[en] Some individuals who have been infected with SARS-CoV-2 can experience long-term effects from their infection, known as post-COVID conditions, post-acute sequelae of COVID-19 or long COVID. Different underlying mechanisms can lead to long COVID, none of which are mutually exclusive. Lingering symptoms can persist years after SARS-CoV-2 infection, including fatigue, muscle weakness, tachycardia, dyspnea and various neurological symptoms. The symptomatology is partly similar to that reported by people with chronic fatigue syndrome and other unwell studied long-lasting diseases that may occur after other infections. People who have experienced more severe COVID-19 illness are at higher risk of developing long COVID, although anyone who was infected can experience post-COVID conditions. Importantly, unvaccinated individuals are more likely to develop long COVID. Here we review the current knowledge and discuss key findings regarding the epidemiology and physiopathology of long COVID. We briefly review current diagnostic and treatment options that remain so far largely insufficient. [fr] Certains individus infectés par le SARS-CoV-2 peuvent présenter des symptômes à long terme, évoluant parfois durant plusieurs années. Il est alors question d’affection post-COVID-19 ou COVID long. Les symptômes sont très polymorphes, fluctuants, et comprennent, notamment, une fatigue intense, des douleurs articulaires et musculaires, de la dyspnée, de la tachycardie, ainsi qu’une constellation de plaintes neurologiques. Cette symptomatologie est, en partie, similaire à celle du syndrome de fatigue chronique et est retrouvée également après d’autres types d’infections. Les mécanismes à l’origine du COVID long sont probablement multiples et encore mal connus. Si le COVID long peut toucher tout individu infecté par le SARS-CoV-2, certains groupes sont plus à risque, notamment les personnes non vaccinées ou les individus ayant présenté une infection sévère. Dans cet article, nous résumons les connaissances actuelles et mettons en lumière les découvertes clés quant à l’épidémiologie et aux mécanismes physiopathologiques du COVID long. Nous discutons aussi des critères diagnostiques et des options thérapeutiques qui sont, à ce jour, largement insuffisantes.
Disciplines :
Immunology & infectious disease
Author, co-author :
El Moussaoui, Majdouline ; Centre Hospitalier Universitaire de Liège - CHU > > Service des maladies infectieuses - médecine interne
Guiot, Julien ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pneumologie - allergologie
FRIPPIAT, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service des maladies infectieuses - médecine interne
Darcis, Gilles ; Centre Hospitalier Universitaire de Liège - CHU > > Service des maladies infectieuses - médecine interne
Language :
French
Title :
Une cause émergente de fatigue et de douleurs chroniques : l’affection post-COVID-19 ou COVID long.
Alternative titles :
[en] An emerging cause of chronic fatigue and pain : post-COVID-19 condition or long COVID.
Darcis G, Bouquegneau A, Maes N, et al. Long-term clinical follow-up of patients suffering from moderate-to-severe COVID-19 infection: a monocentric prospective observational cohort study. Int J Infect Dis 2021;109:209-16.
Une définition de cas clinique pour l’affection post-COVID-19 établie par un consensus Delphi [Internet]. [cité 25 janv 2023]. Disponible sur: https://www.who.int/fr/publications-detail/ WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_ definition-2021.1
Nehme M, Vetter P, Chappuis F, et al. Prevalence of post-COVID condition 12 weeks after Omicron infection compared to negative controls and association with vaccination status. Clin Infect Dis 2022;ciac947.
Taquet M, Dercon Q, Luciano S, et al. Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med 2021;18:e1003773.
Subramanian A, Nirantharakumar K, Hughes S, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med 2022;28:1706-14.
Raman B, Bluemke DA, Lüscher TF, Neubauer S. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J 2022;43:1157-72.
Magnusson K, Kristoffersen DT, Dell’Isola A, et al. Post-COVID medical complaints following infection with SARSCoV-2 Omicron vs Delta variants. Nat Commun 2022;13:7363.
Notarte KI, Catahay JA, Velasco JV, et al. Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: a systematic review. E Clinical Medicine 2022;53:101624.
Richard SA, Pollett SD, Fries AC, et al. Persistent COVID-19 symptoms at 6 months after onset and the role of vaccination before or after SARS-CoV-2 Infection. JAMA Netw Open 2023;6:e2251360.
Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol 2023;21:133-46.
Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 2022;28:2398-405.
Ghosn J, Bachelet D, Livrozet M, et al. Prevalence of postacute coronavirus disease 2019 symptoms twelve months after hospitalization in participants retained in follow-up: analyses stratified by gender from a large prospective cohort. Clin Microbiol Infect 2023;29:254.e7-13.
