Prevalence and risk factors associated with long COVID symptoms in children and adolescents in a southern province of Vietnam

Objective:To investigate the prevalence and risk factors associated with long COVID symptoms among children and adolescents who have recovered from COVID-19.Methods:This study applied a cross-sectional approach within community settings in a southern province of Vietnam.A structured questionnaire featuring socio-demographic information and common long COVID symptoms was employed.Phi correlation coefficients assessed associations among pairs of long COVID symptoms.Additionally,multivariable logistic regression models were performed to investigate the risk factors of long COVID in recovered COVID-19 children and adolescents.Results:Among 422 participants,39.3%reported long COVID symptoms,with a prevalence of 45.2%(SD=0.5)in children and 22.2%(SD=0.4)in adolescents.Common symptoms reported were cough 34.6%(SD=0.5),fatigue 20.6%(SD=0.4),shortness of breath 10.9%(SD=0.3),and lack of appetite 6.6%(SD=0.3).Concerning risk factors of long COVID,a higher risk was observed among demographic groups,including girls(OR 1.25,95%CI 1.15-1.37;P<0.001,reference:boys),children compared to adolescents(OR 1.24,95%CI 1.12-1.37;P<0.001),overweight individuals(OR 1.14,95%CI 1.02-1.27;P=0.018,reference:healthy weight),and participants without any COVID-19 vaccination(OR 1.36,95%CI 1.20-1.54;P<0.001),or have received only one single dose(OR 1.35,95%CI 1.10-1.64;P=0.004)compared to those who have received two doses.Besides,patients with a COVID-19 treatment duration exceeding two weeks also had a higher risk of long COVID(OR 1.32,95%CI 1.09-1.60;P=0.003)than those who recovered less than seven days.Conclusions:The insights from this study provide crucial guidance for predicting the factors associated with the occurrence of long COVID in pediatric patients,contributing to strategic interventions aimed at mitigating the long COVID risks among children and adolescents in Vietnam.

Efficacy and Safety of Lianhua Qingke Tablets in the Treatment of Long Coronavirus Disease (COVID) Cough: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Clinical Study

Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based research evaluating their effect on long coronavirus disease(COVID)cough.A randomized,double-blind,placebo-controlled,multicenter clinical study was conducted among patients with long COVID cough from 19 hospitals and 23 community health centers in China.Patients were randomized 1:1 to receive either Lianhua Qingke tablets or placebo orally for 14 days(four tablets,1.84 g,three times a day).The primary endpoint indicator was the disappearance of cough,with the remission of cough also considered.Among 482 randomized patients,480(full analysis set 480;per-protocol set 470;safety set 480)were included in the primary analysis.According to the full analysis,the time until cough disappearance was significantly shorter in the trial group than in the control group,with a significant increase in the 14-day cough disappearance rate.Accordingly,the time to cough remission was significantly shorter in the trial group than in the control group.The change in the total symptom score was significantly greater in the trial group than in the control group on days 7 and 14,consistent with the results indicated by the visual analog scale(VAS)and cough evaluation test(CET)scores.No serious adverse events were recorded during the study.Lianhua Qingke tablets significantly improved the clinical symptoms of patients with long COVID cough.

Short-Term and Long-Term Outcomes among COVID-19 Survivors: A Multi-Center Prospective Observational Study

Background: Since the outbreak of the COVID-19 pandemic caused massive case fatalities across the world, people have been left with significant physical and mental disabilities, which has had an adverse impact on their quality of life. The objective of this study is to measure the short-term and long-term outcomes among COVID-19 survivors. Methods: This is a six-month-long multicentre prospective observational study, carried out in four specialized hospitals in the capital city Dhaka, where six hundred participants were enrolled by non-probability convenience sampling. Data were collected through three structured interviews, and follow-ups were done during discharge, at 1st month, and 6th month. An analytical study was done on demographic variables, socio-economic conditions, physical findings and outcomes. Data were analysed using Statistical Package for Social Sciences (SPSS). Results: A total of 600 participants were enrolled. The mean age was 49.83. Many participants belong to the age range of 31 to 40 years. More than two-thirds (72.7%) of participants were male, whereas 27.30% were female. Most patients admitted had mild and moderate COVID-19 symptoms (40% and 58%, respectively). Among short-term COVID complications, it was found that 43.3% of the participants complained of fatigue, 32.6% of depression, 24.7% of sleep disturbance, 19% of anxiety and, 5% memory loss. In long-term COVID complications the number reduced significantly: 5% of the participants complained of fatigue, 10% of depression, 2.7% of sleep disturbance, 7.3% of anxiety and, 2.7% memory loss. The severity of lung parenchymal disease also reduced in long term COVID symptoms. The study found a statistically significant relationship between age groups and CT severity index (χ2 = 9.458, p = 0.032). Most patients (29.2%) in the under-30 age group had a CT Severity Index score of 2 & 3 (29.2%). The important CT Severity Index scores for individuals aged 30 to 60 years were 3 and 4, accounting for 37.7% and 33.3%, respectively. In the over-60 age group, 40.8% of patients showed a CT Severity Index score of 4, showing a range of 51% - 75%. Conclusion: This study found that fatigue, depression, and sleep disturbances are prevalent among COVID-19 survivors;however, these symptoms generally reduce over time. Lung problems improved;however, some patients suffered from persistent effects. Older patients, especially those with pre-existing conditions, suffer from more severe outcomes. These findings underscore the need for ongoing care for COVID-19 survivors.

