Long COVID: Difference between revisions

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!Source !! Terms!! Definition
!Source !! Terms!! Definition
|-
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| WHO||align="center"|[[post-COVID-19 condition]]||align="center"|
| WHO||align="center"|[[Post-COVID-19 condition]]||align="center"|
*[[Post COVID-19 condition]]''' occurs in individuals with a history of probable or confirmed [[SARS-CoV-2 infection]], usually 3 months from the onset of [[COVID-19]] with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis.  
*[[Post COVID-19 condition]] occurs in individuals with a history of probable or confirmed [[SARS-CoV-2 infection]], usually 3 months from the onset of [[COVID-19]] with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis.  
*Common symptoms include [[fatigue]], [[shortness of breath]], [[cognitive dysfunction]] and generally have an impact on everyday functioning.  
*Common symptoms include [[fatigue]], [[shortness of breath]], [[cognitive dysfunction]] and generally have an impact on everyday functioning.  
*[[Symptoms]] may be new-onset following initial [[recovery]] from an acute [[COVID-19]] episode or persist from the initial [[illness]].  
*[[Symptoms]] may be new-onset following initial [[recovery]] from an acute [[COVID-19]] episode or persist from the initial [[illness]].  
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* Persistent [[symptom]]s and/or delayed or long-term [[complications]] of [[SARS-CoV-2]] infection beyond 4 weeks from the onset of [[symptoms]].  
* Persistent [[symptom]]s and/or delayed or long-term [[complications]] of [[SARS-CoV-2]] infection beyond 4 weeks from the onset of [[symptoms]].  
|-
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| Lancet||align="center"|[[long COVID]]||align="center"|  
| Lancet <ref name="pmidPMID: 33308453">{{cite journal| author=| title=Facing up to long COVID. | journal=Lancet | year= 2020 | volume= 396 | issue= 10266 | pages= 1861 | pmid=PMID: 33308453 | doi=10.1016/S0140-6736(20)32662-3 | pmc=7834723 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33308453  }} </ref>||align="center"|[[Long COVID]]||align="center"|  
*Multiorgan [[symptoms]] after [[COVID-19]] are being reported by increasing numbers of patients.  
*Multiorgan [[symptoms]] after [[COVID-19]] are being reported by increasing numbers of patients.  
*They range from [[cough]] and [[shortness of breath]] to [[fatigue]], [[headache]], [[palpitations]], [[chest pain]], joint pain, physical limitations, [[depression]], and [[insomnia]], and affect people of varying ages.  
*They range from [[cough]] and [[shortness of breath]] to [[fatigue]], [[headache]], [[palpitations]], [[chest pain]], joint pain, physical limitations, [[depression]], and [[insomnia]], and affect people of varying ages.  
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*So-called [[long COVID]] is a burgeoning health concern and action is needed now to address it.  
*So-called [[long COVID]] is a burgeoning health concern and action is needed now to address it.  
|-
|-
| Nice||align="center"|[[long COVID]]||align="center"|  
| Nice <ref name="urlOverview | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE">{{cite web |url=https://www.nice.org.uk/guidance/ng188 |title=Overview &#124; COVID-19 rapid guideline: managing the long-term effects of COVID-19 &#124; Guidance &#124; NICE |format= |work= |accessdate=}}</ref>||align="center"|[[Long COVID]]||align="center"|  
*[[Signs]] and [[symptoms]] that develop during or after an [[infection]] consistent with [[COVID-19]], continue for more than 12 weeks and are not explained by an alternative [[diagnosis]].
*[[Signs]] and [[symptoms]] that develop during or after an [[infection]] consistent with [[COVID-19]], continue for more than 12 weeks and are not explained by an alternative [[diagnosis]].
|-
|-
| Scientific American||align="center"|[[Long Haul COVID]]||align="center"|  
| Scientific American <ref name="urlThe Problem of Long Haul COVID - Scientific American">{{cite web |url=https://www.scientificamerican.com/article/the-problem-of-long-haul-covid/ |title=The Problem of 'Long Haul' COVID - Scientific American |format= |work= |accessdate=}}</ref>||align="center"|[[Long Haul COVID]]||align="center"|  
* Individuals whose [[symptoms]] persist or develop outside the initial viral [[infection]], but the duration and pathogenesis are unknown.
* Individuals whose [[symptoms]] persist or develop outside the initial viral [[infection]], but the duration and pathogenesis are unknown.
|-
|-
| Royal Society||align="center"|???||align="center"|  
| Royal Society <ref name="urlroyalsociety.org">{{cite web |url=https://royalsociety.org/-/media/policy/projects/set-c/set-c-long-covid.pdf |title=royalsociety.org |format= |work= |accessdate=}}</ref>||align="center"|[[Long COVID]]||align="center"|  
* The onset of persistent or recurrent episodes of one or more of the following symptoms, within x* weeks of infection with [[SARS-CoV-2]] and continuing for y* weeks or more:  
* The onset of persistent or recurrent episodes of one or more of the following symptoms, within x* weeks of infection with [[SARS-CoV-2]] and continuing for y* weeks or more:  
**severe [[fatigue]], reduced [[exercise capacity]], [[chest pain]] or heaviness, [[fever]], [[palpitations[[, [[cognitive impairment]], [[anosmia]] or [[ageusia]], [[vertigo]] and [[tinnitus]], [[headache]], [[peripheral neuropathy]], metallic or bitter [[taste]], [[skin rash]], [[joint pain]] or swelling.
**severe [[fatigue]], reduced [[exercise capacity]], [[chest pain]] or heaviness, [[fever]], [[palpitations[[, [[cognitive impairment]], [[anosmia]] or [[ageusia]], [[vertigo]] and [[tinnitus]], [[headache]], [[peripheral neuropathy]], metallic or bitter [[taste]], [[skin rash]], [[joint pain]] or swelling.
*Maximum period between acquisition of the infection (if known) and the onset of [[symptoms]], and the minimum duration of [[symptoms]], should be specified in the definition.
*Maximum period between acquisition of the infection (if known) and the onset of [[symptoms]], and the minimum duration of [[symptoms]], should be specified in the definition.
|-
|-
| Haute Autorité de santé, France||align="center"|???||align="center"|  
| Haute Autorité de santé, France <ref name="urlÉpidémie de Coronavirus (Covid-19) -Covid long : les recommandations de la Haute Autorité de santé | service-public.fr">{{cite web |url=https://www.service-public.fr/particuliers/actualites/A14678 |title=Épidémie de Coronavirus (Covid-19) -Covid long : les recommandations de la Haute Autorité de santé &#124; service-public.fr |format= |work= |accessdate=}}</ref>||align="center"|[[Long COVID]]||align="center"|  
*Three criteria:  
*Three criteria:  
**Having presented with symptomatic form of [[COVID-19]]
**Having presented with symptomatic form of [[COVID-19]]

