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High-dimensional characterization of post-acute sequelae of COVID-19
Open accessPublished version of a preprint
Abstract
The acute clinical manifestations of COVID-19 have been well characterized 1,2, but the post-acute sequelae of this disease have not been comprehensively described. Here we use the national healthcare databases of the US Department of Veterans Affairs to systematically and comprehensively identify 6-month incident sequelae-including diagnoses, medication use and laboratory abnormalities-in patients with COVID-19 who survived for at least 30 days after diagnosis. We show that beyond the first 30 days of illness, people with COVID-19 exhibit a higher risk of death and use of health resources. Our high-dimensional approach identifies incident sequelae in the respiratory system, as well as several other sequelae that include nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain and anaemia. We show increased incident use of several therapeutic agents-including pain medications (opioids and non-opioids) as well as antidepressant, anxiolytic, antihypertensive and oral hypoglycaemic agents-as well as evidence of laboratory abnormalities in several organ systems. Our analysis of an array of prespecified outcomes reveals a risk gradient that increases according to the severity of the acute COVID-19 infection (that is, whether patients were not hospitalized, hospitalized or admitted to intensive care). Our findings show that a substantial burden of health loss that spans pulmonary and several extrapulmonary organ systems is experienced by patients who survive after the acute phase of COVID-19. These results will help to inform health system planning and the development of multidisciplinary care strategies to reduce chronic health loss among individuals with COVID-19.
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“This is typically referred to as a post-covid syndrome, characterized by several symptoms affecting quality of life (1–5).”
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Does COVID-19 Infection Increase the Risk of Diabetes? Current Evidence
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“Post-Acute sequelae of SARS-CoV-2 infection (PASC) currently affects millions of people worldwide [1,2].”
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“Nevertheless, the sequelae pre-speci fi ed were most relevant to long COVID based on prior evidence, withincreasedriskandburdenconsistentlyreportedbeyondtheacute phase in the currently largest electronic dataset 42 – 48 , the same UK Biobank 50 , and other nationwide cohorts 49,50 .”
Donnachie, E., Hapfelmeier, A., Linde, K., Tauscher, M., Gerlach, R., Greissel, A., & Schneider, A. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-064979 · Cited by 27
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“Based on the abovementioned US Department of Veterans Affairs national healthcare databases, the same group [39] estimated a 6-month incident sequela in COVID-19 patients who survived for at least the first 30 days after the diagnosis (Table 1) [41].”
MethodLate Mortality After COVID-19 Infection Among US Veterans vs Risk-Matched Comparators
Iwashyna, T. J., Seelye, S. M., Berkowitz, T. S. Z., Pura, J. A., Bohnert, A. S. B., Bowling, C. B., Boyko, E. J., Hynes, D. M., Ioannou, G. N., Maciejewski, M. L., et al. (2023) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2023.3587 · Cited by 31
COVID-19 in the Initiation and Progression of Atherosclerosis
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Rhino-orbital mucormycosis following COVID-19 in previously non-diabetic, immunocompetent patients
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Lasting Changes to Circulating Leukocytes in People with Mild SARS-CoV-2 Infections
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“Infections severe enough to require hospitalization can have long-term health consequences, but 330 one of the unusual features of COVID-19 is that a significant proportion of mild infections have lasting 331 cardiovascular, respiratory, and neurologic consequences [26, 31].”
BackgroundDigestive involvement in the Long-COVID syndrome
Bogariu, A. M., & Dumitrascu, D. L. (2021) · Medicine and Pharmacy Reports · doi:10.15386/mpr-2340 · Cited by 31
Appelt, P. A., Sisconetto, A. T., Sucupira, K. S. M. B., Neto, E. D. M., Chagas, T. D. J., Bazán, R., Cabral, A. M., Andrade, A. D. O., de Souza, L. A. P. S., & Luvizutto, G. J. (2022) · Clinical EEG and Neuroscience · doi:10.1177/15500594221103834 · Cited by 31
“Other studies have also observed long-term cognitive and neuropsychiatric alterations after COVID-19.(63,64) This study provides evidence for substantial neurological and psychiatric impairments six months after COVID-19 infection, and these changes were not limited to patients with severe COVID-19.”
