It is unclear how the risk of post-covid symptoms evolved during the pandemic, especially before the spread of Severe Acute Respiratory Syndrome Coronavirus 2 variants and the availability of vaccines. We used modified Poisson regressions to compare the risk of six-month post-covid symptoms and their associated risk factors according to the period of first acute covid: during the French first (March-May 2020) or second (September-November 2020) wave. Non-response weights and multiple imputation were used to handle missing data. Among participants aged 15 or more in a national population-based cohort, the risk of post-covid symptoms was 14.6% (95% CI: 13.9%, 15.3%) in March-May 2020, versus 7.0% (95% CI: 6.3%, 7.7%) in September-November 2020 (adjusted RR: 1.36, 95% CI: 1.20, 1.55). For both periods, the risk was higher in the presence of baseline physical condition(s), and it increased with the number of acute symptoms. During the first wave, the risk was also higher for women, in the presence of baseline mental condition(s), and it varied with educational level. In France in 2020, the risk of six-month post-covid symptoms was higher during the first than the second wave. This difference was observed before the spread of variants and the availability of vaccines.

OBJECTIVE: Post-COVID Conditions (or Long COVID) have been widely reported, but population-based studies exploring the relationship between its risk factors are lacking. We examined the associations between Long COVID, chronic obstructive pulmonary disease [COPD], vaccination status, and cigarette smoking. We also tested for the modifying effect of COPD status.
METHODS: Data from the 2022 US nationwide Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Our primary outcome was Long COVID (Yes/No) after a positive COVID-19 diagnosis. Predictor variables were COPD, coronary heart disease (CHD), diabetes, asthma, body mass index, cigarette smoking status, and number of COVID-19 vaccinations (0-4). Weighted multivariable logistic regression models were used and adjusted for sociodemographic factors. Regression models were used to explore the modifying effects of COPD status.
RESULTS: The weighted prevalence of Long COVID among survivors (N = 121,379) was 21.8% (95%CI: 21.4, 22.3), with tiredness/fatigue (26.2% [95%:25.1, 27.2]) as the most common symptom. Respondents with COPD (aOR: 1.71 [95%CI: 1.45, 2.02]), current daily smokers (aOR: 1.23 [95%CI:1.01, 1.49]), and former smokers (aOR: 1.24 [95%CI:1.12, 1.38]) (vs. never established smokers) had higher odds of Long COVID. However, respondents who had received three (aOR: 0.75 [95%CI:0.65, 0.85]) and four (aOR: 0.71 [95%CI:0.58, 0.86]) vaccine doses (vs. no vaccine) had lower odds of Long COVID. COPD had a modifying effect on the relationship between cigarette smoking and Long COVID (p-value: 0.013).
CONCLUSIONS: Our findings underscore a complex interaction between COPD, cigarette smoking, and Long COVID. Further, COVID-19 vaccination may be protective against Long COVID.

Delirium, memory loss, attention deficit and fatigue are frequently reported by COVID survivors, yet the neurological pathways underlying these symptoms are not well understood. To study the possible mechanisms for these long-term sequelae after COVID-19 recovery, we investigated the microstructural properties of white matter in Indian cohorts of COVID-recovered patients and healthy controls. For the cross-sectional study presented here, we recruited 44 COVID-recovered patients and 29 healthy controls in New Delhi, India. Using deterministic whole-brain tractography on the acquired diffusion MRI scans, we traced 20 white matter tracts and compared fractional anisotropy, axial, mean and radial diffusivity between the cohorts. Our results revealed statistically significant differences (PFWE < 0.01) in the uncinate fasciculus, cingulum cingulate, cingulum hippocampus and arcuate fasciculus in COVID survivors, suggesting the presence of microstructural abnormalities. Additionally, in a subsequent subgroup analysis based on infection severity (healthy control, non-hospitalized patients and hospitalized patients), we observed a correlation between tract diffusion measures and COVID-19 infection severity. Although there were significant differences between healthy controls and infected groups, we found no significant differences between hospitalized and non-hospitalized COVID patients. Notably, the identified tracts are part of the limbic system and orbitofrontal cortex, indicating microstructural differences in neural circuits associated with memory and emotion. The observed white matter alterations in the limbic system resonate strongly with the functional deficits reported in Long COVID. Overall, our study provides additional evidence that damage to the limbic system could be a neuroimaging signature of Long COVID. The findings identify targets for follow-up studies investigating the long-term physiological and psychological impact of COVID-19.

