{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:06:41Z","timestamp":1792606001332,"version":"4.5.0"},"reference-count":112,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Fifty-five patients who suffered from COVID-19, who were still very ill after several months, with extreme fatigue, effort exhaustion, brain fog, anomia, memory disorder, anosmia, dysgeusia, and other multi-systemic health problems have been followed in a family practice setting between May 2021 and July 2022. Data extracted from the medical records of the 55 patients (40 women), mean age 42.4 (12 to 79 years), and a qualitative study of 6 of them using a semi-open-ended questionnaire allowed to highlight the clinical picture described by WHO as post-acute COVID-19 syndrome (PACS) also known as long COVID. We used brain single-photon emission computed tomography (SPECT-CT) in thirty-two patients with a high severity index and a highly impaired functional status, demonstrating vascular encephalopathy in twenty nine patients and supporting the hypothesis of a persistent cerebral vascular flow disorder in post COVID-19 condition. The patients will benefit from the consortium COVID Human Genetic Effort (covidhge.com) to explore the genetic and immunological basis of their problem, as 23\/55 cases don\u2019t have immunological certainty of a COVID-19 infection. There is no known verified treatment. Analyzing the data from the first 52 patients, three categories of patients emerged over time: 16 patients made a full recovery after 6\u20138 months, 15 patients were able to return to life and work after 12\u201318 months with some sequelae, both groups being considered cured. In the third group, 21 patients are still very ill and unable to resume their work and life after 18 months. The biopsychosocial consequences on patients\u2019 lives are severe and family doctors are left out in the cold. It is necessary to test the reproducibility of this description, conducted on a small number of patients. Nevertheless, identifying, monitoring and supporting these patients is a necessity in family medicine.<\/jats:p>","DOI":"10.3390\/v14092000","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:15:02Z","timestamp":1663114502000},"page":"2000","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Follow-Up of a Cohort of Patients with Post-Acute COVID-19 Syndrome in a Belgian Family Practice"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-3856","authenticated-orcid":false,"given":"Marc","family":"Jamoulle","sequence":"first","affiliation":[{"name":"HEC Information Sciences, University of Li\u00e8ge, 4000 Liege, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele","family":"Kazeneza-Mugisha","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Mons, 7000 Mons, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayoub","family":"Zayane","sequence":"additional","affiliation":[{"name":"Centre Medical Janson, 6000 Charleroi, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1038\/s41591-021-01433-3","article-title":"Long COVID in a prospective cohort of home-isolated patients","volume":"27","author":"Blomberg","year":"2021","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/s41591-021-01292-y","article-title":"Attributes and predictors of long COVID","volume":"27","author":"Sudre","year":"2021","journal-title":"Nat. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e2224359","DOI":"10.1001\/jamanetworkopen.2022.24359","article-title":"Rates and Factors Associated with Documentation of Diagnostic Codes for Long COVID in the National Veterans Affairs Health Care System","volume":"5","author":"Ioannou","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.cmi.2022.01.014","article-title":"Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: A systematic review and meta-analysis","volume":"28","author":"Alkodaymi","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mahase, E. (2020). Covid-19: What do we know about \u201clong covid\u201d?. BMJ, 370.","DOI":"10.1136\/bmj.m2815"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Burgers, J. (2020). \u201cLong covid\u201d: The Dutch response. BMJ, 370.","DOI":"10.1136\/bmj.m3202"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rando, H.M., Bennett, T.D., Byrd, J.B., Bramante, C., Callahan, T.J., Chute, C.G., Davis, H.E., Deer, R., Gagnier, J., and Koraishy, F.M. (2021). Challenges in defining Long COVID: Striking differences across literature, Electronic Health Records, and patient-reported information. medRxiv.","DOI":"10.1101\/2021.03.20.21253896"},{"key":"ref_8","unstructured":"WHO (2022, July 07). A Clinical Case Definition of Post COVID-19 Condition by a Delphi Consensus. 