SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC).
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing existing literature and proposed biological mechanisms without systematic search methodology or original human trial data.
PubMed 37667052 · doi:10.1038/s41590-023-01601-2
What was done
This narrative review summarizes published findings detecting persistent SARS-CoV-2 viral RNA, proteins, and associated immune responses in individuals with post-acute sequelae of COVID-19 (PASC). The authors synthesize proposed mechanisms connecting tissue-based viral reservoirs to chronic clinical pathology and highlight research priorities for clinical trials of antivirals.
What was found
The abstract reports no numerical findings, pooled counts, or statistical results. It summarizes qualitative observations that some individuals do not fully clear SARS-CoV-2, retaining replicating virus or translatable viral RNA in tissue reservoirs that may alter host immunity, circulate antigens, and drive coagulation, microbiome, or neuroimmune dysfunction.
Why it matters
It highlights persistent viral reservoirs as a potential root driver of Long COVID pathology, offering a mechanistic rationale for testing antiviral and clearance therapies in clinical trials.
Limits
As a narrative review, it presents no original data, sample size, or systematic methodology. The abstract does not provide empirical prevalence rates for tissue persistence in PASC, nor does it establish causal links between specific viral reservoirs and clinical outcomes.
Cited by
- supports Replicating SARS-CoV-2 virus persists in the bodies of individuals months or years after recovery from acute infection, contributing to long COVID.