Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions, 2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 2782

Special Issue Editor

Special Issue Information

Dear Colleagues,

Newly developed neurological, psychiatric, pulmonary, vascular, renal, and cardiac symptoms and disorders have been reported months after SARS-CoV-2 infection has been resolved. The SARS-CoV-2 virus can directly damage major organs, which can trigger clinical disorders. Indirect insults secondary to the viral infection (such as respiratory distress, sepsis and other co-infections, inflammation, and over-reactive host immune responses) could also cause further damage. Persistent damage to organs such as the lungs, kidneys, heart, and liver after SARS-CoV-2 infection has been reported in some COVID-19 survivors. SARS-CoV-2 infection could also trigger new onset or accelerate the worsening of pre-existing conditions such as diabetes, hypertension, and pulmonary and neurological disorders. The sheer number of COVID-19 patients suggests that long COVID will likely burden healthcare systems for years.

We invite you to contribute to this timely and exciting Special Issue on “Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions, 2nd Edition”. We thank you for your time and look forward to receiving your contributions.

Prof. Dr. Tim Duong
Guest Editor

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Keywords

  • long COVID
  • SARS-CoV-2
  • COVID-19 sequela
  • post-acute sequelae of COVID-19 (PASC)
  • COVID-19 symptoms
  • multiorgan failure
  • diabetes
  • hypertension
  • shortness of breath
  • symptoms
  • diagnosis
  • prognosis
  • management

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Published Papers (3 papers)

