, DD and Loggia, ML},
title = {Neuroinflammation in post-acute sequelae of COVID-19 (PASC) as assessed by [[11]C]PBR28 PET correlates with vascular disease measures.},
journal = {Brain, behavior, and immunity},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.bbi.2024.04.015},
pmid = {38642615},
issn = {1090-2139},
abstract = {The COVID-19 pandemic caused by SARS-CoV-2 has triggered a consequential public health crisis of post-acute sequelae of COVID-19 (PASC), sometimes referred to as long COVID. The mechanisms of the heterogeneous persistent symptoms and signs that comprise PASC are under investigation, and several studies have pointed to the central nervous and vascular systems as being potential sites of dysfunction. In the current study, we recruited individuals with PASC with diverse symptoms, and examined the relationship between neuroinflammation and circulating markers of vascular dysfunction. We used [[11]C]PBR28 PET neuroimaging, a marker of neuroinflammation, to compare 12 PASC individuals versus 43 normative healthy controls. We found significantly increased neuroinflammation in PASC versus controls across a wide swath of brain regions including midcingulate and anterior cingulate cortex, corpus callosum, thalamus, basal ganglia, and at the boundaries of ventricles. We also collected and analyzed peripheral blood plasma from the PASC individuals and found significant positive correlations between neuroinflammation and several circulating analytes related to vascular dysfunction. These results suggest that an interaction between neuroinflammation and vascular health may contribute to common symptoms of PASC.},
}

@article {pmid38641935,
year = {2024},
author = {Samerton, P and Apiwattanakul, N and Assawawiroonhakarn, S and Sahakijpicharn, T and Thongchai, R and Techasaensiri, C and Boonsathorn, S and Chaisavaneeyakorn, S},
title = {Severe acute respiratory syndrome coronavirus 2 infection rate among pediatric patients with respiratory symptoms.},
journal = {Pediatrics international : official journal of the Japan Pediatric Society},
volume = {66},
number = {1},
pages = {e15740},
doi = {10.1111/ped.15740},
pmid = {38641935},
issn = {1442-200X},
support = {RF_64011//Mahidol University/ ; P2050966//National Science and Technology Development Agency/ ; },
mesh = {Humans ; Child ; Female ; Child, Preschool ; Male ; *COVID-19/epidemiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Cross-Sectional Studies ; Prospective Studies ; Obesity ; Dyspnea ; Cough/epidemiology/etiology ; Chest Pain ; },
abstract = {BACKGROUND: The incidence of coronavirus disease 2019 (COVID-19) in children has been increasing worldwide since the onset of the pandemic. This study examined the risk factors and characteristics of COVID-19 among pediatric patients compared to other respiratory viral infections.

METHODS: This was a prospective cross-sectional study. Patients aged 0-18 years presenting with respiratory symptoms from October 2020 to December 2021 were included. Demographic and clinical data were reviewed.

RESULTS: In total, 738 pediatric patients were enrolled. Of these, 48.5% had COVID-19, and 41.3% were infected with another respiratory virus. The COVID-19 incidence increased from 0.5% during the original strain outbreak (October 2020 to March 2021) to 56.5% and 73.4% during the alpha (April to June 2021) and delta (July to December 2021) periods, respectively. Children aged 6-18 years, being female, obesity, exposure to household members with COVID-19, and the delta period were risk factors for COVID-19. Being aged 1-5 years, obesity, shortness of breath, productive cough, and chest pain were associated with COVID-19 pneumonia. Children aged 5-18 years, underlying neurological disease, a history of COVID-19 pneumonia, and the delta period were associated with long COVID.

CONCLUSIONS: Pediatric COVID-19 patients presenting with respiratory symptoms who are obese or have been exposed to household members with COVID-19 should be tested for COVID-19. COVID-19 patients who are obese, younger than five years old, or who present with shortness of breath, productive cough, or chest pain should be evaluated for pneumonia. COVID-19 patients with a history of COVID-19 pneumonia or underlying neurological disease should receive follow-up for long COVID.},
}

Humans
Child
Female
Child, Preschool
Male
*COVID-19/epidemiology
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Cross-Sectional Studies
Prospective Studies
Obesity
Dyspnea
Cough/epidemiology/etiology
Chest Pain

@article {pmid38641397,
year = {2024},
author = {Wills, CP and Perez, B and Moore, J},
title = {Coronavirus Disease 2019: Past, Present, and Future.},
journal = {Emergency medicine clinics of North America},
volume = {42},
number = {2},
pages = {415-442},
doi = {10.1016/j.emc.2024.02.002},
pmid = {38641397},
issn = {1558-0539},
abstract = {Severe acute respiratory syndrome coronavirus 2 is one of the most impactful diseases experienced in the past century. While the official national health emergency concluded in May of 2023, coronavirus disease 2019 (COVID-19) continues to mutate. As the summer of 2023, all countries were experiencing a new surge of cases from the EG.5 Omicron variant. Additionally, a new genetically distinct Omicron descendant BA2.86 had been detected in multiple countries including the United States. This article seeks to offer lessons learned from the pandemic, summarize best evidence for current management of patients with COVID-19, and give insights into future directions with this disease.},
}

@article {pmid38641060,
year = {2024},
author = {Ye, G and Zhu, Y and Bao, W and Zhou, H and Lai, J and Zhang, Y and Xie, J and Ma, Q and Luo, Z and Ma, S and Guo, Y and Zhang, X and Zhang, M and Niu, X},
title = {The Long Coronavirus Disease (COVID) Symptom and Severity Score: Development, Validation, and Application.},
journal = {Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jval.2024.04.009},
pmid = {38641060},
issn = {1524-4733},
abstract = {OBJECTIVES: The primary focus of this research is the proposition of a methodological framework for the clinical application of the long coronavirus disease (COVID) Symptom and Severity Score (LC-SSS). This tool is not just a self-reported assessment instrument developed and validated but serves as a standardized, quantifiable means to monitor the diverse and persistent symptoms frequently observed in individuals suffering from long COVID.

