long Covid-19; post-acute sequelae of COVID-19 (PASC); post-Covid syndrome
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Introduction
Persistent symptoms &/or delayed or long-term complications of SARS-CoV2 infection beyond 4 weeks from the onset of symptoms.
Classification
- late complications of Covid-19 after hospital discharge[23]
- subacute or ongoing symptomatic COVID-19
- symptoms & abnormalities present from 4-12 weeks beyond acute COVID-19
- chronic or post COVID-19 syndrome
- long Covid-19 has 3 forms
- largest group has a cluster of symptoms in the nervous system
- fatigue, brain fog, headaches
- most common subtype among Alpha variant & Delta variant, which was dominant in 2021.
- 2nd form has respiratory symptoms
- chest pain, dyspnea, suggesting lung injury
- most common type for original Wuhan coronavirus strain
- 3rd forms diverse range of physical symptoms,
- heart palpitations, myalgias, pain, skin & hair disorders
- some with severe & debilitating multi-organ symptoms[88]
- largest group has a cluster of symptoms in the nervous system
Etiology
- idiopathic[86]
- comprehensive evaluation of cases did not find cause[86]
- may overlap with post-intensive care syndrome, or multisystem inflammatory disorder
- testing positive for SARS-CoV2 is a risk factor for long Covid-19[50]
- disruption of intestinal flora is linked with susceptibility to long COVID-19[58]
- higher BMI & female sex are risk factors for long Covid-19[109]
- theories
- a virus cryptic reservoir that could reactivate at any time
- viral remnants that trigger chronic inflammation
- autoimmune antibodies that cause ongoing symptoms
- reduced circulating serotonin levels[134]
- risk factors[118]
- female sex, older age, higher body mass index, smoking
- preexisting comorbidities
- previous hospitalization or ICU admission
- SARS-CoV2 vaccination with 2 doses lowers risk[118]
Epidemiology
- 20% of Covid-19 survivors age 18-64 & 25% of Covid-19 survivors > 65 experience at least one symptom of long Covid-19[81][85][97]
- younger patients more likely to have long Covid-19 than older patients[85]
- women more likely to have long Covid-19 than men[85][99][100]
- 50-90% of hospitalized discharged COVID-19 patients report persistent symptoms 1-2 months later
- 37% of patients report at least one symptom 3-6 months after infection with SARS-CoV2[51]
- 30% of patients report persistent symptoms 9 months later[10]
- nearly 1/2 of persons hospitalized with Covid-19 report at least 1 lingering symptom 1 year later[47]
- appears to affect even those who experienced more mild disease[5]
- 15% of patients with mild COVID-19 symptoms still had symptoms 8 months later[27]
- 13% of patients with Covid-19 note somatic complaints 90-150 days later[90]
- 5% of Covid-19 survivors continue to experience symptoms 18 months later[107]
- older people, people with asthma, & people evaluated for hospitalization are more likely to report long-term symptoms[19]
- women in their 40s & 50s at higher risk of long Covid-19 after hospitalization with COVID-19[22]
- children may experience long Covid-19[11]
- estimated prevalence of long Covid-19 in children at 6 months after initial infection range from 0% to 27%[43]
- Omicron ~1/2 as likely to cause long Covid-19 as Delta (~5%)[84]
- ~ 19 million Americans suffer from long Covid-19 (Dec 2022)[112]
- long Covid-19 may persist as a mass diabling event[126][127]
Pathology
- replication-competent SARS-CoV2 has not been isolated after 3 weeks[17]
- possible contributions from
- cellular damage
- a robust innate immune response
- inflammatory cytokine production
- Covid-19 related anosmia likely due to peripheral inflammation[41]
- a pro-coagulant state
- mechanisms associated with 'brain fog'
- activation of TGF-beta signaling & oxidative overload[61]
- microtubule-associated protein tau hyperphosphorylation[61]
- RyR2 in COVID-19 brains expressed a 'leaky' phenotype resulting in cognitive & behavioral deficits[61]
- kynurenine pathway activation is associated with mild cognitive impairment[83]
- cognitive impairment associated with kynurenine pathway metabolites:
- diminished circulating serotonin levels[134]
- inflammation of vagus nerve
- dyspnea, fatigue, & decreased exercise tolerance due to impaired extraction of oxygen in skeletal muscle vs pulmonary or cardiac dysfunction[71]
- diaphragm weakness identified in patients with dyspnea post hospitalization, especially after mechanical ventilation, despite normal pulmonary & cardiac function[120]
- post Covid-19 fatigue associated with
- reduced intracortical facilitation within the primary motor cortex
- autonomic dysfunction
- skeletal muscle myopathy[72]
- SARS-CoV2 associated with axon pathology & microvasculopathy in the olfactory bulb & olfactory tract[76]
- not a result from direct viral injury
- may be associated with local inflammation
- complement activation may last for 6 months[135]
- reactivation of cytomegalovirus & Epstein-Barr virus play a role
- complement activation may induce inflammation, thrombosis & endothelial dysfunction[135]
- inflammation & endothelial dysfunction may play a role in long Covid-19[78]
- neurologic symptoms of long COVID may result from antigenic imprinting, a misdirected immune response to SARS-CoV2[121]
- long Covid-19 & chronic fatigue syndrome share pathophysiology[123]
Clinical manifestations
- presentation with symptoms 4-12 weeks after the start of acute symptoms
- COVID-19 symptoms not resolved after 12 weeks
- symptoms & excess risk for new disease persist for 2 years after acute COVID-19[129]
- common symptoms are fatigue, cough, & headache[1][100]
- fatigue, dyspnea, arthralgia, & chest pain most common[4]
- among patients with mild COVID-19, most common prolonged symptoms were anosmia, fatigue, ageusia, & dyspnea[17][27]
- 75% have >= 1 persistent symptom 6 months after hospitalization[3]
- fibromyalgia[48]
- fatigue or muscle weakness (63%)
- myalgias (55%)[21], arthralgias[62]
- sleep disorder, insomnia (26-29%)[31]
- anxiety or depression (23%)[3][47]; 52% at 4 months[20][40]
- persons with headache during acute infection at elevated risk of post-acute COVID-19 depression[20][40]
- symptoms of chest pain, cough, muscle aches & hair loss tend to resolve within 1 year[113]
- cognitive impairment especially impairment of memory, reasoning & planning[138]
- "brain fog"[52][59] &/or executive dysfunction[7]
- cognitive impairment correlates with persistent anosmia in older adults[44]
- anosmia more predictive of cognitive impairment than Covid-19 disease severity[98]
- poor memory & attention persists months after mild COVID-19 recovery[57]
- 70% report memory problems: 78% difficulty concentrating, 69% "brain fog", 68% forgetfulness, 60% word finding difficulty[73]
- cognitive deficits not mediated by depression or anxiety[130]
- cognitive slowing determined by visual reaction time & number vigilance[136]
- neurocognitive impairment, confusion[100]
- 60% of hospitalized patients & 67% of non-hospitalized patients report symptoms after 2 years, fatigue, pain, & memory loss most common[104]
- 1 year after ICU treatment for COVID-19
- fluctuating symptoms ("good & bad days")
- no clear pattern of either migraines or tension headaches
- paresthesias, tingling or numbness
- dysautonomia, including light-headedness, palpitations
- diarrhea & other GI disturbances[30]
- dysuria[79]
- dizziness, generalized pain, blurred vision, tinnitus[21]
- > 50% of Covid-19 survivors with long Covid-19 symtoms after 6 months[53]
- chest imaging abnormality
- general functional impairments
- fatigue or muscle weakness
- decline in quality of life[17][47]
- more than 50 long-term effects of COVID-19[45]
