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1.
Anaesthesia, Pain & Intensive Care ; 26(2):154-160, 2022.
Article in English | Academic Search Complete | ID: covidwho-1812145

ABSTRACT

Background & Objective: Persistent or new appearance signs and symptoms in post--COVID patients is a well-- recognized complication of the COVID-19 pandemic, the severity of which is still underestimated and, therefore, remains unaddressed. Multiple studies from all over the world have documented the prevalence of post--COVID symptoms;however, the frequency, the severity and the variety of post--COVID symptoms in our country has not been much investigated. We determined the prevalence of post--COVID syndrome in a cohort of faculty working in Fazaia Ruth Pfau Medical College (FRPMC), Karachi, Pakistan, and their family members. Methodology: This cross--sectional, descriptive single--center study was conducted in a medical institute, data was gathered with a questionnaire sent to the cohort of medical faculty and their families. Data was analyzed on SPSS 20 and ODDs Ratio calculated using different variables. Results: A total of 84 patients were enrolled which had suffered from COVID out of which 51 (60.7%) had post-- COVID symptoms, with fatigability 40 (48%), muscle pain 16 (19%), inability to continue the normal chores 12(14%), dry cough 11 (13%), breathlessness 10(12%), sleep disturbance and brain fog or difficulty in concentration 11 (13%), and hair loss 9 (11%) being the common complaints. There was no positive or negative relationship between the severity of COVID infection and the presence of the post--COVID syndrome. Conclusion: The prevalence of post--COVID symptoms in COVID infected population is high, however, no identifiable risk factor is observed. A multidisciplinary team approach is much needed to cater for the needs of the vulnerable post--COVID population, more observational studies are needed to follow the sequel of this comparatively new virus which may still be unidentified. [ FROM AUTHOR] Copyright of Anaesthesia, Pain & Intensive Care is the property of Department of Anaesthesia, Pain & Intensive Care and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

2.
Profilakticheskaya Meditsina ; 25(4):47-54, 2022.
Article in Russian | Academic Search Complete | ID: covidwho-1811636

