Long Covid Weekly #108: LC affecting Resting Heart Rate? Text mining LC and more
Hi everyone! In this edition, we will look into the complex interplay between persistent conditions like Lyme disease and the enigmatic symptoms of Long Covid. We will also look at some interesting studies, including innovative text mining methods to better understand the clinical profiles of hospitalized Long Covid patients, insights on pre-existing health factors that may influence Long Covid risk, and the long-term impacts of wearable sensor data.
This week's article of the week is titled "Long-term changes in wearable sensor data in people with and without Long Covid," published in npj Digital Medicine. The research looks into how Long Covid affects physiological markers and daily activities over an extended period by comparing changes in wearable sensor data among individuals with and without Long Covid after a SARS-CoV-2 infection.
Key findings from the study include:
Participants with Long Covid exhibited resting heart rates (RHR) that remained elevated for an average of 133 days post-infection, contrasting with those without Long Covid, who returned to baseline after 71 days. This persistent change underscores the profound impact of Long Covid on physical health.
The study indicates that "data availability well preceded acute infection," allowing for a clearer understanding of pre-infection baselines and underscoring the objective evidence provided by long-term sensor data.
Here is the link to the Long Covid Weekly Database.
Media
Article: Mysteries of persistent Lyme disease run into enigmas of long Covid | Stat News
DEFINITIONS:
Chronic Lyme disease: Persistent symptoms following the acute phase of Lyme disease, which may evolve into post-treatment Lyme disease syndrome (PTLDS), characterized by fatigue, pain, and cognitive issues.
Post-treatment Lyme disease syndrome (PTLDS): A condition affecting some individuals post-treatment for Lyme disease, where symptoms such as fatigue, pain, and cognitive difficulties can persist for months or years.
SUMMARY:
The struggle to define chronic Lyme disease is complicated by overlapping symptoms with long Covid and the absence of clear diagnostics.
Many Lyme disease patients face challenges in ruling out long Covid, which can obscure their original diagnosis and treatment.
Ongoing research seeks to differentiate between long Covid and post-treatment Lyme disease syndrome (PTLDS), aiming to develop tailored therapies for patients who have suffered for years.
Chronic Lyme disease symptoms, such as body pain, profound fatigue, and cognitive difficulties, mirror those of long Covid, complicating diagnosis.
Without reliable biomarkers, clinicians struggle to determine the root causes of patients' ailments, hindering effective treatment.
The NIH’s recent funding opportunities signal a growing recognition of the need for a comprehensive approach to address chronic illnesses like long Covid and Lyme disease.
My Take:
This situation underscores the need for unified research on chronic post-infectious conditions like Lyme disease and long Covid. Both share a concerning lack of effective therapies and diagnostic clarity.
Article: N3C Study Shows Health Factors Before COVID-19 Infection May Predict Long COVID Risk | National Center for Advancing Translational Sciences
DEFINITIONS:
Electronic Health Records (EHRs): Digital versions of patients' paper charts, containing comprehensive information about patient health and treatment history.
SUMMARY:
A recent study indicates that a person’s healthcare utilization before a COVID-19 infection may be the most significant predictor of developing long COVID.
The research, conducted using electronic health records from over 55,000 individuals in the N3C database, could enhance preventive strategies for at-risk populations.
The study utilized a machine-learning tool, SuperLearner, to effectively predict individuals’ susceptibility to long COVID based on their past healthcare data.
The strongest predictor was the overall frequency of healthcare visits prior to contracting COVID-19, rather than specific medical concerns.
Other contributing risk factors included the number of health visits during acute COVID-19, age, and prior use of systemic corticosteroids
Research
Article: Long-term changes in wearable sensor data in people with and without Long Covid | npj Digital Medicine
DEFINITIONS:
Resting Heart Rate (RHR): The number of times the heart beats per minute while at rest, often used as an indicator of fitness and cardiovascular health.
Wearable sensor data: Information collected from devices such as smartwatches or fitness trackers that monitor physiological and behavioral metrics, including heart rate, physical activity, and sleep patterns.
SUMMARY:
This study analyzes long-term changes in daily wearable data, such as step count, resting heart rate, and sleep quantity, for up to one year in individuals with and without Long COVID.
Participants with Long COVID exhibited significantly different trajectories in resting heart rate and activity levels compared to those without Long COVID, indicating long-lasting physiological changes.
Notably, individuals with Long COVID were primarily younger women who were unvaccinated and reported more acute-phase symptoms than those without Long COVID.
The findings suggest that demographic and acute-phase data could help identify individuals at risk of developing Long COVID and monitor therapeutic interventions.
While individuals with Long COVID experienced prolonged elevations in resting heart rate, those without returned to baseline more quickly.
My Take:
It underscores the potential of wearable technology to transform health monitoring post-infection and the link between unvaccinated status and an increased risk of Long COVID.
Article: Viral, Immunologic, and Laboratory Parameters in Patients With and Without Post-Acute Sequelae of SARS-CoV-2 Infection (PASC):Journal of Korean Medical Science
DEFINITIONS:
Nucleocapsid Protein (NP): A protein associated with the SARS-CoV-2 virus, crucial for packaging viral RNA and a target for diagnostic testing.
Cytokines: Small proteins that facilitate communication in the immune system, playing a key role in the body’s response to infections and injuries.
SUMMARY:
The study investigates the pathophysiological mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC) by examining viral persistence, immune responses, and laboratory parameters.
Among 57 enrolled COVID-19 patients, 51% were identified as having PASC, correlating with significantly elevated nucleocapsid protein (NP) antigen levels three months post-diagnosis.
Various cytokines, including IL-2, IL-17A, and RANTES, were markedly elevated in PASC patients after one and three months, suggesting immune dysregulation.
