Tag: covid-19

Long COVID-A New Challenge in Medicine: Focus on Pregnancy and Breastfeeding

Abstract:

Long COVID (coronavirus disease) has been described as a new multi-organ disease, which appears to be more prevalent in women than in men. Pregnant and breastfeeding women are a special subgroup of patients to consider with long COVID, as only scarce data have been collected to date. Menstrual changes are commonly observed during or after COVID-19; some studies also attribute slight changes of cycle length to previous inoculation against the virus.
Pregnant women who have a symptomatic infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are at a higher risk for adverse outcomes and pregnancy-associated complications. Moreover, more and robust data are required to evaluate vertical transmission. COVID vaccines are the most effective tool against the pandemic, as they prevent infection, but also appear to be able to ease long COVID symptoms. Vaccines have been proven safe and effective in both pregnant and breastfeeding women. This article aims to present current data on long COVID in pregnant and breastfeeding women and elucidate risk factors and possible treatment options.
Source: Han E, Gyöngyösi M. [Long COVID-A New Challenge in Medicine: Focus on Pregnancy and Breastfeeding]. Journal fur Gynakologische Endokrinologie (Osterreichische Ausg.). 2023 Feb:1-6. DOI: 10.1007/s41974-023-00250-5. PMID: 36747883; PMCID: PMC9893966. https://europepmc.org/article/med/36747883 (Full text available in German)

Long-COVID Rates Vary Throughout the SARS-CoV-2 Pandemic

Abstract:

The infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) frequently causes a broad range of long-lasting symptoms. This condition, termed long-COVID, influences everyday life of affected individuals in many ways and causes a high economic burden. There is urgent need to obtain better understanding of the risk factors that contribute to the development of long-COVID.

Aim of this study was to investigate the long-COVID rate of supposedly healthy adults during different phases of the pandemic. Therefore, 71,670 blood donations were screened for SARS-CoV-2 total anti-N antibodies between 5 th June 2020 and 30 th November 2022. 351 individuals could be recruited for our study to monitor long-COVID symptoms and their duration. Despite immense worldwide efforts to stop virus dissemination, our data reveal a constantly rising SARS-CoV-2 anti-N seroprevalence rate in Salzburg, Austria, peaking at 84.9% in October 2022.

In addition, our data demonstrate varying rates of long-COVID in the course of the pandemic. While long-COVID rates were about 20% for the time span between March 2020 and August 2021, long-COVID was reported by 12% for infections from September 2021 to August 2022. This could be attributed to different virus variants, but also to increasing vaccination rates. We further found that long-COVID symptoms decline over time: while 18% of our study participants described persisting symptoms 3 months after the seropositive blood donation, 14% reported persisting symptoms 9 months afterwards and 3% after 18 months.

In conclusion, our data reveal that long-COVID symptoms may persist for more than a year after a SARS-CoV-2 infection and that long-COVID rates are varying in the course of the SARS-CoV-2 pandemic.

Source: Nunhofer, et al. Long-COVID Rates Vary Throughout the SARS-CoV-2 Pandemic. Journal of Infectious Diseases & Therapy. Volume 11 • Issue 01 • 1000520. ISSN: 2332-0877.  https://www.researchgate.net/profile/Sandra-Laner-Plamberger/publication/368293143_Long-COVID_Rates_Vary_Throughout_the_SARS-CoV-2_Pandemic/links/63e0dd9062d2a24f920a4d24/Long-COVID-Rates-Vary-Throughout-the-SARS-CoV-2-Pandemic.pdf (Full text)

Therapeutic Approaches to Dysautonomia in Childhood, with a Special Focus on Long COVID

Abstract:

