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 Molecular Phenomic Approaches to Deconvolving the Systemic Effects of SARS-CoV-2 Infection and Post-acute COVID-19 Syndrome

Phenomics ◽  
2021 ◽  
Author(s):  
Jeremy K. Nicholson
Keyword(s):  
Molecular Level ◽  
Organ Damage ◽  
Zoonotic Diseases ◽  
Mitigation Strategies ◽  
Health Consequence ◽  
Metabolic Phenotyping ◽  
Persistent Symptoms ◽  
Biological Discovery ◽  
New Biomarkers

AbstractSARS COV-2 infection causes acute and frequently severe respiratory disease with associated multi-organ damage and systemic disturbances in many biochemical pathways. Metabolic phenotyping provides deep insights into the complex immunopathological problems that drive the resulting COVID-19 disease and is also a source of novel metrics for assessing patient recovery. A multiplatform metabolic phenotyping approach to studying the pathology and systemic metabolic sequelae of COVID-19 is considered here, together with a framework for assessing post-acute COVID-19 Syndrome (PACS) that is a major long-term health consequence for many patients. The sudden emergence of the disease presents a biological discovery challenge as we try to understand the pathological mechanisms of the disease and develop effective mitigation strategies. This requires technologies to measure objectively the extent and sub-phenotypes of the disease at the molecular level. Spectroscopic methods can reveal metabolic sub-phenotypes and new biomarkers that can be monitored during the acute disease phase and beyond. This approach is scalable and translatable to other pathologies and provides as an exemplar strategy for the investigation of other emergent zoonotic diseases with complex immunological drivers, multi-system involvements and diverse persistent symptoms.

Long COVID—The New “Invisible” Illness: How School Nurses Can Support the Nursing and Educational Teams for Student Success

2021 ◽  
pp. 1942602X2110594
Author(s):  
Megan Roesler ◽  
Patricia Fato ◽  
Barbara Obst
Keyword(s):  
School Nurses ◽  
School Age Children ◽  
Return To School ◽  
School Age ◽  
Long Term Effects ◽  
Persistent Symptoms ◽  
School Based ◽  
School Based Interventions ◽  
The Waves

School-age children are not immune to COVID-19 or the pronounced and persistent symptoms associated with a long-COVID diagnosis. Students may present with a variety of symptoms affecting their physical, cognitive, and mental health. The school community should be educated on the school-based interventions and recommendations for creating an individualized safe and successful return to school plan. As we await approval for vaccinations in school-age children younger than 12 years and continue to reposition ourselves to the waves of this pandemic and new variants of the virus, understanding the medical and educational long-term effects on our students may be a long-term need.

scholarly journals Long COVID: long-term effects?

2021 ◽  
Vol 23 (Supplement_E) ◽  
pp. E1-E5
Author(s):  
Alessandro Di Toro ◽  
Antonio Bozzani ◽  
Guido Tavazzi ◽  
Mario Urtis ◽  
Lorenzo Giuliani ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Long Term Effects ◽  
Non Invasive ◽  
Clinical Events ◽  
Cardiovascular Involvement ◽  
Patients At Risk ◽  
Ischaemic Attack ◽  
Diagnostic Framework ◽  
Open Question

Abstract The term Long COVID (or Post COVID) describes a condition characterized by persistence of symptoms for at least 12 weeks after the onset of COVID-19. It may last several months but the duration is still matter of observation. The symptoms and the clinical manifestations are clinically heterogeneous and suggesting involvement of multi-organs/systems, including the cardiovascular system. The general recurrent symptoms include fatigue, breathlessness, myalgia, headache, loss of memory, and impaired concentration. Patients report loss of their previous psychophysical performance. Cardiovascular involvement manifests with common symptoms such as palpitations and chest pain, and, less commonly, with events such as late arterial and venous thromboembolisms, heart failure episodes, strokes or transient ischaemic attack, ‘myo-pericarditis’. The diagnostic criteria are mainly based on the narrative of the patients. Measurable biomarkers or instrumental findings or clinical events are not yet framed in a shared diagnostic framework. The open question for clinicians and researchers is whether biomarkers, electrocardiogram, non-invasive imaging, and clinical monitoring should be included in a shared diagnostic protocol aimed at defining the diagnostic path and protecting patients at risk of unexpected events.

scholarly journals SARS-CoV-2 (COVID-19) and the Endocrine System

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Michelle D Lundholm ◽  
Caroline Poku ◽  
Nicholas Emanuele ◽  
Mary Ann Emanuele ◽  
Norma Lopez
Keyword(s):  
Severe Disease ◽  
Clinical Manifestations ◽  
Endocrine System ◽  
The Body ◽  
Active Area ◽  
Gonadal Function ◽  
Long Term Effects ◽  
The World ◽  
The Impact