6 October 2021. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1."},{"key":"ref_9","unstructured":"Ayoubkhani, D., and Munro, M. (2022, July 07). Prevalence of Ongoing Symptoms following Coronavirus (COVID-19) Infection in the UK. 7 July 2022. Available online: https:\/\/tinyurl.com\/long-covid-uk."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Taquet, M., Dercon, Q., Luciano, S., Geddes, J.R., Husain, M., and Harrison, P.J. (2021). Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med., 18.","DOI":"10.1371\/journal.pmed.1003773"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long COVID or post-acute sequelae of COVID-19 (PASC): An overview of biological factors that may contribute to persistent symptoms","volume":"12","author":"Proal","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1038\/s41591-022-01766-7","article-title":"Studying severe long COVID to understand post-infectious disorders beyond COVID-19","volume":"28","author":"Brodin","year":"2022","journal-title":"Nat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S0140-6736(22)01214-4","article-title":"Persistence of somatic symptoms after COVID-19 in the Netherlands: An observational cohort study","volume":"400","author":"Ballering","year":"2022","journal-title":"Lancet"},{"key":"ref_14","first-page":"20499361211009385","article-title":"COVID-19 and post-infectious myalgic encephalomyelitis\/chronic fatigue syndrome: A narrative review","volume":"8","author":"Poenaru","year":"2021","journal-title":"Ther. Adv. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Greenhalgh, T., Knight, M., Buxton, M., and Husain, L. (2020). Management of post-acute covid-19 in primary care. BMJ, 370.","DOI":"10.1136\/bmj.m3026"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2130645","DOI":"10.1001\/jamanetworkopen.2021.30645","article-title":"Assessment of cognitive function in patients after COVID-19 infection","volume":"4","author":"Becker","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Malik, P., Patel, K., Pinto, C., Jaiswal, R., Tirupathi, R., Pillai, S., and Patel, U. (2021). Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)\u2014A systematic review and meta-analysis. J. Med. Virol.","DOI":"10.1002\/jmv.27309"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1016\/S1473-3099(20)30701-5","article-title":"Long-term consequences of COVID-19: Research needs","volume":"20","author":"Yelin","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00259-020-05178-y","article-title":"The cerebral network of COVID-19-related encephalopathy: A longitudinal voxel-based 18F-FDG-PET study","volume":"48","author":"Kas","year":"2021","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-021-93546-5","article-title":"Clinical characterization of dysautonomia in long COVID-19 patients","volume":"11","author":"Barizien","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1177\/01410768211032850","article-title":"Symptoms, complications and management of long COVID: A review","volume":"114","author":"Aiyegbusi","year":"2021","journal-title":"J. R. Soc. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/fampra\/cmab076","article-title":"Post-acute and long-COVID-19 symptoms in patients with mild diseases: A systematic review","volume":"39","author":"Lucassen","year":"2022","journal-title":"Fam. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Taquet, M., Sillett, R., Zhu, L., Mendel, J., Camplisson, I., Dercon, Q., and Harrison, P.J. (2022). 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.","DOI":"10.1016\/S2215-0366(22)00260-7"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Godeau, D., Petit, A., Richard, I., Roquelaure, Y., and Descatha, A. (2021). Return-to-work, disabilities and occupational health in the age of COVID-19. Scand. J. Work. Environ. Health.","DOI":"10.5271\/sjweh.3960"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Messin, L., Puyraveau, M., Benabdallah, Y., Lepiller, Q., Gendrin, V., Zayet, S., Klopfenstein, T., Toko, L., Pierron, A., and Royer, P.Y. (2021). COVEVOL: Natural Evolution at 6 Months of COVID-19. Viruses, 13.","DOI":"10.3390\/v13112151"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1038\/s41586-022-04569-5","article-title":"SARS-CoV-2 is associated with changes in brain structure in UK Biobank","volume":"604","author":"Douaud","year":"2022","journal-title":"Nature"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1080\/07853890.2022.2076901","article-title":"Pathophysiology and mechanism of long COVID: A comprehensive review","volume":"54","author":"Chalon","year":"2022","journal-title":"Ann. Med."