Post-COVID aus pneumologischer Sicht

2021 ◽  
Vol 146 (23) ◽  
pp. 1559-1563
Author(s):  
Inga Jarosch ◽  
Daniela Leitl ◽  
Andreas Rembert Koczulla

Was ist neu? Pulmonale Manifestation Eine Mehrheit der COVID-19-Erkrankten leidet 6 Monate nach akuter Erkrankung an Spätfolgen. Dyspnoe gehört zu den häufigsten Symptomen und geht oft mit pathologischen Veränderungen der Lunge einher. Husten und Schlafstörungen finden sich ebenfalls häufig in der postakuten Phase. Die Abnormalitäten der Lunge und die damit verbundenen Symptome zeigen mit der Zeit enorme Verbesserungen. Schlaf bei Post-COVID Nach COVID-19-Erkrankung zeigt der Schlaf vieler Betroffener Auffälligkeiten. Insbesondere die REM-Schlafphase (REM = Rapid Eye Movement) zeigt Störungen, die zu häufigem Erwachen in der Nacht unqd zu Tagesmüdigkeit führen. Das chronische Fatigue-Syndrom (CFS), das als Folge einer viralen Infektion auftreten kann, kann sich durch die Therapie von Schlafstörungen verbessern. Belastungsspezifische Besonderheiten In der postakuten Krankheitsphase haben viele Patienten eine eingeschränkte körperliche Leistungsfähigkeit. Ursachen für eine reduzierte körperliche Belastbarkeit können Anämie, eingeschränkte Sauerstoffextraktion und myopathische Veränderungen sein. Pneumologische Rehabilitation In der Postakutphase einer COVID-19-Erkrankung ist eine pneumologische Rehabilitation machbar, sicher und effektiv und führt zu signifikanten Verbesserungen in der körperlichen Belastbarkeit und Lungenfunktion. Eine Rehabilitation kann die Langzeitfolgen einer COVID-19-Erkrankung positiv beeinflussen und scheint unabhängig vom Schweregrad wirksam zu sein. Medikamentöse Therapie: Kortikosteroide COVID-19-Erkrankte mit neu erworbener und anhaltender interstitieller Lungenerkrankung sollten keine systemischen Kortikosteroide oder Antifibrotika erhalten, da die Datenlage bisher noch keine Evidenz dafür hergibt. In Einzelfällen können Patienten jedoch von der Einnahme von Kortikosteroiden profitieren.

Neuroforum ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Maryam Ghorbani ◽  
Lisa Marshall

AbstractSleep contributes actively to the consolidation of many forms of memory. This review describes the neural oscillations of non-rapid eye movement (NREM) sleep, the structures underlying these oscillations and their relation to hippocampus-dependent memory consolidation. A main focus lies on the relation between inter- and intraregional interactions and their electrophysiological representation. Methods for modulating neural oscillations with the intent of affecting memory consolidation are presented.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 159-159
Author(s):  
Tiana Broen ◽  
Tomiko Yoneda ◽  
Jonathan Rush ◽  
Jamie Knight ◽  
Nathan Lewis ◽  
...  

Abstract Previous cross-sectional research suggests that age-related decreases in Rapid-Eye Movement (REM) sleep may contribute to poorer cognitive functioning (CF); however, few studies have examined the relationship at the intraindividual level by measuring habitual sleep over multiple days. Applying a 14-day daily diary design, the current study examines the dynamic relationship between REM sleep and CF in 69 healthy older adults (M age=70.8 years, SD=3.37; 73.9% female; 66.6% completed at least an undergraduate degree). A Fitbit device provided actigraphy indices of REM sleep (minutes and percentage of total sleep time), while CF was measured four times daily on a smartphone via ambulatory cognitive tests that captured processing speed and working memory. This research addressed the following questions: At the within-person level, are fluctuations in quantity of REM sleep associated with fluctuations in next day cognitive measures across days? Do individuals who spend more time in REM sleep on average, perform better on cognitive tests than adults who spend less time in REM sleep? A series of multilevel models were fit to examine the extent to which each index of sleep accounted for daily fluctuations in performance on next day cognitive tests. Results indicated that during nights when individuals had more REM sleep minutes than was typical, they performed better on the working memory task the next morning (estimate = -.003, SE = .002, p = .02). These results highlight the impact of REM sleep on CF, and further research may allow for targeted interventions for earlier treatment of sleep-related cognitive impairment.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Andreas Rembert Koczulla ◽  
Antje Stegemann ◽  
Rainer Gloeckl ◽  
Sandra Winterkamp ◽  
Bernd Sczepanski ◽  
...  

Abstract Background Coronavirus disease 2019 has become a health problem spreading worldwide with pandemic characteristics since March 2020. Post coronavirus disease 2019 symptoms are more frequent than initially expected, with fatigue as an often-mentioned issue. Case presentations We describe a 32-year-old white male and a 55-year-old white female who suffered from post coronavirus disease 2019 fatigue syndrome. On polysomnography, rapid eye movement associated sleep apnea with an increased hypopnea index during rapid eye movement phases of 36.8 and 19.5 events per hour was found. Based on the patients’ burdensome fatigue symptoms, we initiated automatic positive airway pressure therapy, which diminished sleep apnea (rapid eye movement index: 0.0 in both patients) and, consequently, also the fatigue symptoms. Conclusions Since sleep apnea and coronavirus disease 2019 are both associated with fatigue, a screening for sleep apnea might be considered in coronavirus disease 2019 patients with fatigue syndrome.


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