Post-acute COVID-19 Syndrome and Predicting Factors: A Narrative Review

Abstract

Accumulating evidence indicates a high prevalence rate of persistent symptoms leading to post-acute COVID-19 syndrome. It has been identified as a multi-organ disease with a wide range of prolonged symptoms that may be reflective of underlying respiratory, cardiovascular, neuropsychiatric, gastrointestinal, dermatological, renal, and endocrine disorders. The most frequent symptoms of post-acute COVID-19 include fatigue, dyspnea, anosmia, ageusia, and cough. Additionally, female gender, older age, pre-existing comorbidities, and initial COVID-19 severity, especially those requiring intensive care unit treatments and mechanical ventilation seem to relate to developing persistent symptoms. Studies also suggest that biological factors such as higher viral load, reactivation of the Epstein-Barr Virus, presence of certain autoantibodies, alterations in the gut microbiome, and other factors such as ambient air pollution, not being vaccinated, and reinfection with COVID-19 increase one’s susceptibility to developing lasting symptoms. This narrative review presents an overview of the current understanding of the postacute symptoms and sequelae, and their potential predicting factors. In addition, this highlights the need for further research to be conducted to improve understanding of the pathophysiological aspects of the post-acute COVID-19 syndrome and develop effective therapies.