Long COVID: Clinical Findings, Pathology, and Endothelial Molecular Mechanisms

H Bradford Hawley

doi:10.1016/j.amjmed.2023.08.008

Long COVID: Clinical Findings, Pathology, and Endothelial Molecular Mechanisms

Am J Med. 2023 Sep 11:S0002-9343(23)00539-9. doi: 10.1016/j.amjmed.2023.08.008. Online ahead of print.

Author

H Bradford Hawley¹

Affiliation

¹ Department of Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio. Electronic address: hbhawley@twc.com.

PMID: 37704072
DOI: 10.1016/j.amjmed.2023.08.008

Abstract

Persistence of COVID-19 symptoms may follow severe acute respiratory syndrome coronavirus 2 infection. The incidence of long COVID increases with the severity of acute disease, but even mild disease can be associated with sequelae. The symptoms vary widely, with fatigue, shortness of breath, and cognitive dysfunction the most common. Abnormalities of multiple organs have been documented, and histopathology has revealed widespread microthrombi. Elevated levels of complement are present in acute COVID-19 patients and may persist at lower levels in long COVID. Evidence supports complement activation, with endotheliopathy-associated disease as the molecular mechanism causing both acute and long COVID.

Keywords: Complement; Endotheliopathy; Long COVID; Microthrombosis.

Publication types

Review