ResultInfluentialThe role of sleep and dreams in long‐ COVID
Scarpelli, S., Santis, A. D., Alfonsi, V., Gorgoni, M., Morin, C. M., Espie, C. A., Merikanto, I., Chung, F. F., Penzel, T., Bjorvatn, B., et al. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13789 · Cited by 33
“For instance, recent investigations assessed the chance of new sequelae at a 6-month follow-up showing a greater risk of long-term complications after the acute phase of the infection among non-hospitalized patients compared with control subjects, and the same pattern was observed among hospitalized COVID-19 patients…”
BackgroundResultInfluentialVakili, K. G., Fathi, M., Yaghoobpoor, S., Sayehmiri, F., Nazerian, Y., Nazerian, A., Mohamadkhani, A., Khodabakhsh, P., Réus, G. Z., Hajibeygi, R., et al. (2022) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2022.983089 · Cited by 32
Ryu, J. K., Sözmen, E. G., Dixit, K., Montaño, M., Matsui, Y., Liu, Y., Helmy, E. W., Deerinck, T. J., Yan, Z., Schuck, R., et al. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.10.12.464152 · Cited by 33
“Aberrant clots form in multiple organs causing significant morbidity and mortality in COVID-19 patients (1, 2).”
BackgroundPost-acute Sequelae of SARS-CoV-2 Infection: A Neglected Public Health Issue
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“There is an increased long-term risk of cardiovascular complications such as heart failure among patients with SARS-CoV-2 infection, even among mild cases (15).”
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“A recent study of 5 million patients revealed that COVID-19 survivors experienced a significant increase (up to 2,000%) in the risk of suffering from cardiovascular (infarction, arrhythmias), pulmonary (hypoxemia, dyspnea), metabolic (diabetes, dyslipidemia) and neurological (cognitive impairment, sleep disorders, cer…”
BackgroundGebhard, C. E., Sütsch, C., Bengs, S., Todorov, A., Deforth, M. E., Buehler, K. P., Meisel, A., Schuepbach, R. A., Zinkernagel, A. S., Brugger, S. D., et al. (2021) · medRxiv · doi:10.1101/2021.06.30.21259757 · Cited by 29
Human coronavirus OC43-elicited CD4+ T cells protect against SARS-CoV-2 in HLA transgenic mice
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“These estimates were based on evidence demonstrating that various 14 symptoms and other post-COVID-19 sequelae correlate with the severity of acute SARS-CoV-2 infection 15 [4, 21, 22].”
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Transcriptomic profiling of cardiac tissues from SARS‐CoV ‐2 patients identifies DNA damage
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“Individuals who have recovered from mild COVID-19 suffer an increased burden of arrhythmias, chest pain, heart failure and vascular complications compared to uninfected patients, and this sequelae has been accompanied by excess use of drug therapies [16].”
BackgroundCardiac Manifestations of Post-Acute COVID-19 Infection
Mohammad, K. O., Lin, A., & Rodriguez, J. B. C. (2022) · Current Cardiology Reports · doi:10.1007/s11886-022-01793-3 · Cited by 30
The global challenges of the long COVID-19 in adults and children
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“and affecting different systems and organs after the acute phase of the illness [17].”
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An Overview of Post–COVID-19 Condition (Long COVID)
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“57 This study demonstrated that a stable circulating vascular proteome is important for functional recovery.”
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Wiemken, T. L., McGrath, L. J., Andersen, K. M., Khan, F. L., Malhotra, D., Alfred, T., Nguyen, J. L., Puzniak, L., Thoburn, E., Jódar, L., et al. (2022) · Clinical Infectious Diseases · doi:10.1093/cid/ciac661 · Cited by 28
“The incidence of these syndromes varies significantly and appears to be driven by the demographic and clinical characteristics of the patient [11].”
