Long covid—an update for primary care

Greenhalgh, Trisha; Sivan, Manoj; Delaney, Brendan; Evans, Rachael A.; Milne, Ruairidh

doi:10.1136/bmj-2022-072117

Cited by 111 publications

(103 citation statements)

References 62 publications

(100 reference statements)

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“…It is becoming increasingly clear that COVID-19 is a multi-system disease and can also lead to heart failure, acute kidney and neurovascular injuries [5,9,10]. In addition, growing patient testimony and scientific evidence demonstrate that a large number of patients (approximately 2% of the UK population alone) also suffer from post-COVID syndrome (long COVID or postacute sequelae of COVID-19 (PASC)) which cause debilitating physical or mental symptoms for long periods after infection [5,[11][12][13].…”

Section: Emergence Of Covid-19 and Variants Of Concernmentioning

confidence: 99%

Use of Antiandrogens as Therapeutic Agents in COVID-19 Patients

Giotis¹,

Cil²,

Brooke³

2022

Preprint

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COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), is estimated to have caused over 6.5 million deaths to date worldwide. The emergence of fast-evolving SARS-CoV-2 variants of concern alongside increased transmissibility and/or virulence as well as immune and vaccine escape capabilities highlight the urgent need for more effective antivirals to combat the disease in the long run along with regularly updated vaccine boosters. One of the early risk factors identified during the COVID-19 pandemic was that men are more likely to get infected by the virus, more likely to develop severe disease and exhibit higher likelihood of hospitalisation and mortality rates compared to women. An association exists between SARS-CoV-2 infectiveness and disease severity with sex steroid hormones and in particular androgens. Several studies underlined the importance of the androgen-mediated regulation of the host protease TMPRSS2 and the cell entry protein ACE2 as well as the key role of these factors in the entry of the virus into target cells. In this context, modulating androgen signalling is a promising strategy to block viral infection and antiandrogens could be used as a preventative measure at the pre- or early-hospitalisation stage of COVID-19 disease. Different antiandrogens, including commercial drugs used to treat metastatic castration-sensitive prostate cancer and other conditions, have been tested as antivirals with varying success. In this review, we summarise the most recent updates concerning the use of antiandrogens as prophylactic and therapeutic options for COVID-19.

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Section: Emergence Of Covid-19 and Variants Of Concernmentioning

confidence: 99%

Use of Antiandrogens as Therapeutic Agents in COVID-19 Patients

Giotis¹,

Cil²,

Brooke³

2022

Preprint

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“…I was bothered by the lack of any mention by Greenhalgh and colleagues of a functional element to long covid 1. It seemed a huge omission to me.…”

mentioning

confidence: 99%

Long covid update for primary care should acknowledge functional symptoms

Ward

2022

BMJ

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It must be a fraught task, writing about long covid. The list of symptoms is huge and we don't really know how it arises. I often feel inadequate faced with patients distressed by their long covid symptoms.I was bothered by the lack of any mention by Greenhalgh and colleagues of a functional element to long covid. 1 It seemed a huge omission to me. Many of the complaints we see in primary care are of a functional nature and there is often a large functional component to physical illnesses like chronic obstructive pulmonary disease, asthma, heart disease, and musculoskeletal pains. How can we start to help people who suffer functional symptoms if there is a taboo about mentioning it?People with functional symptoms are suffering in the same way as those with physical symptoms and if we are to destigmatise this area of medicine then authors as important and respected as Greenhalgh and colleagues should acknowledge their existence. It would be extraordinary if many people suffering long covid did not have a functional element to their presentations. Concentrating on physical tests and bodily mechanisms wholly risks missing this component.

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“…Greenhalgh and colleagues’ Practice Pointer1 and the Opinion article from Long Covid SOS2 serve as a reminder that “there is no health without mental health.”3…”

mentioning

confidence: 99%