Long COVID: major findings,mechanisms and recommendations

Hannah E. Davis, Lisa McCorkell, Julia Moore Vogel & Eric J. Topol

Abstract:

“Long COVID is an often debilitating illness that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. More than 200 symptoms have been identifed with impacts on multiple organ systems. At least 65 million individuals worldwide are estimated to have long COVID, with cases increasing daily. Biomedical research has made substantial progress in identifying various pathophysiological changes and risk factors and in characterizing the illness; further, similarities with other viral-onset illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome have laid the groundwork for research in the feld. In this Review, we explore the current literature and highlight key fndings, the overlap with other conditions, the variable onset of symptoms, long COVID in children and the impact of vaccinations. Although these key fndings are critical to understanding long COVID, current diagnostic and treatment options are insufcient, and clinical trials must be prioritized that address leading hypotheses. Additionally, to strengthen long COVID research, future studies must account for biases and SARS-CoV-2 testing issues, build on viral-onset research, be inclusive of marginalized populations and meaningfully engage patients throughout the research process.”