Recent findings suggest that chronic inflammation may be a significant factor in the persistent symptoms of long COVID, a condition estimated to impact more than **400 million individuals** globally. This research, published in the journal **Nature Immunology**, offers insights that could lead to new treatment options for those suffering from the lingering effects of COVID-19.
The study, led by **Dan Barouch**, director of the Center for Virology and Vaccine Research at **Beth Israel Deaconess Medical Center**, indicates that individuals with long COVID exhibit activated immune defenses and heightened inflammatory responses for over **six months** following initial infection. This contrasts with those who fully recovered from the virus.
Barouch noted, “This leads to a hypothesis that there might be therapeutic targets related to inflammation worth exploring in clinical studies.” His comments highlight the potential for new interventions targeting inflammatory pathways, which have been shown to be active in individuals suffering from long COVID.
Research has previously suggested that lingering symptoms might stem from the virus’s persistence in the body. However, this latest study emphasizes the role of chronic inflammation, presenting a different angle on the issue. According to **Ziyad Al-Aly**, a clinical epidemiologist at **Washington University in St. Louis**, “This is one piece of the puzzle… It’s eye-opening in the sense that it gives us more information that these pathways seem to be upregulated or activated in people with long COVID.”
Long COVID can manifest in various symptoms, with reports detailing as many as **200 different** effects including brain fog, fatigue, dizziness, and heart palpitations. The **World Health Organization** has indicated that anyone, regardless of age or the severity of their initial COVID-19 symptoms, can develop long COVID, although some are at a higher risk than others.
The study examined a cohort of **180 participants** over two periods: the early pandemic years from **2020 to 2021**, and a more recent cohort from **2023 to 2024**. Participants included healthy individuals, those who recovered fully from COVID-19, and individuals with long COVID. The researchers analyzed protein levels, immune responses, and gene expression to identify differences among the groups.
Findings revealed that numerous inflammatory pathways remained activated in individuals suffering from long COVID. Barouch speculated, “We would suggest that the initial COVID infection triggered chronic inflammation in the host… this is probably one of the factors associated with long COVID afterward.”
While Barouch acknowledged the limitations of the study, including a small participant group, he emphasized the need for larger studies involving diverse populations over extended periods. Based on the findings, he has initiated a clinical trial involving an anti-inflammatory drug commonly used for eczema, targeting one of the identified inflammatory pathways. This trial currently has **45 participants** enrolled.
Previous efforts to use anti-inflammatory drugs, such as a treatment for gout, yielded disappointing results, showing no significant benefit for long COVID patients. Barouch cautioned that further research is needed to determine the efficacy of targeting individual inflammatory pathways given the complexity of the condition. He stated, “More research is needed to understand if targeting just one pathway is sufficient to treat long COVID.”
Understanding the biological underpinnings of long COVID is essential for developing effective treatments. Some studies have explored the antiviral drug **Paxlovid**, typically used for acute COVID infections, but initial findings have shown limited therapeutic efficacy in long COVID treatment.
**Alba Azola**, a rehabilitation physician and co-director of the Long COVID/Chronic Fatigue Syndrome Clinic at **Johns Hopkins Medicine**, welcomed the new research. She noted that while previous studies have focused heavily on viral persistence, this study broadens the scope to include inflammatory pathways as significant contributors to long COVID. Azola remarked, “If we can find specific biologics that are effective against the common pathways, that may provide a more comprehensive approach to addressing the symptoms.”
This groundbreaking research marks a critical step forward in understanding long COVID and opens the door for potential new treatments that could alleviate the significant suffering experienced by millions worldwide. As investigations continue, the scientific community remains hopeful that these findings will lead to effective therapies that address the complexities of long COVID.
