Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

Abstract

The COVID-19 pandemic has infected millions worldwide, leaving a global burden for long-term care of COVID-19 survivors. It is thus imperative to study post-COVID (i.e., short-term) and long-COVID (i.e., long-term) effects, specifically as local and systemic pathophysiological outcomes of other coronavirus-related diseases (such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)) were well-cataloged. We conducted a comprehensive review of adverse post-COVID health outcomes and potential long-COVID effects. We observed that such adverse outcomes were not localized. Rather, they affected different human systems, including: (i) immune system (e.g., Guillain–Barré syndrome, rheumatoid arthritis, pediatric inflammatory multisystem syndromes such as Kawasaki disease), (ii) hematological system (vascular hemostasis, blood coagulation), (iii) pulmonary system (respiratory failure, pulmonary thromboembolism, pulmonary embolism, pneumonia, pulmonary vascular damage, pulmonary fibrosis), (iv) cardiovascular system (myocardial hypertrophy, coronary artery atherosclerosis, focal myocardial fibrosis, acute myocardial infarction, cardiac hypertrophy), (v) gastrointestinal, hepatic, and renal systems (diarrhea, nausea/vomiting, abdominal pain, anorexia, acid reflux, gastrointestinal hemorrhage, lack of appetite/constipation), (vi) skeletomuscular system (immune-mediated skin diseases, psoriasis, lupus), (vii) nervous system (loss of taste/smell/hearing, headaches, spasms, convulsions, confusion, visual impairment, nerve pain, dizziness, impaired consciousness, nausea/vomiting, hemiplegia, ataxia, stroke, cerebral hemorrhage), (viii) mental health (stress, depression and anxiety). We additionally hypothesized mechanisms of action by investigating possible molecular mechanisms associated with these disease outcomes/symptoms. Overall, the COVID-19 pathology is still characterized by cytokine storm that results to endothelial inflammation, microvascular thrombosis, and multiple organ failures.

Post-COVID-19 Arthritis and Sacroiliitis: Natural History with Longitudinal Magnetic Resonance Imaging Study in Two Cases and Review of the Literature

“…Most authors assume the existence of molecular mimicry between viral epitopes and the synovial membrane causing local inflammation; other theories speculate about the presence of circulating immune complexes or possible localisation of the virus directly on joint tissue [ 14 , 44 ].…”

S1-Leitlinie Post-COVID/Long-COVID

“…EMPFEHLUNGBisher ist keine kausale Therapie der Fatigue bekannt. Therapieziel sollte eine Symptomlinderung sowie die Vermeidung einer Chronifizierung sein.EMPFEHLUNGZur Einschätzung der Symptomatik sollten Selbstauskunftsinstrumente zum Einsatz kommen.10 Dermatologische Aspekte10.1 EinleitungHautveränderungen nach COVID-19-Infekt stoßen auf großes öffentliches Interesse und werden relativ häufig berichtet, wenn auch in einem elativ geringen Prozentsatz an Patienten (bis 25 %)[58][59][60][61]. Es zeigt sich ein buntes Bild von Hautläsionen, das von makulopapulösen und morbilliformen (flach bis kleinknotig-erhaben) und Livedo reticularis/racemosa-artigen (netzartig, bläulich), über urtikarielle (flüchtig, quaddelförmig) und Erythema multiforme-artige (vielgestaltig bis großblasig auf rotem Grund) bis hin zu varizelliformen (klare Bläschen auf gerötetem, oft juckendem Grund) Hautveränderungen reicht.…”

A Comprehensive Overview on COVID-19: Future Perspectives

“…The majority of COVID-19 patients recover within a week or two after infection; on the other hand, some of them have been noticed to experience moderate to severe post-COVID conditions ( Silva Andrade et al., 2021 ). The data from COVID-19 hospitals from different nations suggest multiple health issues extending from a week to a month, even in people who did not have symptoms during COVID-19 infection ( Silva Andrade et al., 2021 ).…”

“…The majority of COVID-19 patients recover within a week or two after infection; on the other hand, some of them have been noticed to experience moderate to severe post-COVID conditions ( Silva Andrade et al., 2021 ). The data from COVID-19 hospitals from different nations suggest multiple health issues extending from a week to a month, even in people who did not have symptoms during COVID-19 infection ( Silva Andrade et al., 2021 ). Predominantly it is the fatigue, muscle ache, headache, chest pain, cough, reduced performance, anxiety, lack of concentration, and depression-like symptoms being experienced in the patients with the “Long COVID-19” condition ( Silva Andrade et al., 2021 ).…”