Nasogastric tube syndrome induced by an indwelling long intestinal tube

The nasogastric tube(NGT) has become a frequently used device to alleviate gastrointestinal symptoms. Nasogastric tube syndrome(NTS) is an uncommon but potentially life-threatening complication of an indwelling NGT. NTS is characterized by acute upper airway obstruction due to bilateral vocal cord paralysis. We report a case of a 76-year-old man with NTS, induced by an indwelling long intestinal tube. He was admitted to our hospital for treatment of sigmoid colon cancer. He underwent sigmoidectomy to release a bowel obstruction, and had a long intestinal tube inserted to decompress the intestinal tract. He presented acute dyspnea following prolonged intestinal intubation, and bronchoscopy showed bilateral vocal cord paralysis. The NGT was removed immediately, and tracheotomy was performed. The patient was finally discharged in a fully recovered state. NTS be considered in patients complaining of acute upper airway obstruction, not only with a NGT inserted but also with a long intestinal tube.

Drugs to be avoided in patients with long QT syndrome:Focus on the anaesthesiological management

Long QT syndrome incidence is increasing in general population.A careful pre-,peri-and post-operative management is needed for patients with this syndrome because of the risk of Torsades de Pointes and malignant arrhythmias.The available data regarding prevention of lethal Torsades de Pointes during anesthesia in patients with long QT syndrome is scant and conflicting:only case reports and small case series with different outcomes have been published.Actually,there are no definitive guidelines on pre-,peri-and post-operative anesthetic management of congenital long QT syndrome.Our review focuses on anesthetic recommendations for patients diagnosed with congenital long QT syndrome furnishing some key points for preoperative optimization,intraoperative anesthetic agents and postoperative care plan,which could be the best for patients with c-long QT syndrome who undergo surgery.

Main factors influencing long-term outcomes of liver transplantation in 2022

Liver transplant(LT)outcomes have markedly improved in the recent decades,even if long-term morbidity and mortality are still considerable.Most of late deaths are independent from graft function and different comorbidities,including complications of metabolic syndrome and de novo neoplasms,seem to play a key role in determining long-term outcomes in LT recipients.This review discusses the main factors associated with late mortality and suggests possible strategies to improve long-term management and follow-up after liver transplantation.In particular,the reduction of drug toxicity,the use of tools to identify high-risk patients,and setting up a multidisciplinary team also for long-term management of LT recipients may further improve survival after liver transplantation.

Hyperbaric Oxygen Treatment for Long COVID:From Molecular Mechanism to Clinical Practice

Long COVID symptoms typically occur within 3 months of an initial COVID-19 infection,last for more than 2 months,and cannot be explained by other diagnoses.The most common symptoms include fatigue,dyspnea,coughing,and cognitive impairment.The mechanisms of long COVID are not fully understood,but several hypotheses have been put forth.These include coagulation and fibrosis pathway activation,inflammatory and autoimmune manifestations,persistent virus presence,and Epstein-Barr virus reactivation.Hyperbaric oxygen therapy(HBOT)is a therapeutic method in which a person inhales 100%oxygen under pressure greater than that of the atmosphere.HBOT has some therapeutic effects,including improvement of microcirculation,inhibition of cytokine release leading to a reduction in inflammatory responses,inhibition of autoimmune responses,and promotion of neurological repair.Several clinical trials have been carried out using HBOT to treat long COVID.The results suggest that HBOT helps to improve symptom severity,reduce symptom duration,and enhance patients’quality of life.It is believed that HBOT is an effective option for patients with long COVID,which is worth actively promoting.

