Special Issue "Long-Term COVID-19: The Lasting Health Impacts of COVID-19"

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 January 2022) | Viewed by 14902

Special Issue Editors

Dr. Indre Bileviciute-Ljungar
E-Mail Website
Guest Editor
1. Department of Clinical Sciences, Karolinska Institutet, 182 88 Stockholm, Sweden
2. Multidisciplinary Pain Clinic, St Göran Hospital, 112 19 Stockholm, Sweden
Interests: fatigue; chronic pain; disability; myalgic encephalomyelitis/chronic fatigue syndrome; COVID-19
Dr. Natalie Lambert
E-Mail Website
Guest Editor
Associate Research Professor at Indiana University School of Medicine, Indianapolis, IN, USA
Interests: COVID-19; patient experienes; precision medicine; natural language processing
Prof. Dr. Jonas Bergquist
E-Mail Website
Guest Editor
Professor in Analytical Chemistry and Neurochemistry, Department of Chemistry, Biomedical Centre, Uppsala University, Uppsala, Sweden
Interests: neuroinflammation; autoimmunity; myalgic encephalomyelitis/chronic fatigue syndrome; post-COVID-19 fatigue

Special Issue Information

Dear Colleagues,

A new SARS-CoV-2 virus causes severe infections resulting in both hospitalization and mortal outcomes or “mild to moderate” infections, for which people with COVID-19 are encouraged to recover at home, often while under little medical supervision. Even though as many as one in ten COVID-19 survivors suffer from long-term sequelae for many weeks or months after clearing the initial infection, this group has not received enough attention in clinical practice and research. The first datasets capturing the COVID-19 health experiences of these self-named “long haulers” were gathered based on these sufferers’ own initiative in the early summer of 2020 using social media. However, we still do not have healthcare structures meeting these patients’ healthcare demands for long-term follow up and rehabilitation.

Therefore, this Special Issue published in the Journal of Clinical Medicine will gather up-to-date information on long-term COVID-19 sufferers and, hopefully, will contribute to greater awareness among clinicians, scientists, and researchers.

Some of the health impacts of long-term COVID-19 resemble post-viral fatigue or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The latter condition is associated with persistent symptoms following infection and affects many functions in the body, disrupting patients’ everyday functioning. Considering the severe health impact of long-term COVID-19 and the fact that little data have been collected about non-hospitalized COVID-19 survivors, the first challenge is to characterize long-term COVID-19 in clinical and epidemiological terms. The second challenge is to develop treatment and rehabilitation standards of care, with the goal of normalizing physiological functions and finding strategies to continue daily life activities with as high a quality of life as possible. The third challenge is to adapt and improve existing healthcare structures for long-term COVID-19 patients in order to optimize the management of this patient group.

Dr. Indre Bileviciute-Ljungar
Dr. Natalie Lambert
Prof. Dr. Jonas Bergquist
Guest Editors

Manuscript Submission Information

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Keywords

  • Long-term COVID-19
  • Post-COVID-19 syndrome
  • “Long hauler” syndrome
  • Post-viral fatigue syndrome
  • Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
  • Disability

Published Papers (5 papers)

