Long COVID

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Illustration showing microscopic mechanisms of long COVID—persistent viruses, inflammation, and micro-clots—with scientists researching in a lab.
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Long COVID research points to lingering virus, inflammation and micro-clots—while treatments remain unproven

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New research syntheses suggest long COVID—typically defined as symptoms lasting at least two months after SARS‑CoV‑2 infection with no alternative explanation—may be driven by overlapping processes including viral persistence, chronic inflammation and tiny blood clots. Scientists say there are still no approved, evidence-based treatments, though rehabilitation strategies and several experimental approaches, including metformin given early in infection, are under study.

A major randomized trial led by Mass General Brigham found that a four-week course of high-dose vitamin D3 started soon after a positive COVID-19 test did not reduce acute illness severity, healthcare visits or deaths, and did not curb household spread. But in an analysis limited to participants who consistently took the assigned pills, researchers observed a small, borderline statistically significant difference in lingering symptoms reported eight weeks after infection, a finding they say warrants further study.

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A team of microbiologists suggests that infections occurring alongside SARS-CoV-2 may contribute to some cases of long COVID, potentially by reactivating latent pathogens such as Epstein–Barr virus or altering the course of tuberculosis. Their perspective, published in eLife, stresses that this remains a hypothesis and calls for large studies and better animal models to test whether these co-infections help drive persistent symptoms like fatigue and brain fog.

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