Background: Dysautonomia seems to be important for the pathophysiology of psychosomatic diseases and, more recently, for long COVID. This concept may explain the clinical symptoms and could help open new therapeutic approaches.
Methods: We compared our data from an analysis of heart rate variability (HRV) in an active standing test in 28 adolescents who had developed an inappropriate sinus tachycardia (IST, n = 13) or postural orthostatic tachycardia syndrome (POTS, n = 15) after contracting COVID-19 disease and/or vaccination with 64 adolescents from our database who developed dysautonomia due to psychosomatic diseases prior to the COVID-19 pandemic. We prove the effects of our treatment: omega-3 fatty acid supplementation (O3-FA, n = 18) in addition to propranolol (low dose, up to 20-20-0 mg, n = 32) or ivabradine 5-5-0 mg (n = 17) on heart rate regulation and heart rate variability (HRV).
Results: The HRV data were not different between the adolescents with SARS-CoV-2-related disorders and the adolescents with dysautonomia prior to the pandemic. The heart rate increases in children with POTS while standing were significantly lower after low-dose propranolol (27.2 ± 17.4 bpm***), ivabradine (23.6 ± 8.12 bpm*), and O-3-FA (25.6 ± 8.4 bpm*). The heart rate in children with IST while lying/standing was significantly lower after propranolol (81.6 ± 10.1 bpm**/101.8 ± 18.8***), ivabradine (84.2 ± 8.4 bpm***/105.4 ± 14.6**), and O-3-FA (88.6 ± 7.9 bpm*/112.1/14.9*).
Conclusions: The HRV data of adolescents with dysautonomia after COVID-19 disease/vaccination are not significantly different from a historical control of adolescents with dysautonomia due to psychosomatic diseases prior to the pandemic. Low-dose propranolol > ivabradine > omega-3 fatty acids significantly decrease elevated heart rates in patients with IST and the heart rate increases in patients with POTS and may be beneficial in these children with dysautonomia.
Source: Buchhorn R. Therapeutic Approaches to Dysautonomia in Childhood, with a Special Focus on Long COVID. Children. 2023; 10(2):316. https://doi.org/10.3390/children10020316 https://www.mdpi.com/2227-9067/10/2/316 (Full text)

Autoantigen profiling reveals a shared post-COVID signature in fully recovered and Long COVID patients

Abstract:

Some individuals do not return to baseline health following SARS-CoV-2 infection, leading to a condition known as Long COVID. The underlying pathophysiology of Long COVID remains unknown. Given that autoantibodies have been found to play a role in severity of COVID infection and certain other post-COVID sequelae, their potential role in Long COVID is important to investigate. Here we apply a well-established, unbiased, proteome-wide autoantibody detection technology (PhIP-Seq) to a robustly phenotyped cohort of 121 individuals with Long COVID, 64 individuals with prior COVID-19 who reported full recovery, and 57 pre-COVID controls.

While a distinct autoreactive signature was detected which separates individuals with prior COVID infection from those never exposed to COVID, we did not detect patterns of autoreactivity that separate individuals with Long COVID relative to individuals fully recovered from SARS-CoV-2 infection. These data suggest that there are robust alterations in autoreactive antibody profiles due to infection; however, no association of autoreactive antibodies and Long COVID was apparent by this assay.

Source: Bodansky A, Wang CY, Saxena A, Mitchell A, Takahashi S, Anglin K, Huang B, Hoh R, Lu S, Goldberg SA, Romero J, Tran B, Kirtikar R, Grebe H, So M, Greenhouse B, Durstenfeld MS, Hsue PY, Hellmuth J, Kelly JD, Martin JN, Anderson MS, Deeks SG, Henrich TJ, DeRisi JL, Peluso MJ. Autoantigen profiling reveals a shared post-COVID signature in fully recovered and Long COVID patients. medRxiv [Preprint]. 2023 Feb 9:2023.02.06.23285532. doi: 10.1101/2023.02.06.23285532. PMID: 36798288; PMCID: PMC9934805. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9934805/ (Full text)

Impact of COVID-19 vaccination in post-COVID cardiac complications

Abstract:

Background: After the acute infection, COVID-19 can produce cardiac complications as well as long-COVID persistent symptoms. Although vaccination against COVID-19 represented a clear reduction in both mortality and ICU admissions, there is very little information on whether this was accompanied by a decrease in the prevalence of post-COVID cardiac complications. The aim of this study was to analyze the relationship between COVID-19 vaccination and the prevalence of post-COVID cardiac injury assessed by echocardiogram, and long-COVID persistent cardiac symptoms.

Methods: All patients who consulted for post-COVID evaluation 14 days after discharge from acute illness were included. Patients with heart disease were excluded. The relationship between complete vaccination scheme (at least two doses applied with 14 days or more since the last dose) and pathological echocardiographic findings, as well as the relationship of vaccination with persistent long-COVID symptoms, were evaluated by multivariate analysis, adjusting for age, sex and clinical variables that would have shown significant differences in univariate analysis.

Results: From 1883 patients, 1070 patients (56.8%) suffered acute COVID-19 without a complete vaccination scheme. Vaccination was associated with lower prevalence of cardiac injury (1.35% versus 4.11%, adjusted OR 0.33; 95% CI 0.17-0.65, p=0.01). In addition, vaccinated group had a lower prevalence of persistent long-COVID symptoms compared to unvaccinated patients (10.7% versus 18.3%, adjusted OR 0.52; 95% CI 0.40-0.69, p<0.001).

Conclusion: Vaccination against COVID-19 was associated with lower post-COVID cardiac complications and symptoms, reinforcing the importance of fully vaccinating the population.