ABSTRACT

Objective. To investigate predictors of death within six months of non-ST elevation myocardial infarction (NSTEMI) in postCOVID-19 patients. Material and methods. Outcomes were analyzed in 185 patients treated for NSTEMI at the Demikhov City Clinical Hospital from July 2020 to March 2021. Six months after discharge from the hospital, telephone interviews were conducted with treated patients, and in the absence of the possibility of personal contact, with their next of kin. During the survey, an assessment was made of the vital status (alive/dead), the presence of repeated hospitalizations and their causes. In the event of a patient’s death, the cause of death was clarified on the basis of information received from relatives or from a unified medical information analytical system. Results. Overall mortality within 6 months after NSTEMI was 9.7% (n=18), in the COVID(+) group — 13.8% (n=13), in the COVID(–) group — 5.5% (n=5), p=0.0558. By causes of death, both groups are comparable (p>0.05). Median survival in patients in the COVID(+) group was 5.4 months (95% CI 5.1-5.7) and 5.9 months (95% CI 5.8-6.0) in patients in the COVID(–) group (χ² =5.27;p=0.0217). The deceased and survivors were comparable in terms of gender and age (p>0.05). The deceased patients had lower baseline values of SpO2, hemoglobin, glomerular filtration rate (GFR) and had a higher score on the Syntax scale, C-reactive protein (CRP), creatinine (p<0.05). Patients had a history of COVID-19 in 72.2% (n=13) of lethal cases (p=0.0554). In 72.2% (n=13) of patients with a fatal outcome, multi-vessel coronary artery disease was noted (p<0.0001). With the development of NSTEMI within 28 days of COVID-19 disease, there was an increase in the risk of death (RR 33.2;p<0.0001). Predictors of the development of a lethal outcome after 6 months were an increase in the titer of IgG to SARS-CoV-2 ≥ 234.9 U/l, CRP ≥ 17.3 mg/l, a decrease in prothrombin time <9.5 s, GFR < 46.9 ml/l min/1.73 m² . Conclusion. Patients who survived COVID-19 showed a trend towards a higher incidence of deaths within 6 months. The development of a non-ST elevation myocardial infarction within 28 days of the onset of COVID-19 symptoms was accompanied by a significant increase in the chances of death within 6 months. A significant impact on the risk of death within 6 months was exerted by an increased level of C-reactive protein and IgG to SARS-CoV-2, a decrease in prothrombin time and glomerular filtration rate. (English) [ FROM AUTHOR] Цель исследования. Изучить предикторы летального исхода в течение 6 месяцев после инфаркта миокарда без подъема сегмента ST (ИМбпST) у пациентов, перенесших COVID-19. Материал и методы. У 185 пациентов проанализированы результаты лечения по поводу ИМбпST в ГБУЗ «ГКБ имени Ð’.П. Демихова ДЗМ». Ð’ исследование включены пациенты, выбывшие из стационара в период с июля 2020 г. по март 2021 г. Через 6 мес после выписки из стационара проведено телефонное интервьюирование пациентов (или ближайших родственников при отсутствии возможности личного контакта). Во время опроса осуществляли оценку жизненного статуса (жив/умер), наличия повторных госпитализаций и их причин. Ð’ случае смерти больного уточняли причину смерти по информации, полученной от родственников или из Единой медицинской информационно-аналитической системы. Результаты. Общая летальность в течение 6 мес после ИМбп ST составила 9,7% (n=18), в группе COVID(+) — 13,8% (n=13), в группе COVID(–) — 5,5% (n=5), p=0,0558. По причинам смерти обе группы между собой сопоставимы (p>0,05). Средний срок дожития у пациентов группы COVID(+) составил 5,4 мес (95% ДИ 5,1—5,7), у пациентов группы COVID(–) — 5,9 мес (95% ДИ 5,8—6,0) (χ² =5,27;p=0,0217). Умершие и выжившие сопоставимы по полу и возрасту (p>0,05). У пациентов с летальным исходом отмечены более низкие исходные значения SpO2, гемоглобина, скорости клубочковой фильтрации (СКФ), более высокая оценка в баллах по шкале Syntax Score, более высокий уровень С-реактивного белка, креатинина (p<0,05). Ð’ 72,2% (n=13) летальных случаев у пациентов в анамнезе отмечен COVID-19 (p=0,0554). У 72,2% (n=13) пациентов с летальным исходом наблюдалось многососудистое поражение коронарных артерий (p<0,0001). При развитии ИМбпST в срок до 28 дней от заболевания COVID-19 отмечалось увеличение риска развития летального исхода (ОР 33,2;p<0,0001). Предикторами развития летального исхода через 6 мес являлись повышение титра IgG к SARS-CoV-2 ≥ 234,9 Ед/л, СРБ ≥ 17,3 мг/л, снижение протромбинового времени < 9,5 с, СКФ < 46,9 мл/мин/1,73 м² . Заключение. У пациентов, перенесших COVID-19, отмечена тенденция к большей частоте летальных исходов в течение 6 мес. Развитие инфаркта миокарда без подъема сегмента ST в течение 28 дней от появления симптомов COVID-19 сопровождалосьсущественным увеличением шансов летального исхода в течение 6 мес. Значимое влияние на развитие риска смерти в течени µ 6 мес оказывали повышенные уровни С-реактивного белка и IgG к SARS-CoV-2, снижение протромбинового времени и скорости клубочковой фильтрации. (Russian) [ FROM AUTHOR] Copyright of Profilakticheskaya Meditsina is the property of Media Sphere Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

