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对持续性 COVID-19 后综合征(PPCS)的综述。

A Review of Persistent Post-COVID Syndrome (PPCS).

机构信息

EpicentRx Inc, La Jolla, 11099 North Torrey Pines Road, Suite 160, La Jolla, CA, 92037, USA.

Providence St. John's Health Center, Santa Monica, CA, USA.

出版信息

Clin Rev Allergy Immunol. 2023 Feb;64(1):66-74. doi: 10.1007/s12016-021-08848-3. Epub 2021 Feb 20.

Abstract

Persistent post-COVID syndrome, also referred to as long COVID, is a pathologic entity, which involves persistent physical, medical, and cognitive sequelae following COVID-19, including persistent immunosuppression as well as pulmonary, cardiac, and vascular fibrosis. Pathologic fibrosis of organs and vasculature leads to increased mortality and severely worsened quality of life. Inhibiting transforming growth factor beta (TGF-β), an immuno- and a fibrosis modulator, may attenuate these post-COVID sequelae. Current preclinical and clinical efforts are centered on the mechanisms and manifestations of COVID-19 and its presymptomatic and prodromal periods; by comparison, the postdrome, which occurs in the aftermath of COVID-19, which we refer to as persistent post-COVID-syndrome, has received little attention. Potential long-term effects from post-COVID syndrome will assume increasing importance as a surge of treated patients are discharged from the hospital, placing a burden on healthcare systems, patients' families, and society in general to care for these medically devastated COVID-19 survivors. This review explores underlying mechanisms and possible manifestations of persistent post-COVID syndrome, and presents a framework of strategies for the diagnosis and management of patients with suspected or confirmed persistent post-COVID syndrome.

摘要

持续性新冠后综合征,也称为长新冠,是一种病理实体,涉及新冠感染后持续存在的身体、医学和认知后遗症,包括持续的免疫抑制以及肺部、心脏和血管纤维化。器官和血管的病理性纤维化导致死亡率增加和生活质量严重恶化。抑制转化生长因子-β(TGF-β),一种免疫和纤维化调节剂,可能减轻这些新冠后后遗症。目前的临床前和临床努力集中在新冠及其无症状和前驱期的机制和表现上;相比之下,后综合征发生在新冠之后,我们称之为持续性新冠后综合征,很少受到关注。随着大量接受治疗的患者从医院出院,新冠后综合征的潜在长期影响将变得更加重要,这给医疗保健系统、患者家庭和整个社会带来了照顾这些饱受病痛折磨的新冠幸存者的负担。本综述探讨了持续性新冠后综合征的潜在机制和可能表现,并提出了疑似或确诊持续性新冠后综合征患者的诊断和管理策略框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ec7/7896544/2eb878396d9c/12016_2021_8848_Fig1_HTML.jpg

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