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1.
Int Immunopharmacol ; 113(Pt B): 109428, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2095518

ABSTRACT

Coronavirus disease 2019 (COVID-19) outbreak has become a global public health emergency and has led to devastating results. Mounting evidence proposes that the disease causes severe pulmonary involvement and influences different organs, leading to a critical situation named multi-organ failure. It is yet to be fully clarified how the disease becomes so deadly in some patients. However, it is proven that a condition called "cytokine storm" is involved in the deterioration of COVID-19. Although beneficial, sustained production of cytokines and overabundance of inflammatory mediators causing cytokine storm can lead to collateral vital organ damages. Furthermore, cytokine storm can cause post-COVID-19 syndrome (PCS), an important cause of morbidity after the acute phase of COVID-19. Herein, we aim to explain the possible pathophysiology mechanisms involved in COVID-19-related cytokine storm and its association with multi-organ failure and PCS. We also discuss the latest advances in finding the potential therapeutic targets to control cytokine storm wishing to answer unmet clinical demands for treatment of COVID-19.

2.
JMIR Form Res ; 6(10): e36656, 2022 Oct 25.
Article in English | MEDLINE | ID: covidwho-2089627

ABSTRACT

BACKGROUND: Although the mental health impacts of COVID-19 on the general population have been well studied, studies of the long-term impacts of COVID-19 on infected individuals are relatively new. To date, depression, anxiety, and neurological symptoms associated with post-COVID-19 syndrome (PCS) have been observed in the months following COVID-19 recovery. Suicidal thoughts and behavior (STB) have also been preliminarily proposed as sequelae of COVID-19. OBJECTIVE: We asked 3 questions. First, do participants reporting a history of COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher on depression (Patient Health Questionnaire-9 [PHQ-9]) or state anxiety (State Trait Anxiety Index) screens than those who do not? Second, do participants reporting a COVID-19 diagnosis score higher on PCS-related PHQ-9 items? Third, do participants reporting a COVID-19 diagnosis or a close relative having severe COVID-19 symptoms score higher in STB before, during, or after the first year of the pandemic? METHODS: This preliminary study analyzed responses to a COVID-19 and mental health questionnaire obtained from a US population sample, whose data were collected between February 2021 and March 2021. We used the Mann-Whitney U test to detect differences in the medians of the total PHQ-9 scores, PHQ-9 component scores, and several STB scores between participants claiming a past clinician diagnosis of COVID-19 and those denying one, as well as between participants claiming severe COVID-19 symptoms in a close relative and those denying them. Where significant differences existed, we created linear regression models to predict the scores based on COVID-19 response as well as demographics to identify potential confounding factors in the Mann-Whitney relationships. Moreover, for STB scores, which corresponded to 5 questions asking about 3 different time intervals (i.e., past 1 year or more, past 1 month to 1 year, and past 1 month), we developed repeated-measures ANOVAs to determine whether scores tended to vary over time. RESULTS: We found greater total depression (PHQ-9) and state anxiety (State Trait Anxiety Index) scores in those with COVID-19 history than those without (Bonferroni P=.001 and Bonferroni P=.004) despite a similar history of diagnosed depression and anxiety. Greater scores were noted for a subset of depression symptoms (PHQ-9 items) that overlapped with the symptoms of PCS (all Bonferroni Ps<.05). Moreover, we found greater overall STB scores in those with COVID-19 history, equally in time windows preceding, during, and proceeding infection (all Bonferroni Ps<.05). CONCLUSIONS: We confirm previous studies linking depression and anxiety diagnoses to COVID-19 recovery. Moreover, our findings suggest that depression diagnoses associated with COVID-19 history relate to PCS symptoms, and that STB associated with COVID-19 in some cases precede infection.

