COVID-19 and Long-COVID-19: Pathogenesis, Clinical Manifestation, and Therapeutic Options: 2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 6066

Special Issue Editors

Faculty of Medicine and Surgery, Università degli studi di Bari Aldo Moro, Bari, Italy
Interests: COVID-19
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The global severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic exploded with unstoppable force from China to all around the world from late 2019 to now (COVID-19). This pandemic has similar but also different features to the two prior human coronavirus (HCoV) outbreaks, severe acute respiratory syndrome (SARS) and Middle-East respiratory syndrome (MERS). SARS-CoV2 spread far more quickly and is more contagious than the other two types of HCoV. All these outbreaks have mainly respiratory symptoms, ranging from a sore throat, cough, and dyspnea to acute (often fatal) respiratory distress syndrome (ARDS). Patients discharged from the hospital after acute COVID-19 had an increased risk of multiorgan dysfunction, readmission, and mortality. Recent joint guidelines proposed by the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN), and the Royal College of General Practitioners (RCGP) have divided COVID-19 infection into three phases—‘Acute COVID-19’ (signs and symptoms of COVID-19 infection up to 4 weeks), ‘ongoing symptomatic COVID-19’ (from 4 weeks up to 12 weeks), and ‘post-COVID-19 syndrome’ (when signs and symptoms continue beyond 12 weeks). The term ‘Long-COVID-19’ is given to the signs and symptoms that continue or develop after the ‘acute COVID-19’ phase and include both ‘ongoing symptomatic COVID- 19’ and ‘post COVID-19 syndrome’. In addition to the persistence of symptoms, it is also possible to detect abnormalities of chest radiographs and biomarkers. The pathogenesis, clinical manifestation, and therapeutic options of COVID-19 and long-COVID-19 are currently being studied.

For a previous publication, please see: https://www.mdpi.com/journal/life/special_issues/long_COVID19

Dr. Domenico Acanfora
Dr. Alessandro Santo Bortone
Guest Editors

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Published Papers (4 papers)

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Research

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11 pages, 275 KiB  
Article
Post-COVID Syndrome and Cardiorespiratory Fitness—26-Month Experience of Single Center
by Milan Sova, Eliska Sovova, Jaromir Ozana, Katarina Moravcova, Marketa Sovova, Libor Jelinek, Jan Mizera and Samuel Genzor
Life 2023, 13(3), 684; https://doi.org/10.3390/life13030684 - 02 Mar 2023
Cited by 2 | Viewed by 2090
Abstract
Introduction: Persistent post-COVID syndrome, also referred to as long COVID, is a pathologic entity that involves persistent physical, medical, and cognitive sequelae following COVID-19. Decreased fitness has repeatedly been reported in numerous studies dealing with post-COVID syndrome, however, it is still not fully [...] Read more.
Introduction: Persistent post-COVID syndrome, also referred to as long COVID, is a pathologic entity that involves persistent physical, medical, and cognitive sequelae following COVID-19. Decreased fitness has repeatedly been reported in numerous studies dealing with post-COVID syndrome, however, it is still not fully clear which groups of patients may be more susceptible for persisting symptoms. Aim: The aim of our study was to evaluate the number of post-COVID patients with cardiac symptoms, where these patients were evaluated by CPET and the results compared with a control group of patients. Methods: Follow-up of patients in post-COVID outpatient clinic from 1 March 2020 to 31 May 2022. Inclusion criteria were positive PCR test for SARS-CoV-2 and age 18–100. The initial examination was performed 4–12 weeks after the disease onset. All patients with possible cardiac symptoms had completed cardiopulmonary exercise testing. The control group was randomly selected from a database of clients in 2019, with the preventive reason for evaluation. Results: From 1 March 2020 to 31 May 2022, 2732 patients (45.7% males) were evaluated with a mean age of 54.6 ± 14.7. CPET was indicated only in 97 patients (3.5%). Seventy-four patients (26 male) achieved the exercise maximum and a comparison were made with a control group (same age (p = 0.801), BMI (p = 0.721), and sex ratio). No significant dependence between the parameter VO2 max mL/kg/min and post-COVID disability was demonstrated (p = 0.412). Spearman’s correlation analysis did not show a significant relationship between the parameter VO2 max mL/kg/min and the severity of COVID-19 (p = 0.285). Conclusions: Cardiac symptoms occurred in only a small percentage of patients in our study. There is a need for further studies that would objectively evaluate the effect of COVID-19 disease on the patient’s health. Full article
9 pages, 623 KiB  
Article
The Impact of COVID-19 Pandemic on Surgical Treatment of Resectable Non-Small Cell Lung Cancer in Greece
by Ioannis Tomos, Emmanouil I. Kapetanakis, Konstantina Dimakopoulou, Thomas Raptakis, Katerina Kampoli, Anna Karakatsani, Anna Koumarianou, Spyros Papiris and Periklis Tomos
Life 2023, 13(1), 218; https://doi.org/10.3390/life13010218 - 12 Jan 2023
Cited by 3 | Viewed by 1158
Abstract
Background: The coronavirus disease (COVID-19) pandemic has posed an unprecedented challenge to health systems, and has significantly affected the healthcare of lung cancer patients. The aim of our study was to assess the impact of COVID-19 on early lung cancer patients’ surgical treatment. [...] Read more.
Background: The coronavirus disease (COVID-19) pandemic has posed an unprecedented challenge to health systems, and has significantly affected the healthcare of lung cancer patients. The aim of our study was to assess the impact of COVID-19 on early lung cancer patients’ surgical treatment. Methods: All consecutive patients with early-stage non-small cell lung cancer eligible for surgical treatment stage I/II and resectable stage III, referred to our department during the first wave of COVID-19 between February to May 2020, were included and compared with those on the exact corresponding quarter in 2019, one year before the pandemic. Waiting time to surgical treatment, increase of tumor’s size and increase on lung cancer stage were recorded and compared. All subjects were followed up for 12 months. Multiple linear and logistic regression models were applied to assess the differences in the management of the studied groups adjusting for potential confounders. Results: Sixty-one patients with early-stage lung cancer were included in the study; 28 (median age 67 years, SD: 7.1) during the pandemic and 33 (median age 67.1 years, SD: 7.5) one year earlier. A significantly longer period of waiting for treatment and an increase in tumor size were observed during the pandemic compared to before the pandemic [median time 47 days, interquartile rate (IQR): 23–100] vs. [median time 18 days, IQR: 11–23], p < 0.001. No significant differences were detected in the increase of the stage of lung cancer between the subgroups. Conclusion: The COVID-19 pandemic had a significant impact on surgical and oncological care, leading to significant delays on treatment and an increase in tumor size in early-stage lung cancer patients. Full article
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Review

