Why we need a deeper understanding of the long COVID pathophysiology

Some long-haul passengers recover, but many have been showing symptoms since early 2020. This condition is an umbrella diagnosis that represents a heterogeneous set of pathophysiological processes. As such, several factors may influence long-term COVID symptoms, including severity of acute infection, age, gender, pre-existing comorbidities, genetics, socioeconomic factors, and other environmental factors. I have. Long-distance transporters who have survived severe acute SARS-CoV-2 infection are most likely men over the age of 50 with residual tissue damage and scarring. Long-term sufferers are most likely young women (aged 36–50 years) in whom the acute infection elicits an adverse physiological response.

The main disease hypotheses regarding the underlying causes of long-term COVID include viral persistence (infectious virus, viral RNA, or viral proteins), infection-triggered autoimmunity, reactivation of latent virus, and tissue dysfunction. and chronic changes caused by inflammation leading to damage (shape).

Despite multifactorial etiology, the available data suggest that prolonged COVID is an acute organic disease with distinct physiological dysfunction that is often not consistently revealed using standard medical diagnostic tests. It indicates post-infectious syndrome (PAIS). This discrepancy highlights the need for a new generation of more sensitive testing procedures for people with PAIS. It is unclear whether existing psychological diagnoses can affect long-term COVID risk (e.g., by affecting the host’s endocrine and immune systems), but it is possible that long-term COVID may be associated with psychosomatic disease. Classification as is neither productive nor clinically or scientifically valid.

As COVID-19 becomes increasingly difficult to avoid, deep biological analysis may identify biomarkers of long COVID and different endtypes caused by different underlying causes. , argues that the risk of contracting long-term COVID will become clearer. Identification of biomarkers is not only important for identifying predisposing factors, but also allows safer, evidence-based policies to be implemented. Similarly, molecular, cellular, and physiological analyzes inform precise interventions targeting the root causes of each long COVID endtype. For example, persistent viral infections may be targets for antiviral agents. A long COVID caused by an autoimmune disease can be treated using monoclonal antibodies that target lymphocytes or drugs that block cytokines and cytokine signaling. Also, if reactivation of the herpes virus contributes to the disease, targeting such viruses with antiviral drugs or vaccines can be considered. Root-cause-considered diagnostic criteria for long-term COVID prevention and treatment require large-scale longitudinal studies. Even if therapeutic targeting of the underlying cause is not feasible, pathological changes downstream of long-term COVID can be treated.

Ideally, potential treatments should be evaluated in double-blind, placebo-controlled, randomized clinical trials. However, such studies are very costly, labor intensive, and require substantial government, regulatory, and industry support.