Dissecting the Molecular Mechanisms Surrounding Post-COVID-19 Syndrome and Neurological Features

Mohamed, Mohamed S.; Johansson, Anton; Jönsson, Jan‐Ingvar; Schiöth, Helgi B.

doi:10.3390/ijms23084275

Cited by 21 publications

(17 citation statements)

References 118 publications

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“…Overall, 45.4% of survivors aged ≥65 years in this study had incident conditions. Among adults aged ≥65 years, who are already at higher risk for stroke and neurocognitive impairment, post-COVID conditions affecting the nervous system are of particular concern because these conditions can lead to early entry into supportive services or investment of additional resources into care ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021

Bull-Otterson¹,

Baca²,

Saydah³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

212

179

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Section: Discussionmentioning

confidence: 99%

Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021

Bull-Otterson¹,

Baca²,

Saydah³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

212

179

View full text Add to dashboard Cite

“…Such a loss in synaptophysin 1 level may be mediated by hyperphosphorylated TDP-43 and tau, since hyperphosphorylated, and subsequently aggregated, forms of TDP-43 and tau have been strongly implicated in the development of neurodegeneration by altering the level of various neurotransmitters and critical neuronal proteins [ 57 – 61 ]. Additionally, it is possible that astrocytosis and reactive microglia in brains 12 months post-infection stimulate/release inflammatory molecules [ 62 – 64 ] that may increase BBB permeability and recruitment of peripheral immune cells into the brain post-infection for a longer period. It is, therefore, possible that these above-mentioned factors may have been altered in the brain in SARS-CoV-2 infection and that may contribute to long-term neurodegeneration in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Sequelae of COVID-19 in Experimental Mice

et al. 2022

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We recently reported acute COVID-19 symptoms, clinical status, weight loss, multi-organ pathological changes, and animal death in a murine hepatitis virus-1 (MHV-1) coronavirus mouse model of COVID-19, which were similar to that observed in humans with COVID-19. We further examined long-term (12 months post-infection) sequelae of COVID-19 in these mice. Congested blood vessels, perivascular cavitation, pericellular halos, vacuolation of neuropils, pyknotic nuclei, acute eosinophilic necrosis, necrotic neurons with fragmented nuclei, and vacuolation were observed in the brain cortex 12 months post-MHV-1 infection. These changes were associated with increased reactive astrocytes and microglia, hyperphosphorylated TDP-43 and tau, and a decrease in synaptic protein synaptophysin-1, suggesting the possible long-term impact of SARS-CoV-2 infection on defective neuronal integrity. The lungs showed severe inflammation, bronchiolar airway wall thickening due to fibrotic remodeling, bronchioles with increased numbers of goblet cells in the epithelial lining, and bronchiole walls with increased numbers of inflammatory cells. Hearts showed severe interstitial edema, vascular congestion and dilation, nucleated red blood cells (RBCs), RBCs infiltrating between degenerative myocardial fibers, inflammatory cells and apoptotic bodies and acute myocyte necrosis, hypertrophy, and fibrosis. Long-term changes in the liver and kidney were less severe than those observed in the acute phase. Noteworthy, the treatment of infected mice with a small molecule synthetic peptide which prevents the binding of spike protein to its respective receptors significantly attenuated disease progression, as well as the pathological changes observed post-long-term infection. Collectively, these findings suggest that COVID-19 may result in long-term, irreversible changes predominantly in the brain, lung, and heart.

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“…Clinical syndromes (e.g., dyspnea, hypoxia, and multiple organ failure) ( 4 , 5 ), iatrogenic impairments (e.g., fatigue and muscle weakness) ( 6 ), and prolonged immobilization resulting from COVID-19 can significantly impact physical, psychological, and social functioning and reduce quality of life, which may persist for at least 6 months ( 7 , 8 ). Apart from that, many survivors of COVID-19 have persistent symptoms and/or the development of long-term symptoms such as fatigue, headache, and dyspnea after infection, which is called as long COVID ( 9 , 10 ). It is estimated that 5% of survivors of COVID-19 will need inpatient rehabilitation ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials

Huang

Fan

Zhao

et al. 2022

Front. Public Health

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BackgroundCoronavirus disease 2019 (COVID-19) significantly impacts physical, psychological, and social functioning and reduces quality of life, which may persist for at least 6 months. Given the fact that COVID-19 is a highly infectious disease and therefore healthcare facilities may be sources of contagion, new methods avoiding face-to-face contact between healthcare workers and patients are urgently needed. Telerehabilitation is the provision of rehabilitation services to patients at a distance via information and communication technologies. However, high-quality evidence of the efficacy of telerehabilitation for COVID-19 is still lacking. This meta-analysis aimed to investigate the efficacy of telerehabilitation for patients with and survivors of COVID-19.MethodsWe searched the Cochrane Library, EMBASE, Medline (via PubMed), PEDro, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform from January 1st, 2020 to April 30th, 2022 for randomized controlled trials published in English, which aimed to evaluate the efficacy of telerehabilitation vs. face-to-face rehabilitation, usual care, or no treatment for COVID-19. Methodological quality and overall evidence quality of the included studies were assessed. The statistical reliability of the data was quantified using the trial sequential analysis.ResultsSeven randomized controlled trials with eight comparisons were included and all of them were used for meta-analysis. The meta-analyses of absolute values showed the superiority of telerehabilitation over no treatment or usual care for dyspnea (Borg scale: mean difference = −1.88, −2.37 to −1.39; Multidimensional dyspnea-12: mean difference = −3.70, −5.93 to −1.48), limb muscle strength (mean difference = 3.29; 2.12 to 4.47), ambulation capacity (standardized mean difference = 0.88; 0.62 to 1.14), and depression (mean difference = −5.68; −8.62 to −2.74). Significant improvement in these variables persisted in the meta-analyses of change scores. No significant difference was found in anxiety and quality of life. No severe adverse events were reported in any of the included studies.ConclusionsModerate- to very low-quality evidence demonstrates that telerehabilitation may be an effective and safe solution for patients with and survivors of COVID-19 in dyspnea, lower limb muscle strength, ambulation capacity, and depression. Further well-designed studies are required to evaluate the long-term effects, cost-effectiveness, and satisfaction in larger samples.

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Dissecting the Molecular Mechanisms Surrounding Post-COVID-19 Syndrome and Neurological Features

Cited by 21 publications

References 118 publications

Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021

Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021

Long-Term Sequelae of COVID-19 in Experimental Mice

Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials

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