* a PASC score includes postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, & abnormal movements[122]
Laboratory
- lipid panel: hyperlipidemia common[42]
- higher median CSF C-reactive protein & serum amyloid A in long COVID patients with cognitive symptoms[75]
- elevated plasma fibrinogen relative to plasma C-reactive protein is associated with both objective & subjective cognitive deficits[130]
- elevated plasma D-dimer relative to plasma C-reactive protein is associated with subjective cognitive deficits & occupational impact
- differences in circulating myeloid & lymphocyte populations vs controls
- exaggerated humoral responses directed against SARS-CoV2 vs controls[132]
- higher antibody responses directed against non-SARS-CoV2 viral pathogens, particularly Epstein-Barr virus vs controls[132]
- serum cortisol lower in patients with long Covid-19 vs controls[132]
Diagnostic procedures
- pulmonary function tests*
- 6 minute walk test*[5]
- pulse oximetry at rest & during ambulation[56]
- echocardiogram as indicated
- cardiopulmonary exercise stress testing[95]
- factors associated with exertional intolerance
- deconditioning (common)
- dysfunctional breathing
- chronotropic incompetence
- abnormal peripheral oxygen extraction (common)[95]
- factors associated with exertional intolerance
* impairment at 6 months in patients without hypoxia during acute COVID-19
* 22% with limited mobility based on short physical performance battery evaluating
- balance, walking speed & standing up from a chair[14]
Radiology
- chest X-ray (as indicated)
- thromboembolic workup (as indicated)
- high-resolution CT of chest for interstitial lung disease (as indicated)
- CT imaging findings may persist at 3 months & 1 year after Covid-19[82][119]
- ground-glass opacities & curvilinear bands (reticulations) most common
- no correlation of long Covid-19 symptoms & persistent imaging findings[82]
- CT imaging findings uncommon 1 year after hospitalization for Covid-19[102]
- 6 months, 40% of patients with normal CT scans; 93% with normal scans at 1 year
- ground-glass opacities 100% at baseline; at 1 year, only 2%
- pulmonary fibrosis found in 2% of long Covid-19 patients at 1 year[102]
- CT imaging findings may persist at 3 months & 1 year after Covid-19[82][119]
- brain MRI before & after Covid-19 shows loss of grey matter in primary or secondary cortical gustatory & olfactory areas, in the left hemisphere[38]
- brain MRI shows changes in frontal lobe & brainstem[108]
- frontal lobe changes primarily in white matter regions
- also changes in the orbital-inferior frontal gyrus
- cluster of changes in the right ventral diencephalon region of the brain stem[108]
- frontal lobe changes primarily in white matter regions
- resting-state fluctuation amplitudes from functional MRI identifies chronic cerebrovascular disease after hospitalization for Covid-19.
Complications
- hypoxia, persistent oxygen requirement[17]
- respiratory failure[39][68]
- air trapping suggesting obstruction of small airways[34]
- pulmonary fibrosis[5][17]
- interstitial lung disease
- pulmonary hypertension[36]
- pulmonary embolism (RR=2)[81]
- sleep apnea
- increased risk of cardiovascular disease
- risk elevated at least 1 year after even mild cases of Covid-19[63]
- risk elevated even for those < 65 years & lacked risk factors[63]
- heart failure[63] including stress cardiomyopathy[39]
- hypertension[39][42][68] & stroke[63]
- myocarditis or pericarditis[8]
- cardiac arrhythmia[39]
- postinfectious, immune-mediated myopathy[35]
- inflammation of skeletal muscles associated with duration of illness
- more pronounced than cardiac inflammation[35]
- inflammation of skeletal muscles associated with duration of illness
- microvascular angina, chest pain
- palpitations, cardiac arrhythmias: atrial fibrillation, atrial flutter
- dysautonomia including POTS[15][33][87][111]
- mast cell activation syndrome
- thromboembolic disease:
- pulmonary embolism, cerebral venous thrombosis[68]
- risk for venous thromboembolism persists for months after Covid-19[77]
- risk greater for hospitalized patients[77]
- risk of thromboembolic disease declines more rapidly for arterial thromboses than venous thromboses, but remains elevated up to 49 weeks after COVID-19 diagnosis[91]
- myelopathy, neuropathy, cognitive disorders
- inflammatiom of vagus nerve resulting in dysphagia & dyspnea[66]
- renal impairment (chronic kidney disease)[17][49]
- new onset diabetes mellitus
- subacute thyroiditis[28]
- GI motility disorders, dyspepsia, GERD, peptic ulcer disease, functional intestinal disorders, acute pancreatitis, hepatitis, biliary disease. abnormal liver function tests[116]
- steatosis[117]
- new onset allergies, anaphylaxis
- dysphonia[8]
- alopecia[17]
- 1/3 of survivors diagnosed with neuropsychiatric disorder within 6 months[24]
- long-term neuropsychiatric complications common after hospitalization[25]
- 39% of hospitalized patients, 50% after ICU admission[26]
- cognitive deficits, hyposmia, & postural tremor most common[25]
- intracranial hemorrhage; ischemic stroke; parkinsonism; Guillain-Barre syndrome; nerve, nerve root & plexus disorders; myoneural junction & muscle disease; encephalitis; dementia; psychosis, mood disorders, & anxiety disorders; insomnia[26][92]
- epilepsy, seizures[105], migraine[92]
- small-fiber neuropathy after mild SARS-CoV2 common, beginning within 1 month of COVID-19 onset[69]
- brain-related abnormalities seen on imaging[70]
- reduction in grey matter thickness & tissue-contrast in the orbitofrontal cortex & parahippocampal gyrus
- changes in markers of tissue damage in regions functionally-connected to the primary olfactory cortex
- reduction in global brain size[70]
- severity of acute COVID-19 is associated with chronic cerebrovascular disease, cognitive impairment & mental health disorder[65][70]
- cerebrovascular pathology observed in the lateral lobes, frontal lobe, temporal lobe & parietal lobe[65]
- over-stimulation of the immune system, possibly triggered by ongoing vascular injury & repair may result in persistent post-COVID cognitive changes[74]
- increased risk of anxiety disorders, depressive disorders, stress disorders & adjustment disorders, opioid abuse & nonopioid substance abuse disorders, neurocognitive decline, sleep disorders[68]
- mortality* 7%, readmission* 15% within 60 days of acute COVID-19[17]
- mortality* 12%, readmission* 29% within a mean of 140 days of acute COVID-19[23]
- rates that were 3.5 & 7.7 times higher than in matched controls
- 30 day mortality in hospitalized patients 46 times that of non-hospitalized[42]
- new-onset diagnoses of respiratory diseases were 27 times more common after hospitalization than in controls[23]
- major adverse cardiovascular events, chronic liver disease, chronic kidney disease, & diabetes mellitus were also more common[23]
- higher mortality & health resource utilization[29]
- sequalae of respiratory disorders, nervous system & neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain, & anemia[29]
- increased use of pharmaceuticals: analgesics, antidepressants, anxiolytics, antihypertensives, & oral hypoglycemics
- in children & adolescents acute pulmonary embolism (RR=2.0), myocarditis & cardiomyopathy (RR=2.0), venous thromboembolic event (RR=1.9),renal failure (RR=1.3), & type 1 diabetes (RR=1.2)[93]
- older age (> 60 years, female sex, history of cancer, history of tobacco use, high BMI, higher number of symptoms during acute phase associated with slower resolution of symptoms[103]
Management
- a healthy lifestyle prior to Covid-19 infection is associated with a diminished risk of long Covid-19[115]
