The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID      

4  57   2024/04/14           Cite
Authors:

Research Videos ( author1@researchvideos.net )

Abstract :

Although COVID-19 was initially considered an acute respiratory illness, recent evidence suggests that manifestations including but not limited to those of the cardiovascular, respiratory, neuropsychiatric, gastrointestinal, reproductive, and musculoskeletal systems may persist long after the acute phase. These persistent manifestations, also referred to as long COVID, could impact all patients with COVID-19 across the full spectrum of illness severity. Herein, we comprehensively review the current literature on long COVID, highlighting its epidemiological understanding, the impact of vaccinations, organ-specific sequelae, pathophysiological mechanisms, and multidisciplinary management strategies. In addition, the impact of psychological and psychosomatic factors is also underscored. Despite these crucial findings on long COVID, the current diagnostic and therapeutic strategies based on previous experience and pilot studies remain inadequate, and well-designed clinical trials should be prioritized to validate existing hypotheses. Thus, we propose the primary challenges concerning biological knowledge gaps and efficient remedies as well as discuss the corresponding recommendations.

Keywords :

["long COVID impact","epidemiology","SARS-CoV-2","impact of vaccinations","therapeutic strategies"]

Disciplines :

Medicine

Subdisciplines :

Emergency Medicine , Infectious Diseases

Video Type :

2D

Publishing Licence :

Open-access

Submitted On :

2024/04/14

References :

{1. Halperin, S. A. et al. Final efficacy analysis, interim safety analysis, and immunogenicity of a single dose of recombinant novel coronavirus vaccine (adenovirus type 5 vector) in adults 18 years and older: an international, multicentre, randomised, double-blinded, placebo-controlled phase 3 trial. Lancet. 399,
237–248 (2022).
2. Li, J., Shao, J., Wang, C. & Li, W. The epidemiology and therapeutic options for the COVID-19. Precis. Clin. Med. 3, 71–84 (2020).
3. WHO. WHO coronavirus (COVID-19) dashboard, https://covid19.who.int (2023).
4. Wang, C. et al. COVID-19 in early 2021: current status and looking forward. Signal Transduct. Target Ther. 6, 114 (2021).
5. Liu, M. et al. Potential role of ACE2 in coronavirus disease 2019 (COVID-19) prevention and management. J. Transl. Int. Med. 8, 9–19 (2020).
6. Chen, T. et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 368, m1091 (2020).
7. Nalbandian, A. et al. Post-acute COVID-19 syndrome. Nat. Med. 27, 601–615 (2021).
8. Shah, W., Hillman, T., Playford, E. D. & Hishmeh, L. Managing the long term effects of COVID-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 372, n136 (2021).
9. Venkatesan, P. NICE guideline on long COVID. Lancet Respir. Med. 9, 129 (2021).
10. Greenhalgh, T. et al. Long COVID-an update for primary care. BMJ. 378, e072117 (2022).
11. Pan, L. et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am. J. Gastroenterol. 115, 766–773 (2020).
12. Raman, B. et al. Medium-term effects of SARS-CoV-2 infection on multiple vitalorgans, exercise capacity, cognition, quality of life and mental health, post-hospital discharge. EClinicalMedicine 31, 100683 (2021).
13. Naeije, R. & Caravita, S. Phenotyping long COVID. Eur. Respir. J. 58, 2101763 (2021).
14. Petersen, M. S. et al. Long COVID in the Faroe Islands: a longitudinal study among nonhospitalized patients. Clin. Infect. Dis. 73, e4058–e4063 (2021).
15. Xu, E., Xie, Y. & Al-Aly, Z. Risks and burdens of incident dyslipidaemia in long COVID: a cohort study. Lancet Diabetes Endocrinol. 11, 120–128 (2023).
16. Tan, B. K. J. et al. Prognosis and persistence of smell and taste dysfunction in patients with COVID-19: meta-analysis with parametric cure modelling of recovery curves. BMJ. 378, e069503 (2022).
17. Parker, A. M. et al. Addressing the post-acute sequelae of SARS-CoV-2 infection: a multidisciplinary model of care. Lancet Respir. Med. 9, 1328–1341 (2021).
18. Tran, V. T., Porcher, R., Pane, I. & Ravaud, P. Course of post COVID-19 disease symptoms over time in the ComPaRe long COVID prospective e-cohort. Nat. Commun. 13, 1812 (2022).
19. Seessle, J. et al. Persistent symptoms in adult patients 1 year after coronavirus disease 2019 (COVID-19): a prospective cohort study. Clin. Infect Dis. 74, 1191–1198 (2022).
20. Proal, A. D. & VanElzakker, M. B. Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms. Front. Microbiol. 12, 698169 (2021).
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RVOI :
https://rvoi.org/Medic/Apr/2024/661c32e5ebd52

DOI :
https://doi.org/10.1038/s41392-023-01640-z

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