Post-COVID-Syndrom: Interaktion von Fatigue, Schlafstörungen und Immunsystem

„Genesen, aber nicht gesund“ – das ist die Situation, in der sich etwa 10–15 % der Menschen nach einer COVID-19-Erkrankung befinden. Das Hauptsymptom besteht in einer oft sehr beeinträchtigenden Fatigue. Die subjektive Natur dieses Symptoms und das unvollständige Verständnis von dessen Pathogenese lassen es teils schwer fassbar erscheinen. Dennoch haben wir inzwischen viel über mögliche zugrundeliegende Krankheitsmechanismen gelernt.

Publication History

Article published online:
28 August 2023

• Literatur

• 1 FAIR Health. Patients diagnosed with post-COVID conditions: an analysis of private healthcare claims using the official ICD-10 diagnostic code. FAIR Health 2022
• 2 Ceban F, Ling S, Lui LMW. et al. Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis. Brain Behav Immun 2022; 101: 93-135
• 3 Seeßle J, Waterboer T, Hippchen T. et al. Persistent Symptoms in Adult Patients 1 Year After Coronavirus Disease 2019 (COVID-19): A Prospective Cohort Study. Clin Infect Dis 2022; 74 (7) 1191-1198
• 4 Peter RS, Nieters A, Kräusslich HG. et al. Post-acute sequelae of covid-19 six to 12 months after infection: population based study. Bmj 2022; 379: e071050
• 5 Tran VT, Porcher R, Pane I. et al. Course of post COVID-19 disease symptoms over time in the ComPaRe long COVID prospective e-cohort. Nat Commun 2022; 13 (1) 1812
• 6 Taquet M, Sillett R, Zhu L. et al. Neurological and psychiatric risk trajectories after SARS-CoV-2 infection: an analysis of 2-year retrospective cohort studies including 1 284 437 patients. Lancet Psychiatry 2022; 9 (10) 815-827
• 7 Woelfer M, Kasties V, Kahlfuss S. et al. The Role of Depressive Subtypes within the Neuroinflammation Hypothesis of Major Depressive Disorder. Neuroscience 2019; 403: 93-110
• 8 Davis HE, McCorkell L, Vogel JM. et al. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol 2023; 21: 133-146
• 9 Astin R, Banerjee A, Baker MR. et al. Long COVID: mechanisms, risk factors and recovery. Exp Physiol 2023; 108 (1) 12-27
• 10 Adelman JS, Martin LB. Vertebrate sickness behaviors: Adaptive and integrated neuroendocrine immune responses. Integr Comp Biol 2009; 49 (3) 202-214
• 11 Lange T, Luebber F, Grasshoff H. et al. The contribution of sleep to the neuroendocrine regulation of rhythms in human leukocyte traffic. Semin Immunopathol 2022; 44 (2) 239-254
• 12 Klein J, Wood J, Jaycox J. et al. Distinguishing features of Long COVID identified through immune profiling. medRxiv 2022 [im Druck]
• 13 Irwin MR. Sleep and inflammation: partners in sickness and in health. Nat Rev Immunol 2019; 19 (11) 702-715
• 14 Huang B, Niu Y, Weigui Z. et al. Reduced Sleep in the Week Prior to Diagnosis of COVID-19 is Associated with the Severity of COVID-19. Nat Sci Sleep 2020; 12: 999-1007
• 15 Paul E, Fancourt D. Health behaviours the month prior to COVID-19 infection and the development of self-reported long COVID and specific long COVID symptoms: a longitudinal analysis of 1581 UK adults. BMC Public Health 2022; 22 (1) 1716
• 16 Hurtado-Alvarado G, Dominguez-Slazar E, Pavon L. et al. Blood-Brain Barrier Disruption Induced by Chronic Sleep Loss: Low-Grade Inflammation May Be the Link. J Immunol Res 2016; 4576012
• 17 Schilling C, Meyer-Lindenberg A, Schweiger JA. Cognitive disorders and sleep disturbances in long COVID . Nervenarzt 2022; 93 (8) 779-787
• 18 Moura AEF. et al. Central hypersomnia and chronic insomnia: expanding the spectrum of sleep disorders in long COVID syndrome – a prospective cohort study. BMC Neurol 2022; 22 (1) 417
• 19 Hertenstein E, Feige B, Gmeiner T. et al. Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Sleep Med Rev 2019; 43: 96-105
• 20 Omdal R. The biological basis of chronic fatigue: neuroinflammation and innate immunity. Current opinion in neurology 2020; 33 (3) 391-396