@article{b8c1299db41e4c8aa3e3e21b73b33556,
title = "Immune mechanisms underlying COVID-19 pathology and post-acute sequelae of SARS-CoV-2 infection (PASC)",
abstract = "With a global tally of more than 500 million cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections to date, there are growing concerns about the post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Recent studies suggest that exaggerated immune responses are key determinants of the severity and outcomes of the initial SARS-CoV-2 infection as well as subsequent PASC. The complexity of the innate and adaptive immune responses in the acute and post-acute period requires in-depth mechanistic analyses to identify specific molecular signals as well as specific immune cell populations which promote PASC pathogenesis. In this review, we examine the current literature on mechanisms of immune dysreg-ulation in severe COVID-19 and the limited emerging data on the immunopathology of PASC. While the acute and post-acute phases may share some parallel mechanisms of immunopathology, it is likely that PASC immunopathology is quite distinct and heterogeneous, thus requiring large-scale longitudinal analyses in patients with and without PASC after an acute SARS-CoV-2 infection. By outlining the knowledge gaps in the immunopathology of PASC, we hope to provide avenues for novel research directions that will ultimately lead to precision therapies which restore healthy immune function in PASC patients.",
author = "{RECOVER Mechanistic Pathways Task Force} and Sindhu Mohandas and Prasanna Jagannathan and Henrich, {Timothy J.} and Sherif, {Zaki A.} and Christian Bime and Erin Quinlan and Portman, {Michael A.} and Marila Gennaro and Jalees Rehman",
note = "Funding Information: This work was supported by the Researching Covid to Enhance Recovery (RECOVER) Initiative (OT2HL161847-01) through the American Rescue Plan Act of 2021 (Sec. 2401). We would like to thank the National Community Engagement Group (NCEG), all patient, caregiver, and community Representatives, and all the participants enrolled in the RECOVER Initiative. RECOVER seeks to understand, treat, and prevent the post-acute sequelae of SARS-CoV-2 infection (PASC). This work was made possible through support from the National Institutes of Health, New York University Langone Health, Research Triangle Institute, and the RECOVER Initiative{\textquoteright}s Mechanistic Pathways task force. We thank David Hines for technical assistance with maintaining and updating the bibliography. This content is solely the responsibility of the authors and does not necessarily represent the official views of the RECOVER Program, the NIH, or other funders. This research was funded by the National Institutes of Health (NIH) Agreement OTA OT2HL161847 (contract number 01) as part of the Researching COVID to Enhance Recovery (RECOVER) research program. Funding Information: Erin Quinlan: is employed by the NIH which funded the RECOVER trial. The other authors declare that no competing interests exist. Publisher Copyright: {\textcopyright} 2023, eLife Sciences Publications Ltd. All rights reserved.",
year = "2023",
doi = "10.7554/eLife.86014",
language = "English (US)",
volume = "12",
journal = "eLife",
issn = "2050-084X",
publisher = "eLife Sciences Publications",
}