Citation, DOI, disclosures and article data
Citation:
Sciacca F, Silverstone L, Knipe H, et al. Long COVID-19. Reference article, Radiopaedia.org (Accessed on 29 Mar 2024) https://doi.org/10.53347/rID-94430
Long COVID-19 also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or post COVID-19 condition, is a post-viral syndrome affecting people who have recovered from COVID-19 infection. Symptoms are similar to those experienced by patients with chronic inflammatory response syndrome (CIRS) rather than myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) 6. To aid research, codes have been introduced to identify certain cohorts (ICD-10, U09.9) 11.
Clinical presentation
It can manifest weeks or months after the apparent clinical resolution of the acute phase of the disease. Dyspnea and fatigue are among the most common symptoms 1,2. However, the signs, symptoms and possible clinical manifestations are grouped into two classes 3,4:
general syndrome, e. g. fatigue, fever
-
organ-specific clinical manifestations
neurological, e. g. headache, sleep disturbances, brain fog, anxiety (or depression)
cardiovascular, e. g. tachycardia, myocarditis, chest pain
dermatologic, e. g. rash, alopecia, urticaria
Pathogenesis
The aetiopathogenetic mechanisms by which the SARS-CoV-2 infection determines the post-acute sequelae are not have not yet been fully clarified. Various hypotheses include direct organ damage caused by the virus, innate immune response with release of inflammatory cytokines or the development of a pro-coagulative state. According to some authors, anti-idiotype antibodies play a possible role in the pathogenesis of the disease 5. Basophil function make affect the course of the disease 7, 8 and mast cell activation may play a role in long Covid 9, 10.
-
1. Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V et al. Prevalence of Post-COVID-19 Symptoms in Hospitalized and Non-Hospitalized COVID-19 Survivors: A Systematic Review and Meta-Analysis. Eur J Intern Med. 2021;92:55-70. doi:10.1016/j.ejim.2021.06.009 - Pubmed
-
2. Carfì A, Bernabei R, Landi F, for the Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603. doi:10.1001/jama.2020.12603
-
3. The Lancet Neurology. Long COVID: Understanding the Neurological Effects. Lancet Neurol. 2021;20(4):247. doi:10.1016/S1474-4422(21)00059-4 - Pubmed
-
4. Satterfield B, Bhatt D, Gersh B. Cardiac Involvement in the Long-Term Implications of COVID-19. Nat Rev Cardiol. 2021. doi:10.1038/s41569-021-00631-3 - Pubmed
-
5. Murphy W & Longo D. A Possible Role for Anti-Idiotype Antibodies in SARS-CoV-2 Infection and Vaccination. N Engl J Med. 2021. doi:10.1056/NEJMcibr2113694 - Pubmed
-
6. Yong S. Long COVID or Post-COVID-19 Syndrome: Putative Pathophysiology, Risk Factors, and Treatments. Infect Dis (Lond). 2021;53(10):737-54. doi:10.1080/23744235.2021.1924397 - Pubmed
-
7. Murdaca G, Di Gioacchino M, Greco M et al. Basophils and Mast Cells in COVID-19 Pathogenesis. Cells. 2021;10(10):2754. doi:10.3390/cells10102754 - Pubmed
-
8. Miyake K, Ito J, Karasuyama H. Role of Basophils in a Broad Spectrum of Disorders. Front Immunol. 2022;13:902494. doi:10.3389/fimmu.2022.902494 - Pubmed
-
9. Szukiewicz D, Wojdasiewicz P, Watroba M, Szewczyk G. Mast Cell Activation Syndrome in COVID-19 and Female Reproductive Function: Theoretical Background Vs. Accumulating Clinical Evidence. Journal of Immunology Research. 2022;2022:1-22. doi:10.1155/2022/9534163
-
10. Batiha G, Al-kuraishy H, Al-Gareeb A, Welson N. Pathophysiology of Post-COVID Syndromes: A New Perspective. Virol J. 2022;19(1):158. doi:10.1186/s12985-022-01891-2 - Pubmed
-
11. Pfaff E, Madlock-Brown C, Baratta J et al. Coding Long COVID: Characterizing a New Disease Through an ICD-10 Lens. BMC Med. 2023;21(1):58. doi:10.1186/s12916-023-02737-6 - Pubmed
-
12. Ayoubkhani D, Khunti K, Nafilyan V et al. Post-Covid Syndrome in Individuals Admitted to Hospital with Covid-19: Retrospective Cohort Study. BMJ. 2021;372:n693. doi:10.1136/bmj.n693 - Pubmed
-
13. Venu Chippa, Abdul Aleem, Fatima Anjum. Post-Acute Coronavirus (COVID-19) Syndrome. StatPearls Publishing. 2023. https://www.ncbi.nlm.nih.gov/books/NBK570608/ - Pubmed
-
14. Turner S, Khan M, Putrino D, Woodcock A, Kell D, Pretorius E. Long COVID: Pathophysiological Factors and Abnormalities of Coagulation. Trends Endocrinol Metab. 2023;34(6):321-44. doi:10.1016/j.tem.2023.03.002 - Pubmed
-
15. Xiang M, Jing H, Wang C, Novakovic V, Shi J. Persistent Lung Injury and Prothrombotic State in Long COVID. Front Immunol. 2022;13:862522. doi:10.3389/fimmu.2022.862522 - Pubmed
Promoted articles (advertising)