Long COVID, mitochondrial dysfunction, post-exertional malaise (PEM), microcirculation LONG COVID, reduced cell energy, crash after effort (PEM), Blood flow in the tiniest blood vessels
Conditions
Interventions
To measure mitoPO2 and mitoVO2, a 5-ALA patch is applied to the skin of the upper arm. This substance is converted into PPIX within the mitochondria, which reacts with oxygen. This reaction allows us
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
2 Years to 64 Years
Inclusion criteria
Inclusion criteria: Long - COVID patients (group 1, 2 and 4) Age:Group 1 and 2: >18 years and <65 yearsGroup 4: >6 years and <65 yearsLong COVID-19 diagnosis, based on Positive PCR Positive Sars-Cov2 serology Positive rapid antigen testTypical clinical syndrome during the first pandemic wave, when testing was not possible Long COVID/Post-COVID-19 diagnosis based on World Health Organisation (WHO) consensus diagnosis: (“Long COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time)” Bell's Disability Scale score 30 - 60 (group 1) or =30 (group 2) Long COVID duration > 6 months Reduced school attendance, more than 20% absence (group 4) Presence of post-exertional malaise (self-reported) Provided written informed consent Convalescent Controls Age:Group 1 and 2: >18 years and <65 yearsGroup 4: >6 years and <65 yearsPast COVID-19 diagnosis, based on Positive PCR Positive Sars-Cov2 serology Positive rapid antigen test Typical clinical syndrome during the first pandemic wave, when testing was not possible No diagnosis of long COVID, good recovery. Overall functioning >95% compared to functioning prior COVID-19 infection Self-reported general good wellbeing Provided written informed consent MIS-C patients (Group 3) Age >6 years and <65 years PICU admission in acute fase of illness related to COVID-19 infection Post COVID-19 diagnosis, based on Positive PCR Positive Sars-Cov2 serology Positive rapid antigen test Typical clinical syndrome during the first pandemic wave, when testing was not possible Self-reported complaints resulting in a varying impact on daily life (including PEM, saltered school attendance)
Exclusion criteria
Exclusion criteria: Long COVID and MIS-C patients Unable or not willing to provide written informed consent Unable to complete written questionnaires in Dutch Alternative diagnosis that may explain clinical symptoms Active treatment with hyperbaric oxygen treatment during study start Diagnosis of dementia Suffering from any immune-driven disease or structural use of anti-inflammatory therapy of any kind (including NSAIDs and steroids) during the last 3 months Re-infection with SARS-CoV-2 or a booster vaccination in the past 3 months Suffering from uncontrolled hypertension, diabetes mellitus Use of anticoagulants in last 4 weeks Convalescent Controls Unable or not willing to provide written informed consent Unable to complete written questionnaires in Dutch Diagnosis of dementia Suffering from any immune-driven disease or structural use of anti-inflammatory therapy of any kind (including NSAIDs and steroids), including during the last 3 months Re-infection with SARS-CoV-2 or a booster vaccination in the past 3 months. Suffering from uncontrolled hypertension, diabetes mellitus Use of anticoagulants in last 4 weeks
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Changes in mitoPO2 and mitoVO2 before and after sub-maximal exercise and during a follow-up visit (after 24-72 hours) during a consecutive PEM-episode. | — |
Secondary
| Measure | Time frame |
|---|---|
| As secondary objectives, we aim to explore the underlying mechanisms of PEM in long COVID by investigating potential contributors such as tissue hypoxia, microvascular dysfunction, and impaired oxygen utilization. This includes examining the roles of inflammation, endothelial dysfunction, altered angiogenesis and in vivo mitochondrial testing. | — |
Countries
Netherlands
Contacts
Public ContactF.A. Harms
Erasmus MC, Universitair Medisch Centrum Rotterdam
Outcome results
None listed