Post-acute viral syndromes have emerged as an important challenge in infectious diseases, highlighted by the global impact of COVID-19 and increasingly recognized following other emerging viral infections. Although substantial progress has been made in characterizing acute infection, important questions remain regarding the mechanisms that drive persistent symptoms, organ dysfunction, and long-term disability after the resolution of the initial infectious episode. Understanding these conditions requires an integrated view of host-pathogen interactions, viral and immune-mediated injury, tissue-specific pathogenesis, and the biological factors that shape recovery or chronic sequelae.

This Research Topic aims to advance mechanistic and clinically relevant insight into the pathogenesis and management of post-acute viral syndromes in humans. We welcome contributions that investigate the biological determinants of persistent disease, including viral persistence, immune dysregulation, autoimmunity, endothelial and microvascular injury, metabolic and mitochondrial dysfunction, neuroinflammation, and host genetic or immunological susceptibility. Studies addressing prognostic markers, patient stratification, companion diagnostics, and translational models that clarify the transition from acute infection to long-term sequelae are particularly encouraged. Submissions may focus on post-acute manifestations following SARS-CoV-2 infection as well as other emerging or re-emerging viral pathogens, provided they offer clear relevance to infectious disease pathogenesis and therapy.

In keeping with the scope of Infectious Diseases: Pathogenesis and Therapy, this Research Topic also welcomes clinical investigations that improve diagnosis, disease characterization, and patient management. Relevant submissions include studies of clinical phenotypes linked to defined biological mechanisms, biomarker-informed approaches to diagnosis and prognosis, case reports or case series that provide insight into unusual presentations or natural history, and early clinical evaluation of therapeutic or immunomodulatory strategies. By bringing together experimental, translational, and patient-level research, this collection seeks to clarify the mechanisms underlying post-acute viral syndromes and support the development of more precise diagnostic and therapeutic approaches for affected patients.

To gather further insights in these areas, we welcome articles addressing, but not limited to, the following themes:

• host-pathogen interactions underlying post-acute viral infection syndromes
• molecular and cellular mechanisms of persistent inflammation, immune dysregulation, and tissue injury
• viral persistence and reservoirs in relation to chronic symptomatology
• host susceptibility, including genetic, immunological, and clinical determinants of long-term sequelae
• biomarkers, companion diagnostics, and prognostic indicators for post-acute viral disease
• organ-specific pathogenesis affecting neurological, cardiovascular, respiratory, gastrointestinal, or multisystem outcomes
• coagulation and vascular pathology including persistent microclots, endothelial dysfunction, and impaired fibrinolysis, leading to long-term cardiovascular risk and organ hypoperfusion
• translational and experimental models of post-acute viral pathogenesis
• clinical characterization of post-acute syndromes with clear mechanistic or therapeutic relevance
• case reports and case series that illuminate unusual manifestations, disease course, or innovative diagnostic and therapeutic approaches
• therapeutic strategies, immuno-therapeutics, and patient management pathways for post-acute viral infection syndromes

Studies focused primarily on epidemiology, surveillance, or prevention without a clear emphasis on pathogenesis, biological determinants, diagnosis, or therapy fall outside the scope of this Research Topic.

Are you interested in contributing a manuscript to this Research Topic?

Biological Determinants and Clinical Sequelae of Post-Acute Viral Syndromes: From COVID-19 to Other Emerging Infections