@article {pmid41856572,
year = {2026},
author = {Cao, B and Soriano, JB and Wang, Q and Al-Aly, Z and Gu, X and Wang, G and Leo, YS and Jin, Y and Shi, Q and Ohmagari, N and Liu, E and Paredes, R and Lu, H and Kim, ES and Zhang, D and Estill, J and Li, L and Spruyt, K and Yang, W and Wang, Y and Ran, MS and Luo, X and Zhang, H and Xu, J and Zhang, R and Zhao, J and Zhao, J and Evans, RA and Jeon, J and Peluso, MJ and Errett, LE and Zhang, W and Chalmers, JD and Chen, Y and , },
title = {Clinical practice guideline for long COVID prevention and treatment.},
journal = {The European respiratory journal},
volume = {68},
number = {1},
pages = {},
pmid = {41856572},
issn = {1399-3003},
mesh = {Humans ; *COVID-19/prevention & control/therapy ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Pandemics/prevention & control ; Antiviral Agents/therapeutic use ; Adult ; Evidence-Based Medicine ; Betacoronavirus ; },
abstract = {BACKGROUND: This guideline aims to address key clinical questions of long COVID, and to provide evidence-based recommendations. The target population is adults with long COVID. The primary users of the guideline are clinical physicians, clinical pharmacists, nurses and general practitioners in community healthcare institutions worldwide.

METHODS: The guideline was registered at the Practice guideline REgistration for transPAREncy platform (PREPARE-2024CN123) and followed a pre-specified protocol. A multidisciplinary working group was established and comprised 60 members from 10 countries and 10 areas of expertise, with a strong background in long COVID research and clinical practice, and methodology of guideline development. Through a two-step process, we determined eight PICO (Population, Intervention, Comparator, Outcome) questions focusing on prevention and treatment of long COVID. After comprehensively searching literature, conducting systematic reviews and investigating patients' values and preferences, three rounds of Delphi survey were conducted among 24 international experts to reach consensus. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach was applied to rate the certainty of evidence and determine the strength of recommendations.

RESULTS: The guideline presents 10 specific recommendations, each supported by existing, updated or newly conducted systematic reviews. The key recommendations are pertinent to the following issues: 1) suggestion of vaccination or use of antiviral agents during the acute phase of COVID-19 to prevent long COVID; 2) suggestions against the use of nirmatrelvir/ritonavir and glucocorticoids (patients with persistent respiratory symptoms and olfactory disorders) for long COVID treatment; 3) suggestions supporting the use of multispecies probiotics, cognitive behavioural therapy (patients with fatigue), and personalised rehabilitation (after ruling out post-exertional malaise) for long COVID treatment.

CONCLUSIONS: This guideline provides evidence-based recommendations for the prevention and treatment of long COVID. Given the limited and often low-methodological-quality evidence, all recommendations are supported by very low to moderate certainty. Further high-quality studies are needed to strengthen the evidence base.},
}

Humans
*COVID-19/prevention & control/therapy
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Pandemics/prevention & control
Antiviral Agents/therapeutic use
Adult
Evidence-Based Medicine
Betacoronavirus

@article {pmid41967005,
year = {2026},
author = {Iskander, JK and Haridopolos, S},
title = {Making Invisible Illnesses Visible: Recognizing and Responding to Infection-Associated Chronic Conditions.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
volume = {83},
number = {1},
pages = {e58-e61},
doi = {10.1093/cid/ciag240},
pmid = {41967005},
issn = {1537-6591},
support = {/HH/HHS/United States ; },
mesh = {Humans ; Chronic Disease ; Fatigue Syndrome, Chronic/therapy/diagnosis ; *COVID-19/complications/epidemiology ; Lyme Disease/therapy/diagnosis ; Post-Acute COVID-19 Syndrome ; United States ; SARS-CoV-2 ; Patient-Centered Care ; },
abstract = {The emergence of post-COVID conditions (PCCs) has renewed attention to infection-associated chronic conditions and illnesses (IACCIs), including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Lyme disease-associated chronic symptoms. Millions of Americans are affected by these debilitating, misunderstood conditions, which share symptom profiles and pathophysiologic abnormalities. IACCIs have received insufficient clinical attention and research investment. We outline elements of a patient-centered approach to care, emphasizing validation of patients' experiences, multidisciplinary management, and symptom-focused treatment. Opportunities to strengthen clinical practice include a new Centers for Medicare and Medicaid Services (CMS) code for chronic condition management, extended visits, and creation of welcoming care environments. Advances in PCC and ME/CFS research provide a foundation for exploring shared mechanisms and developing targeted therapies. Improved surveillance, harmonized research, and inclusive trial designs are needed to define disease burden and accelerate therapeutic progress. Coordinated action by clinicians, researchers, and policymakers can help address longstanding gaps and improve outcomes for all individuals with IACCIs.},
}

Humans
Chronic Disease
Fatigue Syndrome, Chronic/therapy/diagnosis
*COVID-19/complications/epidemiology
Lyme Disease/therapy/diagnosis
Post-Acute COVID-19 Syndrome
United States
SARS-CoV-2
Patient-Centered Care

@article {pmid42119693,
year = {2026},
author = {Schomerus, G and Nicolas, ML and Fritz, F and Schneider, D and Büchner, R},
title = {What is the Role of "the Psyche"? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psychotherapy.},
journal = {Psychiatrische Praxis},
volume = {53},
number = {5},
pages = {263-269},
doi = {10.1055/a-2866-9127},
pmid = {42119693},
issn = {1439-0876},
mesh = {Humans ; *Fatigue Syndrome, Chronic/psychology/therapy ; *Psychotherapy ; Post-Acute COVID-19 Syndrome ; *Evidence-Based Medicine ; *Patient-Centered Care ; *COVID-19/psychology ; Psychiatry ; },
abstract = {The role of psychological factors in the development and course of Long Covid (LC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) remains a subject of controversial debate. We argue that psychologizing LC and ME/CFS carries significant risks: it leads to potentially harmful therapies, invalidates the patients' experience of illness, hinders effective interventions such as pacing, diverts focus from necessary physical diagnostics and treatment, disadvantages patients in medical assessments, and places a considerable additional burden on the families of affected children or other relatives. We show that many of the arguments presented for a psychological contribution are nonspecific or insufficiently supported by empirical evidence. Our essay therefore advocates for extreme caution in attributing psychological factors to these conditions, in the interest of a specific, evidence-based, and patient-centered psychiatry and psychotherapy.},
}

Humans
*Fatigue Syndrome, Chronic/psychology/therapy
*Psychotherapy
Post-Acute COVID-19 Syndrome
*Evidence-Based Medicine
*Patient-Centered Care
*COVID-19/psychology
Psychiatry

@article {pmid42173633,
year = {2026},
author = {Agrawal, P},
title = {AI in multi-omics analysis of COVID-19 patient data.},
journal = {Progress in molecular biology and translational science},
volume = {222},
number = {},
pages = {261-293},
doi = {10.1016/bs.pmbts.2026.01.017},
pmid = {42173633},
issn = {1878-0814},
support = {//Non-US Government Research Support type/ ; },
mesh = {Humans ; *Multiomics ; *COVID-19/genetics/virology/metabolism ; *Artificial Intelligence ; *SARS-CoV-2 ; Genomics ; Proteomics ; Pandemics ; Metabolomics ; Machine Learning ; },
abstract = {The COVID-19 pandemic has led to an unprecedented increase in the volume of biological data generation, demonstrating the importance of developing an integrative and intelligent analytical framework. In the last few years, advancements in the artificial intelligence (AI) approaches have completely transformed the biological research landscape. Researchers have integrated the AI approaches with the multi-omics data generated from the COVID-19 patients to have a systems-level understanding of underlying disease mechanisms, predicting new variants and their spread rate, disease severity, immune response, and therapeutic opportunities. In this chapter, we have explored the utility of AI on multi-omics data. We started with an introduction to different kinds of omics data, such as genomics, epigenomics, transcriptomics, proteomics, and metabolomics. Next, we elaborated on what AI is and discussed its types, which include conventional machine learning methods (supervised and unsupervised), deep learning methods (autoencoders and convolutional neural networks), and network-based methods (graph neural networks, network propagation, and knowledge graphs). Next, we discussed different types of integration methods (early, intermediate, and late) used for integrating AI and multi-omics data. Moving ahead, we mentioned several applications of AI, such as biomarker discovery, host-pathogen interaction, drug repurposing, and predicting long COVID. Lastly, we mentioned several important projects and consortia and discussed several important case studies highlighting the usefulness of integrating AI with multi-omics data for personalized medicine.},
}

Humans
*Multiomics
*COVID-19/genetics/virology/metabolism
*Artificial Intelligence
*SARS-CoV-2
Genomics
Proteomics
Pandemics
Metabolomics
Machine Learning

@article {pmid42215147,
year = {2026},
author = {Petropoulou, D and Karampela, I and Christodoulatos, GS and Kounatidis, D and Vallianou, NG and Dalamaga, M},
title = {Hormonal, metabolic and metabolomic biomarkers in long COVID.},
journal = {Advances in clinical chemistry},
volume = {133},
number = {},
pages = {217-283},
doi = {10.1016/bs.acc.2026.01.002},
pmid = {42215147},
issn = {2162-9471},
mesh = {Humans ; Biomarkers/metabolism/blood ; Post-Acute COVID-19 Syndrome ; *COVID-19/metabolism/complications ; *Hormones/metabolism ; Metabolomics ; SARS-CoV-2 ; },
abstract = {Long COVID (LC), a complex syndrome affecting approximately 6-12 % of individuals post infection, is characterized by persistent, fluctuating, or progressive symptoms lasting at least three months. Its pathogenic mechanisms involve viral persistence, chronic inflammation, immune dysregulation, endothelial dysfunction, and endocrine/metabolic abnormalities. Currently, no specific diagnostic tests exist for LC, highlighting the need for reliable biomarkers. This review synthesizes current evidence on hormonal, metabolic, and metabolite biomarkers in LC. While vitamin D deficiency is prevalent in LC, being associated with neurocognitive symptoms, delayed recovery and poor physical performance, particularly in older adults, its lack of specificity reduces diagnostic utility. Insulin resistance markers consistently correlate with fatigue, mood disturbances, and myalgia, suggesting a distinct metabolic LC phenotype. Lower cortisol frequently correlates with fatigue, sensory disturbances, and neurocognitive symptoms. Alterations in cortisol/adrenocorticotropic hormone, growth hormone, prolactin, and gonadotropins suggest a potential hypothalamic-pituitary axis involvement; however, these abnormalities are often transient, dynamic or nonsignificant. While some patients may exhibit low free triiodothyronine associated with fatigue, no significant incidence of thyroid dysfunction and autoimmunity was associated with LC. Despite the absence of a distinct and consistent metabolomic signature, LC is characterized by the activation of the kynurenine pathway, including increased kynurenine and quinolinic acid, being associated with fatigue, neurocognitive and depressive symptoms. Emerging metabolites of mitochondrial dysfunction and lipid metabolism alterations require further validation. Despite promising findings, evidence remains scattered, hindered by small sample sizes and methodological limitations. Future research should prioritize standardization of biomarker assessment, validation in diverse populations, and exploration of targeted therapeutic interventions.},
}

Humans
Biomarkers/metabolism/blood
Post-Acute COVID-19 Syndrome
*COVID-19/metabolism/complications
*Hormones/metabolism
Metabolomics
SARS-CoV-2

@article {pmid42216347,
year = {2026},
author = {Faseeh, A and Rida, M and Karim, NE and Zafar, A and Shah, A and Perveen, A},
title = {Prevalence and long-term outcomes of brain fog and cognitive impairment in individuals with long COVID: A systematic review.},
journal = {Medicine},
volume = {105},
number = {22},
pages = {e49022},
pmid = {42216347},
issn = {1536-5964},
mesh = {Humans ; *Cognitive Dysfunction/epidemiology/etiology ; Prevalence ; *COVID-19/complications/epidemiology ; Post-Acute COVID-19 Syndrome ; Female ; Male ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Long COVID is increasingly recognized as a complex multisystem condition, with brain fog and cognitive impairment emerging as some of its manifestations. Despite growing literature, the pooled prevalence, subgroup differences, and underlying mechanisms remain incompletely understood.

METHODS: We systematically reviewed 47 studies (2000-2025) encompassing over 25,000 patients to evaluate the prevalence of brain fog and cognitive impairment among long COVID populations. Data were extracted on study design, patient demographics, follow-up duration, and subgroup variables including gender, hospitalization, vaccination, and geographic region. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS v9.0) and JBI checklists. Quantitative synthesis was performed with subgroup and temporal analyses, presented in forest plots and summary figures.

RESULTS: The pooled prevalence of brain fog was 30% (95% CI: 28-32), while cognitive impairment was 25% (95% CI: 23-27). Female patients consistently showed higher rates compared to males (34% vs 23% for brain fog; 29% vs 21% for cognitive impairment). Community-managed patients demonstrated higher prevalence compared to hospitalized cohorts, and unvaccinated individuals had a greater burden than vaccinated ones. Temporal analyses indicated that prevalence increased with longer follow-up, suggesting symptom persistence or late manifestation. Pathophysiological explanations include neuroinflammation, microvascular injury, immune dysregulation, and psychosocial stressors.

CONCLUSION: Brain fog and cognitive impairment are common, persistent, and clinically significant features of long COVID. Gender differences, vaccination status, and follow-up duration influence prevalence. Future studies should focus on mechanisms, preventive strategies, and targeted interventions to mitigate long-term cognitive sequelae.},
}

Humans
*Cognitive Dysfunction/epidemiology/etiology
Prevalence
*COVID-19/complications/epidemiology
Post-Acute COVID-19 Syndrome
Female
Male
SARS-CoV-2

@article {pmid42463201,
year = {2026},
author = {Byambasuren, O and Atkins, T and Baptista, S and Glasziou, P and Chakraborty, S},
title = {Effect of low-dose naltrexone for long COVID: a systematic review and meta-analysis.},
journal = {BMJ open},
volume = {16},
number = {7},
pages = {e111253},
doi = {10.1136/bmjopen-2025-111253},
pmid = {42463201},
issn = {2044-6055},
mesh = {Humans ; *Naltrexone/administration & dosage/therapeutic use ; Post-Acute COVID-19 Syndrome ; *COVID-19 Drug Treatment ; *Narcotic Antagonists/administration & dosage/therapeutic use ; Quality of Life ; Fatigue/drug therapy/etiology ; *COVID-19/complications ; SARS-CoV-2 ; },
abstract = {OBJECTIVE: Long covid is a debilitating chronic condition, and the effect of low-dose naltrexone (LDN) on its symptoms is unclear. We aimed to determine the effectiveness of LDN on symptoms of long covid.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: PubMed, Embase and Cochrane Library for published studies; ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) for registered ongoing studies were searched through 5 May 2026.

ELIGIBILITY CRITERIA: We included randomised controlled trials and pre-post studies of patients with long covid reporting on fatigue, quality of life, cognitive symptoms or function and other long covid symptoms.

DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and select included studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models.

RESULTS: Of 397 titles and abstracts screened, no randomised controlled trials were identified. Four observational pre-post studies from the USA and Ireland (n=155) met inclusion criteria. LDN doses varied from 1 mg/day to 6 mg/day. Pooled pre-post analyses showed moderate effects for reducing fatigue (Hedges' g=-0.74; 95% CI -1.11 to -0.37; p<0.001), brain fog (Hedges' g=-0.53; 95% CI -1.01 to -0.05; p=0.03) and improving sleep quality (Hedges' g=-0.60; 95% CI -0.91 to -0.30; p=0.0001), and large effects for pain (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.001) and daily functioning (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.0001) in favour of LDN. Heterogeneity ranged from 0% to 62%. No serious adverse events were reported in the two studies that assessed safety.

CONCLUSION: Limited evidence from small pre-post studies suggests LDN may improve fatigue, cognition, sleep, pain and functioning in long covid. However, certainty of evidence is low. Well-powered trials are needed to confirm efficacy, determine dosing and duration and identify subgroups most likely to benefit.

TRIAL REGISTRATION: https://doi.org/10.17605/OSF.IO/C2VKX.},
}

Humans
*Naltrexone/administration & dosage/therapeutic use
Post-Acute COVID-19 Syndrome
*COVID-19 Drug Treatment
*Narcotic Antagonists/administration & dosage/therapeutic use
Quality of Life
Fatigue/drug therapy/etiology
*COVID-19/complications
SARS-CoV-2

@article {pmid38055113,
year = {2024},
author = {Rayner, DG and Wang, E and Su, C and Patel, OD and Aleluya, S and Giglia, A and Zhu, E and Siddique, M},
title = {Risk factors for long COVID in children and adolescents: a systematic review and meta-analysis.},
journal = {World journal of pediatrics : WJP},
volume = {20},
number = {2},
pages = {133-142},
pmid = {38055113},
issn = {1867-0687},
mesh = {Humans ; *COVID-19/epidemiology ; Child ; Risk Factors ; Adolescent ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: The long-term sequelae of COVID-19 in children and adolescents remain poorly understood and characterized. This systematic review and meta-analysis sought to summarize the risk factors for long COVID in the pediatric population.

METHODS: We searched six databases from January 2020 to May 2023 for observational studies reporting on risk factors for long COVID or persistent symptoms those were present 12 or more weeks post-infection using multivariable regression analyses. Trial registries, reference lists of included studies, and preprint servers were hand-searched for relevant studies. Random-effects meta-analyses were conducted to pool odds ratios for each risk factor. Individual study risk of bias was rated using QUIPS, and the GRADE framework was used to assess the certainty of evidence for each unique factor.

RESULTS: Sixteen observational studies (N = 46,262) were included, and 19 risk factors were amenable to meta-analysis. With moderate certainty in the evidence, age (per 2-year increase), allergic rhinitis, obesity, previous respiratory diseases, hospitalization, severe acute COVID-19, and symptomatic acute COVID-19 are probably associated with an increased risk of long COVID. Female sex, asthma, comorbidity, and heart diseases may be associated with an increased risk of long COVID, and Asian and Black races may be associated with a decreased risk of long COVID. We did not observe any credible subgroup effects for any risk factor.

CONCLUSIONS: The current body of literature presents several compelling risk factors for the development of long COVID in the pediatric population. Further research is necessary to elucidate the pathophysiology of long COVID.},
}

Humans
*COVID-19/epidemiology
Child
Risk Factors
Adolescent
Post-Acute COVID-19 Syndrome

@article {pmid38057315,
year = {2023},
author = {Liu, X and Xiong, W and Ye, M and Lu, T and Yuan, K and Chang, S and Han, Y and Wang, Y and Lu, L and Bao, Y},
title = {Non-coding RNAs expression in SARS-CoV-2 infection: pathogenesis, clinical significance, and therapeutic targets.},
journal = {Signal transduction and targeted therapy},
volume = {8},
number = {1},
pages = {441},
pmid = {38057315},
issn = {2059-3635},
mesh = {Humans ; *COVID-19/genetics ; Post-Acute COVID-19 Syndrome ; Clinical Relevance ; SARS-CoV-2/genetics ; RNA, Untranslated/genetics ; Biomarkers ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has been looming globally for three years, yet the diagnostic and treatment methods for COVID-19 are still undergoing extensive exploration, which holds paramount importance in mitigating future epidemics. Host non-coding RNAs (ncRNAs) display aberrations in the context of COVID-19. Specifically, microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs) exhibit a close association with viral infection and disease progression. In this comprehensive review, an overview was presented of the expression profiles of host ncRNAs following SARS-CoV-2 invasion and of the potential functions in COVID-19 development, encompassing viral invasion, replication, immune response, and multiorgan deficits which include respiratory system, cardiac system, central nervous system, peripheral nervous system as well as long COVID. Furthermore, we provide an overview of several promising host ncRNA biomarkers for diverse clinical scenarios related to COVID-19, such as stratification biomarkers, prognostic biomarkers, and predictive biomarkers for treatment response. In addition, we also discuss the therapeutic potential of ncRNAs for COVID-19, presenting ncRNA-based strategies to facilitate the development of novel treatments. Through an in-depth analysis of the interplay between ncRNA and COVID-19 combined with our bioinformatic analysis, we hope to offer valuable insights into the stratification, prognosis, and treatment of COVID-19.},
}

Humans
*COVID-19/genetics
Post-Acute COVID-19 Syndrome
Clinical Relevance
SARS-CoV-2/genetics
RNA, Untranslated/genetics
Biomarkers

@article {pmid38057338,
year = {2023},
author = {Frallonardo, L and Segala, FV and Chhaganlal, KD and Yelshazly, M and Novara, R and Cotugno, S and Guido, G and Papagni, R and Colpani, A and De Vito, A and Barbagallo, M and Madeddu, G and Babudieri, S and Lochoro, P and Ictho, J and Putoto, G and Veronese, N and Saracino, A and Di Gennaro, F},
title = {Incidence and burden of long COVID in Africa: a systematic review and meta-analysis.},
journal = {Scientific reports},
volume = {13},
number = {1},
pages = {21482},
pmid = {38057338},
issn = {2045-2322},
mesh = {Humans ; *COVID-19/epidemiology ; Post-Acute COVID-19 Syndrome ; Incidence ; *Mental Disorders/epidemiology ; Africa/epidemiology ; },
abstract = {Long COVID, also known as "post-acute sequelae of COVID-19," affects at least 65 million individuals worldwide with a wide spectrum of symptoms that may last weeks, months, or permanently. Its epidemiology and burden in Africa are unclear. This meta-analysis examines long-term COVID-19 effects in the WHO African Region. A systematic search in several databases was carried out up to 12 February 2023 including observational studies from African countries reporting the cumulative incidence of long COVID signs and symptoms. Only studies conducted in African countries were included. Several sensitivity and meta-regression analyses were performed. Among 1547 papers initially screened, 25 were included, consisting of 29,213 participants. The incidence of any long COVID symptomatology was 48.6% (95% CI 37.4-59.8) as psychiatric conditions were the most frequent, particularly post-traumatic stress disorder reaching a cumulative incidence of 25% (95% CI 21.1-30.4). Higher age (p = 0.027) and hospitalization (p = 0.05) were associated with a higher frequency of long COVID. Long COVID poses a significant burden in Africa, particularly concerning psychiatric conditions. The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients. High-quality studies addressing this condition in African setting are urgently needed.},
}

Humans
*COVID-19/epidemiology
Post-Acute COVID-19 Syndrome
Incidence
*Mental Disorders/epidemiology
Africa/epidemiology

@article {pmid38063359,
year = {2023},
author = {Ghram, A and Latiri, I and Methnani, J and Souissi, A and Benzarti, W and Toulgui, E and Ben Saad, H},
title = {Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies.},
journal = {Expert review of respiratory medicine},
volume = {17},
number = {12},
pages = {1095-1124},
doi = {10.1080/17476348.2023.2293226},
pmid = {38063359},
issn = {1747-6356},
mesh = {Humans ; *Cardiac Rehabilitation/methods ; *COVID-19/rehabilitation ; Exercise Therapy/methods ; *Exercise Tolerance ; Post-Acute COVID-19 Syndrome ; *Randomized Controlled Trials as Topic ; SARS-CoV-2 ; Walk Test ; },
abstract = {INTRODUCTION: Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs).

METHODS: A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps.

RESULTS: The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers.

