During the last three and a half years (2020–2023), the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), generated an international emergency, defined as a Public Health Emergency of International Concern (PHEIC) and was later declared a pandemic by the World Health Organization (WHO)[1–4]. In May 2023, the Emergency Committee of the WHO met for the 15th time and recommended to the WHO Director-General Dr. Tedros Adhanom Ghebreyesus, that COVID-19 should no longer be categorized as a PHEIC. Although the recommendation was adopted, COVID-19 is still considered a global health threat [5]. COVID-19 has caused more than 767 million cases and 6.94 million deaths up to June 2023 (https://covid19. who. int/), and these numbers could be significantly higher, potentially even three to four times the excess mortality associated with this disease [6–10]. Moreover, early during this pandemic (2020)[11–14], multiple studies began to recognize and understand that chronic consequences may occur in a significant proportion of patients [15, 16], leading to various manifestations and affecting different systems and organs after the acute phase of the illness [17]. These chronic consequences have also been observed in other viral emerging and reemerging infectious diseases, such as chikungunya, Zika, Ebola, and even dengue [18–28]. Long COVID-19, post-COVID-19 syndrome or post-acute sequelae of SARS-CoV-2 infection (PASC)[29] occur in individuals with a history of probable or confirmed SARS-CoV-2 infection [30], usually three months from the onset of COVID-19, presenting symptoms that last for at least two months and cannot be explained by an alternative diagnosis, as defined by the WHO [31, 32]. The US Centers for Disease Control and Prevention (CDC) uses the term “Post-COVID Conditions”(PCC) as an umbrella term for the wide range of health consequences that can be present four or more weeks after infection with SARS-CoV-2 (https://www. cdc. gov/coronavirus/2019-ncov/h cp/clinical-care/post-covid-conditions. html# print). Common clinical manifestations include fatigue, headache, attention disorder, dyspnea, cognitive dysfunction, and others (Fig. 1), which generally impact the patients’ daily functions [30]. The time frame of the symptoms in terms of onset and persistence is not the same for all presentations. Neurologic and cognitive symptoms tend to occur late and persist longer than gastrointestinal and respiratory symptoms [33, 34]. New onset symptoms may occur after the initial recovery from an acute COVID-19 infection, or may persist from the initial disease [32]. Symptoms may also fluctuate or relapse over time. Some studies have found that the quality of life of long COVID-19 patients is significantly affected compared to controls. In addition to the multiple clinical findings, some associated conditions, or diseases may also be triggered, including autoimmune diseases or diabetes mellitus. Other studies suggest the existence in long COVID-19 patients of clusters of symptoms associated with functional impairments. Different authors also propose that different clinical phenotypes may be related to distinct underlying pathophysiologic mechanisms of disease [35, 36]. The COVID-Home study performed in the Netherlands, and recently presented at the 33rd European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2023), organized its patients into three distinct phenotypes. The first one comprised by younger, healthier patients that had little to no persistent symptoms, the second one comprised of obese morbid women that …