Long Covid Land Toolbox
Structural brain changes in post-COVID condition and its relationship with cognitive impairment
Abstract
It has been estimated that ∼4% of individuals infected with SARS-CoV-2 will be diagnosed with post-COVID condition. Previous studies have evidenced the presence of cognitive dysfunction and structural brain changes in infected individuals; however, the relationship between structural changes and cognitive alterations in post-COVID condition is still not clear. Consequently, the aim of this work is to study structural brain alterations in post-COVID condition patients after almost 2 years of infection and their likely relationship with patients’ cognitive impairment. Additionally, the association with blood biomarkers and clinical variables was also explored…
Introduction
The coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most people recover fully after the infection, but a substantial number of individuals suffer from diverse multi-systemic symptoms months after.1 The post-COVID-19 condition (PCC) is defined as the continuation or development of new symptoms 3 months after the initial infection, with these symptoms lasting for at least 2 months with no other explanation.2 PCC is characterized by a substantial diversity of fixed or fluctuating symptoms including fatigue, muscle and body ache, loss of smell and taste and joint pain as the most reported symptoms according to a population-based cross-sectional study including 4722 participants…
COVID-19-induced gastrointestinal autonomic dysfunction: A systematic review
BACKGROUND
It is common for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to occur in the gastrointestinal tract, which can present itself as an initial symptom. The severity of coronavirus disease 2019 (COVID-19) is often reflected in the prevalence of gastrointestinal symptoms. COVID-19 can damage the nerve supply to the digestive system, leading to gastrointestinal autonomic dysfunction. There is still much to learn about how COVID-19 affects the autonomic nervous system and the gastrointestinal tract.
AIM
To thoroughly explore the epidemiology and clinical aspects of COVID-19-induced gastrointestinal autonomic dysfunction, including its manifestations, potential mechanisms, diagnosis, differential diagnosis, impact on quality of life, prognosis, and management and prevention strategies.
Long-term health outcomes following hospitalisation for COVID-19: a 30- month cohort analysis
Abstract
Context
Increased risks of death and hospitalisation for organ disorders after discharge for COVID-19 hospitalisation have been reported but their persistence is unknown.
Methods
We conducted a nationwide cohort study using the French claims database; subjects hospitalised for COVID-19 between 2020/01/01 and 2020/08/30 were followed up to 30-months and matched to controls from the general population (GP) not hospitalised for COVID-19 during this period. Outcomes were all-cause mortality and organ disorders-related hospitalisation identified using ICD-10 codes. Cumulative incidences were estimated using the Kaplan-Meier method. Incidence rate ratios (IRR) were estimated such as the adjusted sub-distribution hazard ratio on 6-month periods during the follow-up using Cox regressions.
Results
63,990 COVID-19 subjects (mean age (SD) 65 years (18), 53.1% male) were matched to 319,891 controls. The weighted cumulative incidences of all-cause mortality and all-cause hospitalisation were 5,218/105 person-years (PY) [95%CI 5,127; 5,305] and 16,334/105 PY [16,162; 16,664] among COVID-19 subjects and 4,013/105 [3,960; 4,047] and 12,095/105 PY [12,024; 12,197] among controls, respectively. COVID-19 subjects were more likely to be hospitalised for cardiovascular (IRR 1.22 [1.15; 1.29]), psychiatric (IRR 1.41 [1.29; 1.53]), neurological (IRR 1.50 [1.41; 1.61]), and respiratory events (IRR 1.99 [1.87; 2.12]). The excess risk strongly decreased after the first 6 months for all outcomes but remained significantly increased up to 30-month for neurological, respiratory disorders, chronic renal failure and diabetes.
Conclusions
COVID-19 hospitalised subjects were at increased risk of death or hospitalisation for various organ disorders up to 30 months after discharge, reflecting the multi-organ consequences of the disease.
["Ultimately, you are on your own." A qualitative analysis of barriers to health care from the perspective of patients with long COVID]
2025 Feb 27
Abstract
Background: About 5% of the population are affected by post-infectious symptoms after a Sars-CoV-2-infection. Long COVID or a post-COVID-19 condition can affect all organ systems and lead to a complete need for care. 10-50% of patients meet the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Treatment recommendations have so far been limited to stress management and symptomatic, psychological or activity-enhancing measures (physical or exercise therapy). Initial studies of patients’ perspectives indicate that both the recognition of the disease and the medical care for affected patients are insufficient.
Method: Since June 2023, patients with long COVID or their relatives have been able to report medical and social care experiences by telephone or using an online reporting form from the Techniker (TK) Health Insurance fund and the German Society for Patient Safety as part of a project funded by the German Federal Ministry of Health. From 1,216 reports received by December 2023, 264 representative cases were selected and evaluated using structuring and summarizing content analysis. The aim was to understand the experiences of those affected with barriers to health and social care and their consequences.
Results: In the fourth year after the start of the pandemic…
The double invisibility of Long Covid in children
Highlights
- Little public attention has been paid to Long Covid, particularly in children.