Revision as of 11:55, 18 March 2022

WikiDoc Resources for Long COVID

Articles

Most recent articles on Long COVID

Most cited articles on Long COVID

Review articles on Long COVID

Articles on Long COVID in N Eng J Med, Lancet, BMJ

Media

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Evidence Based Medicine

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Clinical Trials

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Trial results on Long COVID

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Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Long COVID

NICE Guidance on Long COVID

NHS PRODIGY Guidance

FDA on Long COVID

CDC on Long COVID

Books

Books on Long COVID

News

Long COVID in the news

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News trends on Long COVID

Commentary

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Definitions

Definitions of Long COVID

Patient Resources / Community

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Directions to Hospitals Treating Long COVID

Risk calculators and risk factors for Long COVID

Healthcare Provider Resources

Symptoms of Long COVID

Causes & Risk Factors for Long COVID

Diagnostic studies for Long COVID

Treatment of Long COVID

Continuing Medical Education (CME)

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International

Long COVID en Espanol

Long COVID en Francais

Business

Long COVID in the Marketplace

Patents on Long COVID

Experimental / Informatics

List of terms related to Long COVID

For COVID-19 main page, click here

For COVID-19 frequently asked inpatient questions, click here

For COVID-19 frequently asked outpatient questions, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mitra Chitsazan, M.D.[2]

Synonyms and keywords: Long COVID Syndrome, long COVID, long-haul COVID, post-COVID-19 condition, post-COVID-19 syndrome, post-acute sequelae of COVID-19 (PASC), chronic COVID syndrome (CCS), Long-hauler COVID-19, Long-COVID, Long-tail COVID, Long-haulers, Post-acute COVID-19 syndrome, Acute post-COVID symptoms, Long post-COVID symptoms Persistent post-COVID symptoms, Post-acute COVID-19, On-going symptomatic COVID-19, Chronic COVID-19


Overview

  • Shortly after the COVID-19 pandemic onset, emerging studies showed that a considerable proportion of patients with COVID-19 might exhibit sustained postinfection sequelae.