BackgroundDiabetes after SARS-CoV-2 infection
Al‐Aly, Z. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00324-2 · Cited by 28
Baskett, W. I., Qureshi, A. I., Shyu, D., Armer, J. M., & Shyu, C. (2022) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofac683 · Cited by 27
“Previous work has briefly investigated the differences in outcomes between hospitalized COVID-19 and influenza patients [22].”
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Generalizable Long COVID Subtypes: Findings from the NIH N3C and RECOVER ProgramsPreprint
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“47 The relatively high rate of pre-COVID corticosteroid use in our study (with the lowest rate being 37.7% in cluster 4 and the two highest rates 61.3% in cluster 1 and 71.6% in cluster 6) is striking.”
BackgroundInfluentialTreatment of Long COVID symptoms with triple anticoagulant therapyPreprint
Laubscher, G. J., Khan, A., Venter, C., Pretorius, J. H., Kell, D. B., & Pretorius, E. (2023) · Research Square · doi:10.21203/rs.3.rs-2697680/v1 · Cited by 28
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Blood DNA methylation in post-acute sequelae of COVID-19 (PASC): a prospective cohort study
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“23 Another important motif identi fi ed in this analysis is MITF, which has been previously reported as part of the macrophage top transcriptional programs de fi ning healthy-to-severe COVID-19 phenotype transition.”
de Lima, I. C., de Menezes, D. C., Uesugi, J. H. E., Bichara, C. N. C., Vasconcelos, P. F. D. C., Quaresma, J. A. S., & Falcão, L. F. M. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20075281 · Cited by 28
The Aftermath of COVID-19: Exploring the Long-Term Effects on Organ Systems
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“US research that used electronic health data from the Veterans Health Administration to perform a complete assessment of long-COVID found that COVID-19 increased the risk of CKD, with the largest risk among individuals with severe disease [71].”
MethodCardiovascular effects of the post-COVID-19 condition
Goerlich, E., Chung, T., Hong, G. H., Metkus, T. S., Gilotra, N. A., Post, W. S., & Hays, A. G. (2024) · Nature Cardiovascular Research · doi:10.1038/s44161-023-00414-8 · Cited by 27
“21,110–112).”
A practical framework for Long COVID treatment in primary care
Brode, W. M., & Melamed, E. (2024) · Life Sciences · doi:10.1016/j.lfs.2024.122977 · Cited by 27
CCL2-mediated endothelial injury drives cardiac dysfunction in long COVID
Thomas, D., Noishiki, C., Gaddam, S., Wu, D., Manhas, A., Liu, Y., Tripathi, D., Kathale, N. D., Adkar, S. S., Garhyan, J., et al. (2024) · Nature Cardiovascular Research · doi:10.1038/s44161-024-00543-8 · Cited by 28
Specific Treatment Exists for SARS-CoV-2 ARDS
Kanwar, B. A., Khattak, A., Lee, J., Balentine, J., Kast, R. E., Oh, S.-S., Sergi, C., & Lee, J. (2021) · Vaccines · doi:10.3390/vaccines9060635 · Cited by 28
“Recently, incident sequelae have been identified in the respiratory system and several others, including the nervous system, leading to neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, musculoskeletal pain, and anemia, with…”
Backgroundde Dios, C., Fernandes, B. S., Whalen, K., Bandewar, S., Suchting, R., Weaver, M. F., & Selvaraj, S. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.109176 · Cited by 28
“These data emphasize the need for planning in health systems to develop long-term strategies that involve multidisciplinary teams to improve the wellbeing of individuals with COVID-19 and others who are impacted by the disease (Al-Aly et al., 2021).”
