Journal article 422 views 731 downloads
Long COVID: mechanisms, risk factors and recovery
Rónan Astin,
Amitava Banerjee,
Mark R. Baker,
Melanie Dani,
Elizabeth Ford,
James H. Hull,
Phang Boon Lim,
Melitta McNarry 
,
Karl Morten,
Oliver O'Sullivan ,
Etheresia Pretorius,
Betty Raman,
Demetris S. Soteropoulos,
Maxime Taquet,
Catherine N. Hall
,
Karl Morten,
Oliver O'Sullivan ,
Etheresia Pretorius,
Betty Raman,
Demetris S. Soteropoulos,
Maxime Taquet,
Catherine N. Hall
Experimental Physiology, Volume: 108, Issue: 1, Pages: 12 - 27
Swansea University Author:
Melitta McNarry
-
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DOI (Published version): 10.1113/ep090802
Abstract
Long COVID, the prolonged illness and fatigue suffered by a small proportion of those infected with SARS CoV-2, is placing an increasing burden on individuals and society. A Physiological Society virtual meeting in February 2022 brought clinicians and researchers together to discuss current understa...
| Published in: | Experimental Physiology |
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| ISSN: | 0958-0670 1469-445X |
| Published: |
Wiley
2023
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa62011 |
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| Abstract: |
Long COVID, the prolonged illness and fatigue suffered by a small proportion of those infected with SARS CoV-2, is placing an increasing burden on individuals and society. A Physiological Society virtual meeting in February 2022 brought clinicians and researchers together to discuss current understanding of long COVID mechanisms, risk factors and recovery. This review highlights the themes arising from that meeting. It considers the nature of long COVID, exploring its links with other post-viral illness such as myalgic encephalolmyelitis/ chronic fatigue syndrome, and highlighting how long COVID research can help us better support those suffering from all post-viral syndromes. Long COVID research started particularly swiftly in populations routinely monitoring their physical performance - namely the military and elite athletes. The review highlights how the high degree of diagnosis, intervention and monitoring of success in these active populations can suggest management strategies for the wider population. We then consider how a key component of performance monitoring in active populations, cardiopulmonary exercise training, has revealed long COVID-related changes in physiology – including alterations in peripheral muscle function, ventilatory inefficiency, and autonomic dysfunction. The nature and impact of dysautonomia are further discussed in relation to Postural Orthostatic Tachycardia Syndrome, fatigue and treatment strategies that aim to combat sympathetic overactivation by stimulating the vagal nerve. We then interrogate the mechanisms that underlie long COVID symptoms, with a focus on impaired oxygen delivery due to micro-clotting and disruption of cellular energy metabolism, before considering treatment strategies that indirectly or directly tackle these mechanisms. These include remote inspiratory muscle training and integrated care pathways that combine rehabilitation and drug interventions with research into long COVID healthcare access across different populations. Overall, this review showcases how physiology research reveals the changes that occur in long COVID and how different therapeutic strategies are being developed and tested to combat this condition. |
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| Keywords: |
cardiovascular, coagulation, dysautonomia, fatigue, long COVID, ME/CFS, respiratory, SARS-CoV-2 |
| College: |
Faculty of Science and Engineering |
| Funders: |
National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre
National Institute for Health Research. Grant Numbers: NIHR200937, COV-LT2-0043
UK Research and Innovation. Grant Number: KTP 11678
NIHR Applied Research Collaboration Kent, Surrey and Sussex
Welsh Government Sêr Cymru III. Grant Number: MA/KW/1457/20
The Higher Education Funding Council for Wales Research Wales Innovation Fund. Grant Numbers: FF4, ID 101390, ID 20045, ID 125132
NRF of South Africa. Grant Number: 142142
SA MRC
BHF Oxford Centre of Research Excellence. Grant Number: RE/18/3/34214
NIHR Oxford BRC
British Medical Association
AstraZeneca
European Union (Innovative Medicines Initiative). Grant Number: 116074
ME Association
MRC. Grant Numbers: MR/S026495/1, MR/V036750/1 |
| Issue: |
1 |
| Start Page: |
12 |
| End Page: |
27 |