Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system and can be severely disabling. The cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion—equivalent to about 1% of the global economy. Several mechanistic pathways are implicated in long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis. Long COVID can have devastating impacts on individual lives and, due to its complexity and prevalence, it also has major ramifications for health systems and economies, even threatening progress toward achieving the Sustainable Development Goals. Addressing the challenge of long COVID requires an ambitious and coordinated—but so far absent—global research and policy response strategy. In this interdisciplinary review, we provide a synthesis of the state of scientific evidence on long COVID, assess the impacts of long COVID on human health, health systems, the economy and global health metrics, and provide a forward-looking research and policy roadmap.

长新冠病毒代表了 SARS-CoV-2 感染引起的一系列急性后和长期健康影响；它是一种复杂的多系统疾病，几乎可以影响每个器官系统，并可能导致严重残疾。全球长期新冠肺炎累计发病人数约为 4 亿，估计每年产生的经济影响约为 1 万亿美元，相当于全球经济的 1% 左右。长期新冠肺炎涉及多种机制途径，包括病毒持续存在、免疫失调、线粒体功能障碍、补体失调、内皮炎症和微生物群失调。长期新冠疫情可能对个人生活产生毁灭性影响，而且由于其复杂性和普遍性，它还会对卫生系统和经济产生重大影响，甚至威胁到实现可持续发展目标的进展。应对长期新冠疫情带来的挑战需要一项雄心勃勃且协调一致（但迄今为止尚不存在）的全球研究和政策应对战略。在这次跨学科综述中，我们综合了有关长期新冠病毒的科学证据状况，评估了长期新冠病毒对人类健康、卫生系统、经济和全球健康指标的影响，并提供了前瞻性的研究和政策路线图。