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

tetano

Editor, Senior Moderator
Nat Immunol


. 2023 Sep 4.
doi: 10.1038/s41590-023-01601-2. Online ahead of print. SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC)

Amy D Proal[SUP] 1 [/SUP], Michael B VanElzakker[SUP] 2 3 [/SUP], Soo Aleman[SUP] 4 [/SUP], Katie Bach[SUP] 2 5 [/SUP], Brittany P Boribong[SUP] 6 7 8 [/SUP], Marcus Buggert[SUP] 9 [/SUP], Sara Cherry[SUP] 10 [/SUP], Daniel S Chertow[SUP] 11 12 [/SUP], Helen E Davies[SUP] 13 [/SUP], Christopher L Dupont[SUP] 14 [/SUP], Steven G Deeks[SUP] 15 [/SUP], William Eimer[SUP] 8 16 17 18 [/SUP], E Wesley Ely[SUP] 19 [/SUP], Alessio Fasano[SUP] 6 7 8 [/SUP], Marcelo Freire[SUP] 20 [/SUP], Linda N Geng[SUP] 21 [/SUP], Diane E Griffin[SUP] 22 [/SUP], Timothy J Henrich[SUP] 23 [/SUP], Akiko Iwasaki[SUP] 24 25 26 [/SUP], David Izquierdo-Garcia[SUP] 27 28 [/SUP], Michela Locci[SUP] 29 [/SUP], Saurabh Mehandru[SUP] 30 31 [/SUP], Mark M Painter[SUP] 32 [/SUP], Michael J Peluso[SUP] 15 [/SUP], Etheresia Pretorius[SUP] 33 34 [/SUP], David A Price[SUP] 35 36 [/SUP], David Putrino[SUP] 37 [/SUP], Richard H Scheuermann[SUP] 38 39 40 [/SUP], Gene S Tan[SUP] 14 41 [/SUP], Rudolph E Tanzi[SUP] 8 16 17 18 [/SUP], Henry F VanBrocklin[SUP] 42 [/SUP], Lael M Yonker[SUP] 6 7 8 [/SUP], E John Wherry[SUP] 32 [/SUP]



Affiliations
Abstract

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.


 
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