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Unveiling the Link Between Long COVID and Mitochondrial Dysfunction

Written by Portland Clinic of Natural Health on July 13, 2023

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), has emerged as a significant concern for individuals recovering from COVID-19. While the focus has primarily been on respiratory symptoms and organ damage, recent research suggests that mitochondrial dysfunction may play a role in the persistent symptoms experienced by long COVID patients. In this blog post, we will explore the connection between long COVID and mitochondrial dysfunction, shedding light on the potential mechanisms involved.

Understanding Mitochondrial Dysfunction: Mitochondria are the powerhouses of our cells, responsible for producing energy in the form of adenosine triphosphate (ATP). Mitochondrial dysfunction occurs when these cellular structures are unable to function optimally, leading to an imbalance in energy production and other metabolic processes. This dysfunction can result from various factors, including viral infections, inflammation, oxidative stress, and genetic predispositions.

  1. Impact of SARS-CoV-2 on Mitochondrial Function: Research suggests that SARS-CoV-2, the virus responsible for COVID-19, can directly affect mitochondrial function. The virus gains entry into cells through the angiotensin-converting enzyme 2 (ACE2) receptor, which is also present on the surface of mitochondria. This interaction can disrupt mitochondrial function and lead to energy production deficits. Additionally, the immune response triggered by SARS-CoV-2 infection can generate excessive reactive oxygen species (ROS) that damage mitochondria, further contributing to dysfunction. (1)
  2. Persistent Inflammation and Oxidative Stress: Long COVID is characterized by chronic inflammation and oxidative stress, which can negatively impact mitochondrial function. Inflammatory cytokines and ROS released during prolonged inflammation can damage mitochondrial DNA, proteins, and membranes. As a result, mitochondrial respiration and ATP production may be impaired, leading to fatigue, muscle weakness, and other persistent symptoms experienced by long COVID patients. (2)
  3. Immune Dysregulation and Metabolic Shifts: Long COVID is associated with immune dysregulation and alterations in metabolic pathways. Mounting evidence suggests that dysregulated immune responses can drive mitochondrial dysfunction. Immune cells rely heavily on mitochondria for energy production and proper functioning. When the immune system is overactivated or dysregulated, it can lead to increased mitochondrial stress and dysfunction. Moreover, metabolic shifts, such as impaired glucose utilization and abnormal lipid metabolism, can further exacerbate mitochondrial dysfunction in long COVID patients. (3)
  4. Impact on Multiple Organ Systems: Mitochondrial dysfunction can have widespread consequences on various organ systems, explaining the diverse and persistent symptoms experienced by long COVID patients. Organs with high energy demands, such as the brain, heart, and muscles, are particularly vulnerable. Neurological symptoms, cardiac abnormalities, exercise intolerance, and cognitive impairments reported in long COVID may stem from compromised mitochondrial function in these vital organs. (4)

The emerging evidence on the link between long COVID and mitochondrial dysfunction provides insights into the persistent symptoms experienced by individuals in the post-acute phase of SARS-CoV-2 infection. Mitochondrial dysfunction resulting from viral impact, inflammation, oxidative stress, immune dysregulation, and metabolic shifts may contribute to the complex clinical picture of long COVID. Further research is needed to fully understand the mechanisms involved and develop targeted interventions to support mitochondrial health in long COVID patients. By addressing mitochondrial dysfunction, we may unlock potential avenues for improving the quality of life and recovery outcomes in individuals grappling with the long-term effects of COVID-19.

If you are experiencing persistent symptoms of long COVID or suspect mitochondrial dysfunction, consulting with a holistic healthcare provider, such as a naturopathic physician, can offer valuable support and guidance. These practitioners take a comprehensive and individualized approach to patient care, considering the interconnectedness of various body systems and addressing the root causes of health issues. A naturopathic physician can work with you to develop a personalized treatment plan that may include dietary modifications, targeted supplementation, stress reduction techniques, and lifestyle adjustments to support mitochondrial function and overall well-being. By collaborating with a holistic provider, you can navigate the complexities of long COVID and mitochondrial dysfunction, empowering yourself to regain vitality and optimize your recovery.


  1. Chen TH, Chang CJ, Hung PH. Possible Pathogenesis and Prevention of Long COVID: SARS-CoV-2-Induced Mitochondrial Disorder. Int J Mol Sci. 2023 Apr 28;24(9):8034. doi: 10.3390/ijms24098034. PMID: 37175745; PMCID: PMC10179190.
  2. Chernyak BV, Popova EN, Prikhodko AS, Grebenchikov OA, Zinovkina LA, Zinovkin RA. COVID-19 and Oxidative Stress. Biochemistry (Mosc). 2020 Dec;85(12):1543-1553. doi: 10.1134/S0006297920120068. PMID: 33705292; PMCID: PMC7768996.
  3. Yin K, Peluso MJ, Thomas R, Shin MG, Neidleman J, Luo X, Hoh R, Anglin K, Huang B, Argueta U, Lopez M, Valdivieso D, Asare K, Ibrahim R, Ständker L, Lu S, Goldberg SA, Lee SA, Lynch KL, Kelly JD, Martin JN, Münch J, Deeks SG, Henrich TJ, Roan NR. Long COVID manifests with T cell dysregulation, inflammation, and an uncoordinated adaptive immune response to SARS-CoV-2. bioRxiv [Preprint]. 2023 Feb 10:2023.02.09.527892. doi: 10.1101/2023.02.09.527892. PMID: 36798286; PMCID: PMC9934605.
  4. Dennis A, Cuthbertson DJ, Wootton D, Crooks M, Gabbay M, Eichert N, Mouchti S, Pansini M, Roca-Fernandez A, Thomaides-Brears H, Kelly M, Robson M, Hishmeh L, Attree E, Heightman M, Banerjee R, Banerjee A. Multi-organ impairment and long COVID: a 1-year prospective, longitudinal cohort study. J R Soc Med. 2023 Mar;116(3):97-112. doi: 10.1177/01410768231154703. Epub 2023 Feb 14. PMID: 36787802; PMCID: PMC10041626.

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