Characterizing Long COVID: Deep Phenotype of a Complex Condition

Deer, Rachel; Rock, Madeline; Vasilevsky, Nicole; Carmody, Leigh C.; Rando, Halie M.; Anzalone, Alfred J.; Basson, Marc D.; Bennett, Tellen D.; Bergquist, Timothy; Boudreau, Eilis; Bramante, Carolyn T.; Byrd, James Brian; Callahan, Tiffany J; Chan, Lauren; Chu, Haitao; Chute, Christopher G.; Coleman, Benjamin; Davis, Hannah; Gagnier, Joel; Greene, Casey S.; Hillegass, William B.; Kavuluru, Ramakanth; Kimble, Wesley; Koraishy, Farrukh M.; Köhler, Sebastian; Liang, Chen; Liu, Feifan; Liu, Hongfang; Madhira, Vithal; Madlock‐Brown, Charisse; Matentzoglu, Nicolas; Mazzotti, Diego R.; McMurry, Julie A.; McNair, Douglas S.; Moffitt, Richard A.; Monteith, Teshamae; Parker, Ann M.; Perry, Mallory; Pfaff, Emily R.; Reese, Justin; Saltz, Joel; Schuff, Robert A; Solomonides, Anthony; Solway, Julian; Spratt, Heidi; Stein, Gary S.; Sule, Anupam A; Topaloğlu, Ümit; Vavougios, George D.; Wang, Liwei; Haendel, Melissa; Robinson, Peter N.

doi:10.1016/j.ebiom.2021.103722

Cited by 158 publications

(187 citation statements)

References 53 publications

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“…The prevalence of malnutrition in our population was quite high, at 48%, which is not surprising since many of the acute and lingering symptoms of COVID-19 affect the gastrointestinal system [ 4 ]. We found that participants at risk for malnutrition experienced significantly greater symptoms of diarrhea, abdominal pain, loss of smell, loss of taste, congestion, or shortness of breath, and those who experienced lingering gastrointestinal symptoms consumed significantly fewer calories on average.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, acute COVID-19 illness can lead to nutritional decline for many reasons. Patients with COVID-19 infection often experience symptoms that can lead to decreased nutritional intake such as loss of taste and smell, nausea, and vomiting [ 3 , 4 ]. During acute COVID-19 illness, severe inflammatory response has been observed, which increases nutritional needs, in some cases to more than two times the caloric requirements determined by predictive equations [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition

et al. 2022

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Persistent malnutrition after COVID-19 infection may worsen outcomes, including delayed recovery and increased risk of rehospitalization. This study aimed to determine dietary intakes and nutrient distribution patterns after acute COVID-19 illness. Findings were also compared to national standards for intake of energy, protein, fruit, and vegetables, as well as protein intake distribution recommendations. Participants (≥18 years old, n = 92) were enrolled after baseline visit at the Post-COVID Recovery Clinic. The broad screening battery included nutritional assessment and 24-h dietary recall. Participants were, on average, 53 years old, 63% female, 69% non-Hispanic White, and 59% obese/morbidly obese. Participants at risk for malnutrition (48%) experienced significantly greater symptoms, such as gastric intestinal issues, loss of smell, loss of taste, or shortness of breath; in addition, they consumed significantly fewer calories. Most participants did not meet recommendations for fruit or vegetables. Less than 39% met the 1.2 g/kg/day proposed optimal protein intake for recovery from illness. Protein distribution throughout the day was skewed; only 3% met the recommendation at all meals, while over 30% never met the threshold at any meal. Our findings highlight the need for nutritional education and support for patients to account for lingering symptoms and optimize recovery after COVID-19 infection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition

et al. 2022

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“… 2 Recent reports have documented that a large proportion of COVID-19 patients develop neuropsychiatric symptoms during or after acute infection. 3 …”

Section: Introductionmentioning

confidence: 99%

“… 6 – 9 Several studies have also found evidence for increased risk of mental illness following SARS-CoV-2 infection. 3 , 10 – 19 …”

Section: Introductionmentioning

confidence: 99%

Increased risk of psychiatric sequelae of COVID-19 is highest early in the clinical course

Coleman

Casiraghi

Blau

et al. 2021

Preprint

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SummaryBackgroundCOVID-19 has been shown to increase the risk of adverse mental health consequences. A recent electronic health record (EHR)-based observational study showed an almost two-fold increased risk of new-onset mental illness in the first 90 days following a diagnosis of acute COVID-19.MethodsWe used the National COVID Cohort Collaborative, a harmonized EHR repository with 2,965,506 COVID-19 positive patients, and compared cohorts of COVID-19 patients with comparable controls. Patients were propensity score-matched to control for confounding factors. We estimated the hazard ratio (COVID-19:control) for new-onset of mental illness for the first year following diagnosis. We additionally estimated the change in risk for new-onset mental illness between the periods of 21-120 and 121-365 days following infection.FindingsWe find a significant increase in incidence of new-onset mental disorders in the period of 21-120 days following COVID-19 (3.8%, 3.6-4.0) compared to patients with respiratory tract infections (3%, 2.8-3.2). We further show that the risk for new-onset mental illness decreases over the first year following COVID-19 diagnosis compared to other respiratory tract infections and demonstrate a reduced (non-significant) hazard ratio over the period of 121-365 days following diagnosis. Similar findings are seen for new-onset anxiety disorders but not for mood disorders.InterpretationPatients who have recovered from COVID-19 are at an increased risk for developing new-onset mental illness, especially anxiety disorders. This risk is most prominent in the first 120 days following infection.FundingNational Center for Advancing Translational Sciences (NCATS).

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“…It is readily apparent that there are different clinical presentations of PASC (eg, neurologic, cardiopulmonary), but these remain poorly defined entities. 3 Therefore, more research is needed to establish clinical phenotypes, to understand underlying mechanisms, and to identify potential therapeutic targets for the millions of individuals who are suffering or at risk for development of PASC.…”

mentioning

confidence: 99%

Findings From Mayo Clinic’s Post-COVID Clinic: PASC Phenotypes Vary by Sex and Degree of IL-6 Elevation

Durstenfeld¹,

Hsue²,

Peluso

et al. 2022

Mayo Clinic Proceedings

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Characterizing Long COVID: Deep Phenotype of a Complex Condition

Cited by 158 publications

References 53 publications

Impact of COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition

Impact of COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition

Increased risk of psychiatric sequelae of COVID-19 is highest early in the clinical course

Findings From Mayo Clinic’s Post-COVID Clinic: PASC Phenotypes Vary by Sex and Degree of IL-6 Elevation

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