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16 pages, 580 KiB  
Review
Sarcopenia and Mortality in Critically Ill COVID-19 Patients
by Fatima Al Zahra Yakti, Lana Abusalah and Vijay Ganji
Life 2024, 14(1), 24; https://doi.org/10.3390/life14010024 - 22 Dec 2023
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Abstract
COVID-19 can manifest as either asymptomatic or progressing to a severe phase in some patients, which may require hospitalization. These patients may experience dyspnea and hypoxia, leading to the development of acute respiratory distress syndrome. Studies have reported an increased risk of severe [...] Read more.
COVID-19 can manifest as either asymptomatic or progressing to a severe phase in some patients, which may require hospitalization. These patients may experience dyspnea and hypoxia, leading to the development of acute respiratory distress syndrome. Studies have reported an increased risk of severe sarcopenia in COVID-19 patients during and after recovery. This narrative review aimed to summarize and synthesize available studies on the association between sarcopenia and mortality in critically ill COVID-19 patients. A total of 22 studies conducted on hospitalized COVID-19 patients were included in this review. Of those, 17 studies reported a direct association, while 5 studies showed no association between sarcopenia and mortality in severe COVID-19 patients. It is important to maintain muscle quality and quantity in defense against COVID-19. The measurement of lean muscle mass should be included in the risk assessment of severely ill COVID-19 patients as part of the therapy plan. Full article
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24 pages, 762 KiB  
Review
Treating COVID-19: Targeting the Host Response, Not the Virus
by David S. Fedson
Life 2023, 13(3), 712; https://doi.org/10.3390/life13030712 - 06 Mar 2023
Cited by 2 | Viewed by 1651
Abstract
In low- and middle-income countries (LMICs), inexpensive generic drugs like statins, ACE inhibitors, and ARBs, especially if used in combination, might be the only practical way to save the lives of patients with severe COVID-19. These drugs will already be available in all [...] Read more.
In low- and middle-income countries (LMICs), inexpensive generic drugs like statins, ACE inhibitors, and ARBs, especially if used in combination, might be the only practical way to save the lives of patients with severe COVID-19. These drugs will already be available in all countries on the first pandemic day. Because they target the host response to infection instead of the virus, they could be used to save lives during any pandemic. Observational studies show that inpatient statin treatment reduces 28–30-day mortality but randomized controlled trials have failed to show this benefit. Combination treatment has been tested for antivirals and dexamethasone but, with the exception of one observational study in Belgium, not for inexpensive generic drugs. Future pandemic research must include testing combination generic drug treatments that could be used in LMICs. Full article
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