Castro, V. M., Rosand, J. M., Giacino, J. T., McCoy, T. H., & Perlis, R. H. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01646-z · Cited by 22
Active Enrichment of Nanoparticles for Ultra-Trace Point-of-Care COVID-19 Detection
Luo, Y., Zhou, M., Fan, C. G., Song, Y., Wang, L., Xu, T., & Zhang, X. (2023) · Analytical Chemistry · doi:10.1021/acs.analchem.2c05381 · Cited by 26
Sjöland, H., Lindgren, M., Toska, T., Hansson, P., Sandblad, K. G., Alex, C., Bjorck, L. M., Cronie, O., Björk, J., Lundberg, C. E., et al. (2023) · Research and Practice in Thrombosis and Haemostasis · doi:10.1016/j.rpth.2023.100284 · Cited by 26
Zhou, J., Wang, Y., & Xu, R. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1429848 · Cited by 27
Postacute Sequelae of COVID (PASC or Long COVID): An Evidenced-Based Approach
Griffin, D. O. (2024) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofae462 · Cited by 29
Kozak, R. A., Armstrong, S. M., Salvant, E., Ritzker, C., Feld, J. J., Biondi, M. J., & Tsui, H. (2021) · Pathogens · doi:10.3390/pathogens10101246 · Cited by 25
“Discussion Post-acute sequelae from COVID-19 are increasingly recognized as a significant cause of morbidity [9,11].”
InfluentialLong-term complications of COVID-19 in ICU survivors: what do we know?
Rasulo, F. A., Piva, S., & Latronico, N. (2021) · Minerva Anestesiologica · doi:10.23736/s0375-9393.21.16032-8 · Cited by 32
Postacute Sequelae of COVID-19 Critical Illness
Schwab, K. E., Schwitzer, E., & Qadir, N. (2022) · Critical Care Clinics · doi:10.1016/j.ccc.2022.01.001 · Cited by 26
“Beyond readmission and death, survivors also have decreased HRQL, increased outpatient health care visits, and increased pharmacotherapy utilization of opioid pain medications, antidepressants, anxiolytics, and more.(78,79)”
Lemos, M. M., Cavalini, G. R., Henrique, C. R. P., Perli, V. A. S., Marchiori, G. D. M., Marchiori, L. L. D. M., Sordi, A. F., de Moraes, S. M. F., Ramos, S. D. P., Valdés-Badilla, P., et al. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.949351 · Cited by 28
“Early diagnosis and targeted interventions for patient recovery can provide better outcomes for disease sequelae and complications of long-term post-COVID or COVID-19 syndrome (Al-Aly et al., 2021), especially in patients with risk factors for respiratory and cardiovascular alterations.”
BackgroundFritsche, L. G., Jin, W., Admon, A. J., & Mukherjee, B. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12041328 · Cited by 24
Wu, K., Zhang, Y., Austin, S. R., Yin‐Declue, H., Byers, D. E., Crouch, E. C., & Holtzman, M. J. (2023) · American Journal Of Pathology · doi:10.1016/j.ajpath.2023.02.005 · Cited by 25
“3,8,9 The present fi ndings also provide additional insights in comparison to previous studies of AT2 cells.”
Use of either transcranial or whole‐body photobiomodulation treatments improves COVID ‐19 brain fog
Bowen, R., & Arany, P. R. (2023) · Journal of Biophotonics · doi:10.1002/jbio.202200391 · Cited by 25
Leitman, M., Fuchs, S., Tyomkin, V., Hadanny, A., Zilberman-Itskovich, S., & Efrati, S. (2023) · Scientific Reports · doi:10.1038/s41598-023-36570-x · Cited by 25
Dagliati, A., Strasser, Z. H., Abad, Z. S. H., Klann, J. G., Wagholikar, K. B., Mesa, R., Visweswaran, S., Morris, M. M., Luo, Y., Henderson, D. W., et al. (2023) · EClinicalMedicine · doi:10.1016/j.eclinm.2023.102210 · Cited by 27
Sanhueza, S., Vidal, M., Hernandez, M. A., Henríquez‐Beltrán, M., Cabrera, C., Quiroga, R. A., Antilef, B., Aguilar, K. P., Castillo, D. A., Llerena, F., et al. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1271863 · Cited by 25
“…disorders, which have already been identified among subsequent COVID-19 patients, for example, lipid disorders with a high load of LDL cholesterol, total cholesterol, and triglycerides, liver problems, a high concentration of glycosylated hemoglobin, diabetes mellitus, or obesity (102, 103).”