CONCLUSION: CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group.

https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].},
}

Humans
*Cardiac Rehabilitation/methods
*COVID-19/rehabilitation
Exercise Therapy/methods
*Exercise Tolerance
Post-Acute COVID-19 Syndrome
*Randomized Controlled Trials as Topic
SARS-CoV-2
Walk Test

@article {pmid38063895,
year = {2024},
author = {Shil, RSK and Hughes, TW and Sargent, BF and Huang, Y and Tamborska, AA and Frank, B and Ellul, MA and Michael, BD},
title = {A clinical approach to the investigation and management of long COVID associated neuropathic pain.},
journal = {European archives of psychiatry and clinical neuroscience},
volume = {274},
number = {8},
pages = {1787-1795},
pmid = {38063895},
issn = {1433-8491},
support = {MC_PC_19059/MRF/MRF/United Kingdom ; MR/V007181/1/MRF/MRF/United Kingdom ; MR/V03605X/1/MRF/MRF/United Kingdom ; ISSF201902/3/WT_/Wellcome Trust/United Kingdom ; MR/V007181/1/MRC_/Medical Research Council/United Kingdom ; MR/T028750/1/MRC_/Medical Research Council/United Kingdom ; NIHR133599//National Institute for Health and Care Research/ ; MC_PC_19059/MRC_/Medical Research Council/United Kingdom ; /WT_/Wellcome Trust/United Kingdom ; MR/V03605X/1/MRC_/Medical Research Council/United Kingdom ; MRF-CPP-R2-2022-100003/MRF/MRF/United Kingdom ; MR/T028750/1/MRF/MRF/United Kingdom ; },
mesh = {Humans ; *COVID-19/complications ; *Neuralgia/etiology/therapy ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {COVID-19 has been associated with a wide range of ongoing symptoms following recovery from the acute SARS-CoV-2 infection. Around one in three people with COVID-19 develop neurological symptoms with many reporting neuropathic pain and associated symptoms, including paraesthesia, numbness, and dysesthesia. Whilst the pathophysiology of long COVID-19-associated neuropathic pain remains unclear, it is likely to be multifactorial. Early identification, exclusion of common alternative causes, and a biopsychosocial approach to the management of the symptoms can help in relieving the burden of disease and improving the quality of life for patients.},
}

Humans
*COVID-19/complications
*Neuralgia/etiology/therapy
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid38068427,
year = {2023},
author = {Choi, YJ and Seo, YB and Seo, JW and Lee, J and Nham, E and Seong, H and Yoon, JG and Noh, JY and Cheong, HJ and Kim, WJ and Kim, EJ and Song, JY},
title = {Effectiveness of Antiviral Therapy on Long COVID: A Systematic Review and Meta-Analysis.},
journal = {Journal of clinical medicine},
volume = {12},
number = {23},
pages = {},
pmid = {38068427},
issn = {2077-0383},
support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; },
abstract = {Antiviral treatment reduces the severity and mortality of SARS-CoV-2 infection; however, its effectiveness against long COVID-19 is unclear. This study aimed to evaluate the effectiveness of antiviral drugs in preventing long COVID and related hospitalizations/deaths. Scientific and medical databases were searched from 1 January 2020 to 30 June 2023. We included observational cohort studies comparing individuals receiving early antiviral therapy for COVID-19 and those receiving supportive treatment. A fixed-effects model was used to merge the effects reported in two or more studies. The risk of post-acute sequelae of COVID-19 (PASC) was combined as an odds ratio (OR). Six studies were selected, including a total of 3,352,235 participants. The occurrence of PASC was 27.5% lower in patients who received antiviral drugs during the early stages of SARS-CoV-2 infection (OR = 0.725; 95% confidence interval [CI] = 0.409-0.747) than in the supportive treatment group. Moreover, the risk of PASC-associated hospitalization and mortality was 29.7% lower in patients receiving early antiviral therapy than in the supportive treatment group (OR = 0.721; 95% CI = 0.697-0.794). Early antiviral therapy was associated with a reduced risk of PASC and related hospitalization or death. Thus, early antiviral therapy is recommended for at-risk individuals.},
}

@article {pmid38069140,
year = {2023},
author = {Pietraszko, P and Zorawski, M and Bielecka, E and Sielatycki, P and Zbroch, E},
title = {Mid-Regional Proadrenomedullin in COVID-19-May It Act as a Predictor of Prolonged Cardiovascular Complications?.},
journal = {International journal of molecular sciences},
volume = {24},
number = {23},
pages = {},
pmid = {38069140},
issn = {1422-0067},
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; SARS-CoV-2 ; Biomarkers ; Adrenomedullin ; *Cardiovascular Diseases/etiology ; Protein Precursors ; },
abstract = {The rising prevalence of cardiovascular disease (CVD) and the impact of the SARS-CoV-2 pandemic have both led to increased mortality rates, affecting public health and the global economy. Therefore, it is essential to find accessible, non-invasive prognostic markers capable of identifying patients at high risk. One encouraging avenue of exploration is the potential of mid-regional proadrenomedullin (MR-proADM) as a biomarker in various health conditions, especially in the context of CVD and COVID-19. MR-proADM presents the ability to predict mortality, heart failure, and adverse outcomes in CVD, offering promise for improved risk assessment and treatment strategies. On the other hand, an elevated MR-proADM level is associated with disease severity and cytokine storms in patients with COVID-19, making it a predictive indicator for intensive care unit admissions and mortality rates. Moreover, MR-proADM may have relevance in long COVID, aiding in the risk assessment, triage, and monitoring of individuals at increased risk of developing prolonged cardiac issues. Our review explores the potential of MR-proADM as a predictor of enduring cardiovascular complications following COVID-19 infection.},
}

Humans
Post-Acute COVID-19 Syndrome
*COVID-19/complications
SARS-CoV-2
Biomarkers
Adrenomedullin
*Cardiovascular Diseases/etiology
Protein Precursors

@article {pmid38069362,
year = {2023},
author = {Scheim, DE and Vottero, P and Santin, AD and Hirsh, AG},
title = {Sialylated Glycan Bindings from SARS-CoV-2 Spike Protein to Blood and Endothelial Cells Govern the Severe Morbidities of COVID-19.},
journal = {International journal of molecular sciences},
volume = {24},
number = {23},
pages = {},
pmid = {38069362},
issn = {1422-0067},
support = {UL1 TR001863/TR/NCATS NIH HHS/United States ; },
mesh = {Animals ; Humans ; *COVID-19 ; Spike Glycoprotein, Coronavirus/metabolism ; SARS-CoV-2/metabolism ; Post-Acute COVID-19 Syndrome ; Endothelial Cells/metabolism ; *Common Cold ; Angiotensin-Converting Enzyme 2/metabolism ; Polysaccharides/metabolism ; Morbidity ; Hypoxia ; Mammals/metabolism ; },
abstract = {Consistent with well-established biochemical properties of coronaviruses, sialylated glycan attachments between SARS-CoV-2 spike protein (SP) and host cells are key to the virus's pathology. SARS-CoV-2 SP attaches to and aggregates red blood cells (RBCs), as shown in many pre-clinical and clinical studies, causing pulmonary and extrapulmonary microthrombi and hypoxia in severe COVID-19 patients. SARS-CoV-2 SP attachments to the heavily sialylated surfaces of platelets (which, like RBCs, have no ACE2) and endothelial cells (having minimal ACE2) compound this vascular damage. Notably, experimentally induced RBC aggregation in vivo causes the same key morbidities as for severe COVID-19, including microvascular occlusion, blood clots, hypoxia and myocarditis. Key risk factors for COVID-19 morbidity, including older age, diabetes and obesity, are all characterized by markedly increased propensity to RBC clumping. For mammalian species, the degree of clinical susceptibility to COVID-19 correlates to RBC aggregability with p = 0.033. Notably, of the five human betacoronaviruses, the two common cold strains express an enzyme that releases glycan attachments, while the deadly SARS, SARS-CoV-2 and MERS do not, although viral loads for COVID-19 and the two common cold infections are similar. These biochemical insights also explain the previously puzzling clinical efficacy of certain generics against COVID-19 and may support the development of future therapeutic strategies for COVID-19 and long COVID patients.},
}

Animals
Humans
*COVID-19
Spike Glycoprotein, Coronavirus/metabolism
SARS-CoV-2/metabolism
Post-Acute COVID-19 Syndrome
Endothelial Cells/metabolism
*Common Cold
Angiotensin-Converting Enzyme 2/metabolism
Polysaccharides/metabolism
Morbidity
Hypoxia
Mammals/metabolism

@article {pmid38083997,
year = {2024},
author = {Collins, E and Philippe, E and Gravel, CA and Hawken, S and Langlois, MA and Little, J},
title = {Serological markers and long COVID-A rapid systematic review.},
journal = {European journal of clinical investigation},
volume = {54},
number = {4},
pages = {e14149},
doi = {10.1111/eci.14149},
pmid = {38083997},
issn = {1365-2362},
support = {//CIHR/ ; },
mesh = {Humans ; *COVID-19/immunology/blood ; *Immunoglobulin G/blood/immunology ; *Biomarkers/blood ; *SARS-CoV-2/immunology ; Post-Acute COVID-19 Syndrome ; Antibodies, Viral/blood ; Spike Glycoprotein, Coronavirus/immunology ; },
abstract = {BACKGROUND: Long COVID is highly heterogeneous, often debilitating, and may last for years after infection. The aetiology of long COVID remains uncertain. Examination of potential serological markers of long COVID, accounting for clinical covariates, may yield emergent pathophysiological insights.

METHODS: In adherence to PRISMA guidelines, we carried out a rapid review of the literature. We searched Medline and Embase for primary observational studies that compared IgG response in individuals who experienced COVID-19 symptoms persisting ≥12 weeks post-infection with those who did not. We examined relationships between serological markers and long COVID status and investigated sources of inter-study variability, such as severity of acute illness, long COVID symptoms assessed and target antigen(s).

RESULTS: Of 8018 unique records, we identified 29 as being eligible for inclusion in synthesis. Definitions of long COVID varied. In studies that reported anti-nucleocapsid (N) IgG (n = 10 studies; n = 989 participants in aggregate), full or partial anti-Spike IgG (i.e. the whole trimer, S1 or S2 subgroups, or receptor binding domain, n = 19 studies; n = 2606 participants), or neutralizing response (n = 7 studies; n = 1123 participants), we did not find strong evidence to support any difference in serological markers between groups with and without persisting symptoms. However, most studies did not account for severity or level of care required during acute illness, and other potential confounders.

CONCLUSIONS: Pooling of studies would enable more robust exploration of clinical and serological predictors among diverse populations. However, substantial inter-study variations hamper comparability. Standardized reporting practices would improve the quality, consistency and comprehension of study findings.},
}

Humans
*COVID-19/immunology/blood
*Immunoglobulin G/blood/immunology
*Biomarkers/blood
*SARS-CoV-2/immunology
Post-Acute COVID-19 Syndrome
Antibodies, Viral/blood
Spike Glycoprotein, Coronavirus/immunology

@article {pmid38091027,
year = {2024},
author = {Rana, P and Patial, S and Soni, V and Singh, P and Khosla, A and Thakur, S and Hussaisn, CM and de Carvalho Nagliate, P and Meili, L and Selvasembian, R and Raizada, P},
title = {"Long COVID" and Its Impact on The Environment: Emerging Concerns and Perspectives.},
journal = {Environmental management},
volume = {73},
number = {3},
pages = {471-480},
pmid = {38091027},
issn = {1432-1009},
mesh = {Humans ; *Air Pollution/analysis ; *COVID-19/epidemiology ; Pandemics ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {The COVID-19 pandemic has caused unprecedented global health and economic crises. The emergence of long COVID-19 has raised concerns about the interplay between SARS-CoV-2 infections, climate change, and the environment. In this context, a concise analysis of the potential long-term effects of the COVID-19 epidemic along with the awareness aboutenvironmental issues are realized. While COVID-19 effects in the short-term have reduced environmental air pollutants and pressures, CO2 emissions are projected to increase as the economy recovers and growth rates return to pre-COVID-19 levels. This review discusses the systematic effects of both the short-term and long-term effects of the pandemic on the clean energy revolution and environmental issues. This article also discusses opportunities to achieve long-term environmental benefits and emphasizes the importance of future policies in promoting global environmental sustainability. Future directions for growth and recovery are presented to cope with long COVID-19 epidemic along with the critical findings focussing on various aspects: waste management, air quality improvement.},
}

Humans
*Air Pollution/analysis
*COVID-19/epidemiology
Pandemics
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid38098317,
year = {2024},
author = {El-Baky, NA and Amara, AA and Uversky, VN and Redwan, EM},
title = {Intrinsic factors behind long COVID: III. Persistence of SARS-CoV-2 and its components.},
journal = {Journal of cellular biochemistry},
volume = {125},
number = {1},
pages = {22-44},
doi = {10.1002/jcb.30514},
pmid = {38098317},
issn = {1097-4644},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Intrinsic Factor ; *COVID-19 ; RNA, Viral/genetics ; },
abstract = {Considerable research has been done in investigating SARS-CoV-2 infection, its characteristics, and host immune response. However, debate is still ongoing over the emergence of post-acute sequelae of SARS-CoV-2 infection (PASC). A multitude of long-lasting symptoms have been reported several weeks after the primary acute SARS-CoV-2 infection that resemble several other viral infections. Thousands of research articles have described various post-COVID-19 conditions. Yet, the evidence around these ongoing health problems, the reasons behind them, and their molecular underpinnings are scarce. These persistent symptoms are also known as long COVID-19. The persistence of SARS-CoV-2 and/or its components in host tissues can lead to long COVID. For example, the presence of viral nucleocapsid protein and RNA was detected in the skin, appendix, and breast tissues of some long COVID patients. The persistence of viral RNA was reported in multiple anatomic sites, including non-respiratory tissues such as the adrenal gland, ocular tissue, small intestine, lymph nodes, myocardium, and sciatic nerve. Distinctive viral spike sequence variants were also found in non-respiratory tissues. Interestingly, prolonged detection of viral subgenomic RNA was observed across all tissues, sometimes in multiple tissues of the same patient, which likely reflects recent but defective viral replication. Moreover, the persistence of SARS-CoV-2 RNA was noticed throughout the brain at autopsy, as late as 230 days following symptom onset among unvaccinated patients who died of severe infection. Here, we review the persistence of SARS-CoV-2 and its components as an intrinsic factor behind long COVID. We also highlight the immunological consequences of this viral persistence.},
}

Humans
*Post-Acute COVID-19 Syndrome
SARS-CoV-2
Intrinsic Factor
*COVID-19
RNA, Viral/genetics

@article {pmid38113020,
year = {2024},
author = {Fernández-de-Las-Peñas, C and Torres-Macho, J and Catahay, JA and Macasaet, R and Velasco, JV and Macapagal, S and Caldararo, M and Henry, BM and Lippi, G and Franco-Moreno, A and Notarte, KI},
title = {Is antiviral treatment at the acute phase of COVID-19 effective for decreasing the risk of long-COVID? A systematic review.},
journal = {Infection},
volume = {52},
number = {1},
pages = {43-58},
pmid = {38113020},
issn = {1439-0973},
mesh = {Humans ; *COVID-19 ; Post-Acute COVID-19 Syndrome ; Ritonavir ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; Dexamethasone/therapeutic use ; *Metformin ; },
abstract = {PURPOSE: Preliminary evidence suggests a potential effect of antiviral medication used during the acute COVID-19 phase for preventing long-COVID. This review investigates if having received pharmacological treatment during acute SARS-CoV-2 infection may reduce the risk of long-COVID.

METHODS: MEDLINE, CINAHL, PubMed, EMBASE, Web of Science databases, as well as medRxiv/bioRxiv preprint servers were searched up to July 15th, 2023. Articles comparing the presence of long-COVID symptoms between individuals who received or not a specific medication, particularly antivirals, during the acute phase of SARS-CoV-2 infection were included. Methodological quality was assessed using the Newcastle-Ottawa Scale or Cochrane's Risk of Bias (Rob) tool.

RESULTS: From 517 studies identified, 6 peer-reviewed studies and one preprint met all inclusion criteria. The sample included 2683 (n = 4) hospitalized COVID-19 survivors and 307,409 (n = 3) non-hospitalized patients. The methodological quality was high in 71% of studies (n = 5/7). Two studies investigating the effects of Nirmaltrevir/Ritonavir and three studies the effect of Remdesivir reported conflicting results on effectiveness for preventing long-COVID. Three studies investigating the effects of other medication such as Dexamethasone (n = 2) or Metformin (n = 1) found positive results of these medications for preventing long-COVID.

CONCLUSION: Available evidence about the effect of medication treatment with antivirals during acute COVID-19 and reduced risk of developing long-COVID is conflicting. Heterogeneous evidence suggests that Remdesivir or Nirmaltrevir/Ritonavir could have a potential protective effect for long-COVID. A limited number of studies demonstrated a potential benefit of other medications such as Dexamethasone or Metformin, but more studies are needed.},
}

Humans
*COVID-19
Post-Acute COVID-19 Syndrome
Ritonavir
SARS-CoV-2
Antiviral Agents/therapeutic use
Dexamethasone/therapeutic use
*Metformin

@article {pmid38117308,
year = {2024},
author = {da Silva, LNM and Filho, AGO and Guimarães, JB},
title = {Musculoskeletal manifestations of COVID-19.},
journal = {Skeletal radiology},
volume = {53},
number = {10},
pages = {2009-2022},
pmid = {38117308},
issn = {1432-2161},
mesh = {Humans ; *COVID-19/complications/diagnostic imaging ; *Musculoskeletal Diseases/diagnostic imaging/etiology ; *SARS-CoV-2 ; },
abstract = {During the COVID-19 pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected millions of people worldwide, with acute respiratory distress syndrome (ARDS) being the most common severe condition of pulmonary involvement. Despite its involvement in the lungs, SARS-CoV-2 causes multiple extrapulmonary manifestations, including manifestations in the musculoskeletal system. Several cases involving bone, joint, muscle, neurovascular and soft tissues were reported shortly after pandemic onset. Even after the acute infection has resolved, many patients experience persistent symptoms and a decrease in quality of life, a condition known as post-COVID syndrome or long COVID. COVID-19 vaccines have been widely available since December 2020, preventing millions of deaths during the pandemic. However, adverse reactions, including those involving the musculoskeletal system, have been reported in the literature. Therefore, the primary goal of this article is to review the main imaging findings of SARS-CoV-2 involvement in the musculoskeletal system, including acute, subacute, chronic and postvaccination manifestations.},
}

Humans
*COVID-19/complications/diagnostic imaging
*Musculoskeletal Diseases/diagnostic imaging/etiology
*SARS-CoV-2

@article {pmid38123233,
year = {2023},
author = {Singh, SJ and Daynes, E and McAuley, HJC and Raman, B and Greening, NJ and Chalder, T and Elneima, O and Evans, RA and Bolton, CE},
title = {Balancing the value and risk of exercise-based therapy post-COVID-19: a narrative review.},
journal = {European respiratory review : an official journal of the European Respiratory Society},
volume = {32},
number = {170},
pages = {},
pmid = {38123233},
issn = {1600-0617},
support = {/WT_/Wellcome Trust/United Kingdom ; },
mesh = {Humans ; *COVID-19 ; Exercise Therapy/adverse effects ; Exercise ; Fatigue ; Dyspnea ; },
abstract = {Coronavirus disease 2019 (COVID-19) can lead to ongoing symptoms such as breathlessness, fatigue and muscle pain, which can have a substantial impact on an individual. Exercise-based rehabilitation programmes have proven beneficial in many long-term conditions that share similar symptoms. These programmes have favourably influenced breathlessness, fatigue and pain, while also increasing functional capacity. Exercise-based rehabilitation may benefit those with ongoing symptoms following COVID-19. However, some precautions may be necessary prior to embarking on an exercise programme. Areas of concern include ongoing complex lung pathologies, such as fibrosis, cardiovascular abnormalities and fatigue, and concerns regarding post-exertional symptom exacerbation. This article addresses these concerns and proposes that an individually prescribed, symptom-titrated exercise-based intervention may be of value to individuals following infection with severe acute respiratory syndrome coronavirus 2.},
}

Humans
*COVID-19
Exercise Therapy/adverse effects
Exercise
Fatigue
Dyspnea

@article {pmid38124476,
year = {2024},
author = {Shetty, AJ and Banerjee, M and Prasad, TN and Bhadada, SK and Pal, R},
title = {Do vitamin D levels or supplementation play A role in COVID-19 outcomes?-a narrative review.},
journal = {Annals of palliative medicine},
volume = {13},
number = {1},
pages = {162-177},
doi = {10.21037/apm-23-113},
pmid = {38124476},
issn = {2224-5839},
mesh = {Humans ; *COVID-19 ; Dietary Supplements ; SARS-CoV-2 ; Vitamin D/therapeutic use ; *Vitamin D Deficiency/complications ; },
abstract = {BACKGROUND AND OBJECTIVE: Hypovitaminosis D has been proposed as a risk factor for increased susceptibility to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and severe outcomes in coronavirus disease 2019 (COVID-19). Likewise, vitamin D supplementation has been proposed as an effective means for preventing and improving clinical outcomes in COVID-19. Nevertheless, available data are markedly inconsistent and contradictory. Considering the heterogeneity in the available clinical evidence, we planned to undertake a narrative review and provide a precise summary of the role of vitamin D in COVID-19.

METHODS: PubMed/MEDLINE database was searched from inception till September 30, 2023 using appropriate MeSH terms. The initial search revealed 900 results. Thereafter, titles and abstracts were scanned and commentaries, letters, and editorials were excluded. Relevant observational studies and clinical trials/randomized controlled trials (RCTs) were full-text assessed and pertinent data were extracted for this narrative review.

KEY CONTENT AND FINDINGS: Data from observational and ecological studies suggest that hypovitaminosis D is associated with a higher risk of acquiring COVID-19. Similarly, evidence support a negative association between 25-hydroxyvitamin D levels and COVID-19 severity, nevertheless, causality remains to be established. With regard to vitamin D supplementation and COVID-19-related health outcomes, data from observational studies and RCTs are contradictory. Even in moderate-to-severe/severe COVID-19, vitamin D supplementation has not been shown to be beneficial. Besides, data suggest that vitamin D levels might alter COVID-19 vaccine efficacy and be associated with long COVID.

CONCLUSIONS: Vitamin D deficiency is linked to an increased risk of acquiring SARS-CoV-2 infection and poor COVID-19 prognosis, however, available evidence with regard to improved clinical outcomes with vitamin D supplementation is inconsistent.},
}

Humans
*COVID-19
Dietary Supplements
SARS-CoV-2
Vitamin D/therapeutic use
*Vitamin D Deficiency/complications

@article {pmid38126937,
year = {2024},
author = {Razzaq, A and Disoma, C and Zhou, Y and Tao, S and Chen, Z and Liu, S and Zheng, R and Zhang, Y and Liao, Y and Chen, X and Liu, S and Dong, Z and Xu, L and Deng, X and Li, S and Xia, Z},
title = {Targeting epidermal growth factor receptor signalling pathway: A promising therapeutic option for COVID-19.},
journal = {Reviews in medical virology},
volume = {34},
number = {1},
pages = {e2500},
doi = {10.1002/rmv.2500},
pmid = {38126937},
issn = {1099-1654},
mesh = {Humans ; Antiviral Agents/therapeutic use/pharmacology ; *COVID-19 ; COVID-19 Drug Treatment ; *ErbB Receptors/genetics/metabolism ; Erlotinib Hydrochloride/therapeutic use ; Post-Acute COVID-19 Syndrome ; Pulmonary Fibrosis/metabolism ; SARS-CoV-2/metabolism ; *Signal Transduction/drug effects ; },
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuously producing new variants, necessitating effective therapeutics. Patients are not only confronted by the immediate symptoms of infection but also by the long-term health issues linked to long COVID-19. Activation of epidermal growth factor receptor (EGFR) signalling during SARS-CoV-2 infection promotes virus propagation, mucus hyperproduction, and pulmonary fibrosis, and suppresses the host's antiviral response. Over the long term, EGFR activation in COVID-19, particularly in COVID-19-induced pulmonary fibrosis, may be linked to the development of lung cancer. In this review, we have summarised the significance of EGFR signalling in the context of SARS-CoV-2 infection. We also discussed the targeting of EGFR signalling as a promising strategy for COVID-19 treatment and highlighted erlotinib as a superior option among EGFR inhibitors. Erlotinib effectively blocks EGFR and AAK1, thereby preventing SARS-CoV-2 replication, reducing mucus hyperproduction, TNF-α expression, and enhancing the host's antiviral response. Nevertheless, to evaluate the antiviral efficacy of erlotinib, relevant clinical trials involving an appropriate patient population should be designed.},
}

Humans
Antiviral Agents/therapeutic use/pharmacology
*COVID-19
COVID-19 Drug Treatment
*ErbB Receptors/genetics/metabolism
Erlotinib Hydrochloride/therapeutic use
Post-Acute COVID-19 Syndrome
Pulmonary Fibrosis/metabolism
SARS-CoV-2/metabolism
*Signal Transduction/drug effects

@article {pmid38128935,
year = {2023},
author = {Fyffe, I and Sorensen, J and Carroll, S and MacPhee, M and Andrews-Paul, A and Crooks, VA and Freeman, S and Davison, K and Walls, J and Berndt, A and Shams, B and Sivan, M and Mithani, A},
title = {Long COVID in long-term care: a rapid realist review.},
journal = {BMJ open},
volume = {13},
number = {12},
pages = {e076186},
pmid = {38128935},
issn = {2044-6055},
mesh = {Humans ; *COVID-19/therapy ; Delivery of Health Care ; Long-Term Care ; *Post-Acute COVID-19 Syndrome ; Quality of Life ; },
abstract = {OBJECTIVES: The goals of this rapid realist review were to ask: (a) what are the key mechanisms that drive successful interventions for long COVID in long-term care (LTC) and (b) what are the critical contexts that determine whether the mechanisms produce the intended outcomes?

DESIGN: Rapid realist review.

DATA SOURCES: Medline, CINAHL, Embase, PsycINFO and Web of Science for peer-reviewed literature and Google for grey literature were searched up to 23 February 2023.

ELIGIBILITY CRITERIA: We included sources focused on interventions, persons in LTC, long COVID or post-acute phase at least 4 weeks following initial COVID-19 infection and ones that had a connection with source materials.

DATA EXTRACTION AND SYNTHESIS: Three independent reviewers searched, screened and coded studies. Two independent moderators resolved conflicts. A data extraction tool organised relevant data into context-mechanism-outcome configurations using realist methodology. Twenty-one sources provided 51 intervention data excerpts used to develop our programme theory. Synthesised findings were presented to a reference group and expert panel for confirmatory purposes.

RESULTS: Fifteen peer-reviewed articles and six grey literature sources were eligible for inclusion. Eleven context-mechanism-outcome configurations identify those contextual factors and underlying mechanisms associated with desired outcomes, such as clinical care processes and policies that ensure timely access to requisite resources for quality care delivery, and resident-centred assessments and care planning to address resident preferences and needs. The underlying mechanisms associated with enhanced outcomes for LTC long COVID survivors were: awareness, accountability, vigilance and empathetic listening.