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Research

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Article
Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID
J. Clin. Med. 2022, 11(5), 1309; https://doi.org/10.3390/jcm11051309 - 27 Feb 2022
Cited by 6 | Viewed by 1699
Abstract
Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one [...] Read more.
Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one month or more after infection. Methods: To determine the key factors that affect the onset and clinical course of sequelae, a retrospective analysis was performed at Okayama University Hospital (Japan) between February and July 2021. We focused on changes in the numbers of symptoms and the background of the patients during a three-month period from the first outpatient visit. We also examined the relationship with SARS-CoV-2 antibody titers. Results: Information was obtained from medical records for 65 patients. The symptoms of sequelae were diverse, with more than 20 types. The most frequent symptoms were general malaise, dysosmia, dysgeusia, sleeplessness, and headache. These symptoms improved in about 60% of the patients after 3 months. Patients who required hospitalization and had a poor condition in the acute phase and patients who received oxygen/dexamethasone therapy had higher antibody titers at the time of consultation. Patients with antibody titers ≥200 U/mL showed significantly fewer improvements in long COVID symptoms in 1 month, but they showed improvements at 3 months after the first visit. Conclusion: Long COVID symptoms were improved at 3 months after the initial visit in more than half of the patients. Serum antibody titers were higher in patients who experienced a severe acute phase, but the serum antibody titers did not seem to be directly related to the long-term persistence of long COVID symptoms. Full article
(This article belongs to the Special Issue Long-Term COVID-19: The Lasting Health Impacts of COVID-19)
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Article
Pain Burden in Post-COVID-19 Syndrome following Mild COVID-19 Infection
J. Clin. Med. 2022, 11(3), 771; https://doi.org/10.3390/jcm11030771 - 31 Jan 2022
Cited by 9 | Viewed by 2148
Abstract
The global pandemic of SARS-CoV-2 has affected several hundred million people, and many infected people have suffered from a milder initial infection but have never fully recovered. This observational study investigates the pain burden in sufferers of post-COVID-19 syndrome after a milder initial [...] Read more.
The global pandemic of SARS-CoV-2 has affected several hundred million people, and many infected people have suffered from a milder initial infection but have never fully recovered. This observational study investigates the pain burden in sufferers of post-COVID-19 syndrome after a milder initial infection. One hundred post-COVID-19 patients filled out questionnaires regarding sociodemographic data, previous comorbidities, present pharmacological treatment, pain intensity and pain localisation. Health-related quality of life, fatigue, emotional status, and insomnia were measured by validated questionnaires. Multiple post-COVID-19 symptoms, including post-exertional malaise, were evaluated by a symptom questionnaire. Among the 100 participants (mean age 44.5 years), 82% were women, 61% had higher education, and 56% were working full or part time. Nine participants reported previous pain or inflammatory conditions. Among the most painful sites were the head/face, chest, lower extremities, and migrating sites. Generalised pain was self-reported by 75 participants and was estimated in 50 participants. Diagnosis of fibromyalgia according to the 2016 criteria was suspected in 40 participants. Subgroup analyses indicated that comorbidities might play a role in the development of pain. In conclusion, a major part of sufferers from post-COVID-19 syndrome develop pain, and in addition to its many disabling symptoms, there is an urgent need for pain management in post-COVID-19 syndrome. Full article
(This article belongs to the Special Issue Long-Term COVID-19: The Lasting Health Impacts of COVID-19)
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Review

