Plasma Exchange Improves Cognitive Function in Long-COVID-Related Postural Orthostatic Tachycardia Syndrome and Autoimmune Neurological Dysfunction

Seeley, Marie-Claire; Hooper, Matthew; Tan, Jason; Wells, Rachel; Gallagher, Celine; Lau, Dennis H.

doi:10.1016/j.amjmed.2023.01.043

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…Furthermore, the study was designed at the very beginning of the COVID-19 pandemic when presentation, symptomatology, natural progression and longer-term complications of COVID-19 were largely unknown; participants were therefore asked to select from symptoms that were reported to WHO at the time. With increasing identification of various complications over time, it is clear that symptoms such as 'dizziness on standing' and 'palpitations' can be attributed to autonomic dysfunction and postural orthostatic tachycardia syndrome (POTS), 24,25 while 'forgetfulness or inability to concentrate' have come to be recognised as post-COVID 'brain fog'. Finally, it is recognised that the total number of participants is small (n = 339), although recruitment commenced towards the beginning of the pandemic (July 2020) when case numbers in Australia were comparatively low and there was much social stigma associated with being a COVID case.…”

Section: Discussionmentioning

confidence: 99%

The lingering symptoms of post‐COVID‐19 condition (long‐COVID): a prospective cohort study

Tan,

Pryor,

Melville

et al. 2023

Internal Medicine Journal

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BackgroundLonger‐term symptoms (long COVID) may be present in seemingly recovered patients for several months and can be debilitating.AimTo investigate the prevalence and type of symptoms in those with a prior COVID‐19 diagnosis.MethodsThis prospective, longitudinal observational study commenced in July 2020 investigating the longer‐term health impacts of COVID‐19. Participants were recruited via public health units and media publicity. Surveys were completed upon enrolment, and at 1, 3, 6 and 12 months. Outcome measures included incidence of activity limitations and symptoms against health and vaccination status, age and gender.ResultsOverall, 339 participants were recruited. At 3 months after COVID‐19, 66.8% reported symptoms, and 44.8% were still experiencing symptoms at 12 months. Fatigue was most common at every point (between 53.1% and 33.1%). Pain symptoms increased in relative prevalence over time, whereas respiratory/pulmonary‐type symptoms decreased substantially after 3 months. Females and younger people were more likely to experience symptoms in the early stages of long COVID (P < 0.01) and those with more comorbidities in the latter stages (P < 0.001). Vaccination showed a statistically significant protective effect against symptoms (P < 0.01–0.001).ConclusionLong‐term COVID‐19 symptoms exist among recovered patients up to 12 months after contracting the virus. Fatigue is a primary contributor, while chronic pain became more problematic after 6 months. Vaccination was a factor in preventing long‐term symptoms and aiding faster recovery from symptoms. Further work exploring additional contributors to symptom prevalence would assist in developing appropriate follow‐up care.

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Section: Discussionmentioning

confidence: 99%

The lingering symptoms of post‐COVID‐19 condition (long‐COVID): a prospective cohort study

Tan,

Pryor,

Melville

et al. 2023

Internal Medicine Journal

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“…Autoantibodies may be inflammatory and result in neuro-inflammation; however, they may also result in molecular mimicry or even negate chemokine responses [112, 113]. Several of these antibodies can be related to brainstem injury and may contribute to POTS in long COVID [89, 114‒117]. Autoantibodies recognizing G protein-coupled receptors are one mechanism thought to be important for POTS and antibodies specific to the beta adreno-receptor have been reported in patients with long COVID [118].…”

Section: Neuroimmunology Of Long Covidmentioning

confidence: 99%

Immune Mechanisms Underpinning Long COVID: Collegium Internationale Allergologicum Update 2024

Untersmayr,

Venter,

Smith

et al. 2024

Int Arch Allergy Immunol

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can result in a prolonged multisystem disorder termed long COVID, which may affect up to 10% of people following coronavirus disease 2019 (COVID-19). It is currently unclear why certain individuals do not fully recover following SARS-CoV-2 infection. Summary: In this review, we examine immunological mechanisms that may underpin the pathophysiology of long COVID. These mechanisms include an inappropriate immune response to acute SARS-CoV-2 infection, immune cell exhaustion, immune cell metabolic reprogramming, a persistent SARS-CoV-2 reservoir, reactivation of other viruses, inflammatory responses impacting the central nervous system, autoimmunity, microbiome dysbiosis, and dietary factors. Key Messages: Unfortunately, the currently available diagnostic and treatment options for long COVID are inadequate, and more clinical trials are needed that match experimental interventions to underlying immunological mechanisms.

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“…Among those complaining of dyspnea, POTS (50), asthma or chronic obstructive pulmonary disease (COPD) (7), and organizing pneumonia (3) were present as complications. Among patients complaining of cough, postinfectious cough or cough-variant asthma (12), gastroesophageal re ux disease (10), and bronchial asthma (4) were present as complications. Among patients who complained of headaches, migraine (31) and tension-type headaches (18) were present as complications.…”

Section: Relationship Between Initial Symptoms and Complicationsmentioning

confidence: 99%

“…Several complications that exist in the background of long COVID have been reported. Seeley et al showed that 79% of patients with long COVID meet the diagnostic criteria of postural orthostatic tachycardia syndrome (POTS) [10]. Headache, which often exhibits phenotypes such as migraines and tension-type headaches, has also been reported to be common, and psychiatric disorders have been reported to newly occur in 16% of those with long COVID [11,12].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of diseases complicating long COVID: A retrospective chart review

Tsuchida,

Hirose,

Fujii

et al. 2024

Preprint

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Purpose Evidence for the pathogenesis and treatment of post-acute coronavirus disease 2019 (COVID-19) (long COVID) is lacking. As long COVID symptoms are predicted to have an impact on the global economy, clarification of the pathogenesis is urgently needed. Our experiences indicated that some symptoms were complicated by diseases established before the COVID-19 pandemic. Methods Using a retrospective, cross-sectional study, we aimed to evaluate the diseases complicating long COVID. Using the medical records of patients with confirmed severe acute respiratory syndrome coronavirus 2 infection exhibiting residual symptoms lasting ≥ 60 days post-infection who visited our clinic in January 2021–February 2023, we investigated the symptoms and diseases observed. We identified diseases that occurred after COVID-19 infection and excluded those that were exacerbations of existing diseases. Results: During the first visit, the most common symptoms reported in a total of 798 patients were fatigue (523 patients), anxiety (349 patients), and lack of motivation (344 patients). Complicating diseases were observed in 452 patients (57%). There were 115, 65, and 60 patients with postural tachycardia syndrome, postural syndrome without tachycardia, and mood disorders, respectively. Some diseases requiring immediate treatment included pulmonary thromboembolism, purulent shoulder arthritis, cerebellopontine angle tumors, myasthenia gravis, and cervical myelopathy. Conclusion All symptoms that occur after COVID-19 infection should not be treated as long COVID. Similar to normal medical treatment, a list of differential diagnoses should be maintained based on symptoms to obtain definitive diagnoses.

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Plasma Exchange Improves Cognitive Function in Long-COVID-Related Postural Orthostatic Tachycardia Syndrome and Autoimmune Neurological Dysfunction

Cited by 4 publications

References 4 publications

The lingering symptoms of post‐COVID‐19 condition (long‐COVID): a prospective cohort study

The lingering symptoms of post‐COVID‐19 condition (long‐COVID): a prospective cohort study

Immune Mechanisms Underpinning Long COVID: Collegium Internationale Allergologicum Update 2024

Evaluation of diseases complicating long COVID: A retrospective chart review

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