Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Nat Immunol. 2022 Feb;23(2):194-202. doi: 10.1038/s41590-021-01104-y. Epub 2022 Feb 1.
The world continues to contend with successive waves of coronavirus disease 2019 (COVID-19), fueled by the emergence of viral variants. At the same time, persistent, prolonged and often debilitating sequelae are increasingly recognized in convalescent individuals, named 'post-COVID-19 syndrome' or 'long-haul COVID'. Clinical symptomatology includes fatigue, malaise, dyspnea, defects in memory and concentration and a variety of neuropsychiatric syndromes as the major manifestations, and several organ systems can be involved. The underlying pathophysiological mechanisms are poorly understood at present. This Review details organ-specific sequelae of post-COVID-19 syndromes and examines the underlying pathophysiological mechanisms available so far, elaborating on persistent inflammation, induced autoimmunity and putative viral reservoirs. Finally, we propose diagnostic strategies to better understand this heterogeneous disorder that continues to afflict millions of people worldwide.
世界继续与 2019 年冠状病毒病（COVID-19）的连续波作斗争，这是由病毒变异的出现推动的。与此同时，在康复个体中越来越多地认识到持续、长期且常常使人衰弱的后遗症，被称为“COVID-19 后综合征”或“长途 COVID”。临床症状包括疲劳、不适、呼吸困难、记忆和注意力缺陷以及各种神经精神综合征等主要表现，并且多个器官系统可能受到影响。目前对潜在的病理生理机制知之甚少。本综述详细介绍了 COVID-19 后综合征的特定器官后遗症，并检查了迄今为止可用的潜在病理生理机制，阐述了持续的炎症、诱导的自身免疫和可能的病毒储库。最后，我们提出了诊断策略，以更好地了解这种继续困扰着全世界数百万人的异质性疾病。
