Long COVID
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 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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A randomized controlled trial at Massachusetts General Hospital tested high-dose nicotinamide riboside, a vitamin B3 derivative, to boost NAD+ levels in people with long COVID. Although between-group differences were limited, participants who took the supplement for at least 10 weeks reported improvements in fatigue, sleep, mood, and some executive function measures compared with their own baseline, suggesting potential benefits for some individuals despite mixed overall results.