},{"key":"ref_28","unstructured":"Castanares-Zapatero, D., Kohn, L., Dauvrin, M., Detollenaere, J., Maertens de Noordhout, C., Primus-de Jong, C., Cleemput, I., and Van den Heede, K. (2022, July 07). Long COVID: Pathophysiology-Epidemiology and Patient Needs. KCE, Belgium, Available online: https:\/\/kce.fgov.be\/sites\/default\/files\/atoms\/files\/2020-04HSR_Long%20COVID_Scientifi."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1038\/d41586-021-03495-2","article-title":"Do vaccines protect against long COVID? What the data say","volume":"599","author":"Ledford","year":"2021","journal-title":"Nature"},{"key":"ref_30","unstructured":"WHO-News (2022, July 07). A Life Altered by Long COVID\u2014Susan\u2019s Experience. Available online: https:\/\/www.who.int\/europe\/news\/item\/09-08-2022-a-life-altered-by-long-covid\u2014susan-s-experience."},{"key":"ref_31","first-page":"1285284","article-title":"Impact of COVID-19 symptoms on social aspects of life among female long haulers: A qualitative study","volume":"rs.3.rs","author":"Aghaei","year":"2022","journal-title":"Res. Sq."},{"key":"ref_32","first-page":"n2933","article-title":"Navigating the social identity of long covid","volume":"375","author":"Leite","year":"2021","journal-title":"BMJ"},{"key":"ref_33","unstructured":"Runco, M.A., and Chand, Y. (1974). Problem Finding, Evaluative Thinking, and Creativity. Problem Finding, Problem Solving, and Creativity, Ablex Publishing. Book Section 2."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2296-8-33","article-title":"Patients with persistent medically unexplained symptoms in general practice: Characteristics and quality of care","volume":"8","author":"Dirkzwager","year":"2007","journal-title":"BMC Fam. Pract."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1136\/bmj.318.7179.323","article-title":"Narrative based medicine in an evidence based world","volume":"318","author":"Greenhalgh","year":"1999","journal-title":"BMJ"},{"key":"ref_36","first-page":"534","article-title":"Naming the illness: The power of words","volume":"23","author":"Wood","year":"1991","journal-title":"Fam. Med."},{"key":"ref_37","unstructured":"Resnik, D.B. (2022, August 24). Glossary of Commonly Used Terms in Research Ethics, Available online: https:\/\/www.niehs.nih.gov\/research\/resources\/bioethics\/glossary\/index.cfm."},{"key":"ref_38","unstructured":"Bentzen, N. (2022, September 01). WONCA Dictionary of General\/Family Practice. Available online: http:\/\/www.ph3c.org\/PH3C\/docs\/27\/000092\/0000052.pdf."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Jamoulle, M., and Kazeneza-Mugisha, G. (2022). Descriptive and Narrative Study of Long Covid Cases in General Practice and Diagnostic Value of Single Photon Emission Computed Tomography. medRxiv.","DOI":"10.1101\/2022.03.01.22270897"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/fampra\/17.2.101","article-title":"ICPC-2-E: The electronic version of ICPC-2. Differences from the printed version and the consequences","volume":"17","author":"Okkes","year":"2000","journal-title":"Fam. Pract."},{"key":"ref_41","unstructured":"Llewelyn, H. (2022, July 07). Reasoning in Medicine and Science. Available online: https:\/\/blog.oup.com\/2013\/09\/medical-diagnosis-reasoning-probable-elimination."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/0895-4356(93)90153-R","article-title":"The Duke Severity of Illness Checklist (DUSOI) for measurement of severity and comorbidity","volume":"46","author":"Parkerson","year":"1993","journal-title":"J. Clin. Epidemiol."},{"key":"ref_43","unstructured":"Parkerson, G. (2022, July 07). Description of the DUSOI-WONCA Severity of Illness Instrument. Available online: http:\/\/www.ph3c.org\/4daction\/w3_CatVisu\/en\/description-of-the-dusoi\u2014-wonca\u2013severity-of-illness-instrument.html?wDocID=157."},{"key":"ref_44","unstructured":"Jamoulle, M., Roland, M., Elkinne, J., and Parkerson, G. (2022, July 07). Le DUSOI\/WONCA un indice de gravit\u00e9 pour la m\u00e9decine g\u00e9n\u00e9rale. Available online: https:\/\/orbi.uliege.be\/handle\/2268\/228936."