3.
Acta Neurol Scand ; 2022.
Article in English | PubMed | ID: covidwho-1807012

ABSTRACT

BACKGROUND: Olfactory dysfunction is common during SARS-CoV-2 infection. The pathophysiology of the persistence of this symptom and the potential relationship with central nervous system involvement is unknown. AIM OF THE STUDY: To evaluate the neural correlates of persistent olfactory dysfunction in a series of patients with post-COVID syndrome. METHODS: Eighty-two patients with post-COVID syndrome were assessed with the Brief Smell Identification Test and a multimodal MRI study including 3D-T1, T2-FLAIR, diffusion-tensor imaging, and arterial spin labeling. Olfactory and neuroimaging examinations were performed 11.18 ± 3.78 months after the acute infection. Voxel-based brain mapping analyses were conducted to correlate the olfactory test with brain volumes, white matter microstructure, and brain perfusion. RESULTS: Olfactory dysfunction was associated with lower tissue perfusion in the orbital and medial frontal regions in the arterial spin labeling sequence. Conversely, no statistically significant findings were detected in brain volumes and diffusion-tensor imaging. Mild changes in paranasal sinuses and nasal cavities were detected in 9.75% of cases, with no association with olfactory deficits. CONCLUSIONS: We provide new insights regarding the pathophysiology of persistent olfactory dysfunction after COVID-19, involving the main brain regions associated with the olfactory system.

4.
Infectious Disease Alert ; 41(8), 2022.
Article in English | ProQuest Central | ID: covidwho-1801451

ABSTRACT

A pro-inflammatory state showed increased interferon-α, tumor necrosis factor-α, granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-17A, IL-6, IL-1β, and IL-13, while interferon-γ-induced protein 10 (IP-10) was decreased. In addition to the aforementioned symptoms reported, there were 20 other symptoms reported, including loss of taste or smell (15% to 17%), tingling of a limb (20%), dizziness (11%), hair loss (7%), and headache (5%). The rates of more specific symptoms, such as tingling of a limb, hair loss, and joint and muscle symptoms, however, seem much higher than those of non-COVID patients.

5.
Nervenarzt ; 2022.
Article in German | PubMed | ID: covidwho-1797661

ABSTRACT

Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to a multiorgan disease and subsequently to very different clinical manifestations of coronavirus disease 2019 (COVID-19). In addition to acute symptoms, the long-term complaints in the context of the infection, known as long or post-COVID syndrome, are increasingly attracting attention. With respect to social insurance systems, expert opinions of such problems will become more and more important, whereby neurological and psychiatric symptoms are the most frequent complaints. In addition to the legal principles of the medico-legal assessment with a focus on statutory accident insurance, this overview article discusses the principles of expert assessment and presents landmarks for the expert opinion of the most frequent neurological and psychiatric symptoms occurring in the context of post-COVID syndrome.

6.
Human Sport Medicine ; 21:94-98, 2021.
Article in Russian | Scopus | ID: covidwho-1791667

ABSTRACT

Aim. The paper aims to develop and test a method of physical rehabilitation in COVID-19 patients. Materials and methods. The following methods were used for the purpose of the study: literature and internet search and analysis, survey, pedagogical observation, pedagogical experiment, statistical processing of the results, their analysis and synthesis. Our 4-month study involved 16 COVID-19 patients (moderate and moderate-severe disease) aged between 18 and 45 years. Results. Our physical rehabilitation method resulted in the improvement of the following mean values: HR - up to 73 bpm, blood pressure - up to115/75 mmHg, Stange test - up to 44 sec, Gench test - up to 36 s, Serkin test - up to 44, 21 and 38 s in the 1st, 2nd and 3rd phases respectively. Therefore, general cardiorespiratory improvement was recorded. Conclusion. As a result of the study, improvement of the functional status and general well-being was recorded in COVID-19 patients. Our study provides the foundation for further research in the field. © 2021 South Ural State University - Institute of Sport, Tourism and Service. All rights reserved.

7.
Meditsinskiy Sovet ; 2022(2):70-75, 2022.
Article in Russian | Scopus | ID: covidwho-1791477

ABSTRACT

There are both scientific interest and practical value to study the medical consequences of the Coronavirus disease 2019 (COVID-19) due to its pandemic status and high prevalence of different complaints among COVID-19 survivors. These complaints are called “post-COVID” or “long COVID” syndrome. One of the frequent symptoms of post-COVID syndrome is sleep disturbances, predominantly insomnia. The article provides epidemiological data, pathogenesis, socioeconomic factors, and therapeutic approach to insomnia associated with post-COVID syndrome. The increase of sleep disturbances prevalence in pandemic conditions has a comprehensive nature. It includes the disease consequences itself and change of lifestyle due to lockdown. The lifestyle change leads to physical activity decrease and inadequate sleep hygiene. Besides, the high stress level is also the reason for sleep disturbances. The direct effects of COVID-19 on the central nervous system are understudied at the moment. Nevertheless, there are reasons to suggest neurotropic characteristics of SARS-CoV-2 to underlie post-COVID neurological and psychiatric disturbances. Taking into account that general practitioners are mainly addressed post-COVID complaints, the recommended hypnotics should be safe, easily prescribed, and highly effective. The probable presence of the psychiatric pathology should be also assessed because the sleep complaints might be its manifestation. © 2022, Remedium Group Ltd. All rights reserved.

