Proposed subtypes of post-COVID-19 syndrome (or long-COVID) and their respective potential therapies, by Shin Jie Yong, Shiliang Liu in Rev Med Virol. 2021 Dec 9; [doi: 10.1002/rmv.2315]

Review abstract:

The effects of coronavirus disease 2019 (COVID-19), a highly transmissible infectious respiratory disease that has initiated an ongoing pandemic since early 2020, do not always end in the acute phase. Depending on the study referred, about 10%-30% (or more) of COVID-19 survivors may develop long-COVID or post-COVID-19 syndrome (PCS), characterised by persistent symptoms (most commonly fatigue, dyspnoea, and cognitive impairments) lasting for 3 months or more after acute COVID-19.

While the pathophysiological mechanisms of PCS have been extensively described elsewhere, the subtypes of PCS have not. Owing to its highly multifaceted nature, this review proposes and characterises six subtypes of PCS based on the existing literature.

The subtypes are:

1. non-severe COVID-19 multi-organ sequelae (NSC-MOS) [3.1]
2. pulmonary fibrosis sequelae (PFS) [3.2]
3. myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) [3.3]
4. postural orthostatic tachycardia syndrome (POTS) [3.4]
5. post-intensive care syndrome (PICS) [3.5]
6. medical or clinical sequelae (MCS) [3.6]

Original studies supporting each of these subtypes are documented in this review, as well as their respective symptoms and potential interventions. Ultimately, the subtyping proposed herein aims to provide better clarity on the current understanding of PCS.

One of the phenotypes is ME/CFS, which was two-fold more likely to happen to COVID-19-positive than—negative patients, especially among women younger than 65 years, at 6- to 9-month post-infection. [from section 3.3]

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