No Impact of Corticosteroid Use During the Acute Phase on Persistent Symptoms Post-COVID-19

Ko, Adrien Chan Sui; Candellier, Alexandre; Mercier, Marie Le; Joseph, C.; Carette, Hortense; Basille, Damien; Lion-Daolio, Sylvie; Devaux, Stéphanie; Schmit, Jean‐Luc; Lanoix, Jean‐Philippe; Andréjak, Claire

doi:10.2147/ijgm.s367273

Cited by 7 publications

(5 citation statements)

References 20 publications

(27 reference statements)

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“…Thus, patients who required ICU admission reported a greater decrease in the quality of life than those who did not (34). In contrast, studies also found that the severity of acute infection is not a risk factor for long COVID (32).…”

Section: Discussionmentioning

confidence: 89%

“…ICU admission is also established as a risk factor for long COVID (31) and a longer length of hospital stay, which, in turn, has also been indicated as a factor associated with persistence at 6-month follow-up (30). In the same vein, a shorter hospital stay was inversely associated with prolonged COVID syndrome (29), as well as a greater number of symptoms during the acute stage of the process (2,(31)(32)(33). Thus, patients who required ICU admission reported a greater decrease in the quality of life than those who did not (34).…”

Section: Discussionmentioning

confidence: 98%

“…The likelihood of experiencing symptoms beyond 28 days post-infection is reduced by 50% with the full vaccination schedule. This regimen also reduces the likelihood of having more than five symptoms in the 1st week of infection by 31% and reduces the likelihood of hospitalization by 71%, so the likelihood of developing long COVID would be similarly decreased by reducing both risk factors (32). The improvement in symptoms of long COVID after vaccination has not been explained yet, although it is theorized that vaccination counteracts immune dysregulation associated with symptomatic persistence (40).…”

Section: Discussionmentioning

confidence: 99%

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Hospital admission and vaccination as predictive factors of long COVID-19 symptoms

et al. 2022

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BackgroundSince the beginning of the COVID-19 pandemic, a great variability of symptoms that affect all organs and systems of the body has been identified in patients with SARS-CoV-2 infection; this symptomatology can sometimes persist over time, giving rise to the so-called long COVID or post-COVID. The aim of this study is to delve into the clinical characterization of these patients, as well as to take into account the influence of factors such as hospitalization, admission to ICU, history of pneumonia, or vaccination status on the persistence of symptoms.Material and methodsAn observational, descriptive, multicenter, and retrospective study was designed with a series of cases of people who presented long COVID, which includes univariate, bivariate, and multivariate analyses. Data were obtained from an online ad hoc questionnaire, and statistical analysis was performed using SPSS Software Version 25 (IBM-Inc., Chicago, IL, USA).ResultsHospitalization, ICU admission, history of pneumonia, and vaccination were predictive factors (positive or negative) for the following long-COVID symptoms: headache, menstrual disorders, joint pain, cough, chills, nasal congestion, back pain, abdominal pain, weight loss, eye discomfort, facial erythema, itching, tremors, dizziness, seizures, sleeping difficulty, dry eyes, palpitations, fatigue, paresthesia, dyspnea, aphonia, chest pain, high blood pressure, vomiting, memory loss, brain fog, hypothermia, low blood pressure, sputum or phlegm, lack of concentration, hair loss, and erectile dysfunction.ConclusionThis study provides evidence on the clinical characterization of patients suffering from long COVID in order to offer them the most appropriate treatments.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Hospital admission and vaccination as predictive factors of long COVID-19 symptoms

et al. 2022

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“…The treatment of corticosteroids has no impact on persistent symptoms in hospitalized patients because long COVID-19 displays multiorgan symptoms that are likely brought on by a variety of mechanisms [36].…”

