Long-Term Sequelae of COVID-19: A Review
DOI:
https://doi.org/10.12775/QS.2026.55.71015Keywords
long COVID, post-COVID syndrome, SARS-CoV-2, brain fog, post-acute infection syndromeAbstract
Introduction. Long COVID (post-COVID-19 syndrome) is defined as a constellation of symptoms persisting or emerging at least three months after acute SARS-CoV-2 infection, lasting for a minimum of two months and not explained by an alternative diagnosis. It affects millions of patients worldwide regardless of the severity of primary infection, and its underlying pathophysiology remains incompletely understood.
Aim. The aim of this review is to summarize the current state of knowledge on Long COVID syndrome, with a particular focus on its clinical manifestations across multiple organ systems, underlying pathophysiological mechanisms, and long-term consequences in both adult and pediatric populations.
Methodology. A review of the literature was conducted through a systematic search of the PubMed database using the keywords: "Long COVID", "post-COVID syndrome", "post-acute sequelae of SARS-CoV-2", "PASC". Publications from 2020 to 2026 were included.
Results. Long COVID affects multiple organ system. The most common symptoms are neurological, including fatigue, brain fog and memory impairment. Cardiovascular complications include POTS, myocarditis, arrhythmias and thromboembolic events. Pulmonary sequelae are common even after a mild course of the disease. Other documented complications include renal dysfunction, female fertility disorders and paediatric post-COVID syndrome. Immunological mechanisms appear to play a key role in the pathogenesis of the syndrome.
Conclusions. Long COVID is a multisystemic and complex condition requiring a holistic diagnostic and therapeutic approach. There are currently no reliable biomarkers or targeted therapies. It poses a serious public health problem, and further research is needed to improve treatment outcomes.
References
1. Greenhalgh T, Sivan M, Perlowski A, Nikolich JŽ. Long COVID: a clinical update. Lancet. 2024;404(10453):707-724. https://doi.org/10.1016/S0140-6736(24)01136-X
2. Peluso MJ, Deeks SG. Mechanisms of long COVID and the path toward therapeutics. Cell. 2024;187(20):5500-5529. https://doi.org/10.1016/j.cell.2024.07.054
3. Monje M, Iwasaki A. The neurobiology of long COVID. Neuron. 2022;110(21):3484-3496. https://doi.org/10.1016/j.neuron.2022.10.006
4. Natarajan A, Shetty A, Delanerolle G, et al. A systematic review and meta-analysis of long COVID symptoms. Syst Rev. 2023;12(1):88. Published 2023 May 27. https://doi.org/10.1186/s13643-023-02250-0
5. Zawilska JB, Kuczyńska K. Psychiatric and neurological complications of long COVID. J Psychiatr Res. 2022;156:349-360. https://doi.org/10.1016/j.jpsychires.2022.10.045
6. Mueller MR, Ganesh R, Beckman TJ, Hurt RT. Long COVID: emerging pathophysiological mechanisms. Minerva Med. 2025;116(2):156-165. https://doi.org/10.23736/S0026-4806.25.09539-4
7. Cáceres E, Divani AA, Viñan-Garces AE, et al. Tackling persistent neurological symptoms in patients following acute COVID-19 infection: an update of the literature. Expert Rev Neurother. 2025;25(1):67-83. https://doi.org/10.1080/14737175.2024.2440543
8. Premraj L, Kannapadi NV, Briggs J, et al. Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: A meta-analysis. J Neurol Sci. 2022;434:120162. https://doi.org/10.1016/j.jns.2022.120162
9. Eckey M, Li P, Morrison B, Bergquist J, Davis RW, Xiao W. Patient-reported treatment outcomes in ME/CFS and long COVID. Proc Natl Acad Sci U S A. 2025;122(28):e2426874122. https://doi.org/10.1073/pnas.2426874122
10. 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(11):1157-1172. https://doi.org/10.1093/eurheartj/ehac031
