Shared Clinical and Immunological Features of Post-Acute COVID-19 and Post-Acute COVID-19 Vaccination Syndromes

Background

Post-acute COVID-19 syndrome (PACS) can cause persistent disability involving fatigue, post-exertional malaise, neurocognitive symptoms, and autonomic manifestations. A clinically overlapping condition has been reported following COVID-19 vaccination and termed post-acute COVID-19 vaccination syndrome (PACVS), but its underlying mechanisms remain poorly understood. We investigated whether immune dysregulation, autoreactivity, antigen persistence, and viral reactivation—mechanisms implicated in PACS—are also present in PACVS.