CONCLUSIONS: Although the LTC sector struggles with organisational capacity issues, they should be aware that comprehensively assessing and monitoring COVID-19 survivors and providing timely interventions to those with long COVID is imperative. This is due to the greater care needs of residents with long COVID, and coordinated efficient care is required to optimise their quality of life.},
}

Humans
*COVID-19/therapy
Delivery of Health Care
Long-Term Care
*Post-Acute COVID-19 Syndrome
Quality of Life

@article {pmid38131885,
year = {2023},
author = {Sideratou, CM and Papaneophytou, C},
title = {Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems.},
journal = {Infectious disease reports},
volume = {15},
number = {6},
pages = {806-830},
pmid = {38131885},
issn = {2036-7430},
abstract = {The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as 'long- COVID-19' (or simply 'long- COVID'), emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as 'post-acute sequelae of SARS-CoV-2 infection' (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review summarizes the primary effects of long COVID on the respiratory, cardiovascular, and nervous systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID's pathogenesis.},
}

@article {pmid38132646,
year = {2023},
author = {Zimmermann, P and Sourij, H and Aberer, F and Rilstone, S and Schierbauer, J and Moser, O},
title = {SGLT2 Inhibitors in Long COVID Syndrome: Is There a Potential Role?.},
journal = {Journal of cardiovascular development and disease},
volume = {10},
number = {12},
pages = {},
pmid = {38132646},
issn = {2308-3425},
abstract = {The coronavirus disease (COVID)-19 has turned into a pandemic causing a global public health crisis. While acute COVID-19 mainly affects the respiratory system and can cause acute respiratory distress syndrome, an association with persistent inflammatory stress affecting different organ systems has been elucidated in long COVID syndrome (LCS). Increased severity and mortality rates have been reported due to cardiophysiological and metabolic systemic disorders as well as multiorgan failure in COVID-19, additionally accompanied by chronic dyspnea and fatigue in LCS. Hence, novel therapies have been tested to improve the outcomes of LCS of which one potential candidate might be sodium-glucose cotransporter 2 (SGLT2) inhibitors. The aim of this narrative review was to discuss rationales for investigating SGLT2 inhibitor therapy in people suffering from LCS. In this regard, we discuss their potential positive effects-next to the well described "cardio-renal-metabolic" conditions-with a focus on potential anti-inflammatory and beneficial systemic effects in LCS. However, potential beneficial as well as potential disadvantageous effects of SGLT2 inhibitors on the prevalence and long-term outcomes of COVID-19 will need to be established in ongoing research.},
}

@article {pmid38138102,
year = {2023},
author = {Fernández-de-Las-Peñas, C and Raveendran, AV and Giordano, R and Arendt-Nielsen, L},
title = {Long COVID or Post-COVID-19 Condition: Past, Present and Future Research Directions.},
journal = {Microorganisms},
volume = {11},
number = {12},
pages = {},
pmid = {38138102},
issn = {2076-2607},
abstract = {The presence of symptoms after an acute SARS-CoV-2 infection (long-COVID) has become a worldwide healthcare emergency but remains underestimated and undertreated due to a lack of recognition of the condition and knowledge of the underlying mechanisms. In fact, the prevalence of post-COVID symptoms ranges from 50% during the first months after the infection up to 20% two-years after. This perspective review aimed to map the existing literature on post-COVID symptoms and to identify gaps in the literature to guide the global effort toward an improved understanding of long-COVID and suggest future research directions. There is a plethora of symptomatology that can be due to COVID-19; however, today, there is no clear classification and definition of this condition, termed long-COVID or post-COVID-19 condition. The heterogeneity in the symptomatology has led to the presence of groups/clusters of patients, which could exhibit different risk factors and different mechanisms. Viral persistence, long-lasting inflammation, immune dysregulation, autoimmune reactions, reactivation of latent infections, endothelial dysfunction and alteration in gut microbiota have been proposed as potential mechanisms explaining the complexity of long-COVID. In such an equation, viral biology (e.g., re-infections, SARS-CoV-2 variants), host biology (e.g., genetics, epigenetics) and external factors (e.g., vaccination) should be also considered. These various factors will be discussed in the current perspective review and future directions suggested.},
}

@article {pmid38139027,
year = {2023},
author = {Ailioaie, LM and Ailioaie, C and Litscher, G},
title = {Gut Microbiota and Mitochondria: Health and Pathophysiological Aspects of Long COVID.},
journal = {International journal of molecular sciences},
volume = {24},
number = {24},
pages = {},
pmid = {38139027},
issn = {1422-0067},
mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; *Gastrointestinal Microbiome ; Inflammation ; Dysbiosis ; },
abstract = {The current understanding of long COVID (LC) is still limited. This review highlights key findings regarding the role of gut microbiota, mitochondria, and the main pathophysiological aspects of LC revealed by clinical studies, related to the complex interplay between infection, intestinal dysbiosis, dysfunctional mitochondria, and systemic inflammation generated in a vicious circle, reflecting the molecular and cellular processes from the "leaky gut" to the "leaky electron transport chain (ETC)" into a quantum leap. The heterogeneity of LC has hindered progress in deciphering all the pathophysiological mechanisms, and therefore, the approach must be multidisciplinary, with a special focus not only on symptomatic management but also on addressing the underlying health problems of the patients. It is imperative to further assess and validate the effects of COVID-19 and LC on the gut microbiome and their relationship to infections with other viral agents or pathogens. Further studies are needed to better understand LC and expand the interdisciplinary points of view that are required to accurately diagnose and effectively treat this heterogeneous condition. Given the ability of SARS-CoV-2 to induce autoimmunity in susceptible patients, they should be monitored for symptoms of autoimmune disease after contracting the viral infection. One question remains open, namely, whether the various vaccines developed to end the pandemic will also induce autoimmunity. Recent data highlighted in this review have revealed that the persistence of SARS-CoV-2 and dysfunctional mitochondria in organs such as the heart and, to a lesser extent, the kidneys, liver, and lymph nodes, long after the organism has been able to clear the virus from the lungs, could be an explanation for LC.},
}

Humans
*COVID-19
SARS-CoV-2
Post-Acute COVID-19 Syndrome
*Gastrointestinal Microbiome
Inflammation
Dysbiosis

@article {pmid38139400,
year = {2023},
author = {Gostimirovic, M and Rajkovic, J and Bukarica, A and Simanovic, J and Gojkovic-Bukarica, L},
title = {Resveratrol and Gut Microbiota Synergy: Preventive and Therapeutic Effects.},
journal = {International journal of molecular sciences},
volume = {24},
number = {24},
pages = {},
pmid = {38139400},
issn = {1422-0067},
support = {NA//Ministry of Science, Technological Development and Innovations of Republic of Serbia/ ; },
mesh = {Humans ; Resveratrol/pharmacology/therapeutic use ; *Gastrointestinal Microbiome/physiology ; *Noncommunicable Diseases ; Quality of Life ; Diet, High-Fat ; *COVID-19 ; },
abstract = {The role of an imbalanced high-fat diet in the pathophysiology of common chronic noncommunicable diseases has been known for years. More recently, the concept of 'gut microbiota' and the interaction between their composition and gut metabolites produced from the intake of dietary products have gained the focus of researchers, mostly from the perspective of the prevention of cardiovascular and metabolic disorders, which are still the leading cause of death globally. The aim of this work is to highlight the health benefits of the interaction between resveratrol (RSV), red grape polyphenol, and gut microbiota, through aspects of their therapeutic and preventive potentials. Since changed microbiota (mostly as a consequence of antibiotic overuse) contribute to the persistence of post ('long')-COVID-19 symptoms, these aspects will be covered too. Data were obtained from the electronic databases (MedLine/PubMed), according to specific keywords regarding the protective role of resveratrol, the gut microbiota, and their synergy. RSV exerts beneficial properties in the modulation of cardiovascular, metabolic, and post-COVID-19-related disorders. In healthy individuals, it maintains an ergogenic capacity, prevents oxidative stress, and modulates the inflammatory response. Overall, it improves quality of life. The RSV-gut-microbiota interaction is beneficial in terms of maintaining human health. Along with physical activity, it is key for the prevention of chronic noncommunicable diseases.},
}

Humans
Resveratrol/pharmacology/therapeutic use
*Gastrointestinal Microbiome/physiology
*Noncommunicable Diseases
Quality of Life
Diet, High-Fat
*COVID-19

@article {pmid38140991,
year = {2024},
author = {Brigido, S and Manes, MT and Ingianni, N and Lanni, F and Cutolo, A and La Rovere, MT and Pavan, D and , },
title = {[Gender cardiology: focus on clinical and pathophysiological peculiarities in women with long COVID syndrome].},
journal = {Giornale italiano di cardiologia (2006)},
volume = {25},
number = {1},
pages = {6-13},
doi = {10.1714/4165.41585},
pmid = {38140991},
issn = {1972-6481},
mesh = {Female ; Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19 ; *Cardiovascular System ; *Cardiology ; *Vascular Diseases ; },
abstract = {Long COVID is a clinical syndrome characterized by the persistence or development of symptoms due to COVID-19 at least 12 weeks after initial infection. More than 200 different symptoms have been ascribed to long COVID, the most common being fatigue, shortness of breath, and muscle weakness. Women have a three-fold higher risk of being diagnosed with long COVID, and the symptoms more often described are persistent weakness, chest pain, altered smell and taste, palpitations or muscle pain, as well as neurological, gastrointestinal and rheumatologic symptoms. Long COVID features are influenced by immune function, endothelial dysfunction and sex hormones. Moreover, it leads to systemic dysfunction, so various therapeutic strategies have been explored and still different trials are ongoing, mainly regarding anticoagulation and immuno-modulators. Nowadays the most quoted interventions are focused rehabilitation programs and pharmacological selected treatments in specifical cases. The aim of this review will be focusing the clinical and pathophysiological sex-related peculiarities to understand the different long COVID phenotypes and possibly address a better tailored approach and treatment.},
}

Female
Humans
Post-Acute COVID-19 Syndrome
*COVID-19
*Cardiovascular System
*Cardiology
*Vascular Diseases

@article {pmid38143784,
year = {2023},
author = {Peterson, BM and Unger, I and Sun, S and Park, JY and Kim, J and Gunasekera, RS and Wilson, J and Galbadage, T},
title = {The vital role of exercise and nutrition in COVID-19 rehabilitation: synergizing strength.},
journal = {Frontiers in sports and active living},
volume = {5},
number = {},
pages = {1305175},
pmid = {38143784},
issn = {2624-9367},
abstract = {Since the outset of the COVID-19 pandemic, the global healthcare community has faced the challenge of understanding and addressing the ongoing and multi-faceted SARS-CoV-2 infection outcomes. As millions of individuals worldwide continue to navigate the complexities of post-hospitalization recovery, reinfection rates, and the increasing prevalence of Long-COVID symptoms, comprehensive COVID-19 rehabilitation strategies are greatly needed. Previous studies have highlighted the potential synergy between exercise and nutrition, suggesting that their integration into patient rehabilitation programs may yield improved clinical outcomes for survivors of COVID-19. Our group aimed to consolidate existing knowledge following the implementation of patient, intervention, comparison, and outcome (PICO) search strategies on the distinct and combined impacts of exercise and nutrition interventions in facilitating the recovery of COVID-19 patients following hospitalization, with a specific focus on their implications for both public health and clinical practice. The incorporation of targeted nutritional strategies alongside exercise-based programs may expedite patient recovery, ultimately promoting independence in performing activities of daily living (ADLs). Nonetheless, an imperative for expanded scientific inquiry remains, particularly in the realm of combined interventions. This mini-review underscores the compelling prospects offered by an amalgamated approach, advocating for the seamless integration of exercise and nutrition as integral components of post-hospitalization COVID-19 rehabilitation. The pursuit of a comprehensive understanding of the synergistic effects and effectiveness of exercise and nutrition stands as a crucial objective in advancing patient care and refining recovery strategies in the wake of this enduring global health crisis.},
}

@article {pmid38156008,
year = {2023},
author = {He, KY and Lei, XY and Zhang, L and Wu, DH and Li, JQ and Lu, LY and Laila, UE and Cui, CY and Xu, ZX and Jian, YP},
title = {Development and management of gastrointestinal symptoms in long-term COVID-19.},
journal = {Frontiers in microbiology},
volume = {14},
number = {},
pages = {1278479},
pmid = {38156008},
issn = {1664-302X},
abstract = {BACKGROUND: Emerging evidence reveals that SARS-CoV-2 possesses the capability to disrupt the gastrointestinal (GI) homeostasis, resulting in the long-term symptoms such as loss of appetite, diarrhea, gastroesophageal reflux, and nausea. In the current review, we summarized recent reports regarding the long-term effects of COVID-19 (long COVID) on the gastrointestine.

OBJECTIVE: To provide a narrative review of abundant clinical evidence regarding the development and management of long-term GI symptoms in COVID-19 patients.

RESULTS: Long-term persistent digestive symptoms are exhibited in a majority of long-COVID patients. SARS-CoV-2 infection of intestinal epithelial cells, cytokine storm, gut dysbiosis, therapeutic drugs, psychological factors and exacerbation of primary underlying diseases lead to long-term GI symptoms in COVID-19 patients. Interventions like probiotics, prebiotics, fecal microbiota transplantation, and antibiotics are proved to be beneficial in preserving intestinal microecological homeostasis and alleviating GI symptoms.

CONCLUSION: Timely diagnosis and treatment of GI symptoms in long-COVID patients hold great significance as they may contribute to the mitigation of severe conditions and ultimately lead to the improvement of outcomes of the patients.},
}

@article {pmid38159046,
year = {2024},
author = {Lui, KO and Ma, Z and Dimmeler, S},
title = {SARS-CoV-2 induced vascular endothelial dysfunction: direct or indirect effects?.},
journal = {Cardiovascular research},
volume = {120},
number = {1},
pages = {34-43},
doi = {10.1093/cvr/cvad191},
pmid = {38159046},
issn = {1755-3245},
mesh = {Animals ; Humans ; SARS-CoV-2/metabolism ; *COVID-19 ; Angiotensin-Converting Enzyme 2/metabolism ; Endothelial Cells/metabolism ; Post-Acute COVID-19 Syndrome ; Peptidyl-Dipeptidase A/metabolism ; *Vascular Diseases ; Mammals/metabolism ; },
abstract = {Clinical evidence reveals that manifestations of endothelial dysfunction are widely observed in COVID-19 and long-COVID patients. However, whether these detrimental effects are caused by direct infection of the endothelium or are indirectly mediated by systemic inflammation has been a matter of debate. It has been well acknowledged that endothelial cells (ECs) of the cardiovascular system ubiquitously express the SARS-CoV-2 entry receptor angiotensin-converting enzyme 2 (ACE2), yet accumulating evidence suggests that it is more predominantly expressed by pericytes and vascular smooth muscle cells of the mammalian blood vessel. Besides, replicative infection of ECs by SARS-CoV-2 has yet to be demonstrated both in vitro and in vivo. In this study, we review latest research on endothelial ACE2 expression in different vascular beds, and the heterogeneity in various EC subsets with differential ACE2 expression in response to SARS-CoV-2. We also discuss ACE2-independent alternative mechanisms underlying endothelial activation in COVID-19, and the clinical manifestations of SARS-CoV-2-induced endothelial dysfunction. Altogether, understanding ACE2-dependent and ACE2-independent mechanisms driving SARS-CoV-2-induced vascular dysfunction would shed light on strategies of more effective therapies targeting cardiovascular complications associated with COVID-19.},
}

Animals
Humans
SARS-CoV-2/metabolism
*COVID-19
Angiotensin-Converting Enzyme 2/metabolism
Endothelial Cells/metabolism
Post-Acute COVID-19 Syndrome
Peptidyl-Dipeptidase A/metabolism
*Vascular Diseases
Mammals/metabolism

@article {pmid38163814,
year = {2024},
author = {Fedorowski, A and Fanciulli, A and Raj, SR and Sheldon, R and Shibao, CA and Sutton, R},
title = {Cardiovascular autonomic dysfunction in post-COVID-19 syndrome: a major health-care burden.},
journal = {Nature reviews. Cardiology},
volume = {21},
number = {6},
pages = {379-395},
pmid = {38163814},
issn = {1759-5010},
mesh = {Humans ; *COVID-19/complications/physiopathology/epidemiology ; *Autonomic Nervous System Diseases/physiopathology/etiology/diagnosis ; *Cardiovascular Diseases/physiopathology/epidemiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {Cardiovascular autonomic dysfunction (CVAD) is a malfunction of the cardiovascular system caused by deranged autonomic control of circulatory homeostasis. CVAD is an important component of post-COVID-19 syndrome, also termed long COVID, and might affect one-third of highly symptomatic patients with COVID-19. The effects of CVAD can be seen at both the whole-body level, with impairment of heart rate and blood pressure control, and in specific body regions, typically manifesting as microvascular dysfunction. Many severely affected patients with long COVID meet the diagnostic criteria for two common presentations of CVAD: postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. CVAD can also manifest as disorders associated with hypotension, such as orthostatic or postprandial hypotension, and recurrent reflex syncope. Advances in research, accelerated by the COVID-19 pandemic, have identified new potential pathophysiological mechanisms, diagnostic methods and therapeutic targets in CVAD. For clinicians who daily see patients with CVAD, knowledge of its symptomatology, detection and appropriate management is more important than ever. In this Review, we define CVAD and its major forms that are encountered in post-COVID-19 syndrome, describe possible CVAD aetiologies, and discuss how CVAD, as a component of post-COVID-19 syndrome, can be diagnosed and managed. Moreover, we outline directions for future research to discover more efficient ways to cope with this prevalent and long-lasting condition.},
}

Humans
*COVID-19/complications/physiopathology/epidemiology
*Autonomic Nervous System Diseases/physiopathology/etiology/diagnosis
*Cardiovascular Diseases/physiopathology/epidemiology
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid38169007,
year = {2024},
author = {Munro, APS and Jones, CE and Faust, SN},
title = {Vaccination against COVID-19 - risks and benefits in children.},
journal = {European journal of pediatrics},
volume = {183},
number = {3},
pages = {1107-1112},
pmid = {38169007},
issn = {1432-1076},
mesh = {Adolescent ; Adult ; Child ; Humans ; Male ; *COVID-19/prevention & control/complications ; *COVID-19 Vaccines/adverse effects ; *Myocarditis/etiology ; Risk Assessment ; SARS-CoV-2 ; Syndrome ; *Systemic Inflammatory Response Syndrome ; Vaccination/adverse effects ; },
abstract = {Countries in Europe and around the world have taken varying approaches to their policies on COVID-19 vaccination for children. The low risk of severe illness from COVID-19 means that even small risks from vaccination warrant careful consideration. Vaccination appears to result in a decreased risk of severe illness including the paediatric multi-system inflammatory syndrome known to be associated with COVID-19. These risks have already decreased significantly with the emergence of the Omicron variant and its subvariants, and due to widespread population immunity through previous infection. There is a relatively high risk of myocarditis following second doses of mRNA vaccines in adolescent males, although the general course of this condition appears mild. Conclusion: COVID-19 vaccination only provides a transient reduction in transmission. Currently, insufficient evidence exists to determine the impact of vaccination on post-acute COVID syndromes in children, which are uncommon. What is Known: • Vaccines against COVID-19 have significantly reduced morbidity and mortality around the world. • Whilst countries have universally recommended vaccines for adults and continue to recommend them for vulnerable populations, there has been more variability in recommendations for children. What is New: • In the setting of near universal existing immunity from infection, the majority of the initial benefit in protecting against severe illness has been eroded. • The risks of myocarditis following mRNA vaccination for children is low, but an important consideration given the modest benefits.},
}

Adolescent
Adult
Child
Humans
Male
*COVID-19/prevention & control/complications
*COVID-19 Vaccines/adverse effects
*Myocarditis/etiology
Risk Assessment
SARS-CoV-2
Syndrome
*Systemic Inflammatory Response Syndrome
Vaccination/adverse effects

@article {pmid38172332,
year = {2024},
author = {Helbing, DL and Dommaschk, EM and Danyeli, LV and Liepinsh, E and Refisch, A and Sen, ZD and Zvejniece, L and Rocktäschel, T and Stabenow, LK and Schiöth, HB and Walter, M and Dambrova, M and Besteher, B},
title = {Conceptual foundations of acetylcarnitine supplementation in neuropsychiatric long COVID syndrome: a narrative review.},
journal = {European archives of psychiatry and clinical neuroscience},
volume = {274},
number = {8},
pages = {1829-1845},
pmid = {38172332},
issn = {1433-8491},
support = {857394 (FAT4BRAIN)//Horizon 2020 Framework Programme/ ; },
mesh = {Humans ; *Acetylcarnitine/pharmacology/therapeutic use ; *COVID-19/complications ; *Dietary Supplements ; *Post-Acute COVID-19 Syndrome ; Fatigue Syndrome, Chronic/drug therapy ; },
abstract = {Post-acute sequelae of COVID-19 can present as multi-organ pathology, with neuropsychiatric symptoms being the most common symptom complex, characterizing long COVID as a syndrome with a significant disease burden for affected individuals. Several typical symptoms of long COVID, such as fatigue, depressive symptoms and cognitive impairment, are also key features of other psychiatric disorders such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and major depressive disorder (MDD). However, clinically successful treatment strategies are still lacking and are often inspired by treatment options for diseases with similar clinical presentations, such as ME/CFS. Acetylcarnitine, the shortest metabolite of a class of fatty acid metabolites called acylcarnitines and one of the most abundant blood metabolites in humans can be used as a dietary/nutritional supplement with proven clinical efficacy in the treatment of MDD, ME/CFS and other neuropsychiatric disorders. Basic research in recent decades has established acylcarnitines in general, and acetylcarnitine in particular, as important regulators and indicators of mitochondrial function and other physiological processes such as neuroinflammation and energy production pathways. In this review, we will compare the clinical basis of neuropsychiatric long COVID with other fatigue-associated diseases. We will also review common molecular disease mechanisms associated with altered acetylcarnitine metabolism and the potential of acetylcarnitine to interfere with these as a therapeutic agent. Finally, we will review the current evidence for acetylcarnitine as a supplement in the treatment of fatigue-associated diseases and propose future research strategies to investigate the potential of acetylcarnitine as a treatment option for long COVID.},
}

Humans
*Acetylcarnitine/pharmacology/therapeutic use
*COVID-19/complications
*Dietary Supplements
*Post-Acute COVID-19 Syndrome
Fatigue Syndrome, Chronic/drug therapy

@article {pmid38185377,
year = {2024},
author = {Rischard, F and Altman, N and Szmuszkovicz, J and Sciurba, F and Berman-Rosenzweig, E and Lee, S and Krishnan, S and Truong, N and Wood, J and Finn, AV and , },
title = {Long-Term Effects of COVID-19 on the Cardiopulmonary System in Adults and Children: Current Status and Questions to be Resolved by the National Institutes of Health Researching COVID to Enhance Recovery Initiative.},
journal = {Chest},
volume = {165},
number = {4},
pages = {978-989},
pmid = {38185377},
issn = {1931-3543},
support = {OTA-21-015A/HL/NHLBI NIH HHS/United States ; },
mesh = {Adult ; Humans ; Child ; United States/epidemiology ; *COVID-19 ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Dyspnea ; Lung ; },
abstract = {TOPIC IMPORTANCE: Long COVID may occur in at least 10% of patients recovering from SARS-CoV-2 infection and often is associated with debilitating symptoms. Among the organ systems that might be involved in its pathogenesis, the respiratory and cardiovascular systems may be central to common symptoms seen in survivors of COVID-19, including fatigue, dyspnea, chest pain, cough, and exercise intolerance. Understand the exact symptomatology, causes, and effects of long COVID on the heart and lungs may help us to discover new therapies. To that end, the National Institutes of Health is sponsoring a national study population of diverse volunteers to support large-scale studies on the long-term effects of COVID-19.

REVIEW FINDINGS: The National Institutes of Health Researching COVID to Enhance Recovery (RECOVER) initiative currently is recruiting participants in the United States to answer critical questions about long COVID. The study comprises adult and pediatric cohorts as well as an electronic health record cohort. Based on symptoms, individuals undergo prespecified medical testing to understand whether abnormalities can be detected and are followed up longitudinally. Herein, we outline current understanding of the clinical symptoms and pathophysiologic features of long COVID with respect to the cardiopulmonary system in adults and children and then determine how the clinical, electronic health record, and autopsy cohorts of the RECOVER initiative will attempt to answer the most pressing questions surrounding the long-term effects of COVID-19.

SUMMARY: Data generated from the RECOVER initiative will provide guidance about missing gaps in our knowledge about long COVID and how they might be filled by data gathered through the RECOVER initiative.},
}

Adult
Humans
Child
United States/epidemiology
*COVID-19
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Dyspnea
Lung

@article {pmid38187378,
year = {2023},
author = {Noonong, K and Chatatikun, M and Surinkaew, S and Kotepui, M and Hossain, R and Bunluepuech, K and Noothong, C and Tedasen, A and Klangbud, WK and Imai, M and Kawakami, F and Kubo, M and Kitagawa, Y and Ichikawa, H and Kanekura, T and Sukati, S and Somsak, V and Udomwech, L and Ichikawa, T and Nissapatorn, V and Tangpong, J and Indo, HP and Majima, HJ},
title = {Mitochondrial oxidative stress, mitochondrial ROS storms in long COVID pathogenesis.},
journal = {Frontiers in immunology},
volume = {14},
number = {},
pages = {1275001},
pmid = {38187378},
issn = {1664-3224},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; *COVID-19 ; Reactive Oxygen Species ; Mitochondria ; Oxidative Stress ; },
abstract = {SIGNIFICANCE: This review discusses the coronavirus disease 2019 (COVID-19) pathophysiology in the context of diabetes and intracellular reactions by COVID-19, including mitochondrial oxidative stress storms, mitochondrial ROS storms, and long COVID.

