Review Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches, 2024, Molnar et al.

[SNT Gatchaman]

Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches
Molnar, Tihamer; Lehoczki, Andrea; Fekete, Monika; Varnai, Reka; Zavori, Laszlo; Erdo-Bonyar, Szabina; Simon, Diana; Berki, Tímea; Csecsei, Peter; Ezer, Erzsebet

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has introduced the medical community to the phenomenon of long COVID, a condition characterized by persistent symptoms following the resolution of the acute phase of infection. Among the myriad of symptoms reported by long COVID sufferers, chronic fatigue, cognitive disturbances, and exercise intolerance are predominant, suggesting systemic alterations beyond the initial viral pathology. Emerging evidence has pointed to mitochondrial dysfunction as a potential underpinning mechanism contributing to the persistence and diversity of long COVID symptoms.

This review aims to synthesize current findings related to mitochondrial dysfunction in long COVID, exploring its implications for cellular energy deficits, oxidative stress, immune dysregulation, metabolic disturbances, and endothelial dysfunction. Through a comprehensive analysis of the literature, we highlight the significance of mitochondrial health in the pathophysiology of long COVID, drawing parallels with similar clinical syndromes linked to post-infectious states in other diseases where mitochondrial impairment has been implicated. We discuss potential therapeutic strategies targeting mitochondrial function, including pharmacological interventions, lifestyle modifications, exercise, and dietary approaches, and emphasize the need for further research and collaborative efforts to advance our understanding and management of long COVID.

This review underscores the critical role of mitochondrial dysfunction in long COVID and calls for a multidisciplinary approach to address the gaps in our knowledge and treatment options for those affected by this condition.

Link | PDF (GeroScience) [Open Access]

 

[SNT Gatchaman]

ME/CFS is perhaps the most well-studied condition in the context of post-infectious syndromes and mitochondrial dysfunction. The symptoms of long COVID syndrome are very similar to those of ME/CFS. It is a chronic, complex disorder characterized by profound fatigue, sleep abnormalities, pain, and other symptoms that are worsened by exertion. The condition often follows viral infections, suggesting a post-infectious origin for some patients. Several studies have implicated mitochondrial dysfunction in ME/CFS, including evidence of structural changes and dysfunctional energy producing pathways, impaired ATP production, abnormalities in mitochondrial respiratory chain function, and elevated lactate levels suggestive of metabolic stress. These findings parallel some of the mitochondrial abnormalities observed in long COVID patients, suggesting a common pathway of disease development. Mitochondria are a major source of reactive oxygen species (ROS) such as H2O2 and superoxide in the cell, making them extremely vulnerable to oxidative stress. In individuals with ME/CFS, elevated levels of peroxide and superoxide correlate with symptom severity. There is evidence that redox imbalance contributes to the pathogenesis of both (ME/CFS) and long COVID syndrome. Proposed mechanisms underlying mitochondrial dysfunction associated with [ME/CFS] may include chronic immune activation and autoimmune responses that target mitochondrial components.

 

[rvallee]

ME/CFS is perhaps the most well-studied condition in the context of post-infectious syndromes and mitochondrial dysfunction

Oof. Not exactly encouraging... It's so poorly studied, and yet it may in fact be the most well-studied. Loooong way to go yet.

I still get a strong feeling that once research produces significant breakthroughs here it will fuel a massive boost in medical science, basically uncovering many common mechanisms of illness, how they relate to symptoms, and why/how it's so limiting to be chronically ill, possibly even what is fatigue and how to deal with it. Possibly marking the shift away from disease-only medicine and onto illness-, well, probably not first but at least illness-aware medicine. The end of silly nonsense like Sharpe's "illness without disease", and hopefully the end of psychosomatic ideology, one of the most harmful ideologies in history.

And wow will a lot of people hate it for that last part alone. But it will be for the greater good, even for those who will everything about it.