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Vasculitis
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Michelle L. Robinette, Eli Miloslavsky, Zachary S. Wallace
Although not discussed in this chapter, the COVID-19 pandemic will undoubtedly continue to shape the future of rheumatology, including vasculitis. We expect that additional studies of the vascular phenomena of COVID-19, especially small-vessel vasculopathy and thrombosis, will provide molecular insights into human vascular injury. Meanwhile, investigations of children with multisystem inflammatory syndrome of children (MIS-C), a post-COVID-19 autoinflammatory syndrome which shares features with KD (119, 120), are likely to generate further insights into the pathogenesis of KD (121). Indeed, the variability of HLA associations observed in KD may be a result of divergent infectious triggers and/or causative antigens across ancestral groups.
Keep Learning
Published in Rose Cull, Daniel Cull, Museums and Well-being, 2023
This disengagement is important in a post-COVID context. While in lockdown we lived in a type of stasis, but we still developed, whereas museums constantly seek engagement with audiences as the only means of audience development when perhaps disengagement has an equally valid place. This can be disruptive, but the audience can still be in control.
Therapeutic Challenges in COVID-19
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Alaa A. A. Aljabali, Murtaza M. Tambuwala, Debmalya Barh, Kenneth Lundstrom
Finally, COVID-19 management must also deal with post-COVID-19 complications, the so-called long COVID-19 phenomenon, and organ injuries. In the context of the potential for a post-viral syndrome that might manifest after SARS-CoV-2 infection, it was discovered that some patients, especially healthcare workers, developed an illness similar to chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) [76]. Based on experience, a subgroup of remitted COVID-19 patients is expected to experience long-term adverse events, long COVID-19, resembling CSF/ME symptoms including persistent fatigue, widespread muscle pain, depression, and non-restorative sleep, which prevent normal activities and return to work for periods up to 20 months [76, 77]. Moreover, in a follow-up study on COVID-19 patients in France, patients experiencing a mild disease complained about relapse with persistent muscle pain, intense fatigue, shortness of breath, tachycardia, headaches, and anxiety [78]. SARS-CoV-2 might trigger a similar immune response as seen for autoimmune diseases. For this reason, patients with post-COVID-19 complications should be tested for antinuclear antibodies in order to rule out any possible underlying autoimmune disease. It has also been suggested that long COVID can be related to the virus- or immune-based disruption of the autonomic nervous system, which might trigger orthostatic intolerance syndromes [79].
Mild COVID-19 infection associated with post-COVID-19 condition after 3 months – a questionnaire survey
Published in Annals of Medicine, 2023
Stefan Rach, Lisa Kühne, Hajo Zeeb, Wolfgang Ahrens, Ulrike Haug, Hermann Pohlabeln
In a considerable proportion of patients with the coronavirus disease 2019 (COVID-19), caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a secondary syndrome of persistent and new post-acute symptoms can be observed that has been coined LongCovid or post-COVID-19 condition [1–4]. Symptoms commonly reported include, but are not limited to, fatigue, shortness of breath, cognitive dysfunction, headache and persistent impairment of taste or smell [5–7]. Typically, patients report that their quality of life decreased considerably [8]. Although a post-COVID-19 condition is more commonly observed in patients severely affected by the initial infection, it is also reported after infections with mild or even no symptoms at all [e.g. 9,10,11]. Given the large number of SARS-CoV-2 infections in the community in Europe and globally, such long-term health consequences may not only impair the quality of life of affected individuals but may also result in high economic costs, e.g. due to sick leaves and long-term treatments, which put substantial strains on the health system.
Long-term central nervous system (CNS) consequences of COVID-19 in children
Published in Expert Review of Neurotherapeutics, 2023
Saskia Howe de la Torre, Valeria Parlatini, Samuele Cortese
Children and young people may also experience persistent symptoms (Long COVID or post-COVID-19 syndrome) [13]. Definitions of long COVID vary across the literature. Following a Delphi process and consensus meeting, a research definition of long COVID or post-COVID 19 condition was proposed in April 2022, indicating that a diagnosis can be made when at least one physical symptom persists more than 12 weeks in children/young people with a confirmed SARS-CoV-2 infection, and cannot be explained by an alternative diagnosis. However, the National Institute for Health and Care Excellence (NICE) guidelines indicate that the term ‘long COVID’ includes both ongoing symptomatic COVID‐19 (from 4 to 12 weeks) and post‐COVID‐19 syndrome (12 weeks or more) [14,15]. Further, there is increasing recognition that long COVID can also manifest in previously asymptomatic individuals [16,17]. Prevalence estimates vary across the literature. For instance, the CloCk study, a large UK cohort study, reported that 14% of infected children and young people experienced persistent symptoms at 15 weeks. However, reported prevalence estimates range from 1.6% to 70% depending on study design, sample size, definition, and method of identification [9,18].
The kids are not alright: A preliminary report of Post-COVID syndrome in university students
Published in Journal of American College Health, 2023
Julie Walsh-Messinger, Hannah Manis, Alison Vrabec, Jenna Sizemore, Karyn Bishof, Marcella Debidda, Dolores Malaspina, Noah Greenspan
The importance of understanding the COVID-19 disease in young adults cannot be overstated, as the weekly number of such cases reported to the CDC is increasing over time and especially as students have returned to campus settings.21 This preliminary study contradicts the perception that this “yet to be defined” post-COVID syndrome predominantly affects middle-aged adults, as just over half of our young adult sample reported at least two COVID-19 symptoms and/or related complications 30 days post illness onset, at minimum; a majority were still symptomatic more than 50 days later. Our comparison of post-COVID syndrome participants to those never diagnosed with COVID-19 suggests that the protracted symptoms experienced by the post-COVID syndrome group are not merely due to stress associated with the current pandemic or college attendance.