scholarly journals Long COVID syndrome – general aspects

2021 ◽  
Vol 16 (2) ◽  
pp. 174-177
Author(s):  
Adriana TICĂRĂU ◽  
◽  
Mihaela Adela IANCU ◽  
Dumitru MATEI ◽  
◽  
...  
Keyword(s):  
Scientific Evidence ◽  
Shortness Of Breath ◽  
Initial Infection ◽  
Persistent Symptoms ◽  
Alternative Diagnosis ◽  
General Aspects

2020), growing scientific evidence worldwide suggests that a small percentage of people who have developed COVID-19 and healed after the initial infection may experience a series of persistent symptoms over a period of more than 12 weeks, such as marked fatigue, shortness of breath, confusion, diarrhea, or other symptoms that cannot be explained by an alternative diagnosis. This status has been called “long COVID syndrome” or ”post COVID syndrome”.

scholarly journals Effect of SARS-CoV-2 vaccination on symptoms from post-acute COVID syndrome: results from the national VAXILONG survey

2021 ◽  
Author(s):  
Marc SCHERLINGER ◽  
Luc Pijnenburg ◽  
Emmanuel Chatelus ◽  
Laurent Arnaud ◽  
Jacques-Eric Gottenberg ◽  
...  
Keyword(s):  
Online Survey ◽  
Vaccine Coverage ◽  
Inclusion Criteria ◽  
Initial Infection ◽  
Persistent Symptoms ◽  
Alternative Diagnosis ◽  
Vaccination Scheme ◽  
Vaccine Type ◽  
Few Data ◽  
To Receive

Introduction: Few data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, also called long-COVID or post-acute COVID-19 syndrome (PACS). Patients and methods: We conducted a nationwide online survey among adult patients with PACS as defined by symptoms persisting over 4 weeks following a confirmed or probable COVID-19, without any identified alternative diagnosis. Information concerning PACS symptoms, vaccine type and scheme and its effect on PACS symptoms were studied. Results: Six hundred and twenty surveys were completed and 567 satisfied the inclusion criteria and were analyzed. Respondents were 83.4% of women of median age 44 (IQR 25-75: 37-50). Initial infection was proven in 365 patients (64%) and 5.1% had been hospitalized to receive oxygen. 396 patients had received at least one injection of SARS-CoV-2 vaccine at the time of the survey, after a median of 357 [198-431] days following the initially-reported SARS-CoV-2 infection. Among the 380 patients who reported persistent symptoms at the time of SARS-CoV-2 vaccination, 201 (52.8%) reported variation of symptoms following the injection, without difference based on the type of vaccine used. After a complete vaccination scheme, 93.3% (28/30) of initially seronegative patients reported a positive anti-SARS-CoV-2 IgG. 170 PACS patients had not been vaccinated. The most common reasons for postponing SARS-CoV-2 vaccine were a fear of worsening PACS symptoms (55.9%) and the idea that vaccination was contraindicated because of PACS (15.6%). Conclusion: Our study suggests that SARS-CoV-2 vaccination is well tolerated in the majority of PACS patients and has good immunogenicity. Disseminating these reassuring data might prove crucial to increase vaccine coverage in patients with PACS.

scholarly journals Post-acute sequelae of COVID-19 in a non-hospitalized cohort: results from the Arizona CoVHORT

2021 ◽  
Author(s):  
Melanie L Bell ◽  
Collin J Catalfamo ◽  
Leslie V. Farland ◽  
Kacey C Ernst ◽  
Elizabeth T Jacobs ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Severe Disease ◽  
Median Number ◽  
Population Based ◽  
Diverse Population ◽  
Shortness Of Breath ◽  
Persistent Symptoms ◽  
Estimate Prevalence ◽  
Hispanic White

