scholarly journals Postacute COVID-19: An Overview and Approach to Classification

2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Eva M Amenta ◽  
Amy Spallone ◽  
Maria C Rodriguez-Barradas ◽  
Hana M El Sahly ◽  
Robert L Atmar ◽  
...  
Keyword(s):  
Large Volume ◽  
Medical Literature ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Persistent Symptoms

Abstract As the coronavirus disease 2019 (COVID-19) pandemic has progressed, a large volume of literature has developed delineating the clinical manifestations of acute infection. Recent reports have also started to describe persistent symptoms extending beyond the period of initial illness or hospitalization. Anecdotes of different signs and symptoms occurring after acute infection have also arisen in the lay press. Here we describe the current existing medical literature on the emerging concept of postacute COVID-19 and suggest an approach to classifying different manifestations of the syndrome. We also review long-term clinical manifestations observed in patients who recovered from infection due to other epidemic coronaviruses and briefly discuss potential mechanisms driving the phenomenon of postacute COVID-19.

scholarly journals Digestive involvement in Long- COVID syndrome

2021 ◽  
Author(s):  
Alina M. Bogariu ◽  
Dan L. Dumitrascu
Keyword(s):  
Chronic Diseases ◽  
Observational Studies ◽  
Digestive System ◽  
Medical Literature ◽  
Liver Enzymes ◽  
Acute Infection ◽  
Gastrointestinal Symptoms ◽  
Long Term Effects ◽  
Search Terms

Background and aim. The SARS-CoV-2 infection which caused a worldwide epidemic was considered first a lung disease. Later on, it was found that the disease caused by this virus, SARS-CoV-2, can affect most organs, including the digestive system. The long-term effects of this infection are now progressively detected and called Long-COVID. This review aims is to present the updated knowledge of the digestive sequelae after SARS-CoV-2 infection. Methods. A search was performed in the main medical literature databases. The following search terms were used: long-covid, gastrointestinal or gastric sequelae SARS-CoV-2 and COVID-19. Data on gastrointestinal symptoms after 12 weeks were collected and presented. Observational studies were included. Studies that focus only on acute COVID-19 infection (<4 weeks) were excluded. Results. The main symptoms that can occur in the long term are: diarrhea, nausea, vomiting, abdominal pain, along with increased liver enzymes. Patients with chronic diseases have a higher risk of developing long-term sequelae, but it is not documented that digestive sequelae are influenced by the presence of chronic diseases. Conclusions. The SARS-CoV-2 virus can affect any part of the digestive system not only in the acute infection phase but also for longer time, leaving long-term sequelae.

scholarly journals Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

2012 ◽  
Vol 45 (6) ◽  
pp. 675-681 ◽  
Author(s):  
Ricardo Tristão-Sá ◽  
Claire Fernandes Kubelka ◽  
Eliana Zandonade ◽  
Sônia Maria Oliveira Zagne ◽  
Natally de Souza Maciel Rocha ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Denv Infection ◽  
Duration Of Symptoms ◽  
Persistent Symptoms ◽  
Study Results ◽  
Taste Alteration

INTRODUCTION: To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV) seropositive and pregnant women were excluded from the study. RESULTS: At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90) of dengue patients. We also observed that, 57.7% (15/26) of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV) infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT) levels overcame aspartate aminotransferase (AST) during the convalescent period. Male patients were more severely affected than females. CONCLUSIONS: Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.

scholarly journals COVID-19 in pediatric population

2021 ◽  
pp. 100-114
Author(s):  
G. P. Evseeva ◽  
R. S. Telepneva ◽  
E. V. Knizhnikova ◽  
S. V. Suprun ◽  
S. V. Pichugina ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Clinical Manifestations ◽  
Limited Data ◽  
Biological Mechanisms ◽  
Missed Opportunities ◽  
Persistent Symptoms ◽  
Global Spread ◽  
Patients At Risk ◽  
Coronavirus Infection

