Immune Mechanisms Underpinning Long COVID: Collegium Internationale Allergologicum Update 2024.

Jurgen Schwarze, Eva Untersmayr, Corinna Sadlier, Liam O'Mahony, Milena Sokolowska, Peter Smith, Carina Venter, Johanna Rohrhofer, Cebile Ndwandwe, Emer Shannon

Journal: International archives of allergy and immunology 2024;185(5):489-502

PMID: 38253027

Free Full Text on S. Karger AG, Basel, Switzerland View on PubMed

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can result in a prolonged multisystem disorder termed long COVID, which may affect up to 10% of people following coronavirus disease 2019 (COVID-19). It is currently unclear why certain individuals do not fully recover following SARS-CoV-2 infection.

SUMMARY

In this review, we examine immunological mechanisms that may underpin the pathophysiology of long COVID. These mechanisms include an inappropriate immune response to acute SARS-CoV-2 infection, immune cell exhaustion, immune cell metabolic reprogramming, a persistent SARS-CoV-2 reservoir, reactivation of other viruses, inflammatory responses impacting the central nervous system, autoimmunity, microbiome dysbiosis, and dietary factors.

KEY MESSAGES

Unfortunately, the currently available diagnostic and treatment options for long COVID are inadequate, and more clinical trials are needed that match experimental interventions to underlying immunological mechanisms.

Address: Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Immunology and Infectiology, Medical University Vienna, Vienna, Austria.; Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.; Department of Clinical Medicine, Griffiths University, Southport, Queensland, Australia.; School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.; Centre for Inflammation Research, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK.; Swiss Institute of Allergy and Asthma Research, University of Zurich, Zurich, Switzerland.; Department of Infectious Diseases, Cork University Hospital, Cork, Ireland.; Department of Medicine, University College Cork, Cork, Ireland.; School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.; Department of Medicine, University College Cork, Cork, Ireland.

DOI: 10.1159/000535736

Link outs

Free resources

Full Text Sources:

https://doi.org/10.1159/000535736

Medical:

https://medlineplus.gov/covid19coronavirusdisease2...

Miscellaneous:

https://assays.cancer.gov/CPTAC-438

MeSH Terms: Humans, COVID-19, SARS-CoV-2, Post-Acute COVID-19 Syndrome, Dysbiosis, Autoimmunity