All mechanisms (22)
AutonomicAfferent baroreflex failureThe baroreflex is the fast loop that keeps your blood pressure steady from one second to the next.NeurologyBlood-brain barrier disruptionThe blood-brain barrier is the seal that keeps the bloodstream and the brain apart.Neuro-immuneCytokine inflammation driving sympathetic activationThe immune system and the autonomic nervous system are wired together, and in long COVID that wiring may be the problem.ContestedDeconditioning (as cause)A persistent claim is that long COVID exercise intolerance is mainly deconditioning: bodies grown unfit from inactivity, fixable by gradually exercising back to strength.AutonomicDysautonomia / autonomic dysfunctionYour autonomic nervous system runs the body's automatic settings: heart rate, blood pressure, digestion, temperature, the moment-to-moment adjustments you never think about.VirologyEBV reactivationMost adults carry Epstein-Barr virus, dormant since a past infection.MechanismEndothelial dysfunctionBreathlessness when your chest scan reads clear.CoagulationFibrinaloid microclotsOne of the most discussed and most disputed ideas in long COVID is that tiny abnormal blood clots, too small to see on ordinary scans, clog the smallest vessels and starve tissue…ImmunologyGPCR autoantibodiesSome of the most disruptive long COVID symptoms may come from the immune system attacking the body's own control switches.MicrobiomeGut dysbiosisThe gut may be quietly driving symptoms far from the stomach.Gut-brainGut-serotonin axisOne of the more elegant theories of long COVID ties the gut, the blood, and the brain together through a single molecule.EndocrineHPA axis and cortisol rhythmThe body's stress hormone system sets your morning alertness and daily energy rhythm.OrthostaticHypovolemia / blood-volume dysregulationMany people with POTS, including after COVID, run on a low blood volume.Immune dysregulationImmune dysregulation & autoimmunity (pathogenic IgG)After most infections the immune system finishes the job and stands down.MicrobiomeIntestinal barrier permeabilityA healthy gut wall keeps its contents on the right side.ImmunologyMast cell activationFlushing, hives, gut upset, palpitations, and fog arriving together can trace back to one overreacting immune cell.MetabolismMitochondrial dysfunctionInside every cell, mitochondria turn fuel into usable energy.NeurologyNeuroinflammationThe brain runs its own immune patrol.ContestedPhysical deconditioningYou will often read that POTS and exercise intolerance after COVID are mostly deconditioning, the result of being inactive, fixable by getting fit again.OrthostaticPlatelet storage pool deficiency / low serotoninA smaller, intriguing line of research links POTS to low serotonin in the blood, stored in platelets that do not hold their normal cargo.NeurologySmall-fiber neuropathyBurning pain, prickling, and autonomic trouble can come from damage to the body's thinnest nerves.Viral persistenceViral persistence / SARS-CoV-2 reservoirOne of the leading explanations for long COVID is simple to state: the virus, or pieces of it, does not fully leave.