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Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 23816

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Special Issue Editors

Prof. Dr. César Fernández De Las Peñas

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Guest Editor

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Domingo Palacios-Ceña

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Guest Editor

Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
Interests: qualitative research; mixed methods; caring science; vulnerable groups; disability and rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

SARS-CoV-2 caused a post-outbreak pandemic. “Long-haulers” are individuals who recover from SARS-CoV-2 acute infection but develop post-COVID symptoms. An increasing amount of evidence in the literature supports the presence of several post-COVID symptoms after the acute phase of COVID-19. In the past year, some advancements in the definition, identification, timeframe, mechanisms, and treatment strategies for the management of post-COVID symptoms have been made. Due to the interest that the first part of the Special Issue elicited, we are pleased to invite you to contribute submissions to this Special Issue, entitled “Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management—Part II”.

This second part of the Special Issue aims to increase our level of knowledge regarding the mechanisms behind post COVID-19 symptomatology and the identification of subgroups of patients to improve management strategies for this group of patients.

This Special Issue will focus on all aspects of post-COVID symptoms, a topic of increasing relevance due to the expected presence of millions of “long-haulers”. We invite researchers/clinicians to submit clinical trials, systematic reviews, narrative reviews, meta-analyses, cohort studies, and case–control studies related to the identification or management of post-COVID symptoms to this Special Issue. The articles can cover any post-COVID symptoms. Particular attention will be paid to the role of vaccines in post-COVID symptoms and other factors emerging in the last year, such as different SARS-CoV-2 variants of concern.

Prof. Dr. César Fernández De Las Peñas
Prof. Dr. Domingo Palacios-Ceña
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

COVID-19
symptoms
long-COVID
pain
function
fatigue
dyspnoea
public health

Published Papers (12 papers)

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Research

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10 pages, 208 KiB

Open AccessArticle

The Impact of Previous Comorbidities on New Comorbidities and Medications after a Mild SARS-CoV-2 Infection in a Lithuanian Cohort

by Dovilė Važgėlienė, Raimondas Kubilius and Indre Bileviciute-Ljungar

J. Clin. Med. 2024, 13(2), 623; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13020623 - 22 Jan 2024

Viewed by 628

Abstract

This cross-sectional study investigates new comorbidities and new medications after a mild SARS-CoV-2 infection. Data were collected after an acute SARS-CoV-2 infection by online survey in a Lithuanian cohort. Sociodemographic data, SARS-CoV-2-related symptoms, previous and new comorbidities, and medications were analysed. The results of 895 participants (mean age: 44 years) show that 91% were women, 58% had higher education, and 84% were working. Among those, 473 (52.8%) answered being “healthy” before infection; 823 (92%) indicated being positive on diagnostic tests; and 841 (94%) were non-hospitalized. Asymptomatic infection was reported by 17 participants (1.9%). Participants reporting any comorbidity before a SARS-CoV-2 infection reported more frequently having remaining symptoms compared to those who were “healthy”, particularly in relation to neurological symptoms. Thirteen percent of participants reported new comorbidities, and thirty-five percent started new medication. Among new medications, an intake of vitamins/supplements (21%) and anti-inflammatory drugs (4%) was more often reported by “unhealthy” participants. Regression analysis revealed that new cardiovascular and pulmonary diagnoses predicted each other. Participants reporting prior neurological disorders tended to have an increased risk of intaking new vitamins/supplements and anti-inflammatory drugs after infection. The results indicate a significantly increased consumption of medication, particularly unprescribed substances, after SARS-CoV-2, indicating a need of more research in this area. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

13 pages, 618 KiB

Open AccessArticle

Effects of COVID-19 Lockdown on Heart Failure Patients: A Quasi-Experimental Study

by Juan Luis Sánchez-González, Luis Almenar-Bonet, Noemí Moreno-Segura, Francisco Gurdiel-Álvarez, Hady Atef, Amalia Sillero-Sillero, Raquel López-Vilella, Iván Santolalla-Arnedo, Raúl Juárez-Vela, Clara Isabel Tejada-Garrido and Elena Marques-Sule

