Targeting the SARS-CoV-2 reservoir in long COVID - 24/04/25
Doi : 10.1016/S1473-3099(24)00769-2
Amy D Proal, PhD a, ⁎ 
, Soo Aleman, MD b, c, Morgane Bomsel, ProfPhD e, f, Petter Brodin, ProfMD d, g, h, Marcus Buggert, PhD i, Sara Cherry, ProfPhD j, Daniel S Chertow, MD n, o, Helen E Davies, MD p, q, Christopher L Dupont, ProfPhD r, Steven G Deeks, ProfMD u, E Wes Ely, ProfMD w, x, Alessio Fasano, ProfMD y, z, ab, Marcelo Freire, PhD t, Linda N Geng, MD ac, Diane E Griffin, ProfPhD ad, Timothy J Henrich, ProfMD v, Stephen M Hewitt, MD ae, Akiko Iwasaki, ProfPhD af, ag, ah, Harlan M Krumholz, ProfMD ag, ai, aj, ak, Michela Locci, PhD k, m, Vincent C Marconi, ProfMD al, am, Saurabh Mehandru, ProfMD an, ap, Michaela Muller-Trutwin, ProfPhD aq, Mark M Painter, PhD m, Etheresia Pretorius, ProfPhD ar, as, David A Price, ProfMD at, au, David Putrino, ProfPhD ao, Yu Qian, PhD s, Nadia R Roan, ProfPhD av, aw, Dominique Salmon, MD ax, ay, Gene S Tan, PhD t, Michael B VanElzakker, PhD a, aa, E John Wherry, ProfPhD l, m, Johan Van Weyenbergh, PhD az, Lael M Yonker, MD y, z, ab, Michael J Peluso, MD u, ⁎
, Soo Aleman, MD b, c, Morgane Bomsel, ProfPhD e, f, Petter Brodin, ProfMD d, g, h, Marcus Buggert, PhD i, Sara Cherry, ProfPhD j, Daniel S Chertow, MD n, o, Helen E Davies, MD p, q, Christopher L Dupont, ProfPhD r, Steven G Deeks, ProfMD u, E Wes Ely, ProfMD w, x, Alessio Fasano, ProfMD y, z, ab, Marcelo Freire, PhD t, Linda N Geng, MD ac, Diane E Griffin, ProfPhD ad, Timothy J Henrich, ProfMD v, Stephen M Hewitt, MD ae, Akiko Iwasaki, ProfPhD af, ag, ah, Harlan M Krumholz, ProfMD ag, ai, aj, ak, Michela Locci, PhD k, m, Vincent C Marconi, ProfMD al, am, Saurabh Mehandru, ProfMD an, ap, Michaela Muller-Trutwin, ProfPhD aq, Mark M Painter, PhD m, Etheresia Pretorius, ProfPhD ar, as, David A Price, ProfMD at, au, David Putrino, ProfPhD ao, Yu Qian, PhD s, Nadia R Roan, ProfPhD av, aw, Dominique Salmon, MD ax, ay, Gene S Tan, PhD t, Michael B VanElzakker, PhD a, aa, E John Wherry, ProfPhD l, m, Johan Van Weyenbergh, PhD az, Lael M Yonker, MD y, z, ab, Michael J Peluso, MD u, ⁎ a PolyBio Research Foundation, Medford, MA, USA
b Department of Infectious Diseases and Unit of Post-COVID Huddinge, Karolinska University Hospital, Stockholm, Sweden
c Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
d Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
e HIV entry and Laboratory of Mucosal Immunity, Institut Cochin, Paris, France
f Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
g Department of Immunology and Inflammation, Imperial College London, London, UK
h Medical Research Council Laboratory of Medical Sciences, Imperial College London, London, UK
i Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Huddinge, Sweden
j Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
k Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
l Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
m Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
n Emerging Pathogens Section, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
o Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
p Department of Respiratory Medicine, University Hospital Llandough, Cardiff, UK
q University School of Medicine, University Hospital of Wales, Cardiff, UK
r Division of Genomic Medicine, Environment & Sustainability, J Craig Venter Institute, University of California San Diego, La Jolla, CA, USA
s Department of Informatics, J Craig Venter Institute, University of California San Diego, La Jolla, CA, USA
t Department of Infectious Diseases, J Craig Venter Institute, University of California San Diego, La Jolla, CA, USA
u Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
v Division of Experimental Medicine, University of California, San Francisco, CA, USA
w The Critical Illness, Brain Dysfunction, Survivorship Center at Vanderbilt University Medical Center, Nashville, TN, USA
x Veteran’s Affairs Tennessee Valley Geriatric Research Education Clinical Center, Nashville, TN, USA
y Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
z Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
aa Division of Neurotherapeutics, Massachusetts General Hospital, Boston, MA, USA
ab Harvard Medical School, Boston, MA, USA
ac J Craig Venter Institute, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
ad W Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
ae Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
af Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
ag Center for Infection and Immunity, Yale University School of Medicine, New Haven, CT, USA
ah Howard Hughes Medical Institute, Chevy Chase, MD, USA
ai Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
aj Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
ak Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
al Emory University School of Medicine and Rollins School of Public Health, Atlanta, GA, USA
am Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
an Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
ao Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
ap Henry D Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
