In 2023, the Keystone Symposia held the first international scientific conference convening research leaders investigating the pathology of post-acute sequelae of COVID-19 (PASC) or Long COVID, a growing and urgent public health priority. In this report, we present insights from the talks and workshops presented during this meeting and highlight key themes regarding what researchers have discovered regarding the underlying biology of PASC and directions toward future treatment. Several themes have emerged in the biology, with inflammation and other immune alterations being the most common focus, potentially related to viral persistence, latent virus reactivation, and/or tissue damage and dysfunction, especially of the endothelium, nervous system, and mitochondria. In order to develop safe and effective treatments for people with PASC, critical next steps should focus on the replication of major findings regarding potential mechanisms, disentangling pathogenic mechanisms from downstream effects, development of cellular and animal models, mechanism-focused randomized, placebo-controlled trials, and closer collaboration between people with lived experience, scientists, and other stakeholders. Ultimately, by learning from other post-infectious syndromes, the knowledge gained may help not only those with PASC/Long COVID, but also those with other post-infectious syndromes.

中文翻译：

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长期新冠肺炎和 SARS-CoV-2 发病机制及治疗的急性后遗症：Keystone 研讨会报告


2023 年，Keystone 研讨会举办了首届国际科学会议，召集了研究领导者，研究了 COVID-19 (PASC) 或长新冠病毒急性后遗症的病理学，这是一个日益紧迫的公共卫生优先事项。在本报告中，我们介绍了本次会议期间的演讲和研讨会的见解，并重点介绍了研究人员在 PASC 基础生物学方面的发现以及未来治疗方向的关键主题。生物学中出现了几个主题，其中炎症和其他免疫改变是最常见的焦点，可能与病毒持久性、潜伏病毒重新激活和/或组织损伤和功能障碍有关，特别是内皮、神经系统和线粒体的损​​伤和功能障碍。为了为 PASC 患者开发安全有效的治疗方法，接下来的关键步骤应侧重于复制有关潜在机制的主要发现，将致病机制与下游效应分开，开发细胞和动物模型，以机制为重点的随机、安慰剂对照试验，以及有生活经验的人、科学家和其他利益相关者之间更密切的合作。最终，通过向其他感染后综合症学习，所获得的知识不仅可以帮助那些患有 PASC/Long COVID 的人，还可以帮助那些患有其他感染后综合症的人。