Interplay between Comorbidities and Long COVID: Challenges and Multidisciplinary Approaches

Abstract

Long COVID, a name often given to the persistent symptoms following acute SARS-CoV-2 infection, poses a multifaceted challenge for health. This review explores the intrinsic relationship between comorbidities and autoimmune responses in shaping the trajectory of long COVID. Autoantibodies have emerged as significant players in COVID-19 pathophysiology, with implications for disease severity and progression. Studies show immune dysregulation persisting months after infection, marked by activated innate immune cells and high cytokine levels. The presence of autoantibodies against various autoantigens suggests their potential as comorbid factors in long COVID. Additionally, the formation of immune complexes may lead to severe disease progression, highlighting the urgency for early detection and intervention. Furthermore, long COVID is highly linked to cardiovascular complications and neurological symptoms, posing challenges in diagnosis and management. Multidisciplinary approaches, including vaccination, tailored rehabilitation, and pharmacological interventions, are used for mitigating long COVID's burden. However, numerous challenges persist, from evolving diagnostic criteria to addressing the psychosocial impact and predicting disease outcomes. Leveraging AI-based applications holds promise in enhancing patient management and improving our understanding of long COVID. As research continues to unfold, unravelling the complexities of long COVID remains paramount for effective intervention and patient care.

Keywords: COVID-19; SARS-CoV-2; autoantibodies; comorbidities; interplay; long COVID; synergistic effects.

Figure 1

Comprehensive overview of immunological and autoantibodies responses in long COVID patients. Programmed cell death protein 1 (PD1); interferon (INF); interleukin (IL); tumor necrosis factor (TNF); induced protein 10 (IP10); angiotensin converting enzyme 2 (ACE2); cyclic citrullinated peptide (anti-CCP); antinuclear antibody (ANA); anti-cardiolipin (aCL), and anti-beta-2-glycoprotein-1 (anti-β2GP1).

Figure 2

Comprehensive overview of complications, diagnostics, and treatment strategies for long COVID. This illustration provides detailed insights into the multifaceted approach to patient care. It highlights various complications, including cardiovascular, respiratory, neurological, and psychosocial impacts. Diagnostic methods for each complication type are outlined, along with potential treatment options. Liver function test (LFT); interleukin-6 (IL-6); C-reactive protein (CRP); erythrocyte sedimentation rate (ESR); complete blood count (CBC); high-sensitivity cardiac troponin I (hs-TnI); n-terminal brain-type natriuretic peptide (NT-proBNP); micro-RNAs (mi-RNAs); computed tomography (CT); and non-steroidal anti-inflammatory drugs (NSAIDs).

Figure 3

The framework of using artificial intelligence applications in the early diagnosis of long COVID.