Long COVID: major findings, mechanisms and recommendations
Three pages on PainSci cite Davis 2023: 1. Chronic, Subtle, Systemic Inflammation 2. Infection aches versus normal chronic pain 3. Paxlovid rebound is not a thing + Covid hurts
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Long COVID is an often debilitating illness that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. More than 200 symptoms have been identified with impacts on multiple organ systems. At least 65 million individuals worldwide are estimated to have long COVID, with cases increasing daily. Biomedical research has made substantial progress in identifying various pathophysiological changes and risk factors and in characterizing the illness; further, similarities with other viral-onset illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome have laid the groundwork for research in the field. In this Review, we explore the current literature and highlight key findings, the overlap with other conditions, the variable onset of symptoms, long COVID in children and the impact of vaccinations. Although these key findings are critical to understanding long COVID, current diagnostic and treatment options are insufficient, and clinical trials must be prioritized that address leading hypotheses. Additionally, to strengthen long COVID research, future studies must account for biases and SARS-CoV-2 testing issues, build on viral-onset research, be inclusive of marginalized populations and meaningfully engage patients throughout the research process.
related content
- “Skeletal Muscle and Peripheral Nerve Histopathology in COVID-19,” Suh et al, Neurology, 2021.
- “Association Between SARS-CoV-2 Infection and Immune-Mediated Myopathy in Patients Who Have Died,” Aschman et al, JAMA Neurol, 2021.
- “Rheumatic Symptoms Following Coronavirus Disease 2019 (COVID-19): A Chronic Post-COVID-19 Condition,” Cui et al, Open Forum Infect Dis, 2022.
- “Prevalence and Risk Factors of de Novo Widespread Post-COVID Pain in Non-Hospitalized COVID-19 Survivors: A Nation-Wide Exploratory Population-Based Survey,” Ebbesen et al, Journal of Pain, 2023.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- The Problematic Nature of Fibromyalgia Diagnosis in the Community. Srinivasan 2019 ACR Open Rheumatol.
- Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. Wolfe 2018 PLoS One.
- Restoring trust in menopause management: menopause hormone therapy is not a panacea, and physical activity remains a critical intervention. Tulloh 2025 Br J Sports Med.
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.