The Long COVID patients we have seen, all had digestive issues and/or I.B.S. long before they developed Long COVID.
What did the virus do to these people?
Just as in HIV, chronic Borrelia, chronic giardia and other longstanding infections the invasion of the microorganism at the level of the gut-immune system has induced an auto-inflammatory syndrome with a late type inflammation (PGE2 elevated) and transfection of LPS originating from Gramnegative intestinal bacteria.
A clinical feature that is present in all these patients is that there is abdominal pain upon palpation of the paraumbilical region on the right side (ileo-caecal region). Thus, it is likely that Long COVID patients already suffered from S.I.B.O. before the COVID-19 infection, but without or minimal auto inflammatory syndrome. During/after the viral infection increased transfection of gut bacteria induced a reaction to LPS and to other bacterial toxins.
In our Long COVID patients we observed increased blood levels of IL-8, sCD14 (a surrogate marker for LPS) and PGE2 (prostaglandin E2).
This is identical to what we published in 2018 in the Journal of Translational Medicine in ME/CFS patients.
It is thus not surprising that Long COVID and ME/CFS patients share similar clinical symptoms.
The point I want to make is that from our experience, it is likely that a compromised gut-immune barrier predisposes to Long COVID and plays an important role in its pathophysiology.
Prof. Dr. De Meirleir Kenny