Source: Parodi JB, Indavere A, Bobadilla Jacob P, Toledo GC, Micali RG, Waisman G, Masson W, Epstein ED, Huerin MS. Impact of COVID-19 vaccination in post-COVID cardiac complications. Vaccine. 2023 Feb 17;41(8):1524-1528. doi: 10.1016/j.vaccine.2023.01.052. Epub 2023 Jan 27. PMID: 36725436; PMCID: PMC9885297. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9885297/ (Full text)

Correlates of long-COVID-19: the role of demographics, chronic illness, and psychiatric diagnosis in an urban sample

Abstract:

Long-COVID-19 symptoms are an emerging public health issue. This study sought to investigate demographics, chronic illness, and probable psychiatric diagnoses as correlates for long-COVID-19 in an urban adult sample. Self-report Qualtrics surveys were sent to students across City University of New York (CUNY) campuses in New York City in Winter 2021-2022. Binary logistic regressions were used to assess the relation of a range of factors with endorsement of long-COVID-19. Results demonstrated that Latinx participants endorsed higher odds of long-COVID-19, as compared to non-Latinx white participants.

Participants who endorsed having a prior chronic illness and those who met the cut-off for probable psychiatric diagnoses all endorsed higher odds of long-COVID-19. Long-COVID-19 may be more likely among specific subpopulations and among persons with other ongoing physical and mental illness.

Source: Schulder T, Rudenstine S, Ettman CK, Galea S. Correlates of long-COVID-19: the role of demographics, chronic illness, and psychiatric diagnosis in an urban sample. Psychol Health Med. 2023 Feb 8:1-13. doi: 10.1080/13548506.2023.2177684. Epub ahead of print. PMID: 36752386. https://pubmed.ncbi.nlm.nih.gov/36752386/

Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis

Abstract:

Background: The relationship between coronavirus disease 2019 (COVID-19) vaccination and long COVID has not been firmly established. We conducted a systematic review and meta-analysis to evaluate the association between COVID-19 vaccination and long COVID.

Methods: PubMed and EMBASE databases were searched on September 2022 without language restrictions (CRD42022360399) to identify prospective trials and observational studies comparing patients with and without vaccination before severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We also included studies reporting symptomatic changes of ongoing long COVID following vaccination among those with a history of SARS-CoV-2 infection. Odds ratios (ORs) for each outcome were synthesized using a random-effects model. Symptomatic changes after vaccination were synthesized by a one-group meta-analysis.

Results: Six observational studies involving 536,291 unvaccinated and 84,603 vaccinated (before SARS-CoV-2 infection) patients (mean age, 41.2-66.6; female, 9.0-67.3%) and six observational studies involving 8,199 long COVID patients (mean age, 40.0 to 53.5; female, 22.2-85.9%) who received vaccination after SARS-CoV-2 infection were included. Two-dose vaccination was associated with a lower risk of long COVID compared to no vaccination (OR, 0.64; 95% confidence interval [CI], 0.45-0.92) and one-dose vaccination (OR, 0.60; 95% CI, 0.43-0.83). Two-dose vaccination compared to no vaccination was associated with a lower risk of persistent fatigue (OR, 0.62; 95% CI, 0.41-0.93) and pulmonary disorder (OR, 0.50; 95% CI, 0.47-0.52). Among those with ongoing long COVID symptoms, 54.4% (95% CI, 34.3-73.1%) did not report symptomatic changes following vaccination, while 20.3% (95% CI, 8.1-42.4%) experienced symptomatic improvement after two weeks to six months of COVID-19 vaccination.

Conclusions: COVID-19 vaccination before SARS-CoV-2 infection was associated with a lower risk of long COVID, while most of those with ongoing long COVID did not experience symptomatic changes following vaccination.

Source: Watanabe A, Iwagami M, Yasuhara J, Takagi H, Kuno T. Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis. Vaccine. 2023 Feb 8:S0264-410X(23)00134-2. doi: 10.1016/j.vaccine.2023.02.008. Epub ahead of print. PMID: 36774332; PMCID: PMC9905096. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905096/ (Full text)

A machine learning approach identifies distinct early-symptom cluster phenotypes which correlate with hospitalization, failure to return to activities, and prolonged COVID-19 symptoms

Abstract:

Background: Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of developing long-term symptoms and associated inflammatory profiles.

Methods: 1,273 SARS-CoV-2 positive U.S. Military Health System beneficiaries with quantitative symptom scores (FLU-PRO Plus) were included in this analysis. We employed machine-learning approaches to identify symptom clusters and compared risk of hospitalization, long-term symptoms, as well as peak CRP and IL-6 concentrations.

