Department of Medical Physics, Alexandru Ioan Cuza University, 11 Carol I Boulevard, 700506 Iasi, Romania.
President of the International Society for Medical Laser Applications (ISLA Transcontinental), German Vice President of the German-Chinese Research Foundation (DCFG) for TCM, Honorary President of the European Federation of Acupuncture and Moxibustion Societies, 8053 Graz, Austria.
Int J Mol Sci. 2023 Jun 29;24(13):10874. doi: 10.3390/ijms241310874.
For over three years, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents has generated repercussions, especially a few weeks after infection, for symptomatic patients who tested positive, for asymptomatic ones, or even just the contacts of an infected person, and evolved from severe forms such as multisystem inflammatory syndrome in children (MIS-C) to multifarious clinical manifestations in long COVID (LC). Referred to under the umbrella term LC, the onset of persistent and highly heterogeneous symptoms such as fatigue, post-exertion malaise, cognitive dysfunction, and others have a major impact on the child's daily quality of life for months. The first aim of this review was to highlight the circumstances of the pathophysiological changes produced by COVID-19 in children and to better understand the hyperinflammation in COVID-19 and how MIS-C, as a life-threatening condition, could have been avoided in some patients. Another goal was to better identify the interplay between infection, dysbiosis, and inflammation at a molecular and cellular level, to better guide scientists, physicians, and pediatricians to advance new lines of medical action to avoid the post-acute sequelae of SARS-CoV-2 infection. The third objective was to identify symptoms and their connection to molecular pathways to recognize LC more easily. The fourth purpose was to connect the triggering factors of LC with related sequelae following acute SARS-CoV-2 injuries to systems and organs, the persistence of the virus, and some of its components in hidden reservoirs, including the gut and the central nervous system. The reactivation of other latent infectious agents in the host's immune environments, the interaction of this virus with the microbiome, immune hyperactivation, and autoimmunity generated by molecular mimicry between viral agents and host proteins, could initiate a targeted and individualized management. New high-tech solutions, molecules, probiotics, and others should be discovered to innovatively solve the interplay between RNA persistent viruses, microbiota, and our immune system.
三年多来，儿童和青少年严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起了反响，尤其是在感染后几周，对症状阳性的患者、无症状患者，甚至只是感染者的接触者，从儿童多系统炎症综合征（MIS-C）等严重形式演变而来，出现了长期 COVID（LC）等多种临床表现。在 LC 的总称下，持续性和高度异质性症状的出现，如疲劳、运动后不适、认知功能障碍等，对儿童的日常生活质量产生了重大影响，持续数月之久。本综述的首要目的是强调 COVID-19 引起的儿童病理生理变化的情况，更好地理解 COVID-19 中的过度炎症，以及如何避免某些患者发生危及生命的 MIS-C。另一个目标是更好地识别感染、菌群失调和炎症在分子和细胞水平上的相互作用，以便更好地指导科学家、医生和儿科医生提出新的医疗行动方案，以避免 SARS-CoV-2 感染后的急性后遗症。第三个目标是识别症状及其与分子途径的联系，以便更轻松地识别 LC。第四个目的是将 LC 的触发因素与急性 SARS-CoV-2 损伤后与系统和器官相关的后遗症、病毒的持续存在及其在隐藏储库中的一些成分（包括肠道和中枢神经系统）联系起来。宿主免疫环境中潜伏性传染因子的重新激活、该病毒与微生物组的相互作用、病毒因子与宿主蛋白之间的分子模拟引起的免疫过度激活和自身免疫，都可能引发有针对性和个体化的管理。应发现新的高科技解决方案、分子、益生菌等，以创新的方式解决 RNA 持续性病毒、微生物组和我们免疫系统之间的相互作用。
