Petropoulou et al. (2026)
- Authors: Dimitra Petropoulou, Irene Karampela, Gerasimos Socrates Christodoulatos, Maria Dalamaga
- Institutes: Second Department of Internal Medicine, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Publisher: Advances in Clinical Chemistry (Elsevier)
- Link: DOI
Summary
This comprehensive review consolidates evidence that Long COVID is a multisystem biological disorder characterized by measurable changes in hormones and metabolism. By identifying specific biomarkers like low cortisol and altered amino acids, the research bridges the gap between patient symptoms and clinical diagnostics, reinforcing the biological similarities between Long COVID and ME/CFS.
What was researched?
The research provides a systematic overview of hormonal, metabolic, and metabolomic alterations found in patients with Long COVID, focusing on identifying reliable biomarkers for diagnosis and monitoring.
Why was it researched?
Because Long COVID lacks a gold-standard diagnostic test, researchers sought to map the complex biochemical landscape of the disease to better understand its pathophysiology and overlap with ME/CFS.
How was it researched?
The authors conducted an extensive review of recent literature, analyzing data from clinical trials and ‘omics’ studies that compared Long COVID patients against recovered and healthy control groups.
What has been found?
The study highlights significant endocrine disruptions, including lower morning cortisol levels and reduced free triiodothyronine (FT3). Metabolomic findings revealed persistent abnormalities 12 months post-infection, such as reduced ATP production and lower concentrations of sarcosine and serine. Additionally, Vitamin D 💊 supplementation was noted for its potential role in modulating immune outcomes, while elevated pro-inflammatory markers like TNF-α and IL-6 were consistently observed.
Discussion
The findings suggest that the metabolic recovery period for SARS-CoV-2 is significantly longer than previously thought, even in those who appear to have recovered. However, the high heterogeneity of symptom clusters makes it challenging to pinpoint a single universal biomarker.
Conclusion & Future Work
Long COVID is associated with clear immune and hormonal dysfunction that mimics other viral-onset illnesses. Future research should focus on longitudinal studies to determine if these metabolic signatures can predict recovery trajectories.