J. Clin. Med. 2023, 12(22), 7090; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12227090 - 14 Nov 2023

Viewed by 733

Abstract

Introduction: The COVID-19 lockdown has been associated with reduced levels of physical activity, quality of life, and sleep quality, but limited evidence exists for its impact on heart failure patients. This study examined the influence of the COVID-19 lockdown on these aspects in heart failure patients, with specific comparisons by age and sex. Methods: A quasi-experimental cross-sectional study of patients with heart failure was conducted. The assessment involved two time points: during the COVID-19 lockdown (March to June 2020) and post-lockdown (July to October 2020). A total of 107 HF patients participated, with assessments of overall PA (using the International Physical Activity Questionnaire), QoL (employing the Cantril Ladder of Life), and sleep quality (utilizing the Minimal Insomnia Symptom Scale) conducted during and after the COVID-19 lockdown. Results: HF patients reported lower levels of total PA (p = 0.001) and walking PA (p < 0.0001) during lockdown than after lockdown, whilst no differences were observed in QoL nor sleep quality. In addition, both younger and older patients reported lower walking PA and total PA during lockdown than after lockdown, while older patients reported lower QoL during lockdown than after lockdown. Moreover, both men and women reported lower walking PA and total PA during lockdown than after lockdown, whilst women reported lower QoL. Conclusions: HF patients need improved PA programs during lockdowns, as these programs can elevate PA levels and enhance QoL, especially when faced with the risk of decompensation during health crises. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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12 pages, 611 KiB

Open AccessArticle

Pulmonary Evaluation in Children with Post-COVID-19 Condition Respiratory Symptoms: A Prospective Cohort Study

by Einat Shmueli, Ophir Bar-On, Ben Amir, Meir Mei-Zahav, Patrick Stafler, Hagit Levine, Guy Steuer, Benjamin Rothschild, Lior Tsviban, Nofar Amitai, Miri Dotan, Gabriel Chodick, Dario Prais and Liat Ashkenazi-Hoffnung

J. Clin. Med. 2023, 12(21), 6891; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12216891 - 01 Nov 2023

Cited by 1 | Viewed by 903

Abstract

Background: Studies on post-COVID-19 condition (PCC) in adults have shown deterioration in pulmonary function tests (PFTs), mainly a diffusion limitation. Among the pediatric population, data are scarce. Aim: To characterize PFTs in children with PCC, including changes over time. Methods: A prospective longitudinal study of children with defined PCC and respiratory complaints who were referred to a designated multidisciplinary clinic from 11/2020 to 12/2022. Results: Altogether, 184 children with a mean age of 12.4 years (SD 4.06) were included. A mild obstructive pattern was demonstrated in 19/170 (11%) at presentation, as indicated by spirometry and/or positive exercise challenge test and/or reversibility post bronchodilators, only three had a previous diagnosis of asthma. Lung volumes and diffusion were normal in all but one patient (1/134, 0.7%). Exhaled nitric oxide levels were elevated in 32/144 (22%). A total of 33 children who had repeated PFTs had normal or near-normal PFTs on follow-up testing, including seven (21.2%) who had mild obstructive PFTs at presentation. Multivariate analysis identified older age [OR 1.36 (95% CI:1.07–1.75)], specific imaging findings (prominent bronchovascular markings (OR 43.28 (95% CI: 4.50–416.49)), and hyperinflation (OR 28.42, 95% CI: 2.18–370.84)] as significant predictors of an obstructive pattern on PFTs. Conclusions: In children with PCC and respiratory symptoms, the most common impairment was a mild obstructive pattern; most were without a history of asthma. Improvement was witnessed in long-term follow-up. In contrast to the adult population, no diffusion limitation was found. Empirical periodic inhaler therapy may be considered in children with factors associated with PFT abnormalities. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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13 pages, 449 KiB

Open AccessFeature PaperArticle

Immediate and Long-Term Effects of Hyperbaric Oxygenation in Patients with Long COVID-19 Syndrome Using SF-36 Survey and VAS Score: A Clinical Pilot Study

by Joerg Lindenmann, Christian Porubsky, Lucija Okresa, Huberta Klemen, Iurii Mykoliuk, Andrej Roj, Amir Koutp, Eveline Kink, Florian Iberer, Gabor Kovacs, Robert Krause, Josef Smolle and Freyja Maria Smolle-Juettner

