Preprint / Version 1

Long Covid - A Comprehensive Review of Post-Acute Sequelae of Covid-19


  • Maharsh Jani Anand Niketan Shilaj



Long-Covid, Covid-19, PASC, SARS-CoV-2, Corona-Virus


Diving into the depths of medical mysteries, Long Covid, a perplexing phenomenon with the alternative nomenclature of Post-Acute Sequelae of SARS-CoV-2 infection (PASC), unveils its enigmatic nature. This condition, veiled in the aftermath of resolved acute COVID-19, unravels a tapestry of persistent symptoms that mercilessly haunt its victims. Fatigue, shortness of breath, cognitive impairment, and a host of other maladies emerge, casting a dark shadow upon the once-vibrant lives of patients. 

A comprehensive expedition awaits as this review article endeavors to shed light on the intricate web of Long Covid, its pharmacological interventions, both present and under scrutiny in clinical trials. But let us not confine ourselves solely to the immediate realm of suffering; let us broaden our horizons and contemplate the far-reaching consequences of Long Covid, both on individuals and the healthcare system at large. 

Within these convoluted lines lies a quest to unravel the diagnostic quandaries and management conundrums of Long Covid. As the research compass diligently points towards a more profound comprehension of this nascent condition, the journey towards enlightenment marches forward unabated. This review paper aims to consolidate the current knowledge, explore unresolved questions, and provide insights into the diagnostic approaches and management strategies for Long Covid. By delving into the underlying mechanisms and exploring potential therapeutic avenues, this abstract serves as a precursor to the comprehensive exploration of Long Covid in the subsequent sections of this review.


Aiyegbusi, O. L., Hughes, S. E., Turner, G., Rivera, S. C., McMullan, C., Chandan, J. S., . . . Calvert, M. J. (2021). Symptoms, complications and management of Long Covid: A Review. Journal of the Royal Society of Medicine, 114(9), 428-442. doi:10.1177/01410768211032850 (Aiyegbusi et al., 2021)

AT1001 for the Treatment of COVID-19 Related MIS-C. Accessed January 17, 2023.

AXA1125 IN LONG COVID. Accessed January 17, 2023.

Brodin, P., Casari, G., Townsend, L., O’Farrelly, C., Tancevski, I., Löffler-Ragg, J., . . . Casanova, J. (2022). Studying severe long covid to understand post-infectious disorders beyond COVID-19. Nature Medicine, 28(5), 879-882. doi:10.1038/s41591-022-01766-7 (Brodin et al., 2022)

Centers for Disease Control and Prevention. Long COVID or Post-COVID Conditions. Accessed November 3, 2023.

Cucinotta, D., & Vanelli, M. (2020). WHO Declares COVID-19 a Pandemic. Acta bio-medica : Atenei Parmensis, 91(1), 157–160. doi:10.23750/abm.v91i1.9397 (Cucinotta et al.,2020)

Di Micco, S., Musella, S., Sala, M., Scala, M. C., Andrei, G., Snoeck, R., . . . Fasano, A. (2021). Peptide derivatives of the zonulin inhibitor Larazotide (AT1001) as potential anti SARS-COV-2: Molecular modelling, synthesis and bioactivity evaluation. International Journal of Molecular Sciences, 22(17), 9427. doi:10.3390/ijms22179427 (Di Micco et al., 2021)

Efficacy, Safety, Tolerability of AXA1125 in Fatigue After COVID-19 Infection. Accessed January 17, 2023.

Imai, K., Yamano, T., Nishi, S., Nishi, R., Nishi, T., Tanaka, H., . . . Nishi, K. (2022). Epipharyngeal abrasive therapy (EAT) has potential as a novel method for long covid treatment [Abstract]. Viruses, 14(5), 907. doi:10.3390/v14050907 (Imai et al., 2022)

Ledford, H. (2022). Long-Covid Treatments: Why the world is still waiting. Nature, 608(7922), 258-260. doi:10.1038/d41586-022-02140-w (Ledford, 2022)

Mantovani, A., Morrone, M. C., Patrono, C., Santoro, M. G., Schiaffino, S., Remuzzi, G., . . . Vineis, P. (2022). Long Covid: Where we stand and challenges ahead. Cell Death & Differentiation. doi:10.1038/s41418-022-01052-6 (Mantovani et al., 2022)

Nalbandian, A., Sehgal, K., Gupta, A., Madhavan, M. V., McGroder, C., Stevens, J. S., . . . Wan, E. Y. (2021). Post-acute COVID-19 syndrome. Nature Medicine, 27(4), 601-615. doi:10.1038/s41591-021-01283-z (Nalbandian et al., 2021)

Pears, K. (2022, June 13). Research summary-what are the current treatments being trialled for long covid?: The Me Association. Retrieved November 3, 2022, from (Pears, 2022)

Szarpak, L., Pruc, M., Filipiak, K. J., Popieluch, J., Bielski, A., Jaguszewski, M. J., . . . Peacock, F. W. (2022). Myocarditis: A complication of COVID-19 and long-covid-19 syndrome as a serious threat in modern cardiology. Cardiology Journal, 29(1), 178-179. doi:10.5603/cj.a2021.0155 (Szarpak et al., 2022)

Virios Therapeutics Announces Research Collaboration Exploring the Potential of Combination Antiviral Therapy for Treating Long COVID. Accessed January 17, 2023.

Wu, F., Zhao, S., Yu, B., Chen, Y., Wang, W., Song, Z., . . . Zhang, Y. (2020). A new coronavirus associated with human respiratory disease in China. Nature, 579(7798), 265-269. doi:10.1038/s41586-020-2008-3 (Wu et al., 2020)

Zonulin Antagonist, Larazotide (AT1001), As an Adjuvant Treatment for Multisystem Inflammatory Syndrome in Children: A Case Series.,_larazotide__at1001_,_as_an.19.aspx. Accessed January 17, 2023.