The studies listed below are peer reviewed papers on the topic of Long Covid, LPCVS and PACVS and include papers examining causality, mechanisms, and treatments. Please check back from time to time as this list is expanded with the release of new papers.
Papers are listed by date, the most recent appearing at the top of the page. Click to expand for a full text link, author details, correspondence and abstract. Where a paper is published in multiple journals, the link provided is to a full text version. If we have missed important validated research, please log in and use the comment box below to send us a link. Acceptance of submitted links is at the discretion of the editors.
Please note that on occasion, a retracted study will still be listed. This is an editorial decision, based on the reasons for the papers retraction. Clear attempts to discredit research with a view to censorship does not warrant retraction. These papers are highlighted in red and where possible PDF versions exist on our servers.
| FULL TEXT LINK: View Paper (PDF) |
| PUBLICATION DATE: February, 2026 |
| PUBLICATION: Thieme |
| AUTHORS |
| Carlos Gracidas, Rakeem Levy, Joseph Varon, Matthew Halma |
| CORRESPONDENCE TO |
| mhalma@imahealth.org |
| DOI: 10.1055/a-2794-9646 |
| PMID: 41672424 |
| ABSTRACT |
| Metabolic alterations characterize a large subset of those with post-acute COVID-19 syndrome, and similar symptoms affect those with post-acute COVID-19 vaccination syndrome. These symptoms are characterized by the triumvirate of post-acute COVID-19 (vaccination) syndrome symptoms: post-exertional malaise, fatigue, and cognitive impairment, commonly referred to as brain fog. These symptoms can be recreated through perturbations that disrupt mitochondria, and spike protein has been observed to disrupt mitochondria in vitro, providing mechanistic support for this relationship. Post-acute COVID-19 (vaccination) syndrome patients suffer from a severely decreased lactate threshold and can experience symptoms of overexertion even at low power output. Furthermore, biopsies have revealed disrupted mitochondria, and energetics and physiological studies have shown that lipid oxidation constitutes a significantly reduced fraction of total energy production/consumption in post-acute COVID-19 (vaccination) syndrome patients. This review explores the therapeutic axes of lactate, carbon dioxide, and fatty acid oxidation for resolving the energy production challenges in post-acute COVID-19 (vaccination) syndrome, suggesting interventions that increase the lactate threshold, increase tissue oxygenation (paradoxically through increasing partial pressure of CO2), and increase the rates at which lipids are oxidized relative to carbohydrates. Analogies from the world of exercise science are introduced, comparing post-acute COVID-19 (vaccination) syndrome to an overabundance of fast-twitch muscle fibers, with oxygenation similar to that experienced at high altitude, and presenting as an inverse ‘fat adaptation’ phenomenon, as observed in endurance athletes, especially those adopting low-carbohydrate diets. |
| FULL TEXT LINK: View Paper (PDF) |
| PUBLICATION DATE: February, 2026 |
| PUBLICATION: BMJ |
| AUTHORS |
| Braeden T Charlton, Kasper Janssen, David M Systrom, David Putrino, Rob CI Wüst |
| CORRESPONDENCE TO |
| r.wust@vu.nl |
| DOI: 10.1136/bjsports-2025-111387 |
| PMID: 41667155 |
| ABSTRACT |
| While the number of fatal acute SARS-CoV-2 infections has declined since 2020, the proportion of these infections that result in persisting symptoms has not reduced significantly. The continuity or development of new symptoms longer than 3 months after an acute SARS-CoV-2 infection is clinically defined as long covid. PEM, a hallmark and debilitating feature, is recognised as one of the most frequent manifestations of long covid and is present in ~80% of patients with the condition. PEM is a delayed exacerbation (or new onset) of symptoms after physical or cognitive activity above a patient- and time-dependent threshold, which may persist for days, weeks or months or even result in a permanent change in a patient’s baseline. The need to screen for PEM in suspected long covid before initiating a rehabilitation strategy has already been recognised by major health authorities, including the WHO, who heavily cautioned against graded exercise therapies for patients experiencing PEM. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: December, 2025 |
| PUBLICATION: Biomedicine and Pharmacotherapy |
| AUTHORS |
| Matthew Halma, Joseph Varon |
| CORRESPONDENCE TO |
| mhalma@imahealth.org |
| DOI: 10.1016/j.biopha.2025.118864 |
| PMID: 41349247 |
