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Diagnostics
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Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID...
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Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 6736

Special Issue Editors

Prof. Dr. Tim Duong

E-Mail Website
Guest Editor
Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, NY 10461, USA
Interests: COVID-19; machine learning; biomedical imaging; radiology
Special Issues, Collections and Topics in MDPI journals
Dr. Stephen Wang

E-Mail Website
Guest Editor
1. Albert Einstein College of Medicine, New York, NY, USA
2. Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, USA
Interests: COVID-19; machine learning; critical care

Special Issue Information

Dear Colleagues,

Newly developed neurological, psychiatric, pulmonary, vascular, renal, and cardiac symptoms and disorders have been reported months after SARS-CoV-2 infection has been resolved. The SARS-CoV-2 virus can directly damage major organs, which can trigger clinical disorders. Indirect insults secondary to the viral infection (such as respiratory distress, sepsis and other co-infections, inflammation, and over-reactive host immune responses) could also cause further damage. Persistent damage to organs such as the lung, kidney, heart, and liver after SARS-CoV-2 infection have been reported in some COVID-19 survivors. SARS-CoV-2 infection could also to trigger newly onset or accelerate the worsening of pre-existing conditions such as diabetes, hypertension, and pulmonary and neurological disorders. The sheer number of COVID-19 patients suggests that long COVID will likely impose a significant burden on healthcare systems for years to come.

We would like to invite you to contribute to this timely and exciting Special Issue on “Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions”. We thank you for your time and look forward to receiving your contributions.

Prof. Dr. Tim Duong
Dr. Stephen Wang
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • long COVID
  • SARS-CoV-2
  • COVID-19 sequela
  • post-acute sequelae of COVID-19 (PASC)
  • COVID-19 symptoms
  • multiorgan failure
  • diabetes
  • hypertension
  • shortness of breath
  • symptoms
  • diagnosis
  • prognosis
  • management

Published Papers (5 papers)

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Research

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14 pages, 4621 KiB  
Article
Incidence of Secondary Sclerosing Cholangitis in Hospitalized Long COVID-19 Patients: A Retrospective Single Center Study
by Christoph R. Werner, Stefano Fusco, Katharina Kienzle, Stefanie Döbele, Kerstin Artzner, Nisar P. Malek, Dörte Wichmann and Siri Göpel
Diagnostics 2024, 14(7), 745; https://doi.org/10.3390/diagnostics14070745 - 30 Mar 2024
Viewed by 637
Abstract
Background: SARS-CoV-2 infection and associated COVID-19 disease can lead to critical illness with a risk of developing a multiple organ failure. Subsequently, this may lead to various pathological sequelae, such as secondary sclerosing cholangitis after surviving COVID-19 (SSC-COVID). Objective: The aim is to [...] Read more.
Background: SARS-CoV-2 infection and associated COVID-19 disease can lead to critical illness with a risk of developing a multiple organ failure. Subsequently, this may lead to various pathological sequelae, such as secondary sclerosing cholangitis after surviving COVID-19 (SSC-COVID). Objective: The aim is to retrospectively analyze a cohort of hospitalized patients with first-wave (February 2020–June 2020) SARS-CoV-2 infection and persisting unclear cholangiopathy to determine the incidence of SSC-COVID and its risk factors. Results: A total of 249 patients were hospitalized at the university hospital in Tübingen, Germany, with SARS-CoV-2 infection during the first wave of the pandemic. Of these, 35.3% (88/249) required intensive care treatment; 16.5% (41/249) of them died due to the complications of COVID-19; 30.8% (64/208) of surviving patients could be followed up und were retrospectively analyzed at our center. The incidence of confirmed SSC-COVID was 7.8% (5/64). All SSC-COVID patients had an ICU stay >20 days, for invasive ventilation, positioning treatment, vasopressor treatment, but possible risk factors for SSC were not significant due to the small number of patients. Conclusions: SSC-COVID is an emerging disease in post-COVID patients with a high incidence in our single-center cohort. SSC-COVID should be considered as a differential diagnosis, if unclear cholangiopathy or cholestasis persists after SARS-CoV-2 infection. Full article
(This article belongs to the Special Issue Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions)
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13 pages, 1283 KiB  
Article
Evaluating Mortality Predictors in COVID-19 Intensive Care Unit Patients: Insights into Age, Procalcitonin, Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Ferritin Lactate Index
by Fatma Meral Ince, Ozge Alkan Bilik and Hasan Ince
Diagnostics 2024, 14(7), 684; https://doi.org/10.3390/diagnostics14070684 - 24 Mar 2024
Viewed by 709
Abstract
Introduction: Numerous studies suggest that alterations in blood parameters, such as changes in platelet, lymphocyte, hemoglobin, eosinophil, and basophil counts; increased neutrophil counts; and elevated neutrophil/lymphocyte and platelet/lymphocyte ratios, signal COVID-19 infection and predict worse outcomes. Leveraging these insights, our study seeks to [...] Read more.
Introduction: Numerous studies suggest that alterations in blood parameters, such as changes in platelet, lymphocyte, hemoglobin, eosinophil, and basophil counts; increased neutrophil counts; and elevated neutrophil/lymphocyte and platelet/lymphocyte ratios, signal COVID-19 infection and predict worse outcomes. Leveraging these insights, our study seeks to create a predictive mortality model by assessing age and crucial laboratory markers. Materials and Methods: Patients were categorized into two groups based on their hospital outcomes: 130 survivors who recovered from their Intensive Care Unit (ICU) stay (Group 1) and 74 who died (Group 2). We then developed a predictive mortality model using patients’ age, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), procalcitonin levels, and ferritin lactate (FL) index results. Results: A total of 204 patients were included. Patients in Group 2 had a notably higher mean age compared to those in Group 1 (76 ± 11 vs. 66 ± 15 years) (p < 0.001). Using specific cut-off values, our analysis revealed varying effectiveness in predicting COVID-19 mortality: Those aged over 73 years showed 74% sensitivity and 60% specificity, with an area under the curve (AUC) of 0.701. Procalcitonin levels above 0.35 ng/mL balanced true-positive and -negative identifications well, achieving an AUC of 0.752. The FL index, with a threshold of 1228 mg/dL, had 68% sensitivity and 65% specificity with an AUC of 0.707. A PLR higher than 212 resulted in 48% sensitivity and 69% specificity, with an AUC of 0.582. An NLR higher than 5.8 resulted in 55% sensitivity and 63% specificity, with an AUC of 0.640, showcasing diverse predictive accuracies across parameters. The statistical analysis evaluated the effects of age (>73), procalcitonin levels (>0.35), FL > 1228, PLR > 212, and NLR > 5.8 on mortality variables using logistic regression. Ages over 73 significantly increased event odds by 2.1 times (p = 0.05), procalcitonin levels above 0.35 nearly quintupled the odds (OR = 5.6, p < 0.001), high FL index levels more than tripled the odds (OR = 3.5, p = 0.003), a PLR > 212 significantly increased event odds by 3.5 (p = 0.030), and an NLR > 5.8 significantly increased event odds by 1.6 (p = 0.043). Conclusions: Our study highlights significant predictors of mortality in COVID-19 ICU patients, including advanced age, elevated procalcitonin, FL index levels, the PLR, and the NLR. Full article
(This article belongs to the Special Issue Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions)
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Review

