Long COVID: a clinical update.

Post-COVID-19 condition (also known as long COVID) is generally defined as symptoms persisting for 3 months or more after acute COVID-19. Long COVID can affect multiple organ systems and lead to severe and protracted impairment of function as a result of organ damage. The burden of this disease, both on the individual and on health systems and national economies, is high. In this interdisciplinary Review, with a coauthor with lived experience of severe long COVID, we sought to bring together multiple streams of literature on the epidemiology, pathophysiology (including the hypothesised mechanisms of organ damage), lived experience and clinical manifestations, and clinical investigation and management of long COVID. Although current approaches to long COVID care are largely symptomatic and supportive, recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification might herald a more mechanism-informed and personally tailored approach to clinical care. We also cover the organisation of services for long COVID, approaches to preventing long COVID, and suggestions for future research.

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Déclaration de conflit d'intérêts

Declaration of interests In the past 36 months, TG has held research grants from UK National Institute for Health and Care Research, Balvi, Medical Research Council, Health Data Research UK, and Research Council of Norway. She is a Governing Body Fellow at Green Templeton College and a Visitor at the Pitt Rivers Museum, University of Oxford, and was until 2022, a trustee of the Hilda Martindale Charitable Trust (an educational hardship fund). MS has held research grants from National Institute for Health and Care Research, Research England Policy Support Fund, and the Engineering and Physical Sciences Research Council. He is the Editor-in-Chief of the Oxford Handbook of Rehabilitation Medicine. AP has received consulting fees and grants from the US National Institutes of Health and is Chief Medical Officer of Blooming Magnolia (a 501[c]3 non-profit organisation). JŽN acknowledges institutional support from the endowed Bowman Professorship in Medical Science that he holds at the University of Arizona. He holds or has held research grants from the US National Institutes of Health. He holds US patent number 11119103 (serological assays for SARS-CoV-2). TG and MS were funded by the UK National Institute for Health and Care Research (LOCOMOTION study), and JŽN by the US National Institutes of Health. The funders had no role in any aspect of the writing of this Review. The authors were not precluded from accessing any data in the study (which, being a Review, came from publicly available published papers), and they accept responsibility to submit this Review for publication.