Evidence map›Paper›PMID 42657238›Full record

ArticleHealth science reports2026

Cytokine-Driven Hyperinflammation in Long COVID: Mechanisms, Biomarkers, Complement Dysregulation, and Emerging Immunotherapies-A Narrative Review.

Emmanuel Ifeanyi Obeagu

Abstract read
In one paragraph

Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Emmanuel Ifeanyi ObeaguDivision of Haematology, Department of Biomedical and Laboratory Science Africa University Mutare Zimbabwe.ORCID https://orcid.org/0000-0002-4538-0161

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is a multisystem condition characterized by persistent symptoms that continue beyond the acute phase of infection. Growing evidence indicates that sustained immune dysregulation involving cytokine-mediated inflammation, complement activation, endothelial dysfunction, thromboinflammation, and viral antigen persistence contributes to its pathogenesis. This narrative review summarizes current evidence on the mechanisms underlying hyperinflammation in Long COVID, highlights emerging biomarkers, and evaluates evolving immunotherapeutic strategies. Methods: A narrative literature search was conducted using PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between 2020 and 2026. Priority was given to systematic reviews, meta-analyses, cohort studies, mechanistic investigations, and clinical trials examining immune dysregulation, inflammatory biomarkers, complement pathways, and targeted therapies in long COVID. Results: Persistent elevation of pro-inflammatory cytokines, including interleukin-6, interleukin-1β, tumor necrosis factor-α, interferon-γ, and interleukin-17, together with activation of the alternative and lectin complement pathways, contributes to endothelial injury, microvascular thrombosis, neuroinflammation, fibrosis, and multisystem dysfunction. Emerging biomarkers include inflammatory cytokines, complement proteins, endothelial activation markers, coagulation indices, and multi-omics signatures that may improve disease stratification and therapeutic monitoring. Investigational therapies include cytokine-targeted biologics, complement inhibitors, Janus kinase inhibitors, mesenchymal stem cell therapy, microbiome-directed interventions, and precision immunotherapy. Conclusion: Long COVID results from complex interactions between persistent inflammation, complement dysregulation, vascular injury, and immune dysfunction. Integrating validated biomarkers with precision immunotherapeutic approaches may improve diagnosis, risk stratification, and individualized management. However, robust prospective studies and randomized clinical trials remain essential to validate these strategies and optimize long-term clinical outcomes.

Indexed as

cytokine stormhyperinflammationimmunomodulationlong COVIDtherapeutic strategies

Identifiers

PMID42657238
PMCPMC13508573

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.