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Ultramicronized palmitoylethanolamide (um-PEA), a compound with antioxidant, anti-inflammatory and neuroprotective properties, appears to be a potential adjuvant treatment for early stages of Coronavirus disease 2019 (COVID-19). In our study, we enrolled 90 patients with confirmed diagnosis of COVID-19 that were randomized into two groups, homogeneous for age, gender and BMI. The first group received oral supplementation based on um-PEA at a dose of 1800 mg/day for a total of 28 days; the second group was the control group (R.S. 73.20). At baseline (T0) and after 28 days of um-PEA treatment (T1), we monitored: routine laboratory parameters, inflammatory and oxidative stress (OS) biomarkers, lymphocytes subpopulation and COVID-19 serological response. At T1, the um-PEA-treated group presented a significant reduction in inflammation compared to the control group (CRP p = 0.007; IL-6 p = 0.0001; neutrophils to lymphocytes ratio p = 0.044). At T1, the controls showed a significant increase in OS compared to the treated group (FORT p = 0.05). At T1, the um-PEA group exhibited a significant decrease in D-dimer levels (p = 0.0001) and higher levels of IgG against SARS-CoV-2 (p = 0.0001) compared to the controls. Our data demonstrated, in a randomized clinical trial, the beneficial effects of um-PEA in both asymptomatic and mild-symptomatic patients related to reductions in inflammatory state, OS and coagulative cascade alterations.

BACKGROUND: Myofascial pain is a complex health condition that affects the majority of the general population. Myalgia has been recognized as a symptom of long COVID syndrome. The treatment for long COVID syndrome-related myalgia lacks research. Dry needling is a technique that involves the insertion of a needle into the tissue of, or overlaying, a pain point. Wet needling is the addition of an injection of an analgesic substance such as lidocaine while performing needling. Both dry and wet needling have are practiced as treatment modalities for myofascial pain. Limited literature exists to define long COVID syndrome-related myalgia and its relation to myofascial pain, or to examine the utility of needling techniques for this pain. We report a case of dry and wet needling as effective treatments for long COVID-related myofascial pain.
METHODS: A 59-year-old, previously healthy Hispanic male with no comorbid conditions was diagnosed with COVID-19 pneumonia. The patient suffered moderate disease without hypoxia and was never hospitalized. Three months later, the patient continued to suffer from symptoms such as exertional dyspnea, \"brain fog,\" and myalgia. An extensive multisystem workup revealed normal cardiac, pulmonary, and end organ functions. The patient was then diagnosed with long COVID syndrome. The nature and chronicity of the patient\'s myalgia meet the criteria for myofascial pain. Both wet and dry needling were used to treat the patient\'s myofascial pain, with good short- and long-term therapeutic effects.
CONCLUSIONS: COVID-19 infection has been shown to exacerbate preexisting myofascial pain syndrome. Our case report indicates that long COVID syndrome-related myalgia is likely a form of new-onset myofascial pain. Additionally, both wet and dry needling can be utilized as an effective treatment modality for this pain syndrome, with short- and long-term benefits.

BACKGROUND: Post-COVID-19 fatigue is a frequent symptom in COVID-19 survivors, which substantially limits patients to achieve full recovery and potentially restrains return to work. The previous literature has not yet reported the use of pulsed electromagnetic fields in this indication.
METHODS: Over the course of 5 weeks, 10 sessions of pulsed electromagnetic field treatment with a high magnetic flux density were applied to a patient suffering from post-COVID-19 fatigue syndrome. Fatigue, work ability, quality of life as well as anxiety, depression, stress level, and resilience were evaluated using validated patient-reported outcome measures.
RESULTS: Fatigue, work ability, quality of life, and psychological well-being improved clearly over the course of the treatment and showed stable results 6 weeks later.
CONCLUSIONS: The use of pulsed electromagnetic field therapy with a device that allows sufficient penetration of the body tissue might be a promising physical modality to manage post-COVID-19 fatigue syndrome, which could reduce clinical and economic health consequences. Clinical sham-controlled studies are needed to evaluate the effect of pulsed electromagnetic fields in this indication.
UNASSIGNED: GRUNDLAGEN: Das Post-COVID-19-Erschöpfungssyndrom ist ein häufiges Syndrom nach COVID-19, das die vollständige Genesung und möglicherweise auch die Rückkehr in den Arbeitsprozess erheblich einschränkt. In der bisherigen wissenschaftlichen Literatur wurde noch nicht über den Einsatz gepulster Magnetfelder bei dieser Indikation berichtet.
METHODS: Eine Patientin, die an einem Post-COVID-19 Erschöpfungssyndrom litt, wurde über einen Zeitraum von 5 Wochen mit 10 Einheiten gepulster Magnetfeldtherapie von hoher magnetischer Flussdichte behandelt. Müdigkeit, Arbeitsfähigkeit, Lebensqualität, Ängstlichkeit, Depression, Stressniveau und Resilienz wurden mittels validierter Fragebögen erfasst.
UNASSIGNED: Die Müdigkeit, Arbeitsfähigkeit, Lebensqualität und das psychische Wohlbefinden besserten sich im Verlauf der Behandlung deutlich und zeigten auch 6 Wochen später stabile Ergebnisse.
UNASSIGNED: Die Anwendung der gepulsten Magnetfeldtherapie mit einem Gerät, das eine ausreichende Eindringtiefe in das Körpergewebe ermöglicht, könnte eine vielversprechende physikalische Methode zur Behandlung des Erschöpfungssyndroms nach COVID-19 sein, um die gesundheitlichen und wirtschaftlichen Folgen der Erkrankung zu reduzieren. Klinische placebokontrollierte Studien sind notwendig, um die Wirkung gepulster Magnetfeldtherapie in dieser Indikation zu erforschen.