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16 pages, 275 KiB  
Review
Long COVID: Long-Term Impact of SARS-CoV2
by Huda Makhluf, Henry Madany and Kenneth Kim
Diagnostics 2024, 14(7), 711; https://doi.org/10.3390/diagnostics14070711 - 28 Mar 2024
Viewed by 1333
Abstract
Four years post-pandemic, SARS-CoV-2 continues to affect many lives across the globe. An estimated 65 million people suffer from long COVID, a term used to encapsulate the post-acute sequelae of SARS-CoV-2 infections that affect multiple organ systems. Known symptoms include chronic fatigue syndrome, [...] Read more.
Four years post-pandemic, SARS-CoV-2 continues to affect many lives across the globe. An estimated 65 million people suffer from long COVID, a term used to encapsulate the post-acute sequelae of SARS-CoV-2 infections that affect multiple organ systems. Known symptoms include chronic fatigue syndrome, brain fog, cardiovascular issues, autoimmunity, dysautonomia, and clotting due to inflammation. Herein, we review long COVID symptoms, the proposed theories behind the pathology, diagnostics, treatments, and the clinical trials underway to explore treatments for viral persistence, autonomic and cognitive dysfunctions, sleep disturbances, fatigue, and exercise intolerance. Full article
(This article belongs to the Special Issue Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions)
16 pages, 1758 KiB  
Review
Pediatric COVID-19 and Diabetes: An Investigation into the Intersection of Two Pandemics
by Silvia Fotea, Cristina Mihaela Ghiciuc, Gabriela Stefanescu, Anca Lavinia Cianga, Cristina Maria Mihai, Ancuta Lupu, Lacramioara Ionela Butnariu, Iuliana Magdalena Starcea, Delia Lidia Salaru, Adriana Mocanu, Tatiana Chisnoiu, Aye Aung Thet, Lucian Miron and Vasile Valeriu Lupu
Diagnostics 2023, 13(14), 2436; https://doi.org/10.3390/diagnostics13142436 - 21 Jul 2023
Cited by 5 | Viewed by 1216
Abstract
Coronavirus disease 2019 (COVID-19) is a complex infectious disease caused by the SARS-CoV-2 virus, and it currently represents a worldwide public health emergency. The pediatric population is less prone to develop severe COVID-19 infection, but children presenting underlying medical conditions, such as diabetes [...] Read more.
Coronavirus disease 2019 (COVID-19) is a complex infectious disease caused by the SARS-CoV-2 virus, and it currently represents a worldwide public health emergency. The pediatric population is less prone to develop severe COVID-19 infection, but children presenting underlying medical conditions, such as diabetes mellitus, are thought to be at increased risk of developing more severe forms of COVID-19. Diabetic children face new challenges when infected with SARS-CoV-2. On one hand, the glycemic values become substantially more difficult to manage as COVID-19 is a predisposing factor for hyperglycemia. On the other hand, alongside other risk factors, high glycemic values are incriminated in modulating immune and inflammatory responses, leading to potentially severe COVID-19 cases in the pediatric population. Also, there are hypotheses of SARS-CoV-2 being diabetogenic itself, but this information is still to be confirmed. Furthermore, it is reported that there was a noticeable increase in the number of cases of new-onset type 2 diabetes among the pediatric population, and the complications in these patients with COVID-19 include the risk of developing autoimmune diseases under the influence of stress. Additionally, children with diabetes mellitus are confronted with lifestyle changes dictated by the pandemic, which can potentially lead to the onset or exacerbation of a potential underlying anxiety disorder or depression. Since the literature contains a series of unknowns related to the impact of COVID-19 in both types of diabetes in children, the purpose of our work is to bring together the data obtained so far and to identify potential knowledge gaps and areas for future investigation regarding COVID-19 and the onset of diabetes type 1 or type 2 among the pediatric population. Full article
(This article belongs to the Special Issue Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions)
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Other