},{"key":"ref_45","unstructured":"van Weel, C., K\u00f6nig Zahn, C., Touw Otten, F., van Duijn, N., and Meyboom de Jong, B. (2022, July 07). Measuring Functional Health Status with the COOP\/WONCA Charts. A Manual. Available online: http:\/\/www.ph3c.org\/PH3C\/docs\/27\/000150\/0000103.pdf."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.cell.2020.05.016","article-title":"A global effort to define the human genetics of protective immunity to SARS-CoV-2 infection","volume":"181","author":"Casanova","year":"2020","journal-title":"Cell"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1007\/s00259-020-04973-x","article-title":"18 F-FDG brain PET hypometabolism in post-SARS-CoV-2 infection: Substrate for persistent\/delayed disorders?","volume":"48","author":"Guedj","year":"2021","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Guedj, E., Lazarini, F., Morbelli, S., Ceccaldi, M., Hautefort, C., Kas, A., Radulesco, T., Salmon-Ceron, D., and Eldin, C. (2021). Long COVID and the brain network of Proust\u2019s madeleine: Targeting the olfactory pathway. Clin. Microbiol. Infect.","DOI":"10.1016\/j.cmi.2021.05.015"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Alfonso, B., Sol\u00eds, S.R., Silva-Hern\u00e1ndez, L., Pascual, I.P., Ib\u00e1\u00f1ez, S.A., and Ant\u00f3n, C.S. (2021). 18F-FDG-PET\/CT in SARS-CoV-2 infection and its sequelae. Rev. Esp. Med. Nucl. Imagen Mol.","DOI":"10.1016\/j.remnie.2021.07.005"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Hugon, J. (2021). Long-covid: Cognitive deficits (brain fog) and brain lesions in non-hospitalized patients. Presse Med.","DOI":"10.1016\/j.lpm.2021.104090"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Verger, A., Kas, A., Dudouet, P., Goehringer, F., Salmon, D., and Guedj, E. (2022). Visual Interpretation of Brain Hypometabolisms Related to Neurological Long COVID: A French Multicentric Experience. Eur. J. Nucl. Med. Mol. Imaging, 32.","DOI":"10.21203\/rs.3.rs-1159513\/v1"},{"key":"ref_52","first-page":"320","article-title":"Brain perfusion scintigraphy with 99mTc-HMPAO or 99mTc-ECD and 123I-beta -CIT single-photon emission tomography in dementia of the Alzheimer-type and diffuse Lewy body disease","volume":"24","author":"Donnemiller","year":"2021","journal-title":"Eur. J. Nucl. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1136\/pgmj.64.747.4","article-title":"Cerebral scintigraphy\u2013the phoenix rises again","volume":"64","author":"Shepstone","year":"1988","journal-title":"Postgrad. Med. J."},{"key":"ref_54","first-page":"259","article-title":"Brain SPECT in clinical practice. Part I: Perfusion","volume":"42","author":"Catafau","year":"2001","journal-title":"J. Nucl. Med."},{"key":"ref_55","first-page":"587","article-title":"SPECT imaging of normal subjects with technetium-99m-HMPAO and technetium-99m-ECD","volume":"38","author":"Koyama","year":"1997","journal-title":"J. Nucl. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1177\/1073858420956905","article-title":"Anosmia in COVID-19: Underlying Mechanisms and Assessment of an Olfactory Route to Brain Infection","volume":"27","author":"Butowt","year":"2020","journal-title":"Neuroscientist"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"117308","DOI":"10.1016\/j.jns.2021.117308","article-title":"Susceptibility-weighted imaging reveals cerebral microvascular injury in severe COVID-19","volume":"421","author":"Conklin","year":"2021","journal-title":"J. Neurol. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e1868","DOI":"10.1212\/WNL.0000000000010112","article-title":"Neurologic and neuroimaging findings in patients with COVID-19: A retrospective multicenter study","volume":"95","author":"Kremer","year":"2020","journal-title":"Neurology"},{"key":"ref_59","first-page":"1","article-title":"The role of 18-FDG PET\/CT assessment of functional brain metabolism in cancer patients after chemotherapy","volume":"52","author":"Gamal","year":"2021","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/gps.4036","article-title":"A comparison of FDG-PET and blood flow SPECT in the diagnosis of neurodegenerative dementias: A systematic review","volume":"29","author":"Davison","year":"2014","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Blazhenets, G., Schr\u00f6ter, N., Bormann, T., Thurow, J., Wagner, D., Frings, L., Weiller, C., Meyer, P.T., Dressing, A., and Hosp, J.A. (2021). Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients. J. Nucl. Med.","DOI":"10.2967\/jnumed.121.262128"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.02.020","article-title":"Reliability and validity of COOP\/WONCA functional health status charts for stroke patients in primary care","volume":"20","author":"Lennon","year":"2011","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2001494","DOI":"10.1183\/13993003.01494-2020","article-title":"The Post-COVID-19 Functional Status scale: A tool to measure functional status over time after COVID-19","volume":"56","author":"Klok","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-021-01862-1","article-title":"Design, validation and implementation of the post-acute (long) COVID-19 quality of life (PAC-19QoL) instrument","volume":"19","author":"Jandhyala","year":"2021","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/0022-3999(93)90081-P","article-title":"Development of a fatigue scale","volume":"37","author":"Chalder","year":"1993","journal-title":"J. Psychosom. Res."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Sackett, D.L., Rosenberg, W.M., Gray, J.M., Haynes, R.B., and Richardson, W.S. (1996). Evidence based medicine: What it is and what it isn\u2019t. Br. Med. J., 312.","DOI":"10.1136\/bmj.312.7023.71"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-020-05888-x","article-title":"Medical heuristics and action-research: Professionalism versus science","volume":"20","author":"Unger","year":"2020","journal-title":"BMC Health Serv. Res."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/0162243913504306","article-title":"Knowing patients: Turning patient knowledge into science","volume":"39","author":"Pols","year":"2014","journal-title":"Sci. Technol. Hum. Values"},{"key":"ref_69","first-page":"1473","article-title":"Problem-solving & decision-making in family practice","volume":"25","author":"McWhinney","year":"1979","journal-title":"Can. Fam. Physician"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/S0140-6736(01)05548-9","article-title":"The art and science of clinical knowledge: Evidence beyond measures and numbers","volume":"358","author":"Malterud","year":"2001","journal-title":"Lancet"},{"key":"ref_71","unstructured":"Environmental Protection Agency (2022, July 07). Radionuclide Basics: Technetium-99, Available online: https:\/\/www.epa.gov\/radiation\/radionuclide-basics-technetium-99."},{"key":"ref_72","first-page":"631:4","article-title":"Technetium-99m production for use in nuclear medicine","volume":"53","author":"Vucina","year":"2000","journal-title":"Med. Pregl."},{"key":"ref_73","first-page":"1460","article-title":"Challenges for health in the Anthropocene epoch","volume":"364","author":"Haines","year":"2019","journal-title":"BMJ"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.ijcard.2021.10.140","article-title":"In-vivo evidence of systemic endothelial vascular dysfunction in COVID-19","volume":"345","author":"Travieso","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"754667","DOI":"10.3389\/fmed.2021.754667","article-title":"Case Report: Neutralization of Autoantibodies Targeting G-Protein-Coupled Receptors Improves Capillary Impairment and Fatigue Symptoms After COVID-19 Infection","volume":"8","author":"Hohberger","year":"2021","journal-title":"Front. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1111\/jth.15490","article-title":"Persistent endotheliopathy in the pathogenesis of long COVID syndrome","volume":"19","author":"Fogarty","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Venter, C., Bezuidenhout, J.A., Laubscher, G.J., Lourens, P.J., Steenkamp, J., Kell, D.B., and Pretorius, E. (2020). Erythrocyte, platelet, serum ferritin, and P-selectin pathophysiology implicated in severe hypercoagulation and vascular complications in COVID-19. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21218234"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"BSR20210611","DOI":"10.1042\/BSR20210611","article-title":"SARS-CoV-2 spike protein S1 induces fibrin (ogen) resistant to fibrinolysis: Implications for microclot formation in COVID-19","volume":"41","author":"Grobbelaar","year":"2021","journal-title":"Biosci. Rep."