BackgroundGrant, R. A., Poor, T. A., Sichizya, L., Diaz, E., Bailey, J. I., Soni, S., Senkow, K. J., Pérez-Leonor, X. G., Abdala‐Valencia, H., Lu, Z., et al. (2024) · JCI Insight · doi:10.1172/jci.insight.178859 · Cited by 27
Profiling post-COVID syndrome across different variants of SARS-CoV-2Preprint
Canas, L. S., Molteni, E., Deng, J., Sudre, C. H., Murray, B. A. K., Kerfoot, E., Antonelli, M., Chen, L., Rjoob, K. W. Y., Pujol, J. C., et al. (2022) · medRxiv · doi:10.1101/2022.07.28.22278159 · Cited by 25
Li, Y.-H., Qin, S.-J., Dong, L., Qiao, S., Wang, X., Yu, D.-S., Gao, P.-Y., Hou, Y., Quan, S.-Z., Li, Y., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-46692-z · Cited by 22
“It might be due to infected variant and participant differences, as female, pre-existing medical conditions, and severity during acute infection were risk factors for developing long COVID 13,43,44 .”
Miller, K. E. M., Hart, J. L., Rosania, M. U., & Coe, N. B. (2024) · Demography · doi:10.1215/00703370-11383976 · Cited by 24
Li, X., Edén, A., Malwade, S., Cunningham, J. L., Bergquist, J., Weidenfors, J. A., Sellgren, C. M., Engberg, G., Piehl, F., Gisslén, M., et al. (2024) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2024.11.031 · Cited by 24
Neuroimaging in patients with COVID-19: a neuroradiology expert group consensus
Kremer, S., Gerevini, S., Ramos, A., Lersy, F., Yousry, T. A., Vernooij, M. W., Anzalone, N., & Jäger, H. R. (2022) · European Radiology · doi:10.1007/s00330-021-08499-0 · Cited by 27
“dysregulation and systemic inflammation, or post-traumatic stress [23, 24].”
BackgroundBusatto, G. F., de Araújo, A. L., Castaldelli-Maia, J. M., Damiano, R. F., Imamura, M., Guedes, B. F., Pinna, F. R., Sawamura, M. V. Y., Mancini, M. C., da Silva, K. R., et al. (2022) · Psychological Medicine · doi:10.1017/s0033291722001374 · Cited by 25
After the virus has cleared—Can preclinical models be employed for Long COVID research?
Jansen, E. B., Orvold, S. N., Swan, C. L., Yourkowski, A., Thivierge, B. M., Francis, M. E., Ge, A., Rioux, M. L., Darbellay, J., Howland, J. G., et al. (2022) · PLoS Pathogens · doi:10.1371/journal.ppat.1010741 · Cited by 29
McAuley, H., Evans, R. A., Bolton, C. E., Brightling, C. E., Chalmers, J. D., Docherty, A. B., Elneima, O., Greenhaff, P. L., Gupta, A., Harris, V. C., et al. (2023) · EClinicalMedicine · doi:10.1016/j.eclinm.2023.101896 · Cited by 26
“Other potential mechanistic factors not explored here but which have been seen in post-COVID populations include prolonged in fl ammation 25 and both persistent cardiac 26 and respiratory damage 27 all of which may contribute to reduced physical performance and the cycle of exhaustion and inactivity.”
Hüfner, K., Tymoszuk, P., Sahanic, S., Luger, A. K., Boehm, A., Pizzini, A., Schwabl, C., Koppelstätter, S., Kurz, K., Aßhoff, M., et al. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111234 · Cited by 29
“Mounting evidence suggests that post-COVID-19 condition occurs independently of COVID-19 severity, cardiopulmonary findings, biochemical and immunity markers [4,19], and proposes demographic, acute disease-related [2,10,11,19], mental health and mental stress [5,6,19,22] as explanatory factors.”
