IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
Cell Death Differ. 2022 Oct;29(10):1891-1900. doi: 10.1038/s41418-022-01052-6. Epub 2022 Sep 7.
Post-acute sequelae of SARS-CoV-2 (PASC), also known as Post-Covid Syndrome, and colloquially as Long Covid, has been defined as a constellation of signs and symptoms which persist for weeks or months after the initial SARS-CoV-2 infection. PASC affects a wide range of diverse organs and systems, with manifestations involving lungs, brain, the cardiovascular system and other organs such as kidney and the neuromuscular system. The pathogenesis of PASC is complex and multifactorial. Evidence suggests that seeding and persistence of SARS-CoV-2 in different organs, reactivation, and response to unrelated viruses such as EBV, autoimmunity, and uncontrolled inflammation are major drivers of PASC. The relative importance of pathogenetic pathways may differ in different tissue and organ contexts. Evidence suggests that vaccination, in addition to protecting against disease, reduces PASC after breakthrough infection although its actual impact remains to be defined. PASC represents a formidable challenge for health care systems and dissecting pathogenetic mechanisms may pave the way to targeted preventive and therapeutic approaches.
新型冠状病毒感染后疾病(post-acute sequelae of SARS-CoV-2, PASC)，也称为新冠后综合征(post-covid syndrome)，俗称长新冠(long covid)，被定义为在初次感染 SARS-CoV-2 后数周或数月持续存在的一系列症状和体征。PASC 影响广泛的不同器官和系统，表现涉及肺部、大脑、心血管系统和其他器官，如肾脏和神经肌肉系统。PASC 的发病机制复杂且多因素。有证据表明，SARS-CoV-2 在不同器官中的定植和持续存在、重新激活以及对 EBV 等无关病毒的反应、自身免疫和失控性炎症是 PASC 的主要驱动因素。发病途径的相对重要性在不同的组织和器官环境中可能不同。有证据表明，疫苗接种除了预防疾病外，还可以减少突破性感染后的 PASC，尽管其实际影响仍有待确定。PASC 对医疗保健系统构成了巨大挑战，剖析发病机制可能为有针对性的预防和治疗方法铺平道路。