The SARS-CoV-2 virus is the cause of the COVID-19 disease. Infection can take a wide variety of forms, from asymptomatic to severe, with numerous complications that can even lead to death. Since the beginning of the pandemic, numerous studies have been carried out to find out the exact expression of the virus. COVID-19 infection also increases the risk of developing neuropsychiatric symptoms, including psychosis. The paper presents the case of a 35-year-old woman with no prior psychiatric interview who developed acute psychosis after being infected with COVID-19. She was treated in the standard way: haloperidol, lorazepam and diazepam. The symptoms disappeared quickly. At the moment, the long-term consequences of SARS-CoV-2 infection are not known, therefore further observation and research in this direction is necessary. Treatment, as shown in this case report, appears to be supportive and symptomatic. The optimal antiviral treatment has yet to be clearly defined, and research into the best treatment for the virus itself is still ongoing.

The purpose of this study was to present and analyze patients with audiovestibular post COVID-19 syndrome, and highlight the most characteristic and most common findings. We analyzed 87 patients aged between 20 and 86 years who presented to the Audiology Division between February 1, 2021 and July 1, 2021 after having been isolated due to the SARS-CoV-2 infection. Study patients presented with complaints of persistent hearing loss, tinnitus, and vertigo, lasting for more than 3 months. Study results showed that there was acute sensorineural hearing loss in 4 patients during the SARS-CoV-2 infection. None of the patients experienced complete hearing recovery after 3 months. High frequency hearing loss (at 4 kHz and 6 kHz) occurred bilaterally, and was found in 52 patients. This finding of gradual hearing loss was both the most characteristic and most common in COVID patients. Extensive damage can directly occur to inner ear structures, including hair cells, the Corti organ, and the cochlear nerve because of this viral infection. A total of 73 patients had tinnitus. 68 patients had unilateral tinnitus, and only 5 patients had bilateral tinnitus. Exacerbation of tinnitus was recorded in 12 patients and new-onset tinnitus in 61 patients. Vertigo occurred in 9 patients, all of which were new-onset. A conclusion of our research is that audiovestibular post-COVID syndrome does exist. Further research with more patients and over a longer period is needed to obtain a better and longer effect on the audiovestibular system and audiovestibular complications, as well as an insight into possible recovery.

Background Long COVID is a multisystem condition with prolonged symptoms that develop after recovery from the COVID-19 infection, often following a mild infection. Few studies have been conducted on cognitive function among medical students after recovery from mild COVID-19. This study aimed to assess the attention span and working memory (WM) capacity of medical students after six months of recovery. Methods A cross-sectional study was performed on 17 young adult medical students who had suffered a mild COVID-19 infection at least six months prior. Eighteen age-matched healthy medical students served as the controls. Audio-visual WM tasks and attention spans were assessed using computerized software for both the cases and controls. Results The mean ages of the case and control were 19.67±1.6 and 20.0±1.2 years, respectively. The most common symptoms among cases were fatigue (33%), weight loss (26%), and nasal stuffiness (13%). The overall proportion of correct responses across all visual and auditory WM tasks (p=0.085) and reaction times (p=0.609) did not differ between the cases and controls. However, the overall target hit rate of the auditory WM task was significantly lower in cases than in controls (p=0.002). This difference was not observed in the visual WM task (p=0.374). Conclusion In the current study, the overall WM functions (visual and auditory combined) and attention span did not differ between cases and controls. However, auditory WM performance was significantly impaired in patients compared with controls, indicating selective impairment of auditory WM in patients with long COVID.

BACKGROUND: An infection with coronavirus disease 2019 (COVID-19) might show a wide range of symptoms. Many individuals still experience symptoms after a prolonged period of initial COVID-19.
OBJECTIVE: The objective is to find out the prolonged consequences of COVID-19 with their associations.
METHODS: Two hundred and eighty-six COVID-19 cases were the subject of this cross-sectional investigation, which was carried out in basic and secondary healthcare facilities in Bangladesh. COVID-19-positive participants with consent were interviewed in person about their sociodemographic traits, the nature of their COVID-19 infection, risk factors, present manifestations, etc. We carried out our statistical exploration by use of IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). To evaluate differences, we utilized the chi-square (χ2) test as well as the unpaired t-test. Our significance threshold level was 0.05.
RESULTS: In this study, 18.5% of participants reported having post-COVID-19 symptoms. The four main symptom categories were anorexia (26.4%), myalgia (34.8%), fatigue (41.5%), and palpitations (25.5%). The majority of post-COVID-19 syndrome patients (e.g., 40.0%) were over 50 years old. Severe disease (81.8%) was more likely to develop post-COVID-19 illness.
CONCLUSIONS: Fifty-three out of 286 participants (or 18.5%) reported having post-COVID-19 symptoms. The main symptom categories included fatigue, myalgia, anorexia, and palpitations. In order to determine the risk variables our data supports, additional investigation is required.

