Long COVID: new persectives and review of the literature

A major, but regrettably understudied, outcome of the pandemic is the significant percentage of patients exhibiting persisting symptoms, of varying localization and severity, for months after acute SARS-CoV-2 infection. These syndromes, collectively termed as Long Covid, may actually increase the pandemic burden for long after its end, leading to debilitation of previously healthy young individuals, in massive numbers. Long Covid as a term incorporates numerous syndromes, either systemic (as fatigue and expressions of dysautonomia) or localized (as residual lung damage or neurological complications). The etiology of Long Covid remains obscure, possibly attributed to viral persistence or continuous hyper-inflammatory reaction or even autoimmunity. Patient evaluation should be complex, extend to non-hospitalized patients, recognize the effect on the patient's quality of life, and the need for multi-task, but individualized, diagnostic and therapeutic approach. There are no specific pharmaceutical options at the time being, and the effect of vaccination on symptom alleviation has been inconsistent (although vaccination continues to reduce the odds of Long Covid development). Recognition of the medical and social burden of Long Covid remains a public health urgency.