Long COVID, a condition affecting survivors of SARS-CoV-2 infection, presents a wide range of persistent symptoms, including respiratory, neurological, cardiovascular, and gastrointestinal issues. It is estimated that 1 in 5 survivors experience long-term symptoms, with prevalence varying by infection severity and variant. Long COVID symptoms may persist for weeks to years, with some cases showing reduced incidence post-pandemic, possibly due to vaccination. Risk factors include age, gender, and comorbidities, with women more likely to report symptoms. Long COVID may result from persistent viral infection, immune dysregulation, or viral proteins crossing the blood-brain barrier, leading to inflammation and neurological effects. It is also associated with endothelial dysfunction, cytokine release, and immune activation, contributing to cardiovascular and renal complications. Long COVID may involve persistent viral RNA in tissues, even after acute infection, and may be linked to gut microbiota dysbiosis, which can influence immune responses and inflammation. The condition is complex, with multiple potential mechanisms, and requires further research to understand its pathophysiology and develop effective treatments.Long COVID, a condition affecting survivors of SARS-CoV-2 infection, presents a wide range of persistent symptoms, including respiratory, neurological, cardiovascular, and gastrointestinal issues. It is estimated that 1 in 5 survivors experience long-term symptoms, with prevalence varying by infection severity and variant. Long COVID symptoms may persist for weeks to years, with some cases showing reduced incidence post-pandemic, possibly due to vaccination. Risk factors include age, gender, and comorbidities, with women more likely to report symptoms. Long COVID may result from persistent viral infection, immune dysregulation, or viral proteins crossing the blood-brain barrier, leading to inflammation and neurological effects. It is also associated with endothelial dysfunction, cytokine release, and immune activation, contributing to cardiovascular and renal complications. Long COVID may involve persistent viral RNA in tissues, even after acute infection, and may be linked to gut microbiota dysbiosis, which can influence immune responses and inflammation. The condition is complex, with multiple potential mechanisms, and requires further research to understand its pathophysiology and develop effective treatments.