Post-COVID-19 syndrome: Insights into a novel post-infectious systemic disorder

Stoian, Marilena; Procopiescu, Bianca; Șeitan, Silviu; Scarlat, Gabriel

doi:10.25122/jml-2022-0329

Cited by 9 publications

(8 citation statements)

References 58 publications

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“…Dramatic elevations of serum ferritin (often elevated above 1,000 ng/dL) (73) have been described in several hyperinflammatory conditions, such as autoimmune (for example, cAPS) and autoinflammatory diseases (particularly sJIA and AOSD), severe COVID-19 and/or multisystem inflammatory syndrome of COVID-19 (MIS) -which could be considered long-COVID or the post-COVID-19 syndrome (PCS) (74,75) -, HLH, sepsis and septic shock, as well as cancer, which includes malignant hemopathies, but also solid malignant tumors (Table 3) (76) .…”

Section: Hyperferritinemia Without Iron Overloadmentioning

confidence: 99%

The Spectrum of Hyperferritinemic Syndromes

Stoian¹,

Scarlat²

2023

Preprint

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The concept of “hyperferritinemic syndrome” defines a complex pathophysiological and clinical entity, characterized by a systemic hyperinflammatory state, generally associated with elevated levels of proinflammatory cytokines (hypercytokinemia) and high serum levels of ferritin (hyperferritinemia), traditionally recognized as an iron-binding plasma protein involved in the storage of iron in a biologically available form for different physiological cellular processes. Recent studies have shown that ferritin has other important functions as well, operating both as a proinflammatory mediator and as a immunosupressive agent, its elevated levels in the serum being detected in various conditions associated with inflammatory states, such as infectious diseases, autoimmune and autoinflammatory disorders and, in some cases, in malignancies. Catastrophic antiphospholipid syndrome (cAPS), systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD) and acquired forms of hemophagocytic lymphohistiocytosis (HLH), which includes macrophage activation syndrome (MAS), have been associated with hyperinflammatory states and dramatic elevations of serum ferritin, generating hyperferritinemic syndromes. Severe forms of coronavirus disease-2019 (COVID-19), in which MAS may frequently develop, has also been linked to the development of a hyperferritinemic syndrome. This review offers several insights into the physiological and pathophysiological roles of ferritin in several (hyper-)inflammatory diseases, but also into the causal entities, the underlying pathophysiological mechanisms, clinical manifestations and diagnostic features of somewhat obscure, yet potentially fatal pathological conditions, reunited under the concept of hyperferritinemic syndromes.

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Section: Hyperferritinemia Without Iron Overloadmentioning

confidence: 99%

The Spectrum of Hyperferritinemic Syndromes

Stoian¹,

Scarlat²

2023

Preprint

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“…These symptoms primarily indicate an inflammatory disorder that emerges in some patients following the resolution of SARS-CoV-2 infection, in the absence of other infections or associated conditions. Consequently, long COVID can be regarded as a complex chronic immunoinflammatory disorder, driven by a hyperinflammatory state [ 8 ]. Although there is currently no universally accepted definition for this syndrome, its clinical and physiological presentation serves as its primary characterization.…”

Section: Introductionmentioning

confidence: 99%

“…Although there is currently no universally accepted definition for this syndrome, its clinical and physiological presentation serves as its primary characterization. Further refinement and clarification are necessary to establish a comprehensive understanding of Long COVID [ 8 ]. Importantly, the pandemic has highlighted both the severe health impacts of the virus and existing health disparities among different racial and ethnic groups [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

From Acute Infection to Prolonged Health Consequences: Understanding Health Disparities and Economic Implications in Long COVID Worldwide

Sweis,

Alnaimat,

Esparza

et al. 2024

IJERPH

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The COVID-19 pandemic has resulted in a growing number of patients experiencing persistent symptoms and physiological changes after recovering from acute SARS-CoV-2 infection, known as Long COVID. Long COVID is characterized by recurring symptoms and inflammation across multiple organ systems. Diagnosis can be challenging, influenced by factors like demographics, comorbidities, and immune responses. Long COVID impacts various organ systems and can have neuropsychological effects. Health disparities, particularly related to race, contribute to a higher burden of infection and ongoing symptoms in minority populations. Managing Long COVID entails addressing a spectrum of symptoms that encompass physical, cognitive, and psychological aspects. The recovery period for patients with Long COVID can vary significantly, influenced by factors like the severity of the disease, hospitalization, comorbidities, and age. Currently, there are no universally effective treatments, although certain interventions show promise, necessitating further research. Self-management and rehabilitation programs can provide relief, but more research is needed to establish their effectiveness. Preventive measures such as vaccination and the use of antiviral medications and metformin. It is imperative to conduct further research to develop evidence-based guidelines and gain a better understanding of the long-term implications of COVID-19. Long COVID could have substantial economic impact on the labor market, productivity, healthcare expenditures, and overall economic growth. To address the challenges patients with long-term complications face, there is a focus on strategies like promoting telework and flexible work arrangements to accommodate diverse symptoms, particularly chronic fatigue and other Long COVID effects. In conclusion, this review emphasizes the multifaceted complexity of Long COVID and the ongoing need to address its potential long-term health and economic impacts.

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“…Encapsulated under the umbrella term "post-acute sequelae of SARS-CoV-2", the presence of new or ongoing symptoms more than 12 weeks after the acute infection is most commonly known as long COVID. [1][2][3] The spectrum of disease is extensive and variable.…”

Section: Introductionmentioning

confidence: 99%

Complement dysregulation is a predictive and therapeutically amenable feature of long COVID

Baillie,

Davies,

Keat

et al. 2023

Preprint

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Background: Long COVID encompasses a heterogeneous set of ongoing symptoms that affect many individuals after recovery from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The underlying biological mechanisms nonetheless remain obscure, precluding accurate diagnosis and effective intervention. Complement dysregulation is a hallmark of acute COVID-19 but has not been investigated as a potential determinant of long COVID. Methods: We quantified a series of complement proteins, including markers of activation and regulation, in plasma samples from healthy convalescent individuals with a confirmed history of infection with SARS-CoV-2 and age/ethnicity/gender/infection/vaccine-matched patients with long COVID. Findings: Markers of classical (C1s-C1INH complex), alternative (Ba, iC3b), and terminal pathway (C5a, TCC) activation were significantly elevated in patients with long COVID. These markers in combination had a receiver operating characteristic predictive power of 0.794. Other complement proteins and regulators were also quantitatively different between healthy convalescent individuals and patients with long COVID. Generalized linear modeling further revealed that a clinically tractable combination of just four of these markers, namely the activation fragments iC3b, TCC, Ba, and C5a, had a predictive power of 0.785. Conclusions: These findings suggest that complement biomarkers could facilitate the diagnosis of long COVID and further suggest that currently available inhibitors of complement activation could be used to treat long COVID. Funding: This work was funded by the National Institute for Health Research (COV-LT2-0041), the PolyBio Research Foundation, and the UK Dementia Research Institute.

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Post-COVID-19 syndrome: Insights into a novel post-infectious systemic disorder

Cited by 9 publications

References 58 publications

The Spectrum of Hyperferritinemic Syndromes

The Spectrum of Hyperferritinemic Syndromes

From Acute Infection to Prolonged Health Consequences: Understanding Health Disparities and Economic Implications in Long COVID Worldwide

Complement dysregulation is a predictive and therapeutically amenable feature of long COVID

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