| ABSTRACT |
| Post-Acute Vaccination Syndrome (PACVS) is a post-vaccination disorder marked by persistent fatigue, cognitive impairment, and exercise intolerance. Current research identifies interconnected pathophysiological processes, including persisting spike protein, mitochondrial dysfunction, decreased tissue oxygenation, and impaired metabolism. Emerging treatments rely on metabolic regulation and therapeutic agents promoting mitochondrial and vascular function. These therapies stimulate cellular energy generation, reduce oxidative stress, and regulate inflammatory pathways. This review examines metabolic and mitochondrial mechanisms underlying PACVS, evaluates existing therapeutic strategies targeting these pathways, and synthesizes current evidence for future research and clinical management. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: November, 2025 |
| PUBLICATION: Frontiers in Medicine |
| AUTHORS |
| Matthew Halma, Joseph Varon |
| CORRESPONDENCE TO |
| mhalma@imahealth.org, jvaron@uh.edu |
| DOI: 10.3389/fmed.2025.1688170 |
| PMID: 41393125 |
| ABSTRACT |
| The National Academies of Science, Engineering, and Medicine (NASEM) has defined Long COVID as “an infection-associated chronic condition (IACC) that occurs after SARS-CoV-2 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.” This definition puts the experience of the patient primary, where the decisive factor for diagnosis is a persistent health problem after COVID-19 infection. Ongoing work aims to characterize the biological signature of both Long COVID and Post-Acute COVID-19 Vaccination Syndrome (PACVS), clinicians and researchers are faced with heterogeneous diseases that are not easily captured by a single biomarker. Candidate biomarkers establish spike protein persistence, either through detection of full length spike, the S1 subunit of spike protein, or anti-spike protein antibody positivity. Additionally, to rule out viral reservoirs or active infection as an explanation, anti-nucleocapsid antibody, a hallmark of COVID-19 infection not present in the vaccine, should be negative. Other candidate biomarkers include detection of vaccine sequence mRNA, or sequence differentiation of viral from vaccinal spike through mass spectrometry. Despite candidate biomarkers, medicine is far from a definitive diagnostic test. Lack of diagnosis has created negative experiences for patients and strengthened vaccine hesitancy. An open acknowledgement of vaccine risks is vital to restoring trust in science and medicine and ensuring those injured have access to the care they need. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: June, 2025 |
| PUBLICATION: Science Direct |
| AUTHORS |
| Matthew Halma, Joseph Varon |
| CORRESPONDENCE TO |
| mhalma@imahealth.org, jvaron@uh.edu |
| DOI: 10.1016/j.heliyon.2025.e43478 |
| PMID: Not indexed |
| ABSTRACT |
| Post-vaccination syndrome has recently gained attention in the scientific community, yet its formal recognition remains elusive. This condition, characterized by long-lasting symptoms similar to long COVID, affects a small percentage of vaccine recipients. Acknowledging post-vaccination syndrome is crucial for ensuring that affected individuals receive proper compensation, care, and research funding. Without recognition, these patients face significant barriers to healthcare and justice, navigating a system unprepared to address their needs. The syndrome presents with symptoms such as dysautonomia, post-exertional malaise, fatigue, neuropathic pain, and cognitive disturbances, overlapping with syndromes like myalgic encephalomyelitis/chronic fatigue syndrome, postural orthostatic syndrome, and small fiber neuropathy. The lack of formal recognition and poor development of diagnostics hampers research funding, treatment development, and compensation processes, leaving patients to navigate without support. Addressing post-vaccination syndrome requires developing rigorous diagnostic criteria, increasing research funding, and improving compensation systems to ensure affected individuals receive appropriate care and support. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: May, 2025 |
| PUBLICATION: Springer, Journal of Neurology |
| AUTHORS |
| Dániel Bereczki, Ádám Dénes, Filippo M. Boneschi, Tamar Akhvlediani, Francesco Cavallieri, Alessandra Fanciulli, Saša R. Filipović, Alla Guekht, Raimund Helbok, Sonja Hochmeister, Tim J. von Oertzen, Serefnur Özturk, Alberto Priori, Martin Rakusa, Barbara Willekens, Elena Moro, Johann Sellner |
| CORRESPONDENCE TO |
| bereczki.daniel@semmelweis.hu |
| DOI: 10.1007/s00415-025-13110-3 |
| PMID: 40327103 |
| ABSTRACT |