AbstractClinical presentation, outcomes, and duration of COVID-19 has ranged dramatically. While some individuals recover quickly, others suffer from persistent symptoms, collectively known as post-acute sequelae of SAR-CoV-2 (PASC). Most PASC research has focused on hospitalized COVID-19 patients with moderate to severe disease. We used data from a diverse population-based cohort of Arizonans to estimate prevalence of various symptoms of PASC, defined as experiencing at least one symptom 30 days or longer. There were 303 non-hospitalized individuals with a positive lab-confirmed COVID-19 test who were followed for a median of 61 days (range 30-250). COVID-19 positive participants were mostly female (70%), non-Hispanic white (68%), and on average 44 years old. Prevalence of PASC at 30 days post-infection was 68.7% (95%CI 63.4, 73.9). The most common symptoms were fatigue (37.5%), shortness-of-breath (37.5%), brain fog (30.8%), and stress (30.8%). The median number of symptoms was 3 (range 1-20). Amongst 157 participants with longer follow-up (≥60 days), PASC prevalence was 77.1%.

scholarly journals Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis

2021 ◽  
Author(s):  
Philipp Breitbart ◽  
Alexander Koch ◽  
Marco Schmidt ◽  
Annett Magedanz ◽  
Edelgard Lindhoff-Last ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Hospital Treatment ◽  
Shortness Of Breath ◽  
Single Patient ◽  
Ventricular Ejection Fraction ◽  
Persistent Symptoms

Abstract Objectives We assessed possible myocardial involvement in previously cardiac healthy post-COVID patients referred for persisting symptoms with suspected myocarditis. Background Prior studies suggested myocardial inflammation in patients with coronavirus-induced disease 2019 (COVID-19). However, the prevalence of cardiac involvement among COVID patients varied between 1.4 and 78%. Methods A total of 56 post-COVID patients without previous heart diseases were included consecutively into this study. All patients had positive antibody titers against SARS-CoV-2. Patients were referred for persistent symptoms such as chest pain/discomfort, shortness of breath, or intolerance to activity. All patients underwent standardized cardiac assessment including electrocardiogram (ECG), cardiac biomarkers, echocardiography, and cardiac magnetic resonance (CMR). Results 56 Patients (46 ± 12 years, 54% females) presented 71 ± 66 days after their COVID-19 disease. In most patients, the course of COVID-19 was mild, with hospital treatment being necessary in five (9%). At presentation, patients most often reported persistent fatigue (75%), chest pain (71%), and shortness of breath (66%). Acute myocarditis was confirmed by T1/T2-weighed CMR and elevated NTpro-BNP levels in a single patient (2%). Left ventricular ejection fraction was 56% in this patient. Additional eight patients (14%) showed suspicious CMR findings, including myocardial edema without fibrosis (n = 3), or non-ischemic myocardial injury suggesting previous inflammation (n = 5). However, myocarditis could ultimately not be confirmed according to 2018 Lake Louise criteria; ECG, echo and lab findings were inconspicuous in all eight patients. Conclusions Among 56 post-COVID patients with persistent thoracic complaints final diagnosis of myocarditis could be confirmed in a single patient using CMR. Graphic abstract

scholarly journals Effect of SARS-CoV-2 Vaccination on Symptoms from Post-Acute Sequelae of COVID-19: Results from the Nationwide VAXILONG Study

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 46
Author(s):  
Marc Scherlinger ◽  
Luc Pijnenburg ◽  
Emmanuel Chatelus ◽  
Laurent Arnaud ◽  
Jacques-Eric Gottenberg ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Inclusion Criteria ◽  
Global Effect ◽  
Initial Infection ◽  
Online Study ◽  
Persistent Symptoms ◽  
Vaccination Scheme ◽  
Vaccine Type ◽  
Few Data ◽  
To Receive

Introduction: Few data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, also called long-COVID or post-acute sequelae of COVID-19 (PASC). Patients and methods: We conducted a nationwide online study among adult patients with PASC as defined by symptoms persisting over 4 weeks following a confirmed or probable COVID-19, without any identified alternative diagnosis. Information concerning PASC symptoms, vaccine type and scheme and its effect on PASC symptoms were studied. Results: 620 questionnaires were completed and 567 satisfied the inclusion criteria and were analyzed. The respondents’ median age was 44 (IQR 25–75: 37–50) and 83.4% were women. The initial infection was proven in 365 patients (64%) and 5.1% had been hospitalized to receive oxygen. A total of 396 patients had received at least one injection of SARS-CoV-2 vaccine at the time of the survey, after a median of 357 (198–431) days following the initially-reported SARS-CoV-2 infection. Among the 380 patients who reported persistent symptoms at the time of SARS-CoV-2 vaccination, 201 (52.8%) reported a global effect on symptoms following the injection, corresponding to an improvement in 21.8% and a worsening in 31%. There were no differences based on the type of vaccine used. After a complete vaccination scheme, 93.3% (28/30) of initially seronegative patients reported a positive anti-SARS-CoV-2 IgG. A total of 170 PASC patients had not been vaccinated. The most common reasons for postponing the SARS-CoV-2 vaccine were fear of worsening PASC symptoms (55.9%) and the belief that vaccination was contraindicated because of PASC (15.6%). Conclusion: Our study suggests that SARS-CoV-2 vaccination is well tolerated in the majority of PASC patients and has good immunogenicity. Disseminating these reassuring data might prove crucial to increasing vaccine coverage in patients with PASC.