J. Clin. Med. 2023, 12(19), 6253; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12196253 - 28 Sep 2023

Cited by 2 | Viewed by 1283

Abstract

(1) Background: Long COVID syndrome (LCS) is a heterogeneous long-standing condition following COVID-19 infection. Treatment options are limited to symptomatic measures, and no specific medication has been established. Hyperbaric oxygenation (HBO) has been found to have a positive impact on the treatment of COVID-19 infection. This study evaluates both the feasibility and outcome of supportive HBO in patients with LCS. (2) Methods: Within 17 months, 70 patients with proven LCS were prospectively included. Each patient underwent a cycle of 10 subsequent HBO treatment sessions administered for 75 min at 2.2 atmospheres. Evaluation of the patients was performed before the first and after the last HBO session and 3 months afterwards. Statistical evaluation was based on an intention-to-treat analysis using Fisher’s exact test and Student’s t-test for paired samples. (3) Results: In total, 59 patients (33 females, 26 males; mean age: 43.9 years; range: 23–74 years; median: 45.0) were evaluable. After HBO, a statistically significant improvement of physical functioning (p < 0.001), physical role (p = 0.01), energy (p < 0.001), emotional well-being (p < 0.001), social functioning (p < 0.001), pain (p = 0.01) and reduced limitation of activities (p < 0.001) was confirmed. (4) Conclusions: Physical functioning and both the physical and emotional role improved significantly and sustainably, suggesting HBO as a promising supportive therapeutic tool for the treatment of LCS. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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11 pages, 686 KiB

Open AccessArticle

Influence of Clinical and Sociodemographic Variables on Health-Related Quality of Life in the Adult Population with Long COVID

by Mª Pilar Rodríguez-Pérez, Patricia Sánchez-Herrera-Baeza, Pilar Rodríguez-Ledo, Elisabet Huertas-Hoyas, Gemma Fernández-Gómez, Rebeca Montes-Montes and Marta Pérez-de-Heredia-Torres

J. Clin. Med. 2023, 12(13), 4222; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12134222 - 22 Jun 2023

Cited by 1 | Viewed by 1062

Abstract

Worldwide, about 10 percent of patients affected by long COVID require appropriate follow-up and intervention. The main objective of this study was to analyze the long-term impact of mild long COVID in the adult population, and to determine the effect of clinical and sociodemographic variables on health-related quality of life in those affected. Methods: A cross-sectional descriptive study of a sample of Spanish adult patients with persistent COVID-19 symptoms at least three months after diagnosis. Data collection took place between April and July 2021. The health-related quality of life of the sample was low, with worse results in the physical component summary (PCS) 24.66 (SD = 4.45) compared to the mental component summary (MCS) 45.95 (SD = 8.65). The multi-regression analysis showed significant differences by sex in the dimensions of physical functioning (p = 0.040); bodily pain (p = 0.036); and health transition (p = 0.018). Additionally, a longer time since infection had a significant effect on physical functioning (p = 0.039); general health (p = 0.037); vitality (p = 0.034); and general health transition (p = 0.002). The effect of occupational imbalance was significant for all dimensions. Conclusions: people with long COVID have a reduced quality of life. Sex, time since infection, and occupational imbalance are predictors of a worse quality of life. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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11 pages, 704 KiB

Open AccessArticle

Physical Health-Related Quality of Life Improves over Time in Post-COVID-19 Patients: An Exploratory Prospective Study

by Stefan Malesevic, Noriane A. Sievi, Dörthe Schmidt, Florence Vallelian, Ilijas Jelcic, Malcolm Kohler and Christian F. Clarenbach

J. Clin. Med. 2023, 12(12), 4077; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12124077 - 15 Jun 2023

Cited by 1 | Viewed by 1059

Abstract

(1) Background: Ongoing symptoms after mild or moderate acute coronavirus disease 19 (COVID-19) substantially affect health-related quality of life (HRQoL). However, follow-up data on HRQoL are scarce. We characterized the change in HRQoL over time in post-COVID-19 patients who initially suffered from mild or moderate acute COVID-19 without hospitalization. (2) Methods: Outpatients who visited an interdisciplinary post-COVID-19 consultation at the University Hospital Zurich and suffered from ongoing symptoms after acute COVID-19 were included in this observational study. HRQoL was assessed using established questionnaires. Six months after baseline, the same questionnaires and a self-constructed questionnaire about the COVID-19 vaccination were distributed. (3) Results: In total, 69 patients completed the follow-up, of whom 55 (80%) were female. The mean (SD) age was 44 (12) years and the median (IQR) time from symptom onset to completing the follow-up was 326 (300, 391) days. The majority of patients significantly improved in EQ-5D-5L health dimensions of mobility, usual activities, pain and anxiety. Furthermore, according to the SF-36, patients showed clinically relevant improvements in physical health, whereas no significant change was found regarding mental health. (4) Conclusions: Physical aspects of HRQoL in post-COVID-19 patients relevantly improved over 6 months. Future studies are needed to focus on potential predictors that allow for establishing individual care and early interventions. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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11 pages, 923 KiB

