Cited by 4,153Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 Research

Long COVID: major findings, mechanisms and recommendations

Open access
Davis, Hannah E., McCorkell, Lisa, Vogel, Julia Moore, Topol, Eric J.·2023·Nature Reviews Microbiology

Abstract

Long COVID is an often debilitating illness that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. More than 200 symptoms have been identified with impacts on multiple organ systems. At least 65 million individuals worldwide are estimated to have long COVID, with cases increasing daily. Biomedical research has made substantial progress in identifying various pathophysiological changes and risk factors and in characterizing the illness; further, similarities with other viral-onset illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome have laid the groundwork for research in the field. In this Review, we explore the current literature and highlight key findings, the overlap with other conditions, the variable onset of symptoms, long COVID in children and the impact of vaccinations. Although these key findings are critical to understanding long COVID, current diagnostic and treatment options are insufficient, and clinical trials must be prioritized that address leading hypotheses. Additionally, to strengthen long COVID research, future studies must account for biases and SARS-CoV-2 testing issues, build on viral-onset research, be inclusive of marginalized populations and meaningfully engage patients throughout the research process.

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Research works printed but not linked: 6

  1. [5]Ayoubkhani, D. et al. Risk of Long Covid in people infected with SARS-CoV-2 after two doses of a COVID-19 vaccine: community-based, matched cohort study. Preprint at medRxiv10.1101/2022.02.23.22271388 (2022).
  2. [13]Demko, Z. O. et al. Post-acute sequelae of SARS-CoV-2 (PASC) impact quality of life at 6, 12 and 18 months post-infection. Preprint at medRxiv10.1101/2022.08.08.22278543 (2022).
  3. [22]Peluso MJ Evidence of recent Epstein-Barr virus reactivation in individuals experiencing Long COVID Preprint at medRxiv 2022 10.1101/2022.06.21.22276660 36523412 PMC9753782 · DOI
  4. [95]Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Board on the Health of Select Populations, & Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness (National Academies Press, 2015). 25695122
  5. [120]Larsen NW Characterization of autonomic symptom burden in long COVID: a global survey of 2,314 adults Front. Neurol. 2022 13 1012668 10.3389/fneur.2022.1012668 36353127 PMC9639503 · DOI
  6. [197]Wagner C Isenmann S Ringendahl H Haensch C-A Anxiety in patients with postural tachycardia syndrome (POTS) Fortschr. Neurol. Psychiatr. 2012 80 458 462 22692879

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Authors
Davis, H. E., McCorkell, L., Vogel, J. M., & Topol, E. J.
Affiliations
  • Patient-Led Research Collaborative (US)
  • Scripps Research Institute (US)
Corresponding author
Topol, Eric J.
Venue
Nature Reviews Microbiology
Published
2023-01-13
Volume
21
Issue
3
Pages
133-146
ISSN
  • 1740-1526 (ISSN-L)
  • 1740-1534
OpenAlex
W4316014106
Cited by
4,153
References
196
Citations by year
2026: 679 · 2025: 1140 · 2024: 1526 · 2023: 798 · 2022: 5 · 2013: 2
FWCI
168.60
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Microbiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (UL1TR002550)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
Keywords
long COVID, pathophysiological mechanisms, risk factors, chronic fatigue syndrome, postural orthostatic tachycardia syndrome, COVID-19 vaccination, research bias, COVID-19 testing, patient engagement, marginalized communities
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Testing, Post-Acute COVID-19 Syndrome, Child, Humans, Biomedical Research

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