ABSTRACT
Post-COVID-19 condition (also known as long COVID) is generally defined as symptoms persisting for 3 months or more after acute COVID-19. Long COVID can affect multiple organ systems and lead to severe and protracted impairment of function as a result of organ damage. The burden of this disease, both on the individual and on health systems and national economies, is high. In this interdisciplinary Review, with a coauthor with lived experience of severe long COVID, we sought to bring together multiple streams of literature on the epidemiology, pathophysiology (including the hypothesised mechanisms of organ damage), lived experience and clinical manifestations, and clinical investigation and management of long COVID. Although current approaches to long COVID care are largely symptomatic and supportive, recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification might herald a more mechanism-informed and personally tailored approach to clinical care. We also cover the organisation of services for long COVID, approaches to preventing long COVID, and suggestions for future research.
Subject(s)
COVID-19 , Post-Acute COVID-19 Syndrome , Humans , COVID-19/epidemiology , Post-Acute COVID-19 Syndrome/epidemiology , Post-Acute COVID-19 Syndrome/physiopathology , Post-Acute COVID-19 Syndrome/therapySubject(s)
Clinical Trials as Topic , Exercise Therapy , National Institutes of Health (U.S.) , Post-Acute COVID-19 Syndrome , Research Support as Topic , Humans , National Institutes of Health (U.S.)/economics , National Institutes of Health (U.S.)/organization & administration , Post-Acute COVID-19 Syndrome/therapy , Research Support as Topic/methods , Research Support as Topic/organization & administration , United States , Exercise Therapy/adverse effectsABSTRACT
Individuals suffering from long-COVID can present with "brain fog", which is characterized by a range of cognitive impairments, such as confusion, short-term memory loss, and difficulty concentrating. To date, several potential interventions for brain fog have been considered. Notably, no systematic review has comprehensively discussed the impact of each intervention type on brain fog symptoms. We included studies on adult (aged > 18 years) individuals with proven long- COVID brain-fog symptoms from PubMed, MEDLINE, Central, Scopus, and Embase. A search limit was set for articles published between 01/2020 and 31/12/2023. We excluded studies lacking an objective assessment of brain fog symptoms and patients with preexisting neurological diseases that affected cognition before COVID-19 infection. This review provided relevant information from 17 studies. The rehabilitation studies utilized diverse approaches, leading to a range of outcomes in terms of the effectiveness of the interventions. Six studies described noninvasive brain stimulation, and all showed improvement in cognitive ability. Three studies described hyperbaric oxygen therapy, all of which showed improvements in cognitive assessment tests and brain perfusion. Two studies showed that the use of Palmitoylethanolamide and Luteolin (PEA-LUT) improved cognitive impairment. Noninvasive brain stimulation and hyperbaric oxygen therapy showed promising results in the treatment of brain fog symptoms caused by long-COVID, with improved perfusion and cortical excitability. Furthermore, both rehabilitation strategies and PEA-LUT administration have been associated with improvements in symptoms of brain fog. Future studies should explore combinations of interventions and include longer follow-up periods to assess the long-term effects of these treatments.
Subject(s)
Cognitive Dysfunction , Mental Fatigue , Post-Acute COVID-19 Syndrome , Humans , Brain , Cognitive Dysfunction/etiology , Cognitive Dysfunction/therapy , Cognitive Dysfunction/physiopathology , COVID-19/complications , Hyperbaric Oxygenation/methods , Post-Acute COVID-19 Syndrome/therapy , SARS-CoV-2 , Transcranial Direct Current Stimulation/methods , Transcranial Magnetic Stimulation/methods , Mental Fatigue/therapyABSTRACT
Coronavirus disease 2019's (COVID-19's) wide dissemination casts long-term health jeopardy for millions. Long COVID-19, a lingering multisystem malady, weaves a complex array of symptoms. Understanding its full impact requires extensive research over months or years. The pace of recovery remains uncertain, challenging healthcare systems. An evidence-based symphony of medical care and support is urgently needed for long haulers. Understanding long COVID's genesis and advocating for patients is vital. Our comprehension remains limited, prompting a systematic scoping study to explore the existing knowledge and pave the way for future research, illuminating the enigma of "long COVID" and guiding the path towards understanding this relentless condition. How to cite this article: Karuturi S. Long COVID-19: A Systematic Review. J Assoc Physicians India 2023;71(9):82-94.