8.
Acta Balneol. ; 64(1):16-19, 2022.
Article in English | Web of Science | ID: covidwho-1791263

ABSTRACT

Aim: Formation of goals of the rehabilitation process of patients with the post-covid syndrome in accordance with the needs of the patient, and the results of sufficient diagnosis. Materials and Methods: A total of 132 people were examined. In 48 patients diagnosed with COVID-19 coronavirus (PCR test). Diagnosis of study participants occurred after 8-12 weeks of the acute period. None of the patients after the acute period of the disease underwent a course of rehabilitation treatment. The diagnosis was performed using a non-invasive blood formula analyzer AMP. Before the measurement, the respiratory rate, heart rate, and the patient`s weight, age, and sex were recorded. Statistical data processing was performed using the statistical package MedStat. Results: The values of such indicators as the Tiffno test, dopamine-beta-hydrolase, skeletal muscle circulation, the complex factor regulating cell mitosis were out of the norm in the group of participants who suffered from covid-19, but compared with the control group, was not found a statistically significant difference between the above indicators (p>0.05). Such values are a consequence of the disease and are the basis for describing the main long-term consequences that correspond to the post-covid syndrome. Conclusions: The goals of the rehabilitation process of patients with the post-covid syndrome should be formed in accordance with the positions of evidence-based medicine. The non-invasive blood formula analyzer allows determining the direction of rehabilitation treatment taking into account concomitant chronic diseases and taking into account the patient`s ability to carry out the correction of rehabilitation programs in real-time.

9.
Italian Journal of Gender-Specific Medicine ; 8(1):18-28, 2022.
Article in English | Scopus | ID: covidwho-1789247

ABSTRACT

COVID-19 was deemed a global pandemic in March 2020 and, since then, millions of people have been affected worldwide. Now, nearly two years later, the long-term sequelae of the virus are becoming increasingly appar-ent. This novel form of the disease, commonly referred to as “long COVID”, appears to be more common in females than in males. In this narrative review, we consulted published studies on long COVID reporting sex-disaggregated findings and discuss the possible mechanisms underlying potential sex differences. We found that females are more likely to experience milder acute COVID-19 disease, lower mortality, and a higher number of persistent physical, cognitive, neu-rological, and neuropsychiatric symptoms compared to males. Stronger innate and adaptive immune responses in females may be one of the mechanisms underlying this sex difference. The arrival of COVID-19 presents a unique occa-sion to study sex differences in the prevalence, symptomatol-ogy, risk factors, and disease progression shortly after disease emergence. We argue that advantage must be taken of this opportunity to provide researchers with the proper tools to address sex differences in COVID-19 and effectively tailor assessments and treatments toward individual needs. © 2022, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.

10.
Paediatrics Eastern Europe ; 10(1):145-161, 2022.
Article in Russian | Scopus | ID: covidwho-1786612

ABSTRACT

The article is about topical issues of the psychological features of the long-term consequences of post-COVID syndrome in children and adolescents. We have described the most frequent residual manifestations of SARS-CoV-2 infection alongside with an analysis of the characteristics of the emotional and behavioral health of children and adolescents. The authors of article have analyzed modern approaches and recommendations for changing the lifestyle, psychological support of patients with the elimination of stress factors and body stress resistance increase. Also in article are presented main symptoms and signs associated with emotional and behavioral responses to stress in children and adolescents. The necessity of early detection and psychological correction of the symptoms of post-COVID syndrome and its inherent stress manifestations is substantiated as well as the stress resistance increase using physiological approaches of micronutrient correction with bioorganic magnesium substances. © 2022, Professionalnye Izdaniya. All rights reserved.

