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      Clinical features, therapeutic outcomes, and recovery period of long COVID

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          Abstract

          To characterize the clinical features of long COVID, 286 patients who received care in our outpatient clinic for long COVID from May to December 2021 were surveyed. The recovery periods of each symptom and the key factors contributing to early recovery were statistically analysed. The median age of the patients was 35.8 years, with 137 men and 149 women. The median number of symptoms was 2.8. The most frequent symptoms were respiratory manifestations (52.1%), followed by fatigue (51.4%). Respiratory symptoms, fatigue, and headache/arthralgia were major complaints in the initial phase, whereas hair loss was a major complaint in the late phase, suggesting that the chief complaint of patients with long COVID may vary temporally. The best treatment outcome was observed for pulmonary symptoms, and hair loss had the worst outcome. COVID‐19 severity, the number of manifestations, and the delay in starting treatment exerted a negative effect on the recovery period of long COVID. In addition, the smoking habit was an independent risk factor for slowing the recovery period from long COVID. This study provides insights into the clinical course of each manifestation and therapeutic options with a more certain future of long COVID to meet the unmet medical needs.

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          Most cited references46

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          Post-acute COVID-19 syndrome

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.
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            Persistent Symptoms in Patients After Acute COVID-19

            This case series describes COVID-19 symptoms persisting a mean of 60 days after onset among Italian patients previously discharged from COVID-19 hospitalization.
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              Attributes and predictors of long COVID

              Reports of long-lasting coronavirus disease 2019 (COVID-19) symptoms, the so-called 'long COVID', are rising but little is known about prevalence, risk factors or whether it is possible to predict a protracted course early in the disease. We analyzed data from 4,182 incident cases of COVID-19 in which individuals self-reported their symptoms prospectively in the COVID Symptom Study app1. A total of 558 (13.3%) participants reported symptoms lasting ≥28 days, 189 (4.5%) for ≥8 weeks and 95 (2.3%) for ≥12 weeks. Long COVID was characterized by symptoms of fatigue, headache, dyspnea and anosmia and was more likely with increasing age and body mass index and female sex. Experiencing more than five symptoms during the first week of illness was associated with long COVID (odds ratio = 3.53 (2.76-4.50)). A simple model to distinguish between short COVID and long COVID at 7 days (total sample size, n = 2,149) showed an area under the curve of the receiver operating characteristic curve of 76%, with replication in an independent sample of 2,472 individuals who were positive for severe acute respiratory syndrome coronavirus 2. This model could be used to identify individuals at risk of long COVID for trials of prevention or treatment and to plan education and rehabilitation services.
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                Author and article information

                Contributors
                takakura@unmed-clinic.jp
                Journal
                J Med Virol
                J Med Virol
                10.1002/(ISSN)1096-9071
                JMV
                Journal of Medical Virology
                John Wiley and Sons Inc. (Hoboken )
                0146-6615
                1096-9071
                02 December 2022
                January 2023
                : 95
                : 1 ( doiID: 10.1002/jmv.v95.1 )
                : e28316
                Affiliations
                [ 1 ] Department of Internal Medicine UnMed Clinic Motomachi Yokohama Kanagawa Japan
                [ 2 ] Department of Public Health and Environmental Medicine The Jikei University School of Medicine Tokyo Japan
                [ 3 ] Department of Internal Medicine Kajihara Clinic Hiratsuka Kanagawa Japan
                [ 4 ] Department of Internal Medicine, Division of Gastroenterology and Hepatology The Jikei University Kashiwa Hospital Chiba Japan
                Author notes
                [*] [* ] Correspondence Kazuki Takakura, Department of Internal Medicine, UnMed Clinic Motomachi 3‐116 Motomachi, Naka‐ku, Yokohama, Kanagawa 231‐0861, Japan.

                Email: takakura@ 123456unmed-clinic.jp

                Author information
                http://orcid.org/0000-0003-1444-3761
                http://orcid.org/0000-0003-2125-2218
                http://orcid.org/0000-0002-3316-1121
                http://orcid.org/0000-0003-0397-4348
                Article
                JMV28316
                10.1002/jmv.28316
                10108287
                36412057
                d174447a-374d-4053-95a6-31d773dc1387
                © 2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 04 October 2022
                : 06 July 2022
                : 17 October 2022
                Page count
                Figures: 1, Tables: 6, Pages: 9, Words: 5581
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                January 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:17.04.2023

                Microbiology & Virology
                herbaceous medication,long covid,multisystem disorder,persistent symptoms,recovery period

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