Abstract
Although
the
coronavirus
disease
2019
(COVID-19)
pandemic
has
ended,
enduring
health
impacts
of
severe
acute
respiratory
syndrome
2
(SARS-CoV-2)
infection
continue
to
garner
global
attention,
as
approximately
10%
patients
develop
long
COVID
(post
COVID-19
condition).
The
epidemiological
characteristics
and
symptoms
have
been
reported,
various
pathogenic
hypotheses
proposed.
Recent
evidence
suggests
that
SARS-CoV-2
nucleic
acids
or
fragments
persist
in
some
post-infection
these
are
correlated
with
symptoms.
This
review
focuses
on
clinical
studies
linking
persistence
symptoms,
explores
relationship
between
viral
other
etiological
hypotheses,
such
immune
dysregulation,
vascular
issues,
coagulation
dysfunction,
microbiome
dysbiosis,
brainstem/vagus
nerve
signaling
latent
virus
reactivation.
Futhermore,
treatment
strategies
for
proposed
based
current
trials
antiviral
modulation
therapies.
Understanding
role
pathogenesis
is
critical
developing
targeted
therapies
improving
management
this
debilitating
condition.
Viruses,
Journal Year:
2025,
Volume and Issue:
17(5), P. 617 - 617
Published: April 25, 2025
SARS-CoV-2
infection
has
resulted
in
more
than
700
million
cases
and
nearly
7
deaths
worldwide.
Although
vaccination
efforts
have
effectively
reduced
mortality
transmission
rates,
a
significant
proportion
of
recovered
patients—up
to
40%—develop
long
COVID
syndrome
(LC)
or
post-acute
sequelae
COVID-19
(PASC).
LC
is
characterized
by
the
persistence
emergence
new
symptoms
following
initial
infection,
affecting
cardiovascular,
neurological,
respiratory,
gastrointestinal,
reproductive,
immune
systems.
Despite
broad
range
clinical
that
been
described,
risk
factors
pathogenic
mechanisms
behind
remain
unclear.
This
review,
first
two-part
series,
distinguished
discussion
role
spike
protein
primary
underlying
pathophysiology
LC.
PLoS Pathogens,
Journal Year:
2025,
Volume and Issue:
21(4), P. e1013109 - e1013109
Published: April 28, 2025
An
important
feature
of
the
evolution
SARS-CoV-2
virus
has
been
emergence
highly
mutated
novel
variants,
which
are
characterised
by
gain
multiple
mutations
relative
to
viruses
circulating
in
general
global
population.
Cases
chronic
viral
infection
have
suggested
as
an
explanation
for
this
phenomenon,
whereby
extended
period
infection,
with
increased
rate
evolution,
creates
substantial
genetic
novelty.
However,
measuring
a
during
is
made
more
difficult
potential
existence
compartmentalisation
population,
host
form
distinct
subpopulations.
We
here
describe
and
apply
statistical
method
study
within-host
identifying
minimum
number
subpopulations
required
explain
sequence
data
observed
from
cases
inferring
rates
evolution.
Across
nine
hospitalised
patients
we
find
that
non-trivial
population
structure
relatively
common,
five
showing
evidence
than
one
evolving
independently
within
host.
The
detection
was
common
severely
immunocompromised
individuals
(p
=
0.04,
Fisher’s
Exact
Test).
proceeding
significantly
faster,
slower,
same
statistically
distinguishable
Non-trivial
associated
high
were
systematically
underestimated
standard
inference
method.
Abstract
Although
the
coronavirus
disease
2019
(COVID-19)
pandemic
has
ended,
enduring
health
impacts
of
severe
acute
respiratory
syndrome
2
(SARS-CoV-2)
infection
continue
to
garner
global
attention,
as
approximately
10%
patients
develop
long
COVID
(post
COVID-19
condition).
The
epidemiological
characteristics
and
symptoms
have
been
reported,
various
pathogenic
hypotheses
proposed.
Recent
evidence
suggests
that
SARS-CoV-2
nucleic
acids
or
fragments
persist
in
some
post-infection
these
are
correlated
with
symptoms.
This
review
focuses
on
clinical
studies
linking
persistence
symptoms,
explores
relationship
between
viral
other
etiological
hypotheses,
such
immune
dysregulation,
vascular
issues,
coagulation
dysfunction,
microbiome
dysbiosis,
brainstem/vagus
nerve
signaling
latent
virus
reactivation.
Futhermore,
treatment
strategies
for
proposed
based
current
trials
antiviral
modulation
therapies.
Understanding
role
pathogenesis
is
critical
developing
targeted
therapies
improving
management
this
debilitating
condition.