The research emphasizes that PASC may be driven by prolonged immune activation due to persistent antigenic stimulation, particularly from NP antigenemia.
These findings highlight the need for ongoing research into the complex immunopathological mechanisms of PASC to develop targeted treatments and understand long-term recovery prospects.
Article: Incidence, symptom clusters and determinants of post-acute COVID symptoms: a population-based surveillance in community-dwelling users of the COVID RADAR app | BMJ Open
DEFINITIONS:
Cohort study: A type of observational study involving a group of individuals who share a common characteristic or experience within a defined period.
Self-selection bias: A form of bias where individuals choose to participate in a study based on their experiences, potentially affecting the generalizability of the findings.
SUMMARY:
The study reports on the incidence and persistence of post-acute COVID symptoms among 1,478 users of the COVID RADAR app in the Netherlands, with data collected from April 2020 to February 2022.
Out of the participants, 8% continued to experience symptoms 100 days after their initial COVID-19 diagnosis, with the most common symptoms being cough, loss of smell or taste, and fatigue.
Three distinct clusters of post-acute COVID symptoms were identified: non-respiratory (including headache and fatigue), olfactory (loss of smell or taste), and respiratory symptoms.
Vaccination before infection appeared to reduce the risk of post-acute COVID symptoms, particularly respiratory symptoms, although wide confidence intervals suggest caution in interpretation.
Participants with more severe acute COVID-19 presentations were more likely to experience prolonged post-acute symptoms.
Article: Text mining method to unravel long COVID’s clinical condition in hospitalized patients | Cell Death & Disease
DEFINITIONS:
Text Mining: The process of deriving high-quality information from text by identifying patterns and extracting meaningful data, often used with unstructured data like Electronic Healthcare Records (EHR).
Phonetic Text Clustering (PTC): A method for grouping text data based on phonetic similarities, accommodating variations in language, spelling, and pronunciation.
SUMMARY:
The study introduces a novel text mining method to automatically extract unstructured data from long COVID surveys conducted at a leading university hospital in São Paulo, Brazil.
The phonetic text clustering (PTC) method unifies various written forms of similar terms into a single phonemic representation, enhancing data extraction from Electronic Healthcare Records.
An analysis revealed that 70.9% of the study population experienced at least one symptom of long COVID after 30 days of discharge, underscoring the prevalence of post-COVID conditions.
The automated PTC method was validated against manual classification, demonstrating a high degree of accuracy in capturing medical conditions and symptoms.
The implications of this study extend beyond Brazil, showcasing how scalable text mining methods can aid in developing global healthcare strategies for managing long COVID.
My Take:
By harnessing these methods, we can better capture patient narratives and improve treatment protocols across diverse healthcare systems.
Super interesting and innovative study!
Article: Chemosensory assessment and impact on quality of life in neurosensorial cluster of the post COVID 19 syndrome | Scientific Reports
DEFINITIONS:
Neurosensorial cluster of post-COVID-19 syndrome (NSc-PCS): A subset of lingering symptoms following COVID-19 characterized primarily by sensory dysfunctions, including loss or alteration of smell (anosmia or hyposmia) and taste (ageusia or dysgeusia).
Olfactory training: A therapeutic approach that involves repeated exposure to different odorants to help individuals recover their sense of smell through structured practice.
Psychophysical assessment: Standardized testing to evaluate sensory functions, such as smell and taste, using validated methodologies to quantify defects or alterations.
SUMMARY:
This study investigates the prevalence and characteristics of the neurosensorial cluster of post-COVID-19 syndrome (NSc-PCS), which includes chemosensory issues such as smell and taste dysfunction.
Of the 1,187 COVID-19 patients evaluated, 550 (47%) reported sensory impairments, significantly impacting quality of life for many individuals.
The research highlights a higher incidence of chemosensory dysfunction in females and suggests that younger age and certain treatments may lower risks.
Psychophysical assessments revealed significant alterations in smell in two-thirds of patients and considerable qualitative changes in taste.
While overall quality of life scores for individuals with NSc-PCS were not markedly different, specific domains related to physical functioning were distinctly impacted.
The study emphasizes the need for enhanced diagnostics and therapeutic strategies, particularly olfactory training, to address these persistent chemosensory issues.
Click on PDF to view full article
SUMMARY:
There is evidence of an elevated risk of new-onset diabetes after COVID-19. This study evaluated whether this association is consistent across time and with contemporary viral variants.
This retrospective cohort study used data from the National COVID Cohort Collaborative (N3C). 7,010,922 participants were included in the final cohort.
Diabetes was diagnosed at an increased rate over the different variant eras (ancestral, Alpha, Delta, and Omicron) of COVID-19.
Risk of incident diabetes 1 year after COVID-19 was increased for patients with any viral variant compared with COVID-negative control patients. This increased risk was similar across viral variants. There was a longer time to diabetes onset in the Omicron variant era.
Despite decreased severity and treatments with contemporary variants, incident diabetes risk is still elevated after COVID-19.
SUMMARY:
This cohort study of 1,766,036 adults in Singapore sought to determine whether there was an increased risk of autoimmune diagnoses after infection from SARS-CoV-2 in vaccinated cohorts who also received boosters against COVID-19.
Twelve autoimmune sequelae were included in the study, including connective tissue disorders (e.g lupus, polymyositis), vasculitis, inflammatory arthritis, inflammatory bowel disease, psoriasis, and autoimmune thyroiditis.
No significantly elevated risk of autoimmune sequelae was recorded across the Omicron and Delta variant cohorts. There was a modestly increased risk of inflammatory bowel disease and bullous skin disorders in one subgroup.
Booster vaccination appeared to mitigate the risk of long-term autoimmune sequelae.