RECENT RESEARCH
due to long COVID . A retrospective descriptive study was performed for patients who visited a COVID-19 aftercare clinic established in Okayama University Hospital during the period from Feb 2021 to Dec 2021 with a focus on symptoms accompanying general fatigue and prescriptions of Kampo medicine . Among the clinical data obtained from medical records of 195 patients , clinical data for 102 patients with general fatigue and accompanying symptoms were analyzed . The patients had various symptoms , and the most frequent symptoms accompanying general fatigue were dysosmia , dysgeusia , headache , insomnia , dyspnea , and hair loss . Prescriptions of Kampo medicine accounted for 24.1 % of the total prescriptions ( n = 609 ). The most frequently prescribed Kampo medicine was hochuekkito ( 71.6 %) and other prescribed Kampo medicines were tokishakuyakusan , ryokeijutsukanto , juzentaihoto , hangekobokuto , kakkonto , ninjin ' yoeito , goreisan , rikkunshito , and keishibukuryogan . Since the pathophysiology of general fatigue after an infectious disease is , in general , considered a qi deficiency in Kampo medicine , treatments with such compensation agents can be the major prescription as a complement for the qi . In conclusion , Kampo medicine can be one of the main pharmacological treatments for long COVID accompanying general fatigue .
Yong SJ . Long COVID or post-COVID-19 syndrome : putative pathophysiology , risk factors , and treatments . Infect Dis ( Lond ). doi : 10.1080 / 23744235.2021.1924397 .
Long COVID or post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific and medical communities . This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity , even younger adults , children , and those not hospitalized . While the precise definition of long COVID may be lacking , the most common symptoms reported in many studies are fatigue and dyspnoea that last for months after acute COVID-19 . Other persistent symptoms may include cognitive and mental impairments , chest and joint pains , palpitations , myalgia , smell and taste dysfunctions , cough , headache , and gastrointestinal and cardiac issues . Presently , there is limited literature discussing the possible pathophysiology , risk factors , and treatments in long COVID , which the current review aims to address . In brief , long COVID may be driven by long-term tissue damage ( e . g . lung , brain , and heart ) and pathological inflammation ( e . g . from viral persistence , immune dysregulation , and autoimmunity ). The associated risk factors may include female sex , more than five early symptoms , early dyspnoea , prior psychiatric disorders , and specific biomarkers ( e . g . D-dimer , CRP , and lymphocyte count ), although more research is required to substantiate such risk factors . While preliminary evidence suggests that personalized rehabilitation training may help certain long COVID cases , therapeutic drugs repurposed from other similar conditions , such as myalgic encephalomyelitis or chronic fatigue syndrome , postural orthostatic tachycardia syndrome , and mast cell activation syndrome , also hold potential . In sum , this review hopes to provide the current understanding of what is known about long COVID .
Ceban F , Ling S , Lui LMW , Lee Y , Gill H , Teopiz KM , Rodrigues NB , Subramaniapillai M , Di Vincenzo JD , Cao B , Lin K , Mansur RB , Ho RC , Rosenblat JD , Miskowiak KW , Vinberg M , Maletic V , McIntyre RS . Fatigue and cognitive impairment in Post-COVID-19 Syndrome : A systematic review and meta-analysis . Brain Behav Immun . 2022 ; 101:93-135 . doi : 10.1016 / j . bbi . 2021.12.020
Importance : COVID-19 is associated with clinically significant symptoms despite resolution of the acute infection ( i . e ., post-COVID-19 syndrome ). Fatigue and cognitive impairment are amongst the most common and debilitating symptoms of post-COVID-19 syndrome .
Objective : To quantify the proportion of individuals experiencing fatigue and cognitive impairment 12 or more weeks following COVID-19 diagnosis , and to characterize the inflammatory correlates and functional consequences of post- COVID-19 syndrome .
Data sources : Systematic searches were conducted without language restrictions from database inception to June 8 , 2021 on PubMed / MEDLINE , The Cochrane Library , PsycInfo , Embase , Web of Science , Google / Google Scholar , and select reference lists .
Study selection : Primary research articles which evaluated individuals at least 12 weeks after confirmed COVID-19 diagnosis and specifically reported on fatigue , cognitive impairment , inflammatory parameters , and / or functional outcomes were selected .
Data extraction & synthesis : Two reviewers independently extracted published summary data and assessed methodological quality and risk of bias . A meta-analysis of proportions was conducted to pool Freeman-Tukey double arcsine transformed proportions using the random-effects restricted maximumlikelihood model .
Main outcomes & measures : The coprimary outcomes were the proportions of individuals reporting fatigue and cognitive impairment , respectively , 12 or more weeks following COVID-19 infection . The secondary outcomes were inflammatory correlates and functional consequences associated with post- COVID-19 syndrome .
Results : The literature search yielded 10,979 studies , and 81 studies were selected for inclusion . The fatigue meta-analysis comprised 68 studies , the cognitive impairment metaanalysis comprised 43 studies , and 48 studies were included in the narrative synthesis . Meta-analysis revealed that the proportion of individuals experiencing fatigue 12 or more weeks following COVID-19 diagnosis was 0.32 ( 95 % CI , 0.27 , 0.37 ; p < 0.001 ; n = 25,268 ; I2 = 99.1 %). The proportion of individuals exhibiting cognitive impairment was 0.22 ( 95 % CI , 0.17 , 0.28 ; p < 0.001 ; n = 13,232 ; I2 = 98.0 ). Moreover , narrative
168 | vol28 | no3 | JATMS