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Adult Long Coronavirus Disease 2019: Definition, Prevalence Pathophysiology, and Clinical Manifestations

Ivette Emery1, Clifford Rosen2

  • 1Center for Clinical and Translational Science, MaineHealth Institute for Research, Scarborough, ME, USA.

Infectious Disease Clinics of North America
|March 11, 2025
PubMed

Insights

Long COVID-19 affects 1 in 10 individuals after SARS-CoV-2 infection, presenting as a complex multisystem disorder. Research explores various causes, including viral persistence and autoimmunity, with identified risk factors like female sex and severe illness.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Pathophysiology

Background:

  • Long coronavirus disease 2019 (COVID-19) is a complex multisystem condition following SARS-CoV-2 infection.
  • Approximately 10% of individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection develop long COVID-19.
  • The etiology of long COVID-19 remains multifactorial, with no single cause identified beyond initial viral exposure.

Purpose of the Study:

  • To summarize the current understanding of long COVID-19.
  • To explore potential pathophysiological mechanisms.
  • To identify risk factors associated with developing long COVID-19.

Main Methods:

  • Review of existing literature on long COVID-19.
  • Analysis of proposed pathophysiological theories (viral persistence, autoimmunity, immune depletion).
  • Identification and summary of epidemiological risk factors.

Main Results:

  • Long COVID-19 is characterized by diverse symptoms and durations.
  • Multiple etiological theories exist, including viral persistence, immune dysregulation, and autoimmunity.
  • Identified risk factors include female sex, severe or hospitalized acute COVID-19, prior SARS-CoV-2 infections, and lack of vaccination.

Conclusions:

  • Long COVID-19 is a significant post-infectious sequela of SARS-CoV-2.
  • Understanding the pathophysiology is crucial for developing effective treatments.
  • Risk factor identification aids in predicting and potentially preventing long COVID-19.

Keywords:
Adult long COVID-19COVID-19Pathophysiology

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