Long Covid Newsletter
Issue #41June 15, 20267 studies

Brain scans show lasting metabolic changes in long COVID patients up to 2 years later

New research is painting a clearer picture of what's happening inside the bodies of people with long COVID—and the findings suggest these aren't just "in their heads."

🧠 Brain scans reveal persistent metabolic dysfunction in long COVID

  • 40 long COVID patients underwent brain PET scans, revealing significant metabolic changes that persisted up to 2 years after infection
  • Those with fatigue and post-exertional malaise (29 patients) showed the most pronounced brain changes, particularly in areas controlling movement and vision
  • The left sensorimotor cortex and bilateral primary visual cortex showed significant hypometabolism (reduced energy use) compared to healthy controls

Why it matters: These objective brain imaging findings provide biological evidence for the neurological symptoms many long COVID patients experience, potentially validating their experiences and guiding future treatments.

Top 20% journal 🔗 Journal of primary care & community health Journal Article 🗓️ Jun 8

Key Findings

🔬 Mitochondrial dysfunction emerges as key long COVID feature

  • Multi-omics analysis across human and animal studies found persistent suppression of cellular energy production (oxidative phosphorylation)
  • Skeletal muscle showed the most pronounced and lasting mitochondrial dysfunction in both hamsters and human patients
  • Serum analysis in long COVID patients revealed sustained mitochondrial stress responses and increased oxidative stress up to 12 months post-infection
💡 Cellular energy dysfunction may help explain the crushing fatigue that defines long COVID for many patients.
🥉 Top 5% journal 🔗 Frontiers in immunology Journal Article 🗓️ Jun 8

🩸 Blood clotting abnormalities persist in long COVID

  • Thromboelastography testing showed long COVID patients had increased clot strength and reduced clot breakdown compared to controls
  • Persistent fibrinoid microclots were found to impair microcirculation in both long COVID and chronic fatigue syndrome patients
  • Promising therapeutic trials with anticoagulants like apixaban and fibrinolytics like lumbrokinase are underway but need further validation
💡 Blood flow problems may contribute to the widespread symptoms experienced across multiple organ systems in long COVID.
Top 50% journal 🔗 Blood Coagul Fibrinolysis Journal Article 🗓️ Jun 11

💉 Vaccination protects kids from long COVID complications

  • Taiwan's DISCOVER study found vaccination significantly reduced gastrointestinal sequelae in children with long COVID
  • Vaccinated children showed preserved lung function by preventing small airway resistance increases
  • A preliminary trial suggested vitamin D supplementation may reduce overall symptom burden and inflammatory markers in pediatric long COVID
💡 Vaccination appears to modify the disease course in children, offering protection beyond just preventing severe acute illness.
Top 50% journal 🔗 Pediatrics and neonatology Review 🗓️ Jun 12

🧬 Genetic variants amplify long-term clotting risks after COVID

  • 504 adults tested 2+ years after COVID showed that common genetic variants (F2, F5, MTHFR) independently predicted higher D-dimer levels
  • COVID-19 significantly amplified the effects of these genetic variants on blood clotting markers
  • Carriers of thrombophilia variants showed 31-67% higher D-dimer levels, with the strongest effects in those with MTHFR TT genotype
💡 Genetic testing could help identify people at higher risk for persistent blood clotting abnormalities after COVID infection.
Top 50% journal 🔗 Biochemical genetics Journal Article 🗓️ Jun 8

🎯 Major clinical trial launches to test exercise interventions

  • RECOVER-ENERGIZE will test two different approaches: cardiopulmonary rehabilitation for patients without post-exertional malaise, and structured activity pacing for those with it
  • The 12-week interventions will be delivered across multiple centers with assessments continuing 12 weeks after completion
  • Novel features include formal PEM assessment and coach-delivered pacing interventions designed to prevent symptom worsening
💡 This trial could provide the first evidence-based exercise guidelines specifically tailored to different long COVID symptom patterns.

⚖️ Healthcare inequities compound long COVID struggles

  • Focus groups with racialized immigrants and non-immigrants in Canada revealed how medical uncertainty around long COVID diagnosis amplifies existing inequalities
  • Participants faced barriers accessing health, economic, and political resources needed for daily survival
  • Long COVID uncertainties created new forms of social suffering by delegitimizing symptoms and placing responsibility on patients
💡 The contested nature of long COVID as an illness may disproportionately harm already marginalized communities.
🔗 Social science & medicine (1982) Journal Article 🗓️ Jun 9

Implications

These studies collectively point to long COVID as a complex, multi-system condition with measurable biological underpinnings—from brain metabolism changes to cellular energy dysfunction. The research suggests that targeted interventions, genetic risk assessment, and addressing healthcare inequities will all be crucial for improving outcomes for the estimated 65 million people worldwide living with long COVID.

Studies in this issue

Primary sources used for this newsletter.

  1. Ongoing Brain Metabolism Changes in Long COVID Patients with Fatigue and Worsening Symptoms After Activity
    main storyJournal of primary care & community health2026-06-08PMID 42259512
  2. Design of RECOVER-ENERGIZE: Testing Treatments for Exercise Problems With and Without Worsening Symptoms After Activity in Long COVID
    key findingmedRxiv : the preprint server for health sciences2026-06-12PMID 42282195
  3. Long COVID is linked to ongoing problems with cellular energy production and immune system imbalance
    key findingFrontiers in immunology2026-06-08PMID 42253978
  4. Using blood clot testing to improve care in long COVID and chronic fatigue syndrome
    key findingBlood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis2026-06-11PMID 42274123
  5. Long-COVID experiences and health challenges in racialized immigrants and non-immigrants in Canada
    key findingSocial science & medicine (1982)2026-06-09PMID 42263424
  6. How COVID-19 Changes Genetic Blood Clotting Risk and What It Means for Personalized Risk Assessment After Infection
    key findingBiochemical genetics2026-06-08PMID 42260034
  7. Long-term symptoms in children after COVID-19 infection in Taiwan from the DISCOVER study
    key findingPediatrics and neonatology2026-06-12PMID 42285845

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