11.
Cardiovasc Hematol Agents Med Chem ; 2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1779862

ABSTRACT

Recently, the post-COVID neurological syndrome has been coined, which describes the functional and structural sequelae of coronavirus infection disease-19 (COVID-19) in the brain. Mild/severe manifestations of the post-COVID neurological syndrome have been identified in approximately 33.00% of COVID-19 survivors. The presence of neurological complications after COVID allowed neuropathologists to investigate in-depth the role of viral infection in neurons. The pathophysiology of the post-COVID neurological syndrome involved the development of a systematic response, including coagulopathy characterized by the formation of microthrombi. Coagulopathy, an old term for a new disease, describes the discrepancy between pro-coagulant and anticoagulant systems due to overexpression of pro-coagulant substances and or their receptors in addition to suppression of the anticoagulant molecules and or their receptors. Vascular endothelial cells and hepatocytes play a central role in the regulation of hemostasis that is disrupted during the acute phase response (APR) of coronavirus-19 (COVID-19). Currently, coagulopathy and inflammation are termed together since both form a complementary system, indicated by the elevation of inflammatory biomarkers (APR) and fibrinolysis biomarkers (D-dimer/fibrin). The later events of post-COVID neurological syndrome are primarily induced by coagulopathy and direct viral tropism. Therefore, the paper introduces the hypothesis of coagulopathy induced post-COVID neurological syndrome.

12.
Brain Commun ; 4(2): fcac057, 2022.
Article in English | MEDLINE | ID: covidwho-1769197

ABSTRACT

Lack of awareness of cognitive impairment (i.e. anosognosia) could be a key factor for distinguishing between neuropsychological post-COVID-19 condition phenotypes. In this context, the 2-fold aim of the present study was to (i) establish the prevalence of anosognosia for memory impairment, according to the severity of the infection in the acute phase and (ii) determine whether anosognosic patients with post-COVID syndrome have a different cognitive and psychiatric profile from nosognosic patients, with associated differences in brain functional connectivity. A battery of neuropsychological, psychiatric, olfactory, dyspnoea, fatigue and quality-of-life tests was administered 227.07 ± 42.69 days post-SARS-CoV-2 infection to 102 patients (mean age: 56.35 years, 65 men, no history of neurological, psychiatric, neuro-oncological or neurodevelopmental disorder prior to infection) who had experienced either a mild (not hospitalized; n = 45), moderate (conventional hospitalization; n = 34) or severe (hospitalization with intensive care unit stay and mechanical ventilation; n = 23) presentation in the acute phase. Patients were first divided into two groups according to the presence or absence of anosognosia for memory deficits (26 anosognosic patients and 76 nosognosic patients). Of these, 49 patients underwent an MRI. Structural images were visually analysed, and statistical intergroup analyses were then performed on behavioural and functional connectivity measures. Only 15.6% of patients who presented mild disease displayed anosognosia for memory dysfunction, compared with 32.4% of patients with moderate presentation and 34.8% of patients with severe disease. Compared with nosognosic patients, those with anosognosia for memory dysfunction performed significantly more poorly on objective cognitive and olfactory measures. By contrast, they gave significantly more positive subjective assessments of their quality of life, psychiatric status and fatigue. Interestingly, the proportion of patients exhibiting a lack of consciousness of olfactory deficits was significantly higher in the anosognosic group. Functional connectivity analyses revealed a significant decrease in connectivity, in the anosognosic group as compared with the nosognosic group, within and between the following networks: the left default mode, the bilateral somatosensory motor, the right executive control, the right salient ventral attention and the bilateral dorsal attention networks, as well as the right Lobules IV and V of the cerebellum. Lack of awareness of cognitive disorders and, to a broader extent, impairment of the self-monitoring brain system, may be a key factor for distinguishing between the clinical phenotypes of post-COVID syndrome with neuropsychological deficits.

