4.7 Review

Pathological sequelae of long-haul COVID

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NATURE IMMUNOLOGY
卷 23, 期 2, 页码 194-202

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NATURE PORTFOLIO
DOI: 10.1038/s41590-021-01104-y

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  1. Gates Foundation [U24 AI118644-05S1, P30 CA196521-05S2]
  2. [DK123749 0S1]

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This review examines the underlying pathophysiological mechanisms of post-COVID-19 syndromes, including persistent inflammation, induced autoimmunity, and putative viral reservoirs. The disease is called 'long-haul COVID' or 'post-COVID-19 syndrome', and clinical symptoms include fatigue, dyspnea, and neuropsychiatric syndromes.
It is increasingly obvious that individuals are experiencing post-COVID-19 syndromes, or 'long-haul COVID'. Here, Merad and Mehandru eview currently available knowledge of the underlying pathophysiological mechanisms of these sequelae, elaborating on persistent inflammation, induced autoimmunity and putative viral reservoirs. 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.

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