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Review
. 2024 Oct 3;187(20):5500-5529.
doi: 10.1016/j.cell.2024.07.054. Epub 2024 Sep 25.

Mechanisms of long COVID and the path toward therapeutics

Michael J Peluso  1 , Steven G Deeks  2
Affiliations
Review

Mechanisms of long COVID and the path toward therapeutics

Michael J Peluso et al. Cell. .

Abstract

Long COVID, a type of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC) defined by medically unexplained symptoms following infection with SARS-CoV-2, is a newly recognized infection-associated chronic condition that causes disability in some people. Substantial progress has been made in defining its epidemiology, biology, and pathophysiology. However, there is no cure for the tens of millions of people believed to be experiencing long COVID, and industry engagement in developing therapeutics has been limited. Here, we review the current state of knowledge regarding the biology and pathophysiology of long COVID, focusing on how the proposed mechanisms explain the physiology of the syndrome and how they provide a rationale for the implementation of a broad experimental medicine and clinical trials agenda. Progress toward preventing and curing long COVID and other infection-associated chronic conditions will require deep and sustained investment by funders and industry.

Keywords: COVID-19; long COVID; post-COVID-19 condition; post-acute COVID-19 syndrome; post-acute sequelae of SARS-CoV-2 infection.

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Conflict of interest statement

Declaration of interests M.J.P. has received consulting fees from Gilead Sciences, AstraZeneca, BioVie, Apellis Pharmaceuticals, and BioNTech and research support from Aerium Therapeutics and Shionogi outside the submitted work. S.G.D. reports consulting for Enanta Pharmaceuticals, BioVie, and Pfizer and reports research support from Aerium Therapeutics outside the submitted work.

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