Stollings, J. L., Poyant, J., Groth, C. M., Rappaport, S. H., Kruer, R. M., Miller, E., Whitten, J. A., McIntire, A. M., McDaniel, C. M., Betthauser, K. D., et al. (2023) · Journal of Intensive Care Medicine · doi:10.1177/08850666231176194 · Cited by 25
“Similar to PICS, many survivors of critical illness secondary to COVID-19 are developing fatigue, dyspnea, cough, headache, loss of taste or smell, cognitive, physical, and mental health impairment which is being termed post acute sequelae of SARS-CoV-2 (PASC) infection or long COVID.(7) An ICU recovery center (ICU-RC…”
BackgroundThe functional and structural changes in the hippocampus of COVID-19 patients
Nouraeinejad, A. (2023) · Acta Neurologica Belgica · doi:10.1007/s13760-023-02291-1 · Cited by 28
The Long-COVID autonomic syndrome in hospitalized patients: A one-year prospective cohort study
Rigo, S., Barbic, F., Khalaf, K., Bisoglio, A., Pani, M., Minonzio, M., Rinaldi, L., Ciccarelli, M., Bordoni, M. G., Verzeletti, P., et al. (2023) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2023.08.018 · Cited by 24
Løkke, F. B., Hansen, K. S., Dalgaard, L., Öbrink-Hansen, K., Schiøttz‐Christensen, B., & Leth, S. (2023) · Infectious Diseases Now · doi:10.1016/j.idnow.2023.104779 · Cited by 25
Qureshi, A. I., Baskett, W. I., Huang, W., Naqvi, S. H., & Shyu, C.-R. (2022) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofac115 · Cited by 23
“Occurrence of new-onset dementia may increase the burden of disability among survivors of SARS-CoV-2 infection [1, 2].”
Strasser, Z. H., Dagliati, A., Abad, Z. S. H., Klann, J. G., Wagholikar, K. B., Mesa, R., Visweswaran, S., Morris, M. M., Luo, Y., Henderson, D. W., et al. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000301 · Cited by 23
Szewczyk, W., Fitzpatrick, A. L., Fossou, H., Gentile, N. L., Sotoodehnia, N., Vora, S. B., West, T. E., Bertolli, J., Cope, J. R., Lin, J.-M. S., et al. (2024) · BMC Infectious Diseases · doi:10.1186/s12879-024-10158-w · Cited by 31
Melkumyants, A. M., Buryachkovskaya, L. I., Lomakin, N. V., Antonova, O. A., & Serebruany, V. L. (2021) · Thrombosis and Haemostasis · doi:10.1055/a-1551-9911 · Cited by 23
Chronic SARS-CoV-2, a Cause of Post-acute COVID-19 Sequelae (Long-COVID)?
O’Donnell, J. S., & Chappell, K. J. (2021) · Frontiers in Microbiology · doi:10.3389/fmicb.2021.724654 · Cited by 24
Immunometabolic Dysregulation at the Intersection of Obesity and COVID-19
Khwatenge, C. N., Pate, M., Miller, L. C., & Sang, Y. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.732913 · Cited by 22
Stefan, N., Sippel, K., Heni, M., Fritsche, A., Wagner, R. J., Jakob, C. E. M., Preissl, H. T., von Werder, A., Khodamoradi, Y., Borgmann, S., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.875430 · Cited by 25
“529)-sars-cov-2-variant-of-concern Fourth, most recently it was shown that, beyond the acute illness, substantial burden of health loss, including disorders of lipid metabolism, diabetes and obesity, is observed in COVID19 survivors (52, 53).”
BackgroundCardiometabolic syndrome — an emergent feature of Long COVID?