Historical Perspective

Definition

  • On October 6, 2021, World Health Organization (WHO) released a clinical case definition of the post-COVID-19 condition through a robust, protocol-based methodology (Delphi consensus), which engaged a diverse group of representative patients, patient-researchers, external experts, WHO staff, and other stakeholders from multiple geographies. [2] It was acknowledged that this definition may change with emerging new evidence and continuously evolving our understanding of the consequences of COVID-19.
  • According to WHO clinical case definition, the post-COVID-19 condition is defined as: [2]
Source Terms Definition
WHO Post-COVID-19 condition
CDC Long COVID
  • While most persons with COVID-19 recover and return to normal health, some patients can have symptoms that can last for weeks or even months after recovery from acute illness.
  • Even people who are not hospitalized and who have a mild illness can experience persistent or late symptoms."
Nature Post-acute COVID-19
Lancet [3] Long COVID
  • Multiorgan symptoms after COVID-19 are being reported by increasing numbers of patients.
  • They range from cough and shortness of breath to fatigue, headache, palpitations, chest pain, joint pain, physical limitations, depression, and insomnia, and affect people of varying ages.
  • At the Lancet–Chinese Academy of Medical Sciences conference on 23 November 2020, Bin Cao presented data (in press at the Lancet) on the long-term consequences of COVID-19 for patients in Wuhan and warned that dysfunctions and complications could persist in some discharged patients for at least 6 months.
  • So-called long COVID is a burgeoning health concern and action is needed now to address it.
Nice [4] Long COVID
Scientific American [5] Long Haul COVID
  • Individuals whose symptoms persist or develop outside the initial viral infection, but the duration and pathogenesis are unknown.
Royal Society [6] Long COVID
Haute Autorité de santé, France [7] Long COVID
  • Three criteria:
    • Having presented with symptomatic form of COVID-19
    • presenting with one or more initial symptoms 4 weeks after the start of the disease
    • none of these symptoms can be explained by another diagnosis

Classification

There is no established system for the classification of long COVID.

Pathophysiology

The exact pathogenesis of long COVID is not fully understood. However, a number of putative pathophysiologic mechanisms have been suggested.

Epidemiology and Demographics

Risk Factors

Screening

There is insufficient evidence to recommend routine screening for long COVID.

Natural History, Complications, and Prognosis

  • The natural history, clinical course, long-term complications, and prognosis of long COVID-19 are still not completely understood.
  • Manifestations of the post-COVID-19 condition vary considerably in terms of organ involvement and severity of symptoms; however, they generally impact the everyday functioning of affected patients. [2]
  • Symptoms might newly develop following initial recovery from an acute COVID-19 illness or occur as a persist from the initial episode. [2]
  • Symptoms might also fluctuate or relapse over time. [2]

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Long COVID can involve almost every organ. The most common symptoms of long COVID include: [2] [29] [32] [33]

Physical Examination

Laboratory Findings

There are no diagnostic laboratory findings associated with long COVID. Symptoms do not correlate with the serology of SARS-CoV-2.

Electrocardiography

In patients with cardiopulmonary symptoms, an ECG may be needed.

X-ray

A chest x-ray may be helpful in the diagnosis of pulmonary complications of COVID-19 such as lung damage (ie, ground glass opacities, consolidation, interlobular septal thickening) and pleural effusion.

Echocardiography or Ultrasound

In selected patients with cardiopulmonary symptoms, echocardiography may be necessary.

CT scan

In patients with cardiopulmonary symptoms, a chest CT scan may be needed.

MRI

There are no MRI findings associated with long COVID. However, a cardiac MRI may be helpful in the diagnosis of myocarditis in COVID-19 patients.

Other Imaging Findings

There are no other imaging findings associated with long COVID.

Other Diagnostic Studies

In selected patients with cardiopulmonary symptoms, Holter monitoring, cardiopulmonary exercise testing (CPET), and pulmonary function tests may be necessary.

Treatment

Due to the diversity of symptoms and their severity, the mainstay of long COVID treatment is multidisciplinary and supportive. The management should focus on supporting self-management and individualized rehabilitation. [34] [35]

Medical Therapy

  • Alopecia
    • There is no specific therapy for alopecia in COVID-19 patients, and it should be managed similarly to non-COVID-19 patients.
    • In patients with concomitant malnutrition, nutritional deficiencies should be corrected.

