Uncovering the Contrasts and Connections in PASC: Viral Load and Cytokine Signatures in Acute COVID-19 versus Post-Acute Sequelae of SARS-CoV-2 (PASC).

Publication date: Aug 23, 2024

The recent global COVID-19 pandemic has had a profound and enduring impact, resulting in substantial loss of life. The scientific community has responded unprecedentedly by investigating various aspects of the crisis, particularly focusing on the acute phase of COVID-19. The roles of the viral load, cytokines, and chemokines during the acute phase and in the context of patients who experienced enduring symptoms upon infection, so called Post-Acute Sequelae of COVID-19 or PASC, have been studied extensively. Here, in this review, we offer a virologist’s perspective on PASC, highlighting the dynamics of SARS-CoV-2 viral loads, cytokines, and chemokines in different organs of patients across the full clinical spectrum of acute-phase disease. We underline that the probability of severe or critical disease progression correlates with increased viral load levels detected in the upper respiratory tract (URT), lower respiratory tract (LRT), and plasma. Acute-phase viremia is a clear, although not unambiguous, predictor of PASC development. Moreover, both the quantity and diversity of functions of cytokines and chemokines increase with acute-phase disease severity. Specific cytokines remain or become elevated in the PASC phase, although the driving factor of ongoing inflammation found in patients with PASC remains to be investigated. The key findings highlighted in this review contribute to a further understanding of PASC and their differences and overlap with acute disease.

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Concepts	Keywords
Biomedicines	COVID-19
Pandemic	cytokines
Plasma	long COVID
Viral	lower respiratory tract
Virologist	PASC
	plasma
	SARS-CoV-2
	upper respiratory tract
	viral load

Semantics

Type	Source	Name
disease	MESH	Viral Load
disease	MESH	COVID-19
disease	MESH	Sequelae
disease	MESH	infection
disease	MESH	Post-Acute Sequelae of COVID-19
disease	MESH	disease progression
disease	MESH	viremia
disease	MESH	inflammation
disease	MESH	acute disease
drug	DRUGBANK	Coenzyme M
disease	MESH	acute respiratory distress syndrome
pathway	REACTOME	Immune System
disease	IDO	symptom
disease	MESH	anosmia
disease	MESH	tachypnea
disease	MESH	pneumonia
disease	MESH	dyspnea
disease	MESH	coma
disease	MESH	Cytokine storm
disease	IDO	production
disease	MESH	syndrome
disease	MESH	death
disease	MESH	Persistent infection
disease	IDO	acute infection
drug	DRUGBANK	Dimercaprol
disease	IDO	host
disease	IDO	immune response
pathway	KEGG	Viral replication
disease	MESH	viral infection
disease	MESH	fatal outcomes
disease	IDO	replication
disease	MESH	critically ill
disease	MESH	reinfection
disease	MESH	morbidities
disease	MESH	autoimmunity
disease	MESH	necrosis
pathway	REACTOME	Apoptosis
disease	MESH	fibrosis
disease	MESH	respiratory diseases
disease	MESH	Influenza
drug	DRUGBANK	Cefaclor
disease	IDO	site
disease	MESH	comorbidity
disease	IDO	process
disease	IDO	blood
disease	MESH	asymptomatic infection
disease	IDO	susceptibility
disease	MESH	edema
disease	MESH	lung injury
disease	MESH	cognitive dysfunction
disease	MESH	weight loss
disease	MESH	Viral shedding
disease	MESH	abnormalities
disease	MESH	causes
disease	MESH	Severe Acute Respiratory Syndrome
drug	DRUGBANK	Guanosine
drug	DRUGBANK	(S)-Des-Me-Ampa
disease	MESH	Allergy
disease	MESH	Autoimmune Diseases
disease	MESH	cancer
disease	MESH	Pulmonary Fibrosis
pathway	REACTOME	Eicosanoids
drug	DRUGBANK	Efavirenz
drug	DRUGBANK	Sulfasalazine
disease	IDO	cell
drug	DRUGBANK	Tolbutamide
disease	MESH	Obesity

Original Article

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