Frere, J. J., & tenOever, B. R. (2022) · Nature reviews. Immunology · doi:10.1038/s41577-022-00739-8 · Cited by 23
Ogungbe, O., Gilotra, N. A., Davidson, P. M., Farley, J. E., Himmelfarb, C. D., Post, W. S., & Commodore-Mensah, Y. Y. (2022) · Open Heart · doi:10.1136/openhrt-2022-002084 · Cited by 23
Long-Term effects of COVID-19: a review of current perspectives and mechanistic insights
Lenz, C., Slack, M., Shea, K. M., Reinert, R. R., Taysi, B. N., & Swerdlow, D. L. (2023) · Critical Reviews in Microbiology · doi:10.1080/1040841x.2023.2190405 · Cited by 28
“In a US DVA electronic healthcare database study of > 180,000 patients, burden of long COVID manifestations was higher in veterans with poor health status and increased by acute COVID-19 severity (Xie et al. 2021).”
BackgroundInfluential‘I'm still here, I'm alive and breathing’: The experience of Black Americans with long COVID
Bergmans, R. S., Chambers‐Peeple, K., Yu, C., Xiao, L. Z., Wegryn‐Jones, R., Martin, A., Dell’Imperio, S., Aboul‐Hassan, D., Williams, D. A., Clauw, D. J., et al. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16733 · Cited by 24
Yendewa, G., Perez, J. A., Patil, N., & McComsey, G. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1297195 · Cited by 16
“Nonetheless, overall, these fi ndings are consistent with fi ndings from multiple studies, which have reported one or more new or persistent physical and/or mental health conditions in 6% to 90% of COVID-19 survivors up to one year after the initial acute infection (4 – 9, 28, 29).”
BackgroundResultElevated Arterial Blood Pressure as a Delayed Complication Following COVID-19—A Narrative Review
Bielecka, E., Sielatycki, P. J., Pietraszko, P., Zapora-Kurel, A., & Zbroch, E. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25031837 · Cited by 28
Understanding the Post COVID-19 Condition (Long COVID) in Adults and the Expected Burden for Ontario
Quinn, K. L., Katz, G. M., Bobos, P., Sander, B., McNaughton, C., Cheung, A., Herridge, M., Atzema, C., Born, K. B., Chan, C., et al. (2022) · doi:10.47326/ocsat.2022.03.65.1.0 · Cited by 24
Körper, S., Grüner, B., Zickler, D., Wiesmann, T., Wuchter, P., Blasczyk, R., Zacharowski, K. D., Spieth, P. M., Tonn, T., Rosenberger, P., et al. (2022) · Journal of Clinical Investigation · doi:10.1172/jci163657 · Cited by 20
“Patients who had to be treated in hospital or patients who required intensive care have a higher risk of long COVID-19 than patients with a mild to moderate course who could be treated on an out-patient basis (32, 33).”
Metadata
- Authors
- Al-Aly, Z., Xie, Y., & Bowe, B.
- Affiliations
- VA St. Louis Health Care System (US)
- Venue
- Nature
- Published
- 2021-04-22
- Volume
- 594
- Issue
- 7862
- Pages
- 259-264
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W3153493739
- Cited by
- 1,518
- References
- 46
- Citations by year
- 2026: 95 · 2025: 170 · 2024: 268 · 2023: 365 · 2022: 391 · 2021: 228
- FWCI
- 149.17
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nature (publishedVersion)
- Research Square (acceptedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Society of Nephrology
- McDonnell Center for Systems Neuroscience
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- post-COVID-19 sequelae, long COVID, COVID-19 mortality, health resource utilization, pulmonary sequelae, neurocognitive disorders, mental illness, metabolic disorders, cardiovascular disease, gastrointestinal diseases, fatigue, musculoskeletal pain, anemia, medication use, laboratory abnormalities, disease severity, intensive care unit admission, veterans
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Drug Treatment, Post-Acute COVID-19 Syndrome, Female, Hospitalization, Humans, Influenza, Human, Male, Outpatients, Risk, Time Factors, United States, United States Department of Veterans Affairs, Cohort Studies, Databases, Factual, Electronic Health Records, Datasets as Topic
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