Introduction. The global spread of SARS-CoV-2 coronavirus infection worldwide determines the need to study the clinical features, complications, extrapulmonary manifestations and long-term consequences of the infection in children. While many studies have been described in adult patients, there are limited data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2. Aim. Review of the literature containing currently reported cases of SARS-CoV-2 infection in children to present the state of the art, understand the direction of research and unresolved issues. Materials and methods. An analysis of publications containing data from studies of SARS-CoV-2 cases in children was carried out. Results. Researchers from different countries agree that children are less susceptible to COVID19. This can create a dangerous situation, which can lead to a weakening of attention to children. Although their clinical manifestations are mainly mild to moderate symptoms, nevertheless, severe cases of the disease occur in children, which can lead to death. Conclusion. The complexity and variability of COVID-19 manifestations support the hypothesis that further research is needed on the long-term and chronic symptoms of COVID-19 in children. Failure to understand the underlying biological mechanisms behind these persistent symptoms increases missed opportunities to identify patients at risk of chronicity in order to prevent such conditions and seek rehabilitation approaches for children with COVID-19. 

scholarly journals Living with ‘Long COVID-19’: The long-term complications and sequelae

2021 ◽  
Vol 5 (1) ◽  
pp. 011-021
Author(s):  
Nikhra Vinod
Keyword(s):  
Healthcare Providers ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Long Term Effects ◽  
Genomic Changes ◽  
Persistent Symptoms ◽  
Inflammatory Changes ◽  
Symptoms And Signs ◽  
Variable Presentation

Introduction - the perennial pandemic: It is being increasingly realised that the COVID-19 may have become the new reality associated with human existence world over and the mankind may have to live with it for years or even decades. Further, the grievous nature of the disease is evolving further with the genomic changes in the virus in form of mutations and evolution of variants, with enhanced infectivity and probably virulence. There are serious challenges posed by the SARS-CoV-2 virus and COVID-19 as the disease. COVID-19 as acute and chronic disease: On exposure to the SARS-CoV-2 virus, not all patients develop a disease. Further, for those who develop the disease, there is a large variation in disease severity. The known factors including the constituent factors and several still unknown factors influence the disease manifestations, its course, and later the convalescent phase as well. In fact, substantial continuing morbidity after resolution of the infection indicates persisting multisystem effects of COVID-19. The ‘long COVID-19’ or ‘long haulers’: The patients who continue to suffer with persisting symptoms have been described as long haulers and the clinical condition has been called post-COVID-19 or ‘long COVID-19’. The diagnosis should be entertained if various symptoms and signs linger well beyond the period of convalescence in COVID-19. With the chronicity, there occur inflammatory changes and damage in various organs, and the extent of organ damage determines the long-term effects. Management of ‘long COVID’ syndrome: The ‘long COVID’ syndrome has multi-system involvement, variable presentation, and unpredictable course. Following clinical and investigational assessment, the patients should be managed as per clinical manifestations, extent of organ damage and associated complications. The findings from various studies indicate that preventing further organ damage in ‘long COVID’ is crucial. The long COVID’s prognostic challenges: As apparent, the ‘long COVID’ afflictions are more common than realized earlier. The symptoms can escalate in patients with co-morbid conditions. The persistent symptoms among COVID-19 survivors pose new challenges to the healthcare providers and may be suitably managed with a combination of pharmacological and non-pharmacological treatments, and holistic healthcare.

scholarly journals Persistent symptoms and association with inflammatory cytokine signatures in recovered COVID-19 patients

2021 ◽  
Author(s):  
Sean Wei Xiang Ong ◽  
Siew-Wai Fong ◽  
Barnaby Edward Young ◽  
Yi-Hao Chan ◽  
Bernett Lee ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Acute Infection ◽  
Public Hospitals ◽  
Multivariable Model ◽  
Persistent Symptoms ◽  
Immune Mediators ◽  
Prospective Longitudinal ◽  
The Relationship

