Long COVID, a comprehensive systematic scoping review

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Abstract

Purpose

To find out what is known from literature about Long COVID until January 30, 2021.

Methods

We undertook a four-step search with no language restriction. A preliminary search was made to identify the keywords. A search strategy of all electronic databases resulted in 66 eligible studies. A forward and backward search of the references and citations resulted in additional 54 publications. Non-English language articles were translated using Google Translate. We conducted our scoping review based on the PRISMA-ScR Checklist.

Results

Of 120 papers, we found only one randomized clinical trial. Of the 67 original studies, 22 were cohort, and 28 were cross-sectional studies. Of the total 120 publications, 49.1% focused on signs and symptoms, 23.3% on management, and 10.8% on pathophysiology. Ten publications focused on imaging studies. The results are also presented extensively in a narrative synthesis in separated sections (nomenclature, diagnosis, pathophysiology, risk factors, signs/symptoms, management).

Conclusions

The controversies in its definition have impaired proper recognition and management. The predominant symptoms were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness.

Supplementary Information

The online version contains supplementary material available at 10.1007/s15010-021-01666-x.

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Most cited references 167

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Adrian Aldcroft, Chantelle Garritty, Simon Lewin … (2018)

Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.

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Is Open Access

Ror2 signaling regulates Golgi structure and transport through IFT20 for tumor invasiveness

Michiru Nishita, Seung-Yeol Park, Tadashi Nishio … (2017)

Signaling through the Ror2 receptor tyrosine kinase promotes invadopodia formation for tumor invasion. Here, we identify intraflagellar transport 20 (IFT20) as a new target of this signaling in tumors that lack primary cilia, and find that IFT20 mediates the ability of Ror2 signaling to induce the invasiveness of these tumors. We also find that IFT20 regulates the nucleation of Golgi-derived microtubules by affecting the GM130-AKAP450 complex, which promotes Golgi ribbon formation in achieving polarized secretion for cell migration and invasion. Furthermore, IFT20 promotes the efficiency of transport through the Golgi complex. These findings shed new insights into how Ror2 signaling promotes tumor invasiveness, and also advance the understanding of how Golgi structure and transport can be regulated.

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Author and article information

Contributors

Bahar Bastani:

ORCID: http://orcid.org/0000-0002-2138-4248

bahar.bastani@health.slu.edu

Journal

Journal ID (nlm-ta): Infection

Journal ID (iso-abbrev): Infection

Title: Infection

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0300-8126

ISSN (Electronic): 1439-0973

Publication date (Electronic): 28 July 2021

Pages: 1-24

Affiliations

[1 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Student Research Committee, School of Medicine, , Shiraz University of Medical Sciences, ; Shiraz, Iran

[2 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Trauma Research Center, , Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, ; Shiraz, Iran

[3 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Shiraz Nephro-Urology Research Center, , Shiraz University of Medical Sciences, ; Shiraz, Iran

[4 ]GRID grid.29857.31, ISNI 0000 0001 2097 4281, Division of Nephrology, Department of Medicine, , Penn State University College of Medicine, ; Hershey, PA 17033 USA

[5 ]GRID grid.10604.33, ISNI 0000 0001 2019 0495, Department of Psychiatry, , University of Nairobi, ; Nairobi, Kenya

[6 ]GRID grid.83440.3b, ISNI 0000000121901201, Department of Clinical, Educational and Health Psychology, , University College London, ; London, UK

[7 ]GRID grid.4367.6, ISNI 0000 0001 2355 7002, Cardiology Division, Department of Medicine, , Washington University School of Medicine, ; St. Louis, MO 63110 USA

[8 ]GRID grid.413931.d, John Cochran Division, , Veterans Affairs St. Louis Healthcare System, ; St. Louis, MO 63106 USA

[9 ]GRID grid.4367.6, ISNI 0000 0001 2355 7002, Department of Pathology and Immunology, , Washington University School of Medicine, ; St Louis, MO USA

[10 ]GRID grid.262962.b, ISNI 0000 0004 1936 9342, Pulmonary and Critical Care Medicine, , Saint Louis University School of Medicine, ; Saint Louis, MO USA

[11 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Epilepsy Research Center, , Shiraz University of Medical Sciences, ; Shiraz, Iran

[12 ]GRID grid.265008.9, ISNI 0000 0001 2166 5843, Department of Neurology, Jefferson Comprehensive Epilepsy Center, , Thomas Jefferson University, ; Philadelphia, PA USA

[13 ]GRID grid.262962.b, ISNI 0000 0004 1936 9342, Professor of Medicine-Nephrology, , Saint Louis University School of Medicine, ; Saint Louis, MO USA

Author information

Bahar Bastani http://orcid.org/0000-0002-2138-4248

Article

Publisher ID: 1666

DOI: 10.1007/s15010-021-01666-x

PMC ID: 8317481

PubMed ID: 34319569

SO-VID: e02c3ac3-6fc6-4808-b327-3c984fa5ec83

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

History

Date received : 16 April 2021

Date accepted : 10 July 2021

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Long COVID, a comprehensive systematic scoping review

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Abstract

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Supplementary Information

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UCL: Covid-19 Research

Most cited references 167

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Ror2 signaling regulates Golgi structure and transport through IFT20 for tumor invasiveness

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Cited by 129

Most referenced authors 12,748