{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:45:38Z","timestamp":1784133938612,"version":"3.55.0"},"reference-count":154,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Molecules"],"abstract":"<jats:p>COVID-19 has expanded across the world since its discovery in Wuhan (China) and has had a significant impact on people\u2019s lives and health. Long COVID is a term coined by the World Health Organization (WHO) to describe a variety of persistent symptoms after acute SARS-CoV-2 infection. Long COVID has been demonstrated to affect various SARS-CoV-2-infected persons, independently of the acute disease severity. The symptoms of long COVID, like acute COVID-19, consist in the set of damage to various organs and systems such as the respiratory, cardiovascular, neurological, endocrine, urinary, and immune systems. Fatigue, dyspnea, cardiac abnormalities, cognitive and attention impairments, sleep disturbances, post-traumatic stress disorder, muscle pain, concentration problems, and headache were all reported as symptoms of long COVID. At the molecular level, the renin-angiotensin system (RAS) is heavily involved in the pathogenesis of this illness, much as it is in the acute phase of the viral infection. In this review, we summarize the impact of long COVID on several organs and tissues, with a special focus on the significance of the RAS in the disease pathogenesis. Long COVID risk factors and potential therapy approaches are also explored.<\/jats:p>","DOI":"10.3390\/molecules27092903","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T07:08:58Z","timestamp":1651475338000},"page":"2903","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["The Pathophysiology of Long COVID throughout the Renin-Angiotensin System"],"prefix":"10.3390","volume":"27","author":[{"given":"Shaymaa","family":"Khazaal","sequence":"first","affiliation":[{"name":"Faculty of Sciences 3, Department of Biology, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli P.O. Box 45061, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Harb","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Medical Sciences, University of Balamand, Dekouene Campus, Sin El Fil P.O. Box 55251, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0335-9882","authenticated-orcid":false,"given":"Mohamad","family":"Rima","sequence":"additional","affiliation":[{"name":"Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli P.O. Box 45061, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Annweiler","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital & Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, University of Angers, 44312 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingliang","family":"Wu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan 430072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijian","family":"Cao","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Virology, Modern Virology Research Center, College of Life Sciences, Wuhan University, Wuhan 430072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4386-7467","authenticated-orcid":false,"given":"Ziad","family":"Abi Khattar","sequence":"additional","affiliation":[{"name":"Laboratory of Georesources, Geosciences and Environment (L2GE), Microbiology\/Tox-Ecotoxicology Team, Faculty of Sciences 2, Lebanese University, Campus Fanar, Jdeidet El-Matn, Beirut P.O. Box 90656, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-7059","authenticated-orcid":false,"given":"Christian","family":"Legros","sequence":"additional","affiliation":[{"name":"INSERM, CNRS, MITOVASC, Team 2 CarMe, SFR ICAT, University of Angers, 49000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6509-4210","authenticated-orcid":false,"given":"Herv\u00e9","family":"Kovacic","sequence":"additional","affiliation":[{"name":"Institut de Neurophysiopathologie (INP), Aix-Marseille Universit\u00e9 CNRS, 13385 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6502-3110","authenticated-orcid":false,"given":"Ziad","family":"Fajloun","sequence":"additional","affiliation":[{"name":"Faculty of Sciences 3, Department of Biology, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli P.O. Box 45061, Lebanon"},{"name":"Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli P.O. Box 45061, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9040-5647","authenticated-orcid":false,"given":"Jean-Marc","family":"Sabatier","sequence":"additional","affiliation":[{"name":"Institut de Neurophysiopathologie (INP), Aix-Marseille Universit\u00e9 CNRS, 13385 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1002\/jmv.26465","article-title":"The \u201cpost-COVID\u201d syndrome: How deep is the damage?","volume":"93","author":"Garg","year":"2021","journal-title":"J. Med. 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