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12933-021-01359-7","article-title":"Persistent clotting protein pathology in Long COVID\/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin","volume":"20","author":"Pretorius","year":"2021","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Jones, O.Y., and Yeralan, S. (2022). Is Long COVID a State of Systemic Pericyte Disarray?. J. Clin. Med., 11.","DOI":"10.3390\/jcm11030572"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-022-29440-z","article-title":"Neuropathology and virus in brain of SARS-CoV-2 infected non-human primates","volume":"13","author":"Rutkai","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.cell.2020.08.028","article-title":"Effects of COVID-19 on the nervous system","volume":"183","author":"Iadecola","year":"2020","journal-title":"Cell"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"McMahon, D.E., Gallman, A.E., Hruza, G.J., Rosenbach, M., Lipoff, J.B., Desai, S.R., French, L.E., Lim, H., Cyster, J.G., and Fox, L.P. (2021). Long COVID in the skin: A registry analysis of COVID-19 dermatological duration. Lancet Infect. Dis.","DOI":"10.1016\/S1473-3099(20)30986-5"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/cup.14240","article-title":"Histopathology of Persistent Long COVID Toe: A Case Report","volume":"49","author":"Nirenberg","year":"2022","journal-title":"J. Cutan. Pathol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S1473-3099(21)00133-X","article-title":"Chilblain-like acral lesions in long COVID-19: Management and implications for understanding microangiopathy","volume":"7","author":"Mehta","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1001\/jamacardio.2020.3557","article-title":"Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19)","volume":"5","author":"Puntmann","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.chest.2021.08.010","article-title":"Persistent exertional intolerance after COVID-19: Insights from invasive cardiopulmonary exercise testing","volume":"161","author":"Singh","year":"2022","journal-title":"Chest"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Vallejo Camaz\u00f3n, N., Teisa, A., Mart\u00ednez Membrivea, M.J., Llibre, C., Bay\u00e9s-Gen\u00eds, A., and Mateu, L. (2021). Long COVID-19 and microvascular disease-related angina. Rev. Espa\u00f1Ola Cardiol.","DOI":"10.1016\/j.rec.2021.10.010"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1021\/acschemneuro.0c00793","article-title":"Persistent brainstem dysfunction in long-COVID: A hypothesis","volume":"12","author":"Yong","year":"2021","journal-title":"ACS Chem. Neurosci."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ijid.2021.09.043","article-title":"Mast cell activation symptoms are prevalent in Long-COVID","volume":"112","author":"Weinstock","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.3389\/fphys.2020.614590","article-title":"Hyperventilation: A possible explanation for long-lasting exercise intolerance in mild Covid-19 survivors?","volume":"11","author":"Motiejunaite","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Geng, L.N., Bonilla, H.F., Shafer, R.W., Miglis, M.G., and Yang, P.C. (2022). Case Report of Breakthrough Long COVID and the Use of Nirmatrelvir-Ritonavir. Researchsquare.","DOI":"10.21203\/rs.3.rs-1443341\/v1"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"848886","DOI":"10.3389\/fimmu.2022.848886","article-title":"Persistent Overactive Cytotoxic Immune Response in a Spanish Cohort of Individuals With Long-COVID: Identification of Diagnostic Biomarkers","volume":"13","author":"Fuertes","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_94","unstructured":"Ziporyn, T.D. (1992). Nameless Diseases, Rudger Universty Press."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.7326\/M21-1976","article-title":"Symptoms after COVID-19 vaccination in patients with persistent symptoms after acute infection: A case series","volume":"174","author":"Arnold","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"4424","DOI":"10.1016\/j.vaccine.2022.05.090","article-title":"The effect of SARS-CoV-2 vaccination on post-acute sequelae of COVID-19 (PASC): A prospective cohort study","volume":"40","author":"Wynberg","year":"2022","journal-title":"Vaccine"},{"key":"ref_97","unstructured":"Leen, B., Delaunois, I., Carrigan, M., and McCarthy, S. (2022, September 01). Evidence Summary: What Is the Latest Evidence about the Existence of Long-COVID or Post-COVID and Its Persistence for COVID-19 Survivors? What Evidence Is Currently Available on the Management of Patients Who Have Post Viral Fatigue Syndrome Due to COVID-19? [v1.1]. Available online: https:\/\/doi.org\/http:\/\/hdl.handle.net\/10147\/628919."