Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 15, 2026 2 hours, 19 minutes ago
Medical News: Long COVID’s Silent Neurological Fallout
A new study has revealed something many patients feared but few doctors could prove: painful long COVID is linked to hidden damage in the tiny nerves that run the body’s automatic systems.
Researchers uncover hidden autonomic nerve damage driving painful long COVID
symptoms even when standard tests appear normal.
The research was led by scientists at Sapienza University Rome Italy, with support from Aalborg University Denmark, Aalborg University Hospital Denmark, and the Steno Diabetes Center North Denmark.
Uncovering Damage Skin Deep
Researchers reviewed skin biopsies taken from thirty-one people living with persistent pain and unexplained problems such as dizziness, bowel trouble, dry eyes, and changes in sweating. These patients had been suffering for months after COVID-19 infection.
The biopsies focused on three different nerve-fiber types in the skin:
-Piloerector nerves that help regulate temperature and create goosebumps
-Sweat gland nerves that control sweating
-Sensory nerve fibers in the upper skin layers that detect pain and touch
A separate group of forty-two healthy volunteers of similar age and sex served as the comparison baseline.
Damage Others Cannot See
The findings were clear and concerning. Long COVID patients showed a significant loss of autonomic nerve fibers around sweat glands and piloerector muscles.
Even more striking, this injury was also detected in people whose sensory nerve counts were completely normal. This means that routine nerve testing, which focuses on the larger sensory nerves, can completely miss the type of damage affecting long COVID patients.
The study therefore confirms that autonomic nerves may be an early and independent target of COVID-19-related illness.
Living With the Effects
The study participants reported common, debilitating symptoms including:
-Feeling faint or dizzy when standing
-Digestive upset and bowel irregularity
-Abnormally reduced or increased sweating
-Tingling, burning, or electric shock-type pain
Yet the amount of nerve fiber loss did not perfectly match how sick each person felt. Researchers believe that many factors shape symptoms—brain processing, immune activity, persistent inflammation, sleep disruption, and emotional stress all likely play a role.
A New Understanding of Long COVID Pain
This
Medical News report shows why so many people with long COVID struggle to get answers. Their scans, blood tests, and nerve conduction studies often look normal, yet crucial nerve fibers that regulate
unconscious body functions are quietly damaged beneath the skin.
These findings suggest that the virus or the immune system can directly injure the autonomic nerves that govern sweating, blood flow, temperature control, digestion, and other basic functions. Doctors may need to rethink how they diagnose and treat these patients, especially those dismissed because “nothing shows up” on conventional examinations.
Conclusions
This study offers compelling evidence that painful long COVID involves direct damage to autonomic small nerve fibers and that this damage can occur even when other nerves appear healthy. The work helps explain why long COVID symptoms are inconsistent and difficult to diagnose and highlights the need for new tools and targeted therapies. Understanding how COVID injures these nerves may finally lead to proper treatment and recognition of the condition. Larger and long-term studies are essential to discover whether the damaged fibers can recover or whether patients may require long-term care and support.
The study findings were published in the peer reviewed journal: Frontiers in Human Neuroscience.
https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2025.1719705/full
For the latest on Long COVID, keep on logging to Thailand
Medical News.
Read Also:
https://www.thailandmedical.news/articles/long-covid
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