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Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19
Rakhee K Ramakrishnan1,2, Tarek Kashour3, Qutayba Hamid1,4
1College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Insights
Long COVID, or post-acute sequelae of COVID-19, affects recovered patients with persistent symptoms. The immune response to SARS-CoV-2, not the virus itself, is hypothesized to cause these chronic effects.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- COVID-19 remains a global health concern with limited treatments.
- A significant number of patients experience persistent, disabling symptoms post-infection, termed long COVID.
- These long-term effects significantly impair daily life activities.
Purpose of the Study:
- To explore potential immunological mechanisms behind persistent COVID-19 symptoms.
- To describe the multi-organ long-term manifestations of COVID-19.
- To understand the pathology of post-acute sequelae of COVID-19.
Main Methods:
- This is a review article, hypothesizing immunological mechanisms.
- It synthesizes current understanding of long COVID.
- It describes multi-organ manifestations.
Main Results:
- Long COVID symptoms can persist for months after acute infection.
- Symptoms include fatigue, shortness of breath, joint pain, cognitive dysfunction, anxiety, and depression.
- The immune response to SARS-CoV-2 is implicated in ongoing inflammation and persistent symptoms.
Conclusions:
- The immune response, rather than direct viral effects, is likely responsible for long COVID.
- Persistent inflammation may underlie the chronic symptoms and multi-organ effects observed.
- Further research into immunological pathways is crucial for developing effective treatments for long COVID.
Abstract:
More than one year since its emergence, corona virus disease 2019 (COVID-19) is still looming large with a paucity of treatment options. To add to this burden, a sizeable subset of patients who have recovered from acute COVID-19 infection have reported lingering symptoms, leading to significant disability and impairment of their daily life activities. These patients are considered to suffer from what has been termed as "chronic" or "long" COVID-19 or a form of post-acute sequelae of COVID-19, and patients experiencing this syndrome have been termed COVID-19 long-haulers. Despite recovery from infection, the persistence of atypical chronic symptoms, including extreme fatigue, shortness of breath, joint pains, brain fogs, anxiety and depression, that could last for months implies an underlying disease pathology that persist beyond the acute presentation of the disease. As opposed to the direct effects of the virus itself, the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to be largely responsible for the appearance of these lasting symptoms, possibly through facilitating an ongoing inflammatory process. In this review, we hypothesize potential immunological mechanisms underlying these persistent and prolonged effects, and describe the multi-organ long-term manifestations of COVID-19.
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