Subject(s)
Post-Acute COVID-19 Syndrome , Humans , COVID-19/epidemiology , Post-Acute COVID-19 Syndrome/epidemiology , Post-Acute COVID-19 Syndrome/pathology , Post-Acute COVID-19 Syndrome/therapy , SARS-CoV-2ABSTRACT
ABSTRACT: An estimated 21.5% of patients in the United States who have had COVID-19 report development of a prolonged postviral syndrome that has been called postacute sequelae of COVID-19 (PASC). Symptoms can range from very mild to debilitating damage to organ systems caused directly by the virus and indirectly by the body's inflammatory response. Research into defining PASC and discovering effective treatments is ongoing. This article discusses the common presentations of PASC in patients who have had COVID-19; describes specific effects on the pulmonary, cardiovascular, and central nervous systems; and identifies potential treatments based on current literature.
Subject(s)
Post-Acute COVID-19 Syndrome , Post-Acute COVID-19 Syndrome/diagnosis , Post-Acute COVID-19 Syndrome/epidemiology , Post-Acute COVID-19 Syndrome/therapy , Humans , Central Nervous System , Respiratory System , Cardiovascular SystemSubject(s)
Post-Acute COVID-19 Syndrome , Postural Orthostatic Tachycardia Syndrome , Humans , Anti-Infective Agents/therapeutic use , Cardiovascular Agents/therapeutic use , Clinical Trials as Topic , COVID-19/complications , COVID-19/therapy , COVID-19 Drug Treatment , Immunoglobulins, Intravenous/therapeutic use , Ivabradine/therapeutic use , Nervous System Diseases/etiology , Nervous System Diseases/therapy , Post-Acute COVID-19 Syndrome/etiology , Post-Acute COVID-19 Syndrome/therapy , Postural Orthostatic Tachycardia Syndrome/etiology , Postural Orthostatic Tachycardia Syndrome/therapySubject(s)
COVID-19 , Post-Acute COVID-19 Syndrome , Adult , Humans , COVID-19/therapy , Syndrome , Post-Acute COVID-19 Syndrome/therapyABSTRACT
This Medical News article discusses a new study that identified how business have pivoted marketing of unapproved stem cell and exosome products from COVID-19 to long COVID.
Subject(s)
Drug Approval , Post-Acute COVID-19 Syndrome , Stem Cell Transplantation , Humans , Commerce , COVID-19/economics , COVID-19/therapy , Marketing , Post-Acute COVID-19 Syndrome/economics , Post-Acute COVID-19 Syndrome/therapy , Stem Cells , Stem Cell Transplantation/economicsABSTRACT
This Medical News article discusses a US federal advisory that could help clinicians identify and treat mental health symptoms related to postCOVID-19 condition, or long COVID.
Subject(s)
Mental Disorders , Post-Acute COVID-19 Syndrome , Primary Health Care , Humans , COVID-19/complications , COVID-19/psychology , COVID-19/therapy , Mental Disorders/etiology , Mental Disorders/therapy , Mental Health , Post-Acute COVID-19 Syndrome/complications , Post-Acute COVID-19 Syndrome/psychology , Post-Acute COVID-19 Syndrome/therapy , United States , United States Dept. of Health and Human ServicesABSTRACT
This Medical News article discusses challenges to treatment of postCOVID-19 condition in primary care.
Subject(s)
COVID-19 , Physicians, Primary Care , Post-Acute COVID-19 Syndrome , Humans , COVID-19/complications , COVID-19/diagnosis , COVID-19/therapy , Post-Acute COVID-19 Syndrome/diagnosis , Post-Acute COVID-19 Syndrome/therapy , SARS-CoV-2ABSTRACT
New Long Covid trials aim to clear lingering virus-and help patients in dire need.