| Background Neuropathological and clinical studies suggest that infection with SARS-CoV-2 may increase the long-term risk of neurodegeneration. Methods We provide a narrative overview of pathological and clinical observations justifying the implementation of a surveillance program to monitor changes in the incidence of neurodegenerative disorders in the years after COVID-19. Results Autopsy studies revealed diverse changes in the brain, including loss of vascular integrity, microthromboses, gliosis, demyelination, and neuronal- and glial injury and cell death, in both unvaccinated and vaccinated individuals irrespective of the severity of COVID-19. Recent data suggest that microglia play an important role in sustained COVID-19-related inflammation, which contributes to the etiology initiating a neurodegenerative cascade, to the worsening of pre-existing neurodegenerative disease or to the acceleration of neurodegenerative processes. Histopathological data have been supported by neuroimaging, and epidemiological studies also suggested a higher risk for neurodegenerative diseases after COVID-19. Conclusions Due to the high prevalence of COVID-19 during the pandemic, healthcare systems should be aware of, and be prepared for a potential increase in the incidence of neurodegenerative diseases in the upcoming years. Strategies may include follow-up of well-described cohorts, analyses of outcomes in COVID-19-registries, nationwide surveillance programs using record-linkage of ICD-10 diagnoses, and comparing the incidence of neurodegenerative disorders in the post-pandemic periods to values of the pre-pandemic years. Awareness and active surveillance are particularly needed, because diverse clinical manifestations due to earlier SARS-CoV-2 infections may no longer be quoted as post-COVID-19 symptoms, and hence, increasing incidence of neurodegenerative pathologies at the community level may remain unnoticed. |
| FULL LINK: View Paper |
| PUBLICATION DATE: April, 2025 |
| PUBLICATION: Geroscience |
| AUTHORS |
| Titanilla Szögi, Barbara N Borsos, Dejana Masic, Bence Radics, Zsolt Bella, Andrea Bánfi, Nóra Ördög, Csenge Zsiros, Ágnes Kiricsi, Gabriella Pankotai-Bodó, Ágnes Kovács, Dóra Paróczai, Andrea Lugosi Botkáné, Béla Kajtár, Farkas Sükösd, Andrea Lehoczki, Tamás Polgár, Annamária Letoha, Tibor Pankotai, László Tiszlavicz |
| CORRESPONDENCE TO |
| pankotai.tibor@szte.hu |
| DOI: 10.1007/s11357-024-01398-4 |
| PMID: 39495479 |
| ABSTRACT |
| Coronavirus disease 2019 (COVID-19) can lead to severe acute respiratory syndrome, and while most individuals recover within weeks, approximately 30-40% experience persistent symptoms collectively known as Long COVID, post-COVID-19 syndrome, or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC). These enduring symptoms, including fatigue, respiratory difficulties, body pain, short-term memory loss, concentration issues, and sleep disturbances, can persist for months. According to recent studies, SARS-CoV-2 infection causes prolonged disruptions in mitochondrial function, significantly altering cellular energy metabolism. Our research employed transmission electron microscopy to reveal distinct mitochondrial structural abnormalities in Long COVID patients, notably including significant swelling, disrupted cristae, and an overall irregular morphology, which collectively indicates severe mitochondrial distress. We noted increased levels of superoxide dismutase 1 which signals oxidative stress and elevated autophagy-related 4B cysteine peptidase levels, indicating disruptions in mitophagy. Importantly, our analysis also identified reduced levels of circulating cell-free mitochondrial DNA (ccf-mtDNA) in these patients, serving as a novel biomarker for the condition. These findings underscore the crucial role of persistent mitochondrial dysfunction in the pathogenesis of Long COVID. Further exploration of the cellular and molecular mechanisms underlying post-viral mitochondrial dysfunction is critical, particularly to understand the roles of autoimmune reactions and the reactivation of latent viruses in perpetuating these conditions. This comprehensive understanding could pave the way for targeted therapeutic interventions designed to alleviate the chronic impacts of Long COVID. By utilizing circulating ccf-mtDNA and other novel mitochondrial biomarkers, we can enhance our diagnostic capabilities and improve the management of this complex syndrome. |
| FULL PREPRINT LINK: View Paper |
| PUBLICATION DATE: February, 2025 |
| PUBLICATION: medRxiv |
| AUTHORS |