aq Institut Pasteur, Université Paris-Cité, HIV, Inflammation and Persistence Unit, Paris, France
ar Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
as Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
at Division of Infection and Immunity, Cardiff University School of Medicine, University Hospital of Wales, Cardiff, UK
au Systems Immunity Research Institute, Cardiff University School of Medicine, University Hospital of Wales, Cardiff, UK
av Gladstone Institutes, University of California, San Francisco, CA, USA
aw Department of Urology, University of California, San Francisco, CA, USA
ax Department of Infectious Diseases, Institut Fournier, Paris, France
ay Direction of International Relations Assistance Publique Hôpitaux de Paris, Paris, France
az Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
*Correspondence to: Dr Amy D Proal, PolyBio Research Foundation, Medford, MA 02155, USAPolyBio Research FoundationMedfordMA02155USA**Correspondence to: Assist Prof Michael J Peluso, Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA 94110, USADivision of HIV, Infectious Diseases, and Global MedicineUniversity of CaliforniaSan FranciscoCA94110USA
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Summary |
There are no approved treatments for post-COVID-19 condition (also known as long COVID), a debilitating disease state following SARS-CoV-2 infection that is estimated to affect tens of millions of people. A growing body of evidence shows that SARS-CoV-2 can persist for months or years following COVID-19 in a subset of individuals, with this reservoir potentially driving long-COVID symptoms or sequelae. There is, therefore, an urgent need for clinical trials targeting persistent SARS-CoV-2, and several trials of antivirals or monoclonal antibodies for long COVID are underway. However, because mechanisms of SARS-CoV-2 persistence are not yet fully understood, such studies require important considerations related to the mechanism of action of candidate therapeutics, participant selection, duration of treatment, standardisation of reservoir-associated biomarkers and measurables, optimal outcome assessments, and potential combination approaches. In addition, patient subgroups might respond to some interventions or combinations of interventions, making post-hoc analyses crucial. Here, we outline these and other key considerations, with the goal of informing the design, implementation, and interpretation of trials in this rapidly growing field. Our recommendations are informed by knowledge gained from trials targeting the HIV reservoir, hepatitis C, and other RNA viruses, as well as precision oncology, which share many of the same hurdles facing long-COVID trials.
Le texte complet de cet article est disponible en PDF.Plan
© 2025
Elsevier Ltd. Tous droits réservés.
Vol 25 - N° 5
P. e294-e306 - mai 2025 Retour au numéro
Article précédent
- Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM
- Oliver A Cornely, Rosanne Sprute, Matteo Bassetti, Sharon C-A Chen, Andreas H Groll, Oliver Kurzai, Cornelia Lass-Flörl, Luis Ostrosky-Zeichner, Riina Rautemaa-Richardson, Gunturu Revathi, Maria E Santolaya, P Lewis White, Ana Alastruey-Izquierdo, Maiken C Arendrup, John Baddley, Aleksandra Barac, Ronen Ben-Ami, Adrian J Brink, Jan H Grothe, Jesus Guinea, Ferry Hagen, Bruno Hochhegger, Martin Hoenigl, Shahid Husain, Kauser Jabeen, Henrik E Jensen, Souha S Kanj, Philipp Koehler, Thomas Lehrnbecher, Russell E Lewis, Jacques F Meis, M Hong Nguyen, Zoi D Pana, Peter-Michael Rath, Ilana Reinhold, Danila Seidel, Takahiro Takazono, Donald C Vinh, Sean X Zhang, Javier Afeltra, Abdullah M S Al-Hatmi, Amir Arastehfar, Sevtap Arikan-Akdagli, Felix Bongomin, Fabianne Carlesse, Methee Chayakulkeeree, Louis Y A Chai, Leili Chamani-Tabriz, Tom Chiller, Anuradha Chowdhary, Cornelius J Clancy, Arnaldo L Colombo, Andrea Cortegiani, Dora E Corzo Leon, Lubos Drgona, Anna Dudakova, Joveria Farooqi, Sara Gago, Macit Ilkit, Jeffrey D Jenks, Nikolai Klimko, Robert Krause, Anil Kumar, Katrien Lagrou, Michail S Lionakis, Badre E Lmimouni, Michael K Mansour, Joseph Meletiadis, Sibylle C Mellinghoff, Mervyn Mer, Malgorzata Mikulska, Philippe Montravers, Chin Fen Neoh, Volkan Ozenci, Livio Pagano, Peter Pappas, Thomas F Patterson, Pedro Puerta-Alcalde, Laman Rahimli, Sebastian Rahn, Emmanuel Roilides, Coleman Rotstein, Tamara Ruegamer, Raquel Sabino, Jon Salmanton-García, Ilan S Schwartz, Esther Segal, Neeraj Sidharthan, Tanu Singhal, Janos Sinko, Rajeev Soman, Andrej Spec, Joerg Steinmann, Jannik Stemler, Saad J Taj-Aldeen, Alida Fe Talento, George R Thompson, Christina Toebben, Hiram Villanueva-Lozano, Retno Wahyuningsih, Barbora Weinbergerová, Nathan Wiederhold, Birgit Willinger, Patrick C Y Woo, Li-Ping Zhu
- Chronic intestinal spirochaetosis and Giardia lamblia infection mimicking eosinophilic enterocolitis
- Maria Antonia De Francesco, Luca Paroni, Francesco Lanzarotto, Irene Zammarchi, Stefania Manenti, Anna Maria Mazzola, Vincenzo Villanacci
Bienvenue sur EM-consulte, la référence des professionnels de santé.