Nikhil Prasad Fact checked by:Thailand Medical News Team Feb 23, 2026 1 hour, 53 minutes ago
Medical News: Long COVID remains one of the most confusing health problems to emerge after the pandemic, leaving many people struggling with ongoing exhaustion, brain fog, and unexplained symptoms months or even years after infection. A newly published medical case report now highlights a possible missing piece of the puzzle — the gut. Researchers have identified a strong connection between intestinal permeability, often called “leaky gut,” and the severity of chronic fatigue in a patient living with long COVID, offering fresh insight into how the condition may develop and how it might eventually be treated.
A new case report suggests that gut barrier changes may be closely tied to fatigue severity in long COVID patients
Researchers and Institutions Behind the Study
The study covered in this
Medical News report was conducted by researchers from the Department of Hepatology and Gastroenterology at Charité – Universitätsmedizin Berlin, a major academic medical institution affiliated with Freie Universität Berlin and Humboldt Universität zu Berlin in Germany. Their work focused on understanding how gut health might influence persistent symptoms seen in long COVID patients.
Understanding Long COVID and the Gut Connection
Long COVID refers to symptoms that continue long after the initial infection has passed. These symptoms often include severe fatigue, memory problems, dizziness, headaches, and reduced ability to carry out daily activities. Despite how disabling these issues can be, routine medical tests often fail to reveal clear abnormalities, leaving patients without clear answers.
Scientists have increasingly suspected that the gut may play an important role. The digestive system is not only responsible for digestion but also acts as a major immune organ. When the intestinal barrier becomes weakened, harmful substances may pass into the bloodstream, triggering inflammation and possibly affecting the brain and nervous system. This process is commonly described as increased intestinal permeability or “leaky gut.”
The Patient Case That Drew Attention
The case involved a 60-year-old woman who developed long COVID after a mild coronavirus infection. Although she had not been hospitalized, she experienced long-lasting fatigue, cognitive difficulties, dizziness, and symptoms related to autonomic nervous system dysfunction. Standard scans and medical evaluations did not show significant disease that could explain her condition.
Researchers decided to measure her intestinal permeability using a specialized carbohydrate absorption test. This test tracks how certain sugars pass through the gut and allows doctors to calculate a ratio that reflects gut barrier function. The results were striking.
Key Findings and What They Mean
During periods when the patient’s fatigue worsened, the intestinal permeability measurements rose dramatically, showing a significant
disruption of the gut barrier. At one point, the values were several times higher than those seen in healthy individuals. When her symptoms improved, the measurements also moved closer to normal levels.
Over time, five separate tests showed a consistent pattern: worsening fatigue matched higher gut permeability, while symptom improvement aligned with better gut barrier integrity. Even after a second COVID infection, both fatigue and permeability worsened again before gradually improving.
Interestingly, the patient had only mild digestive complaints, suggesting that gut barrier dysfunction may occur even when gastrointestinal symptoms are minimal or absent. This finding could help explain why many long COVID patients experience systemic symptoms without obvious digestive disease.
Probiotics and Medicinal Clay Interventions
As part of the treatment approach, doctors introduced a probiotic containing specific bacterial strains aimed at supporting gut health. During the treatment period, the patient reported noticeable improvement in fatigue, and testing showed normalization of intestinal permeability.
Later, when symptoms returned, a second intervention using medicinal clay was added. Medicinal clay is believed to help bind toxins and support the protective mucus layer of the gut. Over several months, the patient experienced a significant recovery, with fatigue disappearing and gut measurements returning to normal levels.
Although this is only a single case, the improvements observed alongside gut-targeted therapies suggest that restoring gut barrier function could play a role in managing long COVID symptoms.
Why This Matters for the Future
Researchers believe that viral persistence, microbiome disruption, and immune activation may all contribute to long COVID. Since the intestine contains large numbers of receptors used by the coronavirus to enter cells, it may serve as a reservoir that influences long-term inflammation and fatigue. The gut-brain connection may also explain why digestive changes can affect energy levels, cognition, and mood.
Conclusion
This case report provides important early evidence that intestinal permeability may closely mirror the severity of long COVID fatigue. The findings suggest that gut barrier dysfunction could become a valuable clue in understanding why some people remain ill long after infection, even when conventional tests appear normal. While probiotics and medicinal clay showed promising results in this patient, larger studies are needed to confirm whether these approaches are truly effective and safe for broader use. Still, the research highlights a new and hopeful direction, pointing toward gut health as a potential key to easing the burden of long COVID for many patients in the future.
The study findings were published in the peer reviewed journal: Frontiers in Medicine.
https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1725242/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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