May 2022 - Treatment
This is a new literature review updated on may 2022. In case some essential information is missing, please contact us at: rafael@hcuge.ch.
Dietary Recommendations for Post-COVID-19 Syndrome
Barrea L, Grant WB, Frias-Toral E, Vetrani C, Verde L, de Alteriis G, Docimo A, Savastano S, Colao A, Muscogiuri G. Nutrients. 2022 Mar 20;14(6):1305. doi: 10.3390/nu14061305. PMID: 35334962; PMCID: PMC8954128.
Link to study : Dietary Recommendations for Post-COVID-19 Syndrome
Gut Microbiota Disruption in COVID-19 or Post-COVID Illness Association with severity biomarkers: A Possible Role of Pre / Pro-biotics in manipulating microflora
Alharbi KS, Singh Y, Hassan Almalki W, Rawat S, Afzal O, Alfawaz Altamimi AS, Kazmi I, Al-Abbasi FA, Alzarea SI, Singh SK, Bhatt S, Chellappan DK, Dua K, Gupta G.. Chem Biol Interact. 2022 Mar 21;358:109898. doi: 10.1016/j.cbi.2022.109898. Epub ahead of print. PMID: 35331679; PMCID: PMC8934739.
Multi-Level Immune Support by Vitamins C and D during the SARS-CoV-2 Pandemic (Soutien immunitaire à plusieurs niveaux par les vitamines C et D pendant la pandémie de SARS-CoV-2)
Carr AC, Gombart AF. Nutrients. 2022 Feb 6;14(3):689. doi: 10.3390/nu14030689. PMID: 35277048; PMCID: PMC8840673.
Link to study : Multi-Level Immune Support by Vitamins C and D during the SARS-CoV-2 Pandemic
Role of medicinal plants in inhibiting SARS-CoV-2 and in the management of post-COVID-19 complications
Mukherjee PK, Efferth T, Das B, Kar A, Ghosh S, Singha S, Debnath P, Sharma N, Bhardwaj PK, Haldar PK. Phytomedicine. 2022 Jan 5;98:153930. doi: 10.1016/j.phymed.2022.153930. Epub ahead of print. PMID: 35114450; PMCID: PMC8730822.
The present review compiled pharmacological information of more than 50 herbal medicines, which potentially combat the viral infection and post-COVID complications through different mechanisms. Most information is rather based on some in-vitro and in-silico investigations and anecdotal clinical data. The basic molecular mechanisms are also unexplored yet.
It should be noted that there is still no convincing clinical evidence on the activity of most herbal products. Unlike modern medicines, herbs are often claimed to be non-toxic, due to their natural origin and long-term use as traditional medicines. However, numerous difficulties can be occurred due to the adulteration, substitution, contamination, misidentification, intrinsic toxicity, drug-herb interactions and lack of standardization. For that reasons, pre-clinical evaluation of therapeutic effectiveness is a great concern for the further development of safe and effective herbal treatments.
The reviewed data shows that A. paniculata, Cassia tora L., Phyllanthus emblica L., G. glabra, Azadirachta indica A.Juss., Morus alba L., P. longum, Nigella sativa L., Camellia sinensis (L.) Kuntze, U. dioica, C. longa, T. terrestris, Chrysanthemum indicum Thunb., Astragalus propinquus Schischkin, S. miltiorrhiza, Salvia officinalis L., C. zeylanicum, P. nigrum, Z. officinale, Mucuna pruriens (L.) DC., Psoralea corylifolia L., Ecklonia cava, T. cordifolia, Syzygium aromaticum (L.) Merr. & L.M.Perry, W. somnifera were found to have enriched biological benefits due to their varied secondary metabolites and can be beneficial for post-acute symptoms. This may provide a more rational phytotherapeutic choice to improve the general well-being effectively by counteracting the biological complications caused by for patients affected with COVID-19.
Link to study : Role of medicinal plants in inhibiting SARS-CoV-2 and in the management of post-COVID-19 complications
Outpatient Pulmonary Rehabilitation in Patients with Long COVID Improves Exercise Capacity, Functional Status, Dyspnea, Fatigue, and Quality of Life
Nopp S, Moik F, Klok FA, Gattinger D, Petrovic M, Vonbank K, Koczulla AR, Ay C, Zwick RH. Respiration. 2022 Feb 24:1-9. doi: 10.1159/000522118. Epub ahead of print. PMID: 35203084.