Anti-fatigue effect from Ginseng Radix et Rhizoma:a suggestive and promising treatment for long COVID

Two years after the coronavirus disease 2019(COVID-19)outbreak,an increasing number of patients continue to suffer from long COVID(LC),persistent symptoms,and/or delayed or long-term complications beyond the initial 4 weeks from the onset of symptoms.Constant fatigue is one of the most common LC symptoms,leading to severely reduced quality of life among patients.Ginseng Radix et Rhizoma—known as the King of Herbs in traditional Chinese medicine—has shown clinical anti-fatigue effects.In this review,we summarize the underlying anti-fatigue mechanisms of Ginseng Radix et Rhizoma extracts and their bioactive compounds,with a special focus on anti-viral,immune remodeling,endocrine system regulation,and metabolism,suggesting that Ginseng Radix et Rhizoma is a potentially promising treatment for LC,especially regarding targeting fatigue.

Rehabilitation in long COVID-19:A mini-review

We have been experiencing multiple waves of the coronavirus disease 2019(COVID-19)pandemic.With these unprecedented waves,we have entered into an era of‘new normal’.This pandemic has enforced us to rethink the very basics of childhood learning:Habits,health etiquette,and hygiene.Rehabilitation has immense importance during this pandemic considering a few aspects.Multidisciplinary COVID-19 rehabilitation clinics are essential to address the demand.The equitable distribution of COVID-19 rehabilitation services for differently-abled individuals during the pandemic is an important aspect.Rehabilitation needs identification and further studies on various rehabilitation interventions are among the key unmet future research needs.

Long-COVID-19 Symptoms after Infection in COVID Long-Haulers

The negative molecular swab does not mean that the body and mind are healed: even months after Sars-CoV-2 infection, patients may continue to have symptoms. The symptoms mainly present at 6 - 12 months in patients recovered from COVID-19 are: asthenia, breathlessness, difficulty in breathing deeply, myalgia, psychological disorders and difficulty in concentrating such as “brain fog”. The study was conducted from June 2021 to July 2021 at Health Prevention Department in Benevento (Campania Region, South Italy). 133 patients accepted the questionnaire in the form of a telephone interview. The purpose of this study is precisely to highlight how, although a year after infection, a number of patients still show post-COVID symptoms. In particular, 77 out of 133 positive patients became Long-Haulers (58%).

Genotypic diagnosis of long QT syndrome by analysis of candidate genes

Objective To diagnose 6 LQTS families by genetic analysis.Methods A total aof 6 LQTS pedigrees with 43 family members were brought together for genetic diagnosis by using short-sequence tandem-repeat(STR)markers or sequencing.Genomic DNA was extracted from blood samples by standard procedure.STR markers or KCNQ1,KCNH2 and SCN5A were amplified.The haplotype analysis for LQTS was performed.If the family got the negative haplotype analysis,the sequencing was performed.Results LQTS patients were always linkaged with the SCN5A gene in family 1.KCNH2 was linkaged with the disease in family 2 to 5.21 gene carriers were identified from these 5 families.A mutation(A561V-KCNH2)was only found in the proband of family 6 and an SNP(G1691A)was found in all the members of the family.Conclusion Genetic diagnosis can not only improve presymptomatic diagnosis,but also provide the basis for personal therapy and research on disease-causing mutations.

A novel mutation—L539fs/47 of hERG in a Chinese long QT syndrome family

Objective To identify the mutation of human ether-a-go-go-related gene(hERG)and analyze the clinical characteristics of a Chinese family with long ST syndrome(LQTS).Methods The electrocardiogram and DNA samples were obtained from a Chinese LQTS family of 26 members.Genotype was performed with polymorphic short tandem repeat(STR)markers at the known LQT1,LQT2,and LQT3 loci.SSCP analysis was used to find aberrant conformers.hERG mutation was confirmed by cloning and sequencing.Results Three gene carriers were linked to chromosome 7q35-36,where the potassium channel gene hERG was encoded.A 19-base pair deletion was identified.The mutation was located at nucleotide position 1 619-1 637 between transmembrane domains S4 and S5.Furthermore,A1692G polymorphism was found both in the normal control and patients.Conclusion A novel 19 bp deletion mutation of hERG is identified in a Chinese family.All gene carriers are demonstrated to be typical LQT2 ECG phenotype.

COVID-19:Insights into long-term manifestations and lockdown impacts

Coronaviruses are pathogens thought to primarily affect the respiratory tracts of humans.The outbreak of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in 2019 was also marked mainly by its symptoms of respiratory illness,which were named coronavirus disease 2019(COVID-19).Since its initial discovery,many other symptoms have been linked to acute SARS-CoV-2 infections as well as to the long-term outcomes of COVID-19 patients.Among these symptoms are different categories of cardiovascular diseases(CVDs),which continue to be the main cause of death worldwide.The World Health Organization estimates that 17.9 million people die from CVDs each year,accounting for~32%of all deaths globally.Physical inactivity is one of the most important behavioral risk factors for CVDs.The COVID-19 pandemic has affected CVDs as well as the physical activity in different ways.Here,we provide an overview of the current status as well as future challenges and possible solutions.

