Long COVID pathophysiology
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Long COVID, long tail covid, Post-Acute Sequelae of COVID-19 (PASC), post-acute COVID-19 and ongoing COVID are terms used to describe a group of long term health problems that are found in a significant minority of people who developed COVID-19 and remain ill a number of weeks or months later.
Overview[edit | edit source]
Pathophysiology[edit | edit source]
Infection and immunity[edit | edit source]
A range of antibodies have been found in patients with persistent post-acute COVID symptoms. Elevated G-protein coupled receptor autoantibodies have been found.[1] One study founded elevated antinuclear antibody (ANA) titles in 43.6% of long COVID patients twelve months after symptom onset.[2]
Long COVID may be associated herpesvirus reactivation such as Epstein-Barr Virus,[3] which has been shown to cause elevations of certain G-protein coupled receptor autoantibody types.[4][5][6][7]
Neurological and neuropsychiatric[edit | edit source]
Cardiovascular[edit | edit source]
Pulmonary[edit | edit source]
In a single cardiopulmonary exercise test, Post-COVID-19 patients exhibited markedly reduced peak exercise aerobic capacity (VO2) compared to controls and impaired oxygen extraction, even in those without cardiopulmonary disease.[8]
Comparison to other conditions[edit | edit source]
| Findings | Long COVID | Post-acute SARS | ME/CFS | POTS | MCAS |
|---|---|---|---|---|---|
| G-protein coupled receptor autoantibodies | β2- and α1-adrenoceptors, angiotensin II AT1-, muscarinic M2-, MAS-, nociceptin- and ETA-receptors | M3 and M4 muscarinic acetylcholine receptors, as well as ß2 adrenergic receptors | α1, β1 and β2 adrenergic receptor autoantibodies | ||
Post-SARS syndrome[edit | edit source]
ME/CFS[edit | edit source]
Postviral fatigue syndrome[edit | edit source]
Chronic fatigue and Idiopathic chronic fatigue[edit | edit source]
POTS[edit | edit source]
MCAS[edit | edit source]
Post-Ebola syndrome[edit | edit source]
Chronic Epstein-Barr virus[edit | edit source]
Alzheimer's disease[edit | edit source]
Traumatic Brain Injury[edit | edit source]
Notable studies[edit | edit source]
- Jun 2021, Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms[9] - (Full text)
- 2020, Long COVID-19: Challenges in the diagnosis and proposed diagnostic criteria[10] (Full text)
- 2020, Multi-organ impairment in low-risk individuals with long COVID[11] - (Full text)
- 2020, Living with covid-19. A dynamic review of the evidence around ongoing covid-19 symptoms (often called long covid)[12] (Full text)
Learn more[edit | edit source]
- Long COVID Resource Hub (database of Long COVID research)
See also[edit | edit source]
References[edit | edit source]
- ↑ "Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms". Journal of Translational Autoimmunity. 4: 100100. January 1, 2021. doi:10.1016/j.jtauto.2021.100100. ISSN 2589-9090.
- ↑ Seeßle, Jessica; Waterboer, Tim; Hippchen, Theresa; Simon, Julia; Kirchner, Marietta; Lim, Adeline; Müller, Barbara; Merle, Uta (July 5, 2021). "Persistent symptoms in adult patients one year after COVID-19: a prospective cohort study". Clinical Infectious Diseases (ciab611). doi:10.1093/cid/ciab611. ISSN 1058-4838.
- ↑ Gold, Jeffrey E.; Okyay, Ramazan A.; Licht, Warren E.; Hurley, David J. (2021/6). "Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation". Pathogens. 10 (6): 763. doi:10.3390/pathogens10060763. Check date values in:
|date=(help) - ↑ Angelini, Lucia; Bardare, Maria; Martini, Alberto (2002). Immune-mediated Disorders of the Central Nervous System in Children.
- ↑ Gebhardt, B. M. (June 26, 2000). "Evidence for antigenic cross-reactivity between herpesvirus and the acetylcholine receptor". Journal of Neuroimmunology. 105 (2): 145–153. ISSN 0165-5728. PMID 10742556.
- ↑ Brenner, T.; Timore, Y.; Wirguin, I.; Abramsky, O.; Steinitz, M. (October 1989). "In vitro synthesis of antibodies to acetylcholine receptor by Epstein-Barr virus-stimulated B-lymphocytes derived from patients with myasthenia gravis". Journal of Neuroimmunology. 24 (3): 217–222. ISSN 0165-5728. PMID 2553772.
- ↑ Kaminski, Henry J.; Janos, Minarovits. "Epstein-barr virus: Trigger for autoimmunity?". Annals of Neurology. ISSN 0364-5134.
- ↑ Singh, Inderjit; Joseph, Phillip; Heerdt, Paul M.; Cullinan, Marjorie; Lutchmansingh, Denyse D.; Gulati, Mridu; Possick, Jennifer D.; Systrom, David M.; Waxman, Aaron B. (August 10, 2021). "Persistent Exertional Intolerance after COVID-19: Insights from Invasive Cardiopulmonary Exercise Testing". CHEST. 0 (0). doi:10.1016/j.chest.2021.08.010. ISSN 0012-3692.
- ↑ Proal, Amy D.; VanElzakker, Michael B. (2021). "Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms". Frontiers in Microbiology. doi:10.3389/fmicb.2021.698169. ISSN 1664-302X. PMC 8260991. PMID 34248921.
- ↑ Raveendran, A.V. (2021). "Long COVID-19: Challenges in the diagnosis and proposed diagnostic criteria". Diabetes & Metabolic Syndrome. 15 (1): 145–146. doi:10.1016/j.dsx.2020.12.025. ISSN 1871-4021. PMC 7737559. PMID 33341598.
- ↑ Dennis, Andrea; Wamil, Malgorzata; Kapur, Sandeep; Alberts, Johann; Badley, Andrew D.; Decker, Gustav Anton; Rizza, Stacey A.; Banerjee, Rajarshi; Banerjee, Amitava (October 16, 2020). "Multi-organ impairment in low-risk individuals with long COVID". medRxiv: 2020.10.14.20212555. doi:10.1101/2020.10.14.20212555.
- ↑ NIHR (October 2020). "Living with covid-19. A dynamic review of the evidence around ongoing covid-19 symptoms (often called long covid)". evidence.nihr.ac.uk. doi:10.3310/themedreview_41169. Retrieved October 15, 2020.
