text: Post COVID Syndrome An Insight on Its Pathogenesis Post COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS CoV 2 infection Symptoms persisting for more than three weeks after the diagnosis of COVID 19 characterize the post COVID syndrome Its incidence ranges from 10 to 35 however rates as high as 85 have been reported among patients with a history of hospitalization Currently there is no consensus on the classification of post COVID syndrome We reviewed the published information on post COVID syndrome putting emphasis on its pathogenesis The pathogenesis of post COVID syndrome is multi factorial and more than one mechanism may be implicated in several clinical manifestations Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications cognitive dysfunction and several other symptoms A multisystem inflammatory syndrome in adults MIS A of all ages has been also described recently similarly to multisystem inflammatory syndrome in children MIS C The post infectious inflammatory pathogenetic mechanism of MIS A is supported by the fact that its diagnosis is established through serology in up to one third of cases Other pathogenetic mechanisms that are implicated in post COVID syndrome include immune mediated vascular dysfunction thromboembolism and nervous system dysfunction Although the current data are indicating that the overwhelming majority of patients with post COVID syndrome have a good prognosis registries to actively follow them are needed in order to define the full clinical spectrum and its long term outcome A consensus based classification of post COVID syndrome is essential to guide clinical diagnostic and therapeutic management Further research is also imperative to elucidate the pathogenesis of post COVID syndrome 