- COVID-19 vaccination safe[32]
- improvement in symptoms in 23% 1 month after Pfizer or AstraZeneca vaccine[32]
- improvement in symptoms in 36%, some with complete resolution of symptoms[16]
- of benefit even after Covid-19 infection[67][110]
- vaccination prior to Covid-19 provides partial protection against long Covid-19 [80][94][99][100][110][118]
- Covid-19 vaccines prevent new onset long Covid-10 & flare-ups for people with long Covid-19[125]
- Covid-19 vaccination was associated with 30-50% lower risk for long COVID-19 in all age groups[139]
- treatment with Paxlovid during the acute phase of Covid-19 within 5 days of a positive SARS-CoV-2 test is associated with reduced risk of long Covid-19 regardless of vaccination status or history of prior infection[106][114][118]
- see NICE guidelines[2]
- monitoring of pulmonary symptoms with pulse oximetry at rest & during ambulation
- pulmonary rehabilitation as indicated[56]
- fatigue[46]; healthy diet; exercise (rule of tens)
- brain fog & fagigue may respond to low-dose (5 mg QD) naltrexone*[96]
- Hematology:
- consider extended thromboprophylaxis[17]
- Neuropsychiatry
- screening for PTSD, anxiety, sleep disorder
- screening for depression
- screening for cognitive impairment[17]
- cognitive rehabilitation as indicated
- sleep interventions to improve cognitive symptoms[56]
- assess potential impact of medications on cognitive function[56]
- noninvasive brain stimulation using alternating microcurrents appears to rapidly & effectively improve cognitive & visual deficits related to long Covid-19[64]
- hyperbaric oxygen may improve neurocognitive function[89]
- Nephrology:
- follow-up with nephrology after discharge with Covid-19 & acute renal failure [17
- primary care
- early rehabilitation
- patient education
- enrollment in research studies
- engagement with patient advocacy groups[17]
- set achievable goals through shared decision-making[37]
- approach treatment by focusing on specific symptoms[37]
- high-intensity interval training increases left ventricular mass
- not beneficial
- Coenzyme Q10 500 mg QD is not beneficial[101]
* naltrexone is available in 50 mg pills
- low-dose naltrexone must be purchased through a compounding pharmacy[96]
Notes
- on the other hand, a French nun survives Covid-19 to celebrate her 117th birthday with red wine[6]
- new name post-acute sequelae of COVID-19 (PASC) from Anthony Fauci[13]
- ICD10 codes associated with long Covid-19[18]
More general terms
Additional terms
References
- ↑ 1.0 1.1 Russell P NICE Issues Rapid Guideline on Long COVID, Medscape - Dec 18, 2020. https://www.medscape.com/viewarticle/942893
- ↑ 2.0 2.1 NICE guideline [NG188]. December 18, 2020 COVID-19 rapid guideline: managing the long-term effects of COVID-19. https://www.nice.org.uk/guidance/NG188
- ↑ 3.0 3.1 3.2 Walker M Most Hospitalized COVID Patients Not Fully Recovered 6 Months Post- Discharge - Fatigue, weakness are most common, Chinese study finds. MedPage Today January 8, 2021 https://www.medpagetoday.com/infectiousdisease/covid19/90618
Huang C, Huang L, Wang Y et al 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021. Jan 8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33428867 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext
paper under investigation for data errors Buzzy Lancet long COVID paper under investigation for 'data errors' https://retractionwatch.com/2022/12/01/buzzy-lancet-long-covid-paper-under-investigation-for-data-errors/ - ↑ 4.0 4.1 Carfi et al Persistent Symptoms in Patients After Acute COVID-19. JAMA. Published online July 9, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32644129 https://jamanetwork.com/journals/jama/fullarticle/2768351
Chopra V, Flanders SA. O'Malley M et al. Sixty-day outcomes among patients hospitalized with COVID-19. Ann Intern Med 2020 Nov 11 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33175566 PMCID: PMC7707210 Free PMC article https://www.acpjournals.org/doi/10.7326/M20-5661 - ↑ 5.0 5.1 5.2 5.3 5.4 Walker M Clinicians Struggle to Make Sense of 'Long COVID' - No correlation with clinical severity of illness, and some symptoms may be entirely new. MedPage Today January 29, 2021 https://www.medpagetoday.com/infectiousdisease/covid19/90959
- ↑ 6.0 6.1 Peiser J, Hassan J Nun who survived flu pandemic, both world wars and coronavirus celebrates 117th birthday with red wine. Washington Post. Feb 11, 2021 https://www.washingtonpost.com/nation/2021/02/10/nun-117-survive-covid-france/
- ↑ 7.0 7.1 George J Surprise Find in COVID-19 Brain Capillaries - Could this contribute to COVID brain fog? MedPage Today February 17, 2021 https://www.medpagetoday.com/neurology/generalneurology/91246
Nauen DW, Hooper JE, Stewart M, Solomon IH. Assessing Brain Capillaries in Coronavirus Disease 2019. JAMA Neurol. Published online February 12, 2021. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33576767 https://jamanetwork.com/journals/jamaneurology/fullarticle/2776455 - ↑ 8.0 8.1 8.2 Gorna R, MacDermott N, Rayner C et al Long COVID guidelines need to reflect lived experience. Lancet. 2021 Feb 6;397(10273):455-457. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33357467 Free PMC article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755576/
- ↑ 9.0 9.1 Janiri D, Carfi A, Kotzalidis GD et al Posttraumatic Stress Disorder in Patients After Severe COVID-19 Infection. JAMA Psychiatry. 2021, Feb 18, PMID: https://www.ncbi.nlm.nih.gov/pubmed/33599709 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2776722
- ↑ 10.0 10.1 George J Study Puts Numbers to 'Long COVID' Duration, Prevalence - High frequency of debility lasting for months. MedPage Today February 19, 2021 https://www.medpagetoday.com/infectiousdisease/covid19/91270
Logue JK, Franko NM, McCulloch DJ et al Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Netw Open. 2021;4(2):e210830. Feb 19 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33606031 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776560 - ↑ 11.0 11.1 Coffey D Long-COVID in Children: It's a Thing. Medscape - Feb 19, 2021. https://www.medscape.com/viewarticle/946161
- ↑ 12.0 12.1 George J How Long Do COVID Olfactory Problems Last? Sense of smell can be altered for 5 months or longer, Canadian study suggests. MedPage Today February 22, 2021 https://www.medpagetoday.com/meetingcoverage/aan/91311
Bussiere N, et al Persistent Chemosensory Dysfunction Associated with COVID-19 Infection in a Cohort of over 800 Healthcare Workers. American Academy of Neurology (AAN) 2021 - ↑ 13.0 13.1 Lovelace B Jr Dr. Fauci says new data suggests 'long' Covid symptoms can last up to 9 months. CNBC. Feb 24, 2021 https://www.cnbc.com/2021/02/24/fauci-says-new-data-suggest-long-covid-symptoms-can-last-up-to-9-months.html
- ↑ 14.0 14.1 14.2 Henry TA New clues on COVID-19 long-haulers from Italy, an early hot spot. AMA Public Health. Feb 19, 2021 https://www.ama-assn.org/delivering-care/public-health/new-clues-covid-19-long-haulers-italy-early-hot-spot
- ↑ 15.0 15.1 Lou N Postural Tachycardia an Emerging Concern During COVID-19 Recovery. Case series suggests low effectiveness of available treatments. MedPage Today March 10, 2021 https://www.medpagetoday.com/infectiousdisease/covid19/91566
Johansson M et al Long-haul post-COVID-19 symptoms presenting as a variant of postural orthostatic tachycardia syndrome: The Swedish experience. JACC Case Rep 2021. March 10 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33723532 PMCID: PMC7946344 Free PMC article https://www.jacc.org/doi/10.1016/j.jaccas.2021.01.009 - ↑ 16.0 16.1 Goodman B Some With Long COVID See Relief After Vaccination. Medscape - Mar 17, 2021. https://www.medscape.com/viewarticle/947592