| Bornali Bhattacharjee, Peiwen Lu, Valter Silva Monteiro, Alexandra Tabachnikova, Kexin Wang, William B. Hooper, Victoria Bastos, Kerrie Greene, Mitsuaki Sawano, Christian Guirgis, Tiffany J. Tzeng, Frederick Warner, Pavlina Baevova, Kathy Kamath, Jack Reifert, Danice Hertz, Brianne Dressen, Laura Tabacof, Jamie Wood, Lily Cooke, Mackenzie Doerstling, Shadan Nolasco, Amer Ahmed, Amy Proal, David Putrino, Leying Guan, Harlan M. Krumholz, Akiko Iwasaki |
| CORRESPONDENCE TO |
| leying.guan@yale.edu, harlan.krumholz@yale.edu, akiko.iwasaki@yale.edu |
| DOI: 10.1101/2025.02.18.25322379 |
| PMID: Not indexed |
| ABSTRACT |
| COVID-19 vaccines have prevented millions of COVID-19 deaths. Yet, a small fraction of the population reports a chronic debilitating condition after COVID-19 vaccination, often referred to as post- vaccination syndrome (PVS). To explore potential pathobiological features associated with PVS, we conducted a decentralized, cross-sectional study involving 42 PVS participants and 22 healthy controls enrolled in the Yale LISTEN study. Compared with controls, PVS participants exhibited differences in immune profiles, including reduced circulating memory and effector CD4 T cells (type 1 and type 2) and an increase in TNFα+ CD8 T cells. PVS participants also had lower anti-spike antibody titers, primarily due to fewer vaccine doses. Serological evidence of recent Epstein-Barr virus (EBV) reactivation was observed more frequently in PVS participants. Further, individuals with PVS exhibited elevated levels of circulating spike protein compared to healthy controls. These findings reveal potential immune differences in individuals with PVS that merit further investigation to better understand this condition and inform future research into diagnostic and therapeutic approaches. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: October, 2024 |
| PUBLICATION: Clinical Nutrition |
| AUTHORS |
| René Garbsch, Hendrik Schäfer, Frank C Mooren, Boris Schmitz |
| CORRESPONDENCE TO |
| boris.schmitz@uni-wh.de |
| DOI: 10.1016/j.clnu.2024.10.010 |
| PMID: 39423759 |
| ABSTRACT |
| Background & aims: Post-COVID-19 Syndrome (PCS) is characterized by symptoms including fatigue, reduced physical performance, dyspnea, cognitive impairment, and psychological distress. The mechanisms underlying the onset and severity of PCS point to mitochondrial dysfunction as significant contributor. This study examined fat oxidation as a function of mitochondrial capacity during exercise. Methods: Single-center prospective cohort study during inpatient rehabilitation. Cardiopulmonary exercise testing and assessment of fatigue using questionnaires were performed at admission and discharge. Detailed spirometric breath-by-breath data were used to calculate substrate oxidation rates. Results: Patients (N = 187; 38 % women; 49.7 ± 11.4 years) were referred to rehabilitation 253.4 ± 130.6 days after infection. Lead symptoms included fatigue/exercise intolerance (79.9 %), shortness of breath (77.0 %), and cognitive dysfunction (55.1 %). Fat oxidation capacity was disturbed in PCS patients overall (AUC: 11.3 [10.7-11.9]) compared to healthy controls (p < 0.0001), with hospitalization during acute infection predicting the level of disturbance (p < 0.0001). Low exercise capacity and high fatigue scores resulted in reduced fat oxidation (both p < 0.0001). In particular, younger males were affected by significantly reduced fat oxidation capacity (sex: p = 0.002; age: p < 0.001). Metabolic disturbance was significantly improved during exercise-based rehabilitation (AUC: 14.9 [14.4-15.4]; p < 0.0001), even for the group of younger impaired males (+44.2 %; p < 0.0001). Carbohydrate oxidation was not impaired. Conclusions: PCS-specific restrictions in fat oxidation may indicate persistent mitochondrial dysfunction. Clinical assessment of PCS patients should include detailed breath-by-breath analysis during exercise to identify metabolic alterations especially in the group of younger males identified in this report. Exercise-based rehabilitation results in improved exercise capacity and fat oxidation and thus likely mitochondrial function. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: May, 2024 |
| PUBLICATION: Sage Journals |
| AUTHORS |
| Mona Sadat Larijani, Anahita Bavand, M. Banifazl, Fatemeh Ashrafian, Ladan Moradi, Amitis Ramezani |
| CORRESPONDENCE TO |
| amitisramezani@hotmail.com |
| DOI: 10.1177/21501319241251941 |
| PMID: 34024217 |
| ABSTRACT |
