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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Long COVID: Pathophysiology, current concepts, and future directions
Chrysanthi Skevaki1, Charalampos D Moschopoulos2, Paraskevi C Fragkou3
1Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, University of Marburg, Marburg, Germany; German Center for Lung Research (DZL), University of Giessen, Marburg Lung Center (UGMLC), Giessen, Germany; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland.
Insights
Long COVID, a complex condition following SARS-CoV-2 infection, significantly impacts quality of life and healthcare systems. Understanding its pathophysiology through various mechanisms and biomarkers is crucial for developing effective treatments.
Area of Science:
- Infectious Diseases
- Immunology
- Pathophysiology
Background:
- Long COVID presents diverse symptoms post-SARS-CoV-2 infection, affecting patient quality of life and straining global healthcare resources.
- The underlying mechanisms of Long COVID are not fully understood, necessitating further research into its complex nature.
Purpose of the Study:
- To explore the multifaceted pathophysiology of Long COVID.
- To highlight ongoing research into potential biomarkers and therapeutic strategies for Long COVID.
Main Methods:
- Review of proposed hypotheses for Long COVID mechanisms, including viral persistence, immune dysregulation, and autoimmunity.
- Discussion of active investigations into biomarkers such as inflammatory mediators, immunophenotyping, and multiomics.
Main Results:
- Several key areas are being investigated for Long COVID's evolution and complexity: SARS-CoV-2 persistence, organ damage, immune system perturbation, autoimmunity, latent virus reactivation, endothelial dysfunction, and microbiome disturbances.
- Biomarker research is actively exploring inflammatory mediators, immunophenotyping, and multiomics to identify Long COVID endotypes.
Conclusions:
- A comprehensive understanding of Long COVID's pathophysiology is essential for developing targeted therapeutics.
- Continued research into biomarkers and mechanisms is critical for advancing Long COVID patient care and management.
Abstract:
Long COVID, an umbrella term referring to a variety of symptoms and clinical presentations that emerges in a subset of patients after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has a significant effect on quality of life and places a substantial burden on health care systems worldwide, straining financial and human resources. The pathophysiology of long COVID remains incompletely understood, though several hypotheses have been proposed to explain different aspects of this complex condition. SARS-CoV-2 persistence, direct organ damage, innate and adaptive immune system perturbation, autoimmunity, latent virus reactivation, endothelial dysfunction, and microbiome disturbances are among the most relevant avenues for elucidating the evolution, complexity, and mechanisms of long COVID. Active investigation regarding potential biomarkers for long COVID and its associated disease endotypes highlights the role of inflammatory mediators, immunophenotyping, and multiomics approaches. Further advances in understanding long COVID are needed to inform current and future therapeutics.
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