Long-term consequences of COVID-19: research needs

Yelin, Dana; Wirtheim, Eytan; Vetter, Pauline; Kalil, André C.; Bruchfeld, Judith; Runold, Michael; Guaraldi, Giovanni; Mussini, Cristina; Gudiol, Carlota; Pujol, Miquel; Bandera, Alessandra; Scudeller, Luigia; Paul, Mical; Kaiser, Laurent; Leibovici, Leonard

doi:10.1016/s1473-3099(20)30701-5

Cited by 302 publications

(288 citation statements)

References 6 publications

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“…40 Further research is needed to better understand recovery trajectories, to inform and improve the care of patients. 41 The findings from this study will provide important contributions to the development of flexible, person-centred interventions for people recovering and rehabilitating from long-COVID.…”

Section: Implications For Practicementioning

confidence: 85%

Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID

et al. 2020

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BackgroundAn unknown proportion of people who had an apparently mild COVID-19 infection continue to suffer with persistent symptoms, including chest pain, shortness of breath, muscle and joint pains, headaches, cognitive impairment (‘brain fog’), and fatigue. Post-acute COVID-19 (‘long-COVID’) seems to be a multisystem disease, sometimes occurring after a mild acute illness; people struggling with these persistent symptoms refer to themselves as ‘long haulers’.AimTo explore experiences of people with persisting symptoms following COVID-19 infection, and their views on primary care support received.Design & settingQualitative methodology, with semi-structured interviews to explore perspectives of people with persisting symptoms following suspected or confirmed COVID-19 infection. Participants were recruited via social media between July–August 2020.MethodInterviews were conducted by telephone or video call, digitally recorded, and transcribed with consent. Thematic analysis was conducted applying constant comparison techniques. People with experience of persisting symptoms contributed to study design and data analysis.ResultsThis article reports analysis of 24 interviews. The main themes include: the ‘hard and heavy work’ of enduring and managing symptoms and accessing care; living with uncertainty, helplessness and fear, particularly over whether recovery is possible; the importance of finding the 'right' GP (understanding, empathy, and support needed); and recovery and rehabilitation: what would help?ConclusionThis study will raise awareness among primary care professionals, and commissioners, of long-COVID and the range of symptoms people are experiencing. Patients require their GP to believe their symptoms and to demonstrate empathy and understanding. Ongoing support by primary care professionals during recovery and rehabilitation is crucial.

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Section: Implications For Practicementioning

confidence: 85%

Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID

et al. 2020

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“…In the vast majority of other cities and countries, seroprevalence is usually much lower than 10% ( Table 3). Most importantly, given the high risk of long-term morbidity due to tissue damage caused by COVID-19, naturally acquired herd immunity cannot be ethically pursued or encouraged (215)(216)(217)(218). Therefore, the pursuit of natural herd immunity against SARS-CoV-2 is not justifiable in any form or manner and will be associated with very high immediate and long-term healthcare costs due to chronic disease.…”

Section: Epidemiological Implications Of Serology Testing For Sars-cov-2mentioning

confidence: 99%

Humoral Responses and Serological Assays in SARS-CoV-2 Infections

et al. 2020

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In December 2019, the novel betacoronavirus Severe Acute Respiratory Disease Coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China. SARS-CoV-2 has since become a pandemic virus resulting in hundreds of thousands of deaths and deep socioeconomic implications worldwide. In recent months, efforts have been directed towards detecting, tracking, and better understanding human humoral responses to SARS-CoV-2 infection. It has become critical to develop robust and reliable serological assays to characterize the abundance, neutralization efficiency, and duration of antibodies in virus-exposed individuals. Here we review the latest knowledge on humoral immune responses to SARS-CoV-2 infection, along with the benefits and limitations of currently available commercial and laboratory-based serological assays. We also highlight important serological considerations, such as antibody expression levels, stability and neutralization dynamics, as well as cross-reactivity and possible immunological back-boosting by seasonal coronaviruses. The ability to accurately detect, measure and characterize the various antibodies specific to SARS-CoV-2 is necessary for vaccine development, manage risk and exposure for healthcare and at-risk workers, and for monitoring reinfections with genetic variants and new strains of the virus. Having a thorough understanding of the benefits and cautions of standardized serological testing at a community level remains critically important in the design and implementation of future vaccination campaigns, epidemiological models of immunity, and public health measures that rely heavily on up-to-date knowledge of transmission dynamics.

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“…Although, at present, the available literature shows limited evidence in support of postsurvival health issues in COVID‐19, 48 new studies by some authors have proposed the possibilities of repeated lung and intestinal infections, vascular endothelial dysfunction, male infertility (owing to high expression of ACE2 and TMPRSS2 in male reproductive organs, especially, testis), and new onsets of diabetes in COVID‐19 survivors 49,50 …”

Section: Sars‐cov‐2‐specific Virulence Factorsmentioning

confidence: 99%

SARS‐CoV‐2‐specific virulence factors in COVID‐19

Kumar

Prasoon

Kumari

et al. 2020

Journal of Medical Virology

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The paucity of knowledge about severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐specific virulence factors has greatly hampered the therapeutic management of patients with coronavirus disease 2019 (COVID‐19). Recently, a cluster of studies appeared, which presented empirical evidence for SARS‐CoV‐2‐specific virulence factors that can explain key elements of COVID‐19 pathology. These studies unravel multiple structural and nonstructural specifics of SARS‐CoV‐2, such as a unique FURIN cleavage site, papain‐like protease (SCoV2‐PLpro), ORF3b and nonstructural proteins, and dynamic conformational changes in the structure of spike protein during host cell fusion, which give it an edge in infectivity and virulence over previous coronaviruses causing pandemics. Investigators provided robust evidence that SARS‐CoV‐2‐specific virulence factors may have an impact on viral infectivity and transmissibility and disease severity as well as the development of immunity against the infection, including response to the vaccines. In this article, we are presenting a summarized account of the newly reported studies.

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Long-term consequences of COVID-19: research needs

Cited by 302 publications

References 6 publications

Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID

Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID

Humoral Responses and Serological Assays in SARS-CoV-2 Infections

SARS‐CoV‐2‐specific virulence factors in COVID‐19

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