RECENT ADVANCES: The long COVID is suffered in ~10% of the COVID-19 patients. Even the virus does not exist, the patients suffer the long COVID for even over a year, This disease could be a mitochondria dysregulation disease.

CRITICAL ISSUES: Patients who recover from COVID-19 can develop new or persistent symptoms of multi-organ complications lasting weeks or months, called long COVID. The underlying mechanisms involved in the long COVID is still unclear. Once the symptoms of long COVID persist, they cause significant damage, leading to numerous, persistent symptoms.

FUTURE DIRECTIONS: A comprehensive map of the stages and pathogenetic mechanisms related to long COVID and effective drugs to treat and prevent it are required, which will aid the development of future long COVID treatments and symptom relief.},
}

Humans
*Post-Acute COVID-19 Syndrome
*COVID-19
Reactive Oxygen Species
Mitochondria
Oxidative Stress

@article {pmid38197253,
year = {2024},
author = {Hitchcock, S and Cintron, SA and Kasuske, L and J Diaz, F and Pierce, J},
title = {Post-COVID-19 Condition in Military Personnel.},
journal = {Military medicine},
volume = {189},
number = {5-6},
pages = {e1277-e1281},
doi = {10.1093/milmed/usad453},
pmid = {38197253},
issn = {1930-613X},
support = {11189-N23-B01//Tri-Service Nursing Research Program/ ; },
mesh = {Humans ; *COVID-19/epidemiology ; *Military Personnel/statistics & numerical data ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Prevalence ; Pandemics ; },
abstract = {INTRODUCTION: During the COVID-19 pandemic, a significant number of individuals experienced persistent symptoms, collectively termed post-COVID-19 condition (PCC) by the World Health Organization. While civilian prevalence has been extensively studied, little is known about PCC in military personnel. This article highlights the need for increased awareness, documentation, and research on PCC within the military context, utilizing the Defense Health Agency database.

MATERIALS AND METHODS: A keyword search of the PubMed, CINAHL, and Web of Science databases was performed utilizing the keywords: military, post-COVID conditions, long COVID-19, and post-COVID19 syndrome. A five-stage integrative review framework was used to analyze 40 reports and research articles published from 2019 to 2023 to assess the current state of PCC research, including epidemiology, severe acute respiratory syndrome coronavirus 2 variants, pathophysiology, and prevalence in military personnel.

RESULTS: Our review revealed a notable gap in research on PCC within the military population, with only a few mentions in the literature. A key finding was the association between immunization status, symptom severity, and ethnicity in PCC development.

CONCLUSION: To comprehensively address PCC in military personnel, it is imperative to foster both awareness and documentation. Creating a centralized Defense Health Agency-DoD repository for active duty service members with PCC diagnoses offers a valuable opportunity to conduct trend analysis, identify missed cases, and better understand the individual and military readiness implications of this condition. Additionally, to address the educational needs of clinicians, it is essential to develop continuing medical education and continuing nursing education programs focusing on PCC signs, symptoms, and their impact on readiness. Furthermore, randomized controlled trials and longitudinal experimental clinical trials are essential for monitoring service members over time, providing valuable insights into the course of PCC and potential interventions. These research endeavors collectively contribute to improving the health, readiness, and care of military personnel affected by PCC.},
}

Humans
*COVID-19/epidemiology
*Military Personnel/statistics & numerical data
*SARS-CoV-2
Post-Acute COVID-19 Syndrome
Prevalence
Pandemics

@article {pmid38202234,
year = {2023},
author = {Scott, C and Hall, S and Zhou, J and Lehmann, C},
title = {Cannabinoids and the Endocannabinoid System in Early SARS-CoV-2 Infection and Long COVID-19-A Scoping Review.},
journal = {Journal of clinical medicine},
volume = {13},
number = {1},
pages = {},
pmid = {38202234},
issn = {2077-0383},
abstract = {Coronavirus disease-19 (COVID-19) is a highly contagious illness caused by the SARS-CoV-2 virus. The clinical presentation of COVID-19 is variable, often including symptoms such as fever, cough, headache, fatigue, and an altered sense of smell and taste. Recently, post-acute "long" COVID-19 has emerged as a concern, with symptoms persisting beyond the acute infection. Vaccinations remain one of the most effective preventative methods against severe COVID-19 outcomes and the development of long-term COVID-19. However, individuals with underlying health conditions may not mount an adequate protective response to COVID-19 vaccines, increasing the likelihood of severe symptoms, hospitalization, and the development of long-term COVID-19 in high-risk populations. This review explores the potential therapeutic role of cannabinoids in limiting the susceptibility and severity of infection, both pre- and post-SARS-CoV-19 infection. Early in the SARS-CoV-19 infection, cannabinoids have been shown to prevent viral entry, mitigate oxidative stress, and alleviate the associated cytokine storm. Post-SARS-CoV-2 infection, cannabinoids have shown promise in treating symptoms associated with post-acute long COVID-19, including depression, anxiety, post-traumatic stress injury, insomnia, pain, and decreased appetite. While current research primarily focuses on potential treatments for the acute phase of COVID-19, there is a gap in research addressing therapeutics for the early and post-infectious phases. This review highlights the potential for future research to bridge this gap by investigating cannabinoids and the endocannabinoid system as a potential treatment strategy for both early and post-SARS-CoV-19 infection.},
}

@article {pmid38203577,
year = {2023},
author = {Constantinescu-Bercu, A and Lobiuc, A and Căliman-Sturdza, OA and Oiţă, RC and Iavorschi, M and Pavăl, NE and Șoldănescu, I and Dimian, M and Covasa, M},
title = {Long COVID: Molecular Mechanisms and Detection Techniques.},
journal = {International journal of molecular sciences},
volume = {25},
number = {1},
pages = {},
pmid = {38203577},
issn = {1422-0067},
support = {PN-III-Pl-1.1-PD-2021-0273, within PNCDI III//Ministry of Research, Innovation and Digitization, CNCS - UEFISCDI/ ; },
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; *COVID-19 ; Pandemics ; SARS-CoV-2 ; Disease Progression ; },
abstract = {Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), has emerged as a significant health concern following the COVID-19 pandemic. Molecular mechanisms underlying the occurrence and progression of long COVID include viral persistence, immune dysregulation, endothelial dysfunction, and neurological involvement, and highlight the need for further research to develop targeted therapies for this condition. While a clearer picture of the clinical symptomatology is shaping, many molecular mechanisms are yet to be unraveled, given their complexity and high level of interaction with other metabolic pathways. This review summarizes some of the most important symptoms and associated molecular mechanisms that occur in long COVID, as well as the most relevant molecular techniques that can be used in understanding the viral pathogen, its affinity towards the host, and the possible outcomes of host-pathogen interaction.},
}

Humans
*Post-Acute COVID-19 Syndrome
*COVID-19
Pandemics
SARS-CoV-2
Disease Progression

@article {pmid38203745,
year = {2024},
author = {Mantle, D and Hargreaves, IP and Domingo, JC and Castro-Marrero, J},
title = {Mitochondrial Dysfunction and Coenzyme Q10 Supplementation in Post-Viral Fatigue Syndrome: An Overview.},
journal = {International journal of molecular sciences},
volume = {25},
number = {1},
pages = {},
pmid = {38203745},
issn = {1422-0067},
mesh = {Humans ; *Fatigue Syndrome, Chronic/drug therapy/etiology ; Post-Acute COVID-19 Syndrome ; *Fibromyalgia/drug therapy/etiology ; Myalgia ; *Mitochondrial Diseases ; Dietary Supplements ; Ubiquinone/*analogs & derivatives ; },
abstract = {Post-viral fatigue syndrome (PVFS) encompasses a wide range of complex neuroimmune disorders of unknown causes characterised by disabling post-exertional fatigue, myalgia and joint pain, cognitive impairments, unrefreshing sleep, autonomic dysfunction, and neuropsychiatric symptoms. It includes myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS); fibromyalgia (FM); and more recently post-COVID-19 condition (long COVID). To date, there are no definitive clinical case criteria and no FDA-approved pharmacological therapies for PVFS. Given the current lack of effective treatments, there is a need to develop novel therapeutic strategies for these disorders. Mitochondria, the cellular organelles responsible for tissue energy production, have recently garnered attention in research into PVFS due to their crucial role in cellular bioenergetic metabolism in these conditions. The accumulating literature has identified a link between mitochondrial dysfunction and low-grade systemic inflammation in ME/CFS, FM, and long COVID. To address this issue, this article aims to critically review the evidence relating to mitochondrial dysfunction in the pathogenesis of these disorders; in particular, it aims to evaluate the effectiveness of coenzyme Q10 supplementation on chronic fatigue and pain symptoms as a novel therapeutic strategy for the treatment of PVFS.},
}

Humans
*Fatigue Syndrome, Chronic/drug therapy/etiology
Post-Acute COVID-19 Syndrome
*Fibromyalgia/drug therapy/etiology
Myalgia
*Mitochondrial Diseases
Dietary Supplements
Ubiquinone/*analogs & derivatives

@article {pmid38204779,
year = {2023},
author = {Tseng, AA},
title = {Effectiveness of Meditation-based Interventions on Health Problems Caused by COVID-19 Pandemic: Narrative Review.},
journal = {International journal of yoga},
volume = {16},
number = {2},
pages = {72-78},
pmid = {38204779},
issn = {0973-6131},
abstract = {This article provides a quantitative review of the potential applications of meditation-based interventions (MBIs) in addressing the major health issues arising from the COVID-19 pandemic. The review assesses the effectiveness of MBIs on five prevalent disorders during the pandemic, namely depression, anxiety, stress, insomnia, and long COVID. This is achieved by selecting and scrutinizing seven studies that involve various types of online randomized controlled trials and utilize control group outcomes for effectiveness evaluation. The findings reveal a significant impact of MBIs on overall distress disorder, encompassing symptoms of depression, anxiety, and stress, with effectiveness ranging from 20.5% to 68.8%. The interventions also show moderate effectiveness on insomnia disorder with improvements between 5.2% and 38.5%. However, the effectiveness on long COVID disorder presents a mixed picture, with improvements varying from 0.0% to 71.2% across 13 related symptoms or qualities examined. This review offers compelling evidence supporting the effectiveness of MBIs in alleviating these five prevalent disorders resulting from the COVID-19 pandemic.},
}

@article {pmid38212633,
year = {2024},
author = {Goldstein, DS},
title = {Post-COVID dysautonomias: what we know and (mainly) what we don't know.},
journal = {Nature reviews. Neurology},
volume = {20},
number = {2},
pages = {99-113},
pmid = {38212633},
issn = {1759-4766},
support = {/NS/NINDS NIH HHS/United States ; },
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; Pandemics ; *COVID-19 ; SARS-CoV-2 ; *Autonomic Nervous System Diseases ; Disease Progression ; },
abstract = {Following on from the COVID-19 pandemic is another worldwide public health challenge that is referred to variously as long COVID, post-COVID syndrome or post-acute sequelae of SARS-CoV-2 infection (PASC). PASC comes in many forms and affects all body organs. This heterogeneous presentation suggests involvement of the autonomic nervous system (ANS), which has numerous roles in the maintenance of homeostasis and coordination of responses to various stressors. Thus far, studies of ANS dysregulation in people with PASC have been largely observational and descriptive, based on symptom inventories or objective but indirect measures of cardiovascular function, and have paid little attention to the adrenomedullary, hormonal and enteric nervous components of the ANS. Such investigations do not consider the syndromic nature of autonomic dysfunction. This Review provides an update on the literature relating to ANS abnormalities in people with post-COVID syndrome and presents a theoretical perspective on how the ANS might participate in common features of PASC.},
}

Humans
Post-Acute COVID-19 Syndrome
Pandemics
*COVID-19
SARS-CoV-2
*Autonomic Nervous System Diseases
Disease Progression

@article {pmid38212781,
year = {2024},
author = {Azzam, A and Khaled, H and Refaey, N and Mohsen, S and El-Emam, OA and Dawood, N and Ahmed, HA and Soliman, OA and Mostafa, S and Ramadan, H and Mosa, M and Elmowafy, AOI and Rizk, SMA and Zaki, A and Hussien, M and Ahmed, A and Ezzat, AA and Hassan, FE},
title = {The burden of persistent symptoms after COVID-19 (long COVID): a meta-analysis of controlled studies in children and adults.},
journal = {Virology journal},
volume = {21},
number = {1},
pages = {16},
pmid = {38212781},
issn = {1743-422X},
mesh = {Adult ; Child ; Humans ; Ageusia/etiology ; Anosmia/etiology ; *COVID-19/complications/epidemiology ; *Post-Acute COVID-19 Syndrome/complications/epidemiology ; },
abstract = {BACKGROUND: Previous meta-analyses estimating the prevalence of the post-COVID-19 condition (PCC) were confounded by the lack of negative control groups. This may result in an overestimation of the prevalence of those experiencing PCC, as these symptoms are non-specific and common in the general population. In this study, we aimed to compare the burden of persistent symptoms among COVID-19 survivors relative to COVID-19-negative controls.

METHODS: A systematic literature search was conducted using the following databases (PubMed, Web of Science, and Scopus) until July 2023 for comparative studies that examined the prevalence of persistent symptoms in COVID-19 survivors. Given that many of the symptoms among COVID-19 survivors overlap with post-hospitalization syndrome and post-intensive care syndrome, we included studies that compare the prevalence of persistent symptoms in hospitalized COVID-19 patients relative to non-COVID-19 hospitalized patients and in non-hospitalized COVID-19 patients relative to healthy controls that reported outcomes after at least 3 months since infection. The results of the meta-analysis were reported as odds ratios with a 95% confidence interval based on the random effects model.

RESULTS: Twenty articles were included in this study. Our analysis of symptomatology in non-hospitalized COVID-19 patients compared to negative controls revealed that the majority of symptoms examined were not related to COVID-19 infection and appeared equally prevalent in both cohorts. However, non-COVID-19 hospitalized patients had higher odds of occurrence of certain symptoms like anosmia, ageusia, fatigue, dyspnea, and brain fog (P < 0.05). Particularly, anosmia and ageusia showed substantially elevated odds relative to the negative control group at 11.27 and 9.76, respectively, P < 0.05. In contrast, analysis of hospitalized COVID-19 patients compared to those hospitalized for other indications did not demonstrate significantly higher odds for the tested symptoms.

CONCLUSIONS: The persistent symptoms in COVID-19 survivors may result from hospitalization for causes unrelated to COVID-19 and are commonly reported among the general population. Although certain symptoms exhibited higher odds in non-hospitalized COVID-19 patients relative to controls, these symptoms are common post-viral illnesses. Therefore, the persistent symptoms after COVID-19 may not be unique to SARS-CoV-2. Future studies including well-matched control groups when investigating persistent symptoms in COVID-19 survivors are warranted to draw a firm conclusion.},
}

Adult
Child
Humans
Ageusia/etiology
Anosmia/etiology
*COVID-19/complications/epidemiology
*Post-Acute COVID-19 Syndrome/complications/epidemiology

@article {pmid38214724,
year = {2024},
author = {Ludwig, M and Schneider, K and Heß, S and Broich, K},
title = {[Establishment of the new "Health Data Lab" to provide data for science].},
journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
volume = {67},
number = {2},
pages = {131-138},
pmid = {38214724},
issn = {1437-1588},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; Germany ; *Delivery of Health Care ; Electronic Health Records ; },
abstract = {The analysis of real-world data (RWD) has become increasingly important in health research in recent years. With the BfArM Health Data Lab (HDL), which is currently being set up, researchers will in future be able to gain access to routine data from the statutory health insurance of around 74 million people in Germany. Data from electronic patient records can also be made available for research prospectively. In doing so, the Health Data Lab guarantees the highest data protection and IT security standards. The digital application process, the provision of data in secure processing environments as well as the features supporting the analyses such as catalogues of coding systems, a point-and-click analysis tool and predefined standard analyses increase user-friendliness for researchers. The use of the extensive health data accessible at HDL will open a wide range of future possibilities for improving the health system and the quality of care. This article begins by highlighting the advantages of the HDL and outlining the opportunities that the RWD offers for research in healthcare and for the population. The structure and central aspects of the HDL are explained afterwards. An outlook on the opportunities of linking different data is given. What the application and data usage processes at the HDL will look like is illustrated using the example of fictitious possibilities for analysing long COVID based on the routine data available at the HDL in the future.},
}

Humans
*Post-Acute COVID-19 Syndrome
Germany
*Delivery of Health Care
Electronic Health Records

@article {pmid38218363,
year = {2024},
author = {Skok, M},
title = {The role of α7 nicotinic acetylcholine receptors in post-acute sequelae of covid-19.},
journal = {The international journal of biochemistry & cell biology},
volume = {168},
number = {},
pages = {106519},
doi = {10.1016/j.biocel.2024.106519},
pmid = {38218363},
issn = {1878-5875},
mesh = {Humans ; alpha7 Nicotinic Acetylcholine Receptor ; Post-Acute COVID-19 Syndrome ; RNA, Viral ; *COVID-19/complications ; SARS-CoV-2 ; Antibodies ; *Receptors, Nicotinic ; },
abstract = {Post-Acute Sequelae of COVID-19 or Long COVID becomes evident some weeks to months following acute COVID-19. Symptoms include cognitive impairment and varying degrees of memory loss with no definitive etiologies or efficacious therapies forthcoming even after four years of the SARS-Cov2 pandemic virus. The aim of this review is to demonstrate the important role of α7 nicotinic acetylcholine receptors in both acute COVID-19 and Long COVID. Evidence presented implicates immune mechanisms stimulated by SARS-Cov-2 S-protein fragment 674-685 that possesses homology with α7-specific ligands. Cognitive dysfunctions observed in Long COVID patients may be derived from anti-idiotypic α7-specific antibodies stimulated by (674-685)-specific antibodies. Therapeutic interventions capable of neutralizing these antibodies and restoring full functions of α7 nicotinic acetylcholine receptors appear to be of paramount importance in post-acute sequelae of COVID-19.},
}

Humans
alpha7 Nicotinic Acetylcholine Receptor
Post-Acute COVID-19 Syndrome
RNA, Viral
*COVID-19/complications
SARS-CoV-2
Antibodies
*Receptors, Nicotinic

@article {pmid38219763,
year = {2024},
author = {Català, M and Mercadé-Besora, N and Kolde, R and Trinh, NTH and Roel, E and Burn, E and Rathod-Mistry, T and Kostka, K and Man, WY and Delmestri, A and Nordeng, HME and Uusküla, A and Duarte-Salles, T and Prieto-Alhambra, D and Jödicke, AM},
title = {The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: staggered cohort study of data from the UK, Spain, and Estonia.},
journal = {The Lancet. Respiratory medicine},
volume = {12},
number = {3},
pages = {225-236},
doi = {10.1016/S2213-2600(23)00414-9},
pmid = {38219763},
issn = {2213-2619},
mesh = {Adult ; Humans ; BNT162 Vaccine ; Cohort Studies ; *COVID-19/epidemiology/prevention & control ; *COVID-19 Vaccines/therapeutic use ; Estonia ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Spain ; United Kingdom/epidemiology ; },
abstract = {BACKGROUND: Although vaccines have proved effective to prevent severe COVID-19, their effect on preventing long-term symptoms is not yet fully understood. We aimed to evaluate the overall effect of vaccination to prevent long COVID symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2).

METHODS: We conducted a staggered cohort study using primary care records from the UK (Clinical Practice Research Datalink [CPRD] GOLD and AURUM), Catalonia, Spain (Information System for Research in Primary Care [SIDIAP]), and national health insurance claims from Estonia (CORIVA database). All adults who were registered for at least 180 days as of Jan 4, 2021 (the UK), Feb 20, 2021 (Spain), and Jan 28, 2021 (Estonia) comprised the source population. Vaccination status was used as a time-varying exposure, staggered by vaccine rollout period. Vaccinated people were further classified by vaccine brand according to their first dose received. The primary outcome definition of long COVID was defined as having at least one of 25 WHO-listed symptoms between 90 and 365 days after the date of a PCR-positive test or clinical diagnosis of COVID-19, with no history of that symptom 180 days before SARS-Cov-2 infection. Propensity score overlap weighting was applied separately for each cohort to minimise confounding. Sub-distribution hazard ratios (sHRs) were calculated to estimate vaccine effectiveness against long COVID, and empirically calibrated using negative control outcomes. Random effects meta-analyses across staggered cohorts were conducted to pool overall effect estimates.

FINDINGS: A total of 1 618 395 (CPRD GOLD), 5 729 800 (CPRD AURUM), 2 744 821 (SIDIAP), and 77 603 (CORIVA) vaccinated people and 1 640 371 (CPRD GOLD), 5 860 564 (CPRD AURUM), 2 588 518 (SIDIAP), and 302 267 (CORIVA) unvaccinated people were included. Compared with unvaccinated people, overall HRs for long COVID symptoms in people vaccinated with a first dose of any COVID-19 vaccine were 0·54 (95% CI 0·44-0·67) in CPRD GOLD, 0·48 (0·34-0·68) in CPRD AURUM, 0·71 (0·55-0·91) in SIDIAP, and 0·59 (0·40-0·87) in CORIVA. A slightly stronger preventative effect was seen for the first dose of BNT162b2 than for ChAdOx1 (sHR 0·85 [0·60-1·20] in CPRD GOLD and 0·84 [0·74-0·94] in CPRD AURUM).

INTERPRETATION: Vaccination against COVID-19 consistently reduced the risk of long COVID symptoms, which highlights the importance of vaccination to prevent persistent COVID-19 symptoms, particularly in adults.

FUNDING: National Institute for Health and Care Research.},
}

Adult
Humans
BNT162 Vaccine
Cohort Studies
*COVID-19/epidemiology/prevention & control
*COVID-19 Vaccines/therapeutic use
Estonia
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Spain
United Kingdom/epidemiology

@article {pmid38233059,
year = {2024},
author = {Rofail, D and Somersan-Karakaya, S and Choi, JY and Przydzial, K and Zhao, Y and Hussein, M and Norton, TD and Podolanczuk, AJ and Mylonakis, E and Geba, GP},
title = {Thematic analysis to explore patients' experiences with long COVID-19: a conceptual model of symptoms and impacts on daily lives.},
journal = {BMJ open},
volume = {14},
number = {1},
pages = {e076992},
pmid = {38233059},
issn = {2044-6055},
mesh = {Adult ; Humans ; Female ; Male ; *Quality of Life/psychology ; Post-Acute COVID-19 Syndrome ; Activities of Daily Living ; Prospective Studies ; *COVID-19 ; Qualitative Research ; },
abstract = {OBJECTIVES: There is limited qualitative research on patients' experiences with long COVID-19, and how specific symptoms impact their daily lives. The study aimed to understand patients' lived experiences of long COVID-19 and to develop a conceptual model representing the symptoms and their impact on overall quality of life.

SETTING: Qualitative study consisting of a comprehensive literature review, and in-depth clinician and patient semistructured interviews.

PARTICIPANTS: Forty-one adult patients with long COVID-19, of whom 18 (44%) were recruited through Regeneron Pharmaceuticals's clinical trials and 23 (56%) through recruitment agencies; 85.4% were female and 73.2% were White. Five independent clinicians treating patients with long COVID-19 were interviewed. Concept saturation was also assessed.

Interview transcripts were analysed thematically to identify concepts of interest spontaneously mentioned by patients, including symptoms and their impacts on daily life, to guide the development of the conceptual model.

RESULTS: Findings from the literature review and clinician and patient interviews resulted in the development of a conceptual model comprising two overarching domains: symptoms (upper respiratory tract, lower respiratory tract, smell and taste, systemic, gastrointestinal, neurocognitive and other) and impacts (activities of daily living, instrumental activities of daily living, physical impacts, emotional, social/leisure activities and professional impacts). Saturation was achieved for the reported impacts. The symptoms reported were heterogenic; neurocognitive symptoms, such as numbness, ringing in ears, haziness, confusion, forgetfulness/memory problems, brain fog, concentration, difficulties finding the right word and challenges with fine motor skills, were particularly pertinent for several months.

CONCLUSION: The conceptual model, developed based on patient experience data of long COVID-19, highlighted numerous symptoms that impact patients' physical and mental well-being, and suggests humanistic unmet needs. Prospective real-world studies are warranted to understand the pattern of long COVID-19 experienced in larger samples over longer periods of time.},
}

Adult
Humans
Female
Male
*Quality of Life/psychology
Post-Acute COVID-19 Syndrome
Activities of Daily Living
Prospective Studies
*COVID-19
Qualitative Research

@article {pmid38235010,
year = {2023},
author = {Shibafar, S and Jafarlou, F},
title = {A review on the impacts of COVID-19 on the auditory system: Implications for public health promotion research.},
journal = {Health promotion perspectives},
volume = {13},
number = {4},
pages = {280-289},
pmid = {38235010},
issn = {2228-6497},
abstract = {BACKGROUND: Currently, there are few studies on the relationship between COVID-19 and the auditory system. In the current study, a review of the studies conducted in the fields of etiopathology, clinical manifestations, research, and treatment of hearing loss caused byCOVID-19 was conducted, which can be used as a baseline for future studies.

METHODS: We utilized the research approach suggested by Arksey and O'Malley to carry out this scoping review. Search was conducted in Farsi and English with a focus on the onset of hearing loss in patients with COVID-19 through Medline and PubMed, and Google Scholar search engine. Studies included were those involving adult patients diagnosed with COVID-19 who experienced hearing loss, ear pain, ear discharge, and otitis media. Studies were eligible for inclusion if there was a description of the otologic dysfunction, specifically onset, duration, or clinical outcomes.

