The Multisystem Pathophysiology of Post-COVID-19 Syndrome: A Contemporary Summary of Clinical Knowledge

Abstract

Now viewed as a public health and economic challenge rather than a peculiar post-viral issue, Post-COVID-19 Syndrome (PCS) — colloquially known as “Long COVID” — is estimated to affect 10–15% of people after initial infection. This narrative review synthesizes emerging clinical evidence on the mechanisms driving PCS, including incomplete viral clearance, persisting immune dysregulation, endothelial microvascular injury, hypercoagulability, and autonomic dysregulation, and correlates these drivers with systemic, neurological, cardiovascular, and pulmonary findings before considering progressive, personalized treatment approaches.