Abstract As SARS-CoV-2 (COVID-19) overtakes the world, causing moderate to severe disease in about 15% of infected patients, COVID-19 is also found to have widespread effects throughout the body with a myriad of clinical manifestations including the endocrine system. This manuscript reviews what is known about the impact of COVID-19 on the pathophysiology and management of diabetes (both outpatient and inpatient) as well as pituitary, adrenal, thyroid, bone, and gonadal function. Findings in this area are evolving, and long-term effects of infection remain an active area of further research.

scholarly journals Prenatal Cannabinoid Exposure: Emerging Evidence of Physiological and Neuropsychiatric Abnormalities

2021 ◽  
Vol 11 ◽  
Author(s):  
Mina G. Nashed ◽  
Daniel B. Hardy ◽  
Steven R. Laviolette
Keyword(s):  
Healthcare Providers ◽  
Cannabis Use ◽  
Depression And Anxiety ◽  
Long Term Effects ◽  
Placental Development ◽  
Neurodevelopmental Outcomes ◽  
The Past ◽  
Current Trends ◽  
The Social

Clinical reports of cannabis use prevalence during pregnancy vary widely from 3% to upwards of 35% in North America; this disparity likely owing to underestimates from self-reporting in many cases. The rise in cannabis use is mirrored by increasing global legalization and the overall perceptions of safety, even during pregnancy. These trends are further compounded by a lack of evidence-based policy and guidelines for prenatal cannabis use, which has led to inconsistent messaging by healthcare providers and medically licensed cannabis dispensaries regarding prenatal cannabis use for treatment of symptoms, such as nausea. Additionally, the use of cannabis to self-medicate depression and anxiety during pregnancy is a growing medical concern. This review aims to summarize recent findings of clinical and preclinical data on neonatal outcomes, as well as long-term physiological and neurodevelopmental outcomes of prenatal cannabis exposure. Although many of the outcomes under investigation have produced mixed results, we consider these data in light of the unique challenges facing cannabis research. In particular, the limited longitudinal clinical studies available have not previously accounted for the exponential increase in (-)-Δ9– tetrahydrocannabinol (Δ9–THC; the psychoactive compound in cannabis) concentrations found in cannabis over the past two decades. Polydrug use and the long-term effects of individual cannabis constituents [Δ9–THC vs. cannabidiol (CBD)] are also understudied, along with sex-dependent outcomes. Despite these limitations, prenatal cannabis exposure has been linked to low birth weight, and emerging evidence suggests that prenatal exposure to Δ9–THC, which crosses the placenta and impacts placental development, may have wide-ranging physiological and neurodevelopmental consequences. The long-term effects of these changes require more rigorous investigation, though early reports suggest Δ9–THC increases the risk of cognitive impairment and neuropsychiatric disease, including psychosis, depression, anxiety, and sleep disorders. In light of the current trends in the perception and use of cannabis during pregnancy, we emphasize the social and medical imperative for more rigorous investigation of the long-term effects of prenatal cannabis exposure.

scholarly journals СВИНЦОВАЯ ЭКСПОЗИЦИЯ КАК ПРЕДПОСЫЛКА ОГРАНИЧЕНИЯ РЕАЛИЗАЦИИ МАКСИМАЛЬНОЙ ФИЗИЧЕСКОЙ АКТИВНОСТИ

World Science ◽  
2021 ◽  
Author(s):  
Mermanishvili Tatiana ◽  
Pataraia Giorgi ◽  
Chanturidze Nana
Keyword(s):  
Heart Muscle ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Transport Function ◽  
Long Term Effects ◽  
Functional Changes ◽  
Study Results ◽  
Small Doses ◽  
And Diffusion

As a result of man’s technological activities, numerous quantities of lead and its compounds are spread into the environment annually. The long-term effects of low doses of lead on the lungs, heart muscle and the transport function of erythrocytes were investigated.  The study results indicate that long-term intake of small doses of lead, even in the absence of visible clinical manifestations, causes distinct structural changes and therefore, functional changes in the heart muscle, respiratory system, reduces the transport function of erythrocytes, and also possibly limiting the oxygen transport in myocytes and its deposition in tissues and diffusion into cells. There is no doubt that these changes will limit the ability to maximize the realization of physical activity.

scholarly journals More complaints than findings - Long-term pulmonary function in children and adolescents after COVID-19

2021 ◽  
Author(s):  
Leona Knoke ◽  
Anne Schlegtendal ◽  
Christoph Maier ◽  
Lynn Eitner ◽  
Thomas Luecke ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Children And Adolescents ◽  
Respiratory Symptoms ◽  
Severe Infection ◽  
Preliminary Evidence ◽  
Long Term Effects ◽  
Diffusion Capacity ◽  
Persistent Symptoms ◽  
Abnormal Pulmonary Function

