Long-Term Existence of SARS-CoV-2 in COVID-19 Patients: Host Immunity, Viral Virulence, and Transmissibility

Wang, Xingyu; Huang, Kun; Jiang, Haojie; Hua, Lijuan; Yu, Wei; Wang, Ke; Li, Xiaopan; Zou, Zhong; Jin, Meilin; Xu, Shuyun

doi:10.1007/s12250-020-00308-0

Cited by 26 publications

(29 citation statements)

References 22 publications

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“…There have been instances of COVID-19 patients who remained positive for SARS-CoV-2 by reverse transcription real-time polymerase chain reaction (RT-PCR) test for up to three months [95][96][97]98]. Other studies have documented cases of prolonged SARS-CoV-2 shedding in the respiratory tract via quantitative RT-PCR for up to four months [99,100].…”

Section: Pathological Inflammationmentioning

confidence: 99%

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Yong

2021

Infectious Diseases

944

795

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Long COVID or post-COVID-19 syndrome first gained widespread recognition among social support groups and later in scientific and medical communities. This illness is poorly understood as it affects COVID-19 survivors at all levels of disease severity, even younger adults, children, and those not hospitalized. While the precise definition of long COVID may be lacking, the most common symptoms reported in many studies are fatigue and dyspnoea that last for months after acute COVID-19. Other persistent symptoms may include cognitive and mental impairments, chest and joint pains, palpitations, myalgia, smell and taste dysfunctions, cough, headache, and gastrointestinal and cardiac issues. Presently, there is limited literature discussing the possible pathophysiology, risk factors, and treatments in long COVID, which the current review aims to address. In brief, long COVID may be driven by long-term tissue damage (e.g. lung, brain, and heart) and pathological inflammation (e.g. from viral persistence, immune dysregulation, and autoimmunity). The associated risk factors may include female sex, more than five early symptoms, early dyspnoea, prior psychiatric disorders, and specific biomarkers (e.g. D-dimer, CRP, and lymphocyte count), although more research is required to substantiate such risk factors. While preliminary evidence suggests that personalized rehabilitation training may help certain long COVID cases, therapeutic drugs repurposed from other similar conditions, such as myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, and mast cell activation syndrome, also hold potential. In sum, this review hopes to provide the current understanding of what is known about long COVID.

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Section: Pathological Inflammationmentioning

confidence: 99%

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Yong

2021

Infectious Diseases

944

795

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“…This is the exact mechanism described as immunotolerance during virus-host adaptation. In a study that investigated the immune response of patients with long-term SARS-CoV-2 infections extending to 50 days from onset, clinically cured with an absence of related symptoms, it was shown that decreased IFNγ production by NK cells and low neutralizing antibodies might favor SARS-CoV-2 long-term existence together with low viral load and weak viral pathogenicity [70] . Accordingly, NK cells may contribute to SARS-CoV-2 clearance, and the decrease in IFNγ-expressing NK cells might delay viral clearance in these patients favoring viral persistence for a long time in a latent form.…”

Section: Patterns Of Ifnγ Action In Sars-cov-2 Virus Infectionmentioning

confidence: 99%

Between immunomodulation and immunotolerance: The role of IFNγ in SARS-CoV-2 disease

Todorović‐Raković

Whitfield

2021

Cytokine

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Interferons have prominent roles in various pathophysiological conditions, mostly related to inflammation. Interferon-gamma (IFNγ) was, initially discovered as a potent antiviral agent, over 50 years ago, and has recently garnered renewed interest as a promising factor involved in both innate and adaptive immunity. When new disease epidemics appear such as SARS-CoV (severe acute respiratory syndrome coronavirus), MERS-CoV (Middle East respiratory syndrome coronavirus), IAV (Influenza A virus), and in particular the current SARS-CoV-2 pandemic, it is especially timely to review the complexity of immune system responses to viral infections. Here we consider the controversial roles of effectors like IFNγ, discussing its actions in immunomodulation and immunotolerance. We explore the possibility that modulation of IFNγ could be used to influence the course of such infections. Importantly, not only could endogenous expression of IFNγ influence the outcome, there are existing IFNγ therapeutics that can readily be applied in the clinic. However, our understanding of the molecular mechanisms controlled by IFNγ suggests that the exact timing for application of IFNγ-based therapeutics could be crucial: it should be earlier to significantly reduce the viral load and thus decrease the overall severity of the disease.

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“…CoV-2 by reverse transcription real-time polymerase chain reaction (RT-PCR) test for up to three months (Carmo et al 2020;Kandetu et al 2020;X. Wang et al 2020b).…”

Section: Unresolved Inflammationmentioning

confidence: 99%

Long-Haul COVID-19: Putative Pathophysiology, Risk Factors, and Treatments

Yong¹

2020

Preprint

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Long-haul COVID-19 illness first gained widespread recognition among social support groups and later in scientific and medical communities. This illness is mysterious as it affects COVID-19 survivors at all levels of disease severity, even younger adults and children. While the precise definition may be lacking, the defining symptoms are fatigue, dyspnea, and headache that last for months after hospital discharge. The less typical symptoms may include cognitive impairments, chest and joint pains, myalgia, smell and taste dysfunctions, cough, mood changes, and gastrointestinal and cardiac issues. Presently, there is limited literature discussing the possible pathophysiology, risk factors, and treatments in long-haul COVID-19, which the current review aims to address. In brief, long-haul COVID-19 may be driven by long-term lung and brain damage and unresolved inflammation from multiple sources. The associated risk factors may include female sex, more than five early symptoms, early dyspnea, and specific biomarkers like D-dimer. While only rehabilitation training has been useful for long-haul COVID-19, therapeutics repurposed from mast cell activation syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, and pulmonary fibrosis also hold potential. In sum, this review hopes to provide the current understanding of what is known about long-haul COVID-19.

show abstract

Long-Term Existence of SARS-CoV-2 in COVID-19 Patients: Host Immunity, Viral Virulence, and Transmissibility

Cited by 26 publications

References 22 publications

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments

Between immunomodulation and immunotolerance: The role of IFNγ in SARS-CoV-2 disease

Long-Haul COVID-19: Putative Pathophysiology, Risk Factors, and Treatments

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