Behandlungsansätze für das Post-Covid-Syndrom

Summary

Etwa 10 % der Menschen, die sich mit SARS-CoV-2 infiziert haben, leiden nach der Akutinfektion unter dem sogenannten Post-Covid-Syndrom. Symptome hierbei sind Fatigue, Myalgie, Intoleranz für körperliche Betätigung, Schlafstörungen, Konzentrationsschwierigkeiten oder Angstzustände. Die Leitlinie zur Behandlung von Post Covid oder Long Covid empfiehlt eine multimodale und interdisziplinäre Therapie. In der Klinik für Integrative Medizin und Naturheilkunde am Klinikum Bamberg werden Post-Covid-Patient*innen mit Verfahren der Mind-Body-Medizin, der Mindfulness-Based Stress Reduction (MBSR), mit Yoga, Akupunktur, Phytotherapie, naturheilkundlichen Selbsthilfestrategien und wassergefilterter Infrarot-A-Ganzkörperhyperthermie behandelt.

Keywords

PostCovid - LongCovid - Erschöpfung - Fatigue - Sars-CoV-2

• Literatur

• 1 Zhou F, Yu T, Du R. et al Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020; 395: 1054-1062
• 2 National Institute for Health and Care Excellence. COVID-19 rapid guideline: Managing the long-term effects of COVID-19 (12/2020). Im Internet. www.nice.org.uk/guidance/ng188 Stand: 03.07.2023
• 3 Logue JK, Franko NM, McCulloch DJ. et al Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open 2021; 04 (02) e210830
• 4 Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr 2021; 15 (03) 869-875
• 5 Yong SJ. Long COVID or post-COVID-19 syndrome: Putative pathophysiology, risk factors and treatments. Infect Dis 2021; 53 (10) 737-754
• 6 Huang C, Huang L, Wang Y. et al 6-month consequences of COVID-19 in patients discharged from hospital: A cohort stud. Lancet 2021; 397 10270 220-232
• 7 Pušnik J, Monzon-Posadas WO, Zorn J. et al SARS-CoV-2 humoral and cellular immunity following different combinations of vaccination and breakthrough infection. Nat Commun 2023; 14 (01) 572
• 8 Phetsouphanh C, Darley DR, Wilson DB. et al Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection. Nat Immunol 2022; 23 (02) 210-216
• 9 Su Y, Yuan D, Chen D. et al Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 2022; 185 (05) 881-895
• 10 Patterson BK, Francisco EB, Yogendra R. et al Persistence of SARS CoV-2 S1 Protein in CD16+ monocytes in post-acute sequelae of COVID-19 (PASC) up to 15 months post-infection. Front Immunol 2022; 12: 746021
• 11 Cabral-Marques O, Halpert G, Schimke LF. et al Autoantibodies targeting GPCRs and AS-related molecules associate with COVID-19 severity. Nat Commun 2022; 13 (01) 1220
• 12 Wallukat G, Hohberger B, Wenzel K. et al Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms. J Transl Auto immun 2021; 04: 100100
• 13 Scheibenbogen C, Renz-Polster H, Hohberger B. et al Die Pandemie nach der Pandemie. Deutsches Aerzteblatt 2023; 120 (13) 566-570
• 14 Pušnik J, Monzon-Posadas WO, Zorn J. et al SARS-CoV-2 humoral and cellular immunity following different combinations of vaccination and breakthrough infection. Nat Commun 2023; 14 (01) 572
• 15 Couzin-Frankel J, Vogel G. In rare cases, coronavirus vaccines may cause Long Covid-like symptoms. Science 2022; 375 6579 364-366
• 16 Trougakos IP, Terpos E, Alexopoulos H. et al Adverse effects of COVID-19 mRNA vaccines: The spike hypothesis. Trends Mol Med 2022; 28 (07) 542-554
• 17 Koczulla AR, Ankermann T, Behrends U. et al S1 Guideline Post-COVID/Long-COVID. Pneumologie 2021; Nov 75 (11) 869-900
• 18 Müdigkeit. S3-Leitlinie. AWMF-Register-Nr. 053-002. DEGAM-Leitlinie Nr. 2. DEG. AM. Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin e. V
• 19 Larun L, Brurberg KG, Odgaard-Jensen J. et al Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev 2019; 10 (10) CD003200
• 20 Hajibashi A, Sarrafzadeh J, Amiri A, Salehi R. et al Effect of progressive muscle relaxation as an add-on to pulmonary telerehabilitation in discharged patients with COVID-19: A randomised controlled trial. Complement Ther Clin Pract 2023; 51: 101730
• 21 Olsson EM, Schéele B, Panossian AG. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med 2009; 75 (02) 105-112
• 22 Zick SM, Sen A, Wyatt GK. et al Investigation of 2 types of self-administered acupressure for persistent cancer-related fatigue in breast cancer survivors: A randomized clinical trial. JAMA Oncol 2016; 02: 1470-1476
• 23 Deutsche Gesellschaft für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie DGHNO KHC. S2k-Leitlinie 017/050: Riech- und Schmeckstörungen (2016). Im Internet. https://register.awmf.org/assets/guidelines/017-050l_S2k_Riech-und-Schmeckst%C3%B6rungen_2021-04-abgelaufen.pdf Stand: 03.07.2023
• 24 Baguley BJ, Skinner TL, Jenkins DG. et al Mediterranean-style dietary pattern improves cancer-related fatigue and quality of life in men with prostate cancer treated with androgen deprivation therapy: A pilot randomised control trial. Clin Nutr 2021; 40 (01) 245-254
• 25 Vollbracht C, Kraft K. Feasibility of vitamin C in treatment of post viral fatigue with focus on long COVID, based on a systematic review of IV vitamin C on fatigue. Nutrients 2021; 13: 1154
• 26 Deutsche Gesellschaft für Hyperthermie. Leitlinie zur Ganzkörper-Hyperthermie – Version 1.0 (10/2018). Im Internet. https://www.heckel-hyperthermia.com/images/downloads/Leitlinie_GKHT_OKT2018.pdf Stand: 03.07.2023