Primary Prevention

The most effective measure to prevent the post-COVID-19 condition is to prevent COVID-19. These primary prevention strategies include:

Secondary Prevention

There are no established measures for the secondary prevention of long COVID.

See also

References

  1. Callard F, Perego E (2021). "How and why patients made Long Covid". Soc Sci Med. 268: 113426. doi:10.1016/j.socscimed.2020.113426. PMC 7539940 Check |pmc= value (help). PMID 33199035 Check |pmid= value (help).
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV, WHO Clinical Case Definition Working Group on Post-COVID-19 Condition (2021). "A clinical case definition of post-COVID-19 condition by a Delphi consensus". Lancet Infect Dis. doi:10.1016/S1473-3099(21)00703-9. PMC 8691845 Check |pmc= value (help). PMID 34951953 Check |pmid= value (help).
  3. "Facing up to long COVID". Lancet. 396 (10266): 1861. 2020. doi:10.1016/S0140-6736(20)32662-3. PMC 7834723 Check |pmc= value (help). PMID 33308453 PMID: 33308453 Check |pmid= value (help).
  4. "Overview | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE".
  5. "The Problem of 'Long Haul' COVID - Scientific American".
  6. "royalsociety.org" (PDF).
  7. "Épidémie de Coronavirus (Covid-19) -Covid long : les recommandations de la Haute Autorité de santé | service-public.fr".
  8. Truffaut L, Demey L, Bruyneel AV, Roman A, Alard S, De Vos N; et al. (2021). "Post-discharge critical COVID-19 lung function related to severity of radiologic lung involvement at admission". Respir Res. 22 (1): 29. doi:10.1186/s12931-021-01625-y. PMC 7819622 Check |pmc= value (help). PMID 33478527 PMID: 33478527 Check |pmid= value (help).
  9. Han X, Fan Y, Alwalid O, Li N, Jia X, Yuan M; et al. (2021). "Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia". Radiology. 299 (1): E177–E186. doi:10.1148/radiol.2021203153. PMC 7841877 Check |pmc= value (help). PMID 33497317 PMID: 33497317 Check |pmid= value (help).
  10. Bellan M, Soddu D, Balbo PE, Baricich A, Zeppegno P, Avanzi GC; et al. (2021). "Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge". JAMA Netw Open. 4 (1): e2036142. doi:10.1001/jamanetworkopen.2020.36142. PMC 7841464 Check |pmc= value (help). PMID 33502487 PMID: 33502487 Check |pmid= value (help).
  11. Liu D, Zhang W, Pan F, Li L, Yang L, Zheng D; et al. (2020). "The pulmonary sequalae in discharged patients with COVID-19: a short-term observational study". Respir Res. 21 (1): 125. doi:10.1186/s12931-020-01385-1. PMC 7245637 Check |pmc= value (help). PMID 32448391 PMID: 32448391 Check |pmid= value (help).
  12. Marvisi M, Ferrozzi F, Balzarini L, Mancini C, Ramponi S, Uccelli M (2020). "First report on clinical and radiological features of COVID-19 pneumonitis in a Caucasian population: Factors predicting fibrotic evolution". Int J Infect Dis. 99: 485–488. doi:10.1016/j.ijid.2020.08.054. PMC 7443096 Check |pmc= value (help). PMID 32841688 PMID: 32841688 Check |pmid= value (help).
  13. Wei J, Yang H, Lei P, Fan B, Qiu Y, Zeng B; et al. (2020). "Analysis of thin-section CT in patients with coronavirus disease (COVID-19) after hospital discharge". J Xray Sci Technol. 28 (3): 383–389. doi:10.3233/XST-200685. PMC 7369060 Check |pmc= value (help). PMID 32474479 PMID: 32474479 Check |pmid= value (help).
  14. 14.0 14.1 Maksoud R, du Preez S, Eaton-Fitch N, Thapaliya K, Barnden L, Cabanas H | display-authors=etal (2020) A systematic review of neurological impairments in myalgic encephalomyelitis/ chronic fatigue syndrome using neuroimaging techniques. PLoS One 15 (4):e0232475. DOI:10.1371/journal.pone.0232475 PMID: 32353033