- ↑ 17.00 17.01 17.02 17.03 17.04 17.05 17.06 17.07 17.08 17.09 17.10 17.11 17.12 Nalbandian A, Sehgal K, Wan EY et al Post-acute COVID-19 syndrome. Nature Medicine 2021. March 22. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33753937 https://www.nature.com/articles/s41591-021-01283-z
- ↑ 18.0 18.1 ICD10Monitor Arriving Soon: Code U09.9, Post-COVID-19 Condition https://www.icd10monitor.com/arriving-soon-code-u09-9-post-covid-19-condition
- ↑ 19.0 19.1 Sudre CH, Murray B, Varsavsky T et al. Attributes and predictors of long COVID. Nat Med 2021 Mar 10; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33692530 https://www.nature.com/articles/s41591-021-01292-y
- ↑ 20.0 20.1 20.2 Perlis RH et al. Association of acute symptoms of COVID-19 and symptoms of depression in adults. JAMA Netw Open 2021 Mar 1; 4:e213223 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33710287 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777421
- ↑ 21.0 21.1 21.2 Doheny K Neurologic Symptoms Frequent in Nonhospitalized COVID Long-Haulers. Medscape - Mar 23, 2021 https://www.medscape.com/viewarticle/947915
- ↑ 22.0 22.1 Kelland K Women in 40s, 50s Who Survive COVID More Likely to Suffer Persistent Problems: UK Studies Medscape - Mar 24, 2021. https://www.medscape.com/viewarticle/947989
PHOSP-COVID Collaborative Group, Evans RA et al Physical, cognitive and mental health impacts of COVID-19 following hospitalisation - a multi-centre prospective cohort study. medRxiv. arch 24, 2021 https://www.medscape.com/viewarticle/947989 - ↑ 23.0 23.1 23.2 23.3 23.4 Ayoubkhani D, Khunti K, Nafilyan V et al Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ 2021;372:n693 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33789877 https://www.bmj.com/content/372/bmj.n693
- ↑ 24.0 24.1 American Medical Association (AMA) AMA Morning Rounds. April 7, 2021
- ↑ 25.0 25.1 25.2 Cooney E 1 in 3 Covid-19 patients are diagnosed with a neuropsychiatric condition in the next six months, large study finds. STAT Health. April 6, 2021 https://www.statnews.com/2021/04/06/1-in-3-covid19-patients-get-neuropsychiatric-diagnosis-within-six-months/ Long-Term Neurologic Symptoms Emerge in COVID-19 - Hospitalized patients show deficits including cognitive impairment 6 months later MedPage Today January 7, 2021 https://www.medpagetoday.com/infectiousdisease/covid19/90587
Pilotto A, Cristillo V, Piccinelli SC et al COVID-19 severity impacts on long-term neurological manifestation after hospitalisation. medRxiv. 2021. Jan 2 https://www.medrxiv.org/content/10.1101/2020.12.27.20248903v1 - ↑ 26.0 26.1 26.2 Edmonds S 'Beyond a Reasonable Doubt': COVID-19 Brain Health Fallout Is Real, Severe Medscape - Apr 07, 2021. https://www.medscape.com/viewarticle/948882
Taquet M, Geddes JR, Husain M et al 6-month neurological and psychiatric outcomes in 236,379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet Psychiatry. April 6, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33836148 PMCID: PMC8023694 Free PMC article https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00084-5/fulltext - ↑ 27.0 27.1 27.2 Havervall S, Rosell A, Phillipson M et al Symptoms and Functional Impairment Assessed 8 Months After Mild COVID-19 Among Health Care Workers. JAMA. Published online April 7, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33825846 https://jamanetwork.com/journals/jama/fullarticle/2778528
- ↑ 28.0 28.1 Syrek R. Trending Clinical Topic: Thyroid and COVID-19 Medscape - Apr 02, 2021. https://reference.medscape.com/viewarticle/948197
Tucker ME COVID-19 Can Cause Atypical Thyroid Inflammation. Medscape - Mar 21, 2021 https://www.medscape.com/viewarticle/947824 - ↑ 29.0 29.1 29.2 Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequalae of COVID-19. Nature 2021. April 22. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33887749 https://www.nature.com/articles/s41586-021-03553-9
- ↑ 30.0 30.1 Gever J GI Disruption Lasts for Months in Many COVID Survivors.
Persistently loose stools were most common after-effect. MedPage Today May 24, 2021 https://www.medpagetoday.com/meetingcoverage/ddw/92766 - ↑ 31.0 31.1 31.2 Nasserie T, Hittle M, Goodman SN Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19. A Systematic Review. JAMA Netw Open. 2021;4(5):e2111417. May 26 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34037731 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780376
- ↑ 32.0 32.1 32.2 Reuters Staff Vaccines Appear Safe for 'Long COVID' Survivors. Medscape. May 27, 2021 https://www.medscape.com/viewarticle/951945
- ↑ 33.0 33.1 Loose C Little-Known Illnesses Turning Up in COVID Long-Haulers. Kaiser Health News 2021 via Medscape June 2, 2021 https://www.medscape.com/viewarticle/952288
- ↑ 34.0 34.1 Reuters Staff In Some Long COVID Cases, Air Gets Trapped in Lungs. Medscape. June 7, 2021 https://www.medscape.com/viewarticle/952443
Cho JL, Villacreses R, Nagpal P et al Small Airways Disease is a Post-Acute Sequelae of SARS-CoV-2 Infection. medRxiv 2021 May 30 https://www.medrxiv.org/content/10.1101/2021.05.27.21257944v1 - ↑ 35.0 35.1 35.2 Aschman T, Schneider J, Greuel S et al Association Between SARS-CoV-2 Infection and Immune-Mediated Myopathy in Patients Who Have Died. JAMA Neurol. Published online June 11, 2021. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34115106 https://jamanetwork.com/journals/jamaneurology/fullarticle/2781013
- ↑ 36.0 36.1 Daugherty SE et al. Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: Retrospective cohort study. BMJ 2021 May 19; 373:n1098. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34011492 PMCID: PMC8132065 Free PMC article https://www.bmj.com/content/373/bmj.n1098
Maxwell E. Unpacking post-covid symptoms. BMJ 2021 May 19; 373:n1173 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34011496 https://www.bmj.com/content/373/bmj.n1173 - ↑ 37.0 37.1 37.2 Centers for Disease Control & Prevention (CDC) Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance. CDC Clinical Care. Updated June 14, 2021 https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-index.html
- ↑ 38.0 38.1 Ellis R COVID May Cause Long-Term Brain Loss, Study Says. Medscape - Jun 18, 2021. https://www.medscape.com/viewarticle/953410
Douaud G, Lee S, Alfaro-Almagro F et al Brain imaging before and after COVID-19 in UK Biobank. medRxiv 2021 June 15 https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v1.full.pdf - ↑ 39.0 39.1 39.2 39.3 39.4 Chilazi M, Duffy EY, Thakkar A, Michos ED. COVID and Cardiovascular Disease: What We Know in 2021. Curr Atheroscler Rep. 2021 May 13;23(7):37. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33983522 PMCID: PMC8117457 Free PMC article
- ↑ 40.0 40.1 40.2 40.3 Anderson P New Data on COVID-19's Cognitive Fallout. Medscape - Jun 21, 2021. https://www.medscape.com/viewarticle/953478
- ↑ 41.0 41.1 41.2 Renaud M, Thibault C, Le Normand F et al Clinical Outcomes for Patients With Anosmia 1 Year After COVID-19 Diagnosis. JAMA Netw Open. 2021;4(6):e2115352. June 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34165581 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2781319
- ↑ 42.0 42.1 42.2 42.3 Ellis R 23% of Patients With COVID Report Long-Haul Symptoms. Medscape - Jun 25, 2021. https://www.medscape.com/viewarticle/953744
- ↑ 43.0 43.1 Radtke T, Ulyte A, Puhan MA et al Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents. JAMA. Published online July 15, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34264266 https://jamanetwork.com/journals/jama/fullarticle/2782164
- ↑ 44.0 44.1 George J COVID-19: Persistent Cognitive Effects, Uptick in Alzheimer's Biomarkers. Findings link cognitive impairment and long-lasting anosmia. MedPage Today July 29, 2021 https://www.medpagetoday.com/meetingcoverage/aaic/93814
