COVID-19: Prognosis and Long-Term Sequelae, 2nd Edition

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Coronaviruses".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 3212

Special Issue Editors


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Guest Editor
Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
Interests: COVID-19; NIV; antibiotic treatment; pneumonia; sepsis shock
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Guest Editor
Emergency Department, AUSL della Romagna, Forlì, Italy
Interests: emergency medicine; brain injury; cardiovascular medicine; cardiology; risk stratification; acute heart failure; chest pain; cardiac arrest; sepsis; epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific and medical communities. This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity, even younger adults, children, and those not hospitalized. The precise definition of long COVID may be lacking, but the most common symptoms reported in many studies are fatigue and dyspnoea that last for months after acute COVID-19. To those symptoms it will be possible to add cognitive and mental impairments, dry cough, chest and joint pains, palpitations, cardiac issues, myalgia, smell and taste dysfunctions, headache, and gastrointestinal issues. Presently, there is limited literature discussing the possible pathophysiology, risk factors, and treatments in long COVID, which the current review aims to address. In brief, long COVID may be driven by long-term tissue damage (e.g., of the lung, brain, and heart) and pathological inflammation. The principle etiological hypothesis could be due to viral persistence, immune dysregulation, and autoimmunity. The associated risk factors may include female sex, more than five early symptoms, early dyspnoea, prior psychiatric disorders, and specific biomarkers (e.g., D-dimer, CRP, and lymphocyte count); for these reasons, it could be desirable to deepen this topic with a Special Issue.

Dr. Antonio Voza
Dr. Andrea Fabbri
Guest Editors

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Keywords

  • COVID-19
  • pneumonia
  • SARS-CoV-2

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Published Papers (2 papers)

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10 pages, 844 KiB  
Article
Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
by Crhistian-Mario Oblitas, Pablo Demelo-Rodríguez, Luis-Antonio Alvarez-Sala-Walther, Manuel Rubio-Rivas, Francisco Navarro-Romero, Vicente Giner Galvañ, Lucía de Jorge-Huerta, Eva Fonseca Aizpuru, Gema María García García, José Luis Beato Pérez, Paula María Pesqueira Fontan, Arturo Artero Mora, Juan Antonio Vargas Núñez, Nuria Ramírez Perea, José Miguel García Bruñén, Emilia Roy Vallejo, Isabel Perales-Fraile, Ricardo Gil Sánchez, José López Castro, Ángel Luis Martínez González, Luis Felipe Díez García, Marina Aroza Espinar, José-Manuel Casas-Rojo and Jesús Millán Núñez-Cortésadd Show full author list remove Hide full author list
Viruses 2024, 16(3), 335; https://doi.org/10.3390/v16030335 - 22 Feb 2024
Cited by 1 | Viewed by 823
Abstract
Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 [...] Read more.
Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission. Results: A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (±16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68–0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09–4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03–2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis. Conclusions: This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice. Full article
(This article belongs to the Special Issue COVID-19: Prognosis and Long-Term Sequelae, 2nd Edition)
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43 pages, 2419 KiB  
Review
Myocardial Oedema as a Consequence of Viral Infection and Persistence—A Narrative Review with Focus on COVID-19 and Post COVID Sequelae
by Noel G. Panagiotides, Michael Poledniczek, Martin Andreas, Martin Hülsmann, Alfred A. Kocher, Christoph W. Kopp, Aleksandra Piechota-Polanczyk, Annika Weidenhammer, Noemi Pavo and Patricia P. Wadowski
Viruses 2024, 16(1), 121; https://doi.org/10.3390/v16010121 - 14 Jan 2024
Cited by 1 | Viewed by 2103
Abstract
Microvascular integrity is a critical factor in myocardial fluid homeostasis. The subtle equilibrium between capillary filtration and lymphatic fluid removal is disturbed during pathological processes leading to inflammation, but also in hypoxia or due to alterations in vascular perfusion and coagulability. The degradation [...] Read more.
Microvascular integrity is a critical factor in myocardial fluid homeostasis. The subtle equilibrium between capillary filtration and lymphatic fluid removal is disturbed during pathological processes leading to inflammation, but also in hypoxia or due to alterations in vascular perfusion and coagulability. The degradation of the glycocalyx as the main component of the endothelial filtration barrier as well as pericyte disintegration results in the accumulation of interstitial and intracellular water. Moreover, lymphatic dysfunction evokes an increase in metabolic waste products, cytokines and inflammatory cells in the interstitial space contributing to myocardial oedema formation. This leads to myocardial stiffness and impaired contractility, eventually resulting in cardiomyocyte apoptosis, myocardial remodelling and fibrosis. The following article reviews pathophysiological inflammatory processes leading to myocardial oedema including myocarditis, ischaemia-reperfusion injury and viral infections with a special focus on the pathomechanisms evoked by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In addition, clinical implications including potential long-term effects due to viral persistence (long COVID), as well as treatment options, are discussed. Full article
(This article belongs to the Special Issue COVID-19: Prognosis and Long-Term Sequelae, 2nd Edition)
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