Thesis supervisor: Attila József Szabó
Location of studies (in Hungarian): SE Abbreviation of location of studies: SE
Description of the research topic:
An infectious inflammatory disease called COVID-19 is caused by the newly identified Coronavirus strain, SARS-CoV-2. The pandemic, which began in 2019, has infected around 150 million people worldwide in one year. The virus is primarily transmitted from person-to person through respiratory droplets. (5) Typical complaints (e.g., fever, upper respiratory symptoms, loss of smell) appear after an incubation period of 5–14 days. (6) COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. (1) In most cases, the infection occurs in a mild form, but severe pneumonia and other lethal conditions can also develop which is mostly seen in the adult population. (6) By 2020, the pandemic created a global health emergency, placing a significant strain on our health resources. (1)
Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19 as well. It is important to highlight that individuals who suffer from the long-term effects of COVID have greatly contributed to the recognition of post-acute COVID-19 syndrome through the establishment of advocacy groups. These patients developed persistent symptoms and/or delayed complications after 4 weeks from the onset of their first symptoms. (1) The list of persisting and emerging symptoms complained by patients is extensive, including chronic cough, shortness of breath, chest pain, cognitive dysfunction, and extreme fatigue. Symptoms are often overlapping, fluctuating over time, can be change over time, and can affect multiple organ systems. These consequences are a growing health concern. (2) In November, 2020, a survey conducted by the UK Government’s Office for National Statistics, found that around one in five people who tested positive for COVID-19 had symptoms that lasted for 5 weeks or longer, and one in ten people had symptoms that lasted for 12 weeks or longer. (2) Reviewing the international literature, the disease may affect two-thirds, maybe three-quarters of adults infected with COVID-19 with different intensity. (1) Symptoms may be due to virus-specific pathophysiological changes, immunological reaction, inflammatory damage due to acute infection, fibrosis, and increased pro-coagulant state induced by SARS-CoV-2. (1) Clearly, significant resources will be required to enable patients and clinicians to understand and, based on the knowledge gained, properly manage long-term consequences of COVID-19. (2)
Given that the number of cases has just recently begun to rise, research into Long-COVID syndrome is still in its infancy, and there are no clear guidelines for investigation, treatment, and management in the literature.
Data on the clinical outcomes of children with COVID-19 are rare, particularly in those with asymptomatic and mild disease. A recent systematic review estimated that 16% of children have asymptomatic disease, but evidence suggests that as many as half of pediatric infections may be without any complaint. (4) Studies involving adults suggest that long-term multisystem consequences and complications can occur, even with mild COVID-19. (1)
In February 2021, more and more children came for medical examination to the 1st Department of Pediatrics with prolonged, torturous complaints after the infection. Their number showed a definite increase in 1-2 weeks, presumably reflecting the high number of cases in the second wave. Their symptoms were diverse, occasionaly severe, affecting their everyday life greatly. Based on the available recommendations, we started an outpatient service for children with Long-COVID syndrome. (7)
In two months, we examined more than 100 patients, treating them based on the latest literature and our growing experience. We aimed to conduct clinical and translational studies to assess the course of the disease, to objectify the severity of symptoms, and to assess and isolate the influencing effects of existing restrictions. The other aim of these studies are to discover the pathomechanism, to understand the role of predisposing factors, and to determine best-practice standards of care based on evidence.
Number of students who can be accepted: 3
Deadline for application: 2022-05-31
2024. IV. 17. ODT ülés Az ODT következő ülésére 2024. június 14-én, pénteken 10.00 órakor kerül sor a Semmelweis Egyetem Szenátusi termében (Bp. Üllői út 26. I. emelet).
Login