de Erausquin G, et al Olfactory dysfunction and chronic cognitive impairment following SARS-CoV-2 infection in a sample of older adults from the Andes mountains of Argentina. Alzheimer's Association International Conference (AAIC) 2021; abstract 57897. - ↑ 45.0 45.1 Lopez-Leon S, Wegman-Ostrosky T, Perelman C et al More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021 Aug 9;11(1):16144 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34373540 Free article. https://www.nature.com/articles/s41598-021-95565-8
- ↑ 46.0 46.1 Herrera JE, Niehaus WN, Whiteson J et al Multi-Disciplinary Collaborative Consensus Guidance Statement on the Assessment and Treatment of Fatigue in Post-Acute Sequelae of SARS-CoV-2 infection (PASC) Patients. PM&R Practice Management. August 4, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34346558 https://onlinelibrary.wiley.com/doi/abs/10.1002/pmrj.12684
- ↑ 47.0 47.1 47.2 47.3 Brooks M Long COVID Symptoms Can Persist for More Than 1 Year, Study Shows. Medscape. August 27, 2021 https://www.medscape.com/viewarticle/957447
Huang L, Yao Q, Gu X et al 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021. August 28. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34454673 PMCID: PMC8389999 Free PMC article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01755-4/fulltext - ↑ 48.0 48.1 Walsh N Fibromyalgia: A New Feature of Long COVID? Almost one-third of patients in Italian study had musculoskeletal sequelae. MedPage Today August 31, 2021 https://www.medpagetoday.com/rheumatology/fibromyalgia/94299
Ursini F, Ciaffi J, Mancarella L et al Fibromyalgia: a new facet of the post-COVID-19 syndrome spectrum? Results from a web-based survey. RMD Open. Rheumatic & Musculoskeletal Diseases. 2021. 7e001735. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34426540 PMCID: PMC8384499 Free PMC article. https://rmdopen.bmj.com/content/7/3/e001735 - ↑ 49.0 49.1 Bowe B, Xie Y, Xu E, Al-Aly Z Kidney Outcomes in Long COVID J Am Soc Nephrol 2021. September 1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34470828 https://jasn.asnjournals.org/content/early/2021/08/25/ASN.2021060734
- ↑ 50.0 50.1 Frellick M Even Those Who Just Test Positive at More Risk for Long COVID: CDC. Medscape. September 9, 2021 https://www.medscape.com/viewarticle/958477
- ↑ 51.0 51.1 Reuters Staff At Least One Long-Term Symptom Seen in 37% of COVID-19 Patients: Study. Medscape. September 30, 2021 https://www.medscape.com/viewarticle/959924
- ↑ 52.0 52.1 George J Brain Fog After COVID-19 May Last Longer Than We Think. Relatively young people wrestle with cognitive dysfunction for months. MedPage Today October 22, 2021 https://www.medpagetoday.com/neurology/generalneurology/95198
Becker JH, Lin JJ, Doernberg M et al Assessment of Cognitive Function in Patients After COVID-19 Infection. JAMA Netw Open. 2021;4(10):e2130645. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785388 - ↑ 53.0 53.1 Groff D, Sun A, Ssentongo AE et al Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection. A Systematic Review. JAMA Netw Open. 2021;4(10):e2128568 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34643720 PMCID: PMC8515212 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784918
- ↑ Doheeny K Long COVID: More Clues Coming, but No 'Aha' Moments Yet Medscape. November 11, 2021 https://www.medscape.com/viewarticle/962761
- ↑ 55.0 55.1 Khan AM, Kallogjeri D, Piccirillo JF Growing Public Health Concern of COVID-19 Chronic Olfactory Dysfunction. JAMA Otolaryngol Head Neck Surg. Published online November 18, 2021. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34792577 https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2786433
- ↑ 56.0 56.1 56.2 56.3 56.4 Fiore K Long COVID Guidance Focuses on Breathing Discomfort, Cognitive Symptoms. Physiatry society builds on previous guidance on fatigue. MedPage Today December 14, 2021 https://www.medpagetoday.com/special-reports/exclusives/96181
- ↑ 57.0 57.1 Hicks R Poor Memory and Attention Persists Months After Mild COVID Recovery. Medscape News. Jan 19, 2022 https://www.medscape.co.uk/viewarticle/poor-memory-and-attention-persists-months-after-mild-covid-2022a100054z
- ↑ 58.0 58.1 Collins TR Gut Bacteria Linked With Long COVID. Medscape. Jan 25, 2022 https://www.medscape.com/viewarticle/967195
- ↑ 59.0 59.1 Anderson P COVID Brain Fog a 'True Neurologic Condition'. Medscape. January 24, 2022 https://www.medscape.com/viewarticle/967098
- ↑ McNamara D Promising Leads to Crack Long COVID Discovered. Medscape. February 08, 2022 https://www.medscape.com/viewarticle/968125
- ↑ 61.0 61.1 61.2 61.3 George J COVID Brain Changes Show Parallels With Alzheimer's Disease. Findings may point to potential mechanism for brain fog in people with long COVID. MedPage Today February 4, 2022 https://www.medpagetoday.com/neurology/generalneurology/97034
Reiken S, Sittenfeld L, Dridi H et al Alzheimer's-like signaling in brains of COVID-19 patients. Alzhheimer's & Dementia 2022. Feb 3 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35112786 https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12558 - ↑ 62.0 62.1 62.2 Heesakkers H, van der Hoeven JG, Corsten S et al. Clinical outcomes among patients with 1-year survival following intensive care unit treatment for COVID-19. JAMA 2022 Feb 8; 327:559-565. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35072716 PMCID: PMC8787680 (available on 2022-07-24) https://jamanetwork.com/journals/jama/fullarticle/2788504
- ↑ 63.0 63.1 63.2 63.3 63.4 Nature News. Feb 10, 2022 Heart-disease risk soars after COVID. https://www.nature.com/articles/d41586-022-00403-0
Xie Y, Xu E, Bowe B, Al-Aly Z Long-term cardiovascular outcomes of COVID-19. Nature Medicine. 2022 Mar; 28:583. https://www.nature.com/articles/s41591-022-01689-3.epdf - ↑ 64.0 64.1 Anderson P A New Solution for Long-COVID Brain Fog? Medscape. Feb 10, 2022 https://www.medscape.com/viewarticle/968290
Sabel BA, Zhou W, Huber F et al Non-invasive brain microcurrent stimulation therapy of long-COVID-19 reduces vascular dysregulation and improves visual and cognitive impairment. Restor Neurol Neurosci.2021. 39(6):393-408. Dec 28 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34924406 PMCID: PMC8764598 Free PMC article https://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn211249 - ↑ 65.0 65.1 65.2 Hashmi A. Long-term Brain Health Is Impacted by Severity of COVID-19. Medscape. Feb 11, 2022 https://www.medscape.com/viewarticle/968318
Tsvetanov KA, Spindler LRB, Stamatakis EA et al Hospitalisation for COVID-19 predicts long lasting cerebrovascular impairment: A prospective observational cohort study. medRxiv. 2022. Feb 2. https://www.medrxiv.org/content/10.1101/2022.02.01.22270235v1.full - ↑ 66.0 66.1 Crist C Long COVID Symptoms Linked to Effects on Vagus Nerve Medscape. Feb 15, 2022 https://www.medscape.com/viewarticle/968537
- ↑ 67.0 67.1 Phend C Long COVID Less Likely in the Vaccinated. Even getting vaccinated after infection appears to help, review concludes. MedPage Today February 16, 2022 https://www.medpagetoday.com/infectiousdisease/covid19vaccine/97232
UKHSA COVID-19 Evidence Team 2022 The effectiveness of vaccination against long COVID: A rapid evidence briefing. UK Health Security Agency https://ukhsa.koha-ptfs.co.uk/cgi-bin/koha/opac-detail.pl - ↑ 68.0 68.1 68.2 68.3 68.4 Xie Y, Xu E, Al-Aly Z et al. Risks of mental health outcomes in people with covid-19: Cohort study. BMJ 2022 Feb 16; 376:e068993 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35172971 Free PMC article https://www.bmj.com/content/376/bmj-2021-068993
