Exploring the Multisystem Features of Long COVID

A special issue of COVID (ISSN 2673-8112). This special issue belongs to the section "Long COVID and Post-Acute Sequelae".

Deadline for manuscript submissions: 31 May 2026 | Viewed by 1055

Special Issue Editors


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Guest Editor
Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
Interests: antimicrobial resistance; HAI; invasive fungal infections; travel and immigration medicine

Special Issue Information

Dear Colleagues,

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is a complex, multisystem condition where symptoms persist for weeks or months after acute COVID-19. Characterized by persistent symptoms that span multiple organ systems—ranging from neurological and cardiovascular to respiratory and gastrointestinal systems—Long COVID poses significant challenges in diagnosis, management, and rehabilitation. Despite increasing awareness, its pathophysiology remains only partially understood, and evidence-based treatments are still lacking. Emerging research also suggests that genetics may influence susceptibility, severity, and symptom persistence. Key areas of focus include the following: 1) genetic susceptibility to Long COVID (e.g., HLA, FOXP4, ACE2, and TMPRSS2); 2) immune and inflammatory genes (e.g., TLR3, TLR7, IRF7, IFN, and autoantibody IFN); 3) overlap with other post-viral syndromes, e.g., Long COVID shares features with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) and dysautonomia (e.g., POTS); 4) epigenetics and viral persistence, e.g., SARS-CoV-2 may alter host gene expression (e.g., via DNA methylation), thereby exacerbating long-term symptoms. Genetic differences in viral clearance (e.g., APOBEC3 antiviral genes) could allow persistent viral fragments to trigger immune reactions; and 5) genetics likely interacts with age, sex (women are more affected), and prior health conditions.

This Special Issue aims to explore the multisystemic nature of Long COVID through original research, reviews, and clinical insights, fostering a multidisciplinary approach that integrates perspectives from infectious diseases, internal medicine, neurology, cardiology, and beyond. By shedding light on the long-term consequences of SARS-CoV-2 infection, we hope to contribute to improved patient care and the development of targeted therapeutic strategies. We look forward to your submissions.

Dr. Andrea Marino
Dr. Emmanuele Venanzi Rullo
Guest Editors

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Keywords

  • long COVID
  • post-acute COVID-19
  • multisystem involvement
  • PASC
  • COVID-19 sequelae
  • chronic symptoms
  • SARS-CoV-2
  • rehabilitation
  • pathophysiology
  • clinical management
  • genomics studies
  • polygenic risk scores (PRS)
  • personalized medicine
  • biomarker development

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Published Papers (1 paper)

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Review

27 pages, 1876 KB  
Review
Silent Invasion: COVID-19′s Hidden Damage to Human Organs
by Ulugbek Ochilov, Gulomjon Kholov, Otabek Fayzulloyev, Odilshoh Bobokalonov, Shokhida Naimova, Nilufar Akhmedova, Mehriniso Ochilova, Mukhayyo Kutliyeva and Shakhlo Kakharova
COVID 2025, 5(9), 156; https://doi.org/10.3390/covid5090156 - 15 Sep 2025
Viewed by 419
Abstract
Background: SARS-CoV-2, originally described as a respiratory pathogen, has been identified as a multisystem disease with complex and interconnected pathophysiological processes. Methods: The PRISMA framework was used to systematically review the evidence and identify and synthesize it in PubMed, Scopus, and Web of [...] Read more.
Background: SARS-CoV-2, originally described as a respiratory pathogen, has been identified as a multisystem disease with complex and interconnected pathophysiological processes. Methods: The PRISMA framework was used to systematically review the evidence and identify and synthesize it in PubMed, Scopus, and Web of Science databases between January 2020 and May 2025. Of the 1410 screened records, 161 peer-reviewed studies involving more than 2 million patients were included in the analysis. The frequency of organ involvement, important biomarkers, and long-term outcomes were derived, and the quality of the studies was assessed using standardized tools. Results: The quantitative synthesis showed that 78%, 32%, 43%, and 28% of hospitalized patients had pulmonary, cardiovascular, 43% neurological, and 28% renal issues, respectively, with 10–35% showing persistent organ dysfunction at 6 months post-infection. The most common were cytokine storm (IL-6 (Interleukin-6) > 100 pg/mL in 72% of severe cases), endothelial dysfunction (biomarkers elevated in 87% of patients), and microvascular thrombosis (D-dimer > 2000 ng/mL in 46% of patients). Most domains were scored as having moderate-to-high confidence in the quality assessment. Conclusions: COVID-19 has long-term, multi-organ sequelae that require integrated multidisciplinary management. Healthcare systems should be ready to participate in long-term monitoring, rehabilitation, and special therapeutic development. The results offer a strong evidence base for clinical practice and post-pandemic health policy. Full article
(This article belongs to the Special Issue Exploring the Multisystem Features of Long COVID)
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