Scheibenbogen Carmen, Bellmann-Strobl Judith Theresia, Heindrich Cornelia, Wittke Kirsten, Stein Elisa, Franke Christiana, Prüss Harald, Preßler Hannah, Machule Marie-Luise, Audebert Heinrich, Finke Carsten, Zimmermann Hanna Gwendolyn, Sawitzki Birgit, Meisel Christian, Toelle Markus, Krueger Anne, Aschenbrenner Anna C, Schultze Joachim L, Beyer Marc D, Ralser Markus, Mülleder Michael, Sander Leif Erik, Konietschke Frank, Paul Friedemann, Stojanov Silvia, Bruckert Lisa, Hedderich Dennis M, Knolle Franziska, Riemekasten Gabriela, Vehreschild Maria J G T, Cornely Oliver A, Behrends Uta, Burock Susen
Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany.
Front Med (Lausanne). 2023 Jun 15;10:1194754. doi: 10.3389/fmed.2023.1194754. eCollection 2023.
The sequela of COVID-19 include a broad spectrum of symptoms that fall under the umbrella term post-COVID-19 condition or syndrome (PCS). Immune dysregulation, autoimmunity, endothelial dysfunction, viral persistence, and viral reactivation have been identified as potential mechanisms. However, there is heterogeneity in expression of biomarkers, and it is unknown yet whether these distinguish different clinical subgroups of PCS. There is an overlap of symptoms and pathomechanisms of PCS with postinfectious myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). No curative therapies are available for ME/CFS or PCS. The mechanisms identified so far provide targets for therapeutic interventions. To accelerate the development of therapies, we propose evaluating drugs targeting different mechanisms in clinical trial networks using harmonized diagnostic and outcome criteria and subgrouping patients based on a thorough clinical profiling including a comprehensive diagnostic and biomarker phenotyping.
新冠病毒病(COVID-19)的后遗症包括一系列广泛的症状,这些症状统称为新冠后状况或综合征(PCS)。免疫失调、自身免疫、内皮功能障碍、病毒持续存在和病毒再激活已被确定为潜在机制。然而,生物标志物的表达存在异质性,这些生物标志物是否能区分PCS的不同临床亚组尚不清楚。PCS的症状和病理机制与感染后肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)存在重叠。目前尚无针对ME/CFS或PCS的治愈性疗法。迄今确定的机制为治疗干预提供了靶点。为加速治疗的开发,我们建议在临床试验网络中使用统一的诊断和结局标准,评估针对不同机制的药物,并根据全面的临床剖析(包括综合诊断和生物标志物表型分析)对患者进行亚组划分。