Results: We identified three distinct clusters of participants based on their FLU-PRO Plus symptoms: cluster 1 (“Nasal cluster”) is highly correlated with reporting runny/stuffy nose and sneezing, cluster 2 (“Sensory cluster”) is highly correlated with loss of smell or taste, and cluster 3 (“Respiratory/Systemic cluster”) is highly correlated with the respiratory (cough, trouble breathing, among others) and systemic (body aches, chills, among others) domain symptoms. Participants in the Respiratory/Systemic cluster were twice as likely as those in the Nasal cluster to have been hospitalized, and 1.5 times as likely to report that they had not returned-to-activities, which remained significant after controlling for confounding covariates (P < 0.01). Respiratory/Systemic and Sensory clusters were more likely to have symptoms at six-months post-symptom-onset (P = 0.03). We observed higher peak CRP and IL-6 in the Respiratory/Systemic cluster (P < 0.01).

Conclusions: We identified early symptom profiles potentially associated with hospitalization, return-to-activities, long-term symptoms, and inflammatory profiles. These findings may assist in patient prognosis, including prediction of long COVID risk.

Source: Epsi NJ, Powers JH, Lindholm DA, Mende K, Malloy A, Ganesan A, Huprikar N, Lalani T, Smith A, Mody RM, Jones MU, Bazan SE, Colombo RE, Colombo CJ, Ewers EC, Larson DT, Berjohn CM, Maldonado CJ, Blair PW, Chenoweth J, Saunders DL, Livezey J, Maves RC, Sanchez Edwards M, Rozman JS, Simons MP, Tribble DR, Agan BK, Burgess TH, Pollett SD; EPICC COVID-19 Cohort Study Group. A machine learning approach identifies distinct early-symptom cluster phenotypes which correlate with hospitalization, failure to return to activities, and prolonged COVID-19 symptoms. PLoS One. 2023 Feb 9;18(2):e0281272. doi: 10.1371/journal.pone.0281272. PMID: 36757946; PMCID: PMC9910657. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910657/ (Full text)

Symptom patterns and life with post-acute COVID-19 in children aged 8-17: a mixed methods studyprotocol

Abstract:

Background: While there is a substantial body of knowledge about acute COVID-19, less is known about long-COVID, where symptoms continue beyond four weeks.

Aim: This study aims to describe longer-term effects of COVID-19 infection in children and young people (CYP) and identify their needs in relation to long-COVID.

Design & setting: This study comprises an observational prospective cohort study and a linked qualitative study, identifying participants aged 8-17 years in the West Midlands of England.

Method: CYP will be invited to complete online questionnaires to monitor incidences and symptoms of Covid-19 over a 12-month period. CYP who have experienced long-term effects of COVID will be invited to interview, and those currently experiencing symptoms will be asked to document their experiences in a diary. Professionals who work with CYP will be invited to explore the impact of long-COVID on the wider experiences of CYP, in a focus group. Descriptive statistics will be used to describe the incidence and rates of resolution of symptoms, and comparisons made between exposed and non-exposed groups. Logistic regression models will be used to estimate associations between candidate predictors and the development of long-COVID, and linear regression will be used to estimate associations between candidate predictors. Qualitative data will be analysed thematically using the constant comparison method.

Conclusion: This study will describe features and symptoms of long-COVID and explore the impact of long-COVID within the lives of CYP and their families, to provide better understanding of long-COVID and inform clinical practice.

Source: Faux-Nightingale A, Burton C, Twohig H, Blagojevic-Bucknall M, Carroll W, Chew-Graham CA, Dunn K, Gilchrist F, Helliwell T, Lawton O, Lawton S, Mallen C, Saunders B, van der Windt D, Welsh V. Symptom patterns and life with post-acute COVID-19 in children aged 8-17: a mixed methods studyprotocol. BJGP Open. 2023 Feb 9:BJGPO.2022.0149. doi: 10.3399/BJGPO.2022.0149. Epub ahead of print. PMID: 36759021. https://bjgpopen.org/content/early/2023/02/08/BJGPO.2022.0149 (Full text available as PDF file)

A case of post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome characterized by post-exertional malaise and low serum acylcarnitine level

Abstract:

COVID-19 afflicts patients with acute symptoms and longer term sequelae. One of the sequelae is myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which is often difficult to diagnose, having no established tests. In this article, we synthesize information from literature reviews on patients with ME/CSF that developed after recovery from COVID-19.

Source: Jinushi R, Nishiguchi S, Masuda S, Sasaki A, Koizumi K, Ryozawa S. A case of post-COVID-19 myalgic encephalomyelitis/chronic fatigue syndrome characterized by post-exertional malaise and low serum acylcarnitine level. Clin Case Rep. 2023 Feb 10;11(2):e6930. doi: 10.1002/ccr3.6930. PMID: 36789311; PMCID: PMC9913186. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913186/ (Full text)