scholarly journals Limited recovery from post-acute sequelae of SARS-CoV-2 (PASC) at eight months of a prospective cohort

2021 ◽  
Author(s):  
David R DARLEY ◽  
Gregory Dore ◽  
Anthony Byrne ◽  
Marshall Plit ◽  
Bruce J Brew ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Female Gender ◽  
Health Related Quality ◽  
Chest Tightness ◽  
Initial Infection ◽  
Persistent Symptoms ◽  
Related Quality ◽  
Health Related

There is increasing recognition of the prolonged illness following acute coronavirus disease 2019 (COVID-1). In a longitudinal cohort of 99 patients, 32% reported persistent symptoms and 19% had Long COVID (Defined as fatigue or dyspnoea or chest tightness) at median 240 days after initial infection. There was no significant improvement in symptoms or measures of health-related quality of life between 4 and 8-month assessments. In multivariable analysis, female gender (OR 3.2, 95%CI 1.3-7.8, p=0.01) and acute COVID-19 hospitalisation (OR 3.8, 95% 1.1-13.6, p=0.04) were independently associated with Long COVID at 8-months. Only 80% patients reported full recovery at 8 months. Further research is required to understand the immunologic correlates of abnormal recovery and the long-term significance.

scholarly journals COVID-19 associated changes in the right departments of the heart in the elderly people

2021 ◽  
Vol 2 (3 2021) ◽  
pp. 22-26
Author(s):  
Larysa Bodretska ◽  
Iryna Shapovalenko ◽  
Ivanna Antonyuk-Shcheglova ◽  
Olena Bondarenko ◽  
Svitlana Naskalova ◽  
...  
Keyword(s):  
Heart Disease ◽  
Elderly Patients ◽  
The Elderly ◽  
Left Ventricular ◽  
Control Group ◽  
Shortness Of Breath ◽  
Persistent Symptoms ◽  
The Right ◽  
Chronic Pulmonary Heart Disease ◽  
Heart Lesions

Abstract. Purpose of the work: to study the indicators characterizing heart lesions in elderly patients who had carried COVID-19. Materials and methods: 86 patients older than 60 years old, were examined, of whom 56 (32 women and 24 men) who have carried COVID-19 between 3 and 6 months before the study, and 30 patients (12 men and 18 women) who did not have COVID - 19 in the anamnesis. The patients have been examined clinically, electro and echocardiography have been performed. The results. Elderly patients during the post-covid period have complaints of shortness of breath, pain in the heart, swelling, coughing, weakness, which are more stable and intense than before the infection. Patients who have carried COVID-19 demonstrate the signs of a chronic pulmonary heart disease: increase in the size of a right ventricle and decrease of its contractile ability, increase in pressure in a pulmonary artery. Signs of a statistically significant moderate decrease of the contractility in the left ventricular were also identified. Conclusions. The statistically significant changes in the right departments of the heart among the patients with carried COVID-19 with persistent symptoms after infection were defined. Patients who have carried COVID-19 but have no symptoms did not differ statistically from the control group. Key words: COVID-19, old age, post- COVID period, right departments of the heart.