| In this era in which the vast majority of the global population have developed COVID-19 infection and/or got vaccinated against it, identification of the late disorders as the vaccines’ side effect or long-COVID manifestation seems essential. This study included the vaccinated individuals of 4 different vaccine regimens including inactivated virus-based, subunit protein, and adenovirus-based vaccines in a follow-up schedule 6-month post the booster shot. All the documented vaccine adverse events were thoroughly assessed considering the cases’ medical history by Adverse Events Committee of Pasteur Institute of Iran. Totally 329 individuals who got 3 doses of vaccination were followed 6 months after the booster shots among whom 41 (12.4%) cases with the mean age of 40.9 ± 10.48 years had a type of disorder. Gynecological and osteoarticular involvements were the most common recorded disorders of which 73.1% were possibly linked to vaccination outcomes and the rest were affected by both long-COVID-19 and vaccination. Notably, the average time of symptoms persistence was 155 ± 10.4 days. This study has the advantage of long-term follow-up which presents various forms of late events in each episode of COVID-19 infection and vaccination. About 26.8% of people with persistent complications suffered from both long-COVOD/ vaccination in whom the differentiation between the vaccine side effect and long-COVID manifestation was quite challenging. Long-term follow-up studies in large population seems essential to outline the role of long-COVID and vaccination regarding persistent complications. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: January, 2024 |
| PUBLICATION: Science Direct |
| AUTHORS |
| Kenneth A. Scheppke MD, Paul E. Pepe MD, MPH, Jonathan Jui MD, MPH, Remle P. Crowe PhD Eric K. Scheppke BS, Nancy G. Klimas MD, Aileen M. Marty MD |
| CORRESPONDENCE TO |
| Dr.PaulPepe@GMail.com |
| DOI: 10.1016/j.ajem.2023.09.051 |
| PMID: 37944296 |
| ABSTRACT |
| Objective Long COVID has afflicted tens of millions globally leaving many previously-healthy persons severely and indefinitely debilitated. The objective here was to report cases of complete, rapid remission of severe forms of long COVID following certain monoclonal antibody (MCA) infusions and review the corresponding pathophysiological implications. Design Case histories of the first three index events (among others) are presented. Unaware of others with similar remissions, each subject independently completed personal narratives and standardized surveys regarding demographics/occupation, past history, and the presence and respective severity grading of 33 signs/symptoms associated with long COVID, comparing the presence/severity of those symptoms during the pre-COVID, long-COVID, post-vaccination, and post-MCA phases. Setting Patient interviews, e-mails and telephone conversations. Subjects Three previously healthy, middle-aged, highly-functioning persons, two women and one man (ages 60, 43, and 63 years respectively) who, post-acute COVID-19 infection, developed chronic, unrelenting fatigue and cognitive impairment along with other severe, disabling symptoms. Each then independently reported incidental and unanticipated complete remissions within days of MCA treatment. Interventions The casirivimab/imdevimab cocktail. Measurements and main results Irrespective of sex, age, medical history, vaccination status, or illness duration (18, 8 and 5 months, respectively), each subject experienced the same complete remission of their persistent disabling disease within a week of MCA infusion. Each rapidly returned to normal health and previous lifestyles/occupations with normalized exercise tolerance, still sustained to date over two years later. Conclusions These index cases provide compelling clinical signals that MCA infusions may be capable of treating long COVID in certain cases, including those with severe debilitation. While the complete and sustained remissions observed here may only apply to long COVID resulting from pre-Delta variants and the specific MCA infused, the striking rapid and complete remissions observed in these cases also provide mechanistic implications for treating/managing other post-viral chronic conditions and long COVID from other variants. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: May, 2023 |
| PUBLICATION: Elsevier |
| AUTHORS |
| Felix Scholkmann, Christian-Albrecht May |
| CORRESPONDENCE TO |
| Felix.Scholkmann@usz.ch |
| DOI: 10.1016/j.prp.2023.154497 |
| PMID: 37192595 |
| ABSTRACT |
