Long COVID: systemic inflammation and obesity as therapeutic targets

Fernández‐de‐las‐Peñas, César

doi:10.1016/s2213-2600(22)00159-x

Cited by 26 publications

(15 citation statements)

References 10 publications

(16 reference statements)

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“…These findings concur with recent evidence identifying these characteristics as important risk factors for PCC . Obesity and PCC share a metabolic proinflammatory state that promotes inflammatory processes and their associated signs and symptoms to linger for a prolonged period of time . Smoking has been shown to be a significant risk factor for both PCC and severe acute COVID-19 infection .…”

Section: Discussionsupporting

confidence: 89%

Risk Factors Associated With Post−COVID-19 Condition

et al. 2023

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ImportancePost−COVID-19 condition (PCC) is a complex heterogeneous disorder that has affected the lives of millions of people globally. Identification of potential risk factors to better understand who is at risk of developing PCC is important because it would allow for early and appropriate clinical support.ObjectiveTo evaluate the demographic characteristics and comorbidities that have been found to be associated with an increased risk of developing PCC.Data sourcesMedline and Embase databases were systematically searched from inception to December 5, 2022.Study SelectionThe meta-analysis included all published studies that investigated the risk factors and/or predictors of PCC in adult (≥18 years) patients.Data Extraction and SynthesisOdds ratios (ORs) for each risk factor were pooled from the selected studies. For each potential risk factor, the random-effects model was used to compare the risk of developing PCC between individuals with and without the risk factor. Data analyses were performed from December 5, 2022, to February 10, 2023.Main Outcomes and MeasuresThe risk factors for PCC included patient age; sex; body mass index, calculated as weight in kilograms divided by height in meters squared; smoking status; comorbidities, including anxiety and/or depression, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, immunosuppression, and ischemic heart disease; previous hospitalization or ICU (intensive care unit) admission with COVID-19; and previous vaccination against COVID-19.ResultsThe initial search yielded 5334 records of which 255 articles underwent full-text evaluation, which identified 41 articles and a total of 860 783 patients that were included. The findings of the meta-analysis showed that female sex (OR, 1.56; 95% CI, 1.41-1.73), age (OR, 1.21; 95% CI, 1.11-1.33), high BMI (OR, 1.15; 95% CI, 1.08-1.23), and smoking (OR, 1.10; 95% CI, 1.07-1.13) were associated with an increased risk of developing PCC. In addition, the presence of comorbidities and previous hospitalization or ICU admission were found to be associated with high risk of PCC (OR, 2.48; 95% CI, 1.97-3.13 and OR, 2.37; 95% CI, 2.18-2.56, respectively). Patients who had been vaccinated against COVID-19 with 2 doses had a significantly lower risk of developing PCC compared with patients who were not vaccinated (OR, 0.57; 95% CI, 0.43-0.76).Conclusions and RelevanceThis systematic review and meta-analysis demonstrated that certain demographic characteristics (eg, age and sex), comorbidities, and severe COVID-19 were associated with an increased risk of PCC, whereas vaccination had a protective role against developing PCC sequelae. These findings may enable a better understanding of who may develop PCC and provide additional evidence for the benefits of vaccination.Trial RegistrationPROSPERO Identifier: CRD42022381002

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Section: Discussionsupporting

confidence: 89%

Risk Factors Associated With Post−COVID-19 Condition

et al. 2023

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“…The association between obesity and LC might be expected because of the multisystemic changes associated with obesity 22. LC in general and the neuropsychiatric LC cluster were positively impacted by fitness, specifically, the amount of athletic practice before the COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Long COVID in the Belgian Defence forces: prevalence, risk factors and impact on quality of daily functioning

Mazibas¹,

Speybroeck²,

Dhondt³

et al. 2023

BMJ Mil Health

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IntroductionLong COVID (LC) is a medical condition first described and documented through anecdotes on social media by patients prior to being recognised by WHO as a disease. Although >50 prolonged symptoms of LC have been described, it remains a diagnostic challenge for military providers and therefore threatens operational readiness.MethodsOn 9 September 2021, an online survey was emailed to 2192 Belgian Defence personnel who had previously tested PCR positive for SARS-CoV-2 between 17 August 2020 and 31 May 2021. A total of 718 validated responses were received.Descriptive analyses determined the prevalence of LC and 10 most common symptoms and their duration following infection. In the explanatory analyses, risk factors related to LC were identified. To establish the health-related impact of LC on quality of life (HRQoL), we used the results from the EuroQol 5 Dimension 5 Level questionnaire.ResultsThe most frequent symptoms that were reported for >3 months were fatigue, lack of energy and breathing difficulties.47.35% of the respondents reported at least one persistent symptom, while 21.87% reported more than 3 symptoms lasting for at least 3 months after the initial COVID-19 infection. Most patients with LC suffered from symptoms of a neuropsychiatric nature (71.76%).LC was significantly associated with obesity; pre-existing respiratory disease and blood or immune disorders. Physical activity of >3 hours per week halved the risk of LC.The total QoL is reduced in patients with LC. Considering the five dimensions of the questionnaire, only the self-care dimension was not influenced by the presence of LC.ConclusionsAlmost half of Belgian Defence personnel developed LC after a confirmed COVID-19 infection, similar to numbers found in the Belgian population. Patients with LC would likely benefit from a multidisciplinary rehabilitation approach that addresses shortness of breath, fatigue and mood disturbance.

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“…Altogether, our study indicates that inflammation could be a target for treating long COVID. In this sense, previous literature indicates that the management of patients with long COVID should include the promotion of healthy lifestyle habits (e.g., nutrition habits and exercise) [ 27 ] to reduce the impact of proinflammatory status, even if future intervention studies are needed for confirming these findings.…”

Section: Discussionmentioning

confidence: 99%

Can Baseline IL-6 Levels Predict Long COVID in Subjects Hospitalized for SARS-CoV-2 Disease?

Giannitrapani

Mirarchi²,

Amodeo³

et al. 2023

IJMS

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The immune response to infection plays a crucial role in the pathogenesis of COVID-19, but several patients develop a wide range of persistent symptoms, which is becoming a major global health and economic burden. However, reliable indicators are not yet available to predict the persistence of symptoms typical of the so-called long COVID. Our study aims to explore an eventual role of IL-6 levels as a marker of long COVID. Altogether, 184 patients admitted to the COVID Medicine Unit of the University Hospital in Palermo, Italy, from the 1st of September 2020, were analyzed. Patients were divided into two groups according to the IL-6 serum levels (normal or elevated), considering the serum IL-6 levels measured during the first four days of hospitalization. In our study, higher serum IL-6 levels were associated with a doubled higher risk of long COVID (OR = 2.05; 95% CI: 1.04–4.50) and, in particular, they were associated with a higher incidence of mobility decline (OR = 2.55; 95% CI: 1.08–9.40) and PTSD (OR = 2.38; 95% CI: 1.06–8.61). The analysis of our case series confirmed the prominent role of IL-6 levels in response to SARS-CoV-2 infection, as predictors not only of COVID-19 disease severity and unfavorable outcomes, but also long COVID development trends.

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Long COVID: systemic inflammation and obesity as therapeutic targets

Cited by 26 publications

References 10 publications

Risk Factors Associated With Post−COVID-19 Condition

Risk Factors Associated With Post−COVID-19 Condition

Long COVID in the Belgian Defence forces: prevalence, risk factors and impact on quality of daily functioning

Can Baseline IL-6 Levels Predict Long COVID in Subjects Hospitalized for SARS-CoV-2 Disease?

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