Table 2.
Additional long COVID-19 symptoms and mechanisms.
| Disorder | Manifestation/Symptoms | Factors/Mechanisms | References |
|---|---|---|---|
| Corneal nerve fiber loss |
Neurological | Microglial activation, lymphoid inflammation | (100) |
| Vascular endothelial damage | Coagulation, micro thrombosis, organ damage | Long-term viral infection hypoxia, inflammatory response | (101) |
| Epstein-Barr Virus Reactivation (the occurrence in the acute phase of the C-19 hospitalized patients predicts L-C19 symptoms) |
Mononucleosis – associated symptoms and complications: fatigue, insomnia, headache, myalgia, confusion, brain fog, rash, urticaria, folliculitis, pharyngitis, abdominal pain, tinnitus, neck lymphadenopathy, mild hearing loss, cryoglobulinemia; myocarditis, inflammatory cardiopathy, myocardial infarctions; liver, kidney, and respiratory failure | Immune system weakness, physiological stressors, corticosteroid, and glucocorticoids treatments |
(29, 102–105) |
| Mastocytosis | Allergic reactions | Histamine, IL-1 increased levels, promote and intensify the cytokine storm and inflammation | (106) |
| Motor peripheral neuropathy | Muscle weakness, atrophy, Achille reflexes absence, reduced/abnormal distal pin and vibration sensations | Intense inflammation, nerve compression, neuritis with perivascular macrophage infiltrates |
(107) |
| Rheumatologic/ musculoskeletal |
Joint pain, muscle pain, low back pain, back and neck pain, fatigue, myalgia | Cellular invasion, inflammatory and immune response, transformed growth factor beta (TGF-β) – persistent immunosuppression and fibrosis | (108) |
| Postural Orthostatic Tachycardia Syndrome | Fatigue, heart rate variability disfunction, orthostatic hypotension | Hypovolemia, neurotropism, inflammation and autoimmunity |
(109) |
| Cancer development or progression | Immunosuppression, death | Cellular transformation, tumor suppressor protein p53 degradation, genomic instability, aberrant cell growth | (110) |
| Dermatological issues | Pernios lesions and livedo reticularis > 150 days; urticarial, erythema, purpura, palmar/plantar rashes | Microvascular changes | (111, 112) |
| Alopecia | Inflammation, emotional distress | (113) | |
| Metabolic disorder | Diabetes | Insulin resistance, abnormalities in glucometabolic control and β-cell function | (114–117) |
| Emotional | Confusion, fear, loss of individuality, insomnia, hopeless, loss of appetite, bad eating habits | Uncertainty, concerns regarding the incomplete recovery, misdiagnosed symptoms, cognitive deficits, anosmia, parosmia | (118–120) |