COVID-19 and its sequelae: a platform for optimal patient care, discovery and training

Becker, Richard C.

doi:10.1007/s11239-021-02375-w

Cited by 53 publications

(38 citation statements)

References 13 publications

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“…It has been recently estimated (May 2021) that between 10% to 35% of patients not requiring hospitalization for acute COVID-19 may develop post-COVID-19 symptoms, regardless of co-morbidities [1,16,88], while incidence rates of up to 70% have been reported among hospitalized patients and among patients with severe illnesses [89]. The true prevalence of LC/PASC syndrome is currently unknown; however, it has been stated that as many as one-in-three survivors or more depending on the depth and reliability of investigation may develop LC/PASC [89].…”

Section: Discussionmentioning

confidence: 99%

Hypothesis: Neuroglia Activation Due to Increased Peripheral and CNS Proinflammatory Cytokines/Chemokines with Neuroinflammation May Result in Long COVID

Hayden

2021

Neuroglia

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The COVID-19 pandemic has paralleled the great Spanish flu pandemic of 1918–1919 in the United States. Previous historical accounts have strongly suggested a post-viral syndrome and, currently, a post-COVID-19 viral syndrome is unquestionable, which shares many of the characteristics of myalgic encephalomyelitis/chronic fatigue syndrome that is present globally. The original term for this post-acute sequela of SARS-CoV-2 (PASC) was termed long haulers by those who were affected with this syndrome and it is now termed long COVID (LC) or PASC. International researchers and clinicians are desperately trying to better understand the pathobiological mechanisms possibly involved in this syndrome. This review aims to summarize many of the cumulated findings associated with LC/PASC and provides supportive and representative illustrations and transmission electron micrographic remodeling changes within brain tissues associated with a stress type of injury as occurs in the classic db/db and novel BTBR ob/ob obesity and diabetes mellitus mice models. These models are utilized to merely provide a response to metabolic stress injury wound healing mechanisms that are also present in humans. This review posits that neuroglial activation and chronic neuroinflammation may be a common denominator for the development of the complex LC/PASC syndrome following acute COVID-19 due to SARS-CoV-2.

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Section: Discussionmentioning

confidence: 99%

Hypothesis: Neuroglia Activation Due to Increased Peripheral and CNS Proinflammatory Cytokines/Chemokines with Neuroinflammation May Result in Long COVID

Hayden

2021

Neuroglia

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“…Circulating biomarkers may be useful in the diagnosis and management of patients with COVID-19 (reviewed in Grobler) [1]. Levels of vascular and thrombosis-related biomarkers, including those reflecting thrombin generation, fibrin formation, fibrin degradation, platelet activation and extracellular trap formation for example may offer insight for the acuity and stage of disease (reviewed in Becker) [2]. The potential role of biomarkers to gauge targeted therapies and to direct optimal management will require thorough investigation.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and biomarkers of thrombosis: focus on von Willebrand factor and extracellular vesicles

Becker

Sexton

Smyth

2021

J Thromb Thrombolysis

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, caused by the SARS-CoV-2 virus, is responsible for a pandemic of unparalleled portion over the past century. While the acute phase of infection causes significant morbidity and mortality, post-acute sequelae that can affect essentially any organ system is rapidly taking on an equally large part of the overall impact on human health, quality of life, attempts to return to normalcy and the global economy. Herein, we summarize the potential role of von Willebrand Factor and extracellular vesicles toward understanding the pathophysiology, clinical presentation, duration of illness, diagnostic approach and management of COVID-19 and its sequelae. Keywords Thrombosis • Biomarkers • COVID-19 • von Willebrand factor Highlights• COVID-19 has both acute and long-term clinical sequelae. Post-acute sequelae of SARS-CoV-2 infection or PASC is responsible for poor quality of life, impaired productivity, high health care costs and a serious economic impact. An ability to understand the pathophysiology, management and predictors of outcomes is of paramount importance.

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“…Based on the initial symptoms, duration of symptoms, period of quiescence and time of onset of symptoms long COVID (PCS) can be divided into five categories ( Table 1 ) [ 8 ]. As can be noted from the classifications, symptoms could last 3-12 months, and vary in severity from mild to severe, or even lead to death.…”

mentioning

confidence: 99%

Post COVID-19 Syndrome (“Long COVID”) and Diabetes: Challenges in Diagnosis and Management

Raveendran¹,

Misra

2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

110

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Presence of various health issues even after recovering from acute COVID19 is collectively called post COVID syndrome (PCS, or “long COVID”). The symptoms of PCS can be due to organ dysfunction, effects of hospitalisation and drugs, or unrelated to these. Type 2 diabetes mellitus has bidirectional relationship with COVID-19. Presence of diabetes also influences PCS via various pathophysiological mechanisms. COVID-19 can add to or exacerbate postural hypotension with tachycardia, sarcopenia (and muscle fatigue), and microvascular dysfunction in patients with diabetes. Strict control of diabetes and other co-morbidities, supervised rehabilitation and physical exercise, and optimal nutrition could help in reducing and managing PCS. Patients may suffer from several debilitating symptoms/signs that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks after infection, and are not explained by an alternative diagnosis [ 1 ]. Common symptoms include fatigue, breathlessness, myalgia, weakness, headache, cognitive blunting etc. This conglomeration of symptoms is called “Long COVID” or more appropriately as “Post COVID-19 Syndrome (PCS)” [ 2 ]. The aim of the brief review is to summarise current knowledge of health events occurring after COVID-19 in brief and relate them for patients with diabetes.

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COVID-19 and its sequelae: a platform for optimal patient care, discovery and training

Cited by 53 publications

References 13 publications

Hypothesis: Neuroglia Activation Due to Increased Peripheral and CNS Proinflammatory Cytokines/Chemokines with Neuroinflammation May Result in Long COVID

Hypothesis: Neuroglia Activation Due to Increased Peripheral and CNS Proinflammatory Cytokines/Chemokines with Neuroinflammation May Result in Long COVID

COVID-19 and biomarkers of thrombosis: focus on von Willebrand factor and extracellular vesicles

Post COVID-19 Syndrome (“Long COVID”) and Diabetes: Challenges in Diagnosis and Management

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