METHODS: A three-stage process was used to develop, validate, and establish scoring standards for the LC-SSS. Validation measures included correlations with other patient-reported measures, confirmatory factor analysis, Cronbach's α for internal consistency, and test-retest reliability. Scoring standards were determined using K-means clustering, with comparative assessments made against Hierarchical clustering and the Gaussian Mixture Model (GMM).

RESULTS: The LC-SSS showed correlations with EQ-5D-5L (rs = -0.55), EQ-VAS (rs = -0.368), PHQ-9 (rs = 0.538), BAI (rs = 0.689), and ISI (rs = 0.516), confirming its construct validity. Structural validity was good with a CFI of 0.969, with Cronbach's α of 0.93 indicating excellent internal consistency. Test-retest reliability was also satisfactory (ICC = 0.732). K-means clustering identified three distinct severity categories in individuals living with long COVID, providing a basis for personalized treatment strategies.

CONCLUSIONS: The LC-SSS provides a robust and valid tool for assessing long COVID. The severity categories established via K-means clustering demonstrate significant variation in symptom severity, informing personalized treatment and improving care quality for long COVID patients.},
}

@article {pmid38640090,
year = {2024},
author = {Chaze, M and Mériade, L and Rochette, C and Bailly, M and Bingula, R and Blavignac, C and Duclos, M and Evrard, B and Fournier, AC and Pelissier, L and Thivel, D and , },
title = {Relying on the French territorial offer of thermal spa therapies to build a care pathway for long COVID-19 patients.},
journal = {PloS one},
volume = {19},
number = {4},
pages = {e0302392},
doi = {10.1371/journal.pone.0302392},
pmid = {38640090},
issn = {1932-6203},
abstract = {BACKGROUND: Work on long COVID-19 has mainly focused on clinical care in hospitals. Thermal spa therapies represent a therapeutic offer outside of health care institutions that are nationally or even internationally attractive. Unlike local care (hospital care, general medicine, para-medical care), their integration in the care pathways of long COVID-19 patients seems little studied. The aim of this article is to determine what place french thermal spa therapies can take in the care pathway of long COVID-19 patients.

METHODS: Based on the case of France, we carry out a geographic mapping analysis of the potential care pathways for long COVID-19 patients by cross-referencing, over the period 2020-2022, the available official data on COVID-19 contamination, hospitalisations in intensive care units and the national offer of spa treatments. This first analysis allows us, by using the method for evaluating the attractiveness of an area defined by David Huff, to evaluate the accessibility of each French department to thermal spas.

RESULTS: Using dynamic geographical mapping, this study describes two essential criteria for the integration of the thermal spa therapies offer in the care pathways of long COVID-19 patients (attractiveness of spa areas and accessibility to thermal spas) and three fundamental elements for the success of these pathways (continuity of the care pathways; clinical collaborations; adaptation of the financing modalities to each patient). Using a spatial attractiveness method, we make this type of geographical analysis more dynamic by showing the extent to which a thermal spa is accessible to long COVID-19 patients.

CONCLUSION: Based on the example of the French spa offer, this study makes it possible to place the care pathways of long COVID-19 patients in a wider area (at least national), rather than limiting them to clinical and local management in a hospital setting. The identification and operationalization of two geographical criteria for integrating a type of treatment such as a spa cure into a care pathway contributes to a finer conceptualization of the construction of healthcare pathways.},
}

@article {pmid38639670,
year = {2024},
author = {Carstens, M and Trujillo, J and Dolmus, Y and Rivera, C and Calderwood, S and Lejarza, J and López, C and Bertram, K},
title = {Adipose-derived stromal vascular fraction cells to treat long-term pulmonary sequelae of coronavirus disease 2019: 12-month follow-up.},
journal = {Cytotherapy},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jcyt.2024.03.491},
pmid = {38639670},
issn = {1477-2566},
abstract = {BACKGROUND AIMS: Long coronavirus disease (COVID) is estimated to occur in up to 20% of patients with coronavirus disease 2019 (COVID-19) infections, with many having persistent pulmonary symptoms. Mesenchymal stromal cells (MSCs) have been shown to have powerful immunomodulatory and anti-fibrotic properties. Autologous adipose-derived (AD) stromal vascular fraction (SVF) contains MSC and other healing cell components and can be obtained by small-volume lipoaspiration and administered on the same day. This study was designed to study the safety of AD SVF infused intravenously to treat the pulmonary symptoms of long COVID.

METHODS: Five subjects with persistent cough and dyspnea after hospitalization and subsequent discharge for COVID-19 pneumonia were treated with 40 million intravenous autologous AD SVF cells and followed for 12 months, to include with pulmonary function tests and computed tomography scans of the lung.

RESULTS: SVF infusion was safe, with no significant adverse events related to the infusion out to 12 months. Four subjects had improvements in pulmonary symptoms, pulmonary function tests, and computed tomography scans, with some improvement noted as soon as 1 month after SVF treatment.

CONCLUSIONS: It is not possible to distinguish between naturally occurring improvement or improvement caused by SVF treatment in this small, uncontrolled study. However, the results support further study of autologous AD SVF as a treatment for long COVID.},
}