Combined triple treatment of fibrin amyloid microclots and platelet pathology in individuals with Long COVID/ Post-Acute Sequelae of COVID-19 (PASC) can resolve their persistent symptoms

2021 ◽  
Author(s):  
Etheresia Pretorius ◽  
Chantelle Venter ◽  
Gert Laubshder ◽  
Maritha Kotze ◽  
Kelebogile Moremi ◽  
...  
Keyword(s):  
South African ◽  
Dual Antiplatelet Therapy ◽  
Shortness Of Breath ◽  
High Cholesterol ◽  
Blood Samples ◽  
Persistent Symptoms ◽  
Gender Balance ◽  
Cholesterol Levels ◽  
Co Morbidity ◽  
Triple Treatment

Abstract We recognise that fibrin(ogen) amyloid microclots and platelet hyperactivation, that we have previously observed in COVID-19 and Long COVID/Post-Acute Sequelae of COVID-19 (PASC) patients, might form a suitable set of foci for the clinical treatment of the symptoms of long COVID/PASC. We first report on the comorbidities and symptoms found in a cohort of 845 South African Long COVID/PASC patients who filled in the South African Long COVID/PASC registry, of which hypertension and high cholesterol levels (dyslipidaemia) were the most important comorbidities. The gender balance (70% female) and the most commonly reported Long COVID/PASC symptoms (fatigue, brain fog, loss of concentration and forgetfulness, shortness of breath, as well as joint and muscle pains) were comparable to those reported elsewhere. This suggests that our sample was not at all atypical. Using a previously published scoring system for fibrin amyloid microclots and platelet pathology, we analysed blood samples from 70 patients, and report the presence of significant fibrin amyloid microclots and platelet pathology in all cases; these were associated with Long COVID/PASC symptoms that persisted after the recovery from acute COVID-19. A subset of 24 patients was treated with one month of dual antiplatelet therapy (DAPT) (Clopidogrel 75mg/Aspirin 75mg) once a day, as well as a direct oral anticoagulant (DOAC) (Apixiban) 5 mg twice a day. A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole. Thromboelastography (TEG®) was used to assist in determining their clotting status. Each of the 24 treated cases reported that their main symptoms were resolved and fatigue as the main symptom was relieved, and this was also reflected in a decrease of both the fibrin amyloid microclots and platelet pathology scores. Nine patients were genotyped for genetic variation in homocysteine metabolism implicated in hypertension, a common COVID-19 co-morbidity reported in both patients found to be homozygous for the risk-associated MTHFR 677 T-allele. Fibrin amyloid microclots that block capillaries and inhibit the transport of O2 to tissues, accompanied by platelet hyperactivation, provide a ready explanation for the symptoms of Long COVID/PASC. The removal and reversal of these underlying epitheliopathies underlying this provide an important treatment option that seems to be highly efficacious, and warrants controlled clinical studies.

scholarly journals Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254347
Author(s):  
Melanie L. Bell ◽  
Collin J. Catalfamo ◽  
Leslie V. Farland ◽  
Kacey C. Ernst ◽  
Elizabeth T. Jacobs ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Severe Disease ◽  
Median Number ◽  
Population Based ◽  
Diverse Population ◽  
Shortness Of Breath ◽  
Persistent Symptoms ◽  
Estimate Prevalence ◽  
Hispanic White

Clinical presentation, outcomes, and duration of COVID-19 has ranged dramatically. While some individuals recover quickly, others suffer from persistent symptoms, collectively known as long COVID, or post-acute sequelae of SARS-CoV-2 (PASC). Most PASC research has focused on hospitalized COVID-19 patients with moderate to severe disease. We used data from a diverse population-based cohort of Arizonans to estimate prevalence of PASC, defined as experiencing at least one symptom 30 days or longer, and prevalence of individual symptoms. There were 303 non-hospitalized individuals with a positive lab-confirmed COVID-19 test who were followed for a median of 61 days (range 30–250). COVID-19 positive participants were mostly female (70%), non-Hispanic white (68%), and on average 44 years old. Prevalence of PASC at 30 days post-infection was 68.7% (95% confidence interval: 63.4, 73.9). The most common symptoms were fatigue (37.5%), shortness-of-breath (37.5%), brain fog (30.8%), and stress/anxiety (30.8%). The median number of symptoms was 3 (range 1–20). Amongst 157 participants with longer follow-up (≥60 days), PASC prevalence was 77.1%.

