THE RELATIONSHIP BETWEEN COVID-19 AND THE LONG-TERM DEVELOPMENT OF AUTOIMMUNE DISEASES AND POST-COVID-19 CONDITION (LONG COVID). REHABILITATION AND PREVENTION GUIDELINES
DOI:
https://doi.org/10.32782/2786-7684/2026-1-13Keywords:
SARS-CoV-2, Post-COVID-19 Condition, Long COVID, autoimmune diseases, autoantibodies, post-rehabilitation, immunopathogenesis, nano-adjuvants, healthcare systemAbstract
Introduction. The transition of the COVID-19 pandemic to an endemic phase has not removed from the agenda the problem of the longterm consequences of SARS-CoV-2 infection. A significant medical and social burden on healthcare systems worldwide is formed by Post- COVID-19 Condition (Long COVID) and the potential increase in the risk of debut or progression of autoimmune diseases. Aim of the Study. This review study synthesizes current interdisciplinary knowledge on the immunopathogenetic mechanisms mediating the link between past coronavirus infection and the development of long-term pathological conditions. Materials and Methods. The study is based on a critical analysis of current scientific literature, data from international clinical studies, and the results of the author’s own research. Results and Discussion. Key Pathogenetic Mechanisms: The role of persistence of viral antigens, the formation of a wide range of functional autoantibodies, the phenomenon of molecular mimicry, as well as the state of chronic systemic inflammation and endothelial dysfunction. Assessment and Rehabilitation Concept: Based on the analysis, a concept for a multidimensional assessment of patients with Long COVID has been formulated. A structured, multidisciplinary, and personalized program of step-by-step rehabilitation is proposed, integrating neurological, cardiorespiratory, musculoskeletal, and psychological support with mandatory consideration of the risk of post-exertional malaise development. Organizational Measures: Key organizational measures for the healthcare system aimed at creating effective infrastructure for diagnosis, rehabilitation, and dynamic monitoring are outlined. Prevention Prospects: The prospects for the application of innovative technologies, in particular nano-adjuvants, for modulating the immune response and preventing long-term complications are separately considered. Conclusions. The necessity of continuous monitoring of the circulation of new SARS-CoV-2 variants and evaluation of the effectiveness of existing and developing preventive and therapeutic interventions to overcome the long-term consequence of the pandemic is emphasized. In summary, the critical need for a multidisciplinary approach to managing patients with Long COVID and adapting the healthcare system to the long-term challenges of the post-pandemic era is highlighted.
References
Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615. DOI: https://doi.org/10.1038/s41591-021-01283-z
World Health Organization. Post COVID-19 condition (Long COVID). 2023. Available from: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition
Wang EY, Mao T, Klein J, et al. Diverse functional autoantibodies in patients with COVID-19. Nature. 2021;595(7866):283-288. DOI: https://doi.org/10.1038/s41586-021-03631-y
Chang SE, Feng A, Meng W, et al. New-onset IgG autoantibodies in hospitalized patients with COVID-19. Nat Commun. 2021;12(1):5417. DOI: https://doi.org/10.1038/s41467-021-25509-3
Hrytsko RYu. The unpreparedness of the health care system to overcome the consequences of the COVID-19 pandemic [Nehotovnist systemy okhorony zdorovia do podolannia naslidkiv pandemii COVID-19]. Mizhnarodnyi naukovyi zhurnal «Hraal nauky». 2021;10:112-117. DOI: https://doi.org/10.36074/grail-of-science.19.11.2021.018
Hrytsko RYu, Furtak II, Hrytsko OM. Recommendations for the healthcare system of Ukraine to overcome the consequences of the COVID-19 pandemic [Rekomendatsii dlia systemy okhorony zdorovia Ukrainy dlia podolannia naslidkiv pandemii COVID-19]. Derzhava ta rehiony. Seriia: Derzhavne upravlinnia. 2022;1:18-23.
Bila G, Utka V, Grytsko R, Vovk V, Bilyy R. Formation of aggregated neutrophil extracellular traps in tissues is determining the efficacy of particulate nanoadjuvants. Nanomedicine. 2025;55:102757. DOI: https://doi.org/10.1016/j.nano.2024.102757
Bilyy R, Pagneux Q, François N, Bila G, Grytsko R, Lebedin Y, et al. Rapid generation of coronaviral immunity using recombinant peptide modified nanodiamonds. Pathogens. 2021;10(7):861. DOI: https://doi.org/10.3390/pathogens10070861
Hrytsko RYu. An urgent problem – rehabilitation after COVID-19: traditional and innovative approaches [Nahalna problema – reabilitatsiia pislia COVID-19: tradytsiini ta innovatsiini pidkhody]. In: Proceedings of the II International Scientific Conference (Odesa, September 10, 2021). Vinnytsia: Yevropeiska naukova platforma; 2021:213–216.
Hrytsko RYu, Kvasniy LH, Hrytsko OM. Management of the performance of a medical institution in conditions of change [Upravlinnia rezultatyvnistiu roboty medychnoho zakladu v umovakh zmin]. In: The Actual Problems of Regional Economy Development: zbirnyk naukovykh prats. 2023. p. [specify pages according to the collection].
Gaebler C, Wang Z, Lorenzi JCC, et al. Evolution of antibody immunity to SARS-CoV-2. Nature. 2021;591(7851):639-644. DOI: https://doi.org/10.1038/s41586-021-03207-w
Bucciarelli V, Nasi M, Piani F, et al. Depression and cognitive impairment in long COVID: A potential link with immune activation and autoimmunity. Eur Psychiatry. 2022;65(1):e80. DOI: https://doi.org/10.1192/j.eurpsy.2022.2337
Peluso MJ, Deitchman AN, Torres L, et al. Chronic viral coinfections differentially affect the likelihood of developing long COVID. J Clin Invest. 2022;132(9):e155669. DOI: https://doi.org/10.1172/JCI155669
Pretorius E, Vlok M, Venter C, et al. Persistent clotting protein pathology in Long COVID/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin. Cardiovasc Diabetol. 2021;20:172. DOI: https://doi.org/10.1186/s12933-021-01359-7
Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long COVID. Nat Med. 2021;27(4):626-631. DOI: https://doi.org/10.1038/s41591-021-01292-y
Schultheiß C, Willscher E, Paschold L, et al. The IL-1β, IL-6, and TNF cytokine triad is associated with post-acute sequelae of COVID-19. Cell Rep Med. 2022;3(6):100663. DOI: https://doi.org/10.1016/j.xcrm.2022.100663