Section: The Kallikrein-kinin System (Kks)mentioning

confidence: 99%

Role of the Renin-Angiotensin System in Long COVID’s Cardiovascular Injuries

Cojocaru

Vlad

et al. 2023

Biomedicines

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The renin-angiotensin system (RAS) is one of the biggest challenges of cardiovascular medicine. The significance of the RAS in the chronic progression of SARS-CoV-2 infection and its consequences is one of the topics that are currently being mostly discussed. SARS-CoV-2 undermines the balance between beneficial and harmful RAS pathways. The level of soluble ACE2 and membrane-bound ACE2 are both upregulated by the endocytosis of the SARS-CoV-2/ACE2 complex and the tumor necrosis factor (TNF)-α-converting enzyme (ADAM17)-induced cleavage. Through the link between RAS and the processes of proliferation, the processes of fibrous remodelling of the myocardium are initiated from the acute phase of the disease, continuing into the long COVID stage. In the long term, RAS dysfunction may cause an impairment of its beneficial effects leading to thromboembolic processes and a reduction in perfusion of target organs. The main aspects of ACE2—a key pathogenic role in COVID-19 as well as the mechanisms of RAS involvement in COVID cardiovascular injuries are studied. Therapeutic directions that can be currently anticipated in relation to the various pathogenic pathways of progression of cardiovascular damage in patients with longCOVID have also been outlined.

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“…The WHO recommends that patients with con rmed and suspected COVID-19 have access to follow-up care if they have persistent symptoms. (1) Long-COVID, de ned as symptoms that continue or develop after more than 4 weeks after getting COVID-19, has been associated with numerous dysfunctions (2). Described as one of the most prevalent symptoms in long-term, dyspnea is an important multifactorial symptom patient-centered that remains in high proportions since the rst evaluations after hospital discharge and persistent in a group of patients even 2 years of follow-up.…”

mentioning

confidence: 99%

Neuroleptics used in critical COVID associated with moderate- severe dyspnea after hospital discharge

Toufen

Almeida

Pompeo

et al. 2023

Preprint

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Background Dyspnea is a central symptom in patients with long-term COVID, both because of frequency and clinical impact. The effect of the drugs most used in critically ill patients on long-term dyspnea is not known. The aim of this study was to assess the risk factors and impacts associated with moderate to severe dyspnea in COVID-19 survivors.Methods Patients admitted to a university hospital between April 2020 and April 2021 were evaluated. It was collected data associated with clinical preconditions, hospital and ICU stay, use of corticosteroids, neuroleptics, neuromuscular blockers, midazolam, fentanyl, and noradrenaline. After hospital discharge, patients were evaluated in 1 and 12 months. In the evaluations, dyspnea, frailty, quality of life, functional capacity, anxiety and depression were measured. Descriptive statistics in the form of frequencies and percentages and a logistic regression analysis were done to assess the factors associated with moderate to severe dyspnea after 1 and 12 months from hospital discharge and statistical significance was set at P < 0.05.Results 100 patients were prospectively included, with 100 patients underwent the 1-month evaluation and 63 underwent the 12-month evaluation. Presented with limiting dyspnea (defined as mMRC score > 1) 56.6% of patients after 1 month and 33.9% after 12 months. Independent factors associated with limiting dyspnea 1 month after hospital discharge were the total dose of neuroleptics used during hospitalization and the presence of comorbidities prior to hospitalization. Use of corticosteroids, neuromuscular blockers, midazolam, fentanyl, and noradrenaline were not associated with limiting dyspnea. Dyspnea 1 month after hospital discharge was an independent risk factor for the occurrence of limiting dyspnea 12 months after discharge. Patients with limiting dyspnea 12 months after discharge showed more depression, anxiety and frailty, and had lower quality of life and functionality.Conclusions Patients with long-term severe COVID have a high frequency of limiting dyspnea. The total dose of neuroleptics used in hospital and the presence of comorbidities were independently related to the presence of limiting dyspnea after hospital discharge. After 12 months, patients who maintained limiting dyspnea presented in high frequency with other physical and mental dysfunction that should be evaluated and treated in the aim of reducing the burden of disabilities.

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No Impact of Corticosteroid Use During the Acute Phase on Persistent Symptoms Post-COVID-19

Cited by 7 publications

References 20 publications

Hospital admission and vaccination as predictive factors of long COVID-19 symptoms

Hospital admission and vaccination as predictive factors of long COVID-19 symptoms

Role of the Renin-Angiotensin System in Long COVID’s Cardiovascular Injuries

Neuroleptics used in critical COVID associated with moderate- severe dyspnea after hospital discharge

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