3.
Front Med (Lausanne) ; 9: 1017257, 2022.
Article in English | MEDLINE | ID: covidwho-2080187

ABSTRACT

Background: Post-COVID-19 Syndrome (PCS) is characterized by residual symptoms following the initial recovery from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The prevalence of PCS is known to be the highest among severe and critical forms of the disease. However, the occurrence and risk factors for PCS after mild or moderate SARS-CoV-2 infection has not been extensively investigated. Methods: Online and offline via both paper or mailed questionnaires distributed among Jordan collected between 1st and 21st August 2021, including a total number of 800 respondents, of whom 495 had previous mild to moderate COVID-19 infection. The Newcastle post-COVID syndrome Follow-up Screening Questionnaire was modified, translated, and used as a standard instrument for data collection regarding psychological, medical, and socio-economic symptoms post-infection. The primary outcome was the prevalence of PCS after mild to moderate COVID-19 in Jordan. Secondary outcome was the identification of PCS risk factors. Results: The most common PCS symptom was mood disturbance followed by fatigue, anxiety, and myalgia. Female gender significantly increased the risk for multiple PCS symptoms. Age < 30 years was found to be an independent risk factor for myalgia (p = 0.001). Conclusion: PCS is highly prevalent among COVID-19 survivors in Jordan, especially in females and patients with comorbidities. Planning physical and mental rehabilitation services is recommended for those patients with PCS symptoms after mild to moderate COVID-19 infection.

4.
Pathogens ; 11(10)2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2071677

ABSTRACT

Due to the presence of the ACE2 receptor in different tissues (nasopharynx, lung, nervous tissue, intestine, liver), the COVID-19 disease involves several organs in our bodies. SARS-CoV-2 is able to infect different cell types, spreading to different districts. In the host, an uncontrolled and altered immunological response is triggered, leading to cytokine storm, lymphopenia, and cellular exhaustion. Hence, respiratory distress syndrome (ARDS) and systemic multi-organ dysfunction syndrome (MODS) are established. This scenario is also reflected in the composition of the microbiota, the balance of which is regulated by the interaction with the immune system. A change in microbial diversity has been demonstrated in COVID-19 patients compared with healthy donors, with an increase in potentially pathogenic microbial genera. In addition to other symptoms, particularly neurological, the occurrence of dysbiosis persists after the SARS-CoV-2 infection, characterizing the post-acute COVID syndrome. This review will describe and contextualize the role of the immune system in unbalance and dysbiosis during SARS-CoV-2 infection, from the acute phase to the post-COVID-19 phase. Considering the tight relationship between the immune system and the gut-brain axis, the analysis of new, multidistrict parameters should be aimed at understanding and addressing chronic multisystem dysfunction related to COVID-19.

5.
Int J Environ Res Public Health ; 19(20)2022 Oct 11.
Article in English | MEDLINE | ID: covidwho-2071408

ABSTRACT

A substantial number of patients report persisting symptoms after a COVID-19 infection: so-called post-COVID-19 syndrome. There is limited research on patients' perspectives on post-COVID-19 symptoms and ways to recover. This qualitative study explored the illness perceptions and recovery strategies of patients who had been hospitalised for COVID-19. Differences between recovered and non-recovered patients were investigated. Semi-structured in-depth interviews were held with 24 participating patients (8 recovered and 16 non-recovered) 7 to 12 months after hospital discharge. Data were interpreted using reflexive thematic analysis. Four overarching themes were identified: (I) symptoms after hospital discharge; (II) impact of COVID-19 on daily life and self-identity; (III) uncertainty about COVID-19; and (IV) dealing with COVID-19. Formerly hospitalised post-COVID-19 patients seem to have difficulties with making sense of their illness and gaining control over their recovery. The majority of non-recovered participants continue to suffer mostly from weakness or fatigue, dyspnoea and cognitive dysfunction. No notable differences in illness beliefs were observed between recovered and non-recovered participants.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Fatigue , Qualitative Research
6.
SAGE Open Med ; 10: 20503121221129918, 2022.
Article in English | MEDLINE | ID: covidwho-2064698