scholarly journals Deciphering Long Covid: Next Emergent Healthcare Dilemma

2021 ◽  
Vol 3 (6) ◽  
pp. 39-43
Author(s):  
Sana Abbas ◽  
Beenish Abbas ◽  
Haifsa Rafique ◽  
Aisha Rafique ◽  
Saima Zafar ◽  
...  
Keyword(s):  
Severe Disease ◽  
Male Gender ◽  
Chronic Illnesses ◽  
Age Group ◽  
Shortness Of Breath ◽  
Positive Polymerase Chain Reaction ◽  
Disease Symptoms ◽  
Pakistani Population ◽  
Persistent Symptoms ◽  
Loss Of Appetite

Objective: To determine the prevalence of Long Haul COVID–19 Syndrome among Pakistani Population. Methods: This cross-sectional analytical study was conducted after approval from the ethical review committee of the Foundation University College of Dentistry, Islamabad from June 2021 to September 2021. A non-probability consecutive sampling methodology was employed and a total of (168) participants after voluntary consent were enrolled in the study, after explaining the study protocol to the patients. The final Questionnaire is comprised of three sections. Section – I focused on the demographic profile (Age, Gender, Profession) of the participants. Section – II was designed to investigate COVID – 19 disease history, comorbid, coronavirus disease severity along with the number of individuals infected in the family, duration of positive polymerase chain reaction results, and management destination (Hospital or Home). Section – III addressed the frequency of persistent symptoms (Gastrointestinal, Systemic, Cardiovascular, Musculoskeletal, Immunological, Dermatological, Neuropsychiatric, Ophthalmological, Pulmonary, Otorhinolaryngological, Endocrine, Reproductive and Genitourinary systems). Results: 168 responders participated in this survey study,48 (28.6%) males while 120 (71.4%) females. About 36 (11.9%) were found to be suffering from comorbidity, 84 (50.0%) suffered from mild disease symptoms, while only 4 (2.4%) experienced the severe disease. The disease was managed at home for a major chunk of responders, 140 (83.3%).132 (78.6%) were found to have suffered from long COVID syndrome with the persistence of symptoms beyond four weeks of infection. The most common symptoms included fatigue (78.8%), fever (60.0%), loss of taste (57.8%), dry cough (45.5%), headache (42.4%), post-exertional malaise (45.5%), shortness of breath (39.4%), insomnia (39.0%), loss of smell (36.4%), loss of appetite (33.3%) and depression (33.3%).Male gender (p=0.009), with existing chronic illnesses (p<0.001), moderate and severe disease (p<0.001), higher age group (p<0.001) and isolated at hospital (p=0.002). Conclusion: In conclusion, this study has shown that persistence of COVID disease symptoms (most common symptoms included fatigue, fever, loss of taste, dry cough, headache, post-exertional malaise, shortness of breath, insomnia, loss of smell, loss of appetite, and depression) are common in Pakistani population. Male gender, existing chronic illnesses, moderate and severe disease, higher age group, and isolation at the hospital are the probable risk factors.

scholarly journals Usefulness of Pirfenidone in Covid Lung: A Case Series

2021 ◽  
Vol 3 (1) ◽  
pp. 24-26
Author(s):  
Abdul Basit Ibne Momen ◽  
Farhana Khan ◽  
Sadia Saber ◽  
Amrin Sultana ◽  
Rafa Faaria Alam ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Chronic Lung Disease ◽  
Marked Improvement ◽  
Case Series ◽  
New Disease ◽  
Shortness Of Breath ◽  
Radiological Findings ◽  
Initial Infection ◽  
Long Time

The year 2020 has been plagued by the COVID‑19 pandemic that has resulted in an additional 1,800,000 deaths worldwide. Many patients who recover from Covid-19 later present with shortness of breath and fibrosis of the lungs, while some take a long time to recover from the initial infection. A drug such as pirfenidone, which has been used for the treatment of idiopathic pulmonary fibrosis, could offer additional benefits by reverting pulmonary fibrotic damage. Here we describe a case series of five patients where addition of this drug showed marked improvement in symptoms and radiological findings. Apart from the efforts regarding understanding the pathophysiology of this new disease, we must also evaluate the proportion of patients that develop chronic lung disease due to fibrosis following COVID-19 recovery. Certainly, more attention should be given to new studies to determine the actual benefit of pirfenidone in patients with pulmonary fibrosis as a result of Covid-19 infection.

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