Long covid—mechanisms, risk factors, and management

Abstract

Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.

Occurrence of BNT162b2 Vaccine Adverse Reactions Is Associated with Enhanced SARS-CoV-2 IgG Antibody Response

“…To this date, more than 4 billion vaccine doses have been administered worldwide [1], many of them mRNA-based vaccines. The occurrence of serious adverse events seen thus far is extremely rare, as opposed to the proven mortality and morbidity, both short and long term, of the COVID-19 disease [2][3][4][5][6]. Despite the clear evidence that vaccination is beneficial, vaccination hesitancy is a major obstacle to overcoming the pandemic, fueled by anti-vaccination movements and exaggerated media coverage and social media exposure [7,8].…”

Update to post-acute sequelae of SARS-CoV-2 infection: Caring for the 'long-haulers'

“…Cognitive behavioral therapy and graded exercise therapy have been suggested given the benefit in possibly related entities of myalgic encephalomyelitis/chronic fatigue syndrome; however, others caution implementing graded exercise therapy for PASC patients owing to concern of worsening post-exertional malaise. 24 Given the complexity and lingering associated symptoms and their impact on several major organ systems, frequent routine follow-up, establishing rapport, and involving a patient's support system serve as the foundation of management in these patients. A comprehensive, multidisciplinary approach that incorporates detailed management of comorbid medical conditions is the cornerstone of care.…”

“…Several studies are proposed or under way to investigate specific treatment including antihistamines, antidepressants, steroids, non-steroidal antiinflammatory drugs, antioxidants, stimulants, montelukast, melatonin, prolonged thromboprophylaxis, and hyperbaric oxygen. 24 Dietary supplementation and probiotics including a trial high-dose vitamin C and two trials examining nicotinamide riboside are ongoing. 24 Studies of inflammatory modulators such as the CC ligand-5 blocker leronlimab and anti-interleukin-6 tocilizumab are also under way.…”

“…24 Dietary supplementation and probiotics including a trial high-dose vitamin C and two trials examining nicotinamide riboside are ongoing. 24 Studies of inflammatory modulators such as the CC ligand-5 blocker leronlimab and anti-interleukin-6 tocilizumab are also under way. 24 Exercise regimens and cognitive behavioral therapy are also being investigated.…”

“…24 Studies of inflammatory modulators such as the CC ligand-5 blocker leronlimab and anti-interleukin-6 tocilizumab are also under way. 24 Exercise regimens and cognitive behavioral therapy are also being investigated. Efforts to increase vaccination and primary prevention remain important.…”