Open AccessArticle

The Association between Dysnatraemia during Hospitalisation and Post-COVID-19 Mental Fatigue

by Gerardo Salvato, Elvira Inglese, Teresa Fazia, Francesco Crottini, Daniele Crotti, Federica Valentini, Giulio Palmas, Alessandra Bollani, Stefania Basilico, Martina Gandola, Giorgio Gelosa, Davide Gentilini, Luisa Bernardinelli, Andrea Stracciari, Francesco Scaglione, Elio Clemente Agostoni and Gabriella Bottini

J. Clin. Med. 2023, 12(11), 3702; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12113702 - 26 May 2023

Viewed by 977

Abstract

COVID-19 may induce short- and long-term cognitive failures after recovery, but the underlying risk factors are still controversial. Here, we investigated whether (i) the odds of experiencing persistent cognitive failures differ based on the patients’ disease course severity and sex at birth; and (ii) the patients’ electrolytic profile in the acute stage represents a risk factor for persistent cognitive failures. We analysed data from 204 patients suffering from COVID-19 and hospitalised during the first pandemic wave. According to the 7-point WHO-OS scale, their disease course was classified as severe or mild. We investigated the presence of persistent cognitive failures collected after hospital discharge, while electrolyte profiles were collected during hospitalisation. The results showed that females who suffered from a mild course compared to a severe course of COVID-19 had a higher risk of presenting with persistent mental fatigue after recovery. Furthermore, in females who suffered from a mild course of COVID-19, persistent mental fatigue was related to electrolyte imbalance, in terms of both hypo- and hypernatremia, during hospitalisation in the acute phase. These findings have important implications for the clinical management of hospitalised COVID-19 patients. Attention should be paid to potential electrolyte imbalances, mainly in females suffering from mild COVID-19. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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14 pages, 652 KiB

Open AccessArticle

Minimal Clinically Important Differences in Inspiratory Muscle Function Variables after a Respiratory Muscle Training Programme in Individuals with Long-Term Post-COVID-19 Symptoms

by Tamara del Corral, Raúl Fabero-Garrido, Gustavo Plaza-Manzano, César Fernández-de-las-Peñas, Marcos José Navarro-Santana and Ibai López-de-Uralde-Villanueva

J. Clin. Med. 2023, 12(7), 2720; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12072720 - 05 Apr 2023

Cited by 4 | Viewed by 2005

Abstract

Objective: To establish the minimal clinically important difference (MCID) for inspiratory muscle strength (MIP) and endurance (IME) in individuals with long-term post-COVID-19 symptoms, as well as to ascertain which of the variables has a greater discriminatory capacity and to compare changes between individuals classified by the MCID. Design: Secondary analysis of randomised controlled trial of data from 42 individuals who performed an 8-week intervention of respiratory muscle training programme. Results: A change of at least 18 cmH₂O and 22.1% of that predicted for MIP and 328.5s for IME represented the MCID. All variables showed acceptable discrimination between individuals who classified as “improved” and those classified as “stable/not improved” (area under the curve ≥0.73). MIP was the variable with the best discriminative ability when expressed as a percentage of prediction (Youden index, 0.67; sensitivity, 76.9%; specificity, 89.7%). Participants classified as “improved” had significantly greater improvements in quality of life and lung function compared with the participants classified as “stable/not improved”. Conclusion: In individuals with long-term post-COVID-19 symptoms, the inspiratory muscle function variables had an acceptable discriminative ability to assess the efficacy of a respiratory muscle training programme. MIP was the variable with the best discriminative ability, showing better overall performance when expressed as a percentage of prediction. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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10 pages, 255 KiB

Open AccessArticle

Long-COVID-19 in Asymptomatic, Non-Hospitalized, and Hospitalized Populations: A Cross-Sectional Study

by Aysegul Bostanci, Umut Gazi, Ozgur Tosun, Kaya Suer, Emine Unal Evren, Hakan Evren and Tamer Sanlidag