ABSTRACT

A substantial number of COVID-19 survivors describe ongoing symptoms long after the acute phase. This so-called post-COVID-19 syndrome or long COVID occurs irrespective of initial disease severity. Objectives: This cross-sectional study aims to describe and characterise the prevalence of persistent COVID-19 symptoms beyond three months and to evaluate the risk factors for the delayed return to the usual state of health. Methods: An electronic survey was developed, piloted, and conducted during the first wave of the COVID-19 pandemic. The survey consisted of questions exploring socio-demographic data, comorbidities, COVID-19 disease (diagnosis, presenting symptoms, management, and persistent symptoms), and the return to the usual state of health. Participants were users of social media platforms. We received results from 746 respondents. One hundred thirty-six responses were excluded due to a self-diagnosis of COVID-19. Respondents reporting a COVID-19 diagnosis 3 months or more prior to the study (N = 213) were included in the analysis. Predictors of the delayed return to the usual state of health were identified by logistic regression. Results: Three months or more after a COVID-19 diagnosis, almost half of the respondents, 109 (51.2%), had residual symptoms. The five most prevalent persistent symptoms were fatigue (13.6%), altered sense of smell (12.7%), muscle aches (10.3%), headache (9.9%), and body aches (8.5%). When questioned regarding the return to baseline health, 152 (71.4%) answered in the affirmative. The total number of chronic medical conditions was determined as a statistically significant predictor for the delayed return to the usual state of health. Conclusion: Three months or more after acute COVID-19 infection, 5 out of 10 survivors experienced persistent symptoms, and 3 out of 10 reported a delayed return to baseline health. Considering the overall burden of COVID-19 disease, this can pose health and socio-economic challenges. Therefore, health systems need support in managing long COVID and improving long-term COVID-19 outcomes.

7.
World J Methodol ; 12(4): 235-245, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-2056137

ABSTRACT

We have been experiencing multiple waves of the coronavirus disease 2019 (COVID-19) pandemic. With these unprecedented waves, we have entered into an era of 'new normal'. This pandemic has enforced us to rethink the very basics of childhood learning: Habits, health etiquette, and hygiene. Rehabilitation has immense importance during this pandemic considering a few aspects. Multidisciplinary COVID-19 rehabilitation clinics are essential to address the demand. The equitable distribution of COVID-19 rehabilitation services for differently-abled individuals during the pandemic is an important aspect. Rehabilitation needs identification and further studies on various rehabilitation interventions are among the key unmet future research needs.

8.
World J Methodol ; 12(4): 224-234, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-2056136

ABSTRACT

The pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2019-2022 leads to a multisystem illness that results in damage to numerous organ systems. In this review, our goal was to assess current research on long-term respiratory, cardiac, neurological, digestive, rheumatological, urogenital, and dermatological system complications of coronavirus disease 2019 (COVID-19). Bibliographic searches were conducted in December 2021 using PubMed and Google Scholar, retrospectively, covering all COVID-19 literature to determine the consequences of the disease. This review may help to determine the prospects for new studies and predict the upcoming aspects requiring assessment in post-COVID-19 syndrome.

