Abstract
COVID-19, the disease caused by SARS-CoV-2, has diverse long-term consequences of varying severity after recovery from the acute phase. As survivorship and therefore the number of individuals with long COVID continue to increase, the prevalence, origins, and mechanisms of post-acute sequelae manifestation must be critically elucidated. The inappropriate and unique inflammatory response in the acute phase of COVID-19 causes severe respiratory symptoms, which can be subsequently accompanied by multiple-organ damage, affecting the brain, heart, kidneys, etc. This review examines the role of an unregulated antigen-specific immune response to COVID-19 in the onset and development of its consequences. We discuss the potential role of virus persistence in tissue reservoirs, unresolved inflammation, cytokine hyperproduction, tissue damage, and molecular mimicry and autoimmunity in the pathogenesis of post-COVID syndrome the induction and maintenance of imbalanced immune responses after the resolution of acute COVID-19.