Cohen K, Ren S, Heath K et al. Risk of persistent and new clinical sequelae among adults aged 65 years and older during the post-acute phase of SARS-CoV-2 infection: Retrospective cohort study. BMJ 2022 Feb 9; 376:e068414 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35140117 PMCID: PMC8828141 Free PMC article - ↑ 69.0 69.1 George J Nerve Damage May Contribute to Long COVID Symptoms Small-fiber neuropathy may stem from defective immune response to SARS-CoV-2 MedPage Today March 2, 2022 https://www.medpagetoday.com/neurology/generalneurology/97470
Crist C Long COVID Patients May Develop Nerve Damage: Study. Medscape. March 3, 2022 https://www.medscape.com/viewarticle/969611
Oaklander AL, Mills AJ, Kelley M et al Peripheral Neuropathy Evaluations of Patients With Prolonged Long COVID. Neurol Neuroimmunol Neuroinflamm 2022. Mar 1;9(3):e1146 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35232750 PMCID: PMC8889896 Free PMC article https://nn.neurology.org/content/9/3/e1146 - ↑ 70.0 70.1 70.2 70.3 Douaud G, Lee S, Alfaro-Almagro F et al SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature 2022. March 7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/3525549 https://www.nature.com/articles/s41586-022-04569-5
Gollub RL. Brain changes after COVID revealed by imaging. Nature 2022 Apr 28; 604:633 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35260835 https://www.nature.com/articles/d41586-022-00503-x - ↑ 71.0 71.1 Singh I, Joseph P, Heerdt PM et al. Persistent exertional intolerance after COVID-19: Insights from invasive cardiopulmonary exercise testing. Chest 2022 Jan; 161:54 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34389297 PMCID: PMC8354807 Free PMC article https://journal.chestnet.org/article/S0012-3692(21)03635-7/fulltext
- ↑ 72.0 72.1 Austin C Unraveling the Neural Mechanisms Behind Post-COVID Fatigue. Medscape. March 10, 2022 https://www.medscape.com/viewarticle/970072
Baker AME, Maffitt NJ, Del Vecchio A et al Neural Dysregulation in Post-Covid Fatigue medRxiv 2022. Feb 21 https://www.medrxiv.org/content/10.1101/2022.02.18.22271040v1.full.pdf - ↑ 73.0 73.1 George J Memory, Concentration Problems Plague 70% of Long COVID Patients. Cognitive tests show "notable reduction" in memory ability. MedPage Today March 18, 2022 https://www.medpagetoday.com/neurology/generalneurology/97763
Guo P, Benito Ballesteros A, Yeung SP et al COVCOG 2: Cognitive and Memory Deficits in Long COVID: A Second Publication From the COVID and Cognition Study. Front. Aging Neurosci., 17 March 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35370620 PMCID: PMC8967943 Free PMC article https://www.frontiersin.org/articles/10.3389/fnagi.2022.804937/full - ↑ 74.0 74.1 George J What Drives Post-COVID Cognitive Changes? New research hints at why COVID brain fog may persist MedPage Today April 1, 202 https://www.medpagetoday.com/neurology/generalneurology/97981
- ↑ 75.0 75.1 George J Persistent Brain Fog After Mild COVID Infection Tied to CSF Markers. Immune activation, immunovascular markers elevated in people with long COVID cognitive changes. MedPage Today April 4, 2022 https://www.medpagetoday.com/meetingcoverage/aan/98034
- ↑ 76.0 76.1 Anderson P Long-Term Smell Loss in COVID-19 Tied to Damage in the Brain's Olfactory Bulb. Medscape. April 12, 2022 https://www.medscape.com/viewarticle/972005
Ho CY, Salimian M, Hegert J et al Postmortem Assessment of Olfactory Tissue Degeneration and Microvasculopathy in Patients With COVID-19. JAMA Neurol. Published online April 11, 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35404378 https://jamanetwork.com/journals/jamaneurology/fullarticle/2790735 - ↑ 77.0 77.1 77.2 Katsoularis I et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: Nationwide self-controlled cases series and matched cohort study. BMJ 2022 Apr 6; 377:e069590 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35387772 PMCID: PMC8984137 Free PMC article
- ↑ 78.0 78.1 Komaroff AL reviewing Rutkai I et al. Nat Commun 2022 Apr 1; 13:1745.
Rutkai I et al. Neuropathology and virus in brain of SARS-CoV-2 infected non-human primates. Nat Commun 2022 Apr 1; 13:1745. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35365631 PMCID: PMC8975902 Free PMC article https://www.nature.com/articles/s41467-022-29440-z - ↑ 79.0 79.1 79.2 79.3 Steel RW, Brusch JL Long Coronavirus 2019 (COVID-19) Medscape. May 11, 2022 https://emedicine.medscape.com/article/2500143-overview
- ↑ 80.0 80.1 Al-Aly A, Bowe B, Xie Y Long COVID after breakthrough SARS-CoV-2 infection. Nature Medicine 2022. May 25. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35614233 https://www.nature.com/articles/s41591-022-01840-0
- ↑ 81.0 81.1 81.2 Bull-Otterson L, Baca S, Saydah S et al. Post-COVID Conditions Among Adult COVID-19 Survivors Aged 18-64 and >= 65 Years - United States, March 2020-November 2021. MMWR Morb Mortal Wkly Rep 2022;71:713-717 Not indexed in PubMed https://www.cdc.gov/mmwr/volumes/71/wr/mm7121e1.htm
- ↑ 82.0 82.1 82.2 Vijayakumar B et al. CT lung abnormalities after COVID-19 at 3 months and 1 year after hospital discharge. Radiology 2022 May; 303:444-454 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34609195 PMCID: PMC8515207 Free PMC article https://pubs.rsna.org/doi/10.1148/radiol.2021211746
- ↑ 83.0 83.1 Ghanjanasak T A Possible Biomarker for COVID-19 Cognitive Impairment. Medscape. June 16, 2022 https://www.medscape.com/viewarticle/975741
Cysique LA et al Post-acute COVID-19 cognitive impairment and decline uniquely associate with kynurenine pathway activation: a longitudinal observational study. medRxiv. June 7, 2022 https://www.medrxiv.org/content/10.1101/2022.06.07.22276020v1 - ↑ 84.0 84.1 Crist C Omicron Carries Half the Risk of Long COVID as Delta: Study. Medscape. June 17, 2022 https://www.medscape.com/viewarticle/975841
Antonelli M et al Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2. Lancet. 2022. June 18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35717982 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00941-2/fulltext - ↑ 85.0 85.1 85.2 85.3 Centers for Disease Contol & Prevention (CDC) National Center for Health Statistics Long COVID. Household Pulse Survey. June 22, 2022 https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
- ↑ 86.0 86.1 86.2 Sneller MC et al. A longitudinal study of COVID-19 sequelae and immunity: Baseline findings. Ann Intern Med 2022 May 24; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/35605238 PMCID: PMC9128805 Free PMC article https://www.acpjournals.org/doi/10.7326/M21-4905
- ↑ 87.0 87.1 Jamal SM, Landers DB, Hollenberg SM et al Prospective Evaluation of Autonomic Dysfunction in Post-Acute Sequela of COVID-19. J Am Coll Cardiol. 2022 Jun 14;79(23):2325-2330 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35381331 PMCID: PMC8976261 Free PMC article
- ↑ 88.0 88.1 Crist C Long COVID Comes in Three Forms: Study. Medscape. Aug 2, 2022 https://www.medscape.com/viewarticle/978469
Canas LS, Molteni E, Deng J et al Profiling post-COVID syndrome across different variants of SARS-CoV-2. medRxiv 2022. July 31 https://www.medrxiv.org/content/10.1101/2022.07.28.22278159v1 - ↑ 89.0 89.1 Zilberman-Itskovich S et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: Randomized controlled trial. Sci Rep 2022 Jul 12; 12:11252 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35821512 PMCID: PMC9276805 Free PMC article https://www.nature.com/articles/s41598-022-15565-0
- ↑ 90.0 90.1 Ballering AV et al. Persistence of somatic symptoms after COVID-19 in the Netherlands: An observational cohort study. Lancet 2022 Aug 6; 400:452. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35934007 PMCID: PMC9352274 Free PMC article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01214-4/fulltext