13.
Infection ; 2022 Mar 30.
Article in English | MEDLINE | ID: covidwho-1767726

ABSTRACT

PURPOSE: Metabolic disorders have been identified as major risk factors for severe acute courses of COVID-19. With decreasing numbers of infections in many countries, the long COVID syndrome (LCS) represents the next major challenge in pandemic management, warranting the precise definition of risk factors for LCS development. METHODS: We identified 50,402 COVID-19 patients in the Disease Analyzer database (IQVIA) featuring data from 1056 general practices in Germany. Multivariate logistic regression analysis was used to identify risk factors for the development of LCS. RESULTS: Of the 50,402 COVID-19 patients included into this analysis, 1,708 (3.4%) were diagnosed with LCS. In a multivariate regression analysis, we identified lipid metabolism disorders (OR 1.46, 95% CI 1.28-1.65, p < 0.001) and obesity (OR 1.25, 95% CI 1.08-1.44, p = 0.003) as strong risk factors for the development of LCS. Besides these metabolic factors, patients' age between 46 and 60 years (compared to age ≤ 30, (OR 1.81 95% CI 1.54-2.13, p < 0.001), female sex (OR 1.33, 95% CI 1.20-1.47, p < 0.001) as well as pre-existing asthma (OR 1.67, 95% CI 1.39-2.00, p < 0.001) and depression (OR 1.27, 95% CI 1.09-1.47, p = < 0.002) in women, and cancer (OR 1.4, 95% CI 1.09-1.95, p = < 0.012) in men were associated with an increased likelihood of developing LCS. CONCLUSION: Lipid metabolism disorders and obesity represent age-independent risk factors for the development of LCS, suggesting that metabolic alterations determine the risk for unfavorable disease courses along all phases of COVID-19.

14.
J Transl Med ; 20(1): 138, 2022 03 22.
Article in English | MEDLINE | ID: covidwho-1759761

ABSTRACT

BACKGROUND: Fatigue, exertion intolerance and post-exertional malaise are among the most frequent symptoms of Post-COVID Syndrome (PCS), with a subset of patients fulfilling criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). As SARS-CoV-2 infects endothelial cells, causing endotheliitis and damaging the endothelium, we investigated endothelial dysfunction (ED) and endothelial biomarkers in patients with PCS. METHODS: We studied the endothelial function in 30 PCS patients with persistent fatigue and exertion intolerance as well as in 15 age- and sex matched seronegative healthy controls (HCs). 14 patients fulfilled the diagnostic criteria for ME/CFS. The other patients were considered to have PCS. Peripheral endothelial function was assessed by the reactive hyperaemia index (RHI) using peripheral arterial tonometry (PAT) in patients and HCs. In a larger cohort of patients and HCs, including post-COVID reconvalescents (PCHCs), Endothelin-1 (ET-1), Angiopoietin-2 (Ang-2), Endocan (ESM-1), IL-8, Angiotensin-Converting Enzyme (ACE) and ACE2 were analysed as endothelial biomarkers. RESULTS: Five of the 14 post-COVID ME/CFS patients and five of the 16 PCS patients showed ED defined by a diminished RHI (< 1.67), but none of HCs exhibited this finding. A paradoxical positive correlation of RHI with age, blood pressure and BMI was found in PCS but not ME/CFS patients. The ET-1 concentration was significantly elevated in both ME/CFS and PCS patients compared to HCs and PCHCs. The serum Ang-2 concentration was lower in both PCS patients and PCHCs compared to HCs. CONCLUSION: A subset of PCS patients display evidence for ED shown by a diminished RHI and altered endothelial biomarkers. Different associations of the RHI with clinical parameters as well as varying biomarker profiles may suggest distinct pathomechanisms among patient subgroups.


Subject(s)
COVID-19 , Fatigue Syndrome, Chronic , Biomarkers , COVID-19/complications , Endothelial Cells , Endothelium , Humans , SARS-CoV-2
15.
Z Rheumatol ; 2022 Mar 22.
Article in German | MEDLINE | ID: covidwho-1756798