RESULTS: Among 90 studies identified, 35 studies were included in the review process. Our findings suggest several possible mechanisms for sudden sensorineural hearing loss (SSNHL) in COVID-19 patients, and COVID-19 infection could have deleterious effects on the inner ear, specifically on the hair cells of the cochlea despite patients being asymptomatic and early identification of SSNHL in COVID-19patients can save the hearing and also patient.

CONCLUSION: Hearing loss in COVID-19 infection has not received much attention by health care professionals. Sensorineural hearing loss (SNHL), tinnitus, and/or vertigo have been shown to occur during and following COVID-19 infection. Due to lack of research studies, and the inconsistency and even contradictory of the findings, it remains questionable whether COVID-19 contributes to the high incidence of hearing loss. The proper understanding of the mechanisms behind hearing loss in COVID-19 infections needs further research. However, it seems likely that SNHL could be included among the manifestations of those-called "long COVID" syndrome.},
}

@article {pmid38246521,
year = {2024},
author = {Daynes, E and Mills, G and Hull, JH and Bishop, NC and Bakali, M and Burtin, C and McAuley, HJC and Singh, SJ and Greening, NJ},
title = {Pulmonary Rehabilitation for People With Persistent Symptoms After COVID-19.},
journal = {Chest},
volume = {166},
number = {3},
pages = {461-471},
doi = {10.1016/j.chest.2024.01.029},
pmid = {38246521},
issn = {1931-3543},
mesh = {Humans ; *COVID-19/rehabilitation/complications ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Exercise Therapy/methods ; },
abstract = {TOPIC IMPORTANCE: COVID-19 can cause ongoing and persistent symptoms (such as breathlessness and fatigue) that lead to reduced functional capacity. There are parallels in symptoms and functional limitations in adults with post-COVID symptoms and adults with chronic respiratory diseases. Pulmonary rehabilitation is a key treatment for adults with chronic respiratory diseases, with the aims to improve symptom management and increase functional capacity. Given the similarities in presentation and aims, a pulmonary rehabilitation program may be optimal to meet the needs of those with ongoing symptoms after COVID-19.

REVIEW FINDINGS: Aerobic and strength training has shown benefit for adults living with long COVID, although there is little evidence on structured education in this population. Breathing pattern disorder is common in adults with long COVID, and considerations on treatment before rehabilitation, or alongside rehabilitation, are necessary. Considerations on postexertional malaise are important in this population, and evidence from the chronic fatigue syndrome literature supports the need for individualization of exercise programs, and considerations for those who have an adverse reaction to activity and/or exercise.

SUMMARY: This narrative review summarizes the current evidence on pulmonary rehabilitation programs in a long-COVID population. Where the evidence is lacking in long COVID the supporting evidence of these programs in chronic respiratory diseases has highlighted the importance of aerobic and strength training, considerations for fatigue, potential mechanisms for immunology improvement, and management of breathing pattern disorders in these programs.},
}

Humans
*COVID-19/rehabilitation/complications
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Exercise Therapy/methods

@article {pmid38248798,
year = {2024},
author = {Trofor, AC and Robu Popa, D and Melinte, OE and Trofor, L and Vicol, C and Grosu-Creangă, IA and Crișan Dabija, RA and Cernomaz, AT},
title = {Looking at the Data on Smoking and Post-COVID-19 Syndrome-A Literature Review.},
journal = {Journal of personalized medicine},
volume = {14},
number = {1},
pages = {},
pmid = {38248798},
issn = {2075-4426},
abstract = {Long COVID is a recently described entity that is responsible for significant morbidity and that has consequences ranging from mild to life-threatening. The underlying mechanisms are not completely understood, and treatment options are currently limited, as existing data focus more on risk factors and predictors. Smoking has been reported as a risk factor for poor outcomes of acute SARS-CoV-2 infection and seems to also play a role in mediating post-COVID-19 symptoms. We aimed to review relevant work addressing the interaction between smoking and long COVID in order to characterize smoking's role as a risk factor and possibly identify new research directions. Methods: The PubMed/MEDLINE database was searched using the keywords 'smoking', 'long COVID', and 'post-acute COVID' to identify relevant English-language articles published up to October 2023. Results and conclusions: From the 374 initial hits, a total of 36 papers were deemed relevant to the aim of the review. There was significant variability concerning the ways in which tobacco usage was quantified and reported; still, there is compelling evidence linking smoking to an increased risk of developing manifestations of post-acute-COVID disease. Some clinical conditions, such as dyspnea, cardiovascular symptoms, and cognitive or mental-health impairment, seem to be relatively strongly associated with smoking, while the connection between smoking and upper-airway involvement seems less certain. The available data support recommending smoking cessation as a clinical tool for the prevention of long COVID.},
}

@article {pmid38253027,
year = {2024},
author = {Untersmayr, E and Venter, C and Smith, P and Rohrhofer, J and Ndwandwe, C and Schwarze, J and Shannon, E and Sokolowska, M and Sadlier, C and O'Mahony, L},
title = {Immune Mechanisms Underpinning Long COVID: Collegium Internationale Allergologicum Update 2024.},
journal = {International archives of allergy and immunology},
volume = {185},
number = {5},
pages = {489-502},
doi = {10.1159/000535736},
pmid = {38253027},
issn = {1423-0097},
mesh = {Humans ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Post-Acute COVID-19 Syndrome ; Dysbiosis/immunology ; Autoimmunity ; },
abstract = {BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can result in a prolonged multisystem disorder termed long COVID, which may affect up to 10% of people following coronavirus disease 2019 (COVID-19). It is currently unclear why certain individuals do not fully recover following SARS-CoV-2 infection.

SUMMARY: In this review, we examine immunological mechanisms that may underpin the pathophysiology of long COVID. These mechanisms include an inappropriate immune response to acute SARS-CoV-2 infection, immune cell exhaustion, immune cell metabolic reprogramming, a persistent SARS-CoV-2 reservoir, reactivation of other viruses, inflammatory responses impacting the central nervous system, autoimmunity, microbiome dysbiosis, and dietary factors.

KEY MESSAGES: Unfortunately, the currently available diagnostic and treatment options for long COVID are inadequate, and more clinical trials are needed that match experimental interventions to underlying immunological mechanisms.},
}

Humans
*COVID-19/immunology
*SARS-CoV-2/immunology
*Post-Acute COVID-19 Syndrome
Dysbiosis/immunology
Autoimmunity

@article {pmid38255826,
year = {2024},
author = {Müller, L and Di Benedetto, S},
title = {Immunosenescence and Cytomegalovirus: Exploring Their Connection in the Context of Aging, Health, and Disease.},
journal = {International journal of molecular sciences},
volume = {25},
number = {2},
pages = {},
pmid = {38255826},
issn = {1422-0067},
mesh = {Aged ; Humans ; Cytomegalovirus ; Post-Acute COVID-19 Syndrome ; Aging ; *Immunosenescence ; *Cytomegalovirus Infections ; *COVID-19 ; *Latent Infection ; },
abstract = {Aging induces numerous physiological alterations, with immunosenescence emerging as a pivotal factor. This phenomenon has attracted both researchers and clinicians, prompting profound questions about its implications for health and disease. Among the contributing factors, one intriguing actor in this complex interplay is human cytomegalovirus (CMV), a member of the herpesvirus family. Latent CMV infection exerts a profound influence on the aging immune system, potentially contributing to age-related diseases. This review delves into the intricate relationship between immunosenescence and CMV, revealing how chronic viral infection impacts the aging immune landscape. We explore the mechanisms through which CMV can impact both the composition and functionality of immune cell populations and induce shifts in inflammatory profiles with aging. Moreover, we examine the potential role of CMV in pathologies such as cardiovascular diseases, cancer, neurodegenerative disorders, COVID-19, and Long COVID. This review underlines the importance of understanding the complex interplay between immunosenescence and CMV. It offers insights into the pathophysiology of aging and age-associated diseases, as well as COVID-19 outcomes among the elderly. By unraveling the connections between immunosenescence and CMV, we gain a deeper understanding of aging's remarkable journey and the profound role that viral infections play in transforming the human immune system.},
}

Aged
Humans
Cytomegalovirus
Post-Acute COVID-19 Syndrome
Aging
*Immunosenescence
*Cytomegalovirus Infections
*COVID-19
*Latent Infection

@article {pmid38256558,
year = {2024},
author = {Kao, CM},
title = {Overview of COVID-19 Infection, Treatment, and Prevention in Children.},
journal = {Journal of clinical medicine},
volume = {13},
number = {2},
pages = {},
pmid = {38256558},
issn = {2077-0383},
abstract = {Coronavirus disease 2019 (COVID-19), caused by the novel respiratory virus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-was declared a global pandemic by the World Health Organization on 11 March 2020. Since then, substantial gains have been made in our understanding of COVID-19 epidemiology, disease presentation, and management. While children tend to have less severe disease courses compared to adults, children can still develop severe COVID-19 infections, particularly in those with underlying medical conditions such as obesity, chronic lung disease, or prematurity. In addition, children are at risk of severe complications of COVID-19 infection, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. The case definitions of MIS-C and long COVID have continued to evolve with the increased understanding of these new entities; however, improved methods of diagnosis and determination of the optimal management are still needed. Furthermore, with the continued circulation of SARS-CoV-2 variants, there remains a need for clinicians to remain up-to-date on the latest treatment and prevention options. The purpose of this review is to provide an evidence-based review of what we have learned about COVID-19 in children since the start of the pandemic and how best to counsel children and their families on the best methods of prevention.},
}

@article {pmid38257728,
year = {2023},
author = {Len, JS and Koh, CWT and Chan, KR},
title = {The Functional Roles of MDSCs in Severe COVID-19 Pathogenesis.},
journal = {Viruses},
volume = {16},
number = {1},
pages = {},
pmid = {38257728},
issn = {1999-4915},
support = {MOH-000610-00//National Medical Research Council/ ; },
mesh = {Aged ; Humans ; *COVID-19 ; Post-Acute COVID-19 Syndrome ; *Myeloid-Derived Suppressor Cells ; Gene Expression Profiling ; Immunocompromised Host ; },
abstract = {Severe COVID-19 is a major cause of morbidity and mortality worldwide, especially among those with co-morbidities, the elderly, and the immunocompromised. However, the molecular determinants critical for severe COVID-19 progression remain to be fully elucidated. Meta-analyses of transcriptomic RNAseq and single-cell sequencing datasets comparing severe and mild COVID-19 patients have demonstrated that the early expansion of myeloid-derived suppressor cells (MDSCs) could be a key feature of severe COVID-19 progression. Besides serving as potential early prognostic biomarkers for severe COVID-19 progression, several studies have also indicated the functional roles of MDSCs in severe COVID-19 pathogenesis and possibly even long COVID. Given the potential links between MDSCs and severe COVID-19, we examine the existing literature summarizing the characteristics of MDSCs, provide evidence of MDSCs in facilitating severe COVID-19 pathogenesis, and discuss the potential therapeutic avenues that can be explored to reduce the risk and burden of severe COVID-19. We also provide a web app where users can visualize the temporal changes in specific genes or MDSC-related gene sets during severe COVID-19 progression and disease resolution, based on our previous study.},
}

Aged
Humans
*COVID-19
Post-Acute COVID-19 Syndrome
*Myeloid-Derived Suppressor Cells
Gene Expression Profiling
Immunocompromised Host

@article {pmid38257821,
year = {2024},
author = {Panagiotides, NG and Poledniczek, M and Andreas, M and Hülsmann, M and Kocher, AA and Kopp, CW and Piechota-Polanczyk, A and Weidenhammer, A and Pavo, N and Wadowski, PP},
title = {Myocardial Oedema as a Consequence of Viral Infection and Persistence-A Narrative Review with Focus on COVID-19 and Post COVID Sequelae.},
journal = {Viruses},
volume = {16},
number = {1},
pages = {},
pmid = {38257821},
issn = {1999-4915},
mesh = {Humans ; *COVID-19/complications ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Virus Diseases ; Disease Progression ; Edema ; },
abstract = {Microvascular integrity is a critical factor in myocardial fluid homeostasis. The subtle equilibrium between capillary filtration and lymphatic fluid removal is disturbed during pathological processes leading to inflammation, but also in hypoxia or due to alterations in vascular perfusion and coagulability. The degradation of the glycocalyx as the main component of the endothelial filtration barrier as well as pericyte disintegration results in the accumulation of interstitial and intracellular water. Moreover, lymphatic dysfunction evokes an increase in metabolic waste products, cytokines and inflammatory cells in the interstitial space contributing to myocardial oedema formation. This leads to myocardial stiffness and impaired contractility, eventually resulting in cardiomyocyte apoptosis, myocardial remodelling and fibrosis. The following article reviews pathophysiological inflammatory processes leading to myocardial oedema including myocarditis, ischaemia-reperfusion injury and viral infections with a special focus on the pathomechanisms evoked by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In addition, clinical implications including potential long-term effects due to viral persistence (long COVID), as well as treatment options, are discussed.},
}

Humans
*COVID-19/complications
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Virus Diseases
Disease Progression
Edema

@article {pmid38258769,
year = {2024},
author = {Hodel, K and Fonseca, A and Barbosa, I and Medina, C and Alves, B and Maciel, C and Nascimento, D and Oliveira-Junior, G and Pedreira, L and de Souza, M and Godoy, AL},
title = {Obesity and its Relationship with Covid-19: A Review of the Main Pharmaceutical Aspects.},
journal = {Current pharmaceutical biotechnology},
volume = {25},
number = {13},
pages = {1651-1663},
pmid = {38258769},
issn = {1873-4316},
mesh = {Humans ; *Obesity/metabolism ; *COVID-19/complications ; *COVID-19 Drug Treatment ; *SARS-CoV-2 ; Antiviral Agents/therapeutic use/pharmacokinetics ; COVID-19 Vaccines ; },
abstract = {Important physiological changes are observed in patients with obesity, such as intestinal permeability, gastric emptying, cardiac output, and hepatic and renal function. These differences can determine variations in the pharmacokinetics of different drugs and can generate different concentrations at the site of action, which can lead to sub therapeutic or toxic concentrations. Understanding the physiological and immunological processes that lead to the clinical manifestations of COVID-19 is essential to correlate obesity as a risk factor for increasing the prevalence, severity, and lethality of the disease. Several drugs have been suggested to control COVID- 19 like Lopinavir, Ritonavir, Ribavirin, Sofosbuvir, Remdesivir, Oseltamivir, Oseltamivir phosphate, Oseltamivir carboxylate, Hydroxychloroquine, Chloroquine, Azithromycin, Teicoplanin, Tocilizumab, Anakinra, Methylprednisolone, Prednisolone, Ciclesonide and Ivermectin. Similarly, these differences between healthy people and obese people can be correlated to mechanical factors, such as insufficient doses of the vaccine for high body mass, impairing the absorption and distribution of the vaccine that will be lower than desired or can be linked to the inflammatory state in obese patients, which can influence the humoral immune response. Additionally, different aspects make the obese population more prone to persistent symptoms of the disease (long COVID), which makes understanding these mechanisms fundamental to addressing the implications of the disease. Thus, this review provides an overview of the relationship between COVID-19 and obesity, considering aspects related to pharmacokinetics, immunosuppression, immunization, and possible implications of long COVID in these individuals.},
}

Humans
*Obesity/metabolism
*COVID-19/complications
*COVID-19 Drug Treatment
*SARS-CoV-2
Antiviral Agents/therapeutic use/pharmacokinetics
COVID-19 Vaccines

@article {pmid38269219,
year = {2023},
author = {Schaefer, J and Khanna, D},
title = {Nutritional and Wellness Strategies for Neurological and Psychiatric Recovery From Post-COVID Syndrome and Post-acute Sequelae of COVID-19.},
journal = {Cureus},
volume = {15},
number = {12},
pages = {e51076},
pmid = {38269219},
issn = {2168-8184},
abstract = {The post-COVID syndrome was officially recognized as a disability under the Americans with Disabilities Act, indicating that this syndrome has made a significant impact on our populace. Also, post-acute sequelae of COVID-19 (PASC) is a term that describes the long-term health problems that some people experience after being infected with the virus that causes COVID-19. These problems can last for weeks, months, or even years, and can affect various parts of the body, such as the heart, lungs, brain, and blood vessels. This narrative review paper utilized the PubMed database to explore the pathophysiology of post-COVID syndrome's neurological and psychiatric symptoms and PASC and make therapeutic connections to the known mechanisms of various nutritional, supplemental, and wellness approaches. Searches were queried on the PubMed database between March 29 and April 16, 2022, using the phrases "long-covid," "post-COVID syndrome," "Vitamin D covid," "vitamin C covid," "omega-3 covid," "kynurenine covid," "whole-body hyperthermia," "mushrooms immunity," "n-acetyl cysteine covid," "mushrooms cognition," "sugar consumption inflammation," and "covid microbiome." Articles were screened for their relevance to the discussion of post-COVID syndrome's neurological and psychiatric pathophysiology at the discretion of the principal researcher. There were no limitations regarding publication years, but articles from 2005 to April 2022 were cited. Micro-ischemic disease, neuropathy, autoimmune processes, mast-cell activation, and impaired blood-brain barriers have all been implicated in the pathological processes of this syndrome with varying degrees of supportive evidence. The common denominators, however, are inflammation and oxidative stress. Therefore, a beneficial approach to dealing with the complications of post-COVID syndrome would be to reduce the exacerbations of these common denominators with lifestyle and nutritional changes. Replenishing nutritional deficiencies, supplementing with N-acetylcysteine, decreasing consumption of refined sugars, preventing dysbiosis of the microbiome, performing exercises, increasing dietary intake of mushrooms, utilizing beneficial herbs such as rosemary, and increasing the core body temperature through whole-body hyperthermia seem to show potential for efficacy in this pursuit. Considering the safety and evidence-based connections of the therapies explored for dealing with the post-Covid syndrome, it could be of great benefit and of little harm to our patients to include these considerations in formulating post-Covid treatment plans.},
}

@article {pmid38274052,
year = {2023},
author = {Ahmad, I and Amelio, A and Merla, A and Scozzari, F},
title = {A survey on the role of artificial intelligence in managing Long COVID.},
journal = {Frontiers in artificial intelligence},
volume = {6},
number = {},
pages = {1292466},
pmid = {38274052},
issn = {2624-8212},
abstract = {In the last years, several techniques of artificial intelligence have been applied to data from COVID-19. In addition to the symptoms related to COVID-19, many individuals with SARS-CoV-2 infection have described various long-lasting symptoms, now termed Long COVID. In this context, artificial intelligence techniques have been utilized to analyze data from Long COVID patients in order to assist doctors and alleviate the considerable strain on care and rehabilitation facilities. In this paper, we explore the impact of the machine learning methodologies that have been applied to analyze the many aspects of Long COVID syndrome, from clinical presentation through diagnosis. We also include the text mining techniques used to extract insights and trends from large amounts of text data related to Long COVID. Finally, we critically compare the various approaches and outline the work that has to be done to create a robust artificial intelligence approach for efficient diagnosis and treatment of Long COVID.},
}

@article {pmid38274511,
year = {2023},
author = {Martínez-Borba, V and Martínez-García, L and Peris-Baquero, Ó and Osma, J and Del Corral-Beamonte, E},
title = {Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review.},
journal = {Frontiers in public health},
volume = {11},
number = {},
pages = {1305463},
pmid = {38274511},
issn = {2296-2565},
mesh = {Adult ; Humans ; Psychosocial Intervention ; Post-Acute COVID-19 Syndrome ; Pandemics ; *COVID-19/epidemiology ; *Cognitive Behavioral Therapy/methods ; },
abstract = {OBJECTIVE: The COVID-19 pandemic has been emotionally challenging for the entire population and especially for people who contracted the illness. This systematic review summarizes psychological interventions implemented in COVID-19 and long COVID-19 patients who presented comorbid emotional disorders.

METHODS AND MEASURES: 3,839 articles were identified in 6 databases and 43 of them were included in this work. Two independent researchers selected the articles and assessed their quality.

RESULTS: 2,359 adults were included in this review. Severity of COVID-19 symptoms ranged from asymptomatic to hospitalized patients; only 3 studies included long COVID-19 populations. Similar number of randomized controlled studies (n = 15) and case studies (n = 14) were found. Emotional disorders were anxiety and/or depressive symptoms (n = 39) and the psychological intervention most represented had a cognitive behavioral approach (n = 10). Length of psychological programs ranged from 1-5 sessions (n = 6) to 16 appointments (n = 2). Some programs were distributed on a daily (n = 4) or weekly basis (n = 2), but other proposed several sessions a week (n = 4). Short (5-10 min, n = 4) and long sessions (60-90 min, n = 3) are proposed. Most interventions were supported by the use of technologies (n = 18). Important risk of bias was present in several studies.

CONCLUSION: Promising results in the reduction of depressive, anxiety and related disorders have been found. However, important limitations in current psychological interventions were detected (i.e., duration, format, length, and efficacy of interventions were not consistently established across investigations). The results derived from our work may help to understand clinical practices in the context of pandemics and could guide future efforts to manage emotional suffering in COVID-19 patients. A stepped model of care could help to determine the dosage, length and format of delivery for each patient.Systematic review registration: PROSPERO 2022 CRD42022367227. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022367227.},
}

Adult
Humans
Psychosocial Intervention
Post-Acute COVID-19 Syndrome
Pandemics
*COVID-19/epidemiology
*Cognitive Behavioral Therapy/methods

@article {pmid38275749,
year = {2023},
author = {León-Moreno, LC and Reza-Zaldívar, EE and Hernández-Sapiéns, MA and Villafaña-Estarrón, E and García-Martin, M and Ojeda-Hernández, DD and Matias-Guiu, JA and Gomez-Pinedo, U and Matias-Guiu, J and Canales-Aguirre, AA},
title = {Mesenchymal Stem Cell-Based Therapies in the Post-Acute Neurological COVID Syndrome: Current Landscape and Opportunities.},
journal = {Biomolecules},
volume = {14},
number = {1},
pages = {},
pmid = {38275749},
issn = {2218-273X},
support = {9790-2021.//Fondo de Desarrollo Científico de Jalisco/ ; },
mesh = {Humans ; *COVID-19/therapy ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; *Mesenchymal Stem Cells/physiology ; Central Nervous System ; },
abstract = {One of the main concerns related to SARS-CoV-2 infection is the symptoms that could be developed by survivors, known as long COVID, a syndrome characterized by persistent symptoms beyond the acute phase of the infection. This syndrome has emerged as a complex and debilitating condition with a diverse range of manifestations affecting multiple organ systems. It is increasingly recognized for affecting the Central Nervous System, in which one of the most prevalent manifestations is cognitive impairment. The search for effective therapeutic interventions has led to growing interest in Mesenchymal Stem Cell (MSC)-based therapies due to their immunomodulatory, anti-inflammatory, and tissue regenerative properties. This review provides a comprehensive analysis of the current understanding and potential applications of MSC-based interventions in the context of post-acute neurological COVID-19 syndrome, exploring the underlying mechanisms by which MSCs exert their effects on neuroinflammation, neuroprotection, and neural tissue repair. Moreover, we discuss the challenges and considerations specific to employing MSC-based therapies, including optimal delivery methods, and functional treatment enhancements.},
}

Humans
*COVID-19/therapy
SARS-CoV-2
Post-Acute COVID-19 Syndrome
*Mesenchymal Stem Cells/physiology
Central Nervous System

@article {pmid38277732,
year = {2024},
author = {Gamero-de-Luna, EJ and Sánchez-Jaén, MR},
title = {[Genetic factors associated with long COVID].},
journal = {Semergen},
volume = {50},
number = {2},
pages = {102187},
doi = {10.1016/j.semerg.2023.102187},
pmid = {38277732},
issn = {1578-8865},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; *COVID-19/genetics ; Forkhead Transcription Factors ; },
abstract = {INTRODUCTION: The variability in expression and evolution of COVID is not completely explained by clinical factors. In fact, genetic factors play an important role. Moreover, it is unknown whether the genetic factor that contribute to susceptibility and severity are also involved in the onset and evolution of long-COVID. The objective of this review is to gather information from literature to understand which genetic factors are involved in the onset of persistent COVID.

MATERIAL AND METHODS: Systematic review in PubMed and bioRxiv and medRxiv repositories based on MeSH-descriptors and MeSH-terms related to COVID and genetic factors. Using these terms 2715 articles were pooled. An initial screening performed by authors independently, selected 205 articles of interest. A final deeper screening a total of 85 articles were chosen for complete reading and summarized in this review.

RESULTS: Although ACE2 and TMPSS6 are involved in COVID susceptibility, their involvement in long-COVID has not been found. On the other hand, the severity of the disease and the onset of long-COVID has been associated with different genes involved in the inflammatory and immune response. Particularly interesting has been the association found with the FOXP4 locus.