  15. Rubin R (2020). "As Their Numbers Grow, COVID-19 "Long Haulers" Stump Experts". JAMA. 324 (14): 1381–1383. doi:10.1001/jama.2020.17709. PMID 32965460 Check |pmid= value (help).
  16. 16.0 16.1 Dani M, Dirksen A, Taraborrelli P, Torocastro M, Panagopoulos D, Sutton R; et al. (2021). "Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies". Clin Med (Lond). 21 (1): e63–e67. doi:10.7861/clinmed.2020-0896. PMC 7850225 Check |pmc= value (help). PMID 33243837 Check |pmid= value (help).
  17. Komaroff AL, Bateman L (2020). "Will COVID-19 Lead to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?". Front Med (Lausanne). 7: 606824. doi:10.3389/fmed.2020.606824. PMC 7848220 Check |pmc= value (help). PMID 33537329 Check |pmid= value (help).
  18. Motiejunaite J, Balagny P, Arnoult F, Mangin L, Bancal C, d'Ortho MP; et al. (2020). "Hyperventilation: A Possible Explanation for Long-Lasting Exercise Intolerance in Mild COVID-19 Survivors?". Front Physiol. 11: 614590. doi:10.3389/fphys.2020.614590. PMC 7849606 Check |pmc= value (help). PMID 33536937 Check |pmid= value (help).
  19. Yong SJ (2021). "Persistent Brainstem Dysfunction in Long-COVID: A Hypothesis". ACS Chem Neurosci. 12 (4): 573–580. doi:10.1021/acschemneuro.0c00793. PMC 7874499 Check |pmc= value (help). PMID 33538586 Check |pmid= value (help).
  20. Zang R, Gomez Castro MF, McCune BT, Zeng Q, Rothlauf PW, Sonnek NM; et al. (2020). "TMPRSS2 and TMPRSS4 promote SARS-CoV-2 infection of human small intestinal enterocytes". Sci Immunol. 5 (47). doi:10.1126/sciimmunol.abc3582. PMC 7285829 Check |pmc= value (help). PMID 32404436 Check |pmid= value (help).
  21. Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H (2020). "Evidence for Gastrointestinal Infection of SARS-CoV-2". Gastroenterology. 158 (6): 1831–1833.e3. doi:10.1053/j.gastro.2020.02.055. PMC 7130181 Check |pmc= value (help). PMID 32142773 Check |pmid= value (help).
  22. Gaebler C, Wang Z, Lorenzi JCC, Muecksch F, Finkin S, Tokuyama M; et al. (2021). "Evolution of antibody immunity to SARS-CoV-2". Nature. 591 (7851): 639–644. doi:10.1038/s41586-021-03207-w. PMC 8221082 Check |pmc= value (help). PMID 33461210 Check |pmid= value (help).
  23. Lamers MM, Beumer J, van der Vaart J, Knoops K, Puschhof J, Breugem TI; et al. (2020). "SARS-CoV-2 productively infects human gut enterocytes". Science. 369 (6499): 50–54. doi:10.1126/science.abc1669. PMC 7199907 Check |pmc= value (help). PMID 32358202 Check |pmid= value (help).
  24. Cheung KS, Hung IFN, Chan PPY, Lung KC, Tso E, Liu R; et al. (2020). "Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis". Gastroenterology. 159 (1): 81–95. doi:10.1053/j.gastro.2020.03.065. PMC 7194936 Check |pmc= value (help). PMID 32251668 Check |pmid= value (help).
  25. Mao R, Qiu Y, He JS, Tan JY, Li XH, Liang J; et al. (2020). "Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis". Lancet Gastroenterol Hepatol. 5 (7): 667–678. doi:10.1016/S2468-1253(20)30126-6. PMC 7217643 Check |pmc= value (help). PMID 32405603 Check |pmid= value (help).
  26. Tavakolpour S, Rakhshandehroo T, Wei EX, Rashidian M (2020). "Lymphopenia during the COVID-19 infection: What it shows and what can be learned". Immunol Lett. 225: 31–32. doi:10.1016/j.imlet.2020.06.013. PMC 7305732 Check |pmc= value (help). PMID 32569607 Check |pmid= value (help).
  27. Karlsson AC, Humbert M, Buggert M (2020). "The known unknowns of T cell immunity to COVID-19". Sci Immunol. 5 (53). doi:10.1126/sciimmunol.abe8063. PMID 33208380 Check |pmid= value (help).