J. Clin. Med. 2023, 12(7), 2613; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12072613 - 30 Mar 2023

Cited by 2 | Viewed by 3551

Abstract

A substantial proportion of coronavirus disease 2019 (COVID-19) survivors continue to suffer from long-COVID-19 (LC) symptoms. Our study aimed to determine the risk factors for LC by using a patient population from Northern Cyprus. Subjects who were diagnosed with severe acute respiratory syndrome-2 (SARS-CoV-2) infection in our university hospital were invited and asked to fill in an online questionnaire. Data from 296 survivors who had recovered from COVID-19 infection at least 28 days prior the study was used in the statistical analysis. For determination of risk factors for “ongoing symptomatic COVID-19 (OSC)” and “Post-COVID-19 (PSC)” syndromes, the patient population was further divided into group 1 (Gr1) and group 2 (Gr2), that included survivors who were diagnosed with COVID-19 within 4-12 weeks and at least three months prior the study, respectively. The number of people with post-vaccination SARS-CoV-2 infection was 266 (89.9%). B.1.617.2 (Delta) (41.9%) was the most common SARS-CoV-2 variant responsible for the infections, followed by BA.1 (Omicron) (34.8%), B.1.1.7 (Alpha) (15.5%), and wild-type SARS-CoV-2 (7.8%). One-hundred-and-nineteen volunteers (40.2%) stated an increased frequency of COVID-19-related symptoms and experienced the symptoms in the week prior to the study. Of those, 81 (38.8%) and 38 (43.7%) were from Gr1 and Gr2 groups, respectively. Female gender, chronic illness, and symptomatic status at PCR testing were identified as risk factors for developing OSC syndrome, while only the latter showed a similar association with PSC symptoms. Our results also suggested that ongoing and persistent COVID-19-related symptoms are not influenced by the initial viral cycle threshold (Ct) values of the SARS-CoV-2, SARS-CoV-2 variant as well as vaccination status and type prior to COVID-19. Therefore, strategies other than vaccination are needed to combat the long-term effect of COVID-19, especially after symptomatic SARS-CoV-2 infection, and their possible economic burden on healthcare settings. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

11 pages, 967 KiB

Open AccessArticle

The Very Long COVID: Persistence of Symptoms after 12–18 Months from the Onset of Infection and Hospitalization

by Marco Ranucci, Ekaterina Baryshnikova, Martina Anguissola, Sara Pugliese, Luca Ranucci, Mara Falco and Lorenzo Menicanti

J. Clin. Med. 2023, 12(5), 1915; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12051915 - 28 Feb 2023

Cited by 6 | Viewed by 3516

Abstract

According to the World Health Organization’s definition, long COVID is the persistence or development of new symptoms 3 months after the initial infection. Various conditions have been explored in studies with up to one-year follow-up but very few looked further. This prospective cohort study addresses the presence of a wide spectrum of symptoms in 121 patients hospitalized during the acute phase of COVID-19 infection, and the association between factors related to the acute phase of the disease and the presence of residual symptoms after one year or longer from hospitalization. The main results are as follows: (i) post-COVID symptoms persist in up to 60% of the patient population at a mean follow-up of 17 months; (ii) the most frequent symptoms are fatigue and dyspnea, but neuropsychological disturbances persist in about 30% of the patients (iii) when corrected for the duration of follow-up with a freedom-from-event analysis; only complete (2 doses) vaccination at the time of hospital admission remained independently associated with persistence of the major physical symptoms, while vaccination and previous neuropsychological symptoms remained independently associated with persistence of major neuropsychological symptoms. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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14 pages, 1003 KiB

Open AccessArticle

Association between Experimental Pain Measurements and the Central Sensitization Inventory in Patients at Least 3 Months after COVID-19 Infection: A Cross-Sectional Pilot Study

by Lisa Goudman, Ann De Smedt, Stijn Roggeman, César Fernández-de-las-Peñas, Samar M. Hatem, Marc Schiltz, Maxime Billot, Manuel Roulaud, Philippe Rigoard and Maarten Moens