CONCLUSIONS: Although studies on long-COVID are insufficient to fully comprehend the cause, it is clear that the current identified genetic factors do not fully explain the progression and onset of long-COVID. Other factors such as polygenic action, pleiotropic genes, the microbiota and epigenetic changes must be considered and studied.},
}

Humans
*Post-Acute COVID-19 Syndrome
*COVID-19/genetics
Forkhead Transcription Factors

@article {pmid38277734,
year = {2024},
author = {Suárez, D and Pascual, E and Soravilla, JR},
title = {[Long covid and disability].},
journal = {Semergen},
volume = {50},
number = {2},
pages = {102189},
doi = {10.1016/j.semerg.2023.102189},
pmid = {38277734},
issn = {1578-8865},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; *COVID-19/epidemiology ; SARS-CoV-2 ; Anxiety ; Pandemics ; },
abstract = {Long covid is a health problem that will entail a high hidden cost attributable to the pandemic years after it because it affects the work capacity of many workers. Given the millions of covid-19 cases worldwide and current research showing that one in 7covid-19 patients remain symptomatic at 12 weeks, the number of long covid patients is likely to be substantial. Long covid is characterized by heterogeneous sequelae that often affect multiple systems, organs with an impact on the functioning and capacity of the worker. Workers with long covid symptoms can return to their occupation but this involves a complex individualized approach to the impact of symptoms on work, adjustments and modifications to the workplace. Patients with long covid typically report prolonged multisystem involvement and signicant disability. The psychological cost to the worker must also be addressed. A survey by the Community of Madrid (CCOO, SATSE, CSIF, AMYTS) in 2022 reveals that 24.5% of those affected by long covid were sick for more than 12 months; 30% of those affected by persistent covid need and adaption to their workplace. In Spain, more than 10million people infected with SARS-CoV-2 have been reported since the pandemic began, so it is estimated that there could be one million people with persistent covid. In 2021 alone there were more than 2.6 million sick leave due to covid-19 in Spain, the average duration of which was 10 days. One hundred million people around the world suffer from persistent covid, but few countries officially count them, nor do they help those affected with employment. In advanced countries, like the United States, long covid is treated as a disability,and the number of people with disabilities working or looking for work increased by 1.36 million, an increase of 23%, between January 2021 and January 2022. In the United Kingdom, some 200,000 people are not working or are not looking for work due to long-term health problems attributable to long covid, since the pandemic began.},
}

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

@article {pmid38279014,
year = {2024},
author = {Toepfner, N and Brinkmann, F and Augustin, S and Stojanov, S and Behrends, U},
title = {Long COVID in pediatrics-epidemiology, diagnosis, and management.},
journal = {European journal of pediatrics},
volume = {183},
number = {4},
pages = {1543-1553},
pmid = {38279014},
issn = {1432-1076},
mesh = {Adolescent ; Humans ; Child ; Infant, Newborn ; Post-Acute COVID-19 Syndrome ; *Fatigue Syndrome, Chronic ; *COVID-19/diagnosis/epidemiology/therapy ; Quality of Life ; SARS-CoV-2 ; Disease Progression ; COVID-19 Testing ; },
abstract = {This review summarizes current knowledge on post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children and adolescents. A literature review was performed to synthesize information from clinical studies, expert opinions, and guidelines. PASC also termed Long COVID - at any age comprise a plethora of unspecific symptoms present later than 4 weeks after confirmed or probable infection with severe respiratory syndrome corona virus type 2 (SARS-CoV-2), without another medical explanation. PCC in children and adolescents was defined by the WHO as PASC occurring within 3 months of acute coronavirus disease 2019 (COVID-19), lasting at least 2 months, and limiting daily activities. Pediatric PASC mostly manifest after mild courses of COVID-19 and in the majority of cases remit after few months. However, symptoms can last for more than 1 year and may result in significant disability. Frequent symptoms include fatigue, exertion intolerance, and anxiety. Some patients present with postural tachycardia syndrome (PoTS), and a small number of cases fulfill the clinical criteria of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). To date, no diagnostic marker has been established, and differential diagnostics remains challenging. Therapeutic approaches include appropriate self-management as well as the palliation of symptoms by non-pharmaceutical and pharmaceutical strategies. Conclusion: PASC in pediatrics present with heterogenous severity and duration. A stepped, interdisciplinary, and individualized approach is essential for appropriate clinical management. Current health care structures have to be adapted, and research was extended to meet the medical and psychosocial needs of young people with PASC or similar conditions. What is Known: • Post-acute sequelae of coronavirus 2019 (COVID-19) (PASC) - also termed Long COVID - in children and adolescents can lead to activity limitation and reduced quality of life. • PASC belongs to a large group of similar post-acute infection syndromes (PAIS). Specific biomarkers and causal treatment options are not yet available. What is New: • In February 2023, a case definition for post COVID-19 condition (PCC) in children and adolescents was provided by the World Health Organization (WHO), indicating PASC with duration of at least 2 months and limitation of daily activities. PCC can present as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). • Interdisciplinary collaborations are necessary and have been established worldwide to offer harmonized, multimodal approaches to diagnosis and management of PASC/PCC in children and adolescents.},
}

Adolescent
Humans
Child
Infant, Newborn
Post-Acute COVID-19 Syndrome
*Fatigue Syndrome, Chronic
*COVID-19/diagnosis/epidemiology/therapy
Quality of Life
SARS-CoV-2
Disease Progression
COVID-19 Testing

@article {pmid38279329,
year = {2024},
author = {Álvarez-Santacruz, C and Tyrkalska, SD and Candel, S},
title = {The Microbiota in Long COVID.},
journal = {International journal of molecular sciences},
volume = {25},
number = {2},
pages = {},
pmid = {38279329},
issn = {1422-0067},
support = {00006/COVI/20//Fundación Séneca - Agencia de Ciencia y Tecnología de la Región de Murcia/ ; 21118/SF/19//Fundación Séneca - Agencia de Ciencia y Tecnología de la Región de Murcia/ ; Juan de la Cierva-Incorporación//Ministerio de Ciencia e Innovación/ ; },
mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19 ; SARS-CoV-2 ; Dysbiosis ; *Microbiota ; *Vaccines ; },
abstract = {Interest in the coronavirus disease 2019 (COVID-19) has progressively decreased lately, mainly due to the great effectivity of vaccines. Furthermore, no new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants able to circumvent the protection of these vaccines, while presenting high transmissibility and/or lethality, have appeared. However, long COVID has emerged as a huge threat to human health and economy globally. The human microbiota plays an important role in health and disease, participating in the modulation of innate and adaptive immune responses. Thus, multiple studies have found that the nasopharyngeal microbiota is altered in COVID-19 patients, with these changes associated with the onset and/or severity of the disease. Nevertheless, although dysbiosis has also been reported in long COVID patients, mainly in the gut, little is known about the possible involvement of the microbiota in the development of this disease. Therefore, in this work, we aim to fill this gap in the knowledge by discussing and comparing the most relevant studies that have been published in this field up to this point. Hence, we discuss that the relevance of long COVID has probably been underestimated, and that the available data suggest that the microbiota could be playing a pivotal role on the pathogenesis of the disease. Further research to elucidate the involvement of the microbiota in long COVID will be essential to explore new therapeutic strategies based on manipulation of the microbiota.},
}

Humans
Post-Acute COVID-19 Syndrome
*COVID-19
SARS-CoV-2
Dysbiosis
*Microbiota
*Vaccines

@article {pmid38284464,
year = {2024},
author = {Çulha, Y and Büyükyılmaz, F and Çulha, MG},
title = {The effect of long-term COVID-19 on aetiological factors related to nocturia.},
journal = {Journal of clinical nursing},
volume = {33},
number = {3},
pages = {1161-1168},
doi = {10.1111/jocn.17037},
pmid = {38284464},
issn = {1365-2702},
mesh = {Humans ; *Nocturia/etiology/drug therapy ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *Urinary Bladder, Overactive/complications/drug therapy ; Urinary Bladder ; },
abstract = {AIMS AND OBJECTIVES: This study was conducted to examine the possible aetiology of nocturia in patients with long-term COVID-19.

BACKGROUND: Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID-19, 10-14 weeks after the illness.

DESIGN: A descriptive design.

METHODS: The study consisted of 70 patients who had experienced COVID-19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist.

RESULTS: When the nocturia effects of long-term COVID-19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p < .05). According to post-hoc analysis, the mean age of patients with a dominant cardio-metabolic factor was found to be significantly younger (p < .05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p < .05).

CONCLUSIONS: It was found that the urinary tract aetiological factor was dominant in patients with long-term COVID-19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor.

Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post-COVID-19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia.

The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID-19 infection.},
}

Humans
*Nocturia/etiology/drug therapy
Post-Acute COVID-19 Syndrome
*COVID-19/complications
*Urinary Bladder, Overactive/complications/drug therapy
Urinary Bladder

@article {pmid38285646,
year = {2026},
author = {McMaster, MW and Dey, S and Fishkin, T and Wang, A and Frishman, WH and Aronow, WS},
title = {The Impact of Long COVID-19 on the Cardiovascular System.},
journal = {Cardiology in review},
volume = {34},
number = {1},
pages = {11-18},
doi = {10.1097/CRD.0000000000000654},
pmid = {38285646},
issn = {1538-4683},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Cardiovascular Diseases/physiopathology/etiology/virology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; },
abstract = {Long coronavirus disease (COVID) is the development or persistence of symptoms after an acute SARS-CoV-2 (COVID-19) infection. Fewer patients are developing acute COVID-19 infections, but patients with long COVID continue to have alarming long-term sequelae. Many cardiac magnetic resonance imaging studies show significant changes in cardiac structure after a COVID-19 infection, suggestive of an increased burden of many cardiovascular diseases, notably myocarditis. The pathophysiology of COVID-19 requires viral binding to angiotensin-converting enzyme 2 protein receptors throughout the body, which are upregulated by inflammation. Consequently, the numerous preexisting conditions that worsen or prolong inflammation enhance this binding and have differing effects on patients based on their unique immune systems. These pathophysiological changes drive long COVID cardiac sequelae such as inappropriate sinus tachycardia, postural orthostatic tachycardia, and other types of orthostatic intolerance. Increased screening for long COVID and low-risk interventions such as exercise regimens could alleviate the suffering endured by patients with long COVID. Many studies such as the Researching COVID to Enhance Recovery Initiative (RECOVER) trials at the National Institutes of Health are exploring potential treatments for long COVID patients.},
}

Humans
*COVID-19/complications/physiopathology
*Cardiovascular Diseases/physiopathology/etiology/virology
SARS-CoV-2
Post-Acute COVID-19 Syndrome

@article {pmid38294616,
year = {2024},
author = {Kelleni, MT},
title = {Repurposing metformin to manage idiopathic or long COVID Tinnitus: self-report adopting a pathophysiological and pharmacological approach.},
journal = {Inflammopharmacology},
volume = {32},
number = {2},
pages = {945-948},
pmid = {38294616},
issn = {1568-5608},
mesh = {Male ; Humans ; Self Report ; Post-Acute COVID-19 Syndrome ; *Tinnitus/drug therapy ; *COVID-19 ; },
abstract = {Chronic tinnitus is a common neurological disorder that affects millions of patients globally with no available successful pharmacotherapy. It can be extremely bothersome to some patients to the extent that it occasionally qualifies as a disability that can hinder them from leading a normal life. In this short communication, the author discusses how he suffered from idiopathic tinnitus and how he managed to adopt a combined pathophysiological and pharmacological approach to the reason for the first time in the medical literature that low-dose metformin might be safely and effectively repurposed to manage at least a subset of tinnitus patients while discussing the potential role of adenosine receptor agonists as potential future tinnitus therapeutics.},
}

Male
Humans
Self Report
Post-Acute COVID-19 Syndrome
*Tinnitus/drug therapy
*COVID-19

@article {pmid38299237,
year = {2024},
author = {Lempesis, IG and Georgakopoulou, VE and Reiter, RJ and Spandidos, DA},
title = {A mid‑pandemic night's dream: Melatonin, from harbinger of anti‑inflammation to mitochondrial savior in acute and long COVID‑19 (Review).},
journal = {International journal of molecular medicine},
volume = {53},
number = {3},
pages = {},
pmid = {38299237},
issn = {1791-244X},
mesh = {Humans ; Antioxidants/pharmacology/therapeutic use/metabolism ; *COVID-19 ; *Melatonin/pharmacology/therapeutic use/metabolism ; Pandemics ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/metabolism ; },
abstract = {Coronavirus disease 2019 (COVID‑19), a systemic illness caused by severe acute respiratory distress syndrome 2 (SARS‑CoV‑2), has triggered a worldwide pandemic with symptoms ranging from asymptomatic to chronic, affecting practically every organ. Melatonin, an ancient antioxidant found in all living organisms, has been suggested as a safe and effective therapeutic option for the treatment of SARS‑CoV‑2 infection due to its good safety characteristics and broad‑spectrum antiviral medication properties. Melatonin is essential in various metabolic pathways and governs physiological processes, such as the sleep‑wake cycle and circadian rhythms. It exhibits oncostatic, anti‑inflammatory, antioxidant and anti‑aging properties, exhibiting promise for use in the treatment of numerous disorders, including COVID‑19. The preventive and therapeutic effects of melatonin have been widely explored in a number of conditions and have been well‑established in experimental ischemia/reperfusion investigations, particularly in coronary heart disease and stroke. Clinical research evaluating the use of melatonin in COVID‑19 has shown various improved outcomes, including reduced hospitalization durations; however, the trials are small. Melatonin can alleviate mitochondrial dysfunction in COVID‑19, improve immune cell function and provide antioxidant properties. However, its therapeutic potential remains underexplored due to funding limitations and thus further investigations are required.},
}

Humans
Antioxidants/pharmacology/therapeutic use/metabolism
*COVID-19
*Melatonin/pharmacology/therapeutic use/metabolism
Pandemics
Post-Acute COVID-19 Syndrome
SARS-CoV-2/metabolism

@article {pmid38306758,
year = {2024},
author = {Ahmed, S and Ahmad, E and Ahmad, B and Arif, MH and Ilyas, HMA and Hashmi, N and Ahmad, S},
title = {Long COVID-19 and primary care: Challenges, management and recommendations.},
journal = {Semergen},
volume = {50},
number = {3},
pages = {102188},
doi = {10.1016/j.semerg.2023.102188},
pmid = {38306758},
issn = {1578-8865},
mesh = {Humans ; *COVID-19/therapy ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Chronic Disease ; Primary Health Care ; Disease Progression ; },
abstract = {Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent symptoms after COVID-19 onset. This article explores the challenges, management strategies, and recommendations for addressing long COVID-19 in primary care settings. The epidemiology of long COVID-19 reveals significant variability, with a substantial portion of COVID-19 survivors experiencing post-acute symptoms. Pathophysiological mechanisms include viral persistence, endothelial dysfunction, autoimmunity, neurological dysregulation, and gastrointestinal dysbiosis. Multiple risk factors, including age, sex, pre-existing comorbidities, smoking, BMI, and acute COVID-19 severity, influence the development of long COVID-19. Effective management requires proactive measures such as vaccination, identification of high-risk populations, public awareness, and post-infection vaccination. Collaboration of primary care physicians with specialists is essential for holistic and individualized patient care. This article underscores the role of primary care physicians in diagnosing, managing, and mitigating the long-term effects of COVID-19.},
}

Humans
*COVID-19/therapy
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Chronic Disease
Primary Health Care
Disease Progression

@article {pmid38316434,
year = {2024},
author = {Laskowski, NM and Brandt, G and Paslakis, G},
title = {[Gender Inequalities of the COVID-19 Pandemic: A Synthesis of Systematic Reviews with a Focus on Sexual and Gender Minorities].},
journal = {Psychotherapie, Psychosomatik, medizinische Psychologie},
volume = {74},
number = {2},
pages = {57-69},
doi = {10.1055/a-2228-6244},
pmid = {38316434},
issn = {1439-1058},
mesh = {Male ; Humans ; Female ; *COVID-19/epidemiology ; Pandemics ; Gender Equity ; Post-Acute COVID-19 Syndrome ; Systematic Reviews as Topic ; *Sexual and Gender Minorities ; Gender Identity ; },
abstract = {OBJECTIVE: From the very beginning of the COVID-19 pandemic, gender was shown to play a significant role in how people were affected by it, while aspects related to sexual and gender minorities (SGM) have been rather understudied. The aim of this review was to synthesize systematic reviews and meta-analyses that explicitly addressed the impact of gender within the context of the pandemic, with a focus on SGM.

METHODS: We based the narrative synthesis of results on a literature search of PubMed. We included systematic reviews and meta-analyses as of 2019 with an identifiable gender comparison or SGM reference and a specified clinical outcome.

RESULTS: The search yielded 2 658 hits; 29 systematic reviews were included for content synthesis. Of these, we identified 23 systematic reviews with gender comparisons and 8 related to SGM. Men showed higher prevalence, severity, and mortality of COVID-19 compared with women, but the psychological consequences of the COVID-19 pandemic affected women more compared with men. Evidence suggests that women are at higher risk for Long-COVID-19. SGM experienced increased mental health problems during the COVID-19 pandemic compared to the general population.

DISCUSSION: It appears that biological and social risks led to differential susceptibility to infection and manifestation of COVID-19 disease and also accounted for differences in mortality between men and women. Insights on prevalence, disease burden, and mortality among SGM during the COVID-19 pandemic are lacking. This suggests an underrepresentation of SGM in COVID-19-related research. Despite the abundance of COVID-19 publications, gender effects have not often been explicitly and adequately studied.

CONCLUSION: Future studies should examine gender differences and needs and concerns of SGM in mental disorders and further understudied entities like Long-COVID-19, to gain insights and help to provide preventive measures and adequate treatments for all, for potential future pandemics as well.},
}

Male
Humans
Female
*COVID-19/epidemiology
Pandemics
Gender Equity
Post-Acute COVID-19 Syndrome
Systematic Reviews as Topic
*Sexual and Gender Minorities
Gender Identity

@article {pmid38321404,
year = {2024},
author = {Seighali, N and Abdollahi, A and Shafiee, A and Amini, MJ and Teymouri Athar, MM and Safari, O and Faghfouri, P and Eskandari, A and Rostaii, O and Salehi, AH and Soltani, H and Hosseini, M and Abhari, FS and Maghsoudi, MR and Jahanbakhshi, B and Bakhtiyari, M},
title = {The global prevalence of depression, anxiety, and sleep disorder among patients coping with Post COVID-19 syndrome (long COVID): a systematic review and meta-analysis.},
journal = {BMC psychiatry},
volume = {24},
number = {1},
pages = {105},
pmid = {38321404},
issn = {1471-244X},
mesh = {Humans ; *Anxiety/epidemiology ; Coping Skills ; *Depression/epidemiology ; *Post-Acute COVID-19 Syndrome/psychology ; Prevalence ; *Sleep Wake Disorders/epidemiology ; },
abstract = {BACKGROUND: Post COVID-19 syndrome, also known as "Long COVID," is a complex and multifaceted condition that affects individuals who have recovered from SARS-CoV-2 infection. This systematic review and meta-analysis aim to comprehensively assess the global prevalence of depression, anxiety, and sleep disorder in individuals coping with Post COVID-19 syndrome.

METHODS: A rigorous search of electronic databases was conducted to identify original studies until 24 January 2023. The inclusion criteria comprised studies employing previously validated assessment tools for depression, anxiety, and sleep disorders, reporting prevalence rates, and encompassing patients of all age groups and geographical regions for subgroup analysis Random effects model was utilized for the meta-analysis. Meta-regression analysis was done.

RESULTS: The pooled prevalence of depression and anxiety among patients coping with Post COVID-19 syndrome was estimated to be 23% (95% CI: 20%-26%; I2 = 99.9%) based on data from 143 studies with 7,782,124 participants and 132 studies with 9,320,687 participants, respectively. The pooled prevalence of sleep disorder among these patients, derived from 27 studies with 15,362 participants, was estimated to be 45% (95% CI: 37%-53%; I2 = 98.7%). Subgroup analyses based on geographical regions and assessment scales revealed significant variations in prevalence rates. Meta-regression analysis showed significant correlations between the prevalence and total sample size of studies, the age of participants, and the percentage of male participants. Publication bias was assessed using Doi plot visualization and the Peters test, revealing a potential source of publication bias for depression (p = 0.0085) and sleep disorder (p = 0.02). However, no evidence of publication bias was found for anxiety (p = 0.11).

CONCLUSION: This systematic review and meta-analysis demonstrate a considerable burden of mental health issues, including depression, anxiety, and sleep disorders, among individuals recovering from COVID-19. The findings emphasize the need for comprehensive mental health support and tailored interventions for patients experiencing persistent symptoms after COVID-19 recovery.},
}

Humans
*Anxiety/epidemiology
Coping Skills
*Depression/epidemiology
*Post-Acute COVID-19 Syndrome/psychology
Prevalence
*Sleep Wake Disorders/epidemiology

@article {pmid38321938,
year = {2024},
author = {Rao, S and Gross, RS and Mohandas, S and Stein, CR and Case, A and Dreyer, B and Pajor, NM and Bunnell, HT and Warburton, D and Berg, E and Overdevest, JB and Gorelik, M and Milner, J and Saxena, S and Jhaveri, R and Wood, JC and Rhee, KE and Letts, R and Maughan, C and Guthe, N and Castro-Baucom, L and Stockwell, MS},
title = {Postacute Sequelae of SARS-CoV-2 in Children.},
journal = {Pediatrics},
volume = {153},
number = {3},
pages = {},
pmid = {38321938},
issn = {1098-4275},
support = {K23 DC019678/DC/NIDCD NIH HHS/United States ; OT2 HL161847/HL/NHLBI NIH HHS/United States ; P30 DK111022/DK/NIDDK NIH HHS/United States ; },
mesh = {Child ; Humans ; *Autoimmune Diseases ; *COVID-19/complications/epidemiology ; Disease Progression ; Observational Studies as Topic ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Systemic Inflammatory Response Syndrome ; United States ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has caused significant medical, social, and economic impacts globally, both in the short and long term. Although most individuals recover within a few days or weeks from an acute infection, some experience longer lasting effects. Data regarding the postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) in children, or long COVID, are only just emerging in the literature. These symptoms and conditions may reflect persistent symptoms from acute infection (eg, cough, headaches, fatigue, and loss of taste and smell), new symptoms like dizziness, or exacerbation of underlying conditions. Children may develop conditions de novo, including postural orthostatic tachycardia syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, autoimmune conditions and multisystem inflammatory syndrome in children. This state-of-the-art narrative review provides a summary of our current knowledge about PASC in children, including prevalence, epidemiology, risk factors, clinical characteristics, underlying mechanisms, and functional outcomes, as well as a conceptual framework for PASC based on the current National Institutes of Health definition. We highlight the pediatric components of the National Institutes of Health-funded Researching COVID to Enhance Recovery Initiative, which seeks to characterize the natural history, mechanisms, and long-term health effects of PASC in children and young adults to inform future treatment and prevention efforts. These initiatives include electronic health record cohorts, which offer rapid assessments at scale with geographical and demographic diversity, as well as longitudinal prospective observational cohorts, to estimate disease burden, illness trajectory, pathobiology, and clinical manifestations and outcomes.},
}

Child
Humans
*Autoimmune Diseases
*COVID-19/complications/epidemiology
Disease Progression
Observational Studies as Topic
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Systemic Inflammatory Response Syndrome
United States

@article {pmid38335908,
year = {2024},
author = {Bronowicka-Szydełko, A and Gostomska-Pampuch, K and Kuzan, A and Pietkiewicz, J and Krzystek-Korpacka, M and Gamian, A},
title = {Effect of advanced glycation end-products in a wide range of medical problems including COVID-19.},
journal = {Advances in medical sciences},
volume = {69},
number = {1},
pages = {36-50},
doi = {10.1016/j.advms.2024.01.003},
pmid = {38335908},
issn = {1898-4002},
mesh = {*Glycation End Products, Advanced/metabolism ; Humans ; *COVID-19/metabolism/virology ; *SARS-CoV-2/isolation & purification/metabolism ; Diabetes Complications/metabolism ; Atherosclerosis/metabolism ; Neurodegenerative Diseases/metabolism ; },
abstract = {Glycation is a physiological process that determines the aging of the organism, while in states of metabolic disorders it is significantly intensified. High concentrations of compounds such as reducing sugars or reactive aldehydes derived from lipid oxidation, occurring for example in diabetes, atherosclerosis, dyslipidemia, obesity or metabolic syndrome, lead to increased glycation of proteins, lipids and nucleic acids. The level of advanced glycation end-products (AGEs) in the body depends on rapidity of their production and the rate of their removal by the urinary system. AGEs, accumulated in the extracellular matrix of the blood vessels and other organs, cause irreversible changes in the biochemical and biomechanical properties of tissues. As a consequence, micro- and macroangiopathies appear in the system, and may contribute to the organ failure, like kidneys and heart. Elevated levels of AGEs also increase the risk of Alzheimer's disease and various cancers. In this paper, we propose a new classification due to modified amino acid residues: arginyl-AGEs, monolysyl-AGEs and lysyl-arginyl-AGEs and dilysyl-AGEs. Furthermore, we describe in detail the effect of AGEs on the pathogenesis of metabolic and old age diseases, such as diabetic complications, atherosclerosis and neurodegenerative diseases. We summarize the currently available data on the diagnostic value of AGEs and present the AGEs as a therapeutic goal in a wide range of medical problems, including SARS-CoV-2 infection and so-called long COVID.},
}

*Glycation End Products, Advanced/metabolism
Humans
*COVID-19/metabolism/virology
*SARS-CoV-2/isolation & purification/metabolism
Diabetes Complications/metabolism
Atherosclerosis/metabolism
Neurodegenerative Diseases/metabolism

