Pathophysiological mechanisms underlying COVID-19 and post-COVID-19 condition
Pathophysiological mechanisms underlying COVID-19 and post-COVID-19 condition
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly evolved into a global and prolonged health crisis. Although most infections followed a mild and self-limiting course, a substantial proportion of patients developed severe disease, ranging from pneumonia and acute respiratory distress syndrome (ARDS) to multi-organ failure and death. In addition, a significant group of individuals continues to experience persistent symptoms long after acute infection, a condition known as post-COVID-19 condition (PCC) or Long COVID.
This thesis of Larissa Vlaming-van Eijk describes multiple aspects of SARS-CoV-2 infection in individuals with diverse health states. It focuses on viral cell entry, viral persistence, and viral shedding, as well as on the pathogenesis of COVID-19, with particular emphasis on immune-mediated pathology, systemic oxidative stress, and disturbances in iron metabolism. Furthermore, the development and heterogeneity of PCC are investigated.
The findings highlight the importance of an integrated, multilayered approach in which different pathophysiological mechanisms are studied in conjunction. Such an approach is essential for the development of personalized medicine strategies for both acute COVID-19 and PCC. For PCC, this includes the establishment of robust patient registries, integration of clinical characteristics and symptom profiles with multi-omics data to refine PCC phenotypes, identification and validation of reliable biomarkers, and the development of effective, safe, and targeted therapies addressing the underlying pathophysiological mechanisms.