Mission COVID

 
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Post-acute sequelae of
COVID-19 (PASC)

PASC, also known as the ‘long COVID’, has emerged as a novel clinical condition in COVID-19 survivors with lingering symptoms (or develop new ones) who fail to return to their baseline health. Based on the duration of persistent clinical manifestations, PASC has been further categorized: i) post-acute COVID with symptoms and abnormalities that persist 4-12 weeks; and ii) chronic COVID with symptoms and abnormalities that persist >12 weeks and not attributable to alternative diagnoses. The PASC pathology is a cumulative outcome of several viral-mediated HMR at cellular level such as: i) SARS-CoV-2 infection-induced tissue damage, ii) hyperinflammation-mediated multiorgan impairment, iii) immune exhaustion/dysregulation, iv) hormonal disturbances from maladaptation of ACE2-related pathways, v) coagulopathies due to endothelial damage/microvascular injury, iv) post-viral autoimmunity, vi) microbial dysbiosis, vii) critical care-associated sequelae or a combination of all above. The burden of individual PASC sequelae vary by demography (age, race, and sex) but consistently higher among patients with existing metabolic syndromes and in survivors from severe acute infection. The five most long-term clinical manifestations of PASC include:

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COVID

Human ‘severe acute respiratory syndrome coronavirus 2’ (SARS-CoV-2) is a highly transmissible viral pathogen responsible for the ongoing ‘coronavirus disease 2019’ (COVID-19) pandemic. Like other viral pathogens, SARS-CoV-2 lacks its own metabolic machinery; therefore, totally depends on host (human) cellular metabolism for its replication and spread. In SARS-CoV-2 infection, the first and foremost trigger is alteration and re-direction of host bioenergetic resources (mitochondrial ATP pool) to support the neo-synthesis and assembly of viral particles – a biological switch known as the host metabolic reprogram (HMR). The virulence potential of SARS-CoV-2 to invade a wide range of cells and tissues beyond the respiratory system, is manifested into a broad range of clinical syndromes, with varying degrees of severity ranging from asymptomatic, mild, moderate, to severe fatal multi-organ dysfunction syndrome (MODS). The possible risk of a long-term damage to certain affected host organ/systems or the elevated risk of disorders in later life could significantly worsen the burden on global healthcare. Considering the broad diversity of clinical symptoms, varied populations, and underlying comorbidities there is dire necessity for human host-targeted clinical management strategies to combat COVID-19 pandemic. However, the high viral replication rate with inherent genetic mutability, and compact genomic size with lack of metabolic machinery makes SARS-CoV-2 an extremely challenging druggable antiviral target. Nutritional restoration of HMR could provide a potential strategy to combat COVID-19 and its post sequelae. The WHO COVID-19 global statistics as of October 22, 2022:

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