- Covid was publicly represented as mild, not affecting children, and ‘over’ by 2022.
- The invisibility of Long Covid means it receives poor social currency.
- Children face a ‘double invisibility’ due to their age and associated stereotypes.
The Covid-19 pandemic has been dominated by discussions of mild and short-lasting cases or acutely serious or lethal forms of the disease; less attention has been paid to long-term Covid-19 symptoms (‘Long Covid’), particularly in children. This analysis of the experiences of children and adolescents with Long Covid, and those of their parents/caregivers, argues that children with Long Covid encounter a ‘double invisibility’ due to the condition’s limited social currency and their status as the youngest members of society. We draw on 39 narrative interviews about children’s and adolescents’ experiences, conducted in 2021–2022 in the United Kingdom. The occurrence of Long Covid in children challenges key aspects of a dominant pandemic narrative, some of which have persisted from the early stages of the pandemic into 2023…
First wave of COVID-19 increased risk of heart attack, stroke up to three years later
NIH-funded study focused on original virus strain, unvaccinated participants during pandemic.
Infection from COVID-19 appeared to significantly increase the risk of heart attack, stroke, and death for up to three years among unvaccinated people early in the pandemic when the original SARS-CoV-2 virus strain emerged, according to a National Institutes of Health (NIH)-supported study. The findings, among people with or without heart disease, confirm previous research showing an associated higher risk of cardiovascular events after a COVID-19 infection but are the first to suggest the heightened risk might last up to three years following initial infection, at least among people infected in the first wave of the pandemic.
Compared to people with no COVID-19 history, the study found those who developed COVID-19 early in the pandemic had double the risk for cardiovascular events, while those with severe cases had nearly four times the risk. The findings were published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
Long Covid Perspectives: history, paradigm shifts, global challenges
Elisa Perego (MA, PhD) University College London (UK)
The Covid-19 pandemic is one of the most devastating health disasters in recorded history. In addition to the significant death toll, the pandemic is leaving behind a devastating long tail of prolonged disease and disability. The long-term symptoms, clinical signs and sequelae of SARS-CoV-2 infection are collectively known as Long Covid – a patient-made term that was created and gained consistency in just a few months in Spring to Summer 2020. Long Covid was openly recognized by the World Health Organization (WHO) in August 2020, following intense advocacy by Covid-19 survivors. Long Covid has been described as the first illness identified, named and defined by patients finding one other on social media such as Twitter. As a disease entity named and defined collectively by patients, Long Covid has the potential to change knowledge building in medicine, while centring patient expertise within the biomedical community.
This paper will, first, explore the rise of Long Covid as patient-made term, clinical entity and collective, grassroots, international advocacy–research movement in early 2020 and beyond. This happened while people with Covid-19 suffered abandonment and lack of care in the pandemic’s disaster context. Second, I will discuss some key paradigm shifts triggered by this ground-breaking patient-driven, collective advocacy–research, while sketching links with earlier patient movements, such as around HIV/AIDS. Then, I will explore the role of Long Covid advocacy–research in our digital era. This advocacy took place during a pandemic when digital spaces such as Twitter and Facebook were often the only arenas available to Covid-19 survivors. Moreover, I will raise some pressing issues around epistemic injustice in relation to the use of patient-produced data and the recognition of patient contributions to knowledge. Finally, I will address the need to fully acknowledge the nature, scope, and severity of Long Covid, which is detailed in thousands of scientific publications, including in relation to the ongoing spread of SARS-CoV-2.
I Feel Lousy: Could This Be Long COVID?
In the aftermath of COVID-19 infections—even if you weren’t aware of having one—many people find themselves grappling with lingering symptoms that don’t quite add up. You may feel fatigued, struggle with brain fog, experience shortness of breath, or notice a rapid heart rate after minimal exertion. If you’ve asked yourself, Could this be Long COVID?—you’re not alone.
What Is Long COVID?
Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 (PASC), refers to a range of symptoms linked to underlying physiological harm that persist after the acute phase of a COVID-19 infection has resolved. While COVID-19 is often thought of as a respiratory illness, the infection impacts blood vessels and many tissues, with effects that can persist in multiple locations in the body. This means that COVID-19 is a systemic disease, affecting multiple organs and bodily systems.
Long COVID symptoms can include, but are not limited to [Find a more comprehensive list of Long COVID symptoms here]:
- Fatigue: Unrelenting, debilitating tiredness that doesn’t improve with rest.
- Brain fog: Difficulty concentrating, memory lapses, and confusion.
- Breathing issues: Persistent shortness of breath or chest tightness.
- Heart problems: Palpitations or a rapid heart rate.
- Muscle and joint pain: Unexplained aches and stiffness.
- Neurological symptoms: Headaches, dizziness, or sleep disturbances.
- Gastrointestinal issues: Nausea, diarrhea, or abdominal pain.
- Immunological issues: Vulnerability to other infections, and heightened sensitivity to allergens or new allergies.
- Emotional challenges: Anxiety, depression, or atypical mood swings resulting from neurological and physical damage.