Klinische, radiologische und histopathologische Merkmale des pulmonalen Post-COVID-Syndroms

Steinestel, Konrad; Czech, A.; Hackenbroch, Carsten; Bloch, Wilhelm; Gagiannis, Daniel

doi:10.1007/s00292-021-01024-6

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…A lot of studies to date are based on self-reported data or questionnaires without including clinical data or results of examinations. Available clinical data reveal limitations, e.g., in pulmonary function [ 18 , 19 , 20 , 21 ]. Improvements in lung function after pulmonary rehabilitation were published by Bouteleux [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

Steinmetz

Groß

Lehnert

et al. 2023

JCM

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Post-COVID-19 syndrome (PCS) has been described as ‘the pandemic after the pandemic’ with more than 65 million people worldwide being affected. The enormous range of symptoms makes both diagnosis complex and treatment difficult. In a post-COVID rehabilitation outpatient clinic, 184 patients, mostly non-hospitalized, received a comprehensive, interdisciplinary diagnostic assessment with fixed follow-up appointments. At baseline, three in four patients reported more than 10 symptoms, the most frequent symptoms were fatigue (84.9%), decreased physical capacity (83.0%), tiredness (81.1%), poor concentration (73.6%), sleeping problems (66.7%) and shortness of breath (67.3%). Abnormalities were found in the mean values of scores for fatigue (FAS = 34.3), cognition (MoCA = 25.5), psychological alterations (anxiety, depression, post-traumatic stress disorder), limitation of lung function (CAT) and severity scores for PCS (PCFS, MCRS). Clinical abnormalities were found in elevated values of heart rate, breathing rate at rest, blood pressure and NT-proBNP levels. As the frequency of the described symptoms decreases only slowly but most often significantly over the course, it is important to monitor the patients over a longer period of time. Many of them suffer from an immense symptom burden, often without pre-existing clinical correlates. Our results show a clear association with objectifiable assessments and tests as well as pronounced symptoms.

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Section: Introductionmentioning

confidence: 99%

Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

Steinmetz

Groß

Lehnert

et al. 2023

JCM

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“…(Other autoimmune complications of statins are also reported [139][140][141][142][143]-which can affect muscle [144][145][146][147]-and in some cases, these accompany autoimmune myositis [13][14][15][16]148].) Autoimmunity is also a complication of COVID-19 [149][150][151][152] (encompassing, specifically, autoimmune conditions reported with statins [6,7,[153][154][155] including necrotizing myositis [8,9]) and is a factor in long-COVID [156][157][158][159]: in one "multi-omics" study of long-COVID, an autoimmune profile represented one of the four key patterns observed [160]. (See Section 11 for further discussion of long-COVID.…”

Section: Skeletal Muscle (Airway Dilator Muscles and Muscles Of Respi...mentioning

confidence: 99%

Statin Use in Relation to COVID-19 and Other Respiratory Infections: Muscle and Other Considerations

Golomb

Han

Langsjoen³

et al. 2023

JCM

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Statins have been widely advocated for use in COVID-19 based on large favorable observational associations buttressed by theoretical expected benefits. However, past favorable associations of statins to pre-COVID-19 infection outcomes (also buttressed by theoretical benefits) were unsupported in meta-analysis of RCTs, RR = 1.00. Initial RCTs in COVID-19 appear to follow this trajectory. Healthy-user/tolerator effects and indication bias may explain these disparities. Moreover, cholesterol drops in proportion to infection severity, so less severely affected individuals may be selected for statin use, contributing to apparent favorable statin associations to outcomes. Cholesterol transports fat-soluble antioxidants and immune-protective vitamins. Statins impair mitochondrial function in those most reliant on coenzyme Q10 (a mevalonate pathway product also transported on cholesterol)—i.e., those with existing mitochondrial compromise, whom data suggest bear increased risks from both COVID-19 and from statins. Thus, statin risks of adverse outcomes are amplified in those patients at risk of poor COVID-19 outcomes—i.e., those in whom adjunctive statin therapy may most likely be given. High reported rates of rhabdomyolysis in hospitalized COVID-19 patients underscore the notion that statin-related risks as well as benefits must be considered. Advocacy for statins in COVID-19 should be suspended pending clear evidence of RCT benefits, with careful attention to risk modifiers.

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Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis: a meta-analysis

Vasilevska,

Guest,

Szardenings

et al. 2024

Transl Psychiatry

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The global impact of SARS-CoV-2 infection has raised concerns about secondary diseases beyond acute illness. This review explores the significance and potential underlying mechanisms of how SARS-CoV-2 infection might elicit an immune response targeting N-methyl-D-aspartate (NMDA) receptors, and its implications for autoimmune-driven neuropsychiatric manifestations. We identified 19 published case reports of NMDA receptor encephalitis associated with SARS-CoV-2 infection or vaccination by a systematic literature search. The significance of these reports was limited since it is not clear if a coincidental or causal relationship exists between SARS-CoV-2 infection or vaccination and manifestation of NMDA receptor encephalitis. The included studies were hampered by difficulties in establishing if these patients had pre-existing NMDA receptor antibodies which entered the brain by infection- or vaccination-associated transient blood-brain barrier leakage. In addition, four cases had comorbid ovarian teratoma, which is a known trigger for development of NMDA receptor encephalitis. Considering that billions of people have contracted COVID-19 or have been vaccinated against this virus, the publication of only 19 case reports with a possible link to NMDA receptor encephalitis, indicates that it is rare. In conclusion, these findings do not support the case that SARS-CoV-2 infection or vaccination led to an increase of existing or de novo encephalitis mediated by an autoimmune response targeting NMDA receptor function. Nevertheless, this work underscores the importance of ongoing vigilance in monitoring viral outbreaks and their potential impact on the central nervous system through basic, epidemiological and translational research.

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Klinische, radiologische und histopathologische Merkmale des pulmonalen Post-COVID-Syndroms

Cited by 4 publications

References 13 publications

Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

Statin Use in Relation to COVID-19 and Other Respiratory Infections: Muscle and Other Considerations

Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis: a meta-analysis

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