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23 pages, 1418 KiB  
Systematic Review
Short- and Long-Term Chest-CT Findings after Recovery from COVID-19: A Systematic Review and Meta-Analysis
by Mustufa Babar, Hasan Jamil, Neil Mehta, Ahmed Moutwakil and Tim Q. Duong
Diagnostics 2024, 14(6), 621; https://doi.org/10.3390/diagnostics14060621 - 14 Mar 2024
Cited by 1 | Viewed by 1674
Abstract
While ground-glass opacity, consolidation, and fibrosis in the lungs are some of the hallmarks of acute SAR-CoV-2 infection, it remains unclear whether these pulmonary radiological findings would resolve after acute symptoms have subsided. We conducted a systematic review and meta-analysis to evaluate chest [...] Read more.
While ground-glass opacity, consolidation, and fibrosis in the lungs are some of the hallmarks of acute SAR-CoV-2 infection, it remains unclear whether these pulmonary radiological findings would resolve after acute symptoms have subsided. We conducted a systematic review and meta-analysis to evaluate chest computed tomography (CT) abnormalities stratified by COVID-19 disease severity and multiple timepoints post-infection. PubMed/MEDLINE was searched for relevant articles until 23 May 2023. Studies with COVID-19-recovered patients and follow-up chest CT at least 12 months post-infection were included. CT findings were evaluated at short-term (1–6 months) and long-term (12–24 months) follow-ups and by disease severity (severe and non-severe). A generalized linear mixed-effects model with random effects was used to estimate event rates for CT findings. A total of 2517 studies were identified, of which 43 met the inclusion (N = 8858 patients). Fibrotic-like changes had the highest event rate at short-term (0.44 [0.3–0.59]) and long-term (0.38 [0.23–0.56]) follow-ups. A meta-regression showed that over time the event rates decreased for any abnormality (β = −0.137, p = 0.002), ground-glass opacities (β = −0.169, p < 0.001), increased for honeycombing (β = 0.075, p = 0.03), and did not change for fibrotic-like changes, bronchiectasis, reticulation, and interlobular septal thickening (p > 0.05 for all). The severe subgroup had significantly higher rates of any abnormalities (p < 0.001), bronchiectasis (p = 0.02), fibrotic-like changes (p = 0.03), and reticulation (p < 0.001) at long-term follow-ups when compared to the non-severe subgroup. In conclusion, significant CT abnormalities remained up to 2 years post-COVID-19, especially in patients with severe disease. Long-lasting pulmonary abnormalities post-SARS-CoV-2 infection signal a future public health concern, necessitating extended monitoring, rehabilitation, survivor support, vaccination, and ongoing research for targeted therapies. Full article
(This article belongs to the Special Issue Symptoms, Diagnosis, Prognosis and Management of Long COVID or Post-COVID Conditions)
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