Long COVID: An update for clinical practice

Long COVID: an update for your medical practice Long COVID is best conceptualized as one or several post‑infectious syndromes: a disease with a known trigger (SARS‑CoV‑2 infection) that develops in only a definable proportion of infected individuals, and which manifests as a set of recognizable phenotypes. Rather than a single entity, it appears to represent the downstream result of multiple biological pathways—viral persistence, immune dysregulation, endothelial and microvascular injury, neuroinflammation, autonomic dysfunction—acting alone or in combination after acute infection. Clinical patterns include fatigue and exertion‑intolerance, neurocognitive and neuropsychiatric symptoms, cardiorespiratory and dysautonomic complaints, pain‑predominant complaints, and organ‑specific sequelae. Origin and epidemiologic context Long COVID, or post‑acute sequelae of SARS‑CoV‑2 infection (PASC), refers to new, recurrent, or persistent symptoms lasting beyond the acute phase, typically defined as at least 4–12 weeks after infection. Early in the pandemic, high estimates of prevalence likely reflected a mix of post‑ICU sequelae, background symptoms, and pandemic‑related stress. As...