10.
J Popul Ther Clin Pharmacol ; 29(3): e123-e133, 2022.
Article in English | MEDLINE | ID: covidwho-2044393

ABSTRACT

BACKGROUND: Long-term effects of the disease were founded and described as post-COVID-19 syndrome post-COVID syndrome are the symptoms that develop and last for four weeks or even months and cannot be explained by an alternative diagnosis; symptoms may remain for >3 months. The cause of persistent symptoms is unclear. Objectives: This study aimed to Estimate the prevalence of residual symptoms among a sample of people infected with COVID-19 who survived and recovered in Erbil city and to find out the relation between the severity of the disease and post-COVID-19 syndrome. And to know the incidence of post-COVID-19 syndrome in chronic disease patients. PATIENTS AND METHODS: This cross-sectional study was conducted in 6 primary health care centers in 6 municipalities in Erbil city, Kurdistan region, Iraq. A convenience sample of randomly selected 300 patients was involved in the study depending on inclusion criteria. For one year, starting from March 1, 2021, until the end of February 2022. RESULTS: The prevalence of post-COVID syndrome among the 300 cases was 54.67%. Of these cases, 11.7% had one symptom, 26% had two signs, and 17% had with three or more symptoms. There was a significant statistical association between persistent symptoms and the severity of COVID-19. Also, there was a substantial statistical association between persistent symptoms and chronic disease, most (67.9%) respondents with post-COVID-19 syndromes suffered from chronic disease, and the p-value was 0.001. There was a significant statistical association between persistent symptoms and disease duration; most (73%) of cases with post-COVID-19 syndrome got the disease from 7 to 14 days, while 54.5% of them struggled with COVID-19 for >14 days. CONCLUSION: Most people who have recovered from COVID-19 have many long-lasting symptoms that make it hard to go about their daily lives. This is now called a post-COVID syndrome. Getting to this status could have been caused by several things. Age, gender, whether a person has a chronic disease, disease severity, and duration are all things to consider, Even though all COVID-19 victims should be kept an eye on for long-term evaluation and treatment of post-COVID symptoms.


Subject(s)
COVID-19 , COVID-19/complications , COVID-19/epidemiology , Cities , Cross-Sectional Studies , Humans , Prevalence
11.
Environ Sci Pollut Res Int ; 2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2041313

ABSTRACT

European Association of Spa Rehabilitation (ESPA) recommends spa rehabilitation for patients with post-COVID-19 syndrome. We tested the hypothesis that a high-altitude environment with clean air and targeted spa rehabilitation (MR - mountain spa rehabilitation) can contribute to the improving platelet mitochondrial bioenergetics, to accelerating patient health and to the reducing socioeconomic problems. Fifteen healthy volunteers and fourteen patients with post-COVID-19 syndrome were included in the study. All parameters were determined before MR (MR1) and 16-18 days after MR (MR2). Platelet mitochondrial respiration and OXPHOS were evaluated using high resolution respirometry method, coenzyme Q10 level was determined by HPLC, and concentration of thiobarbituric acid reactive substances (TBARS) as a parameter of lipid peroxidation was determined spectrophotometrically. This pilot study showed significant improvement of clinical symptoms, lungs function, and regeneration of reduced CI-linked platelet mitochondrial respiration after MR in patients with post-COVID-19 syndrome. High-altitude environment with spa rehabilitation can be recommended for the acceleration of recovery of patients with post-COVID-19 syndrome.

