scholarly journals Long COVID Patient Symptoms and its Evaluation and Management

2021 ◽  
Vol 59 (240) ◽  
Author(s):  
Deepak Sundar Shrestha ◽  
Richard Love
Keyword(s):  
Chronic Disease ◽  
Hormonal Regulation ◽  
Organ Damage ◽  
Acute Case ◽  
Major Organ ◽  
Specific Organ ◽  
Restorative Sleep ◽  
Function Testing ◽  
Medical Meeting ◽  
Site Pain

While the acute case burdens and deaths from the COVID-19 pandemic (in Nepal approaching 700,000 and 10,000 respectively) have been costly, the characteristics and potentially huge dimensions of the chronic disease sequelae of this infectious disease are only slowly becoming apparent. We reviewed Pub Med, major medical meeting and medical journal, and investigative journalist materials seeking to frame and describe COVID-19 chronic disease. The consequences of COVID-19 infections follow major organ damage, and induction of immunological and hormonal systems dysfunction. The first injuries are consequent to direct viral effects on tissues, and vasculitis, endothelialitis, thrombosis and inflammatory events. Pulmonary, cardiac, brain, and kidney tissues incur function-limiting damage, with dyspnea, arrythmias, decreased exercise capacity, cognitive dysfunction, and decreased glomerular filtration rates. The second process is characterized by immune dysregulation and autoimmunity, and dysfunction of hormonal regulation systems, with high, fluctuating levels of physical and mental fatigue, multiple-site pain and ache, and non-restorative sleep, in 10-30% of cases. This communication proposes evaluation and management of chronic COVID-19 patients with efficient assessment of commonest symptoms, targeted physical examination and organ function testing, and interventions based on specific organ functional status, and experience with similar chronic immune syndromes, such as myalgic encephalomyelitis.

Antiphospholipid syndrome (APS) in patients with systemic lupus erythematosus (SLE) implies a more severe disease with more damage accrual and higher mortality

Lupus ◽  
2020 ◽  
Vol 29 (12) ◽  
pp. 1556-1565
Author(s):  
Leyre Riancho-Zarrabeitia ◽  
Victor Martínez-Taboada ◽  
Iñigo Rúa-Figueroa ◽  
Fernando Alonso ◽  
María Galindo-Izquierdo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Severe Disease ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Katz Index ◽  
Damage Accrual ◽  
Major Organ ◽  
Clinical Profiles

Introduction Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in systemic lupus erythematosus(SLE) patients. Our aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome (APS). Materials and methods Patients from the RELESSER-T registry were included. RELESSER-T is a Spanish multicenter, hospital-based, retrospective, SLE registry. Results We included 2398 SLE patients, 1372 of whom were positive for aPL. Overall 1026 patients were classified as SLE, 555 as SLE-APS and817 as SLE-aPL. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes than those with SLE-aPL and SLE ( p < 0.001). SLE-APS patients showed higher rates of neuropsychiatric, cardiac, pulmonary, renal and ophthalmological manifestations than the other groups ( p < 0.001). SLE-APS patients presented greater damage accrual with higher SLICC values (1.9 ± 2.2 in SLE-APS, 0.9 ± 1.4 in SLE-aPL and 1.1 ± 1.6 in SLE, p < 0.001) and more severe disease as defined by the Katz index (3 ± 1.8 in SLE-APS, 2.7 ± 1.7 in SLE-aPL and 2.6 ± 1.6 in SLE, p  < 0.001). SLE-APS patients showed higher mortality rates ( p < 0.001). Conclusions SLE-APS patients exhibited more severe clinical profiles with higher frequencies of major organ involvement, greater damage accrual and higher mortality than SLE-aPL and SLE patients.

scholarly journals Treatment of Systemic Lupus Erythematosus

2020 ◽  
Vol 95 (3) ◽  
pp. 162-169
Author(s):  
Bo Young Kim ◽  
Sung-Soo Kim
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Immunosuppressive Agents ◽  
Organ Damage ◽  
Long Term Outcomes ◽  
Systemic Lupus ◽  
Multiple Organs ◽  
Organ Manifestations ◽  
Specific Organ

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies that result in the inflammation of multiple organs, including the skin and musculoskeletal, renal, nervous, cardiovascular, respiratory, and gastrointestinal systems. Treatment includes the use of immunomodulatory and immunosuppressive agents to target specific organ manifestations. The treatment goal in SLE is to reduce disease activity and prevent organ damage and death. Optimal long-term outcomes require not only treatment of the disease, but also the management of comorbidities. This paper reviews treatments of SLE with the aim of improving outcomes.

scholarly journals A European pharmacotherapeutic agent Roflumilast exploring integrated preclinical and clinical evidences for SARS CoV-2 mediated inflammation to organ damage

2021 ◽  
Author(s):  
yogendra Singh ◽  
Neeraj Fuloria ◽  
Shivkanya Fuloria ◽  
Vetriselvan Subramaniyan ◽  
Waleed Almalki ◽  
...  
Keyword(s):  
Immune Cell ◽  
Organ Damage ◽  
Pde4 Inhibitor ◽  
The European Union ◽  
Phosphodiesterase 4 ◽  
Organ Systems ◽  
Major Organ ◽  
Organ Tissue ◽  
Camp Levels ◽  
Inflammatory Burden

COVID-19 has spread globally, affecting almost 160 million individuals. Elderly and pre-existing patients (such as diabetes, heart disease and asthma), seems more susceptible to serious illness with COVID-19. Roflumilast was licensed for usage in the European Union in July 2010 as a phosphodiesterase-4 (PDE4) inhibitor. Roflumilast has been shown to decrease bleomycin-induced lung fibrosis, lung hydroxyproline, right heart thickning in animal prophylactic. The current study reviewed existing data that the PDE-4 inhibitor protects not just renal tissues but also other major organ systems after COVID-19 infection by decreasing immune cell infiltration. These immune-balancing effects of roflumilast were related with a decrease in oxidative and inflammatory burden, caspase-3 suppression, and increased PKA/cAMP levels in renal and other organ tissue.

