CC BY-NC-ND 4.0 · Horm Metab Res 2022; 54(08): 562-566
DOI: 10.1055/a-1878-9307
Review

Long-COVID, Metabolic and Endocrine Disease

Stefan R. Bornstein
1   Department of Medicine III, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
2   School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK
,
Diana Cozma
1   Department of Medicine III, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
,
Margrit Kamel
3   Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
,
Mawieh Hamad
4   Sharjah Institute for Medical Research, University of Sharjah College of Health Sciences, Sharjah, United Arab Emirates
,
5   Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
,
Naveed A. Khan
6   College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
,
6   College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
,
Mohammad H. Semreen
7   College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
,
Charlotte Steenblock
1   Department of Medicine III, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
› Author Affiliations

Abstract

In the aftermath of the corona pandemic, long-COVID or post-acute COVID-19 syndrome still represents a great challenge, and this topic will continue to represent a significant health problem in the coming years. At present, the impact of long-COVID on our health system cannot be fully assessed but according to current studies, up to 40% of people who have been infected with SARS-CoV-2 suffer from clinically relevant symptoms of long-COVID syndrome several weeks to months after the acute phase. The main symptoms are chronic fatigue, dyspnea, and various cognitive symptoms. Initial studies have shown that people with overweight and diabetes mellitus have a higher risk of developing long-COVID associated symptoms. Furthermore, repeated treatment of acute COVID-19 and long-COVID with steroids can contribute to long-term metabolic and endocrine disorders. Therefore, a structured program with rehabilitation and physical activity as well as optimal dietary management is of utmost importance, especially for patients with metabolic diseases and/or long-COVID. Furthermore, the removal of autoantibodies and specific therapeutic apheresis procedures could lead to a significant improvement in the symptoms of long-COVID in individual patients.



