Post-acute sequelae of COVID-19: A metabolic perspective

Elife. 2022 Mar 23:11:e78200. doi: 10.7554/eLife.78200.

Abstract

The SARS-CoV-2 pandemic continues to rage around the world. At the same time, despite strong public health measures and high vaccination rates in some countries, a post-COVID-19 syndrome has emerged which lacks a clear definition, prevalence, or etiology. However, fatigue, dyspnea, brain fog, and lack of smell and/or taste are often characteristic of patients with this syndrome. These are evident more than a month after infection, and are labeled as Post-Acute Sequelae of CoV-2 (PASC) or commonly referred to as long-COVID. Metabolic dysfunction (i.e., obesity, insulin resistance, and diabetes mellitus) is a predisposing risk factor for severe acute COVID-19, and there is emerging evidence that this factor plus a chronic inflammatory state may predispose to PASC. In this article, we explore the potential pathogenic metabolic mechanisms that could underly both severe acute COVID-19 and PASC, and then consider how these might be targeted for future therapeutic approaches.

Keywords: COVID-19; PASC; medicine; metabolic dysfunction; obesity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / etiology
  • COVID-19 / metabolism
  • COVID-19 / therapy
  • Diabetes Mellitus, Type 2
  • Disease Management
  • Disease Susceptibility*
  • Energy Metabolism*
  • Glucose / metabolism
  • Glucose Intolerance
  • Humans
  • Insulin Resistance
  • Islets of Langerhans / metabolism
  • Liver / metabolism
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / etiology
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / therapy
  • Post-Acute COVID-19 Syndrome
  • Risk Assessment
  • Risk Factors
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism

Substances

  • Glucose