- ↑ 91.0 91.1 Knight T, Walker V, Ip S et al Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales. Circulation. 2022 Sep 20;146(12):892-906 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36121907 PMCID: PMC9484653 Free PMC article https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.060785
- ↑ 92.0 92.1 92.2 Xu E, Xie Y, Al-Aly Z Long-term neurologic outcomes of COVID-19. Nature Medicine. 2022. Sept 22 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36138154 https://www.nature.com/articles/s41591-022-02001-z
- ↑ 93.0 93.1 Kompaniyets L, Bull-Otterson L, Boehmer TK et al Post-COVID-19 Symptoms and Conditions Among Children and Adolescents - United States, March 1, 2020-January 31, 2022. MMWR Morb Mortal Wkly Rep. 2022 Aug 5;71(31):993-999 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35925799 PMCID: PMC9368731 Free PMC article
- ↑ 94.0 94.1 Brannock MD, Chew RF, Preiss AJ et al Long COVID Risk and Pre-COVID Vaccination: An EHR-Based Cohort Study from the RECOVER Program. medRxiv. Oct 7, 2022 https://www.medrxiv.org/content/10.1101/2022.10.06.22280795v1
- ↑ 95.0 95.1 95.2 Durstenfeld MS, Sun K, Tahir P et al Use of Cardiopulmonary Exercise Testing to Evaluate Long COVID-19 Symptoms in Adults. A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(10):e2236057. Oct 12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36223120 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797203
- ↑ 96.0 96.1 96.2 Steenhuysen J Addiction Drug Shows Promise Lifting Long COVID Brain Fog, Fatigue. Medscape. Oct 18, 2022 https://www.medscape.com/viewarticle/982604
- ↑ 97.0 97.1 Department of Health & Human Services. August 2022 Services and Supports for Longer-Term Impacts of COVID-19 https://www.covid.gov/assets/files/Services-and-Supports-for-Longer-Term-Impacts-of-COVID-19-08012022.pdf
- ↑ 98.0 98.1 Bronze MS. Rapid Review Quiz: COVID-19 Updates. Medscape. Sep 28, 2022. https://reference.medscape.com/viewarticle/980879
Di Stadio A, Brenner MJ, De Luca P et al Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study. Brain Sci. 2022 Jan 24;12(2):154 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35203918 PMCID: PMC8870047 Free PMC article https://pubmed.ncbi.nlm.nih.gov/35203918/ - ↑ 99.0 99.1 99.2 99.3 Perlis RH, Santillana M, Ognyanova K et al Prevalence and Correlates of Long COVID Symptoms Among US Adults. JAMA Netw Open. 2022;5(10):e2238804 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36301542 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797782
- ↑ 100.0 100.1 100.2 100.3 100.4 100.5 Peter RS et al. Post-acute sequelae of covid-19 six to 12 months after infection: Population based study. BMJ 2022 Oct 13; 379:e071050. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36229057 PMCID: PMC9557001 Free PMC article https://www.bmj.com/content/379/bmj-2022-071050
Hastie CE et al. Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study. Nat Commun 2022 Oct 12; 13:5663. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36224173 PMCID: PMC9556711 Free PMC article https://www.nature.com/articles/s41467-022-33415-5 - ↑ 101.0 101.1 Hansen KS, Mogensen TH, Agergaard J et al High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: A randomized, phase 2, crossover trial. Lancet Regional Health Europe. 2022. Nov 2 https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00235-6/fulltext
- ↑ 102.0 102.1 102.2 Bocchino M et al. Chest CT-based Assessment of 1-year Outcomes after Moderate COVID-19 Pneumonia. Radiology 2022 Nov; 305:479. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35536134 PMCID: PMC9619196 Free PMC article https://pubs.rsna.org/doi/10.1148/radiol.220019
- ↑ 103.0 103.1 Robineau O, Zins M, Touvier M et al Long-lasting Symptoms After an Acute COVID-19 Infection and Factors Associated With Their Resolution. JAMA Netw Open. 2022;5(11):e2240985 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798224
- ↑ 104.0 104.1 Hein I Hospitalized or Not, COVID Symptoms Persist in Many After 2 Years. Fatigue, pain, and memory loss cited most frequently. MedPage Today November 15, 2022. https://www.medpagetoday.com/infectiousdisease/longcovid/101758
Fernandez-de-las-Penas C,Rodriguez-Jimenez J, Cancela-Cilleruelo I et al Post-COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients. JAMA Netw Open. 2022;5(11):e2242106 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36378309 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798446 - ↑ 105.0 105.1 Taquet M, Devinsky O, Cross HJ et al Incidence of Epilepsy and Seizures Over the First 6 Months After a COVID-19 Diagnosis: A Retrospective Cohort Study. Neurology. 2022. Nov 16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36384658 https://n.neurology.org/content/early/2022/11/16/WNL.0000000000201595
- ↑ 106.0 106.1 Xie Y, Choi T, Al-Aly Z Nirmatrelvir and the Risk of Post-Acute Sequelae of COVID-19. medRxiv. Nov 5, 2022 https://www.medrxiv.org/content/10.1101/2022.11.03.22281783v1
- ↑ 107.0 107.1 McNamara D For Many, Long COVID's Impacts Go On And On, Major Study Says. Medscape. Oct 13, 2022 https://www.medscape.com/viewarticle/982390
- ↑ 108.0 108.1 108.2 Susman E MRI Highlights Brain Blips Long After COVID Symptoms Have Subsided. Findings will advance understanding of SARS-CoV-2 neurological impact, researcher says. MedPage Today November 28, 2022 https://www.medpagetoday.com/meetingcoverage/rsna/101930
- ↑ 109.0 109.1 Monaco K Higher BMI a Risk Factor for Long COVID Symptoms. Female sex was another independent risk factor, U.K. study showed MedPage Today November 30, 2022 https://www.medpagetoday.com/primarycare/longcovid/101981
- ↑ 110.0 110.1 110.2 O'Mary L Vaccines Are Effective Against Long COVID: Study. Medscape. Dec 7, 2022 https://www.medscape.com/viewarticle/985222
- ↑ 111.0 111.1 Kwan AC, Ebinger JE, Wei J et al Apparent risks of postural orthostatic tachycardia syndrome diagnoses after COVID-19 vaccination and SARS-Cov-2 Infection. Nat Cardiovasc Res 2022. Dec 12 Not indexed in PubMed https://www.nature.com/articles/s44161-022-00177-8
- ↑ 112.0 112.1 jdeshmukh Around 19 million Americans Suffer from Long COVID: Study. Mentigo. Dec 27, 2022 https://medtigo.com/news/around-19-million-americans-suffer-from-long-covid-study
- ↑ 113.0 113.1 113.2 Mizrahi B Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study. BMJ 2023;380:e072529 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36631153 https://www.bmj.com/content/380/bmj-2022-072529
- ↑ 114.0 114.1 Berg S What doctors wish patients knew about long COVID-19 brain fog. American Medical Association. AMA News Wire. Feb 17, 2023 https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-long-covid-19-brain-fog
- ↑ 115.0 115.1 Wang S et al. Adherence to healthy lifestyle prior to infection and risk of post-COVID-19 condition. JAMA Intern Med 2023 Feb 6; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36745445 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2800885
- ↑ 116.0 116.1 Marasco G et al. Post COVID-19 irritable bowel syndrome. Gut 2023 Mar; 72:484. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36591612 https://gut.bmj.com/content/72/3/484
Xu E et al. Long-term gastrointestinal outcomes of COVID-19. Nat Commun 2023 Mar 7; 14:983. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36882400 PMCID: PMC9992516 ree PMC article https://www.nature.com/articles/s41467-023-36223-7 - ↑ 117.0 117.1 Dennis A et al. Multi-organ impairment and long COVID: A 1-year prospective, longitudinal cohort study. J R Soc Med 2023 Feb 14; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36787802 Free article https://journals.sagepub.com/doi/10.1177/01410768231154703
