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Immune Mechanisms Underpinning Long COVID: Collegium Internationale Allergologicum Update 2024
Eva Untersmayr1, Carina Venter2, Peter Smith3
1Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Immunology and Infectiology, Medical University Vienna, Vienna, Austria.
Background:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can result in a prolonged multisystem disorder termed long COVID, which may affect up to 10% of people following coronavirus disease 2019 (COVID-19). It is currently unclear why certain individuals do not fully recover following SARS-CoV-2 infection.
Summary:
In this review, we examine immunological mechanisms that may underpin the pathophysiology of long COVID. These mechanisms include an inappropriate immune response to acute SARS-CoV-2 infection, immune cell exhaustion, immune cell metabolic reprogramming, a persistent SARS-CoV-2 reservoir, reactivation of other viruses, inflammatory responses impacting the central nervous system, autoimmunity, microbiome dysbiosis, and dietary factors.
Key Messages:
Unfortunately, the currently available diagnostic and treatment options for long COVID are inadequate, and more clinical trials are needed that match experimental interventions to underlying immunological mechanisms.
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