Abstract Background The complications and sequelae of coronavirus disease 2019 (COVID-19) and their effect on long-term health are unclear, and the trajectory of associated immune dysregulation poorly understood. Methods We conducted a prospective longitudinal multi-center cohort study at four public hospitals in Singapore. COVID-19 patients were monitored for a median of six months after recovery from acute infection. Clinical symptoms and radiologic data were collected, along with plasma samples for quantification of immune mediators. The relationship between clinical symptoms and immune cytokine profiles was investigated. Results 288 participants were recruited, and follow-up data were available for 183, 175, and 120 participants at days 30, 90 and 180 post-symptom onset respectively. Symptoms related to COVID-19 were present in 31 (16.9%), 13 (7.4%), and 14 (11.7%) at days 30, 90 and 180. In a multivariable model, age &gt;65 years, non-Chinese ethnicity, and the severity of acute infection were associated with increased likelihood of persistent symptoms. Recovered COVID-19 patients had elevated levels of pro-inflammatory IL-17A, SCF, IL-12p70, IL-1βand pro-angiogenic MIP-1β, BDNF, VEGF at day 180 compared to healthy controls. Higher levels of MCP-1 and PDGF-BB were detected in patients with persistent symptoms, versus symptom-free patients. Conclusions About 10% of recovered patients had persistent symptoms six months after initial infection. Immune cytokine signatures of the recovered patients reflected ongoing chronic inflammation and angiogenesis. COVID-19 patients should be monitored closely for emerging long-term health consequences.

Lo shock settico nei primi tre mesi di vita

2021 ◽  
Vol 40 (9) ◽  
pp. 567-575
Author(s):  
Sara Crestani ◽  
Erica Passini ◽  
valentina Spaggiari ◽  
Carlotta Toffoli ◽  
Alessandra Boncompagni ◽  
...  
Keyword(s):  
Septic Shock ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Epidemiological Data ◽  
International Studies ◽  
Term Outcome ◽  
Adequate Treatment ◽  
Long Term Outcome ◽  
Sepsis And Septic Shock

Shock is a generalized tissue hypoperfusion that leads to severe cellular distress and complicates some cases of paediatric and neonatal sepsis. Although a reduction in associated sepsis mortality has been observed in the last decades, it remains one of the most important causes of death or long-term neurodevelopmental disabilities in children. Prompt recognition of this condition is therefore essential to improve survival and long-term outcome. The paediatrician and the neonatologist must therefore be able to promptly recognize the signs and symptoms of sepsis and septic shock to set up an adequate treatment according to the most recent international guidelines. This article provides epidemiological data from Italian and international studies, describes the pathophysiology and clinical manifestations of sepsis and septic shock, as well as the therapeutic indications according to very recent recommendations.

Concussion in sports in children and adolescents – to play or not to play?

2017 ◽  
Vol 65 (3) ◽  
Keyword(s):  
Gender Differences ◽  
Children And Adolescents ◽  
Return To Sport ◽  
Consensus Conference ◽  
Return To School ◽  
The Novel ◽  
International Consensus ◽  
Persistent Symptoms ◽  
New Findings

A lot has been published on the topic concussion in sports during the last years, conscience was sharpened, much was structured and defined more precisely, help tools were developed and rules changed. This article summarizes the fifth edition of the recently published guidelines of the “International Consensus Conference on Concussion in Sport”. In addition, new findings regarding gender differences and recovery will be presented, as well as the modified “return-to-sport” and the novel “return-to-school” protocols. Despite increased knowledge many questions remain such as the therapy of persistent symptoms or long-term sequelae of recurrent concussions.

NEUROENDOCRINE TUMORS OF THE PANCREAS: ETIOLOGY, PATHOGENESIS, DIAGNOSIS, AND CURRENT TREATMENT APPROACHES

2018 ◽  
Vol 64 (6) ◽  
pp. 830-839
Author(s):  
Temuri Morgoshiya
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Manifestations ◽  
Gastrointestinal Hormones ◽  
Current Treatment ◽  
High Potential ◽  
Long Term Results ◽  
Considerable Part ◽  
Treatment Approaches ◽  
By Products

The overview of literature on modem classification issues, diagnostics and treatments of neuroendocrinal tumors of a pancreas is provided. According to modern views all neuroendocrinal tumors of a pancreas having clinical manifestations (in the form of the syndromes caused by products of specific hormones; increases in level of hormones in blood of patients without clinical manifestations; in the form of signs of existence of volume education in various departments of PZh) and/or the researches (more than 5 mm) revealed by means of beam methods are malignant in the biology as they have high potential to innidiation. In article it is shown that a considerable part of neuroendocrinal tumors of a pancreas are nonfunctioning, i.e. not cosecreting various gastrointestinal hormones and polypeptides in blood and thereof not followed characteristic clinical manifestations. It is noted that diagnostics of neuroendocrinal tumors of a pancreas is extremely difficult task on which solution the choice of a method of treatment and its long-term results depends...