@article {pmid38337760,
year = {2024},
author = {Negrut, N and Menegas, G and Kampioti, S and Bourelou, M and Kopanyi, F and Hassan, FD and Asowed, A and Taleouine, FZ and Ferician, A and Marian, P},
title = {The Multisystem Impact of Long COVID: A Comprehensive Review.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {14},
number = {3},
pages = {},
pmid = {38337760},
issn = {2075-4418},
abstract = {(1) Background: COVID-19 was responsible for the latest pandemic, shaking and reshaping healthcare systems worldwide. Its late clinical manifestations make it linger in medical memory as a debilitating illness over extended periods. (2) Methods: the recent literature was systematically analyzed to categorize and examine the symptomatology and pathophysiology of Long COVID across various bodily systems, including pulmonary, cardiovascular, gastrointestinal, neuropsychiatric, dermatological, renal, hematological, and endocrinological aspects. (3) Results: The review outlines the diverse clinical manifestations of Long COVID across multiple systems, emphasizing its complexity and challenges in diagnosis and treatment. Factors such as pre-existing conditions, initial COVID-19 severity, vaccination status, gender, and age were identified as influential in the manifestation and persistence of Long COVID symptoms. This condition is highlighted as a debilitating disease capable of enduring over an extended period and presenting new symptoms over time. (4) Conclusions: Long COVID emerges as a condition with intricate multi-systemic involvement, complicating its diagnosis and treatment. The findings underscore the necessity for a nuanced understanding of its diverse manifestations to effectively manage and address the evolving nature of this condition over time.},
}

@article {pmid38339115,
year = {2024},
author = {Bielecka, E and Sielatycki, P and Pietraszko, P and Zapora-Kurel, A and Zbroch, E},
title = {Elevated Arterial Blood Pressure as a Delayed Complication Following COVID-19-A Narrative Review.},
journal = {International journal of molecular sciences},
volume = {25},
number = {3},
pages = {},
pmid = {38339115},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/complications ; SARS-CoV-2 ; Arterial Pressure ; Angiotensin-Converting Enzyme Inhibitors ; Renin-Angiotensin System ; *Hypertension ; Blood Pressure/physiology ; },
abstract = {Arterial hypertension is one of the most common and significant cardiovascular risk factors. There are many well-known and identified risk factors for its development. In recent times, there has been growing concern about the potential impact of COVID-19 on the cardiovascular system and its relation to arterial hypertension. Various theories have been developed that suggest a connection between COVID-19 and elevated blood pressure. However, the precise link between SARS-CoV-2 infection and the long-term risk of developing hypertension remains insufficiently explored. Therefore, the primary objective of our study was to investigate the influence of COVID-19 infection on blood pressure elevation and the subsequent risk of developing arterial hypertension over an extended period. To accomplish this, we conducted a thorough search review of relevant papers in the PubMed and SCOPUS databases up to 3 September 2023. Our analysis encompassed a total of 30 eligible articles. Out of the 30 papers we reviewed, 19 of them provided substantial evidence showing a heightened risk of developing arterial hypertension following COVID-19 infection. Eight of the studies showed that blood pressure values increased after the infection, while three of the qualified studies did not report any notable impact of COVID-19 on blood pressure levels. The precise mechanism behind the development of hypertension after COVID-19 remains unclear, but it is suggested that endothelial injury and dysfunction of the renin-angiotensin-aldosterone system may be contributory. Additionally, changes in blood pressure following COVID-19 infection could be linked to lifestyle alterations that often occur alongside the illness. Our findings emphasize the pressing requirement for thorough research into the relationship between COVID-19 and hypertension. These insights are essential for the development of effective prevention and management approaches for individuals who have experienced COVID-19 infection.},
}

Humans
*COVID-19/complications
SARS-CoV-2
Arterial Pressure
Angiotensin-Converting Enzyme Inhibitors
Renin-Angiotensin System
*Hypertension
Blood Pressure/physiology

@article {pmid38347167,
year = {2024},
author = {Lui, DTW and Lee, CH and Woo, YC and Hung, IFN and Lam, KSL},
title = {Thyroid dysfunction in COVID-19.},
journal = {Nature reviews. Endocrinology},
volume = {20},
number = {6},
pages = {336-348},
pmid = {38347167},
issn = {1759-5037},
mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; *Thyroid Diseases/epidemiology/physiopathology ; *SARS-CoV-2 ; COVID-19 Vaccines ; Thyroid Gland/physiopathology ; },
abstract = {The COVID-19 pandemic has affected over 772 million people globally. While lung damage is the major contributor to the morbidity and mortality of this disease, the involvement of multiple organs, including the endocrine glands, has been reported. This Review aims to provide an updated summary of evidence regarding COVID-19 and thyroid dysfunction, incorporating highlights of recent advances in the field, particularly in relation to long COVID and COVID-19 vaccination. Since subacute thyroiditis following COVID-19 was first reported in May 2020, thyroid dysfunction associated with COVID-19 has been increasingly recognized, secondary to direct and indirect effects on the hypothalamic-pituitary-thyroid axis. Here, we summarize the epidemiological evidence, pattern and clinical course of thyroid dysfunction following COVID-19 and examine radiological, molecular and histological evidence of thyroid involvement in SARS-CoV-2 infection. Beyond acute SARS-CoV-2 infection, it is also timely to examine the course and implication of thyroid dysfunction in the context of long COVID owing to the large population of survivors of COVID-19 worldwide. This Review also analyses the latest evidence on the relationship between the therapeutics and vaccination for COVID-19 and thyroid dysfunction. To conclude, evidence-based practice recommendations for thyroid function testing during and following COVID-19 and concerning COVID-19 vaccination are proposed.},
}

Humans
*COVID-19/complications/epidemiology/physiopathology
*Thyroid Diseases/epidemiology/physiopathology
*SARS-CoV-2
COVID-19 Vaccines
Thyroid Gland/physiopathology

@article {pmid38349116,
year = {2024},
author = {Eltayeb, A and Al-Sarraj, F and Alharbi, M and Albiheyri, R and Mattar, EH and Abu Zeid, IM and Bouback, TA and Bamagoos, A and Uversky, VN and Rubio-Casillas, A and Redwan, EM},
title = {Intrinsic factors behind long COVID: IV. Hypothetical roles of the SARS-CoV-2 nucleocapsid protein and its liquid-liquid phase separation.},
journal = {Journal of cellular biochemistry},
volume = {125},
number = {3},
pages = {e30530},
doi = {10.1002/jcb.30530},
pmid = {38349116},
issn = {1097-4644},
mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Coronavirus Nucleocapsid Proteins ; Endothelial Cells ; Phase Separation ; Nucleocapsid Proteins ; },
abstract = {When the SARS-CoV-2 virus infects humans, it leads to a condition called COVID-19 that has a wide spectrum of clinical manifestations, from no symptoms to acute respiratory distress syndrome. The virus initiates damage by attaching to the ACE-2 protein on the surface of endothelial cells that line the blood vessels and using these cells as hosts for replication. Reactive oxygen species levels are increased during viral replication, which leads to oxidative stress. About three-fifths (~60%) of the people who get infected with the virus eradicate it from their body after 28 days and recover their normal activity. However, a large fraction (~40%) of the people who are infected with the virus suffer from various symptoms (anosmia and/or ageusia, fatigue, cough, myalgia, cognitive impairment, insomnia, dyspnea, and tachycardia) beyond 12 weeks and are diagnosed with a syndrome called long COVID. Long-term clinical studies in a group of people who contracted SARS-CoV-2 have been contrasted with a noninfected matched group of people. A subset of infected people can be distinguished by a set of cytokine markers to have persistent, low-grade inflammation and often self-report two or more bothersome symptoms. No medication can alleviate their symptoms efficiently. Coronavirus nucleocapsid proteins have been investigated extensively as potential drug targets due to their key roles in virus replication, among which is their ability to bind their respective genomic RNAs for incorporation into emerging virions. This review highlights basic studies of the nucleocapsid protein and its ability to undergo liquid-liquid phase separation. We hypothesize that this ability of the nucleocapsid protein for phase separation may contribute to long COVID. This hypothesis unlocks new investigation angles and could potentially open novel avenues for a better understanding of long COVID and treating this condition.},
}

Humans
*COVID-19
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Coronavirus Nucleocapsid Proteins
Endothelial Cells
Phase Separation
Nucleocapsid Proteins

@article {pmid38359962,
year = {2024},
author = {Seylanova, N and Chernyavskaya, A and Degtyareva, N and Mursalova, A and Ajam, A and Xiao, L and Aktulaeva, K and Roshchin, P and Bobkova, P and Aiyegbusi, OL and Anbu, AT and Apfelbacher, C and Asadi-Pooya, AA and Ashkenazi-Hoffnung, L and Brackel, C and Buonsenso, D and de Groote, W and Diaz, JV and Dona, D and Dunn Galvin, A and Genuneit, J and Goss, H and Hughes, SE and Jones, CJ and Kuppalli, K and Malone, LA and McFarland, S and Needham, DM and Nekliudov, N and Nicholson, TR and Oliveira, CR and Schiess, N and Segal, TY and Sigfrid, L and Thorne, C and Vijverberg, S and Warner, JO and Were, WM and Williamson, PR and Munblit, D and , },
title = {Core outcome measurement set for research and clinical practice in post-COVID-19 condition (long COVID) in children and young people: an international Delphi consensus study "PC-COS Children".},
journal = {The European respiratory journal},
volume = {63},
number = {3},
pages = {},
pmid = {38359962},
issn = {1399-3003},
support = {001/WHO_/World Health Organization/International ; K23 AI159518/AI/NIAID NIH HHS/United States ; OT2 HL161847/HL/NHLBI NIH HHS/United States ; },
mesh = {Adolescent ; Child ; Humans ; *COVID-19 ; Delphi Technique ; Outcome Assessment, Health Care ; *Post-Acute COVID-19 Syndrome ; Research Design ; Treatment Outcome ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic substantially impacted different age groups, with children and young people not exempted. Many have experienced enduring health consequences. Presently, there is no consensus on the health outcomes to assess in children and young people with post-COVID-19 condition. Furthermore, it is unclear which measurement instruments are appropriate for use in research and clinical management of children and young people with post-COVID-19. To address these unmet needs, we conducted a consensus study, aiming to develop a core outcome set (COS) and an associated core outcome measurement set (COMS) for evaluating post-COVID-19 condition in children and young people. Our methodology comprised of two phases. In phase 1 (to create a COS), we performed an extensive literature review and categorisation of outcomes, and prioritised those outcomes in a two-round online modified Delphi process followed by a consensus meeting. In phase 2 (to create the COMS), we performed another modified Delphi consensus process to evaluate measurement instruments for previously defined core outcomes from phase 1, followed by an online consensus workshop to finalise recommendations regarding the most appropriate instruments for each core outcome. In phase 1, 214 participants from 37 countries participated, with 154 (72%) contributing to both Delphi rounds. The subsequent online consensus meeting resulted in a final COS which encompassed seven critical outcomes: fatigue; post-exertion symptoms; work/occupational and study changes; as well as functional changes, symptoms, and conditions relating to cardiovascular, neuro-cognitive, gastrointestinal and physical outcomes. In phase 2, 11 international experts were involved in a modified Delphi process, selecting measurement instruments for a subsequent online consensus workshop where 30 voting participants discussed and independently scored the selected instruments. As a result of this consensus process, four instruments met a priori consensus criteria for inclusion: PedsQL multidimensional fatigue scale for "fatigue"; PedsQL gastrointestinal symptom scales for "gastrointestinal"; PedsQL cognitive functioning scale for "neurocognitive" and EQ-5D for "physical functioning". Despite proposing outcome measurement instruments for the remaining three core outcomes ("cardiovascular", "post-exertional malaise", "work/occupational and study changes"), a consensus was not achieved. Our international, consensus-based initiative presents a robust framework for evaluating post-COVID-19 condition in children and young people in research and clinical practice via a rigorously defined COS and associated COMS. It will aid in the uniform measurement and reporting of relevant health outcomes worldwide.},
}

Adolescent
Child
Humans
*COVID-19
Delphi Technique
Outcome Assessment, Health Care
*Post-Acute COVID-19 Syndrome
Research Design
Treatment Outcome

@article {pmid38366966,
year = {2024},
author = {Fernández-de-Las-Peñas, C and Torres-Macho, J and Macasaet, R and Velasco, JV and Ver, AT and Culasino Carandang, THD and Guerrero, JJ and Franco-Moreno, A and Chung, W and Notarte, KI},
title = {Presence of SARS-CoV-2 RNA in COVID-19 survivors with post-COVID symptoms: a systematic review of the literature.},
journal = {Clinical chemistry and laboratory medicine},
volume = {62},
number = {6},
pages = {1044-1052},
pmid = {38366966},
issn = {1437-4331},
mesh = {Humans ; *COVID-19/virology/diagnosis ; *RNA, Viral/analysis ; *SARS-CoV-2/isolation & purification/genetics ; Survivors ; Feces/virology/chemistry ; Female ; },
abstract = {INTRODUCTION: Viral persistence is one of the main hypotheses explaining the presence of post-COVID symptoms. This systematic review investigated the presence of SARS-CoV-2 RNA in plasma, stool, urine, and nasal/oral swab samples in individuals with post-COVID symptomatology.

CONTENT: MEDLINE, CINAHL, PubMed, EMBASE, Web of Science databases, as well as medRxiv/bioRxiv preprint servers were searched up to November 25th, 2023. Articles investigating the persistence of SARS-CoV-2 RNA in plasma, stool, urine or nasal/oral swab samples in patients with post-COVID symptoms were included. Methodological quality was assessed using the Newcastle-Ottawa Scale or Cochrane's Risk of Bias (Rob) tool.

SUMMARY: From 322 studies identified, six studies met all inclusion criteria. The sample included 678 COVID-19 survivors (52 % female, aged from 29 to 66 years). The methodological quality was moderate in 88 % of the studies (n=5/6). Three papers investigated the presence of SARS-CoV-2 RNA in plasma, three studies in nasal/oral swabs, two studies in stool samples, one in urine and one in saliva. The follow-up was shorter than two months (<60 days after) in 66 % of the studies (n=4/6). The prevalence of SARS-CoV-2 RNA ranged from 5 to 59 % in patients with post-COVID symptoms the first two months after infection, depending on the sample tested, however, SARS-CoV-2 RNA was also identified in COVID-19 survivors without post-COVID symptoms (one study).

OUTLOOK: Available evidence can suggest the presence of persistent SARS-CoV-2 RNA in post-COVID patients in the short term, although the biases within the studies do not permit us to make firm assumptions. The association between post-COVID symptoms and SARS-CoV-2 RNA in the samples tested is also conflicting. The lack of comparative group without post-COVID symptoms limits the generalizability of viral persistence in post-COVID-19 condition.},
}

Humans
*COVID-19/virology/diagnosis
*RNA, Viral/analysis
*SARS-CoV-2/isolation & purification/genetics
Survivors
Feces/virology/chemistry
Female

@article {pmid38372528,
year = {2024},
author = {Maybin, JA and Watters, M and Rowley, B and Walker, CA and Sharp, GC and Alvergne, A},
title = {COVID-19 and abnormal uterine bleeding: potential associations and mechanisms.},
journal = {Clinical science (London, England : 1979)},
volume = {138},
number = {4},
pages = {153-171},
pmid = {38372528},
issn = {1470-8736},
support = {/WT_/Wellcome Trust/United Kingdom ; },
mesh = {Female ; Humans ; *Endometrium ; Post-Acute COVID-19 Syndrome ; Quality of Life ; COVID-19 Vaccines ; *COVID-19/complications ; SARS-CoV-2 ; Menstruation/physiology ; Uterine Hemorrhage/etiology ; Menstruation Disturbances/complications ; },
abstract = {The impact of COVID-19 on menstruation has received a high level of public and media interest. Despite this, uncertainty exists about the advice that women and people who menstruate should receive in relation to the expected impact of SARS-CoV-2 infection, long COVID or COVID-19 vaccination on menstruation. Furthermore, the mechanisms leading to these reported menstrual changes are poorly understood. This review evaluates the published literature on COVID-19 and its impact on menstrual bleeding, discussing the strengths and limitations of these studies. We present evidence consistent with SARS-CoV-2 infection and long COVID having an association with changes in menstrual bleeding parameters and that the impact of COVID vaccination on menstruation appears less significant. An overview of menstrual physiology and known causes of abnormal uterine bleeding (AUB) is provided before discussing potential mechanisms which may underpin the menstrual disturbance reported with COVID-19, highlighting areas for future scientific study. Finally, consideration is given to the effect that menstruation may have on COVID-19, including the impact of the ovarian sex hormones on acute COVID-19 severity and susceptibility and reported variation in long COVID symptoms across the menstrual cycle. Understanding the current evidence and addressing gaps in our knowledge in this area are essential to inform public health policy, direct the treatment of menstrual disturbance and facilitate development of new therapies, which may reduce the severity of COVID-19 and improve quality of life for those experiencing long COVID.},
}

Female
Humans
*Endometrium
Post-Acute COVID-19 Syndrome
Quality of Life
COVID-19 Vaccines
*COVID-19/complications
SARS-CoV-2
Menstruation/physiology
Uterine Hemorrhage/etiology
Menstruation Disturbances/complications

@article {pmid38375735,
year = {2024},
author = {Ribeiro, J and Caldeira, D and Dores, H},
title = {Long-term manifestations of COVID-19 in athletes: a narrative review.},
journal = {The Physician and sportsmedicine},
volume = {52},
number = {5},
pages = {452-459},
doi = {10.1080/00913847.2024.2321629},
pmid = {38375735},
issn = {2326-3660},
mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; *Athletes ; *Return to Sport ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Athletic Performance/physiology ; Fatigue/physiopathology/etiology ; },
abstract = {BACKGROUND: Long COVID is a condition where symptoms or complications persist beyond 3 months after COVID-19 infection. Although most athletes experience mild symptoms, those involved in sports with higher cardiovascular demands can develop long COVID, which can negatively impact sports performance. This narrative review aimed to analyze the long COVID in athletes, especially cardiovascular effects; to alert medical and sporting community for the clinical aftermaths of COVID-19, focusing on physical activity; and to discuss the potential return-to-play strategies for these athletes.

METHODS: An electronic search in PubMed database for articles published between January/2020 and February/2023 was performed including athletic populations with COVID-19, emphasizing long-term complications, especially the cardiovascular effects.

RESULTS AND CONCLUSIONS: While severe cardiac complications are rare, athletes with long COVID often experience symptoms such as fatigue, dyspnea, palpitations, and exercise intolerance. To manage athletes with long COVID, individualized and structured return-to-play programs with the involvement of multidisciplinary teams are crucial. This underscores the importance of recognizing long COVID in athletes, raising awareness of its potential impacts, and implementing strategies to ensure a safe return to play.},
}

Humans
*COVID-19/complications/epidemiology/physiopathology
*Athletes
*Return to Sport
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Athletic Performance/physiology
Fatigue/physiopathology/etiology

@article {pmid38378550,
year = {2024},
author = {Valencia, I and Lumpuy-Castillo, J and Magalhaes, G and Sánchez-Ferrer, CF and Lorenzo, Ó and Peiró, C},
title = {Mechanisms of endothelial activation, hypercoagulation and thrombosis in COVID-19: a link with diabetes mellitus.},
journal = {Cardiovascular diabetology},
volume = {23},
number = {1},
pages = {75},
pmid = {38378550},
issn = {1475-2840},
support = {CD22/00101//Instituto de Salud Carlos III/ ; FPI-UAM//Universidad Autónoma de Madrid/ ; Maria Zambrano postdoctoral grant//European Union-Next Generation EU/ ; SAF2017-84776-R//Ministerio de Economía y Competitividad/ ; P120/00923//Instituto de Salud Carlos III and Fondo de Investigaciones Sanitarias/ ; SPACE2-CV-COVID-CM//REACT-EU-Comunidad de Madrid and the European Regional Development Fund/ ; },
mesh = {Humans ; *COVID-19/complications ; Post-Acute COVID-19 Syndrome ; Pandemics ; SARS-CoV-2 ; *Thrombophilia/diagnosis/drug therapy ; *Thrombosis ; *Diabetes Mellitus/diagnosis/drug therapy/epidemiology ; Endothelium ; },
abstract = {Early since the onset of the COVID-19 pandemic, the medical and scientific community were aware of extra respiratory actions of SARS-CoV-2 infection. Endothelitis, hypercoagulation, and hypofibrinolysis were identified in COVID-19 patients as subsequent responses of endothelial dysfunction. Activation of the endothelial barrier may increase the severity of the disease and contribute to long-COVID syndrome and post-COVID sequelae. Besides, it may cause alterations in primary, secondary, and tertiary hemostasis. Importantly, these responses have been highly decisive in the evolution of infected patients also diagnosed with diabetes mellitus (DM), who showed previous endothelial dysfunction. In this review, we provide an overview of the potential triggers of endothelial activation related to COVID-19 and COVID-19 under diabetic milieu. Several mechanisms are induced by both the viral particle itself and by the subsequent immune-defensive response (i.e., NF-κB/NLRP3 inflammasome pathway, vasoactive peptides, cytokine storm, NETosis, activation of the complement system). Alterations in coagulation mediators such as factor VIII, fibrin, tissue factor, the von Willebrand factor: ADAMST-13 ratio, and the kallikrein-kinin or plasminogen-plasmin systems have been reported. Moreover, an imbalance of thrombotic and thrombolytic (tPA, PAI-I, fibrinogen) factors favors hypercoagulation and hypofibrinolysis. In the context of DM, these mechanisms can be exacerbated leading to higher loss of hemostasis. However, a series of therapeutic strategies targeting the activated endothelium such as specific antibodies or inhibitors against thrombin, key cytokines, factor X, complement system, the kallikrein-kinin system or NETosis, might represent new opportunities to address this hypercoagulable state present in COVID-19 and DM. Antidiabetics may also ameliorate endothelial dysfunction, inflammation, and platelet aggregation. By improving the microvascular pathology in COVID-19 and post-COVID subjects, the associated comorbidities and the risk of mortality could be reduced.},
}

Humans
*COVID-19/complications
Post-Acute COVID-19 Syndrome
Pandemics
SARS-CoV-2
*Thrombophilia/diagnosis/drug therapy
*Thrombosis
*Diabetes Mellitus/diagnosis/drug therapy/epidemiology
Endothelium

@article {pmid38380482,
year = {2024},
author = {Warnaerts, N and Beeckmans, K and Morrens, M and De Picker, L},
title = {[Impairments in neurocognitive functions in patients with long COVID: A systematic review].},
journal = {Tijdschrift voor psychiatrie},
volume = {66},
number = {1},
pages = {12-18},
pmid = {38380482},
issn = {0303-7339},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; Neuropsychological Tests ; Case-Control Studies ; *COVID-19/complications ; Executive Function ; },
abstract = {BACKGROUND: Studies have shown impairments in neurocognitive functions which persist more than 3 months after COVID-19 (long COVID). It remains unclear what these impairments entail, how long they persist and what proportion of the patients exhibit them.

AIM: To define the specific neurocognitive profile and to determine the proportion of deficits in at least one cognitive domain in patients with long COVID.

METHOD: We conducted a systematic search in PubMed according to PRISMA 2020 guidelines with the following inclusion criteria: peer reviewed publications in which patients were assessed more than 3 months following acute COVID-19 by means of a test battery for different domains of neurocognition.

RESULTS: We found a total of 1178 papers, of which 7 cohort studies and 1 case-control study were selected. The proportion of patients having deficits in at least one domain of neurocognition ranged from 23% to 100%. Most frequent impairments were found in attention and speed of information processing, anterograde memory, working memory and executive function. Quality of the included studies was moderate.

CONCLUSION: Impairments in neurocognitive functions are highly prevalent among patients with long COVID and include various cognitive domains. We encourage further research to continue studying the complex interaction of COVID-19, neurocognitive impairments and neuropsychiatric syndromes.},
}

Humans
*Post-Acute COVID-19 Syndrome
Neuropsychological Tests
Case-Control Studies
*COVID-19/complications
Executive Function

@article {pmid38381595,
year = {2025},
author = {Tsampasian, V and Bäck, M and Bernardi, M and Cavarretta, E and Dębski, M and Gati, S and Hansen, D and Kränkel, N and Koskinas, KC and Niebauer, J and Spadafora, L and Frias Vargas, M and Biondi-Zoccai, G and Vassiliou, VS},
title = {Cardiovascular disease as part of Long COVID: a systematic review.},
journal = {European journal of preventive cardiology},
volume = {32},
number = {6},
pages = {485-498},
doi = {10.1093/eurjpc/zwae070},
pmid = {38381595},
issn = {2047-4881},
mesh = {Humans ; *COVID-19/complications/epidemiology/diagnosis ; *Cardiovascular Diseases/epidemiology/diagnosis/therapy/etiology/physiopathology ; SARS-CoV-2 ; Risk Factors ; Risk Assessment ; Heart Disease Risk Factors ; },
abstract = {AIMS: Long COVID syndrome has had a major impact on million patients' lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome.

METHODS AND RESULTS: An in-depth systematic search of the literature has been conducted for this narrative review. The systematic search of PubMed and Cochrane databases yielded 3993 articles, of which 629 underwent full-text screening. A total of 78 studies were included in the final qualitative synthesis and data evaluation. The pathophysiology of the cardiovascular sequelae of Long COVID syndrome and the cardiac manifestations and complications of Long COVID syndrome are critically evaluated. In addition, potential cardiovascular risk factors are assessed, and preventive methods and treatment options are examined in this review.