| Worldwide there have been over 760 million confirmed coronavirus disease 2019 (COVID-19) cases, and over 13 billion COVID-19 vaccine doses have been administered as of April 2023, according to the World Health Organization. An infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to an acute disease, i.e. COVID-19, but also to a post-acute COVID-19 syndrome (PACS, “long COVID”). Currently, the side effects of COVID-19 vaccines are increasingly being noted and studied. Here, we summarise the currently available indications and discuss our conclusions that (i) these side effects have specific similarities and differences to acute COVID-19 and PACS, that (ii) a new term should be used to refer to these side effects (post-COVID-19 vaccination syndrome, PCVS, colloquially “post-COVIDvac-syndrome”), and that (iii) there is a need to distinguish between acute COVID-19 vaccination syndrome (ACVS) and post-acute COVID-19 vaccination syndrome (PACVS) – in analogy to acute COVID-19 and PACS (“long COVID”). Moreover, we address mixed forms of disease caused by natural SARS-CoV-2 infection and COVID-19 vaccination. We explain why it is important for medical diagnosis, care and research to use the new terms (PCVS, ACVS and PACVS) in order to avoid confusion and misinterpretation of the underlying causes of disease and to enable optimal medical therapy. We do not recommend to use the term “Post-Vac-Syndrome” as it is imprecise. The article also serves to address the current problem of “medical gaslighting” in relation to PACS and PCVS by raising awareness among the medical professionals and supplying appropriate terminology for disease. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: May, 2023 |
| PUBLICATION: MDPI |
| AUTHORS |
| Matthew T. J. Halma, Christof Plothe,Paul Marik, Theresa A. Lawrie |
| CORRESPONDENCE TO |
| tess@e-bmc.co.uk |
| DOI: 10.3390/microorganisms11051308 |
| PMID: 34024217 |
| ABSTRACT |
| In the wake of the COVID-19 crisis, a need has arisen to prevent and treat two related conditions, COVID-19 vaccine injury and long COVID-19, both of which can trace at least part of their aetiology to the spike protein, which can cause harm through several mechanisms. One significant mechanism of harm is vascular, and it is mediated by the spike protein, a common element of the COVID-19 illness, and it is related to receiving a COVID-19 vaccine. Given the significant number of people experiencing these two related conditions, it is imperative to develop treatment protocols, as well as to consider the diversity of people experiencing long COVID-19 and vaccine injury. This review summarizes the known treatment options for long COVID-19 and vaccine injury, their mechanisms, and their evidentiary basis. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: November, 2022 |
| PUBLICATION: Journal of Clinical and Translational Research |
| AUTHORS |
| Josef Finterer, F. Scorza |
| CORRESPONDENCE TO |
| fifigs1@yahoo.de |
| J Clin Transl Res: 2022 Nov 9;8(6):506-508.eCollection 2022 Dec 29 |
| PMID: 36452006 |
| ABSTRACT |
| Background and aim: Long post-COVID vaccination syndrome (LPCVS) is an increasingly recognized disease that occurs after SARS-CoV-2 vaccinations and lasts >4 weeks. However, little is known about the clinical presentation, underlying pathophysiology, treatment, and outcome of LPCVS. This study aims to present a series of patients with LPCVS, their treatment, and outcomes. Methods: This was a retrospective analysis of three patients with LPCVS. Results: In an observation period of 2 months (January and February 2022), three patients were collected in whom side effects after vaccination against COVID-19 lasted >4 weeks and in whom instrumental examinations were largely unremarkable. All three patients received only symptomatic therapy and only partially recovered within 6-8 months after vaccination. LPCVS significantly impaired the quality of life of the included patients. Conclusions: SARS-CoV-2 vaccinations may cause not only short-term but also long-term side effects that include not only known diseases but also non-specific symptoms with normal or slightly abnormal clinical and instrumental findings. Although LPCVS leads to long-term disability, it is not widely recognized and not always accepted by manufacturers, health authorities, and even scientists. LPCVS should not be dismissed as a functional disorder and patients with LPCVS should be taken seriously. Relevance for patients: The possible causal relation between some long side effects and SARS-CoV-2 vaccines cannot be ignored. The pathophysiology of LPCVS should be further studied to lay a foundation for further improvement of the vaccines. |
| FULL TEXT LINK: View Paper |
| PUBLICATION DATE: May, 2021 |
| PUBLICATION: Taylor and Francis |
| AUTHORS |
| Shin Jie Yong |
| CORRESPONDENCE TO |
| shinjieyong@gmail.com |
| DOI: 10.1080/23744235.2021.1924397 |
| PMID: 34024217 |
| ABSTRACT |
| 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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