Number of initial symptoms is more related to long COVID-19 than acute severity of infection: a prospective cohort of hospitalized patients

Ko, Adrien Chan Sui; Candellier, Alexandre; Mercier, Marie Le; Joseph, C.; Schmit, Jean‐Luc; Lanoix, Jean‐Philippe; Andréjak, Claire

doi:10.1016/j.ijid.2022.03.006

Cited by 28 publications

(37 citation statements)

References 10 publications

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“…Quite interestingly, long-COVID-19 appears to be more probable in women than in men [46] in contrast to severe acute COVID-19 [47,48], independent of the severity of the original infection. Other risk factors for having long-COVID-19 seem to be a higher body mass index and older age [49][50][51].…”

Section: Discussionmentioning

confidence: 99%

Serum NGF and BDNF in Long-COVID-19 Adolescents: A Pilot Study

et al. 2022

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COVID-19 (COronaVIrus Disease 19) is an infectious disease also known as an acute respiratory syndrome caused by the SARS-CoV-2. Although in children and adolescents SARS-CoV-2 infection produces mostly mild or moderate symptoms, in a certain percentage of recovered young people a condition of malaise, defined as long-COVID-19, remains. To date, the risk factors for the development of long-COVID-19 are not completely elucidated. Neurotrophins such as NGF (Nerve Growth Factor) and BDNF (Brain-Derived Neurotrophic Factor) are known to regulate not only neuronal growth, survival and plasticity, but also to influence cardiovascular, immune, and endocrine systems in physiological and/or pathological conditions; to date only a few papers have discussed their potential role in COVID-19. In the present pilot study, we aimed to identify NGF and BDNF changes in the serum of a small cohort of male and female adolescents that contracted the infection during the second wave of the pandemic (between September and October 2020), notably in the absence of available vaccines. Blood withdrawal was carried out when the recruited adolescents tested negative for the SARS-CoV-2 (“post-infected COVID-19”), 30 to 35 days after the last molecular test. According to their COVID-19 related outcomes, the recruited individuals were divided into three groups: asymptomatics, acute symptomatics and symptomatics that over time developed long-COVID-19 symptoms (“future long-COVID-19”). As a control group, we analyzed the serum of age-matched healthy controls that did not contract the infection. Inflammatory biomarkers (TNF-α, TGF-β), MCP-1, IL-1α, IL-2, IL-6, IL-10, IL-12) were also analyzed with the free oxygen radicals’ presence as an oxidative stress index. We showed that NGF serum content was lower in post-infected-COVID-19 individuals when compared to healthy controls; BDNF levels were found to be higher compared to healthy individuals only in post-infected-COVID-19 symptomatic and future long-COVID-19 girls, leaving the BDNF levels unchanged in asymptomatic individuals if compared to controls. Oxidative stress and inflammatory biomarkers were unchanged in male and female adolescents, except for TGF-β that, similarly to BDNF, was higher in post-infected-COVID-19 symptomatic and future long-COVID-19 girls. We predicted that NGF and/or BDNF could be used as early biomarkers of COVID-19 morbidity in adolescents.

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Section: Discussionmentioning

confidence: 99%

Serum NGF and BDNF in Long-COVID-19 Adolescents: A Pilot Study

et al. 2022

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“…Most studies indicate female sex and older age as risk factors for long-term neurological consequences of the COVID-19 [ 39 , 42 , 47 , 48 , 49 , 50 ].…”

Section: Predictors Of Post-covid Neurological Complicationsmentioning

confidence: 99%

“…Data on the relationship of the disease severity with the likelihood of long-term consequences of COVID-19 are contradictory. A number of studies showed the association of the severity of the acute COVID-19 with the occurrence of long-term neurological consequences [ 23 , 39 , 42 , 46 , 48 , 49 , 50 ]. It was also found that the number of initial symptoms better predicts the presence of long COVID than the severity of the acute phase of the disease [ 47 , 50 , 56 ].…”

Section: Predictors Of Post-covid Neurological Complicationsmentioning

confidence: 99%

“…A number of studies showed the association of the severity of the acute COVID-19 with the occurrence of long-term neurological consequences [ 23 , 39 , 42 , 46 , 48 , 49 , 50 ]. It was also found that the number of initial symptoms better predicts the presence of long COVID than the severity of the acute phase of the disease [ 47 , 50 , 56 ]. Other studies showed that severity of the acute phase of the disease is less important as predictor of the long-term health complications than cumulative number of the specific COVID-19 symptoms, so-called number of initial symptoms, during the first week of acute phase [ 47 , 50 , 56 ].…”

Section: Predictors Of Post-covid Neurological Complicationsmentioning

confidence: 99%

“…It was also found that the number of initial symptoms better predicts the presence of long COVID than the severity of the acute phase of the disease [ 47 , 50 , 56 ]. Other studies showed that severity of the acute phase of the disease is less important as predictor of the long-term health complications than cumulative number of the specific COVID-19 symptoms, so-called number of initial symptoms, during the first week of acute phase [ 47 , 50 , 56 ]. Miskowiak et al [ 23 ] studied the relationship between acute phase severity and cognitive changes in post-COVID patients.…”

Section: Predictors Of Post-covid Neurological Complicationsmentioning

confidence: 99%

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Role of Demyelination in the Persistence of Neurological and Mental Impairments after COVID-19

Khodanovich

Parshukova

Naumova

2022

IJMS

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Long-term neurological and mental complications of COVID-19, the so-called post-COVID syndrome or long COVID, affect the quality of life. The most persistent manifestations of long COVID include fatigue, anosmia/hyposmia, insomnia, depression/anxiety, and memory/attention deficits. The physiological basis of neurological and psychiatric disorders is still poorly understood. This review summarizes the current knowledge of neurological sequelae in post-COVID patients and discusses brain demyelination as a possible mechanism of these complications with a focus on neuroimaging findings. Numerous reviews, experimental and theoretical studies consider brain demyelination as one of the mechanisms of the central neural system impairment. Several factors might cause demyelination, such as inflammation, direct effect of the virus on oligodendrocytes, and cerebrovascular disorders, inducing myelin damage. There is a contradiction between the solid fundamental basis underlying demyelination as the mechanism of the neurological injuries and relatively little published clinical evidence related to demyelination in COVID-19 patients. The reason for this probably lies in the fact that most clinical studies used conventional MRI techniques, which can detect only large, clearly visible demyelinating lesions. A very limited number of studies use specific methods for myelin quantification detected changes in the white matter tracts 3 and 10 months after the acute phase of COVID-19. Future research applying quantitative MRI assessment of myelin in combination with neurological and psychological studies will help in understanding the mechanisms of post-COVID complications associated with demyelination.

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