12.
Vestnik Vosstanovitel'noj Mediciny ; 21(3):9-23, 2022.
Article in Russian | Scopus | ID: covidwho-2040697

ABSTRACT

Aim. To investigate the prevalence of clinical manifestations of post-coronavirus syndrome and evaluate the effectiveness of medical rehabilitation course in patients after new coronavirus infection (COVID-19) in a day care hospital, taking into account the severity of the disease course. Material and methods. At the first stage of the study, 203 residents of the Ivanovo region (140 women and 63 men) aged 40 to 80 years who had a new coronavirus infection, who had no more than one year since the onset of the disease, were surveyed on the basis of the Ivanovo State Medical Academy (ISMA) of the Ministry of Health of Russia. For this purpose, “COVID-19 Yorkshire Rehabilitation Screening (C19-YRS)” telephone screening questionnaire was used, developed by groups of rehabilitation therapists from the training medical centers of the National Health Service of Great Britain to identify multisystem functional disorders of patients who have suffered a new coronavirus infection, and to address the need for rehabilitation intervention. At the second stage, 54 patients (38 women and 16 men) aged 29-81 years were examined, who were admitted to the 3rd stage of rehabilitation in the department of medical rehabilitation of patients with somatic diseases of the ISMA Clinic after suffering a new coronavirus infection COVID-19. Among them, 3 groups were formed depending on the severity of the infection: 16 patients with a mild course of the disease made up the 1st group, 20 patients who had a moderate course of coronavirus infection - the 2nd group, 18 patients with a severe course of COVID-19 - 3rd group. Results. The questionnaire showed that COVID-19 survivors had a multisystem decrease in functioning, which was maximally pronounced during the first month from the onset of the disease and did not return to the baseline level for 6-12 months. The most significant disturbances occurred with patients who, due to the severity of the condition, were treated in a hospital. The most lasting symptoms were impaired exercise tolerance and increased fatigue, which had a significant impact on daily life. In patients admitted for rehabilitation, functional impairments and disabilities were detected regardless of the severity of the course of the new coronavirus infection (COVID-19). In patients with a mild course of infection, they were manifested mainly by decreased tolerance to physical load, frequent disorders of sleep function, emotions, volitional and motivational functions, in some patients - by mild disorders of respiratory function and cognitive impairment in the form of reduced volume of cranio-temporal memory. In patients with moderate and severe COVID-19, against the background of impaired exercise tolerance function, sleep function, emotions, volitional and motivational functions, we mainly detected moderate and pronounced respiratory disorders, cognitive disorders, which were manifested by decreased short-term memory and attention concentration, increased attention exhaustion, and bradyphrenia. The functional disorders detected in patients primarily led to limitation of their mobility in the form of walking for long distances, ability to self-care and household activities, ability to work, which before the disease did not cause difficulties for patients. Study of the indexes in dynamics showed the effectiveness of rehabilitation measures in improving the functions, regardless of the severity of the course of coronavirus infection. Conclusion. The findings of the present study justify the necessity of early complex rehabilitation of patients by multidisciplinary rehabilitation team taking into account individually detected functional impairment. Individual rehabilitation program should be developed for each patient taking into account the revealed problems on the basis of problem-oriented approach. © 2022 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.

14.
Br J Hosp Med (Lond) ; 83(8): 1-5, 2022 Aug 02.
Article in English | MEDLINE | ID: covidwho-2025626

ABSTRACT

The COVID-19 illness trajectory involves persistent cardio-renal inflammation, activation of the haemostatic pathway and lung involvement. Results of a study carried out by the authors' team demonstrate a link between post-COVID-19 syndrome (people who have long COVID) and multisystem disease, which partly explains the lingering impairments in patient-reported health-related quality of life, physical function and psychological wellbeing after COVID-19. This article discusses what hospital physicians need to be aware of when considering the likelihood of myocarditis in patients with post-COVID-19 syndrome and the implications in the longer term.


Subject(s)
COVID-19 , COVID-19/complications , Heart , Humans , Quality of Life , SARS-CoV-2
15.
Meditsinskiy Sovet ; 2022(14):193-199, 2022.
Article in Russian | Scopus | ID: covidwho-2026184

