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While some manifestations (#110) of Long COVID (LC) are likely a consequence of organ damage following severe disease requiring hospitalization (PHLC), the LC syndrome seen in people who develop chronic clinical impairment after a relatively mild initial course (IMLC) is suggestive of an ongoing, active process.

An obvious possibility is that SARS-CoV-2 virions (virus particles) are persisting somewhere in the body and continue to kill (or compromise the function of) physiologically important cells. Another idea is that much of the characteristic IMLC symptomatology is a side effect of unsuccessful ‘over-the-top’ efforts by the ‘adaptive’ virus-specific immune response to eliminate either persistent SARs-CoV-2, or some subviral component of the pathogen.