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Review
. 2023 Apr 20:14:1117464.
doi: 10.3389/fimmu.2023.1117464. eCollection 2023.

Long COVID: a review and proposed visualization of the complexity of long COVID

Rubeshan Perumal  1   2   3 , Letitia Shunmugam  1 , Kogieleum Naidoo  1 , Salim S Abdool Karim  1 , Dave Wilkins  3   4 , Alfredo Garzino-Demo  3   5 , Christian Brechot  3 , Sairam Parthasarathy  6 , Anders Vahlne  3   7 , Janko Ž Nikolich  3   8   9
Affiliations
Review

Long COVID: a review and proposed visualization of the complexity of long COVID

Rubeshan Perumal et al. Front Immunol. .

Abstract

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2) infection, or Long COVID, is a prevailing second pandemic with nearly 100 million affected individuals globally and counting. We propose a visual description of the complexity of Long COVID and its pathogenesis that can be used by researchers, clinicians, and public health officials to guide the global effort toward an improved understanding of Long COVID and the eventual mechanism-based provision of care to afflicted patients. The proposed visualization or framework for Long COVID should be an evidence-based, dynamic, modular, and systems-level approach to the condition. Furthermore, with further research such a framework could establish the strength of the relationships between pre-existing conditions (or risk factors), biological mechanisms, and resulting clinical phenotypes and outcomes of Long COVID. Notwithstanding the significant contribution that disparities in access to care and social determinants of health have on outcomes and disease course of long COVID, our model focuses primarily on biological mechanisms. Accordingly, the proposed visualization sets out to guide scientific, clinical, and public health efforts to better understand and abrogate the health burden imposed by long COVID.

Keywords: COVID-19; SARS-CoV-2; long COVID; long-haul COVID; post-acute sequelae of SARS-CoV-2.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A systems-level visualization of the complexity of Long COVID and its pathogenesis.
Figure 2
Figure 2
A network map of the risk factors and clinical sequelae associated with autoimmunity in the context of Long COVID.
Figure 3
Figure 3
A network map of the risk factors and biological mechanisms associated with the development of fatigue in the context of Long COVID.
See this image and copyright information in PMC

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