ABSTRACT

Introduction. The COVID-19 pandemic has become a global health problem worldwide. The consequences of the new coronavirus infection continue to be studied. Cardiovascular symptoms and sleep disorders are among the dominant complaints in post-COVID-19 syndrome in women. Aim. To assess sleep disorders, cardiovascular symptoms, body weight dynamics and their statistical relationships in women with post-COVID-19 syndrome. Materials and methods. Using a voluntary anonymous questionnaire, we assessed cardiovascular symptoms, body weight dynamics and sleep disorders in 253 women of different age groups who had COVID-19 at least 12 weeks ago. The severity of dyspnea was assessed using the mMRC (Modified Medical Research Council) scale. Resting heart rate was measured. Statistical processing of the obtained data was carried out using the StatPlus 2009 Professional program. Results and discussion. Among the manifestations of the cardiovascular system in post-COVID-19 syndrome in women of different age groups, palpitations, shortness of breath, and increased blood pressure predominate. There is a statistical pattern in the increased prevalence of rises in blood pressure in post-COVID-19 syndrome among women, depending on age. A variety of sleep disorders occur in all age groups of women, most often in the group of older women. Statistical relationships between sleep disorders and increased blood pressure, severity of dyspnea, palpitations in post-COVID-19 syndrome in women of different age groups were revealed. Severe dyspnea in post-COVID-19 syndrome was frequent noticed in older women. Weight loss in women with post-COVID-19 syndrome is associated with sleep disorders. Conclusions. Cardiovascular symptoms and sleep disorders in post-COVID-19 syndrome in women of different age groups are closely interrelated. The management of patients in post-COVID-19 syndrome should be carried out taking into account the diver-sity and interaction of various clinical manifestations. Correction of the identified violations should be comprehensive, based on an interdisciplinary approach of various specialists. © 2022, Remedium Group Ltd. All rights reserved.

16.
Front Immunol ; 13: 920627, 2022.
Article in English | MEDLINE | ID: covidwho-2022711

ABSTRACT

Background: The pathophysiology of long-COVID remains unknown, and information is particularly limited for symptoms of very long duration. We aimed to assess the serological, T-cell immune responses and ANA titers of patients with long-COVID-19 syndrome of 1-year duration. Methods: Prospective, longitudinal study of hospitalized COVID-19 patients followed-up for 12 months. Sequential blood samples and COVID-19 symptom questionnaires (CSQ) were obtained, and humoral and cellular immune responses, antinuclear antibodies (ANA) and inflammation biomarkers were analyzed. Results: Of 154 patients discharged from hospital, 72 non-vaccinated with available CSQ in all visits were included. Of them, 14 (19.4%) reported persistent symptoms both at 6-months and 12-months, mainly asthenia (15.3%), myalgia (13.9%), and difficulty concentrating/memory loss (13.9%). Symptomatic patients were more frequently women, smokers, showed higher WHO severity score, and a trend to higher ICU admission. In the adjusted analysis, long-COVID syndrome was associated with lower frequency of detectable neutralizing antibodies (adjusted hazard ratio [aHR] 0.98; 95% confidence interval [CI], 0.97-0.99) and lower SARS-CoV-2-S1/S2 titers (aHR [95%CI] 0.14 [0.03-0.65]). T-cell immune response measured with a SARS-CoV-2-interferon-γ release assay was not different between groups. There was a higher frequency of positive ANA titers (≥160) in symptomatic patients (57.1% vs 29.3%, p=0.04), that was attenuated after adjustment aHR [95% CI] 3.37 [0.84-13.57], p=0.087. Levels of C-reactive protein and D-dimer were higher during follow-up in symptomatic patients, but with no differences at 12 months. Conclusion: Patients with 1-year duration long-COVID-19 syndrome exhibit a distinct immunologic phenotype that includes a poorer SARS-CoV-2 antibody response, low-degree chronic inflammation that tends to mitigate, and autoimmunity.


Subject(s)
COVID-19 , COVID-19/complications , Female , Humans , Inflammation , Longitudinal Studies , Phenotype , Prospective Studies , SARS-CoV-2 , Viral Envelope Proteins
17.
J Cardiovasc Magn Reson ; 24(1): 50, 2022 09 12.
Article in English | MEDLINE | ID: covidwho-2021309

