tetano
Editor, Senior Moderator
Elife
. 2025 Nov 17:14:e106308.
doi: 10.7554/eLife.106308. The role of co-infection in the pathogenesis of acute SARS-CoV-2 infection and development of post-acute sequelae: A perspective
Timothy J Henrich[SUP] 1 [/SUP], Christopher P Montgomery[SUP] 2 3 [/SUP], Joerg Graf[SUP] 4 [/SUP], Nahed Ismali[SUP] 5 [/SUP], Sindhu Mohandas[SUP] 6 [/SUP], Mehul S Suthar[SUP] 7 [/SUP], Hassan Brim[SUP] 8 [/SUP], John M Coffin[SUP] 9 [/SUP], Aayush Pagaria[SUP] 1 [/SUP], Jeisac Guzmán Rivera[SUP] 10 [/SUP], Urmila Vudali[SUP] 1 [/SUP], Paul Keim[SUP] 11 [/SUP], Guangming Zhong[SUP] 12 [/SUP], Rebecca McGrath[SUP] 13 [/SUP], Belinda Edwards[SUP] 14 [/SUP], Adolfo García-Sastre[SUP] 15 [/SUP], Maria Laura Gennaro[SUP] 10 16 [/SUP]
Affiliations
A major health challenge resulting from the COVID-19 pandemic is the manifestation of post-acute sequelae of SARS-CoV-2 (PASC). PASC (or long COVID) is a collective term used for clinical symptoms, various pathologies, and life-quality-changing functional impairment that persist for months to years after the initial SARS-CoV-2 infection. The mechanisms underlying PASC are not understood, although advances have been made in identifying factors that may contribute to long-term pathology. Recent data have emerged, showing an association between SARS-CoV-2 viral persistence and non-SARS-CoV-2 infections (pre-existing, viral reactivation, or new infections) in facilitating or mediating PASC. However, the heterogeneous nature and timing of co-infections have made it challenging to understand, interpret, and contextualize their contribution to PASC. Here, we summarize the impact of potential viral, bacterial, and fungal infections on SARS-CoV-2 pathogenesis, with a focus on their possible roles in the development of PASC. We also provide a framework to understand the mechanisms of PASC and inform basic, translational, and clinical research initiatives, including RECOVER, a large and ongoing research initiative to understand, treat, and prevent long COVID.
Keywords: PASC; SARS-CoV-2; co-infection; immunology; infectious disease; inflammation; long COVID; microbiology.
. 2025 Nov 17:14:e106308.
doi: 10.7554/eLife.106308. The role of co-infection in the pathogenesis of acute SARS-CoV-2 infection and development of post-acute sequelae: A perspective
Timothy J Henrich[SUP] 1 [/SUP], Christopher P Montgomery[SUP] 2 3 [/SUP], Joerg Graf[SUP] 4 [/SUP], Nahed Ismali[SUP] 5 [/SUP], Sindhu Mohandas[SUP] 6 [/SUP], Mehul S Suthar[SUP] 7 [/SUP], Hassan Brim[SUP] 8 [/SUP], John M Coffin[SUP] 9 [/SUP], Aayush Pagaria[SUP] 1 [/SUP], Jeisac Guzmán Rivera[SUP] 10 [/SUP], Urmila Vudali[SUP] 1 [/SUP], Paul Keim[SUP] 11 [/SUP], Guangming Zhong[SUP] 12 [/SUP], Rebecca McGrath[SUP] 13 [/SUP], Belinda Edwards[SUP] 14 [/SUP], Adolfo García-Sastre[SUP] 15 [/SUP], Maria Laura Gennaro[SUP] 10 16 [/SUP]
Affiliations
- PMID: 41247781
- DOI: 10.7554/eLife.106308
A major health challenge resulting from the COVID-19 pandemic is the manifestation of post-acute sequelae of SARS-CoV-2 (PASC). PASC (or long COVID) is a collective term used for clinical symptoms, various pathologies, and life-quality-changing functional impairment that persist for months to years after the initial SARS-CoV-2 infection. The mechanisms underlying PASC are not understood, although advances have been made in identifying factors that may contribute to long-term pathology. Recent data have emerged, showing an association between SARS-CoV-2 viral persistence and non-SARS-CoV-2 infections (pre-existing, viral reactivation, or new infections) in facilitating or mediating PASC. However, the heterogeneous nature and timing of co-infections have made it challenging to understand, interpret, and contextualize their contribution to PASC. Here, we summarize the impact of potential viral, bacterial, and fungal infections on SARS-CoV-2 pathogenesis, with a focus on their possible roles in the development of PASC. We also provide a framework to understand the mechanisms of PASC and inform basic, translational, and clinical research initiatives, including RECOVER, a large and ongoing research initiative to understand, treat, and prevent long COVID.
Keywords: PASC; SARS-CoV-2; co-infection; immunology; infectious disease; inflammation; long COVID; microbiology.