New research published in the Proceedings of the National Academy of Sciences reveals critical pathways that lead to organ damage and long-term complications in survivors of severe COVID-19.

The study, co-authored by Afshin Beheshti, Ph.D., from the University of Pittsburgh, found that SARS-CoV-2 disrupts mitochondrial functions, resulting in mitochondrial stress and the activation of the renin-angiotensin-aldosterone system (RAAS).

When overactivated, RAAS can trigger a cascade of organ damage and is linked to severe immune responses known as cytokine storms, which are particularly dangerous in severe COVID-19 cases.

Utilizing autopsy samples from patients who died from COVID-19, the study highlighted the extensive impact of RAAS overactivation and cytokine storms on multiple organ systems, including the heart and kidneys.

Consequences of this inflammation have been observed in long COVID patients, manifesting as heart failure, myocardial injury, pulmonary fibrosis, and chronic kidney disease.

Additionally, researchers discovered significant damage to lymph nodes, which may contribute to long-lasting immune dysregulation and an increase in cancer cases post-pandemic.

The findings suggest that targeting RAAS overactivation and supporting mitochondrial function could offer new therapeutic strategies to prevent severe outcomes from COVID-19.

Understanding these mechanisms is crucial for developing effective treatment strategies for both acute and long-term complications of COVID-19.

The study involved a multi-institutional team, including experts from Johns Hopkins University and Children's Hospital of Philadelphia, underscoring the collaborative effort in addressing this public health crisis.

Co-senior authors of the study include Douglas C. Wallace, Ph.D., and Stephen B. Baylin, M.D., with significant contributions from co-lead authors Michael J. Topper, Ph.D., and Joseph W. Guarnieri, Ph.D.

Overall, the research aims to explain the long-term complications faced by COVID-19 survivors, shedding light on the ongoing impact of the virus.