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The role of mitochondrial dysfunction in the development of long covid: a review

Title: The role of mitochondrial dysfunction in the development of long covid: a review
Authors: Ksenia S. Avdeeva; Tatiana I. Petelina; Aleksandr V. Gorbachevskii; Marina I. Bessonova
Source: КардиоСоматика, Vol 16, Iss 4, Pp 352-362 (2025)
Publisher Information: Concilium Medicum
Publication Year: 2025
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: mitochondria; glycolysis; reactive oxygen species; adenosine triphosphate; metabolic reprogramming; long covid; lactate; cardiorespiratory fitness; cardiopulmonary exercise testing; Diseases of the circulatory (Cardiovascular) system; RC666-701; Diseases of the endocrine glands. Clinical endocrinology; RC648-665
Description: Despite the end of the COVID-19 pandemic, many patients continue to experience adverse sequelae of the disease, including cardiometabolic disturbances. The spectrum of symptoms associated with long COVID is broad and heterogeneous, necessitating a deeper understanding of the underlying mechanisms. One of the proposed mechanisms contributing to long COVID is transient postviral mitochondrial dysfunction. It is hypothesized that SARS-CoV-2, either directly or indirectly via systemic inflammation, induces metabolic reprogramming of cells, leading to impaired oxidative phosphorylation, reduced ATP production, and increased generation of reactive oxygen species (ROS). Under conditions of metabolic reprogramming, cells preferentially rely on glycolysis for lactate production. Elevated blood lactate levels at low exercise intensity are indicative of mitochondrial dysfunction. Cardiorespiratory fitness is directly related to the integrated function of multiple physiological systems and is considered a reflection of overall health status. The most objective and accurate measure of cardiorespiratory fitness is the direct assessment of maximal oxygen uptake (VO₂max) using cardiopulmonary exercise testing (CPET). Accordingly, monitoring blood lactate levels in conjunction with peak oxygen consumption assessed by CPET may be effectively used in the design of future research studies. The search, selection, and analysis of relevant sources were conducted using scientific databases including cyberleninka.ru, elibrary.ru, link.springer.com, frontiersin.org, pubmed.ncbi.nlm.nih.gov, Google Scholar, and others, with the aim of systematizing current evidence supporting mitochondrial dysfunction as a key pathogenetic mechanism of long COVID.
Document Type: article in journal/newspaper
Language: English; Russian
Relation: https://cardiosomatics.ru/2221-7185/article/viewFile/679567/219058; https://doaj.org/toc/2221-7185; https://doaj.org/toc/2658-5707; https://doaj.org/article/9940cc9fdbf548a7873553f0807b789e
DOI: 10.17816/CS679567
Availability: https://doi.org/10.17816/CS679567; https://doaj.org/article/9940cc9fdbf548a7873553f0807b789e
Accession Number: edsbas.DB994AE
Database: BASE