Long COVID and Post-Acute COVID-19 Syndrome: Pathophysiology, Clinical Features and Management

Posted on:October 28, 2022
Last Updated: November 3, 2022
Time to read: 36–43 minutes

Long COVID is a term introduced in 2020 to denote the persistence of symptoms post SARS-CoV-2 nfection.  It is characterised by persistent heterogeneous symptoms affecting multiple organ systems.

COVID-19 infection first emerged in Wuhan province, China, in late 2019. [Crook et al., 2021]

Its impact has been felt in every part of the world, with around 3.97 million deaths now reported globally. [Dong et al., 2020]; [World Health Organization, 2021]

Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), the virus which causes COVID-19, enters the body via the angiotensin-converting enzyme 2 (ACE-2) receptor [Chen et al., 2020]

The clinical spectrum of disease is vast, varying from asymptomatic in the best cases to fatal. [Gupta et al., 2020]; [Kim et al., 2020]

Many variants of COVID-19 have now been discovered. The first variant, alpha, was found in Kent, UK, and as of 30 June 2021, it was confirmed in more than 275,000 cases in the UK and spread to at least 136 other countries. [UK Gov, 2021] Other investigated variants include Beta, Gamma, Zeta, Theta, and Kappa. [UK Gov, 2021]

New covid-19 variants will continue to emerge and spread as the pandemic progresses, for example, Eta and Delta, with the delta variant accounting for over 161,000 cases in the UK as of 30 June 2021. [UK Gov, 2021]

The Lambda variant is a more recent strain that needs to be fully evaluated to establish the outcome of any long-term complications. [UK Gov, 2021]

In this article we cover the pathophysiology of long COVID with a greater emphasis on the neuropsychiatric aspects.

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