ABSTRACT

BACKGROUND: While the first wave of the coronavirus disease 2019 (COVID-19) pandemic mainly affected the old, currently younger patients also become infected and hospitalized. After severe and critical COVID-19 infections and also after surviving acute phase symptoms, these patients often show symptoms (e.g. exertional dyspnea), organ damage (e.g. of the lungs, the cardiovascular system) as well as psychological impairments. OBJECTIVE: The severe courses after critical cases of COVID-19 represent challenges for rehabilitation and require more than ever rehabilitative treatment approaches even in acute hospitals. METHODS: This article presents a selected case series of patients with a typical constellation of pre-existing conditions due to immunosuppression plus critical course of COVID-19 and indications for acute rehabilitation. RESULTS: This case series depicts the long duration of hospitalization with high numbers of hours on ventilation in the intensive care unit. At the time of transfer to acute rehabilitation these patients are immobile and have severe limitations in all activities of daily life, so that an inpatient rehabilitation in an acute hospital is indicated and the usual means of continuation of rehabilitation were not feasible. The sequelae of lying prone and complications, such as exertional desaturation in the early stage of convalescence are detected in the acute phase of early rehabilitation. CONCLUSION: After severe COVID-19 infections new challenges for rehabilitation are to be expected, so that rehabilitative treatment approaches with an interdisciplinary early rehabilitation in an acute hospital are urgently needed. Finally, acute rehabilitation not only enables a seamless treatment chain for these patients but also the flow of patients from the intensive care unit to ensure the functioning of local infrastructures.

16.
Anal Bioanal Chem ; 2022 Mar 18.
Article in English | MEDLINE | ID: covidwho-1750681

ABSTRACT

There is an urgent need to have reliable technologies to diagnose post-coronavirus disease syndrome (PCS), as the number of people affected by COVID-19 and related complications is increasing worldwide. Considering the amount of risks associated with the two chronic lung diseases, asthma and chronic obstructive pulmonary disease (COPD), there is an immediate requirement for a screening method for PCS, which also produce symptoms similar to these conditions, especially since very often, many COVID-19 cases remain undetected because a good share of such patients is asymptomatic. Breath analysis techniques are getting attention since they are highly non-invasive methods for disease diagnosis, can be implemented easily for point-of-care applications even in primary health care centres. Electronic (E-) nose technology is coming up with better reliability, ease of operation, and affordability to all, and it can generate signatures of volatile organic compounds (VOCs) in exhaled breath as markers of diseases. The present report is an outcome of a pilot study using an E-nose device on breath samples of cohorts of PCS, asthma, and normal (control) subjects. Match/no-match and k-NN analysis tests have been carried out to confirm the diagnosis of PCS. The prediction model has given 100% sensitivity and specificity. Receiver operating characteristics (ROC) has been plotted for the prediction model, and the area under the curve (AUC) is obtained as 1. The E-nose technique is found to be working well for PCS diagnosis. Our study suggests that the breath analysis using E-nose can be used as a point-of-care diagnosis of PCS.Trial registrationBreath samples were collected from the Kasturba Hospital, Manipal. Ethical clearance was obtained from the Institutional Ethics Committee, Kasturba Medical College, Manipal (IEC 60/2021, 13/01/2021) and Indian Council of Medical Research (ICMR) (CTRI/2021/02/031357, 06/02/2021) Government of India; trials were prospectively registered.

17.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 65(4): 462-470, 2022 Apr.
Article in German | MEDLINE | ID: covidwho-1748536

ABSTRACT

Organ-specific sequelae after COVID-19 occur frequently and are highly diverse in their features. Sequelae and symptoms persisting for more than four weeks after COVID-19 define the condition "long COVID."Organ-specific sequelae of COVID-19 generally occur more often after severe disease. Yet, duration and intensity of organ-specific sequelae are highly variable. While pulmonary sequelae typically persist after more severe acute disease, COVID-19 sequelae may also develop weeks after infection and can affect any organ. The degree of SARS-CoV­2 specificity of COVID-19 sequelae, however, remains unclear. Thus, diagnosis and treatment of COVID-19 sequelae represent an interdisciplinary challenge. Diagnostic and therapeutic approaches are guided by type, extent, and cause of the specific sequelae as targeted therapy options for long COVID are lacking.In the present work, we review current knowledge regarding the prevalence/incidence, duration, specificity, type, and extent of organ-specific COVID-19 sequelae and summarize current diagnostic and therapeutic strategies (as of November 2021).


