Post-COVID syndrome. A case series and comprehensive review

被引:138
作者
Anaya, Juan-Manuel [1 ,2 ]
Rojas, Manuel [1 ]
Salinas, Martha L. [2 ]
Rodriguez, Yhojan [1 ,2 ]
Roa, Geraldine [1 ]
Lozano, Marcela [1 ]
Rodriguez-Jimenez, Monica [1 ]
Montoya, Norma [2 ]
Zapata, Elizabeth [1 ]
Monsalve, Diana M. [1 ]
Acosta-Ampudia, Yeny [1 ]
Ramirez-Santana, Carolina [1 ]
机构
[1] Univ del Rosario, Ctr Autoimmune Dis Res CREA, Sch Med & Hlth Sci, Carrera 24 63c 69, Bogota 110010, Colombia
[2] Clin Occidente, Bogota, Colombia
[3] Univ Rosario, Sch Med & Hlth Sci, Bogota, Colombia
关键词
Post-COVID syndrome; Long COVID; Prolonged COVID; Post-acute COVID-19; anti-Sars-Cov-2; antibodies; ACUTE RESPIRATORY SYNDROME; QUALITY-OF-LIFE; TACHYCARDIA SYNDROME; PULMONARY-FUNCTION; IMPACT; CAPACITY; OUTCOMES; COHORT;
D O I
10.1016/j.autrev.2021.102947
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The existence of a variety of symptoms with a duration beyond the acute phase of COVID-19, is referred to as post-COVID syndrome (PCS). We aimed to report a series of patients with PCS attending a Post-COVID Unit and offer a comprehensive review on the topic. Adult patients with previously confirmed SARS-CoV-2 infection and PCS were systematically assessed through a semi-structured and validated survey. Total IgG, IgA and IgM serum antibodies to SARS-CoV-2 were evaluated by an electrochemiluminescence immunoassay. A systematic review of the literature and meta-analysis were conducted, following PRISMA guidelines. Univariate and multivariate methods were used to analyze data. Out of a total of 100 consecutive patients, 53 were women, the median of age was 49 years (IQR: 37.8-55.3), the median of post-COVID time after the first symptoms was 219 days (IQR: 143-258), and 65 patients were hospitalized during acute COVID-19. Musculoskeletal, digestive (i.e., diarrhea) and neurological symptoms including depression (by Zung scale) were the most frequent observed in PCS patients. A previous hospitalization was not associated with PCS manifestation. Arthralgia and diarrhea persisted in more than 40% of PCS patients. The median of anti-SARS-CoV-2 antibodies was 866.2 U/mL (IQR: 238.2-1681). Despite this variability, 98 patients were seropositive. Based on autonomic symptoms (by COMPASS 31) two clusters were obtained with different clinical characteristics. Levels of anti-SARS-CoV-2 antibodies were not different between clusters. A total of 40 articles (11,196 patients) were included in the meta-analysis. Fatigue/ muscle weakness, dyspnea, pain and discomfort, anxiety/depression and impaired concentration were presented in more than 20% of patients reported. In conclusion, PCS is mainly characterized by musculoskeletal, pulmonary, digestive and neurological involvement including depression. PCS is independent of severity of acute illness and humoral response. Long-term antibody responses to SARS-CoV-2 infection and a high inter-individual variability were confirmed. Future studies should evaluate the mechanisms by which SARS-CoV-2 may cause PCS and the best therapeutic options.
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页数:15
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