Background On December 21, 2019, a pneumonia-like outbreak of an unknown cause or origin was found to be emerging in Wuhan, China. In India, the first case of COVID-19 was found in Kerala and then started to spread all over India. Most of the infected people have recovered from the disease, but some patients were found to have symptoms at post-discharge follow-up. Although there are many studies on COVID-19 symptoms and signs during hospital stays, there is a scarcity of information regarding post-COVID-19 manifestations. The purpose of this study is to analyze the clinical characteristics of post-COVID-19 symptoms in patients attending the post-COVID-19 clinics. Methods A descriptive study was started on August 2021 at a tertiary care hospital in Southern India after institutional research and ethics committee clearance. All patients attending the post-COVID clinic, who tested positive for COVID-19 (RT-PCR or rapid antigen test (RAT) diagnosed or radiographically diagnosed COVID-19 (COVID-19 Reporting and Data System [CO-RADS] 5) were recruited. The proportion of people developing post-COVID-19 manifestations and categorization of symptoms in post-COVID-19 and its relationship to the severity of COVID-19 infections and the differences in post-COVID symptoms between hospitalized and non-hospitalized patients were studied. Results We enrolled 227 post-COVID patients who presented to the post-COVID clinic. The median age (IQR) of the participant was 52 (38-59) years, and the male-to-female ratio was 126/101 (1.24). Among 227 patients, 164 (72%) patients had exertional dyspnea, 109 (48%) patients had cough with expectoration, 96 (42.2%) patients with fatigue, 28 (12.33%) patients had myalgia, 18 (7.92) patients had a fever, 12 (5.28%) patients had hair loss, and 30 (13%) had other issues (loss of smell, sleep disturbances, and headache). Among 227, 142 (62.5%) patients were admitted to the hospital for acute COVID-19, and 85 (37.4) patients were in home isolation, but no statistical significance was found between in symptoms. Conclusion From this descriptive study, a high prevalence of post-COVID symptoms was noted, such aslike post-SARS syndrome. Mostly, researchers and clinicians have focused on acute COVID-19, but long-term follow-up with multidisciplinary evaluation and treatment is needed in all patients who recovered from acute COVID-19.

This study aims to demonstrate the improvements in clinical symptoms in patients with post-COVID syndrome after a community pharmacy-based intervention in Serbia. The Pharmaceutical Chamber of Serbia (\"Chamber\") invited pharmacists to deliver post-COVID patient care counselling, supported by the SMART Pharmacist Program, offering education and guidance. Present symptoms, duration and patient self-reported severity of symptoms on a scale of 1-5 on the first visit were recorded. After the counselling and proposed self-medication treatment, the time of the follow-up visit and the severity of the recorded symptoms were also recorded. The prospective data collection lasted from December 2021 to September 2022. In total, 871 patients with post-COVID symptoms were included in the study, served by 53 pharmacists. The most frequently reported post-COVID symptoms coincided with the literature, mostly related to the respiratory system (51.2%), immunity status (32.2%), fatigue and exhaustion (30.7%), skin, hair and nails (27.4%) and cognitive functions (27.9%). A total of 26.5% of patients were referred to their family physician (general practitioner), and 69.5% returned to the pharmacist for a follow-up visit. On the first visit, the median severity of patients\' symptoms was three, while on the second visit it dropped to one. The pharmacists\' intervention led to a significant improvement in the post-COVID patients\' condition.

Food supplements based on fermented Carica papaya and Morinda citrifolia, known for their immune modulating, redox balancing, and anti-inflammatory effects, were added to conventional treatment protocols prescribed to patients recovering after severe and moderate COVID-19 disease in order to alleviate long-lasting post-COVID symptoms. A randomized single-center placebo-controlled clinical laboratory study was designed and performed (total number of participants 188, with delta variant of virus 157, with omicron 31). Clinical statuses were assessed using computer tomography, electrocardiography, a questionnaire, and physical endurance. Plasma cytokines (IL-6, IL-8, IL-17A, and INF-gamma), nitrate/nitrite ratio, antioxidant activity (AOA), and polymorphonuclear leukocyte (PMN) ATP levels were determined before and 20 days following the addition of 28 g of fermented supplements twice per day. The capacity of PMN to phagocyte and the oral-nasal-pharyngeal microbiota were assessed. Clinical symptoms, IL-6, IL-8, and nitric oxide metabolites diminished significantly compared to the placebo group and their background expression. The PMN capacity to phagocyte, AOA, and ATP content remarkably increased. The oral-nasal-pharyngeal microbiota were unchanged. On these grounds, we suggest that fermented tropical fruits could efficiently diminish post-COVID clinical symptoms through several immune-modulating, redox balancing, and pro-energy mechanisms.