Long COVID: An inevitable sequela of SARS-CoV-2 infection

Chih-Cheng Lai; Chi-Kuei Hsu; Muh-Yong Yen; Ping-Ing Lee; Wen-Chien Ko; Po-Ren Hsueh

doi:10.1016/j.jmii.2022.10.003

Long COVID: An inevitable sequela of SARS-CoV-2 infection

J Microbiol Immunol Infect. 2023 Feb;56(1):1-9. doi: 10.1016/j.jmii.2022.10.003. Epub 2022 Oct 15.

Authors

Chih-Cheng Lai¹, Chi-Kuei Hsu², Muh-Yong Yen³, Ping-Ing Lee⁴, Wen-Chien Ko⁵, Po-Ren Hsueh⁶

Affiliations

¹ Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
² Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
³ Division of Infectious Diseases, Cheng Hsin General Hospital, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁵ Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@gmail.com.

Abstract

At present, there are more than 560 million confirmed cases of the coronavirus disease 2019 (COVID-19) worldwide. Although more than 98% of patients with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection can survive acute COVID, a significant portion of survivors can develop residual health problems, which is termed as long COVID. Although severe COVID-19 is generally associated with a high risk of long COVID, patients with asymptomatic or mild disease can also show long COVID. The definition of long COVID is inconsistent and its clinical manifestations are protean. In addition to general symptoms, such as fatigue, long COVID can affect many organ systems, including the respiratory, neurological, psychosocial, cardiovascular, gastrointestinal, and metabolic systems. Moreover, patients with long COVID may experience exercise intolerance and impaired daily function and quality of life. Long COVID may be caused by SARS-CoV-2 direct injury or its associated immune/inflammatory response. Assessment of patients with long COVID requires comprehensive evaluation, including history taking, physical examination, laboratory tests, radiography, and functional tests. However, there is no known effective treatment for long COVID. Based on the limited evidence, vaccines may help to prevent the development of long COVID. As long COVID is a new clinical entity that is constantly evolving, there are still many unknowns, and further investigation is warranted to enhance our understanding of this disease.

Keywords: COVID-19; Long COVID; Post-acute COVID; SARS-CoV-2; Vaccine.

Publication types

Review

MeSH terms

COVID-19* / complications
Disease Progression
Humans
Lung
Post-Acute COVID-19 Syndrome
Quality of Life
SARS-CoV-2