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What Role Does Microthrombosis Play in Long COVID?
Toshiaki Iba1, Jean M Connors2, Jerrold H Levy3
1Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Seminars in Thrombosis and Hemostasis
|September 25, 2023
Summary
Long COVID, or post-acute sequelae of COVID-19 (PASC), affects 10-20% of patients. While microclots are a potential cause, PASC is complex and requires symptom-specific treatments.
Area of Science:
- Medical Research
- Infectious Diseases
- Pathophysiology
Background:
- Post-acute sequelae of COVID-19 (PASC), commonly known as long COVID, affects 10-20% of recovered patients.
- Persistent symptoms include fatigue, cognitive issues, and muscle weakness.
- The exact pathophysiological mechanisms underlying PASC remain largely unknown.
Purpose of the Study:
- To explore the potential role of persistent microclots in the development of long COVID.
- To review the current understanding of PASC pathophysiology and treatment strategies.
Main Methods:
- Review of existing literature on COVID-19 pathophysiology, thromboinflammation, and PASC.
- Analysis of studies investigating microclots, viral persistence, and treatment outcomes.
Main Results:
- Hypercoagulability and thrombosis are key in acute COVID-19, with ongoing thromboinflammation possibly linked to persistent viral elements.
- Microclots are hypothesized to contribute to PASC symptoms, but evidence is inconclusive.
- Current treatments targeting coagulation and vascular protection show inconsistent benefits.
Conclusions:
- Post-acute sequelae of COVID-19 (PASC) is a heterogeneous condition, not solely explained by microclots.
- Future research should focus on clarifying the pathomechanisms of individual symptoms.
- A stratified approach based on symptoms or biomarkers is recommended for effective PASC management.
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