Long COVID: A Molecular, Cellular and Histopathology Overview

Long COVID has been studied as different sequelae that some individuals can develop after the acute phase of the disease. Persistent symptoms such as dry cough, fatigue, and dyspnea can remain after six months of COVID-19 cure. Others such as lung fibrosis, kidney injury, and thrombotic risk also are observed. Here, a deep review of each human organ and system infected by the virus was performed aiming to show how molecules expression and cell signaling can induce the organism cure or injuries and, subsequently sequelae. The review also suggests the importance of public health surveillance for these cases including a more comprehensive analysis of molecular biology tools that can clarify and assist in the prognosis, treatment, and preventive methods for potentially more serious disorders in post-COVID-19 patients.

Effects of long COVID-19 among young adults in Turkey:A cross-sectional study

Objective:To investigate the cognitive state,psychological problems such as depression and anxiety,and pain in the musculoskeletal system among young adults with post-COVID-19(long COVID)syndrome.Methods:This descriptive study included 361 students studying at the Vocational School of Health Services of Bingöl University in Turkey.Data were collected using the Socio-Demographic Information form,the Beck’s Depression Inventory,the Cognitive Appraisal Scale,and the Visual Analogue Scale for pain.Results:Compared to those without COVID-19,the mean depression score,cognitive appraisal score,and mean Visual Analogue Scale score of the young adults with COVID-19 were significantly higher.There was no significant difference in pain assessment at rest between those with COVID-19 and those without COVID-19.Conclusions:Young adults with COVID-19 are more depressed,their cognitive functions are more easily negatively affected,and experience more pain during exercise.

Prevalence and risk factors for acquired long QT syndrome in the emergency department:a retrospective observational study

BACKGROUND: Long QT syndrome(LQTS) is a heterogeneous syndrome that may be congenital or, more frequently, acquired. The real-world prevalence of acquired LQTS(aLQTS) in the emergency department(ED) remains to be determined. The aim of this study was to determine prevalence of aLQTS and its impact on symptoms on ED admissions.METHODS: Electrocardiograms(ECG) of 5,056 consecutively patients admitted in the ED of a tertiary hospital between January 28th and March 17th of 2020 were reviewed. All patients with aLQTS were included. Clinical data with a focus on QT prolonging drugs and clinical factors were recorded. Statistical comparison was made between the groups with and without corrected QT(QTc) interval greater than 500 ms(value that is considered severely increased).RESULTS: A total of 383 ECGs with prolonged QTc were recognized, corresponding to a prevalence of aLQTS at admission of 7.82%. Patients with aLQTS were more commonly men(53.3%) with an age of(73.49±14.79) years old and QTc interval of(505.3±32.4) ms. Only 20.4% of these patients with aLQTS were symptomatic. No ventricular arrhythmias were recorded. Patients with QT interval greater than 500 ms were more frequently female(59.5%;P<0.001) and were more frequently on QT prolonging drugs(77.3%;P=0.025). Main contributing factor was intake of antibiotics(odds ratio [OR] 4.680) followed by female gender(OR 2.473) and intake of antipsychotics(OR 1.925).CONCLUSION: aLQTS is particularly prevalent in the ED. Female patients on antibiotics and antipsychotics are at particularly high risk. Efforts must be made to avoid, detect and treat aLQTS as early as possible.

COVID-19 survivors:Multi-disciplinary efforts in psychiatry and medical humanities for long-term realignment

The coronavirus disease 2019 pandemic represents an enduring transformation in health care and education with the advancement of smart universities,telehealth,adaptive research protocols,personalized medicine,and self-controlled or artificial intelligence-controlled learning.These changes,of course,also cover mental health and long-term realignment of coronavirus disease 2019 survivors.Fatigue or anxiety,as the most prominent psychiatric“long coronavirus disease 2019”symptoms,need a theory-based and empirically-sound procedure that would help us grasp the complexity of the condition in research and treatment.Considering the systemic character of the condition,such strategies have to take the whole individual and their sociocultural context into consideration.Still,at the moment,attempts to build an integrative framework for providing meaning and understanding for the patients of how to cope with anxiety when they are confronted with empirically reduced parameters(e.g.,severe acute respiratory syndrome coronavirus type 2)or biomarkers(e.g.,the FK506 binding protein 5)are rare.In this context,multidisciplinary efforts are necessary.We therefore join in a plea for an establishment of‘translational medical humanities’that would allow a more straightforward intervention of humanities(e.g.,the importance of the therapist variable,continuity,the social environment,etc)into the disciplinary,medial,political,and popular cultural debates around health,health-care provision,research(e.g.,computer scientists for simulation studies),and wellbeing.

