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SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC)

Proal, Amy D., VanElzakker, Michael B., Aleman, Soo, Bach, Katie, Boribong, Brittany P., Buggert, Marcus, Cherry, Sara, Chertow, Daniel S., Davies, Helen E., Dupont, Christopher L., Deeks, Steven G., Eimer, William, Ely, E. Wesley, Fasano, Alessio, Freire, Marcelo, Geng, Linda N., Griffin, Diane E., Henrich, Timothy J., Iwasaki, Akiko, Izquierdo-Garcia, David, Locci, Michela, Mehandru, Saurabh, Painter, Mark M., Peluso, Michael J., Pretorius, Etheresia, Price, David A. ORCID:, Putrino, David, Scheuermann, Richard H., Tan, Gene S., Tanzi, Rudolph E., VanBrocklin, Henry F., Yonker, Lael M. and Wherry, E. John 2023. SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC). Nature Immunology 24 , pp. 1616-1627. 10.1038/s41590-023-01601-2

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Millions of people are suffering from Long COVID or post-acute sequelae of COVID-19 (PASC). Several biological factors have emerged as potential drivers of PASC pathology. Some individuals with PASC may not fully clear the coronavirus SARS-CoV-2 after acute infection. Instead, replicating virus and/or viral RNA—potentially capable of being translated to produce viral proteins—persist in tissue as a ‘reservoir’. This reservoir could modulate host immune responses or release viral proteins into the circulation. Here we review studies that have identified SARS-CoV-2 RNA/protein or immune responses indicative of a SARS-CoV-2 reservoir in PASC samples. Mechanisms by which a SARS-CoV-2 reservoir may contribute to PASC pathology, including coagulation, microbiome and neuroimmune abnormalities, are delineated. We identify research priorities to guide the further study of a SARS-CoV-2 reservoir in PASC, with the goal that clinical trials of antivirals or other therapeutics with potential to clear a SARS-CoV-2 reservoir are accelerated.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: An Author Correction to this article was published on 18 September 2023 -
Publisher: Nature Research
ISSN: 1529-2908
Date of First Compliant Deposit: 12 September 2023
Date of Acceptance: 18 July 2023
Last Modified: 21 Jul 2024 18:46

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