ABSTRACT

BACKGROUND: The underlying pathophysiology of post-coronavirus disease 2019 (long-COVID-19) syndrome remains unknown, but increased cardiometabolic demand and state of mitochondrial dysfunction have emerged as candidate mechanisms. Cardiovascular magnetic resonance (CMR) provides insight into pathophysiological mechanisms underlying cardiovascular disease and 31-phosphorus CMR spectroscopy (31P-CMRS) allows non-invasive assessment of the myocardial energetic state. The main aim of the study was to assess whether long COVID-19 syndrome is associated with abnormalities of myocardial structure, function, perfusion and energy metabolism. METHODS: Prospective case-control study. A total of 20 patients with a clinical diagnosis of long COVID-19 syndrome (seropositive) and no prior underlying cardiovascular disease (CVD) and 10 matching healthy controls underwent 31P-CMRS and CMR at 3T at a single time point. All patients had been symptomatic with acute COVID-19, but none required hospital admission. RESULTS: Between the long COVID-19 syndrome patients and matched contemporary healthy controls there were no differences in myocardial energetics (phosphocreatine to ATP ratio), in cardiac structure (biventricular volumes), function (biventricular ejection fractions, global longitudinal strain), tissue characterization (T1 mapping and late gadolinium enhancement) or perfusion (myocardial rest and stress blood flow, myocardial perfusion reserve). One patient with long COVID-19 syndrome showed subepicardial hyperenhancement on late gadolinium enhancement imaging compatible with prior myocarditis, but no accompanying abnormality in cardiac size, function, perfusion, extracellular volume fraction, native T1, T2 or cardiac energetics. CONCLUSIONS: In this prospective case-control study, the overwhelming majority of patients with a clinical long COVID-19 syndrome with no prior CVD did not exhibit any abnormalities in myocardial energetics, structure, function, blood flow or tissue characteristics.


Subject(s)
COVID-19 , Myocarditis , COVID-19/complications , Case-Control Studies , Contrast Media , Gadolinium , Humans , Magnetic Resonance Imaging , Predictive Value of Tests , Spectrum Analysis
18.
Viruses ; 14(9)2022 08 28.
Article in English | MEDLINE | ID: covidwho-2006222

ABSTRACT

BACKGROUND: The adaptive antiviral immune response requires interaction between CD8+ T cells, dendritic cells, and Th1 cells for controlling SARS-CoV-2 infection, but the data regarding the role of CD8+ T cells in the acute phase of COVID-19 and post-COVID-19 syndrome are still limited. METHODS: . Peripheral blood samples collected from patients with acute COVID-19 (n = 71), convalescent subjects bearing serum SARS-CoV-2 N-protein-specific IgG antibodies (n = 51), and healthy volunteers with no detectable antibodies to any SARS-CoV-2 proteins (HC, n = 46) were analyzed using 10-color flow cytometry. RESULTS: Patients with acute COVID-19 vs. HC and COVID-19 convalescents showed decreased absolute numbers of CD8+ T cells, whereas the frequency of CM and TEMRA CD8+ T cells in acute COVID-19 vs. HC was elevated. COVID-19 convalescents vs. HC had increased naïve and CM cells, whereas TEMRA cells were decreased compared to HC. Cell-surface CD57 was highly expressed by the majority of CD8+ T cells subsets during acute COVID-19, but convalescents had increased CD57 on 'naïve', CM, EM4, and pE1 2-3 months post-symptom onset. CXCR5 expression was altered in acute and convalescent COVID-19 subjects, whereas the frequencies of CXCR3+ and CCR4+ cells were decreased in both patient groups vs. HC. COVID-19 convalescents had increased CCR6-expressing CD8+ T cells. Moreover, CXCR3+CCR6- Tc1 cells were decreased in patients with acute COVID-19 and COVID-19 convalescents, whereas Tc2 and Tc17 levels were increased compared to HC. Finally, IL-27 negatively correlated with the CCR6+ cells in acute COVID-19 patients. CONCLUSIONS: We described an abnormal CD8+ T cell profile in COVID-19 convalescents, which resulted in lower frequencies of effector subsets (TEMRA and Tc1), higher senescent state (upregulated CD57 on 'naïve' and memory cells), and higher frequencies of CD8+ T cell subsets expressing lung tissue and mucosal tissue homing molecules (Tc2, Tc17, and Tc17.1). Thus, our data indicate that COVID-19 can impact the long-term CD8+ T cell immune response.