A novel splice mutation of HERG in a Chinese family with long QT syndrome

Congenital long QT syndrome (LQTS) is a genetically heterogeneous disease in which six ion-channel genes have been identified. The phenotype-genotype relationships of the HERG (human ether-a-go-go-related gene) mutations are not fully understood. The objective of this study is to identify the underlying genetic basis of a Chinese family with LQTS and to characterize the clinical manifestations properties of the mutation. Single strand conformation polymorphism (SSCP) analyses were conducted on DNA fragments amplified by polymerase chain reaction from five LQT-related genes. Aberrant conformers were analyzed by DNA sequencing. A novel splice mutation in C-terminus of HERG was identified in this Chinese LQTS family,leading to the deletion of 11-bp at the acceptor splice site of Exon9 [Exon9 IVS del (-12→-2)]. The mutation might affect,through deficient splicing, the putative cyclic nucleotide binding domain (CNBD) of the HERG K+ channel. This mutation resulted in a mildly affected phenotype. Only the proband had a history of syncopes, while the other three individuals with long QT interval had no symptoms. Two other mutation carriers displayed normal phenotype. No sudden death occurred in the family. The 4 affected individuals and the two silent mutation carriers were all heterozygous for the mutation. It is the first splice mutation of HERG reported in Chinese LQTS families. Clinical data suggest that the CNBD mutation may be less malignant than mutations occurring in the pore region and be partially dominant over wild-type function.

Diagnosis of long QT syndrome via support vector machines classification

Congenital Long QT Syndrome (LQTS) is a genetic disease and associated with significant arrhythmias and sudden cardiac death. We introduce a noninva-sive procedure in which Discrete Wavelet Trans-form (DWT) is used to extract features from elec-trocardiogram (ECG) time-series data first, then the extracted features data is classified as either abnormal or unaffected using Support Vector Machines (SVM). A total of 26 genetically identified patients with LQTS and 19 healthy controls were studied. Due to the limited number of samples, model selection was done by training 44 instances and testing it on remaining one in each run. The proposed method shows reasonably high average accuracy in LQTS diagnosis when combined with best parameter selection process in the classifica-tion stage. An accuracy of 80%is achieved when Sigmoid kernel is used in v-SVM with parameters v = 0.58 and r = 0.5. The corresponding SVM model showed a classification rate of 21/26 for LQTS pa-tients and 15/19 for controls. Since the diagnosis of LQTS can be challenging, the proposed method is promising and can be a potential tool in the correct diagnosis. The method may be improved further if larger data sets can be obtained and used.

Prolonged impacts of COVID-19-associated cystitis:A study on longterm consequences

BACKGROUND The Coronavirus Disease 2019(COVID-19)caused by the severe acute respiratory syndrome coronavirus 2 virus is an international health concern with substantial morbidity and mortality.COVID-associated cystitis(CAC),presents as new onset or exacerbated urinary symptoms,resembling overactive bladder(OAB)symptoms.AIM To examines the long-term outcomes of patients with CAC in the context of Long COVID.METHODS A cohort of 350 patients admitted to Detroit Hospitals with COVID-19 between May and December 2020,displaying CAC symptoms following discharge,was prospectively followed.Initial urologic evaluations occurred at 10-14 wk and were repeated at 21-28 mo postdischarge.Symptoms were managed conservatively,employing behavioral modifications and standard OAB medications.Participants completed surveys assessing urinary symptoms and quality of life(QoL)at both time points.The primary outcome was the Urology Care Foundation Overactive Bladder Assessment Tool.RESULTS 87%of the final cohort(n=310)reported symptom improvement at 21-28 mo post-discharge.Patients with new onset CAC symptoms showed a median decrease of 9-10 points in OAB and QoL scores,while those with existing symptoms experienced a decrease of 6 points.Overall,95.4%of patients with new onset symptoms reported symptom improvement at follow-up,contrasting with 60.7%among those with existing symptoms.CONCLUSION This study presents the first long-term follow-up of adult patients with CAC,revealing a promising prognosis with conservative management measures in the context of Long COVID.These findings provide reassurance to patients regarding symptom resolution and underscore the need for further research into this evolving aspect of COVID-19's impact on urological health.