- ↑ 118.0 118.1 118.2 118.3 118.4 Tsampasian V, Elghazaly H, Chattopadhyay R et al Risk Factors Associated With Post-COVID-19 Condition. A Systematic Review and Meta-analysis. JAMA Intern Med. Published online March 23, 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36951832 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2802877
Xie Y et al. Association of treatment with nirmatrelvir and the risk of post-COVID-19 condition. JAMA Intern Med 2023 Mar 23; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36951829 PMCID: PMC10037200 Free PMC article https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2802878
Katz MH. While waiting for a randomized clinical trial of nirmatrelvir for prevention of post-COVID-19 condition. JAMA Intern Med 2023 Mar 23; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36951848 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2802879 - ↑ 119.0 119.1 Stewart I et al. Residual lung abnormalities after COVID-19 hospitalization: Interim Analysis of the UKILD Post-COVID-19 Study. Am J Respir Crit Care Med 2023 Mar 15; 207:693. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36457159 PMCID: PMC10037479 Free PMC article https://www.atsjournals.org/doi/10.1164/rccm.202203-0564OC
Hatabu H et al. Viral infection, pulmonary fibrosis, and long COVID. Am J Respir Crit Care Med 2023 Mar 15; 207:647. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36470237 PMCID: PMC10037483 Free PMC article https://www.atsjournals.org/doi/10.1164/rccm.202211-2121ED - ↑ 120.0 120.1 Regmi B et al. Diaphragm muscle weakness might explain exertional dyspnea 15 months after hospitalization for COVID-19. Am J Respir Crit Care Med 2023 Apr 15; 207:1012. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36596223 PMCID: PMC10112448 Free PMC article https://www.atsjournals.org/doi/10.1164/rccm.202206-1243OC
- ↑ 121.0 121.1 Bosworth T Explanation Proposed for Long-COVID Symptoms in the CNS. Medscape. April 25, 2023 https://www.medscape.com/viewarticle/991160
- ↑ 122.0 122.1 Thaweethai T, Jolley SE, Karlson EW et al Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection. JAMA. Published online May 25, 2023. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37278994 https://jamanetwork.com/journals/jama/fullarticle/2805540
- ↑ 123.0 123.1 Komaroff A Long COVID and Chronic Fatigue Syndrome Share Pathophysiology. NEJM Journal Watch. June 15, 2023 (subscription needed) https://www.jwatch.org/na56219/2023/06/15/long-covid-and-chronic-fatigue-syndrome-share
Komaroff A, Lipkin WL ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature. Front. Med., 02 June 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37342500 PMCID: PMC10278546 Free PMC article https://www.frontiersin.org/articles/10.3389/fmed.2023.1187163/full
Davis HE, McCorkell L, Vogel JM, Topol EJ Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol 2023; 21:133-146. Jan 13 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36639608 PMCID: PMC9839201 Free PMC article https://www.nature.com/articles/s41579-022-00846-2 - ↑ Substance Abuse & Mental Health Services Administration (SAMHSA) Identification and Management of Mental Health Symptoms and Conditions Associated with Long COVID. SAMSHA Advisory. 2023. June https://store.samhsa.gov/product/identification-and-management-symptoms-conditions-long-covid/pep23-06-05-007
- ↑ 125.0 125.1 Levine H Long Covid and Vaccines: Separating Facts From Falsehoods. Medscape. July 14, 2023 https://www.medscape.com/viewarticle/994385
- ↑ 126.0 126.1 Bonuck K Long COVID Persists as a Mass Disabling Event. We must do more to show we care. Medscape. July 23, 2023 https://www.medpagetoday.com/opinion/second-opinions/105599
- ↑ 127.0 127.1 United Nations. UN News. June 27, 2023 WHO: 'Long Covid' may obstruct return to normal life for 36 million Europeans. https://news.un.org/en/story/2023/06/1138157
- ↑ 128.0 128.1 Rasmussen IE, Lok M, Durrer CG et al Impact of high-intensity interval training on cardiac structure and function after COVID-19: an investigator-blinded randomized controlled trial. J Appl Physiol (1985). 2023 Aug 1;135(2):421-435. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37391888 Free article. Clinical Trial. https://journals.physiology.org/doi/full/10.1152/japplphysiol.00078.2023
- ↑ 129.0 129.1 Bowe B et al. Postacute sequelae of COVID-19 at 2 years. Nat Med 2023 Aug 21; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/37605079 https://www.nature.com/articles/s41591-023-02521-2
- ↑ 130.0 130.1 130.2 130.3 Taquet M, Skorniewska Z, Hampshire A et al Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization. Nat Med 2023. August 31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37653345 https://www.nature.com/articles/s41591-023-02525-y
- ↑ Harris E Two New Analyses Add to Long COVID Understanding. JAMA. Published online August 23, 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37610793 https://jamanetwork.com/journals/jama/fullarticle/2808856
- ↑ 132.0 132.1 132.2 132.3 Klein J, Wood J, Jaycox J et al Distinguishing features of Long COVID identified through immune profiling. Nature. 2023. Sept 25. medRxiv. 2022 Aug 10;2022.08.09.22278592 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35982667 PMCID: PMC9387160 Free PMC article https://www.nature.com/articles/s41586-023-06651-y
- ↑ Vivaldi G et al Long-term symptom profiles after COVID-19 vs other acute respiratory infections: an analysis of data from the COVIDENCE UK study. eClinicalMedicine. 2023. Oct 6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38106559 PMCID: PMC10721552 Free PMC article https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext
- ↑ 134.0 134.1 134.2 134.3 Wong AC, Devason AS, Umana IC et al Serotonin reduction in post-acute sequelae of viral infection. Cell. 2023. Oct 16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37848036 Free Article https://www.cell.com/cell/fulltext/S0092-8674(23)01034-6
- ↑ 135.0 135.1 135.2 Cervia-Hasler C et al. Persistent complement dysregulation with signs of thromboinflammation in active Long Covid. Science 2024 Jan 19; 383:eadg79 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38236961 https://www.science.org/doi/10.1126/science.adg7942
Ruf W. Immune damage in Long Covid. Science 2024 Jan 19; 383:262 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38236985 https://www.science.org/doi/10.1126/science.adn1077 - ↑ 136.0 136.1 Zhao S et al Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study. eClinical Medicine. 2024. 68:102434, Feb PMID: https://www.ncbi.nlm.nih.gov/pubmed/38318123 PMCID: PMC10839583 Free PMC article https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00013-0/fulltext
- ↑ Jewells V. Long COVID: Literature Review and Comparison of Impacts, and Pathophysiology, to Neurological Disorders VuMedi. 2023. July 18 https://www.vumedi.com/video/long-covid-literature-review-and-comparison-of-impacts-and-pathophysiology-to-neurological-disorders/
- ↑ 138.0 138.1 Hampshire A et al Cognition and Memory after Covid-19 in a Large Community Sample. N Engl J Med 2024; 390:806-818 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38416429 https://www.nejm.org/doi/full/10.1056/NEJMoa2311330
- ↑ 139.0 139.1 Catala M et al. The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: Staggered cohort study of data from the UK, Spain, and Estonia. Lancet Respir Med 2024 Mar; 12:225. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38219763 Free article https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(23)00414-9/fulltext
- ↑ Long Covid Medscape. Resource Center. https://www.medscape.com/resource/long-covid