Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec 6;1(4):231-240.
doi: 10.1016/j.pccm.2023.10.003. eCollection 2023 Dec.

Mechanisms of long COVID: An updated review

Yan Liu  1   2 , Xiaoying Gu  3 , Haibo Li  1 , Hui Zhang  1   4 , Jiuyang Xu  1
Affiliations
Review

Mechanisms of long COVID: An updated review

Yan Liu et al. Chin Med J Pulm Crit Care Med. .

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has been ongoing for more than 3 years, with an enormous impact on global health and economies. In some patients, symptoms and signs may remain after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which cannot be explained by an alternate diagnosis; this condition has been defined as long COVID. Long COVID may exist in patients with both mild and severe disease and is prevalent after infection with different SARS-CoV-2 variants. The most common symptoms include fatigue, dyspnea, and other symptoms involving multiple organs. Vaccination results in lower rates of long COVID. To date, the mechanisms of long COVID remain unclear. In this narrative review, we summarized the clinical presentations and current evidence regarding the pathogenesis of long COVID.

Keywords: Angiotensin-converting enzyme 2; Long COVID; Post-acute sequelae of SARS-CoV-2 infection; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1:
Fig. 1
Symptoms and symptom proportions in long COVID. A longitudinal study among patients in Wuhan with the original SARS-CoV-2 strain reported symptoms and the changing proportion of symptoms of long COVID at different follow-up time. SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.
Fig 2:
Fig. 2
Common symptoms and possible mechanisms of long COVID. POTS: Postural orthostatic tachycardia syndrome; PTSD: Post-traumatic stress disorder.
See this image and copyright information in PMC

References

    1. National Institute for Health and Care Excellence: Clinical Guidelines. COVID-19 rapid guideline: Managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (NICE) Copyright © NICE 2020, 2020. - PubMed
    1. Shah W, Hillman T, Playford ED, Hishmeh L. Managing the long term effects of COVID-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021;372:n136. doi: 10.1136/bmj.n136. - DOI - PubMed
    1. Venkatesan P. NICE guideline on long COVID. Lancet Respir Med. 2021;9:129. doi: 10.1016/s2213-2600(21)00031-x. - DOI - PMC - PubMed
    1. Shaffer L. Lots of Long COVID treatment leads, but few are proven. Proc Natl Acad Sci U S A. 2022;119 doi: 10.1073/pnas.2213524119. - DOI - PMC - PubMed
    1. Korompoki E, Gavriatopoulou M, Hicklen RS, et al. Epidemiology and organ specific sequelae of post-acute COVID-19: a narrative review. J Infect. 2021;83:1–16. doi: 10.1016/j.jinf.2021.05.004. - DOI - PMC - PubMed

LinkOut - more resources