scholarly journals 1005 Antibiotic-Impregnated Calcium Sulfate Beads Are Not Effective in the Primary Prevention of Infection in Open Femur and Tibia Fractures

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Fung ◽  
A Ward ◽  
K Patel ◽  
M Krkovic
Keyword(s):  
Primary Prevention ◽  
Infection Rate ◽  
Calcium Sulfate ◽  
Acute Infection ◽  
Open Fractures ◽  
Prevention Of Infection ◽  
Significant Difference ◽  
Tibia Fractures ◽  
Systemic Antibiotics

Abstract Introduction Infection is a major complication of open fractures. Antibiotic-impregnated calcium sulfate (AICS) beads are widely used as an adjuvant to systemic antibiotics. Whilst their efficacy in the secondary prevention of infection is established, we present the first retrospective study evaluating AICS beads in the primary prevention of infection in open fractures. Method 214 open femur and tibia fractures in 207 patients were reviewed over a seven-year period. 148 fractures received only systemic antibiotic prophylaxis. 66 fractures also received AICS beads. The occurrence of acute infection (wound infection and acute osteomyelitis) was recorded, as well as that of long-term complications (chronic osteomyelitis, non-union and death). Results Fractures that received AICS with systemic antibiotics had an overall acute infection rate of 42% (28/66), compared to 43% (63/148) in fractures that received only systemic antibiotics (p &gt; 0.05). There was no significant difference in infection rate even when fractures were stratified by Gustilo-Anderson grade. There was also no significant difference in the rate of long-term complications. Conclusions Our results indicate that the adjuvant use of AICS beads is not effective for the primary prevention of acute infection or long-term complications in open leg fractures. Further research is needed to elucidate the factors influencing the outcomes of AICS use.

scholarly journals What’s going on following acute covid-19? Clinical characteristics of patients in an out-patient rehabilitation program

2021 ◽  
pp. 1-12
Author(s):  
Sergiu Albu ◽  
Nicolas Rivas Zozaya ◽  
Narda Murillo ◽  
Alberto Garcia-Molina ◽  
Cristian Andres Figueroa Chacón ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Acute Infection ◽  
Rehabilitation Program ◽  
Neuropsychological Impairment ◽  
Outpatient Rehabilitation ◽  
Screening Process ◽  
Icu Patients ◽  
Persistent Symptoms

BACKGROUND: Coronavirus disease 2019 (COVID-19) patients present long-lasting physical and neuropsychological impairment, which may require rehabilitation. OBJECTIVES: The current cross-sectional study characterizes post COVID-19 sequelae and persistent symptoms in patients in an outpatient rehabilitation program. METHODS: Thirty patients [16 post-ICU and 14 non-ICU; median age = 54(43.8–62) years; 19 men] presenting sequelae and/or persistent symptoms (>3 months after acute COVID-19) were selected of 41 patients referred for neurorehabilitation. Patients underwent physical, neuropsychological and respiratory evaluation and assessment of impact of fatigue and quality of life. RESULTS: The main reasons for referral to rehabilitation were: fatigue (86.6%), dyspnea (66.7%), subjective cognitive impairment (46.7%) and neurological sequelae (33.3%). Post-ICU patient presented sequelae of critical illness myopathy and polyneuropathy, stroke and encephalopathy and lower forced vital capacity compared to non-ICU patients. Cognitive impairment was found in 63.3% of patients, with a similar profile in both sub-groups. Increased physical fatigue, anxiety and depression and low quality of life were prevalent irrespective of acute COVID-19 severity. CONCLUSIONS: The variability of post COVID-19 physical and neuropsychological impairment requires a complex screening process both in ICU and non-ICU patients. The high impact of persistent symptoms on daily life activities and quality of life, regardless of acute infection severity, indicate need for rehabilitation.

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