Publication History

Received: 16 March 2022

Accepted after revision: 06 April 2022

Accepted Manuscript online:
20 June 2022

Article published online:
09 August 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Kim Y, Bitna H, Kim SW. et al. Post-acute COVID-19 syndrome in patients after 12 months from COVID-19 infection in Korea. BMC Infect Dis 2022; 22: 93
  • 2 Nasserie T, Hittle M, Goodman SN. Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: a systematic review. JAMA Netw Open 2021; 4: e2111417
  • 3 Rogers JP, Chesney E, Oliver D. et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020; 7: 611-627
  • 4 Koczulla AR, Ankermann T, Behrends U. et al. [S1 guideline post-COVID/long-COVID]. Pneumologie 2021; 75: 869-900
  • 5 Ceravolo MG, Arienti C, de Sire A. et al. Rehabilitation and COVID-19: the Cochrane rehabilitation 2020 rapid living systematic review. Eur J Phys Rehabil Med 2020; 56: 642-651
  • 6 National Institute for Health and Care Excellence. Clinical guidelines. In: COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (NICE). NIE; 2020. available at: https://www.ncbi.nlm.nih.gov/books/NBK567264/
  • 7 Sudre CH, Murray B, Varsavsky T. et al. Attributes and predictors of long COVID. Nat Med 2021; 27: 626-631
  • 8 Blomberg B, Mohn KG, Brokstad KA. et al. Long COVID in a prospective cohort of home-isolated patients. Nat Med 2021; 27: 1607-1613
  • 9 Bornstein SR, Rubino F, Ludwig B. et al. Consequences of the COVID-19 pandemic for patients with metabolic diseases. Nat Metab 2021; 3: 289-292
  • 10 Bornstein SR, Zimmet P, Rubino F. et al. Management of diabetes in patients with COVID-19 – Authors’ reply. Lancet Diabetes Endocrinol 2020; 8: 669-670
  • 11 Steenblock C, Richter S, Berger I. et al. Viral infiltration of pancreatic islets in patients with COVID-19. Nat Commun 2021; 12: 3534
  • 12 Steenblock C, Schwarz PEH, Ludwig B. et al. COVID-19 and metabolic disease: mechanisms and clinical management. Lancet Diabetes Endocrinol 2021; 9: 786-798
  • 13 Wu Q, Zhou L, Sun X. et al. Altered lipid metabolism in recovered SARS patients twelve years after infection. Sci Rep 2017; 7: 9110
  • 14 Rubino F, Amiel SA, Zimmet P. et al. New-onset diabetes in Covid-19. N Engl J Med 2020; 383: 789-790
  • 15 Couzin-Frankel J. Antiviral pills could change pandemic’s course. Science 2021; 374: 799-800
  • 16 Mikus G, Foerster KI, Terstegen T. et al. Oral drugs against COVID-19-management of drug interactions with the use of nirmatrelvir/ritonavir. Dtsch Arztebl Int 2022; DOI: 10.3238/arztebl.m2022.0152.
  • 17 Foisy MM, Yakiwchuk EM, Chiu I. et al. Adrenal suppression and Cushing’s syndrome secondary to an interaction between ritonavir and fluticasone: a review of the literature. HIV Med 2008; 9: 389-396
  • 18 Dias SSG, Soares VC, Ferreira AC. et al. Lipid droplets fuel SARS-CoV-2 replication and production of inflammatory mediators. PLoS Pathog 2020; 16: e1009127
  • 19 Wang S, Li W, Hui H. et al. Cholesterol 25-Hydroxylase inhibits SARS-CoV-2 and other coronaviruses by depleting membrane cholesterol. EMBO J 2020; 39: e106057
  • 20 Kanczkowski W, Evert K, Stadtmuller M. et al. COVID-19 targets human adrenal glands. Lancet Diabetes Endocrinol 2022; 10: 13-16
  • 21 Steenblock C, Schwarz PEH, Perakakis N. et al. The interface of COVID-19, diabetes, and depression. Discover Mental Health 2022; 2: 5
  • 22 Su Y, Yuan D, Chen DG. et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 2022; 185: 881-895.e820
  • 23 Codo AC, Davanzo GG, Monteiro LB. et al. Elevated glucose levels favor SARS-CoV-2 infection and monocyte response through a HIF-1alpha/glycolysis-dependent axis. Cell Metab 2020; 32: 437-446 e435
  • 24 Mittal J, Ghosh A, Bhatt SP. et al. High prevalence of post COVID-19 fatigue in patients with type 2 diabetes: a case-control study. Diabetes Metab Syndr 2021; 15: 102302
  • 25 Fernandez-de-Las-Penas C, Guijarro C, Torres-Macho J. et al. Diabetes and the risk of long-term post-COVID symptoms. Diabetes 2021; 70: 2917-2921
  • 26 Montefusco L, Ben Nasr M, D’Addio F. et al. Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection. Nat Metab 2021; 3: 774-785
  • 27 Sathish T, Anton MC, Sivakumar T. New-onset diabetes in “long COVID”. J Diabetes 2021; 13: 693-694
  • 28 Mrigpuri P, Sonal S, Spalgais S. et al. Uncontrolled diabetes mellitus: A risk factor for post COVID fibrosis. Monaldi Arch Chest Dis 2021; 91 DOI: 10.4081/monaldi.2021.1607.
  • 29 Raveendran AV, Misra A. Post COVID-19 Syndrome (“Long COVID”) and diabetes: challenges in diagnosis and management. Diabetes Metab Syndr 2021; 15: 102235
  • 30 Miller L, Berber E, Sumbria D. et al. Controlling the burden of COVID-19 by manipulating host metabolism. Viral Immunol 2022; 35: 24-32
  • 31 Cengiz M, Borku Uysal B, Ikitimur H. et al. Effect of oral l-glutamine supplementation on Covid-19 treatment. Clin Nutr Exp 2020; 33: 24-31
  • 32 Eroglu I, Eroglu BC, Guven GS. Altered tryptophan absorption and metabolism could underlie long-term symptoms in survivors of coronavirus disease 2019 (COVID-19). Nutrition 2021; 90: 111308
  • 33 Lawler NG, Gray N, Kimhofer T. et al. Systemic perturbations in amine and kynurenine metabolism associated with acute SARS-CoV-2 infection and inflammatory cytokine responses. J Proteome Res 2021; 20: 2796-2811
  • 34 Matsuyama T, Yoshinaga SK, Shibue K. et al. Comorbidity-associated glutamine deficiency is a predisposition to severe COVID-19. Cell Death Differ 2021; 28: 3199-3213
  • 35 Thomas T, Stefanoni D, Reisz JA. et al. COVID-19 infection alters kynurenine and fatty acid metabolism, correlating with IL-6 levels and renal status. JCI Insight 2020; 5 DOI: 10.1172/jci.insight.140327.
  • 36 Julius U, Tselmin S, Schatz U. et al. Actual situation of lipoprotein apheresis in patients with elevated lipoprotein (a) levels. Atheroscler Suppl 2019; 40: 1-7
  • 37 Bornstein SR, Voit-Bak K, Donate T. et al. Chronic post-COVID-19 syndrome and chronic fatigue syndrome: is there a role for extracorporeal apheresis?. Mol Psychiatry 2022; 22: 34-37
  • 38 Morawietz H, Julius U, Bornstein SR. Cardiovascular diseases, lipid-lowering therapies and European registries in the COVID-19 pandemic. Cardiovasc Res 2020; 116: e122-e125