He Xiaomeng, Zhang Xiang, Zhong Wu
National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, China.
Department of Blood Transfusion Medicine, The 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, China.
Front Pharmacol. 2024 Oct 9;15:1457672. doi: 10.3389/fphar.2024.1457672. eCollection 2024.
Long COVID, or Post-Acute Sequelae of COVID-19 (PASC), was characterized by persistent symptoms such as fatigue, shortness of breath, and cognitive impairments. These symptoms, emerging one to 2 months post-infection and persisting for several months, cannot be attributed to other diagnoses. The pathophysiology of long COVID remained elusive; however, emerging studies suggested multiple potential mechanisms, including the reactivation of Epstein-Barr virus, persistent SARS-CoV-2 reservoirs, neuroinflammation, and vascular damage, which may contribute to its development. Long COVID affected multiple organ systems, including respiratory, circulatory, and nervous systems, leading to a range of functional impairments. Additionally, it showed a profound impact on mental health, manifesting as anxiety and depression, which significantly degraded the quality of life. The absence of definitive treatments underscored the importance of prevention. Recent evidence indicated that early antiviral intervention-particularly with small-molecule drugs such as Metformin, Ensitrelvir, Molnupiravir, and Nirmatrelvir-may effectively reduce the incidence of long COVID. This underscored the promising role of small-molecule compounds in mitigating long-term COVID-19 consequences, offering a novel preventive strategy against long COVID and its extensive impacts on patients.
长期新冠，即新冠病毒感染后急性后遗症（PASC），其特征为疲劳、呼吸急促和认知障碍等持续症状。这些症状在感染后1至2个月出现，并持续数月，无法归因于其他诊断。长期新冠的病理生理学仍不清楚；然而，新出现的研究提出了多种潜在机制，包括爱泼斯坦-巴尔病毒的重新激活、持续存在的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）储存库、神经炎症和血管损伤，这些可能导致其发生。长期新冠影响多个器官系统，包括呼吸、循环和神经系统，导致一系列功能障碍。此外，它对心理健康有深远影响，表现为焦虑和抑郁，这显著降低了生活质量。缺乏确切的治疗方法凸显了预防的重要性。最近的证据表明，早期抗病毒干预——特别是使用二甲双胍、恩昔洛韦、莫努匹拉韦和奈玛特韦等小分子药物——可能有效降低长期新冠的发病率。这凸显了小分子化合物在减轻新冠长期后果方面的潜在作用，为预防长期新冠及其对患者的广泛影响提供了一种新的策略。
