Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19.

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.

Ramakrishnan RK ，Kashour T ，Hamid Q ，Halwani R ，Tleyjeh IM ... -  《Frontiers in Immunology》

Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved.

Carod-Artal FJ 《-》

The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study.

Fernández-de-Las-Peñas C ，Gómez-Mayordomo V ，Cuadrado ML ，Palacios-Ceña D ，Florencio LL ，Guerrero AL ，García-Azorín D ，Hernández-Barrera V ，Arendt-Nielsen L ... -  《-》

Long COVID Clusters of Symptoms Persist beyond Two Years after Infection: Insights from the CARDIO COVID 20-21 Registry.

Arango-Ibanez JP ，Córdoba-Melo BD ，Gutiérrez Posso JM ，Barbosa-Rengifo MM ，Herrera CJ ，Quintana Da Silva MA ，Buitrago AF ，Coronel Gilio ML ，Pow-Chong-Long F ，Gómez-Mesa JE ... -  《Viruses-Basel》

Pathological sequelae of long-haul COVID.

The world continues to contend with successive waves of coronavirus disease 2019 (COVID-19), fueled by the emergence of viral variants. At the same time, persistent, prolonged and often debilitating sequelae are increasingly recognized in convalescent individuals, named 'post-COVID-19 syndrome' or 'long-haul COVID'. Clinical symptomatology includes fatigue, malaise, dyspnea, defects in memory and concentration and a variety of neuropsychiatric syndromes as the major manifestations, and several organ systems can be involved. The underlying pathophysiological mechanisms are poorly understood at present. This Review details organ-specific sequelae of post-COVID-19 syndromes and examines the underlying pathophysiological mechanisms available so far, elaborating on persistent inflammation, induced autoimmunity and putative viral reservoirs. Finally, we propose diagnostic strategies to better understand this heterogeneous disorder that continues to afflict millions of people worldwide.

Mehandru S ，Merad M 《-》