Biological mechanisms underpinning the development of long COVID

Rubeshan Perumal; Letitia Shunmugam; Kogieleum Naidoo; Dave Wilkins; Alfredo Garzino-Demo; Christian Brechot; Anders Vahlne; Janko Nikolich

doi:10.1016/j.isci.2023.106935

Biological mechanisms underpinning the development of long COVID

iScience. 2023 Jun 16;26(6):106935. doi: 10.1016/j.isci.2023.106935. Epub 2023 May 18.

Authors

Rubeshan Perumal^{1

2

3}, Letitia Shunmugam¹, Kogieleum Naidoo¹, Dave Wilkins⁴, Alfredo Garzino-Demo^{4

5}, Christian Brechot^{4

6}, Anders Vahlne^{4

7}, Janko Nikolich^{4

8}

Affiliations

¹ South African Medical Research Council (SAMRC)-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban 4001, South Africa.
² Department of Pulmonology and Critical Care, Division of Internal Medicine, School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban 4001, South Africa.
³ Department of Immunobiology and the University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, AZ 85724, USA.
⁴ The Global Virus Network, Baltimore, MD 21201, USA.
⁵ Department of Molecular Medicine, University of Padova, Padova 1- 35129, Italy.
⁶ Infectious Disease and International Health, University of South Florida, Tampa, FL 33620, USA.
⁷ Division of Clinical Microbiology, Karolinska Institute, Stockholm 17165, Sweden.
⁸ The Aegis Consortium for Pandemic-Free Future, University of Arizona Health Sciences, University of Arizona College of Medicine-Tucson, Tucson, AZ 85724, USA.

Abstract

As COVID-19 evolves from a pandemic to an endemic disease, the already staggering number of people that have been or will be infected with SARS-CoV-2 is only destined to increase, and the majority of humanity will be infected. It is well understood that COVID-19, like many other viral infections, leaves a significant fraction of the infected with prolonged consequences. Continued high number of SARS-CoV-2 infections, viral evolution with escape from post-infection and vaccinal immunity, and reinfections heighten the potential impact of Long COVID. Hence, the impact of COVID-19 on human health will be seen for years to come until more effective vaccines and pharmaceutical treatments become available. To that effect, it is imperative that the mechanisms underlying the clinical manifestations of Long COVID be elucidated. In this article, we provide an in-depth analysis of the evidence on several potential mechanisms of Long COVID and discuss their relevance to its pathogenesis.

Keywords: Health sciences; Medicine.

Publication types

Review

Grants and funding

MC_PC_16022/MRC_/Medical Research Council/United Kingdom