Background: The frequency of persistent symptoms after coronavirus disease 2019 (COVID-19) in adults varies from 4.5% to 87%. Pulmonary function can also show long-term impairment in adults: 10% of hospitalised adults had reduced spirometry values, and 24% had decreased diffusion capacity. To date, only preliminary evidence is available on persistent respiratory sequelae in children and adolescents, therefore our objective was to examine the long-term effects of COVID-19 on pulmonary function in this age group. Methods: Multiple-breath washout, body plethysmography, and diffusion capacity testing were performed after an average of 2.6 months (range 0.4-6.0) following COVID-19 in 73 children and adolescents (age 5-18 years) with different disease severity. Cases were compared to 45 controls with and without infection within six months prior to assessment after exclusion of severe acute respiratory coronavirus-2 infection (SARS-CoV-2). Results: Of the 19 patients (27.1%) who complained about persistent or newly emerged symptoms since COVID-19, 8 (11.4%) reported respiratory symptoms. Comparing patients with COVID-19 to controls, no significant differences were detected in frequency of abnormal pulmonary function (COVID-19: 12, 16.4%; controls: 12, 27.7%; OR 0.54, 95% CI 0.22-1.34). Only two patients with persistent respiratory symptoms showed abnormal pulmonary function. Multivariate analysis revealed reduced forced vital capacity (p=0.045) in patients with severe infection regardless of SARS-CoV-2 infection. Discussion: Pulmonary function is rarely impaired in children and adolescents after COVID-19, except of those with severe infection. The discrepancy between persistent respiratory symptoms and normal pulmonary function suggests a different underlying pathology such as dysfunctional breathing.

scholarly journals PREDICTION OF LONG-TERM EFFECTS OF POLYARTICULAR VARIANT OF JUVENILE IDIOPATHIC ARTHRITIS

2018 ◽  
Vol 13 (3-4) ◽  
pp. 28-37
Author(s):  
M.B. Dzhus ◽  
T.V. Marushko ◽  
H.V. Mostbauer ◽  
О.І. Ivashkivsky ◽  
I.V. Kurylchyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Prognostic Model ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Binary Logistic Regression ◽  
Response To Therapy ◽  
Adult Patients ◽  
Long Term Effects

Relevance. It is known that the poly-articular variant of JIA is associated with significant articular and extra-articular damages with predominant lesions of small and medium joints with limitation of their function and the development of ankylosis, requiring surgical intervention in these patients. Objective. The aim of the study was to evaluate the risk factors of articular and extra-articular damages in adults with the poly-articular variant of the JIA and to work out a prognostic model for their development. Materials and methods. The study included 45 adult patients with poly-articular (RF+ and RF-) variant of the JIA. Retrospective analysis of medical records of patients with poly-articular variant of JIA was made, taking into account clinical manifestations in the onset of the disease, laboratory parameters and response to therapy. In adulthood, the integral index of articular (JADI-A) and extra-articular (JADI-E) damages was used to assess the long-term effects of JIA. Results. Unfavorable prognostic factors were revealed by method of binary logistic regression. Mathematical model for predicting the probability of long-term negative articular and extra-articular damages of poly-articular JIA was developed. Conclusions 1. The risk factors for the development of articular and extra-articular damages in adulthood in patients with a poly-articular variant of the JIA are female sex, the presence of lymphadenopathy and/or splenomegaly in childhood, the level of ESR during treatment in childhood, the activity of JADAS in childhood, the presence of symmetric arthritis in childhood, the RF positivity in the debut of the disease, the treatment with glucocorticoids, the cumulative dose of the DMARDs, and lack of therapy by DMARDs. 2. A prognostic model for the development of articular and extra-articular damages in adult patients with a poly-articular variant of the JIA is developed. This model is effective and allows determine the adverse course of the disease and can be the basis for personalized treatment for the prevention of the development of significant articular and extra-articular damages of JIA.

scholarly journals Liver damage while Covid-19: problems of pathogenesis and treatment

2021 ◽  
pp. 178-185
Author(s):  
E. A. Lyalyukova ◽  
I. V. Dolgalev ◽  
E. N. Chernysheva ◽  
I. V. Druk ◽  
G. M. Konovalova ◽  
...  
Keyword(s):  
Liver Damage ◽  
Liver Diseases ◽  
Scientific Information ◽  
Organ Damage ◽  
Chronic Liver Diseases ◽  
Long Term Effects ◽  
Initial State ◽  
Cytopathogenic Effect ◽  
Optimal Patient Management

The purpose of the review is to present an analysis of the current literature data on the pathogenesis and therapy of liver damage in Covid-19. Liver damage in COVID-19 patients can be caused by the direct cytopathogenic effect of SARS-CoV-2, an uncontrolled immune response, sepsis, severe hypoxia, or drug damage. In addition, COVID-19 can exacerbate and decompensate previously formed chronic liver diseases with the development of acute liver failure. Physicians should carefully assess the initial state of the liver, and after prescribing therapy, intensify monitoring of its functional state, especially in patients with severe COVID-19. In each clinical case, the doctor needs to establish the possible mechanisms of organ damage in order to select the most optimal patient management tactics, which would take into account all aspects of the COVID-19 course and liver damage. Currently, additional scientific information is required to uncover the features of liver damage during SARS-CoV-2 infection and in the postcovid period. Patients who have undergone COVID-19 need further monitoring to assess the long-term effects of the disease.

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