CONCLUSION: This systematic review poignantly summarizes the evidence from the available literature regarding the cardiovascular manifestations of Long COVID syndrome and reviews potential mechanistic pathways, diagnostic approaches, preventive measures, and treatment options.},
}

Humans
*COVID-19/complications/epidemiology/diagnosis
*Cardiovascular Diseases/epidemiology/diagnosis/therapy/etiology/physiopathology
SARS-CoV-2
Risk Factors
Risk Assessment
Heart Disease Risk Factors

@article {pmid38383157,
year = {2024},
author = {Steinruecke, M and Mason, I and Keen, M and McWhirter, L and Carson, AJ and Stone, J and Hoeritzauer, I},
title = {Pain and functional neurological disorder: a systematic review and meta-analysis.},
journal = {Journal of neurology, neurosurgery, and psychiatry},
volume = {95},
number = {9},
pages = {874-885},
pmid = {38383157},
issn = {1468-330X},
mesh = {Humans ; *Nervous System Diseases/complications ; *Chronic Pain ; },
abstract = {BACKGROUND: Functional neurological disorder (FND) is characterised by neurological symptoms, such as seizures and abnormal movements. Despite its significance to patients, the clinical features of chronic pain in people with FND, and of FND in people with chronic pain, have not been comprehensively studied.

METHODS: We systematically reviewed PubMed, Embase and PsycINFO for studies of chronic pain in adults with FND and FND in patients with chronic pain. We described the proportions of patients reporting pain, pain rating and timing, pain-related diagnoses and responsiveness to treatment. We performed random effects meta-analyses of the proportions of patients with FND who reported pain or were diagnosed with pain-related disorders.

RESULTS: Seven hundred and fifteen articles were screened and 64 were included in the analysis. Eight case-control studies of 3476 patients described pain symptoms in a higher proportion of patients with FND than controls with other neurological disorders. A random effects model of 30 cohorts found that an estimated 55% (95% CI 46% to 64%) of 4272 patients with FND reported pain. Random effects models estimated diagnoses of complex regional pain syndrome in 22% (95% CI 6% to 39%) of patients, irritable bowel syndrome in 16% (95% CI 9% to 24%) and fibromyalgia in 10% (95% CI 8% to 13%). Five studies of FND diagnoses among 361 patients with chronic pain were identified. Most interventions for FND did not ameliorate pain, even when other symptoms improved.

CONCLUSIONS: Pain symptoms and pain-related diagnoses are common in FND. Classification systems and treatments should routinely consider pain as a comorbidity in patients with FND.},
}

Humans
*Nervous System Diseases/complications
*Chronic Pain

@article {pmid38384747,
year = {2024},
author = {Lammers, N and Beese, F and Hoebel, J and Poethko-Müller, C and Wachtler, B},
title = {Social Inequalities in Long-Term Health Effects After COVID-19-A Scoping Review.},
journal = {International journal of public health},
volume = {69},
number = {},
pages = {1606739},
pmid = {38384747},
issn = {1661-8564},
mesh = {Humans ; *COVID-19/epidemiology ; *Socioeconomic Factors ; *SARS-CoV-2 ; Health Status Disparities ; Post-Acute COVID-19 Syndrome ; },
abstract = {Objectives: We aimed to map and synthesize evidence about social inequalities in long-term health effects after COVID-19 (LTHE), often referred to as "long COVID" or "post-COVID-19 conditions." Methods: We conducted a scoping review of peer-reviewed articles by searching the databases Embase and Scopus. According to predefined inclusion criteria, titles/abstracts and full texts were screened for eligibility. Additionally, reference lists of all included studies were hand-searched for eligible studies. This study followed the PRISMA guidelines for scoping reviews. Results: Nineteen articles were included. LTHE were analysed according to ethnicity, education, income, employment and deprivation indices. The studies varied significantly in their definitions of LTHE. Eighty-two analyses showed no statistically significant associations. At least 12 studies had a high risk of type II errors. Only studies associating deprivation indices and long COVID tended to show a higher prevalence of LTHE in deprived areas. Conclusion: Although some studies indicated social inequalities in LTHE, evidence was generally weak and inconclusive. Further studies with larger sample sizes specifically designed to detect social inequalities regarding LTHE are needed to inform future healthcare planning and public health policies.},
}

Humans
*COVID-19/epidemiology
*Socioeconomic Factors
*SARS-CoV-2
Health Status Disparities
Post-Acute COVID-19 Syndrome

@article {pmid38389299,
year = {2024},
author = {Martínez-Pozas, O and Meléndez-Oliva, E and Rolando, LM and Rico, JAQ and Corbellini, C and Sánchez Romero, EA},
title = {The pulmonary rehabilitation effect on long covid-19 syndrome: A systematic review and meta-analysis.},
journal = {Physiotherapy research international : the journal for researchers and clinicians in physical therapy},
volume = {29},
number = {2},
pages = {e2077},
doi = {10.1002/pri.2077},
pmid = {38389299},
issn = {1471-2865},
support = {//Award for Best Research Project in post-COVID-19 sequelae/ ; //the Ilustre Colegio Profesional de Fisioterapeutas de la Comunidad de Madrid, December 2021/ ; },
mesh = {Adult ; Humans ; *Quality of Life ; Post-Acute COVID-19 Syndrome ; *COVID-19 ; Fatigue ; Dyspnea ; },
abstract = {OBJECTIVES: This systematic review and meta-analysis aims to evaluate the efficacy of pulmonary rehabilitation (PR) in improving dyspnea, fatigue, physical activity, quality of life, anxiety and depression in patients with Long COVID-19 (LC). The impact of PR on LC and a comparison of face-to-face and telerehabilitation approaches was explored.

METHODS: This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. A literature search included PubMed, Web of Science, and Cochrane Library until January 2023. No language filters were applied. Randomized controlled trials, non-randomized controlled trials, and observational studies were included. The risk of bias was assessed using appropriate tools. Descriptive analysis and meta-analysis were performed. Forest plots presented results. Statistical analyses were conducted using the Metafor Package in R v.3.4.2.

RESULTS/FINDINGS: This systematic review and meta-analysis included 16 studies on PR in LC patients. A total of 1027 adults were included. The studies varied in design, with seven observational studies, three quasi-experimental studies, and six randomized controlled trials. Dyspnea, physical function, quality of life, psychological state, and fatigue were assessed as outcomes. The review found that pulmonary rehabilitation had a significant positive effect on dyspnea, physical function, quality of life (both global and physical domain), anxiety, and depression. However, the effect on fatigue was not significant. Heterogeneity was observed in some analyses, and publication bias was found in certain outcomes. Age and study design were identified as potential moderators. Both face-to-face and telerehabilitation interventions improved the studied outcomes, with only differences in the physical domain of quality of life favoring the face-to-face group.

PR improved dyspnea, physical function, quality of life, and psychological state in LC patients, but not fatigue. Face-to-face and telerehabilitation have similar effects, except for physical quality of life.},
}

Adult
Humans
*Quality of Life
Post-Acute COVID-19 Syndrome
*COVID-19
Fatigue
Dyspnea

@article {pmid38390594,
year = {2024},
author = {Adler, BL and Chung, T and Rowe, PC and Aucott, J},
title = {Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?.},
journal = {Frontiers in neurology},
volume = {15},
number = {},
pages = {1344862},
pmid = {38390594},
issn = {1664-2295},
abstract = {Dysautonomia, or dysfunction of the autonomic nervous system (ANS), may occur following an infectious insult and can result in a variety of debilitating, widespread, and often poorly recognized symptoms. Dysautonomia is now widely accepted as a complication of COVID-19 and is an important component of Post-Acute Sequelae of COVID-19 (PASC or long COVID). PASC shares many overlapping clinical features with other infection-associated chronic illnesses including Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Treatment Lyme Disease Syndrome (PTLDS), suggesting that they may share common underlying mechanisms including autonomic dysfunction. Despite the recognition of this complication of Lyme disease in the care of patients with PTLD, there has been a scarcity of research in this field and dysautonomia has not yet been established as a complication of Lyme disease in the medical literature. In this review, we discuss the evidence implicating Borrelia burgdorferi as a cause of dysautonomia and the related symptoms, propose potential pathogenic mechanisms given our knowledge of Lyme disease and mechanisms of PASC and ME/CFS, and discuss the diagnostic evaluation and treatments of dysautonomia. We also outline gaps in the literature and priorities for future research.},
}

@article {pmid38391754,
year = {2024},
author = {Leão Batista Simões, J and Webler Eichler, S and Raitz Siqueira, ML and de Carvalho Braga, G and Bagatini, MD},
title = {Amyotrophic Lateral Sclerosis in Long-COVID Scenario and the Therapeutic Potential of the Purinergic System in Neuromodulation.},
journal = {Brain sciences},
volume = {14},
number = {2},
pages = {},
pmid = {38391754},
issn = {2076-3425},
support = {Proj. No 404256/2021-0 and 310606/2021-7).//National Council for Scientific and Technological Development/ ; },
abstract = {Amyotrophic lateral sclerosis (ALS) involves the degeneration of motor neurons and debilitating and possibly fatal symptoms. The COVID-19 pandemic directly affected the quality of life of this group, and the SARS-CoV-2 infection accelerated the present neuroinflammatory process. Furthermore, studies indicate that the infection may have led to the development of the pathology. Thus, the scenario after this pandemic presents "long-lasting COVID" as a disease that affects people who have been infected. From this perspective, studying the pathophysiology behind ALS associated with SARS-CoV-2 infection and possible supporting therapies becomes necessary when we understand the impact on the quality of life of these patients. Thus, the purinergic system was trained to demonstrate how its modulation can add to the treatment, reduce disease progression, and result in better prognoses. From our studies, we highlight the P2X7, P2X4, and A2AR receptors and how their activity can directly influence the ALS pathway.},
}

@article {pmid38391826,
year = {2024},
author = {Daniels, K and Mourad, J and Bonnechère, B},
title = {Exploring the Use of Mobile Health for the Rehabilitation of Long COVID Patients: A Scoping Review.},
journal = {Healthcare (Basel, Switzerland)},
volume = {12},
number = {4},
pages = {},
pmid = {38391826},
issn = {2227-9032},
abstract = {The COVID-19 pandemic has led to a substantial revolution in the incorporation of digital solutions in healthcare. This systematic review investigates the enduring physical and psychological consequences individuals experience up to two years post-recovery. Additionally, it focuses on examining the influence of mHealth interventions on these effects. Significantly, 41.7% of survivors experience lingering symptoms that have not been addressed, while 14.1% encounter difficulties in returning to work. The presence of anxiety, compromised respiratory functioning, and persistent symptoms highlight the immediate requirement for specific therapies. Telehealth, particularly telerehabilitation, presents itself as a possible way to address these difficulties. The study thoroughly examines 10 studies encompassing 749 COVID-19 patients, investigating the efficacy of telerehabilitation therapies in addressing various health markers. Telerehabilitation-based breathing exercises yield substantial enhancements in functional performance, dyspnea, and overall well-being. The results emphasize the potential of telerehabilitation to have a favorable effect on patient outcomes; however, more research is needed to strengthen the existing evidence base, as one of the most important limitations is the limited number of trials and the evaluation of varied therapies. This analysis highlights the significance of digital solutions in post-COVID care and calls for ongoing research to improve the comprehension and implementation of telehealth interventions in a swiftly changing healthcare environment.},
}

@article {pmid38392036,
year = {2024},
author = {Taieb, A and Nassim, BHS and Asma, G and Jabeur, M and Ghada, S and Asma, BA},
title = {The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review.},
journal = {Advances in respiratory medicine},
volume = {92},
number = {1},
pages = {96-109},
pmid = {38392036},
issn = {2543-6031},
mesh = {Humans ; *Post-Acute COVID-19 Syndrome ; *COVID-19 ; SARS-CoV-2 ; Pituitary Gland ; Fatigue/etiology ; },
abstract = {Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body's stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.},
}

Humans
*Post-Acute COVID-19 Syndrome
*COVID-19
SARS-CoV-2
Pituitary Gland
Fatigue/etiology

@article {pmid38393096,
year = {2024},
author = {Nederlof, RA and de la Garza, MA and Bakker, J},
title = {Perspectives on SARS-CoV-2 Cases in Zoological Institutions.},
journal = {Veterinary sciences},
volume = {11},
number = {2},
pages = {},
pmid = {38393096},
issn = {2306-7381},
abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in a zoological institution were initially reported in March 2020. Since then, at least 94 peer-reviewed cases have been reported in zoos worldwide. Among the affected animals, nonhuman primates, carnivores, and artiodactyls appear to be most susceptible to infection, with the Felidae family accounting for the largest number of reported cases. Clinical symptoms tend to be mild across taxa; although, certain species exhibit increased susceptibility to disease. A variety of diagnostic tools are available, allowing for initial diagnostics and for the monitoring of infectious risk. Whilst supportive therapy proves sufficient in most cases, monoclonal antibody therapy has emerged as a promising additional treatment option. Effective transmission of SARS-CoV-2 in some species raises concerns over potential spillover and the formation of reservoirs. The occurrence of SARS-CoV-2 in a variety of animal species may contribute to the emergence of variants of concern due to altered viral evolutionary constraints. Consequently, this review emphasizes the need for effective biosecurity measures and surveillance strategies to prevent and control SARS-CoV-2 infections in zoological institutions.},
}

@article {pmid38393535,
year = {2024},
author = {Pszczołowska, M and Walczak, K and Misków, W and Antosz, K and Batko, J and Karska, J and Leszek, J},
title = {Molecular cross-talk between long COVID-19 and Alzheimer's disease.},
journal = {GeroScience},
volume = {46},
number = {3},
pages = {2885-2899},
pmid = {38393535},
issn = {2509-2723},
mesh = {Humans ; *Alzheimer Disease/metabolism ; *COVID-19 ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Amyloid beta-Peptides ; Chronic Disease ; },
abstract = {The long COVID (coronavirus disease), a multisystemic condition following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, is one of the widespread problems. Some of its symptoms affect the nervous system and resemble symptoms of Alzheimer's disease (AD)-a neurodegenerative condition caused by the accumulation of amyloid beta and hyperphosphorylation of tau proteins. Multiple studies have found dependence between these two conditions. Patients with Alzheimer's disease have a greater risk of SARS-CoV-2 infection due to increased levels of angiotensin-converting enzyme 2 (ACE2), and the infection itself promotes amyloid beta generation which enhances the risk of AD. Also, the molecular pathways are alike-misregulations in folate-mediated one-carbon metabolism, a deficit of Cq10, and disease-associated microglia. Medical imaging in both of these diseases shows a decrease in the volume of gray matter, global brain size reduction, and hypometabolism in the parahippocampal gyrus, thalamus, and cingulate cortex. In some studies, a similar approach to applied medication can be seen, including the use of amino adamantanes and phenolic compounds of rosemary. The significance of these connections and their possible application in medical practice still needs further study but there is a possibility that they will help to better understand long COVID.},
}

Humans
*Alzheimer Disease/metabolism
*COVID-19
SARS-CoV-2
Post-Acute COVID-19 Syndrome
Amyloid beta-Peptides
Chronic Disease

@article {pmid38396973,
year = {2024},
author = {Nakane, S and Koike, H and Hayashi, T and Nakatsuji, Y},
title = {Autoimmune Autonomic Neuropathy: From Pathogenesis to Diagnosis.},
journal = {International journal of molecular sciences},
volume = {25},
number = {4},
pages = {},
pmid = {38396973},
issn = {1422-0067},
support = {22FC1007//Ministry of Health Labour and Welfare/ ; },
mesh = {Humans ; Ganglia, Autonomic ; Post-Acute COVID-19 Syndrome ; *Autoimmune Diseases of the Nervous System ; Autonomic Nervous System ; *Autonomic Nervous System Diseases/diagnosis/etiology ; *Autoimmune Diseases/diagnosis/pathology ; *Peripheral Nervous System Diseases/pathology ; Autoantibodies ; },
abstract = {Autoimmune autonomic ganglionopathy (AAG) is a disease of autonomic failure caused by ganglionic acetylcholine receptor (gAChR) autoantibodies. Although the detection of autoantibodies is important for distinguishing the disease from other neuropathies that present with autonomic dysfunction, other factors are important for accurate diagnosis. Here, we provide a comprehensive review of the clinical features of AAG, highlighting differences in clinical course, clinical presentation, and laboratory findings from other neuropathies presenting with autonomic symptoms. The first step in diagnosing AAG is careful history taking, which should reveal whether the mode of onset is acute or chronic, followed by an examination of the time course of disease progression, including the presentation of autonomic and extra-autonomic symptoms. AAG is a neuropathy that should be differentiated from other neuropathies when the patient presents with autonomic dysfunction. Immune-mediated neuropathies, such as acute autonomic sensory neuropathy, are sometimes difficult to differentiate, and therefore, differences in clinical and laboratory findings should be well understood. Other non-neuropathic conditions, such as postural orthostatic tachycardia syndrome, chronic fatigue syndrome, and long COVID, also present with symptoms similar to those of AAG. Although often challenging, efforts should be made to differentiate among the disease candidates.},
}

Humans
Ganglia, Autonomic
Post-Acute COVID-19 Syndrome
*Autoimmune Diseases of the Nervous System
Autonomic Nervous System
*Autonomic Nervous System Diseases/diagnosis/etiology
*Autoimmune Diseases/diagnosis/pathology
*Peripheral Nervous System Diseases/pathology
Autoantibodies

@article {pmid38398460,
year = {2024},
author = {Parzen-Johnson, S and Katz, BZ},
title = {Navigating the Spectrum of Two Pediatric COVID-19 Complications: Multi-System Inflammatory Syndrome in Children and Post-Acute Sequelae of SARS-CoV-2 Infection.},
journal = {Journal of clinical medicine},
volume = {13},
number = {4},
pages = {},
pmid = {38398460},
issn = {2077-0383},
abstract = {PURPOSE: This review summarizes the current scope of understanding associated with two common post-infectious complications associated with COVID-19 infection: Multi-System Inflammatory Syndrome in Children (MIS-C) and Post-Acute Sequelae of SARS-CoV-2 infection (PASC). It identifies current gaps in the knowledge and issues that may limit the ability to fill these gaps. This review provides a framework to drive continued research.

METHODS: A comprehensive review of the current literature was performed, identifying seminal articles describing the emergence of MIS-C and PASC, and works from the literature focused on the clinical implications and pathophysiologic understanding of these disorders.

FINDINGS: Although pediatric patients experienced few severe cases of acute COVID-19 infection, the burden of disease from post-infectious sequelae is substantial. Mortality is low, but morbidity is significant. There are still numerous unknowns about the pathophysiology of both MIS-C and PASC; however, with widespread immunity developing after increased vaccination and prior infection, it may be difficult to perform adequate prospective studies to answer pathophysiologic questions. Long-term sequalae of MIS-C seem to be minimal whereas, by definition, PASC is an ongoing problem and may be severe.

IMPLICATIONS: The rapid sharing of information regarding novel conditions such as MIS-C and PASC are key to interventions related to future post-infectious sequelae outside of those stemming from COVID-19. Although MIS-C seems unlikely to return as a clinical condition in substantial numbers, there is still significant learning that can be gleaned from existing patients about general aspects of epidemiology, equity, and pathophysiology. There is significant morbidity associated with PASC and additional resources need to be dedicated to determining appropriate and effective therapies moving forward.},
}

@article {pmid38399736,
year = {2024},
author = {Liu, S and Zhong, M and Wu, H and Su, W and Wang, Y and Li, P},
title = {Potential Beneficial Effects of Naringin and Naringenin on Long COVID-A Review of the Literature.},
journal = {Microorganisms},
volume = {12},
number = {2},
pages = {},
pmid = {38399736},
issn = {2076-2607},
support = {2023A1515011953//Natural Science Foundation of Guangdong Province/ ; 2022SDZG07//Open Competition Program of Ten Major Directions of Agricultural Science and Technology Innovation for the 14th Five-Year Plan of Guangdong Province/ ; 2022ZD006//Research Fund of Maoming Branch, Guangdong Laboratory for Lingnan Modern Agriculture/ ; },
abstract = {Coronavirus disease 2019 (COVID-19) caused a severe epidemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Recent studies have found that patients do not completely recover from acute infections, but instead, suffer from a variety of post-acute sequelae of SARS-CoV-2 infection, known as long COVID. The effects of long COVID can be far-reaching, with a duration of up to six months and a range of symptoms such as cognitive dysfunction, immune dysregulation, microbiota dysbiosis, myalgic encephalomyelitis/chronic fatigue syndrome, myocarditis, pulmonary fibrosis, cough, diabetes, pain, reproductive dysfunction, and thrombus formation. However, recent studies have shown that naringenin and naringin have palliative effects on various COVID-19 sequelae. Flavonoids such as naringin and naringenin, commonly found in fruits and vegetables, have various positive effects, including reducing inflammation, preventing viral infections, and providing antioxidants. This article discusses the molecular mechanisms and clinical effects of naringin and naringenin on treating the above diseases. It proposes them as potential drugs for the treatment of long COVID, and it can be inferred that naringin and naringenin exhibit potential as extended long COVID medications, in the future likely serving as nutraceuticals or clinical supplements for the comprehensive alleviation of the various manifestations of COVID-19 complications.},
}

@article {pmid38400172,
year = {2024},
author = {Man, MA and Rosca, D and Bratosin, F and Fira-Mladinescu, O and Ilie, AC and Burtic, SR and Fildan, AP and Fizedean, CM and Jianu, AM and Negrean, RA and Marc, MS},
title = {Impact of Pre-Infection COVID-19 Vaccination on the Incidence and Severity of Post-COVID Syndrome: A Systematic Review and Meta-Analysis.},
journal = {Vaccines},
volume = {12},
number = {2},
pages = {},
pmid = {38400172},
issn = {2076-393X},
abstract = {This systematic review critically evaluated the impact of a pre-infection COVID-19 vaccination on the incidence and severity of post-COVID-19 syndrome and aimed to assess the potential protective effect across different vaccines and patient demographics. This study hypothesized that vaccination before infection substantially reduces the risk and severity of post-COVID-19 syndrome. In October 2023, a comprehensive literature search was conducted across three databases, PubMed, Embase, and Scopus, focusing on studies published up to that date. Utilizing a wide array of keywords, the search strategy adhered to the PRISMA guidelines and was registered in the Open Science Framework. The inclusion criteria comprised studies focusing on patients with a breakthrough SARS-CoV-2 infection who developed post-COVID-19 syndrome. We included a total of 13 articles that met the inclusion criteria, analyzing more than 10 million patients with a mean age of 50.6 years, showing that the incidence of intensive care unit (ICU) admissions post-vaccination was as low as 2.4%, with a significant reduction in mortality risk (OR 0.66, 95% CI 0.58-0.74). The prevalence of post-COVID-19 syndrome symptoms was lower in vaccinated individuals (9.5%) compared to unvaccinated (14.6%), with a notable decrease in activity-limiting symptoms (adjusted OR 0.59, 95% CI 0.48-0.73). Vaccinated patients also showed a quicker recovery and return to work (HR 1.37, 95% CI 1.04-1.79). The pooled odds ratio of 0.77 indicates that vaccination is associated with a 23% reduction in the risk of developing post-COVID-19 syndrome (95% CI 0.75-0.79). Despite the protective effects observed, a substantial heterogeneity among the studies was noted. In conclusion, a pre-infection COVID-19 vaccination is associated with a significant reduction in the risk and severity of post-COVID-19 syndrome. However, the observed heterogeneity across studies suggests a need for further research with standardized methods to fully comprehend vaccine efficacy against long COVID.},
}

@article {pmid38405190,
year = {2024},
author = {Chu, XJ and Song, DD and Zhou, MH and Chen, XZ and Chu, N and Li, M and Li, BZ and Liu, SH and Hou, S and Wu, JB and Gong, L},
title = {Perturbations in gut and respiratory microbiota in COVID-19 and influenza patients: a systematic review and meta-analysis.},
journal = {Frontiers in medicine},
volume = {11},
number = {},
pages = {1301312},
pmid = {38405190},
issn = {2296-858X},
abstract = {OBJECTIVES: Coronavirus disease-19 (COVID-19)/influenza poses unprecedented challenges to the global economy and healthcare services. Numerous studies have described alterations in the microbiome of COVID-19/influenza patients, but further investigation is needed to understand the relationship between the microbiome and these diseases. Herein, through systematic comparison between COVID-19 patients, long COVID-19 patients, influenza patients, no COVID-19/influenza controls and no COVID-19/influenza patients, we conducted a comprehensive review to describe the microbial change of respiratory tract/digestive tract in COVID-19/influenza patients.

METHODS: We systematically reviewed relevant literature by searching the PubMed, Embase, and Cochrane Library databases from inception to August 12, 2023. We conducted a comprehensive review to explore microbial alterations in patients with COVID-19/influenza. In addition, the data on α-diversity were summarized and analyzed by meta-analysis.

RESULTS: A total of 134 studies comparing COVID-19 patients with controls and 18 studies comparing influenza patients with controls were included. The Shannon indices of the gut and respiratory tract microbiome were slightly decreased in COVID-19/influenza patients compared to no COVID-19/influenza controls. Meanwhile, COVID-19 patients with more severe symptoms also exhibited a lower Shannon index versus COVID-19 patients with milder symptoms. The intestinal microbiome of COVID-19 patients was characterized by elevated opportunistic pathogens along with reduced short-chain fatty acid (SCFAs)-producing microbiota. Moreover, Enterobacteriaceae (including Escherichia and Enterococcus) and Lactococcus, were enriched in the gut and respiratory tract of COVID-19 patients. Conversely, Haemophilus and Neisseria showed reduced abundance in the respiratory tract of both COVID-19 and influenza patients.

CONCLUSION: In this systematic review, we identified the microbiome in COVID-19/influenza patients in comparison with controls. The microbial changes in influenza and COVID-19 are partly similar.},
}