Fernández-de-las-Peñas C, Rodríguez-Jiménez J, Cancela-Cilleruelo I, et al. Post–COVID-19 symptoms 2 years after SARS-CoV-2 infection among hospitalized vs nonhospitalized patients. JAMA Netw Open 2022;5:e2242106.
Symptômes prolongés suite à une Covid-19 de l’adulte - Diagnostic et prise en charge [Internet]. Haute Autorité de Santé. [cité 1 févr 2023]. Disponible sur: https://www.has-sante.fr/jcms/p_3237041/fr/symptomes-prolonges-suite-a-une-covid-19-de-l-adulte-diagnostic-et-prise-en-charge
Swank Z, Senussi Y, Manickas-Hill Z, et al. Persistent circulating severe acute respiratory syndrome coronavirus 2 spike is associated with post-acute coronavirus disease 2019 sequelae. Clin Infect Dis 2023;76;e487-90.
Stein SR, Ramelli SC, Grazioli A, et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature 2022;612:758-63.
Peluso M, Deveau TM, Munter S,, et al. Impact of preexisting chronic viral infection and reactivation on the development of long COVID. medRxiv 2022. doi: 10.1101/2022.06.21.22276660
Peluso MJ, Spinelli MA, Deveau TM, et al. Postacute sequelae and adaptive immune responses in people with HIV recovering from SARS-COV-2 infection. AIDS 2022;36:F7-16.
Schultheiß C, Willscher E, Paschold L, et al. The IL-1β, IL-6, and TNF cytokine triad is associated with post-acute sequelae of COVID-19. Cell Rep Med 2022;3:100663.
Su Y, Yuan D, Chen DG, et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 2022;185:881-95.e20.
Haffke M, Freitag H, Rudolf G, et al. Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME/ CFS). J Transl Med 2022;20:138.
Sørland K, Sandvik MK, Rekeland IG, et al. Reduced endothelial function in myalgic encephalomyelitis / chronic fatigue syndrome-results from open-label cyclophosphamide intervention study. Front Med (Lausanne) 2021;8:642710.
Choutka J, Jansari V, Hornig M, Iwasaki A. Unexplained postacute infection syndromes. Nat Med 2022;28:911-23.
Morroy G, Keijmel SP, Delsing CE, et al. Fatigue following acute q-fever: a systematic literature review. PLoS ONE 2016;11:e0155884.
Hung TM, Wills B, Clapham HE, et al. The uncertainty surrounding the burden of post-acute consequences of dengue infection. Trends Parasitol 2019;35:673-6.
PREVAIL III Study Group; Sneller MC, Reilly C, Badio M, et al. A longitudinal study of Ebola Sequelae in Liberia. N Engl J Med 2019;380:924-34.
Patel H, Sander B, Nelder MP. Long-term sequelae of West Nile virus-related illness: a systematic review. Lancet Infect Dis 2015;15:951-9.
Ursinus J, Vrijmoeth HD, Harms MG, et al. Prevalence of persistent symptoms after treatment for Lyme borreliosis: a prospective observational cohort study. Lancet Reg Health Eur 2021;6:100142.
Xie Y, Al-Aly Z. Risks and burdens of incident diabetes in long COVID: a cohort study. Lancet Diabetes Endocrinol 2022;10:311-21.
Post-COVID: Remboursement des soins en cas de symptômes COVID-19 persistants - INAMI [Internet]. [cité 1 févr 2023]. Disponible sur: https://www.inami.fgov.be/fr/themes/cout-remboursement/maladies/Pages/post-covid-remboursement-soins-1re-ligne-symptomes-persistants.aspx
Fawzy NA, Shaar BA, Taha R, et al. A systematic review of trials currently investigating therapeutic modalities for post-acute COVID-19 Syndrome and Registered on WHO international clinical trials platform. Clin Microbiol Infect 2023;29:570-7.
Darcis G, Vaira D, Moutschen M. Impact of coronavirus pandemic and containment measures on HIV diagnosis. Epidemiol Infect 2020;148:e185.
El Moussaoui M, Lambert N, Maes N, et al. Impact of the COVID-19 pandemic situation on HIV care in Liège, Belgium. HIV Res Clin Pract 2021;22:63-70.
El Moussaoui M, Maes N, Hong SL, et al. Evaluation of screening program and phylogenetic analysis of SARS-CoV-2 infections among hospital healthcare workers in Liège, Belgium. Viruses 2022;14:1302.