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11910-021-01130-1","article-title":"The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 infection","volume":"21","author":"Moghimi","year":"2021","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"5338","DOI":"10.1523\/JNEUROSCI.3188-20.2021","article-title":"SARS-CoV-2 Neuronal Invasion and Complications: Potential Mechanisms and Therapeutic Approaches","volume":"41","author":"Swain","year":"2021","journal-title":"J. Neurosci."},{"key":"ref_100","unstructured":"Housman, H.A. (2022, July 07). Exploring Neuroplasticity in the Classroom: Teaching Cortical Reorganization in the Visual System with a Stroke Patient Study, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/33880107\/."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1186\/s13063-021-05569-y","article-title":"A randomised controlled trial testing the efficacy of Fit after COVID, a cognitive behavioural therapy targeting severe post-infectious fatigue following COVID-19 (ReCOVer): Study protocol","volume":"22","author":"Kuut","year":"2021","journal-title":"Trials"},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Fugazzaro, S., Contri, A., Esseroukh, O., Kaleci, S., Croci, S., Massari, M., Facciolongo, N.C., Besutti, G., Iori, M., and Salvarani, C. (2022). Rehabilitation Interventions for Post-Acute COVID-19 Syndrome: A Systematic Review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095185"},{"key":"ref_103","unstructured":"Jamoulle, M. (2022, September 01). Trajet de Soins \u00abLong Covid\u00bb: Comment \u00e7a marche?\u2014[Long Covid Pathway, How It Works?]. Available online: https:\/\/orbi.uliege.be\/handle\/2268\/293637."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Yong, S.J. (2021). Long COVID or post-COVID-19 syndrome: Putative pathophysiology, risk factors, and treatments. Infect. Dis., 1\u201318.","DOI":"10.20944\/preprints202012.0242.v1"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Krzych, \u0141.J., Putowski, Z., Czok, M., and Hofman, M. (2021). What Is the Role of Therapeutic Plasma Exchange as an Adjunctive Treatment in Severe COVID-19: A Systematic Review. Viruses, 13.","DOI":"10.3390\/v13081484"},{"key":"ref_106","unstructured":"Parry, C. (2022, September 01). Opening the Black Box: The Researchers Trying to Find Treatments for Long COVID\u2014The Pharmaceutical Journal. Available online: https:\/\/pharmaceutical-journal.com\/article\/feature\/opening-the-black-box-the-researchers-trying-to-find-treatments-for-long-covid."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"10760296221084300","DOI":"10.1177\/10760296221084300","article-title":"Sulodexide: A Benefit for Cardiovascular Sequelae of Long COVID Patients?","volume":"28","author":"Szolnoky","year":"2022","journal-title":"Clin. Appl. Thromb."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e629","DOI":"10.7861\/clinmed.2021-0462","article-title":"Hyperbaric oxygen therapy for the treatment of long COVID: Early evaluation of a highly promising intervention","volume":"21","author":"Robbins","year":"2021","journal-title":"Clin. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e630","DOI":"10.1016\/S2352-3026(20)30218-0","article-title":"Coagulation disorder in COVID-19","volume":"7","author":"Kander","year":"2020","journal-title":"Lancet Haematol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"e000741","DOI":"10.1136\/fmch-2020-000741","article-title":"Rationales and uncertainties for aspirin use in COVID-19: A narrative review","volume":"9","author":"Ahmed","year":"2021","journal-title":"Fam. Med. Community Health"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Pretorius, E., Venter, C., Laubscher, G.J., Kotze, M.J., Moremi, K., Oladejo, S., Watson, L.R., Rajaratnam, K., Watson, B.W., and Kell, D.B. (2021). Combined triple treatment of fibrin amyloid microclots and platelet pathology in individuals with Long COVID\/Post-Acute Sequelae of COVID-19 (PASC) can resolve their persistent symptoms. Res. Sq.","DOI":"10.21203\/rs.3.rs-1205453\/v1"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/s41591-020-01202-8","article-title":"Immune determinants of COVID-19 disease presentation and severity","volume":"27","author":"Brodin","year":"2021","journal-title":"Nat. Med."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/9\/2000\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:28:36Z","timestamp":1760142516000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/9\/2000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,9]]},"references-count":112,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["v14092000"],"URL":"https:\/\/doi.org\/10.3390\/v14092000","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,9]]}}}