  28. Singh I, Joseph P, Heerdt PM, Cullinan M, Lutchmansingh DD, Gulati M; et al. (2022). "Persistent Exertional Intolerance After COVID-19: Insights From Invasive Cardiopulmonary Exercise Testing". Chest. 161 (1): 54–63. doi:10.1016/j.chest.2021.08.010. PMC 8354807 Check |pmc= value (help). PMID 34389297 Check |pmid= value (help).
  29. 29.0 29.1 29.2 Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A; et al. (2021). "More than 50 long-term effects of COVID-19: a systematic review and meta-analysis". Sci Rep. 11 (1): 16144. doi:10.1038/s41598-021-95565-8. PMC 8352980 Check |pmc= value (help). PMID 34373540 Check |pmid= value (help). Review in: Ann Intern Med. 2022 Jan;175(1):JC10
  30. 30.0 30.1 Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC; et al. (2021). "Attributes and predictors of long COVID". Nat Med. 27 (4): 626–631. doi:10.1038/s41591-021-01292-y. PMC 7611399 Check |pmc= value (help). PMID 33692530 Check |pmid= value (help).
  31. Ayoubkhani D, Khunti K, Nafilyan V, Maddox T, Humberstone B, Diamond I; et al. (2021). "Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study". BMJ. 372: n693. doi:10.1136/bmj.n693. PMC 8010267 Check |pmc= value (help). PMID 33789877 Check |pmid= value (help).
  32. Cares-Marambio K, Montenegro-Jiménez Y, Torres-Castro R, Vera-Uribe R, Torralba Y, Alsina-Restoy X; et al. (2021). "Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis". Chron Respir Dis. 18: 14799731211002240. doi:10.1177/14799731211002240. PMC 7975482 Check |pmc= value (help). PMID 33729021 Check |pmid= value (help).
  33. Shah W, Hillman T, Playford ED, Hishmeh L (2021). "Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline". BMJ. 372: n136. doi:10.1136/bmj.n136. PMID 33483331 Check |pmid= value (help).
  34. Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L (2020). "Management of post-acute covid-19 in primary care". BMJ. 370: m3026. doi:10.1136/bmj.m3026. PMID 32784198 Check |pmid= value (help).
  35. Herrera JE, Niehaus WN, Whiteson J, Azola A, Baratta JM, Fleming TK; et al. (2021). "Multidisciplinary collaborative consensus guidance statement on the assessment and treatment of fatigue in postacute sequelae of SARS-CoV-2 infection (PASC) patients". PM R. 13 (9): 1027–1043. doi:10.1002/pmrj.12684. PMC 8441628 Check |pmc= value (help). PMID 34346558 Check |pmid= value (help).
  36. Bouteleux B, Henrot P, Ernst R, Grassion L, Raherison-Semjen C, Beaufils F; et al. (2021). "Respiratory rehabilitation for Covid-19 related persistent dyspnoea: A one-year experience". Respir Med. 189: 106648. doi:10.1016/j.rmed.2021.106648. PMC 8511554 Check |pmc= value (help). PMID 34689061 Check |pmid= value (help).
  37. Hargreaves IR, Mantle D (2021). "COVID-19, Coenzyme Q10 and Selenium". Adv Exp Med Biol. 1327: 161–168. doi:10.1007/978-3-030-71697-4_13. PMID 34279837 Check |pmid= value (help).
  38. Ouyang L, Gong J (2020). "Mitochondrial-targeted ubiquinone: A potential treatment for COVID-19". Med Hypotheses. 144: 110161. doi:10.1016/j.mehy.2020.110161. PMC 7403158 Check |pmc= value (help). PMID 32795832 Check |pmid= value (help).
  39. Gvozdjakova A, Klauco F, Kucharska J, Sumbalova Z (2020). "Is mitochondrial bioenergetics and coenzyme Q10 the target of a virus causing COVID-19?". Bratisl Lek Listy. 121 (11): 775–778. doi:10.4149/BLL_2020_126. PMID 33164536 Check |pmid= value (help).
  40. 40.0 40.1 Vollbracht C, Kraft K (2021). "Feasibility of Vitamin C in the Treatment of Post Viral Fatigue with Focus on Long COVID, Based on a Systematic Review of IV Vitamin C on Fatigue". Nutrients. 13 (4). doi:10.3390/nu13041154. PMC 8066596 Check |pmc= value (help). PMID 33807280 Check |pmid= value (help).