Subject(s)
COVID-19 , Adult , COVID-19/complications , Disease Progression , Germany , Humans , SARS-CoV-2
18.
J Transl Med ; 20(1): 129, 2022 03 16.
Article in English | MEDLINE | ID: covidwho-1745447

ABSTRACT

Autoimmunity has emerged as a characteristic of the post-COVID syndrome (PCS), which may be related to sex. In order to further investigate the relationship between SARS-CoV-2 and autoimmunity in PCS, a clinical and serological assessment on 100 patients was done. Serum antibody profiles against self-antigens and infectious agents were evaluated by an antigen array chip for 116 IgG and 104 IgM antibodies. Thirty pre-pandemic healthy individuals were included as a control group. The median age of patients was 49 years (IQR: 37.8 to 55.3). There were 47 males. The median post-COVID time was 219 (IQR: 143 to 258) days. Latent autoimmunity and polyautoimmunity were found in 83% and 62% of patients, respectively. Three patients developed an overt autoimmune disease. IgG antibodies against IL-2, CD8B, and thyroglobulin were found in more than 10% of the patients. Other IgG autoantibodies, such as anti-interferons, were positive in 5-10% of patients. Anti-SARS-CoV-2 IgG antibodies were found in > 85% of patients and were positively correlated with autoantibodies, age, and body mass index (BMI). Few autoantibodies were influenced by age and BMI. There was no effect of gender on the over- or under-expression of autoantibodies. IgG anti-IFN-λ antibodies were associated with the persistence of respiratory symptoms. In summary, autoimmunity is characteristic of PCS, and latent autoimmunity correlates with humoral response to SARS-CoV-2.


Subject(s)
Autoimmunity , COVID-19 , Adult , Antibodies, Viral/blood , Humans , Immunoglobulin M/blood , Male , Middle Aged , SARS-CoV-2
19.
Medicina (Kaunas) ; 58(3)2022 Mar 12.
Article in English | MEDLINE | ID: covidwho-1742544

ABSTRACT

Dyspnea, shortness of breath, and chest pain are frequent symptoms of post-COVID syndrome (PCS). These symptoms are unrelated to organ damage in most patients after mild acute COVID infection. Hyperventilation has been identified as a cause of exercise-induced dyspnea in PCS. Since there is a broad overlap in symptomatology with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), causes for dyspnea and potential consequences can be deduced by a stringent application of assumptions made for ME/CFS in our recent review papers. One of the first stimuli of respiration in exercise is caused by metabolic feedback via skeletal muscle afferents. Hyperventilation in PCS, which occurs early on during exercise, can arise from a combined disturbance of a poor skeletal muscle energetic situation and autonomic dysfunction (overshooting respiratory response), both found in ME/CFS. The exaggerated respiratory response aggravating dyspnea does not only limit the ability to exercise but further impairs the muscular energetic situation: one of the buffering mechanisms to respiratory alkalosis is a proton shift from intracellular to extracellular space via the sodium-proton-exchanger subtype 1 (NHE1), thereby loading cells with sodium. This adds to two other sodium loading mechanisms already operative, namely glycolytic metabolism (intracellular acidosis) and impaired Na+/K+ATPase activity. High intracellular sodium has unfavorable effects on mitochondrial calcium and metabolism via sodium-calcium-exchangers (NCX). Mitochondrial calcium overload by high intracellular sodium reversing the transport mode of NCX to import calcium is a key driver for fatigue and chronification. Prevention of hyperventilation has a therapeutic potential by keeping intracellular sodium below the threshold where calcium overload occurs.


Subject(s)
COVID-19 , Fatigue Syndrome, Chronic , COVID-19/complications , Dyspnea/etiology , Exercise , Fatigue Syndrome, Chronic/etiology , Fatigue Syndrome, Chronic/therapy , Humans , Sodium
20.
Curr Pain Headache Rep ; 2022 Mar 10.
Article in English | MEDLINE | ID: covidwho-1734056

ABSTRACT

Although the number of SARS-CoV-2 new cases may be declining due to the implementation of the vaccine in the USA, there is a rising cohort of people with long-term effects from the virus. These long-term effects include loss of taste, heart palpitations, and chronic pain syndromes. In this commentary, we assess the current literature to appraise the knowledge of long-term COVID-19 effects related to long-term pain syndromes including testicular pain, headache, chronic pain, and chest pain.

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