The Natural History of SARS-CoV-2-Incurred Disease: From Infection to Long COVID
Abstract
:1. Background
2. The Natural History of SARS-CoV-2 and Human Interactions
2.1. The Viral Life Cycle
2.2. The Early Infection Stage
2.3. The Pulmonary Stage
2.4. Thrombosis Stage
2.5. The Hyper-Inflammatory Stage
2.6. The Convalescent Stage
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Stage | Clinical Features | Biomarkers | Virus–Host Interactions/Immunology | Treatments |
---|---|---|---|---|
Early Infection Stage | Fever, cough, shortness of breath, muscle pain, fatigue, diarrhea, loss of taste or smell | Viral load by RT-PCR or viral antigens by antigenic assays from nasal swab or sputum samples | Viral entry through ACE2 receptors on host cells leading to replication and symptom development | Antiviral drugs and neutralizing antibodies to reduce disease progression |
Pulmonary Stage | Breathing difficulties, lung inflammation | Chest X-ray or computed tomography showing lung inflammation | Immune response produces antibodies and activates immune cells (T cells, NK cells) to target and destroy the virus | Antiviral drugs targeting viral replication and assembly/release |
Thrombosis Stage | Shortness of breath, chest pain, respiratory distress, oxygen desaturation | Elevated D-dimer and von Willebrand factor (vWF) levels | SARS-CoV-2 infection triggering endothelial injury and inflammation, leading to a prothrombotic state | Aspirin, low-molecular-weight heparin, novel oral anticoagulants |
Hyper-Inflammatory Stage | Cytokine storm, widespread inflammation, severe illness, ARDS, sepsis, organ failure | Elevated levels of proinflammatory cytokines (e.g., IL-6, IL-17, IFN-γ) | Overproduction of proinflammatory cytokines and immune mediators causing organ damage and complications | Corticosteroids (e.g., dexamethasone) to reduce inflammation and improve oxygenation Supportive care (oxygen therapy, mechanical ventilation, ECMO) |
Convalescent Stage | Gradual recovery after acute infection subsides Long COVID conditions with persisting symptoms | Supportive care to alleviate symptoms (pulmonary rehabilitation, cognitive-behavioral therapy) |
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Liang, K.-H.; Teng, Y.-C.; Liao, Y.-T.; Yarmishyn, A.A.; Chiang, S.-H.; Hung, W.-C.; Hsiao, C.-Y.; Tsai, E.-T.; Chang, T.-J.; Yang, D.-M.; et al. The Natural History of SARS-CoV-2-Incurred Disease: From Infection to Long COVID. Int. J. Transl. Med. 2024, 4, 72-86. https://doi.org/10.3390/ijtm4010004
Liang K-H, Teng Y-C, Liao Y-T, Yarmishyn AA, Chiang S-H, Hung W-C, Hsiao C-Y, Tsai E-T, Chang T-J, Yang D-M, et al. The Natural History of SARS-CoV-2-Incurred Disease: From Infection to Long COVID. International Journal of Translational Medicine. 2024; 4(1):72-86. https://doi.org/10.3390/ijtm4010004
Chicago/Turabian StyleLiang, Kung-Hao, Yuan-Chi Teng, Yi-Ting Liao, Aliaksandr A. Yarmishyn, Su-Hua Chiang, Wei-Chun Hung, Chun-Yen Hsiao, En-Tung Tsai, Tai-Jay Chang, De-Ming Yang, and et al. 2024. "The Natural History of SARS-CoV-2-Incurred Disease: From Infection to Long COVID" International Journal of Translational Medicine 4, no. 1: 72-86. https://doi.org/10.3390/ijtm4010004