Distinguishing Incubation and Acute Disease Stages of Mild-to-Moderate COVID-19

Müller, Michael; Volzke, Johann; Subin, Behnam; Schmidt, Christian Johann; Geerdes-Fenge, H.; Reisinger, Emil C.; Müller‐Hilke, Brigitte

doi:10.3390/v14020203

Cited by 3 publications

(3 citation statements)

References 43 publications

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“…Typically, the initial active stage of COVID-19 extends for about four weeks after the onset of the infection [ 4 ]. Some individuals report symptoms that persist beyond the initial infection, entering the ‘long COVID’ phase.…”

Section: Introductionmentioning

confidence: 99%

Persistent Vascular Complications in Long COVID: The Role of ACE2 Deactivation, Microclots, and Uniform Fibrosis

Sideratou,

Papaneophytou

2024

Infectious Disease Reports

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Angiotensin-converting enzyme 2 (ACE2), a key regulator in vasoregulation and the renin–angiotensin system, is hypothesized to be downregulated in patients with COVID-19, leading to a cascade of cardiovascular complications. This deactivation potentially results in increased blood pressure and vessel injury, contributing to the formation and persistence of microclots in the circulation. Herein, we propose a hypothesis regarding the prolonged vascular complications observed in long COVID, focusing on the role of ACE2 deactivation and/or shedding, the persistence of microclots, and the unique pattern of fibrosis induced by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Furthermore, we propose that the distinctive, uniform fibrosis associated with COVID-19, which is challenging to detect through conventional X-ray imaging, exacerbates vascular injury and impairs oxygenation. The persistence of these microclots and the unique fibrosis pattern are suggested as key factors in the extended duration of vascular complications post-COVID-19 infection, regardless of the initial disease severity. Moreover, plasma ACE2 activity has the potential to serve as prognostic or diagnostic biomarkers for monitoring disease severity and managing long COVID symptoms. Elucidating the role of ACE2 deactivation and the consequent events is vital for understanding the long-term effects of COVID-19. The experimental verification of this hypothesis through in vitro studies, clinical longitudinal studies, and advanced imaging techniques could yield significant insights into the pathophysiological mechanisms underlying long COVID, thereby improving the management of patients, particularly those with cardiovascular complications.

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Section: Introductionmentioning

confidence: 99%

Persistent Vascular Complications in Long COVID: The Role of ACE2 Deactivation, Microclots, and Uniform Fibrosis

Sideratou,

Papaneophytou

2024

Infectious Disease Reports

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“…The acute phase of COVID-19 generally lasts up to 4 weeks from the onset of the initial infection [14]. However, in a subset of patients, symptoms may continue beyond this period into a post-acute phase known as 'long COVID-19'.…”

Section: Introductionmentioning

confidence: 99%

Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems

Sideratou,

Papaneophytou

2023

Infectious Disease Reports

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The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as ‘long- COVID-19′ (or simply ‘long- COVID’), emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as ‘post-acute sequelae of SARS-CoV-2 infection’ (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review summarizes the primary effects of long COVID on the respiratory, cardiovascular, and nervous systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID’s pathogenesis.

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“…The last section of this Topical Collection covers different clinical studies related to SARS-CoV-2 performed in different countries and scenarios. These include a brief report on the burden of pediatric SARS-CoV-2 hospitalizations during the Omicron wave in Germany (97), and four research articles describing the risk factors for the hospitalization of COVID-19 patients in the GENCOV study (98), an analysis of the variability in the clinical course of COVID-19 using a large real-world database (99), a characterization of hematological changes in COVID-19 patients (100), and an analysis of incubation and acute disease stages in mild-to-moderate COVID-19 patients (101).…”

mentioning

confidence: 99%