J. Clin. Med. 2023, 12(2), 661; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12020661 - 13 Jan 2023

Cited by 3 | Viewed by 1454

Abstract

Fatigue, pain, headache, brain fog, anosmia, ageusia, mood symptoms, and sleep disorders are symptoms commonly experienced by people with post-COVID-19 condition. These symptoms could be considered as manifestations of central sensitization. The aim of this study is to evaluate whether there are indicators of central sensitization by using experimental pain measurements and to determine their association with patient-reported outcome measures (PROMs). A cross-sectional study including 42 patients after COVID-19 infection was conducted. The central sensitization inventory (CSI) was administered as a PROM to evaluate central-sensitization-associated symptoms. Pressure pain thresholds (PPT), temporal summation, and descending nociceptive pain inhibition (CPM) were assessed as experimental pain measurements. The median score on the CSI was 46.5 (Q1–Q3: 33–54). The presence of central-sensitization-associated symptoms was seen in 64.3% of patients based on the CSI (≥40/100 points). A deficient CPM was seen in 12% and 14% of patients when measured at the trapezius and rectus femoris, respectively. A negative correlation between pressure sensitivity on the rectus femoris and the CSI score (r = −0.36, 95%CI −0.13 to −0.65, p = 0.007) was observed. Central-sensitization-associated symptoms were present in up to 64.3% of patients post-COVID-19 infection, based on a PROM, i.e., the CSI. A more objective evaluation of nociceptive processing through experimental pain measurements was less suggestive of indicators of central sensitization. Only a small negative correlation between pressure sensitivity and the CSI was observed, thereby pointing towards the discrepancy between the CSI and experimental pain measurements and presumably the complementary need for both to evaluate potential indicators of central sensitization in this population. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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Review

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24 pages, 3216 KiB

Open AccessReview

Age, Sex and Previous Comorbidities as Risk Factors Not Associated with SARS-CoV-2 Infection for Long COVID-19: A Systematic Review and Meta-Analysis

by Kin Israel Notarte, Maria Helena Santos de Oliveira, Princess Juneire Peligro, Jacqueline Veronica Velasco, Imee Macaranas, Abbygail Therese Ver, Flos Carmeli Pangilinan, Adriel Pastrana, Nathaniel Goldrich, David Kavteladze, Ma. Margarita Leticia Gellaco, Jin Liu, Giuseppe Lippi, Brandon Michael Henry and César Fernández-de-las-Peñas

J. Clin. Med. 2022, 11(24), 7314; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11247314 - 09 Dec 2022

Cited by 73 | Viewed by 5870

Abstract

Identification of predictors of long COVID-19 is essential for managing healthcare plans of patients. This systematic literature review and meta-analysis aimed to identify risk factors not associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, but rather potentially predictive of the development of long COVID-19. MEDLINE, CINAHL, PubMed, EMBASE, and Web of Science databases, as well as medRxiv and bioRxiv preprint servers were screened through 15 September 2022. Peer-reviewed studies or preprints evaluating potential pre-SARS-CoV-2 infection risk factors for the development of long-lasting symptoms were included. The methodological quality was assessed using the Quality in Prognosis Studies (QUIPSs) tool. Random-effects meta-analyses with calculation of odds ratio (OR) were performed in those risk factors where a homogenous long COVID-19 definition was used. From 1978 studies identified, 37 peer-reviewed studies and one preprint were included. Eighteen articles evaluated age, sixteen articles evaluated sex, and twelve evaluated medical comorbidities as risk factors of long COVID-19. Overall, single studies reported that old age seems to be associated with long COVID-19 symptoms (n = 18); however, the meta-analysis did not reveal an association between old age and long COVID-19 (n = 3; OR 0.86, 95% CI 0.73 to 1.03, p = 0.17). Similarly, single studies revealed that female sex was associated with long COVID-19 symptoms (n = 16); which was confirmed in the meta-analysis (n = 7; OR 1.48, 95% CI 1.17 to 1.86, p = 0.01). Finally, medical comorbidities such as pulmonary disease (n = 4), diabetes (n = 1), obesity (n = 6), and organ transplantation (n = 1) were also identified as potential risk factors for long COVID-19. The risk of bias of most studies (71%, n = 27/38) was moderate or high. In conclusion, pooled evidence did not support an association between advancing age and long COVID-19 but supported that female sex is a risk factor for long COVID-19. Long COVID-19 was also associated with some previous medical comorbidities. Full article

(This article belongs to the Special Issue Post-COVID Symptoms in Long-Haulers: Definition, Identification, Mechanisms, and Management-Part II)

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