scholarly journals Harnessing the Potential of miRNAs in Malaria Diagnostic and Prevention

2021 ◽  
Vol 11 ◽  
Author(s):  
Himanshu Gupta ◽  
Samuel C. Wassmer
Keyword(s):  
Organ Dysfunction ◽  
Current Knowledge ◽  
Wide Spectrum ◽  
Positive Outcome ◽  
Organ Damage ◽  
Severe Form ◽  
Parasitic Infections ◽  
Specific Organ ◽  
Clinical Models ◽  
Future Evaluation

Despite encouraging progress over the past decade, malaria remains a major global health challenge. Its severe form accounts for the majority of malaria-related deaths, and early diagnosis is key for a positive outcome. However, this is hindered by the non-specific symptoms caused by malaria, which often overlap with those of other viral, bacterial and parasitic infections. In addition, current tools are unable to detect the nature and degree of vital organ dysfunction associated with severe malaria, as complications develop silently until the effective treatment window is closed. It is therefore crucial to identify cheap and reliable early biomarkers of this wide-spectrum disease. microRNAs (miRNAs), a class of small non-coding RNAs, are rapidly released into the blood circulation upon physiological changes, including infection and organ damage. The present review details our current knowledge of miRNAs as biomarkers of specific organ dysfunction in patients with malaria, and both promising candidates identified by pre-clinical models and important knowledge gaps are highlighted for future evaluation in humans. miRNAs associated with infected vectors are also described, with a view to expandind this rapidly growing field of research to malaria transmission and surveillance.

scholarly journals Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies

2021 ◽  
Vol 8 (1) ◽  
pp. e000590
Author(s):  
Manuel Francisco Ugarte-Gil ◽  
Anselm Mak ◽  
Joanna Leong ◽  
Bhushan Dharmadhikari ◽  
Nien Yee Kow ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Observational Studies ◽  
Case Reports ◽  
Damage Index ◽  
Organ Damage ◽  
Systemic Lupus ◽  
Major Organ ◽  
Meta Regression ◽  
Longitudinal Observational Studies

ObjectiveIn systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence.MethodsWe conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966–October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded.ResultsWe selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis.ConclusionsWe confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.

Lifestyle medicine: A pragmatic approach to chronic disease management

2020 ◽  
Vol 13 (11) ◽  
pp. 642-649
Author(s):  
Mishkat Shehata ◽  
Emma Thurston
Keyword(s):  
Chronic Disease ◽  
Disease Burden ◽  
Chronic Disease Management ◽  
Therapeutic Modality ◽  
Evidence Based ◽  
Social Connection ◽  
Pragmatic Approach ◽  
Exciting Field ◽  
Lifestyle Medicine ◽  
Restorative Sleep

This article gives a generic outline of lifestyle medicine as an evidence-based specialty and how to develop a portfolio career in this new and exciting field. It also discusses the current disease burden associated with non-communicable diseases. Lifestyle medicine is defined by the American College of Lifestyle Medicine as ‘the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease’.

Levels of anti-Müllerian hormone in premenopausal women with the antiphospholipid syndrome and its association with the risk of clinical complications

Lupus ◽  
2019 ◽  
Vol 28 (3) ◽  
pp. 427-431 ◽  
Author(s):  
D Castillo-Martínez ◽  
V Rivera ◽  
N Mouneu-Ornelas ◽  
L A Martínez-Martínez ◽  
V Jiménez-Rojas ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Ovarian Reserve ◽  
Premenopausal Women ◽  
Organ Damage ◽  
Clinical Complications ◽  
Single Center Study ◽  
Specific Organ ◽  
Premenopausal Female ◽  
Disease Specific ◽  
Center Study

Objective The study aims to investigate the ovarian reserve in premenopausal women with antiphospholipid syndrome (APS) and to evaluate whether it is associated with cumulative organ damage or the risk of clinical complications. Methods This single-center study was conducted in 23 premenopausal female patients (10 with primary APS and 13 with secondary APS) and 24 healthy volunteers. Serum anti-Müllerian hormone (AMH) levels were measured by enzyme-linked immunoassay. Disease-specific organ damage (DIAPS score) and the risk of clinical complications (aGAPSS score) were additionally evaluated in APS patients. Results Serum AMH levels were similar in APS patients (median 6.06, interquartile range 4.31–7.54 ng/ml) and in controls (4.87, 2.64–6.40 ng/ml; P = 0.116), and no differences were observed between the primary (6.60, 5.49–8.88 ng/ml) and secondary (6.06, 3.91–7.30 ng/ml; P = 0.532) forms of the syndrome. In individuals with APS, serum AMH levels correlated inversely with the aGAPSS score (rho–0.421, 95% confidence intervals −0.716 to −0.001; P = 0.045), while no associations were observed with the DIAPS score (rho–0.001, −0.423 to 0.422; P = 0.996). Conclusions Ovarian reserve is not reduced in premenopausal women with APS. In addition, serum AMH levels may reflect the risk of APS-related clinical complications but not the burden of disease-specific organ damage.

scholarly journals Isozyme profiles and protein patterns in specific organ damage

1970 ◽  
Vol 16 (2) ◽  
pp. 411-423 ◽  
Author(s):  
Herbert H. Cornish ◽  
Mary L. Barth ◽  
Vernon N. Dodson
Keyword(s):  
Organ Damage ◽  
Protein Patterns ◽  
Specific Organ
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