Subject(s)
COVID-19 , Interleukin-27 , Antiviral Agents/metabolism , CD8-Positive T-Lymphocytes , COVID-19/complications , Humans , Immunoglobulin G , SARS-CoV-2
19.
J Clin Med ; 11(17)2022 Aug 31.
Article in English | MEDLINE | ID: covidwho-2006094

ABSTRACT

Patients with "post-COVID" syndrome manifest with a variety of signs and symptoms that continue/develop after acute COVID-19. Among the most common are gastrointestinal (GI) and mental symptoms. The reason for symptom occurrence lies in the SARS-CoV-2 capability of binding to exact receptors, among other angiotensin converting enzyme 2 (ACE2) receptors in gastrointestinal lining and neuropilin-1 (NRP-1) in the nervous system, which leads to loss of gastrointestinal and blood-brain barriers integrity and function. The data are mounting that SARS-CoV-2 can trigger systemic inflammation and lead to disruption of gut-brain axis (GBA) and the development of disorders of gut brain interaction (DGBIs). Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most common DGBIs syndromes. On the other hand, emotional disorders have also been demonstrated as DGBIs. Currently, there are no official recommendations or recommended procedures for the use of probiotics in patients with COVID-19. However, it can be assumed that many doctors, pharmacists, and patients will want to use a probiotic in the treatment of this disease. In such cases, strains with documented activity should be used. There is a constant need to plan and conduct new trials on the role of probiotics and verify their clinical efficacy for counteracting the negative consequences of COVID-19 pandemic. Quality control is another important but often neglected aspect in trials utilizing probiotics in various clinical entities. It determines the safety and efficacy of probiotics, which is of utmost importance in patients with post-acute COVID-19 syndrome.

20.
Infect Dis (Lond) ; 54(12): 897-908, 2022 12.
Article in English | MEDLINE | ID: covidwho-2004938

ABSTRACT

BACKGROUND: ABO blood group system modulates the inflammatory response and has been implicated in COVID-19. Group O protects against SARS-CoV-2 infection, but there are no data regarding post-COVID-19 syndrome (PCS). Our aim was to assess this possible association. METHODS: Case-control study in a community setting, with subjects who had experienced mild COVID-19. Cases were PCS+, controls were PCS-, and the exposure variable, group O. We collected age, sex, BMI, smoking, comorbidities, inflammatory markers, anti-SARS-CoV-2 IgG antibodies, blood type and clinical data. Five composite inflammatory indices were developed. Multivariate analyses were performed. RESULTS: We analysed 121 subjects (56.2% women), mean age 45.7 ± 16 years. Blood group frequencies were 41.5%, 7.9%, 5.9%, and 44.5% for A, B, AB and O, respectively. Thirty-six patients were PCS+, without significant differences between cases and controls. Compared to non-O, a higher prevalence of PCS (p = .036), and number of symptoms of PCS (p = .017) were noted in group O. Concerning biomarkers, PCS + and PCS- showed no differences in A, B, and AB groups. In contrast, group O PCS + patients had significantly lower albumin-to-globulin ratio and higher lymphocyte count, fibrinogen, CRP levels, and higher percentages of 3 composite indices, than PCS- subjects. Group O showed a 6-fold increased risk of PCS, compared to non-O (adjusted OR = 6.25 [95%CI, 1.6-23]; p = .007). CONCLUSIONS: Group O has shown a consistent relationship with PCS, characterised by a more intense inflammatory burden than the other blood groups. Blood group O could be part of the immunological link between acute COVID-19 and PCS.


Subject(s)
COVID-19 , Humans , Female , Adult , Middle Aged , Male , COVID-19/epidemiology , ABO Blood-Group System , Case-Control Studies , Outpatients , Retrospective Studies , SARS-CoV-2 , Antibodies, Viral , Comorbidity , Immunoglobulin G , Biomarkers , Fibrinogen , Albumins
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