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Long COVID: mechanisms, risk factors and recovery.
Astin, Rónan; Banerjee, Amitava; Baker, Mark R; Dani, Melanie; Ford, Elizabeth; Hull, James H; Lim, Phang Boon; McNarry, Melitta; Morten, Karl; O'Sullivan, Oliver; Pretorius, Etheresia; Raman, Betty; Soteropoulos, Demetris S; Taquet, Maxime; Hall, Catherine N.
  • Astin R; Department of Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
  • Banerjee A; Centre for Human Health and Performance, Institute for Sport Exercise and Health, University College London, London, UK.
  • Baker MR; Institute of Health Informatics, University College London, London, UK.
  • Dani M; Department of Cardiology, Barts Health NHS Trust, London, UK.
  • Ford E; Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
  • Hull JH; Imperial Syncope Unit, Imperial College Healthcare NHS Trust, London, UK.
  • Lim PB; Brighton and Sussex Medical School, Falmer, UK.
  • McNarry M; Institute of Sport, Exercise and Health (ISEH), Division of Surgery and Interventional Science, University College London, London, UK.
  • Morten K; Royal Brompton Hospital, London, UK.
  • O'Sullivan O; Imperial Syncope Unit, Imperial College Healthcare NHS Trust, London, UK.
  • Pretorius E; Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK.
  • Raman B; Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, UK.
  • Soteropoulos DS; Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.
  • Taquet M; Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Stanford Hall, Loughborough, UK.
  • Hall CN; School of Medicine, University of Nottingham, Nottingham, UK.
Exp Physiol ; 2022 Nov 22.
Article in English | MEDLINE | ID: covidwho-2227711
ABSTRACT
NEW

FINDINGS:

What is the topic of this review? The emerging condition of long COVID, its epidemiology, pathophysiological impacts on patients of different backgrounds, physiological mechanisms emerging as explanations of the condition, and treatment strategies being trialled. The review leads from a Physiological Society online conference on this topic. What advances does it highlight? Progress in understanding the pathophysiology and cellular mechanisms underlying Long COVID and potential therapeutic and management strategies. ABSTRACT Long COVID, the prolonged illness and fatigue suffered by a small proportion of those infected with SARS-CoV-2, is placing an increasing burden on individuals and society. A Physiological Society virtual meeting in February 2022 brought clinicians and researchers together to discuss the current understanding of long COVID mechanisms, risk factors and recovery. This review highlights the themes arising from that meeting. It considers the nature of long COVID, exploring its links with other post-viral illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome, and highlights how long COVID research can help us better support those suffering from all post-viral syndromes. Long COVID research started particularly swiftly in populations routinely monitoring their physical performance - namely the military and elite athletes. The review highlights how the high degree of diagnosis, intervention and monitoring of success in these active populations can suggest management strategies for the wider population. We then consider how a key component of performance monitoring in active populations, cardiopulmonary exercise training, has revealed long COVID-related changes in physiology - including alterations in peripheral muscle function, ventilatory inefficiency and autonomic dysfunction. The nature and impact of dysautonomia are further discussed in relation to postural orthostatic tachycardia syndrome, fatigue and treatment strategies that aim to combat sympathetic overactivation by stimulating the vagus nerve. We then interrogate the mechanisms that underlie long COVID symptoms, with a focus on impaired oxygen delivery due to micro-clotting and disruption of cellular energy metabolism, before considering treatment strategies that indirectly or directly tackle these mechanisms. These include remote inspiratory muscle training and integrated care pathways that combine rehabilitation and drug interventions with research into long COVID healthcare access across different populations. Overall, this review showcases how physiological research reveals the changes that occur in long COVID and how different therapeutic strategies are being developed and tested to combat this condition.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Long Covid Language: English Journal subject: Physiology Year: 2022 Document Type: Article Affiliation country: EP090802

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Long Covid Language: English Journal subject: Physiology Year: 2022 Document Type: Article Affiliation country: EP090802