Why we need a deeper understanding of the pathophysiology of long COVID.
Why we need a deeper understanding of the pathophysiology of long COVID.
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DOI：
10.1016/s1473-3099(23)00053-1
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发表时间：
2023-04
影响因子：
56.3
通讯作者：
Putrino, David
中科院分区：
文献类型：
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作者：
Iwasaki, Akiko;Putrino, David
尽管一些长途运输者康复了，但许多人自2020年初以来就出现了症状。这种情况是一种全面的诊断，代表了一组异质性的病理生理过程。因此，有几个因素可以影响长期COVID的表现，例如急性感染的严重程度、年龄、性别、预先存在的合并症、遗传学、社会经济因素和其他环境因素。在严重急性SARS-CoV-2感染中幸存下来的长途运输者最有可能是50岁以上的男性，他们有挥之不去的组织损伤和疤痕。感染不太严重的新冠病毒后长期患病的人最有可能是年轻女性（36-50岁），其急性感染引发了不良生理反应。长期COVID根本原因的主要疾病假设包括病毒持续存在（感染性病毒、病毒RNA或病毒蛋白质），由感染引发的自身免疫，潜伏病毒的再激活，以及炎症引发的慢性变化，导致组织功能障碍和损伤（图）。
Although some long haulers recover, many people have had symptoms since early 2020. The condition is a blanket diagnosis that represents a heterogeneous set of pathophysiological processes. As such, several factors can affect the presentation of long COVID, such as the severity of acute infection, age, sex, pre-existing comorbidities, genetics, socioeconomic factors, and other environmental factors. Long haulers who survived severe acute SARS-CoV-2 infection are most likely to be men older than 50 years with lingering tissue damage and scarring. People with long COVID after a less-severe infection are most likely to be younger women (aged 36–50 years) whose acute infection has triggered adverse physiological responses.The main disease hypotheses for the root causes of long COVID include viral persistence (infectious virus, viral RNA, or viral proteins), autoimmunity triggered by the infection, reactivation of latent viruses, and inflammation-triggered chronic changes leading to tissue dysfunction and damage (figure).