Science and Technology 科学技術 Vol.16 / #Coronavirus #コロナウイルス Vol.17(sequelae 後遺症)

All the links and excerpts are in English.

JFYI   あくまでご参考です。

Late Sequelae of COVID-19 (11/13/2020) | @CDCgov
Characterization of the etiology and pathophysiology of late sequelae is underway, and may reflect organ damage from the acute infection phase, manifestations of a persistent hyperinflammatory state, ongoing viral activity associated with a host viral reservoir, or an inadequate antibody response. Factors in addition to acute disease that may further complicate the picture include physical deconditioning at baseline or after a long disease course, pre-COVID-19 comorbidities, and psychological sequelae following a long or difficult disease course as well as those relating to lifestyle changes due to the pandemic. Likely, the persistent sequelae of COVID-19 represent multiple syndromes resulting from distinct pathophysiological processes along the spectrum of disease.
Though there is limited information on late sequelae of COVID-19, reports of persistent symptoms in persons who recovered from acute COVID-19 illness have emerged. The most commonly reported symptoms include fatigue, dyspnea, cough, arthralgia, and chest pain. Other reported symptoms include cognitive impairment, depression, myalgia, headache, fever, and palpitations. More serious complications appear to be less common but have been reported. These complications include:
・Cardiovascular: myocardial inflammation, ventricular dysfunction
・Respiratory: pulmonary function abnormalities
・Renal: acute kidney injury
・Dermatologic: rash, alopecia
・Neurological: olfactory and gustatory dysfunction, sleep dysregulation, altered cognition, memory impairment
・Psychiatric: depression, anxiety, changes in mood

Long-term Health Consequences of COVID-19 (w PDF; 10/05/2020) | @JAMA_current
The most commonly reported symptoms after acute COVID-19 are fatigue and dyspnea. Other common symptoms include joint pain and chest pain. In addition to these general symptoms, specific organ dysfunction has been reported, involving primarily the heart, lungs, and brain. From a pathogenesis standpoint, these complications could be the consequence of direct tissue invasion by the virus (possibly mediated by the presence of angiotensin-converting enzyme 2 receptor), profound inflammation and cytokine storm, related immune system damage, the hypercoagulable state described in association with severe COVID-19, or a combination of these factors.
Myocardial injury, as defined by an increased troponin level, has been described in patients with severe acute COVID-19, along with thromboembolic disease. Myocardial inflammation and myocarditis, as well as cardiac arrhythmias, have been described after SARS-CoV-2 infection. … However, an increased incidence of heart failure as a major sequela of COVID-19 is of concern, with considerable potential implications for the general population of older adults with multimorbidity, as well as for younger previously healthy patients, including athletes.
…interstitial thickening and evidence of fibrosis. …decreased diffusion capacity for carbon monoxide and diminished respiratory muscle strength…
…headache, vertigo, and chemosensory dysfunction (eg, anosmia and ageusia). …encephalitis, seizures, and other conditions such as major mood swings and “brain fog”…

What we know about sequelae and lingering COVID-19 symptoms (09/16/2020) | @SingleCare
What are coronavirus sequelae?
…brain fog, fatigue, difficulty concentrating…
Who will experience coronavirus sequelae?
…“Sequelae of the disease have been seen in people with mild cases of COVID-19.”
In other words, it’s not yet proven who is affected by sequelae.
What are the symptoms of coronavirus sequelae?
Fever; Fatigue; Muscle or body aches; Joint pain; Shortness of breath; Difficulty concentrating (or “brain fog”); Nausea, heartburn, or vomiting; Headache; Difficulty sleeping; Prolonged loss of taste or smell; Hair loss …
… “There are some individuals who may have long-lasting kidney damage, blood clots, or other problems of the blood vessels and skin as well as worsening hypertension (high blood pressure).”
…lasting effects on the heart. …cardiac involvement…myocardial inflammation…lasting damage to the lungs, including post-COVID fibrosis.
What causes coronavirus sequelae?
…the SARS-COV-2 utilizes the spiky protein on its membrane to interact and bind to the ACE 2 receptors, which can be seen in the lungs, heart, and various organs to trigger an inflammatory response…
…inflammation of the heart muscle…heart palpitations, fast heart rate (tachycardia), irregular heartbeat or chest pressure…
… Part of the cascade of events includes the release of cytokines, in the blood, which mediate subsequent immune responses against the foreign invader (the virus). In the event where such mediators cross the blood brain barrier and accumulate in the central nervous system, they can activate the primitive regulatory parts of the brain phenomenon, resulting in many of the symptoms seen in post-viral syndrome. This was also observed in select patients who contracted SARS during the 2002-2003 outbreak.”
What should you do if you experience coronavirus sequelae?
Taking over-the-counter pain relievers such as Tylenol or ibuprofen; Eating a balanced and healthy diet; Getting plenty of sleep and resting during the day as needed; Practicing relaxation techniques such as yoga, massage therapy, and meditation

Coronavirus disease 2019 (COVID-19): Clinical features (11/20/2020) | @UpToDate
Recovery and long-term sequelae
… The most common persistent symptoms were fatigue (53 percent), dyspnea (43 percent), joint pain (27 percent), and chest pain (22 percent)…
… Although a lack of return to baseline health was associated with older age and a greater number of underlying comorbidities, approximately one in five individuals aged 18 to 34 years who were previously healthy reported that they did not return to baseline within two to three weeks.

Will the COVID-19 pandemic result in significant neuropsychiatric sequelae? | @Immunopaedia
Epidemiological Alert: Complications and sequelae of COVID-19 (w PDF; 12/08/2020) | @pahowho
Epidemiological Alert: Complications and sequelae of COVID-19 (w PDF; 12/08/2020) | @reliefweb

投稿者: ワールド ソルーションズ