Vipin M. Vashishtha Profile picture
Pediatrician, ‘rational’ vaccine thinker, Editor Covid Vaccines, TB on Vaccines & many others, Past-Convener IAP COI, Member-WHO-VSN https://t.co/eOvazlWmWg

Oct 22, 5 tweets

Understanding Long COVID

➡️ Long COVID isn’t one disease — it’s a complex web of immune, vascular, and metabolic dysfunctions.
From fatigue & brain fog to heart & lung complications, it stems from viral persistence, autoimmunity, and mitochondrial damage. 1/

Proposed mechanisms:

1️⃣ Persistent viral reservoirs or antigen remnants

2️⃣ Reactivation of latent viruses (e.g., EBV)

3️⃣ Immune dysregulation & autoimmunity

4️⃣ Endothelial injury and microclots

5️⃣ Gut microbiome imbalance

6️⃣ Mitochondrial dysfunction and energy metabolism impairment. 2/

Current management:

- largely symptomatic—rehabilitation, pacing, and supportive therapies.

-Emerging treatments: under study — antiviral drugs, immune-modulating agents, microbiome restoration, and mitochondria-targeted therapies.

-Vaccination: reduces risk and severity of LongCOVID. 3/

A global health challenge

➡️ #LongCovid affects millions — regardless of how mild the initial infection was.

➡️ Vaccination lowers the risk, but many still suffer lingering inflammation & multi-organ issues.

➡️ We must invest in mechanism-driven, integrative treatments. 4/

Takeaway

➡️ #LongCOVID is a multi-mechanistic, chronic condition involving immune, vascular, and metabolic pathways.
Future breakthroughs will likely come from integrative approaches targeting viral persistence, immune balance, and cellular energy repair. 5/5

tandfonline.com/doi/full/10.10…

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