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Review
Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems
J. Clin. Med. 2022, 11(3), 524; https://doi.org/10.3390/jcm11030524 - 20 Jan 2022
Cited by 23 | Viewed by 5108
Abstract
Though the acute effects of SARS-CoV-2 infection have been extensively reported, the long-term effects are less well described. Specifically, while clinicians endure to battle COVID-19, we also need to develop broad strategies to manage post-COVID-19 symptoms and encourage those affected to seek suitable [...] Read more.
Though the acute effects of SARS-CoV-2 infection have been extensively reported, the long-term effects are less well described. Specifically, while clinicians endure to battle COVID-19, we also need to develop broad strategies to manage post-COVID-19 symptoms and encourage those affected to seek suitable care. This review addresses the possible involvement of the lung, heart and brain in post-viral syndromes and describes suggested management of post-COVID-19 syndrome. Post-COVID-19 respiratory manifestations comprise coughing and shortness of breath. Furthermore, arrhythmias, palpitations, hypotension, increased heart rate, venous thromboembolic diseases, myocarditis and acute heart failure are usual cardiovascular events. Among neurological manifestations, headache, peripheral neuropathy symptoms, memory issues, lack of concentration and sleep disorders are most commonly observed with varying frequencies. Finally, mental health issues affecting mental abilities and mood fluctuations, namely anxiety and depression, are frequently seen. Finally, long COVID is a complex syndrome with protracted heterogeneous symptoms, and patients who experience post-COVID-19 sequelae require personalized treatment as well as ongoing support. Full article
(This article belongs to the Special Issue Long-Term COVID-19: The Lasting Health Impacts of COVID-19)
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Review
Dysautonomia and Implications for Anosmia in Long COVID-19 Disease
J. Clin. Med. 2021, 10(23), 5514; https://doi.org/10.3390/jcm10235514 - 25 Nov 2021
Cited by 5 | Viewed by 1711
Abstract
Long COVID-19 patients often reported anosmia as one of the predominant persisting symptoms. Recent findings have shown that anosmia is associated with neurological dysregulations. However, the involvement of the autonomic nervous system (ANS), which can aggregate all the long COVID-19 neurological symptoms, including [...] Read more.
Long COVID-19 patients often reported anosmia as one of the predominant persisting symptoms. Recent findings have shown that anosmia is associated with neurological dysregulations. However, the involvement of the autonomic nervous system (ANS), which can aggregate all the long COVID-19 neurological symptoms, including anosmia, has not received much attention in the literature. Dysautonomia is characterized by the failure of the activities of components in the ANS. Long COVID-19 anosmia fatigue could result from damage to olfactory sensory neurons, leading to an augmentation in the resistance to cerebrospinal fluid outflow by the cribriform plate, and further causing congestion of the glymphatic system with subsequent toxic build-up in the brain. Studies have shown that anosmia was an important neurologic symptom described in long COVID-19 in association with potential COVID-19 neurotropism. SARS-CoV-2 can either travel via peripheral blood vessels causing endothelial dysfunction, triggering coagulation cascade and multiple organ dysfunction, or reach the systemic circulation and take a different route to the blood–brain barrier, damaging the blood–brain barrier and leading to neuroinflammation and neuronal excitotoxicity. SARS-CoV-2 entry via the olfactory epithelium and the increase in the expression of TMPRSS2 with ACE2 facilitates SARS-CoV-2 neurotropism and then dysautonomia in long COVID-19 patients. Due to this effect, patients with anosmia persisting 3 months after COVID-19 diagnosis showed extensive destruction of the olfactory epithelium. Persistent anosmia observed among long COVID-19 patients may be involved by a cascade of effects generated by dysautonomia leading to ACE2 antibodies enhancing a persistent immune activation. Full article
(This article belongs to the Special Issue Long-Term COVID-19: The Lasting Health Impacts of COVID-19)
Review
Changes in EEG Recordings in COVID-19 Patients as a Basis for More Accurate QEEG Diagnostics and EEG Neurofeedback Therapy: A Systematic Review
J. Clin. Med. 2021, 10(6), 1300; https://doi.org/10.3390/jcm10061300 - 22 Mar 2021
Cited by 10 | Viewed by 3258
Abstract
Introduction and purpose: The SARS-CoV-2 virus is able to cause abnormalities in the functioning of the nervous system and induce neurological symptoms with the features of encephalopathy, disturbances of consciousness and concentration and a reduced ability to sense taste and smell as well [...] Read more.
Introduction and purpose: The SARS-CoV-2 virus is able to cause abnormalities in the functioning of the nervous system and induce neurological symptoms with the features of encephalopathy, disturbances of consciousness and concentration and a reduced ability to sense taste and smell as well as headaches. One of the methods of detecting these types of changes in COVID-19 patients is an electroencephalogram (EEG) test, which allows information to be obtained about the functioning of the brain as well as diagnosing diseases and predicting their consequences. The aim of the study was to review the latest research on changes in EEG in patients with COVID-19 as a basis for further quantitative electroencephalogram (QEEG) diagnostics and EEG neurofeedback training. Description of the state of knowledge: Based on the available scientific literature using the PubMed database from 2020 and early 2021 regarding changes in the EEG records in patients with COVID-19, 17 publications were included in the analysis. In patients who underwent an EEG test, changes in the frontal area were observed. A few patients were not found to be responsive to external stimuli. Additionally, a previously non-emerging, uncommon pattern in the form of continuous, slightly asymmetric, monomorphic, biphasic and slow delta waves occurred. Conclusion: The results of this analysis clearly indicate that the SARS-CoV-2 virus causes changes in the nervous system that can be manifested and detected in the EEG record. The small number of available articles, the small number of research groups and the lack of control groups suggest the need for further research regarding the short and long term neurological effects of the SARS-CoV-2 virus and the need for unquestionable confirmation that observed changes were caused by the virus per se and did not occur before. The presented studies described non-specific patterns appearing in encephalograms in patients with COVID-19. These observations are the basis for more accurate QEEG diagnostics and EEG neurofeedback training. Full article
(This article belongs to the Special Issue Long-Term COVID-19: The Lasting Health Impacts of COVID-19)
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