In this prospective observational cohort study, patients admitted to an outpatient pulmonary rehabilitation center due to persistent symptoms after COVID-19 were evaluated. The primary endpoint was change in 6-min walk distance (6MWD) after undergoing a 6-week interdisciplinary individualized pulmonary rehabilitation program. Secondary endpoints included change in the post-COVID-19 functional status (PCFS) scale, Borg dyspnea scale, Fatigue Assessment Scale, and quality of life. Further, changes in pulmonary function tests were explored. Of 64 patients undergoing rehabilitation, 58 patients (mean age 47 years, 43% women, 38% severe/critical COVID-19) were included in the study. At baseline (i.e., in mean 4.4 months after infection onset), mean 6MWD was 584.1 m (±95.0), and functional impairment was graded in median at 2 (IQR, 2-3) on the PCFS. On average, patients improved their 6MWD by 62.9 m (±48.2, p < 0.001) and reported an improvement of 1 grade on the PCFS scale. Accordingly, authors observed significant improvements across secondary endpoints including presence of dyspnea (p < 0.001), fatigue (p < 0.001), and quality of life (p < 0.001). Also, pulmonary function parameters (forced expiratory volume in 1 s, lung diffusion capacity, inspiratory muscle pressure) significantly increased during rehabilitation.
ESCMID rapid guidelines for assessment and management of long COVID
Yelin D, Moschopoulos CD, Margalit I, Gkrania-Klotsas E, Landi F, Stahl JP, Yahav D. Clin Microbiol Infect. 2022 Feb 16:S1198-743X(22)00092-1. doi: 10.1016/j.cmi.2022.02.018. Epub ahead of print. PMID: 35182760; PMCID: PMC8849856.
Authors performed a search of the literature to provide recommendation guidelines for the assessment and management of post-COVID condition. Evidence was insufficient to provide any recommendation other than conditional guidance. The panel recommends considering routine blood tests, chest imaging and pulmonary functions tests for patients with persistent respiratory symptoms at 3 months. Other tests should be performed mainly to exclude other conditions according to symptoms. For management, no evidence-based recommendations could be provided. Physical and respiratory rehabilitation should be considered. On the basis of limited evidence, the panel suggests designing high quality prospective clinical studies/trials, including a control group, to further evaluate assessment and management of individuals with persistent symptoms of COVID-19.
Link to study: ESCMID rapid guidelines for assessment and management of long COVID
Endocrine Follow-Up During Post-Acute COVID-19: Practical Recommendations Based On Available Clinical Evidence
Pal R, Joshi A, Bhadada SK, Banerjee M, Vaikkakara S, Mukhopadhyay S. Endocr Pract. 2022 Feb 11:S1530-891X(22)00044-1. doi: 10.1016/j.eprac.2022.02.003. Epub ahead of print. PMID: 35158058; PMCID: PMC8832848.
COVID-19 can lead to new-onset hyperglycemia/diabetes mellitus or worsening of dysglycemia in patients with pre-existing diabetes mellitus. Hence, those with pre-existing diabetes mellitus should ensure optimum glycemic control in the post-COVID period. New-onset diabetes mellitus has been described post-acute COVID-19; hence, a selected group of patients (age <70 years, those requiring ICU admission) might be screened for the same at 3 months. Thyroid dysfunction (sick euthyroid syndrome, atypical thyroiditis) and adrenal insufficiency have been described in COVID-19; however, thyroid/adrenal functions usually normalize on follow-up, hence, widespread screening post-acute COVID-19 should not be recommended. Pituitary apoplexy and male hypogonadism have rarely been documented in COVID-19; therefore, appropriate follow-up might be undertaken as per the clinical context. Hypocalcemia during COVID-19 is not uncommon, however, routine estimation of serum calcium post-COVID is not warranted. The recommendations herein provide a rational approach that would be expected to guide physicians to better delineate and manage the endocrine sequelae during post-acute COVID-19.
Link to study : Endocrine Follow-Up During Post-Acute COVID-19: Practical Recommendations Based On Available Clinical Evidence
Therapeutics for COVID-19 and post COVID-19 complications: An update
Basu D, Chavda VP, Mehta AA. Curr Res Pharmacol Drug Discov. 2022;3:100086. doi: 10.1016/j.crphar.2022.100086. Epub 2022 Feb 4. PMID: 35136858; PMCID: PMC8813675.
In this review, a consolidated summary of the therapeutic developments against SARS-CoV-2 are depicted along with an overview of effective management of post COVID-19 complications.
Link to study: Therapeutics for COVID-19 and post COVID-19 complications: An update
Long-COVID diagnosis: From diagnostic to advanced AI-driven models
Cau R, Faa G, Nardi V, Balestrieri A, Puig J, Suri JS, SanFilippo R, Saba L. Eur J Radiol. 2022 Jan 19;148:110164. doi: 10.1016/j.ejrad.2022.110164. Epub ahead of print. PMID: 35114535; PMCID: PMC8791239.
Link to study: Long-COVID diagnosis: From diagnostic to advanced AI-driven models