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18 pages, 1038 KiB  
Article
The Impact of Prior COVID-19 on Long-Term Mortality and Echocardiographic Predictors in Chronic Kidney Disease Patients
by Laura Vasiliu, Gianina Dodi, Mihai Onofriescu, Anca Diaconu, Luminita Voroneanu, Radu A. Sascau, Cristian Statescu and Adrian C. Covic
Diagnostics 2025, 15(6), 678; https://doi.org/10.3390/diagnostics15060678 - 10 Mar 2025
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Abstract
Background/Objectives: Chronic kidney disease (CKD) patients are at an increased risk for severe outcomes following a COVID-19 infection. However, the long-term impact of prior COVID-19 on survival in this population remains unclear. This study evaluates the association between a prior COVID-19 infection, [...] Read more.
Background/Objectives: Chronic kidney disease (CKD) patients are at an increased risk for severe outcomes following a COVID-19 infection. However, the long-term impact of prior COVID-19 on survival in this population remains unclear. This study evaluates the association between a prior COVID-19 infection, echocardiographic parameters, and mortality in CKD patients over a 24-month follow-up period. Methods: A prospective cohort study was conducted on 239 CKD patients, including those on hemodialysis. A Kaplan–Meier survival analysis and Cox proportional hazards models were used to assess the impact of COVID-19, age, and comorbidities on the mortality rate. A mediation analysis examined the role of age and the echocardiographic parameters in this relationship. Results: Kaplan–Meier curves demonstrated a significantly lower 24-month survival probability in the COVID-19 group compared to controls (72.5% vs. 87.1%, p = 0.01), particularly in hemodialysis patients (62.5% vs. 83.8%, p = 0.01). In contrast, no significant survival difference was observed in the non-dialysis CKD patients (p = 0.52). A multivariate Cox analysis confirmed age as the key mediator, with COVID-19 losing significance after the age adjustment (p = 0.05). An echocardiographic analysis identified left and right ventricular dysfunction as independent mortality predictors, with right ventricular dysfunction partially mediating the COVID-19–mortality relationship. Conclusions: COVID-19 significantly reduces the survival rate in CKD patients, while left and right dysfunction are strong predictors of mortality. Age partially mediates the relationship between COVID-19 and mortality, but COVID-19 remains an independent risk factor. These findings underscore the need for cardiac function monitoring in post-COVID-19 CKD patients to improve long-term outcomes. Full article
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11 pages, 1090 KiB  
Article
Long-Term Outcomes of Patients with Pre-Existing Essential Tremor After SARS-CoV-2 Infection
by Rachel Pakan, Roham Hadidchi, Yousef Al-Ani, Hannah Piskun, Katie S. Duong, Sonya Henry, Stephen Wang, Carine W. Maurer and Tim Q. Duong
Diagnostics 2024, 14(24), 2774; https://doi.org/10.3390/diagnostics14242774 - 10 Dec 2024
Cited by 3 | Viewed by 1460
Abstract
Background/Objectives: Although COVID-19 has been linked to worse outcomes in patients with neurological disorders, its impact on those with essential tremor (ET) remains unclear. To investigate clinical outcomes of ET patients with and without COVID-19 three and a half years post-pandemic. Methods: 1074 [...] Read more.
Background/Objectives: Although COVID-19 has been linked to worse outcomes in patients with neurological disorders, its impact on those with essential tremor (ET) remains unclear. To investigate clinical outcomes of ET patients with and without COVID-19 three and a half years post-pandemic. Methods: 1074 ET patients were evaluated in this retrospective study in the Montefiore Health System from January 2016 to July 2023. Comparisons between ET patients with and without a positive SARS-CoV-2 polymerase chain reaction test were made. Outcomes included post-index date major adverse cardiovascular events (MACEs), new-onset sleep disturbances, fatigue, dyspnea, first-time fall, new-onset anxiety, new-onset depression, headache, new-onset imbalance, new-onset mild cognitive impairment, and all-cause mortality, adjusted hazard ratios (aHR) adjusting for covariates were calculated. Results: ET patients with COVID-19 had higher prevalence of pre-existing type-2 diabetes, depression, and anxiety compared to ET patients without COVID-19. COVID-19 was significantly associated with higher risk of MACEs, (aHR = 2.39 [1.49, 3.82]), new-onset sleep disturbance, (aHR = 2.12 [1.44, 3.13]), fatigue, (aHR = 1.83 [1.27, 2.65]), dyspnea, (aHR = 1.98 [1.40, 2.80]), first-time fall, (aHR = 4.76 [2.24, 10.14]), new-onset anxiety, (aHR = 3.66 [2.02, 6.64]), and new-onset depression, (aHR = 2.38 [1.20, 4.70]). COVID-19 was not associated with all-cause mortality. Conclusions: In patients with ET, COVID-19 significantly increases the risk of several long-term adverse health outcomes, but not mortality. Full article
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11 pages, 1940 KiB  
Case Report
Pituitary Apoplexy in a Child with Short Stature and Possible Recent SARS-CoV-2 Infection
by Carmen Gabriela Barbu, Luminita Nicoleta Cima, Marian Andrei, Simona Vasilache, Mihaela Țarnă, Ileana Olguta Rizea, Carmen Sorina Martin, Anca Elena Sîrbu and Simona Fica
Diagnostics 2025, 15(12), 1453; https://doi.org/10.3390/diagnostics15121453 - 7 Jun 2025
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Abstract
Background and Clinical Significance: Pituitary apoplexy is an extremely rare condition in children and adolescents with a rapid onset due to acute hemorrhage, infarction, or both in the pituitary gland. Most frequently, pituitary apoplexy is an asymptomatic or subclinical entity. Few cases of [...] Read more.
Background and Clinical Significance: Pituitary apoplexy is an extremely rare condition in children and adolescents with a rapid onset due to acute hemorrhage, infarction, or both in the pituitary gland. Most frequently, pituitary apoplexy is an asymptomatic or subclinical entity. Few cases of pituitary apoplexy with concurrent SARS-CoV-2 infection or COVID-19 vaccination have been reported. Case Presentation: We present the case of a 13-year-8-month-old boy who presented in our pediatric endocrinology department for the evaluation of short stature. He was previously diagnosed with secondary hypothyroidism and was treated with levothyroxine. At admission, clinical examination revealed a height of 141 cm (−2.68 SD/−2.4 SD corrected for mid-parental height), normal weight (60th centile), Tanner-stage G2P1, and delayed bone age. Basal IGF1 was normal, but the tests performed to assess the GH reserve confirmed the GH deficiency (peak GH value 3.11 ng/mL after clonidine/0.95 ng/mL after insulin). The brain MRI revealed a subacute pituitary hemorrhage. Thrombophilia and coagulopathies were excluded by further testing. Anti-SARS-CoV-2 (anti-S-protein IgG) antibodies (>200 BAU/mL) were compatible with COVID-19 infection, indicating a possible association between these two entities. At 3-month follow-up, physical examination showed a 3 cm height gain and advancing pubertal development (G4P2). Newer MRI found changes consistent with resolving hemorrhage. The patient was provided immediately with recombinant human GH and aromatase inhibitor therapy to maximize GH treatment response. During follow-up, the rGH dose was adjusted based on IGF1 values, and after 3 years and 10 months, rGH treatment was stopped, reaching a height of 172.3 cm (−0.51 SD) and surpassing the initial prediction of 164.5 cm. Conclusions: Pituitary apoplexy, an even rarer complication in the pediatric population, may be associated with SARS-CoV-2 infection. Further studies are necessary to better understand the intertwining of those conditions. Full article
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