11. Składanek JA, Leśkiewicz M, Gumiężna K, et al. Long COVID and its cardiovascular consequences: What is known?. Adv Clin Exp Med. 2024;33(3):299-308. https://doi.org/10.17219/acem/167482
12. Zhang T, Li Z, Mei Q, et al. Cardiovascular outcomes in long COVID-19: a systematic review and meta-analysis. Front Cardiovasc Med. 2025;12:1450470. Published 2025 Jan 29. https://doi.org/10.3389/fcvm.2025.1450470
13. Parhizgar P, Yazdankhah N, Rzepka AM, et al. Beyond Acute COVID-19: A Review of Long-term Cardiovascular Outcomes. Can J Cardiol. https://doi.org/10.1016/j.cjca.2023.01.031
14. Sommer N, Schmeck B. Pulmonale Manifestationen bei Long-COVID [Pulmonary manifestations in long COVID]. Inn Med (Heidelb). 2022;63(8):819-829. https://doi.org/10.1007/s00108-022-01371-3
15. Toepfner N, Brinkmann F, Augustin S, Stojanov S, Behrends U. Long COVID in pediatrics-epidemiology, diagnosis, and management. Eur J Pediatr. 2024;183(4):1543-1553. https://doi.org/10.1007/s00431-023-05360-y
16. Coughtrey A, Pereira SMP, Ladhani S, Shafran R, Stephenson T. Long COVID in children and young people: then and now. Curr Opin Infect Dis. 2025;38(5):487-492. https://doi.org/10.1097/QCO.0000000000001136
17. Lopez-Leon S, Wegman-Ostrosky T, Ayuzo Del Valle NC, et al. Long-COVID in children and adolescents: a systematic review and meta-analyses. Sci Rep. 2022;12(1):9950. Published 2022 Jun https://doi.org/10.1038/s41598-022-13495-5
18. Stephenson T, Shafran R, Ladhani SN. Long COVID in children and adolescents. Curr Opin Infect Dis. 2022;35(5):461-467. https://doi.org/10.1097/QCO.0000000000000854
19. Van der Feltz-Cornelis C, Turk F, Sweetman J, et al. Prevalence of mental health conditions and brain fog in people with long COVID: A systematic review and meta-analysis. Gen Hosp Psychiatry. 2024;88:10-22. https://doi.org/10.1016/j.genhosppsych.2024.02.009
20. Schiffl H, Lang SM. Long-term interplay between COVID-19 and chronic kidney disease. Int Urol Nephrol. 2023;55(8):1977-1984. https://doi.org/10.1007/s11255-023-03528-x
21. Rai V. COVID-19 and Kidney: The Importance of Follow-Up and Long-Term Screening. Life (Basel). 2023;13(11):2137. Published 2023 Oct 30. https://doi.org/10.3390/life13112137
22. Yende S, Parikh CR. Long COVID and kidney disease. Nat Rev Nephrol. 2021;17(12):792-793. https://doi.org/10.1038/s41581-021-00487-3
23. Pollack B, von Saltza E, McCorkell L, et al. Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review. Front Rehabil Sci. 2023;4:1122673. Published 2023 Apr 28. https://doi.org/10.3389/fresc.2023.1122673
24. Maham S, Yoon MS. Clinical Spectrum of Long COVID: Effects on Female Reproductive Health. Viruses. 2024;16(7):1142. Published 2024 Jul 16. https://doi.org/10.3390/v16071142
25. Bechmann N, Maccio U, Kotb R, et al. COVID-19 Infections in Gonads: Consequences on Fertility?. Horm Metab Res. 2022;54(8):549-555. https://doi.org/10.1055/a-1891-6621
26. Gorenshtein A, Liba T, Leibovitch L, Stern S, Stern Y. Intervention modalities for brain fog caused by long-COVID: systematic review of the literature. Neurol Sci. 2024;45(7):2951-2968. https://doi.org/10.1007/s10072-024-07566-w
27. Kavanagh E. Long Covid brain fog: a neuroinflammation phenomenon?. Oxf Open Immunol. 2022;3(1):iqac007. Published 2022 Sep 27. https://doi.org/10.1093/oxfimm/iqac007
28. Talwar S, Harker JA, Openshaw PJM, Thwaites RS. Autoimmunity in long COVID. J Allergy Clin Immunol. 2025;155(4):1082-1094. https://doi.org/10.1016/j.jaci.2025.02.005
29. Rodriguez L, Brodin P. Immune system perturbations in patients with long COVID. Trends Mol Med. 2024;30(3):200-201. https://doi.org/10.1016/j.molmed.2023.12.008
30. Borczuk AC. Pathogenesis of Pulmonary Long COVID-19. Mod Pathol. 2024;37(2):100378. https://doi.org/10.1016/j.modpat.2023.100378
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