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New insights into post‐acute sequelae of coronavirus disease 2019 (PASC) or long COVID are emerging at great speed. Proposed mechanisms driving long COVID include the overlapping pathologies of immune and inflammatory dysregulation, microbiota dysbiosis, autoimmunity, endothelial dysfunction, abnormal neurological signalling, reactivation of endogenous herpesviruses, and persistence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). In this commentary, we describe some of these advances that indicate that long COVID may be driven by “long infection” and that persistent replicating SARS‐CoV‐2 may be the potentially mechanistically unifying driver for long COVID.

This MJA Perspective shares more.

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Authors: Michelle JL Scoullar, Gabriela Khoury, Suman S Majumdar, Emma Tippett and Brendan S Crabb

Article Type: Perspective