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Review
. 2023 Apr 26:10:1157651.
doi: 10.3389/fmolb.2023.1157651. eCollection 2023.

Long COVID: Clinical characteristics, proposed pathogenesis and potential therapeutic targets

Grace Kenny  1   2 , Liam Townsend  2 , Stefano Savinelli  1   2 , Patrick W G Mallon  1   2
Affiliations
Review

Long COVID: Clinical characteristics, proposed pathogenesis and potential therapeutic targets

Grace Kenny et al. Front Mol Biosci. .

Abstract

The emergence of persistent ill-health in the aftermath of SARS-CoV-2 infection has presented significant challenges to patients, healthcare workers and researchers. Termed long COVID, or post-acute sequelae of COVID-19 (PASC), the symptoms of this condition are highly variable and span multiple body systems. The underlying pathophysiology remains poorly understood, with no therapeutic agents proven to be effective. This narrative review describes predominant clinical features and phenotypes of long COVID alongside the data supporting potential pathogenesis of these phenotypes including ongoing immune dysregulation, viral persistence, endotheliopathy, gastrointestinal microbiome disturbance, autoimmunity, and dysautonomia. Finally, we describe current potential therapies under investigation, as well as future potential therapeutic options based on the proposed pathogenesis research.

Keywords: PASC; SARS-CoV-2; long COVID; post COVID condition; post-acute sequelae of SARS-CoV-2 infection.

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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
Multisystem symptoms associated with long COVID. Legend: Selection of symptoms reported by patients suffering with long COVID, demonstrating the multi-system nature of the disease. Created with BioRender.com.
FIGURE 2
FIGURE 2
Hypothesised sequelae of SARS-CoV-2 that lead to long COVID. Legend: A selection of the possible sequelae of SARS-CoV-2 that may lead to the various post-acute pathologies that occur in a subset of individuals.
FIGURE 3
FIGURE 3
Proposed mechanisms of long COVID. Legend: Multiple possible precipitants, including persistent virus, reactivation of latent viruses, altered microbiome, endothelial dysfunction, and autoimmunity, may lead to ongoing immune activation and subsequent systemic symptoms. Created with BioRender.com.
See this image and copyright information in PMC

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