The American journal of medicine
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Long COVID is a syndrome persisting 12+ weeks after COVID-19 infection, impacting life and work ability. Autonomic nervous system imbalance has been hypothesized as the cause. This study aims to investigate cardiovascular autonomic function in health care workers (HCWs) with Long COVID and the effectiveness of slow-paced breathing (SPB) on autonomic modulation. ⋯ Resting vascular modulation was reduced in Long COVID, while during SPB, baroreflex sensitivity effectively improved. Long-term studies are needed to evaluate whether multiple sessions of breathing exercises can restore basal vascular reactivity and reduce cardiovascular risk in these patients.
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The diagnosis and treatment of long COVID patients is challenging. Our aim is to share lessons learned using a multidisciplinary approach within the Veterans Affairs system. ⋯ We conducted an extensive work-up to evaluate the presence of end-organ damage, ongoing inflammation, and dysautonomia. Our treatments are based on the prior experience that the Veterans Affairs system has on chronic fatigue syndrome and gulf war illness.
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Well-being and cognitive function had not previously been compared between people with long COVID and people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Therefore, this study examined well-being and cognitive function in people with long COVID (∼16 months illness duration; n = 17) and ME/CFS (∼16 years illness duration; n = 24), versus age-matched healthy controls (n = 16). ⋯ These data suggest that both people with long COVID and people with ME/CFS have similar impairment on well-being measures examined herein. Therefore, interventions that target well-being of people with ME/CFS and long COVID are required.
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Individuals with long COVID lack evidence-based treatments and have difficulty participating in traditional site-based trials. Our digital, decentralized trial investigates the efficacy and safety of nirmatrelvir/ritonavir, targeting viral persistence as a potential cause of long COVID. ⋯ The PAX LC trial uses a novel decentralized design and a participant-centric approach to test a 15-day regimen of nirmatrelvir/ritonavir for long COVID.
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Comparative Study
Acute Kidney Injury and Patients Undergoing Both Right and Left Heart Catheterization with Coronary Angiography Versus Right Heart Catheterization Only.
Recent studies have challenged the reported causal association between acute kidney injury and iodinated contrast administration, ascribing some cases to changes in renal function that are independent of contrast administration. ⋯ The incidence of changes in creatinine consistent with acute kidney injury at 3 days and of nephropathy at 3 months was not significantly different in patients undergoing R&LHC compared with patients undergoing RHC only. This supports the thesis that not all changes in creatinine after procedures involving administration of contrast are caused by the contrast.